1. Each managed care organization shall provide coverage for medically necessary emergency services provided at any hospital.
2. A managed care organization shall not require prior authorization for medically necessary emergency services.
3. As used in this section, "medically necessary emergency services" means health care services that are provided to an insured by a provider of health care after the sudden onset of a medical condition that manifests itself by symptoms of such sufficient severity that a prudent person would believe that the absence of immediate medical attention could result in:
(a) Serious jeopardy to the health of an insured;
(b) Serious jeopardy to the health of an unborn child;
(c) Serious impairment of a bodily function; or
(d) Serious dysfunction of any bodily organ or part.
4. A health care plan subject to the provisions of this section that is delivered, issued for delivery or renewed on or after October 1, 1999, has the legal effect of including the coverage required by this section, and any provision of the plan or the renewal which is in conflict with this section is void.
(Added to NRS by 1997, 304; A 1999, 3097)
Structure Nevada Revised Statutes
NRS 695G.012 - "Adverse determination" defined.
NRS 695G.014 - "Authorized representative" defined.
NRS 695G.015 - "Benefits" defined.
NRS 695G.016 - "Clinical peer" defined.
NRS 695G.017 - "Covered person" defined.
NRS 695G.019 - "Health benefit plan" defined.
NRS 695G.020 - "Health care plan" defined.
NRS 695G.022 - "Health care services" defined.
NRS 695G.024 - "Health carrier" defined.
NRS 695G.026 - "Independent review organization" defined.
NRS 695G.030 - "Insured" defined.
NRS 695G.040 - "Managed care" defined.
NRS 695G.050 - "Managed care organization" defined.
NRS 695G.053 - "Medical or scientific evidence" defined.
NRS 695G.055 - "Medically necessary" defined.
NRS 695G.060 - "Primary care physician" defined.
NRS 695G.070 - "Provider of health care" defined.
NRS 695G.080 - "Utilization review" defined.
NRS 695G.085 - "Utilization review organization" defined.
NRS 695G.090 - Applicability of chapter and other provisions.
NRS 695G.100 - Documents filed with Commissioner treated as public record; exception.
NRS 695G.110 - Medical director required to be physician licensed in this State.
NRS 695G.125 - Contracts with certain federally qualified health centers.
NRS 695G.140 - Certain persons in managed care organization in fiduciary relationship to insured.
NRS 695G.150 - Authorization of recommended and covered health care services required.
NRS 695G.190 - Quality improvement committee: Administration; duties.
NRS 695G.210 - Review board; appeal; right to expedited review of complaint; notice to insured.
NRS 695G.245 - Written notice of right to request external review; form; contents.
NRS 695G.247 - Requests for external review to be in writing; exception; form and content.
NRS 695G.271 - Expedited approval or denial of request.
NRS 695G.280 - Basis for decision of independent review organization.
NRS 695G.300 - Submission of complaint of covered person to independent review organization.