Nevada Revised Statutes
Chapter 695D - Plans for Dental Care
NRS 695D.225 - Contracts between organization for dental care and dentist: Modification; submission of schedule of payments upon request; exceptions.


1. Except as otherwise provided in NRS 695D.227, a contract between an organization for dental care and a dentist may be modified:
(a) At any time pursuant to a written agreement executed by both parties.
(b) Except as otherwise provided in this paragraph, by the organization for dental care upon giving to the dentist 45 days’ written notice of the modification of the organization for dental care’s schedule of payments, including any changes to the fee schedule applicable to the dentist’s practice. If the dentist fails to object in writing to the modification within the 45-day period, the modification becomes effective at the end of that period. If the dentist objects in writing to the modification within the 45-day period, the modification must not become effective unless agreed to by both parties as described in paragraph (a).
2. If an organization for dental care contracts with a dentist, the organization for dental care shall:
(a) If requested by the dentist at the time the contract is made, submit to the dentist the schedule of payments applicable to the dentist; or
(b) If requested by the dentist at any other time, submit to the dentist the schedule of payments, including any changes to the fee schedule applicable to the dentist’s practice, specified in paragraph (a) within 7 days after receiving the request.
3. The provisions of this section do not apply to an organization for dental care that provides services to recipients of Medicaid under the State Plan for Medicaid or insurance pursuant to the Children’s Health Insurance Program pursuant to a contract with the Division of Health Care Financing and Policy of the Department of Health and Human Services. This subsection does not exempt an organization for dental care from any provision of this chapter for services provided pursuant to any other contract.
(Added to NRS by 2011, 2536; A 2013, 1240)

Structure Nevada Revised Statutes

Nevada Revised Statutes

Chapter 695D - Plans for Dental Care

NRS 695D.010 - Definitions.

NRS 695D.012 - "Administrator" defined.

NRS 695D.020 - "Commissioner" defined.

NRS 695D.030 - "Dental care" defined.

NRS 695D.040 - "Dentist" defined.

NRS 695D.050 - "Member" defined.

NRS 695D.060 - "Organization for dental care" defined.

NRS 695D.070 - "Plan for dental care" defined.

NRS 695D.080 - "Policy" defined.

NRS 695D.090 - Applicability of title to organizations for dental care; applicability of chapter.

NRS 695D.095 - Applicability of chapter and certain other provisions to organizations for dental care.

NRS 695D.100 - Regulations.

NRS 695D.102 - Summary of coverage: Contents of disclosure; approval by Commissioner; regulations.

NRS 695D.104 - Summary of coverage: Copy required to be provided to group policyholder before issuance of policy; organization prohibited from offering plan unless disclosure approved by Commissioner.

NRS 695D.110 - Certificate of authority: Required for establishing, operating, acting as administrator of, selling or offering to sell plan for dental care.

NRS 695D.120 - Certificate of authority: Application.

NRS 695D.130 - Certificate of authority: Issuance; fees.

NRS 695D.140 - Certificate of authority: Notice of change of information; application for amendment; fee; approval.

NRS 695D.150 - Certificate of authority: Expiration; renewal; fees.

NRS 695D.153 - Capital account: Minimum amount; requirements.

NRS 695D.157 - Hazardous financial condition: Regulations; determination; powers of Commissioner.

NRS 695D.160 - Composition of board of directors for organization for dental care that is corporation.

NRS 695D.170 - Bond or deposit: Required; amount; creation of Fund for Bonds of Organizations for Dental Care; judgment as lien; disposition upon dissolution, liquidation or other termination of organization.

NRS 695D.180 - Requirements concerning bond.

NRS 695D.190 - Certain persons in organization for dental care in fiduciary relationship to members; dentist subject to disciplinary action for breaches of fiduciary or contractual obligations.

NRS 695D.200 - Policy: Review by prospective members at meeting; provision of copy to members; approval by Commissioner; form and contents; notice of change.

NRS 695D.203 - Group plan issued to replace discontinued policy or coverage: Requirements; notice of reduction of benefits; statement of benefits; applicability to self-insured employer.

NRS 695D.205 - Copayments and deductibles: Reasonableness; approval of Commissioner; regulations.

NRS 695D.210 - Policy covering dependent of member required to include coverage for member’s newly born and adopted children and children placed with member for adoption to same extent as other dependents.

NRS 695D.215 - Claims: Approval or denial; request for additional information; payment; interest on unpaid claim.

NRS 695D.2153 - Claims: Organization for dental care or administrator prohibited from denying claim for which prior authorization has been granted; exceptions.

NRS 695D.2157 - Recovery of overpayments: Notice; procedures for challenging attempted recovery; limitation of period for recovery; exception.

NRS 695D.216 - Required provision concerning coverage for services provided through telehealth to same extent and in same amount as though provided in person or by other means; exception; prohibited acts. [Effective through the earlier of 1 year afte...

NRS 695D.217 - Organization for dental care prohibited from denying coverage solely because claim involves act that constitutes domestic violence or applicant or insured was victim of domestic violence.

NRS 695D.219 - Organization for dental care prohibited from denying coverage solely because applicant or member was intoxicated or under the influence of controlled substance; exceptions.

NRS 695D.220 - Licensing of agents.

NRS 695D.225 - Contracts between organization for dental care and dentist: Modification; submission of schedule of payments upon request; exceptions.

NRS 695D.227 - Prohibitions related to setting of fees by plan or organization for dental care other than covered services to members.

NRS 695D.230 - Advertising or materials used to enroll or solicit members: Approval of Commissioner; penalties.

NRS 695D.240 - Limitation on use of charges or premiums for marketing and administrative expenses; regulations.

NRS 695D.250 - Reserves: Maintenance; exception; held in fiduciary capacity; deposit; penalty for diversion or appropriation; regulations.

NRS 695D.260 - Annual report; financial statement; quarterly statement; administrative penalty for failure to file timely report or statement; extension of time; payment of premium tax and filing fee.

NRS 695D.270 - Examination by Commissioner.

NRS 695D.280 - Rehabilitation, liquidation or conservation: Conduct.

NRS 695D.290 - Trade practices and frauds: Applicability of provisions to organizations for dental care.

NRS 695D.300 - Disciplinary action: Grounds; penalties.

NRS 695D.310 - Disciplinary or other action: Notice; hearing; order.