Nevada 2019 Regular Session Status: To Executive

AB 469 — Revises provisions governing billing for certain medically necessary emergency services. (BDR 40-704)

Last action — Enrolled and delivered to Governor. Approved by the Governor. Chapter 62.

Track this bill free

No card. One bill, free forever — alerts when it moves.

  1. ✓
    Introduced
  2. ✓
    In Committee
  3. ✓
    Passed Assembly
  4. ✓
    Passed Senate
  5. 5
    To Executive
  6. 6
    Enacted

This bill died with 2019 Regular Session. It reached “To Executive” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.

This bill is no longer active — its legislative session has ended, so there is no live prognosis. It would have to be reintroduced in the current session to move again.

Summary

AN ACT relating to health care; limiting the amount a provider of health care may charge a person who has health insurance for certain medically necessary emergency services provided when the provider is out-of-network; requiring an insurer to arrange for the transfer of a person who has health insurance to an in-network facility under certain circumstances; prescribing procedures for determining the amount that an insurer is required to pay a provider of health care which is out-of-network for certain medically necessary emergency services provided to an insured; requiring the reporting of certain information related to that process; and providing other matters properly relating thereto.

Bill Text

What changed in the latest version

893 added · 908 removed

893 line(s) added, 908 removed.

→
Previous
Latest
(Reprinted with amendments adopted on May 13, 2019) SECOND REPRINT A.B.
Assembly Bill No.
469 ASSEMBLY BILLN O.
469–Committee on Health and Human Services CHAPTER..........
469–C OMMITTEE ON H EALTH AND H UMAN SERVICES M ARCH 25, 2019 ____________ Referred to Committee on Health and Human Services SUMMARY—Revises provisions governing billing for certain medically necessary emergency services.
(BDR 40-704) FISCAL NOTE:
Effect on Local Government:
May have Fiscal Impact.
Effect on the State:
Yes.
~ EXPLANATION – Matter in bolded italics is new;
matter between brackets [omitted material] is material to be omitted.
LegUnder existing law, a hospital is required to provide emergency services and care and to admit certain patients where appropriate, regardless of the financial status of the patient.
Legislative Counsel’s Digest:
(NRS 439B.410) Existing law also requires certain major hospitals to reduce total billed charges by at least 30 percent for hospital services provided to certain patients who have no insurance or other contractual provision 439B.260) Section 7 of this bill defines the term “out-of-network provider” to mean, for a particular person covered by a policy of health insurance, a provider of health care or medical facility that has not entered into a contract with a third party for the provision of health care to persons who are covered by a policy of insurance issued by that third party.
Under existing law, a hospital is required to provide emergency services and care and to admit certain patients where appropriate, regardless of the financial status of the patient.
(NRS 439B.410) Existing law also requires certain major hospitals to reduce total billed charges by at least 30 percent for hospital services for the payment of the charges by a third party, which is an insurer.
(NRSovision 439B.260) Section 7 of this bill defines the term “out-of-network provider” to mean, for a particular person covered by a policy of health insurance, a provider of health care or medical facility that has not entered into a contract with a third party for the provision of health care to persons who are covered by a policy of insurance issued by that third party.
Section 14 of this bill - *AB469_R2* – 2 – prohibits an out-of-network provider from collecting from a person covered by a policy of health insurance an amount for medically necessary emergency services that exceeds the copayment, coinsurance or deductible required by that policy.
Section 14 of this bill policy of health insurance an amount for medically necessary emergency services that exceeds the copayment, coinsurance or deductible required by that policy.
and (2) the person’s stabilization occurs.
and (2) the person’s emergency medical condition is stabilized not later than 24 hours after such transfer to an in-network hospital or independent center for emergency medical care not later than 24 hours after receiving such notice.
Section 14 requires the third party to arrange for such a transfer to an in-network hospital or independent center for emergency medical care not later than 24 hours after receiving such notice.
If an out-of-network hospital or independent center for emergency medical care had a contract as an in-network hospital or independent center for emergency medical care with the third party that provides coverage for the covered person within the 24 months immediately preceding the provision of medically necessary emergency services to a covered person, section 15 of this bill requires the third accept, as compensation for those services an amount based on the amount thatre to would have been paid for those services under the most recent contract between the third party and the hospital or independent center for emergency medical care.
If an out-of-network hospital or independent center for emergency medical care had a contract as an in-network hospital or independent center for emergency medical care with the third party that provides coverage for the covered person within the 24 months immediately preceding the provision of medically necessary emergency services to a covered person, section 15 of this bill requires the third party to pay, and the hospital or independent center for emergency medical care to accept, as compensation for those services an amount based on the amount that third party and the hospital or independent center for emergency medical care.
