1. A health maintenance organization shall be deemed to be insolvent if:
(a) The health maintenance organization fails to meet its obligations as they mature; and
(b) The assets of the health maintenance organization are less than the sum of its liabilities and the minimum surplus required to be maintained by the health maintenance organization under this Code for authority to transact business in this State.
2. In addition to the provisions of subsection 1, a health maintenance organization shall be deemed to be insolvent as otherwise expressly provided in this Code.
3. A health maintenance organization shall be deemed to be impaired if the assets of the health maintenance organization are less than the sum of its liabilities and the minimum surplus required to be maintained by the health maintenance organization under this Code for authority to transact business in this State.
4. The Commissioner may adopt regulations to define when a health maintenance organization is considered to be in a hazardous financial condition and to set forth the standards to be considered by the Commissioner in determining whether the continued operation of a health maintenance organization transacting business in this State may be considered to be hazardous to its enrollees or creditors or to the general public.
5. If the Commissioner determines after a hearing that any health maintenance organization is in a hazardous financial condition, the Commissioner may, instead of suspending or revoking the certificate of authority of the health maintenance organization, limit the certificate of authority as the Commissioner deems reasonably necessary to correct, eliminate or remedy any conduct, condition or ground that is deemed to be a cause of the hazardous financial condition.
6. An order or decision of the Commissioner under this section is subject to review in accordance with NRS 679B.310 to 679B.370, inclusive, at the request of any party to the proceedings whose interests are substantially affected.
(Added to NRS by 2017, 2392)
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.