The Commissioner shall issue or deny a certificate of authority to any person filing an application pursuant to NRS 695C.060 within 90 days after certification. Issuance of a certificate of authority must be granted upon payment of the fees prescribed in NRS 695C.230 if the Commissioner is satisfied that the following conditions are met:
1. The persons responsible for the conduct of the affairs of the applicant are competent, trustworthy and possess good reputations.
2. The Commissioner certifies, in accordance with NRS 695C.080, that the health maintenance organization’s proposed plan of operation meets the requirements of subsection 1 of NRS 695C.080.
3. The health care plan furnishes comprehensive health care services.
4. The health maintenance organization is financially responsible and may reasonably be expected to meet its obligations to enrollees and prospective enrollees. In making this determination, the Commissioner may consider:
(a) The financial soundness of the health care plan’s arrangements for health care services and the schedule of charges used in connection therewith;
(b) The adequacy of working capital;
(c) Any agreement with an insurer, a government, or any other organization for insuring the payment of the cost of health care services;
(d) Any agreement with providers for the provision of health care services; and
(e) Any surety bond or deposit of cash or securities submitted in accordance with NRS 695C.270 as a guarantee that the obligations will be duly performed.
5. The enrollees will be afforded an opportunity to participate in matters of program content pursuant to NRS 695C.110.
6. Nothing in the proposed method of operation, as shown by the information submitted pursuant to NRS 695C.060, 695C.070 and 695C.140, or by independent investigation is contrary to the public interest.
(Added to NRS by 1973, 1249; A 1987, 469; 1993, 2400; 2013, 3640)
Structure Nevada Revised Statutes
Chapter 695C - Health Maintenance Organizations
NRS 695C.020 - Legislative declaration.
NRS 695C.050 - Applicability of certain provisions.
NRS 695C.055 - Applicability of certain other provisions.
NRS 695C.060 - Establishment of health maintenance organization.
NRS 695C.070 - Certificate of authority: Application.
NRS 695C.080 - Certificate of authority: Evaluation of application.
NRS 695C.090 - Certificate of authority: Issuance.
NRS 695C.100 - Certificate of authority: Denial.
NRS 695C.110 - Governing body: Composition; participation by enrollees.
NRS 695C.120 - Powers of health maintenance organization.
NRS 695C.123 - Contracts with certain federally qualified health centers.
NRS 695C.130 - Notice and approval required for exercise of powers; rules or regulations.
NRS 695C.140 - Notice and approval required for modification of operations; regulations.
NRS 695C.150 - Fiduciary responsibilities.
NRS 695C.170 - Evidence of coverage: Issuance; form and contents.
NRS 695C.176 - Required provision concerning coverage for hospice care.
NRS 695C.1765 - Reimbursement for acupuncture.
NRS 695C.177 - Reimbursement for treatments by licensed psychologist.
NRS 695C.1783 - Reimbursement for treatment by podiatrist.
NRS 695C.1789 - Reimbursement for treatment by licensed clinical alcohol and drug counselor.
NRS 695C.179 - Reimbursement for services provided by certain nurses.
NRS 695C.1795 - Reimbursement to provider of medical transportation.
NRS 695C.200 - Approval of forms and schedules.
NRS 695C.215 - Financial statement required to include report of net worth.
NRS 695C.220 - Applications, filings and reports open to public inspection; exception.
NRS 695C.230 - Fees; forwarding of premium tax.
NRS 695C.240 - Information required to be available for inspection.
NRS 695C.270 - Surety bond or deposit required; waiver.
NRS 695C.280 - Commissioner authorized to adopt regulations for licensing of agents or brokers.
NRS 695C.300 - Prohibited practices.
NRS 695C.315 - Financial examination: Payment of expense.
NRS 695C.317 - Procedures required for examination and hearing.
NRS 695C.320 - Rehabilitation, liquidation or conservation: Conduct.
NRS 695C.330 - Disciplinary proceedings: Grounds; effect of suspension or revocation.
NRS 695C.340 - Disciplinary proceedings: Notice; hearing; judicial review.