If an out-of-network hospital or independent center for emergency medical care did not - 80th Session (2019) – 2 – have a contract as with the third party that provides coverage for the covered person as an in-network hospital or independent center for emergency medical care during that time, section 15 requires the third party to pay to the provider an amount that the third party has determined to be fair and reasonable as payment for the medically necessary emergency services.
If an out-of-network hospital or independent center for emergency medical care did not have a contract as with the third party that provides coverage for the covered person as an in-network hospital or independent center for emergency medical care during that time, section 15 requires the third party to pay to the provider an amount that the third party has determined to be fair and reasonable as payment for the medically necessary emergency services.
If an out-of-network provider did not have a contract with the third party that provides coverage for the covered person as an in-network provider during that time or if such a contract was terminated by the third party for cause, section 16 requires to be fair and reasonable as payment for the medically necessary emergencydetermined services.
If an out-of-network provider did not have a contract with the third party that provides coverage for the covered person as an in-network provider during that time or if such a contract was terminated by the third party for cause, section 16 requires the third party to pay to the provider an amount that the third party has determined to be fair and reasonable as pIf the provider does not accept a payment made pursuant to section 15 or 16 as payment in full for the medically necessary emergency services, section 17 of this bill requires the out-of-network provider to request from the third party an additional amount which, when combined with the amount previously paid, the out- of-network provider is willing to accept as payment in full and, if not paid, the parties are required to submit the dispute to binding arbitration.
If the provider does not accept a payment made pursuant to section 15 or 16 as payment in full for the medically necessary emergency services, section 17 of this bill requires the out-of-network provider to request from the third party an additional amount which, when combined with the amount previously paid, the out- of-network provider is willing to accept as payment in full and, if not paid, the parties are required to submit the dispute to binding arbitration.
Section 17 provides that 27 of this bill make conforming changes.
Section 17 provides that interest does not accrue on a claim during the arbitration process, and sections 21- health insurers not included in this bill to opt in to the provisions of the bill.
Section 18 of this bill authorizes certain- health insurers not included in this bill to opt in to the provisions of the bill.
Section of this bill provides for the annual reporting of certain information concerning arbitration conducted pursuant to section 17.
Section 19 of this bill provides for the annual reporting of certain information concerning arbitration conducted pursuant to section 17.
Sections 17, 19 and 20 of this bill provide for the confidentiality of the decisions of arbitrators and documents associated with arbitration.
Sections 17, 19 and 20 of this bill - *AB469_R2* – 3 – provide for the confidentiality of the decisions of arbitrators and documents associated with arbitration.
EXPLANATION – Matter in bolded italics is new;
matter between brackets [omitted material] is material to be omitted.
Sec.
- 80th Session (2019) – 3 – Sec.
“In-network emergency facility” means a hospital or independent center for emergency medical care that is an in- network provider.
“In-network emergency facility” means a hospital or independent center for emergency medical care that is an in-network provider.
Sec.
health care services that are provided by a provider of health care to screen and to stabilize a covered person 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:
6.
“Medically necessary emergency services” means health care services that are provided by a provider of health care to screen and to stabilize a covered person 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:
- *AB469_R2* – 4 – Sec.
third party and an in-network provider to provide health care services to a covered person.
7.5.
“Provider contract” means a contract between a third party and an in-network provider to provide health care services to a covered person.
Sec.
- 80th Session (2019) – 4 – Sec.
The term does not include the State Plan for Medicaid, the organization, as defined in NRS 695C.030, or managed carece organization, as defined in NRS 695G.050, when providing health care services through managed care 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.
The term does not include the State Plan for Medicaid, the Children’s Health Insurance Program or a health maintenance organization, as defined in NRS 695C.030, or managed care organization, as defined in NRS 695G.050, when providing health care services through managed care 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.
A person who is covered by a policy of health insurance that was sold outside this State;
A person who is covered by a policy of health insurance tha3.waAny health care services provided more than 24 hours after notification is provided pursuant to section 14 of this act that a person has been stabilized.
or - *AB469_R2* – 5 – 3.
Any health care services provided more than 24 hours after notification is provided pursuant to section 14 of this act that a person has been stabilized.
(a) When possible, notify the third party that provides coverage for the covered person not later than 8 hours after the covered person presents at the out-of-network emergency facility to receive medically necessary emergency services;
(a) When possible, notify the third party that provides coverage for the covered person not later than 8 hours after the covered - 80th Session (2019) – 5 – person presents at the out-of-network emergency facility to receive medically necessary emergency services;
Show all 150 changed rows (110 more)
Previous
Latest
Sec.
provider contract as an in-network emergency facility within the months immediately preceding the date on which the medically necessary emergency services were rendered to a covered person, the third party that provides coverage for the covered person shall pay to the out-of-network emergency facility for those services, and the out-of-network emergency facility shall accept as payment in full for those services, except for any copayment, coinsurance or deductible that the coverage requires the covered person to pay for the services when provided by an in-network emergency facility:
15.
1.
If an out-of-network emergency facility had a 24 months immediately preceding the date on which the medicallye necessary emergency services were rendered to a covered person, pay to the out-of-network emergency facility for those services,all and the out-of-network emergency facility shall accept as payment in full for those services, except for any copayment, coinsurance or deductible that the coverage requires the covered person to pay for the services when provided by an in-network emergency facility:
(b) If the out-of-network emergency facility was an in-network emergency facility within the 24 months immediately preceding the provision of medically necessary emergency services, but not within the 12 months immediately preceding the provision of those services, 115 percent of the amount that would have been paid for - *AB469_R2* – 6 – those services pursuant to the most recent applicable provider contract between the third party and the out-of-network emergency facility, less the amount of the copayment, coinsurance or deductible, if applicable.
(b) If the out-of-network emergency facility was an in-network emergency facility within the 24 months immediately preceding within the 12 months immediately preceding the provision of those services, 115 percent of the amount that would have been paid for those services pursuant to the most recent applicable provider contract between the third party and the out-of-network emergency facility, less the amount of the copayment, coinsurance or deductible, if applicable.
If an out-of-network emergency facility did not have a provider contract as an in-network emergency facility within the 24 months immediately preceding the date on which the medically necessary emergency services were rendered to a covered person, the third party that provides coverage to the covered person shall pay to the out-of-network emergency facility an amount that the third party has determined to be fair and reasonable as payment for the medically necessary emergency services, except for any copayment, coinsurance or deductible that the coverage requires the covered person to pay for the services when provided by an in- network emergency facility.
If an out-of-network emergency facility did not have a provider contract as an in-network emergency facility within the months immediately preceding the date on which the medically necessary emergency services were rendered to a covered person, the third party that provides coverage to the covered person shall pay to the out-of-network emergency facility an amount that the third party has determined to be fair and reasonable as payment - 80th Session (2019) – 6 – for the medically necessary emergency services, except for any copayment, coinsurance or deductible that the coverage requires the covered person to pay for the services when provided by an in-network emergency facility.
(a) The out-of-network provider terminated the most recent applicable provider contract between the third party that provides coverage for the covered person and the out-of-network provider shall pay to the out-of-network provider for those services, and the out-of-network provider shall accept as payment in full for those the coverage requires the covered person to pay for the servicesat when provided by an in-network provider, the amount that would have been paid for those services pursuant to that provider contract, less the amount of the copayment, coinsurance or deductible, if applicable.
applicable provider contract between the third party that provides coverage for the covered person and the out-of-network provider without cause before it was scheduled to expire, the third party shall pay to the out-of-network provider for those services, and the out-of-network provider shall accept as payment in full for those services, except for any copayment, coinsurance or deductible that the coverage requires the covered person to pay for the services when provided by an in-network provider, the amount that would have been paid for those services pursuant to that provider contract, less the amount of the copayment, coinsurance or deductible, if applicable.
(b) The out-of-network provider terminated the most recent applicable provider contract between the third party that provides coverage for the covered person and the out-of-network provider for cause before it was scheduled to expire or the third party terminated the contract without cause, the third party shall pay to the out-of-network provider for those services, and the out-of- network provider shall accept as payment in full for those services, except for any copayment, coinsurance or deductible that the coverage requires the covered person to pay for the services when provided by an in-network provider, 108 percent of the amount that would have been paid for those services pursuant to the provider contract, less the amount of the copayment, coinsurance or deductible, if applicable.
(b) The out-of-network provider terminated the most recent applicable provider contract between the third party that provides coverage for the covered person and the out-of-network provider for cause before it was scheduled to expire or the third party terminated the contract without cause, the third party shall pay to the out-of-network provider for those services, and the out-of- network provider shall accept as payment in full for those services, except for any copayment, coinsurance or deductible that the provided by an in-network provider, 108 percent of the amountwhen that would have been paid for those services pursuant to the provider contract, less the amount of the copayment, coinsurance or deductible, if applicable.
- *AB469_R2* – 7 – (c) The third party that provides coverage for the covered person terminated the most recent applicable provider contract between the third party and the out-of-network provider for cause before it was scheduled to expire, the third party shall pay to the out-of-network provider an amount that the third party has determined to be fair and reasonable as payment for the medically necessary emergency services, except for any copayment, coinsurance or deductible that the coverage requires the covered person to pay for the services when provided by an in-network provider.
(c) The third party that provides coverage for the covered person terminated the most recent applicable provider contract between the third party and the out-of-network provider for cause before it was scheduled to expire, the third party shall pay to the out-of-network provider an amount that the third party has determined to be fair and reasonable as payment for the medically necessary emergency services, except for any copayment, coinsurance or deductible that the coverage requires the covered - 80th Session (2019) – 7 – person to pay for the services when provided by an in-network provider.
(d) The contract was not terminated by either party, the third party that provides coverage for the covered person shall pay to the out-of-network provider for those services, and the out-of- network provider shall accept as payment in full for those services, except for any copayment, coinsurance or deductible that the coverage requires the covered person to pay for the services when provided by an in-network provider, the amount that would have been paid for those services pursuant to the most recent applicable provider contract between the third party and the out-of-network provider plus an amount equal to the percentage of increase in the Consumer Price Index, Medical Care Component, during the immediately preceding calendar year, less the amount of the copayment, coinsurance or deductible, if applicable.
(d) The contract was not terminated by either party, the third party that provides coverage for the covered person shall pay to the out-of-network provider for those services, and the out-of- network provider shall accept as payment in full for those services, except for any copayment, coinsurance or deductible that the coverage requires the covered person to pay for the services when provided by an in-network provider, the amount that would have provider contract between the third party and the out-of-networkble provider plus an amount equal to the percentage of increase in the Consumer Price Index, Medical Care Component, during the immediately preceding calendar year, less the amount of the copayment, coinsurance or deductible, if applicable.
network emergency facility, did not have a provider contract as an in-network provider within the 12 months immediately preceding were rendered to a covered person, the third party that provides coverage to the covered person shall submit to the out-of-network provider an offer of payment in full for the medically necessary emergency services, except for any copayment, coinsurance or deductible that the coverage requires the covered person to pay for the services when provided by an in-network provider.
2.
If an out-of-network provider, other than an out-of- network emergency facility, did not have a provider contract as an in-network provider within the 12 months immediately preceding the date on which the medically necessary emergency services were rendered to a covered person, the third party that provides coverage to the covered person shall submit to the out-of-network provider an offer of payment in full for the medically necessary emergency services, except for any copayment, coinsurance or deductible that the coverage requires the covered person to pay for the services when provided by an in-network provider.
An out-of-network provider shall accept or reject an amount paid pursuant to subsection 2 of section 15 of this act or paragraph (c) of subsection 1 or subsection 2 of section 16 of this act as payment in full for the medically necessary emergency services for which the payment was offered within 30 days after receiving the payment.
An out-of-network provider shall accept or reject an amount paid pursuant to subsection 2 of section 15 of this act or paragraph (c) of subsection 1 or subsection 2 of section of this act as payment in full for the medically necessary days after receiving the payment.
If an out-of-network provider fails to comply with the requirements of this section, the amount paid shall be deemed accepted as payment in full for the medically necessary emergency services for which the payment was offered 30 days after the out-of-network provider received the payment.
If an out-of-network provider fails to comply with the requirements of this section, the amount paid shall be deemed accepted as payment in full for the medically necessary emergency services for which the payment was offered days after the out-of-network provider received the payment.
If an out-of-network provider rejects the amount paid as payment in full, the out-of-network provider must request from the - *AB469_R2* – 8 – third party an additional amount which, when combined with the amount previously paid, the out-of-network provider is willing to accept as payment in full for the medically necessary emergency services.
If an out-of-network provider rejects the amount paid as payment in full, the out-of-network provider must request from the third party an additional amount which, when combined with the amount previously paid, the out-of-network provider is willing to accept as payment in full for the medically necessary emergency services.
If the third party refuses to pay the additional amount requested by the out-of-network provider pursuant to subsection 2 or fails to pay that amount within 30 days after receiving the request for the additional amount, the out-of-network provider must request a list of five randomly selected arbitrators from an entity authorized by regulations of the Director of the Department to provide such arbitrators.
If the third party refuses to pay the additional amount requested by the out-of-network provider pursuant to subsection 2 - 80th Session (2019) – 8 – or fails to pay that amount within 30 days after receiving the request for the additional amount, the out-of-network provider must request a list of five randomly selected arbitrators from an entity authorized by regulations of the Director of the Department to provide such arbitrators.
Such arbitrators may include, without limitation, qualified employees of the State and arbitrators from the voluntary program for the use of binding arbitration established in the judicial district pursuant to NRS 38.255 or, if no such program has been established in the judicial district, from the program established in the nearest judicial district that has established such a program.
Such arbitrators may include, without limitation, qualified employees of the State and arbitrators from the voluntary program pursuant to NRS 38.255 or, if no such program has beenjudicial district established in the judicial district, from the program established in the nearest judicial district that has established such a program.
pursuant to subsection 3, the out-of-network provider and theors third party shall each strike two arbitrators from the list.
4.
If one concerning the amount to be paid for the medically necessaryte emergency services.
Upon receiving the list of randomly selected arbitrators pursuant to subsection 3, the out-of-network provider and the third party shall each strike two arbitrators from the list.
If one arbitrator remains, that arbitrator must arbitrate the dispute concerning the amount to be paid for the medically necessary emergency services.
The out-of-network provider and the third party shall participate in binding arbitration of the dispute concerning the amount to be paid for the medically necessary emergency services conducted by the arbitrator selected pursuant to subsection 4.
The out-of-network provider and the third party shall participate in binding arbitration of the dispute concerning the amount to be paid for the medically necessary emergency services out-of-network provider or third party may provide the arbitratore with any relevant information to assist the arbitrator in making a determination.
The out-of-network provider or third party may provide the arbitrator with any relevant information to assist the arbitrator in making a determination.
(a) The out-of-network provider to accept as payment in full for the provision of the medically necessary emergency services, except for any copayment, coinsurance or deductible that the coverage requires the covered person to pay for the services when provided by an in-network provider, the amount paid by the third - *AB469_R2* – 9 – party pursuant to subsection 2 of section 15 of this act or paragraph (c) of subsection 1 or subsection 2 of section 16 of this act, as applicable;
(a) The out-of-network provider to accept as payment in full for the provision of the medically necessary emergency services, except for any copayment, coinsurance or deductible that the coverage requires the covered person to pay for the services when provided by an in-network provider, the amount paid by the third party pursuant to subsection 2 of section 15 of this act or paragraph (c) of subsection 1 or subsection 2 of section 16 of this act, as applicable;
or (b) The third party to pay the additional amount requested by the out-of-network provider pursuant to subsection 2.
or - 80th Session (2019) – 9 – (b) The third party to pay the additional amount requested by the out-of-network provider pursuant to subsection 2.
(a) The out-of-network provider to accept the amount paid by the third party pursuant to subsection 2 of section 15 of this act or paragraph (c) of subsection 1 or subsection 2 of section 16 of this act, as applicable, as payment in full for the provision of the medically necessary emergency services, except for any copayment, coinsurance or deductible that the coverage requires the covered person to pay for the services when provided by an in- network provider, the out-of-network provider must pay the costs of the arbitrator.
(a) The out-of-network provider to accept the amount paid by the third party pursuant to subsection 2 of section 15 of this act or paragraph (c) of subsection 1 or subsection 2 of section 16 of this act, as applicable, as payment in full for the provision of the medically necessary emergency services, except for any copayment, coinsurance or deductible that the coverage requires network provider, the out-of-network provider must pay the costsn- of the arbitrator.
Interest does not accrue on any claim for which an offer of payment is rejected pursuant to subsection 1 for the period arbitrator renders a decision.ejection and ending 30 days after the 10.
Interest does not accrue on any claim for which an offer of payment is rejected pursuant to subsection 1 for the period beginning on the date of the rejection and ending 30 days after the arbitrator renders a decision.
Except as otherwise provided in this subsection and section and any documents associated with such a decision aret to this confidential and are not admissible as evidence during a legal proceeding, including, without limitation, a legal proceeding between the third party and the out-of-network provider.
10.
The decision of an arbitrator and any documents associated with such a decision may be disclosed and are admissible as evidence during a legal proceeding to enforce the decision.
Except as otherwise provided in this subsection and section 19 of this act, any decision of an arbitrator pursuant to this section and any documents associated with such a decision are confidential and are not admissible as evidence during a legal proceeding, including, without limitation, a legal proceeding between the third party and the out-of-network provider.
Sec.
The decision of an arbitrator and any documents associated with such a legal proceeding to enforce the decision.ble as evidence during Sec.
Any entity or organization, not otherwise subject to the provisions of sections 2 to 19, inclusive, of this act, that provides coverage for emergency medical services, including, without limitation, a participating public agency, as defined in NRS 287.04052, and any other local governmental agency which provides a system of health insurance for the benefit of its officers and employees, and the dependents of such officers and employees, pursuant to chapter 287 of NRS, may elect for the provisions of sections 2 to 19, inclusive, of this act to apply to the provision of medically necessary emergency services by out-of- - *AB469_R2* – 10 – network providers to covered persons.
Any entity or organization, not otherwise subject to the provisions of sections 2 to 19, inclusive, of this act, that provides coverage for emergency medical services, including, without limitation, a participating public agency, as defined in NRS 287.04052, and any other local governmental agency which provides a system of health insurance for the benefit of its officers and employees, and the dependents of such officers and employees, pursuant to chapter 287 of NRS, may elect for the provisions of sections 2 to 19, inclusive, of this act to apply to the provision of medically necessary emergency services by out-of- network providers to covered persons.
1.
- 80th Session (2019) – 10 – 1.
On or before December 31 of each year, an arbitrator who arbitrated a matter pursuant to section 17 of this act during the immediately preceding 12 months shall report to the Department of Health and Human Services in the form prescribed by the Department:
On or before December 31 of each year, an arbitrator who arbitrated a matter pursuant to section 17 of this act during the immediately preceding 12 months shall report to the by the Department:th and Human Services in the form prescribed (a) The number of cases arbitrated by the arbitrator;
(a) The number of cases arbitrated by the arbitrator;
(a) Shall provide to the Department any information requested andthe Department to complete the report required by subsection 3;
(a) Shall provide to the Department any information requested by the Department to complete the report required by subsection 3;
(b) May provide to the Department any other information rel3.anOn or before January 31 of each year, the Department shall:
and (b) May provide to the Department any other information relevant to that report.
3.
On or before January 31 of each year, the Department shall:
(1) Aggregated information provided to the Department pursuant to subsections 1 and 2, presented in a manner that does not reveal the identity of any provider of health care, third party or patient;
(1) Aggregated information provided to the Department not reveal the identity of any provider of health care, third party or patient;
and - *AB469_R2* – 11 – (2) In odd-numbered years, the next regular session of the Legislature.
and - 80th Session (2019) – 11 – (2) In odd-numbered years, the next regular session of the Legislature.
Except as otherwise provided in this section and NRS 1.4683, 1.4687, 1A.110, 3.2203, 41.071, 49.095, 49.293, 62D.420, 62D.440, 62E.516, 62E.620, 62H.025, 62H.030, 62H.170, 62H.220, 62H.320, 75A.100, 75A.150, 76.160, 78.152, 80.113, 81.850, 82.183, 86.246, 86.54615, 87.515, 87.5413, 87A.200, 87A.580, 87A.640, 88.3355, 88.5927, 88.6067, 88A.345, 88A.7345, 89.045, 89.251, 90.730, 91.160, 116.757, 116A.270, 116B.880, 118B.026, 119.260, 119.265, 119.267, 119.280, 119A.280, 119A.653, 119B.370, 119B.382, 120A.690, 125.130, 125B.140, 126.141, 126.161, 126.163, 126.730, 127.007, 127.057, 127.130, 127.140, 127.2817, 128.090, 130.312, 130.712, 136.050, 159.044, 159A.044, 172.075, 172.245, 176.01249, 176.015, 176.0625, 176.09129, 176.156, 176A.630, 178.39801, 178.4715, 178.5691, 179.495, 179A.070, 179A.165, 179D.160, 200.3771, 200.3772, 200.5095, 200.604, 202.3662, 205.4651, 209.392, 209.3925, 209.419, 209.521, 211A.140, 213.010, 213.040, 213.095, 213.131, 217.105, 217.110, 217.464, 217.475, 218A.350, 218E.625, 218F.150, 218G.130, 218G.240, 218G.350, 228.270, 228.450, 239.0113, 239B.030, 239B.040, 239B.050, 239C.140, 239C.210,0105, 239C.230, 239C.250, 239C.270, 240.007, 241.020, 241.030, 250.087, 250.130, 250.140, 250.150, 268.095, 268.490, 268.910, 271A.105, 281.195, 281.805, 281A.350, 281A.680, 281A.685, 281A.750, 281A.755, 281A.780, 284.4068, 286.110, 287.0438, 289.025, 289.080, 289.387, 289.830, 293.4855, 293.5002, 293.503, 293.504, 293.558, 293.906, 293.908, 293.910, 293B.135, 293D.510, 331.110, 332.061, 332.351, 333.333, 333.335, 338.070, 338.1379, 338.1593, 338.1725, 338.1727, 348.420, 349.597, 349.775, 353.205, 353A.049, 353A.085, 353A.100, 353C.240, 360.240, 360.247, 360.255, 360.755, 361.044, 361.610, 365.138, 366.160, 368A.180, 370.257, 370.327, 372A.080, 378.290, 378.300, 379.008, 379.1495, 385A.830, 385B.100, 387.626, 387.631, 388.1455, 388.259, 388.501, 388.503, 388.513, 388.750, 388A.247, 388A.249, 391.035, 391.120, 391.925, 392.029, 392.147, 392.264, 392.271, 392.315, 392.317, 392.325, 392.327, 392.335, 392.850, 394.167, 394.1698, 394.447, 394.460, 394.465, 396.3295, 396.405, 396.525, 396.535, 396.9685, 398A.115, 408.3885, 408.3886, 408.3888, 408.5484, 412.153, 416.070, 422.2749, 422.305, 422A.342, 422A.350, 425.400, 427A.1236, 427A.872, 432.028, 432.205, 432B.175, - *AB469_R2* – 12 – 432B.280, 432B.290, 432B.407, 432B.430, 432B.560, 432B.5902, 433.534, 433A.360, 437.145, 439.840, 439B.420, 440.170, 441A.195, 441A.220, 441A.230, 442.330, 442.395, 442.735, 445A.665, 445B.570, 449.209, 449.245, 449A.112, 450.140, 453.164, 453.720, 453A.610, 453A.700, 458.055, 458.280, 459.050, 459.3866, 459.555, 459.7056, 459.846, 463.120, 463.15993, 463.240, 463.3403, 463.3407, 463.790, 467.1005, 480.365, 480.940, 481.063, 481.091, 481.093, 482.170, 482.5536, 483.340, 483.363, 483.575, 483.659, 483.800, 484E.070, 485.316, 501.344, 503.452, 522.040, 534A.031, 561.285, 571.160, 584.655, 587.877, 598.0964, 598.098, 598A.110, 599B.090, 603.070, 603A.210, 604A.710, 612.265, 616B.012, 616B.015, 616B.315, 616B.350, 618.341, 618.425, 622.310, 623.131, 623A.137, 624.110, 624.265, 624.327, 625.425, 625A.185, 628.418, 628B.230, 628B.760, 629.047, 629.069, 630.133, 630.30665, 630.336, 630A.555, 631.368, 632.121, 632.125, 632.405, 633.283, 633.301, 633.524, 634.055, 634.214, 634A.185, 635.158, 636.107, 637.085, 637B.288, 638.087, 638.089, 639.2485, 639.570, 640.075, 640A.220, 640B.730, 640C.400, 640C.600, 640C.620, 640C.745, 640C.760, 640D.190, 640E.340, 641.090, 641.325, 641A.191, 641A.289, 641B.170, 641B.460, 641C.760, 641C.800, 642.524, 643.189, 644A.870, 645.180, 645.625, 645A.050, 645A.082, 645B.060, 645B.092, 645C.220, 645C.225, 645D.130, 645D.135, 645E.300, 645E.375, 648.197, 649.065, 649.067, 652.228, 654.110, 656.105, 661.115, 665.130, 665.133, 669.275, 669.285, 669A.310, 671.170, 673.450, 679B.152, 679B.159, 679B.190, 679B.285, 679B.690, 680A.270, 681A.440, 681B.260, 681B.410, 681B.540, 683A.0873, 685A.077, 686A.289, 686B.170, 686C.306, 687A.110, 687A.115, 687C.010, 688C.230, 688C.480, 688C.490, 689A.696, 692A.117, 692C.190, 692C.3507, 692C.3536, 692C.3538, 692C.354, 692C.420, 693A.480, 693A.615, 696B.550, 696C.120, 703.196, 704B.320, 704B.325, 706.1725, 706A.230, 710.159, 711.600, and sections 17 and 19 of this act, sections 35, 38 and 41 of chapter 478, Statutes of Nevada 2011 and section 2 of chapter 391, Statutes of Nevada 2013 and unless otherwise declared by law to be confidential, all public books and public records of a governmental entity must be open at all times during office hours to inspection by any person, and may be fully copied or an abstract or memorandum may be prepared from those public books and public records.
Except as otherwise provided in this section and NRS 1.4683, 1.4687, 1A.110, 3.2203, 41.071, 49.095, 49.293, 62D.420, 62D.440, 62E.516, 62E.620, 62H.025, 62H.030, 62H.170, 62H.220, 62H.320, 75A.100, 75A.150, 76.160, 78.152, 80.113, 87A.580, 87A.640, 88.3355, 88.5927, 88.6067, 88A.345, 88A.7345, 89.045, 89.251, 90.730, 91.160, 116.757, 116A.270, 116B.880, 118B.026, 119.260, 119.265, 119.267, 119.280, 119A.280, 119A.653, 119B.370, 119B.382, 120A.690, 125.130, 125B.140, 126.141, 126.161, 126.163, 126.730, 127.007, 127.057, 127.130, 127.140, 127.2817, 128.090, 130.312, 130.712, 136.050, 159.044, 159A.044, 172.075, 172.245, 176.01249, 176.015, 176.0625, 176.09129, 176.156, 176A.630, 178.39801, 178.4715, 178.5691, 179.495, 179A.070, 179A.165, 179D.160, 200.3771, 200.3772, 200.5095, 200.604, 202.3662, 205.4651, 209.392, 209.3925, 209.419, 209.521, 211A.140, 213.010, 213.040, 213.095, 213.131, 217.105, 217.110, 217.464, 217.475, 218A.350, 218E.625, 218F.150, 218G.130, 218G.240, 218G.350, 228.270, 228.450, 228.495, 228.570, 231.069, 231.1473, 233.190, 237.300, 239.0105, 239.0113, 239B.030, 239B.040, 239B.050, 239C.140, 239C.210, 239C.230, 239C.250, 239C.270, 240.007, 241.020, 241.030, 241.039, 242.105, 244.264, 244.335, 247.540, 247.550, 247.560, 250.087, 250.130, 250.140, 250.150, 268.095, 268.490, 268.910, 271A.105, 281.195, 281.805, 281A.350, 281A.680, 281A.685, 289.025, 289.080, 289.387, 289.830, 293.4855, 293.5002, 293.503, 293.504, 293.558, 293.906, 293.908, 293.910, 293B.135, 293D.510, 331.110, 332.061, 332.351, 333.333, 333.335, 338.070, 338.1379, 338.1593, 338.1725, 338.1727, 348.420, 349.597, 349.775, 353.205, 353A.049, 353A.085, 353A.100, 353C.240, 360.240, 360.247, 360.255, 360.755, 361.044, 361.610, 365.138, 366.160, 368A.180, 370.257, 370.327, 372A.080, 378.290, 378.300, 379.008, 379.1495, 385A.830, 385B.100, 387.626, 387.631, 388.1455, 388.259, 388.501, 388.503, 388.513, 388.750, 388A.247, 388A.249, 391.035, 391.120, 391.925, 392.029, 392.147, 392.264, 392.271, 392.315, 392.317, 392.325, 392.327, 392.335, 392.850, 394.167, 394.1698, 394.447, 394.460, 394.465, 396.3295, 396.405, 396.525, 396.535, 396.9685, 398A.115, 408.3885, 408.3886, 408.3888, 408.5484, - 80th Session (2019) – 12 – 412.153, 416.070, 422.2749, 422.305, 422A.342, 422A.350, 425.400, 427A.1236, 427A.872, 432.028, 432.205, 432B.175, 432B.280, 432B.290, 432B.407, 432B.430, 432B.560, 432B.5902, 433.534, 433A.360, 437.145, 439.840, 439B.420, 440.170, 441A.195, 441A.220, 441A.230, 442.330, 442.395, 442.735, 445A.665, 445B.570, 449.209, 449.245, 449A.112, 450.140, 453.164, 453.720, 453A.610, 453A.700, 458.055, 458.280, 459.050, 459.3866, 459.555, 459.7056, 459.846, 463.120, 463.15993, 463.240, 463.3403, 463.3407, 463.790, 467.1005, 480.365, 480.940, 483.575, 483.659, 483.800, 484E.070, 485.316, 501.344, 503.452, 522.040, 534A.031, 561.285, 571.160, 584.655, 587.877, 598.0964, 598.098, 598A.110, 599B.090, 603.070, 603A.210, 604A.710, 612.265, 616B.012, 616B.015, 616B.315, 616B.350, 618.341, 618.425, 622.310, 623.131, 623A.137, 624.110, 624.265, 624.327, 625.425, 625A.185, 628.418, 628B.230, 628B.760, 629.047, 629.069, 630.133, 630.30665, 630.336, 630A.555, 631.368, 632.121, 632.125, 632.405, 633.283, 633.301, 633.524, 634.055, 634.214, 634A.185, 635.158, 636.107, 637.085, 637B.288, 638.087, 638.089, 639.2485, 639.570, 640.075, 640A.220, 640B.730, 640C.400, 640C.600, 640C.620, 640C.745, 640C.760, 640D.190, 640E.340, 641.090, 641.325, 641A.191, 641A.289, 641B.170, 641B.460, 641C.760, 641C.800, 642.524, 643.189, 644A.870, 645.180, 645.625, 645A.050, 645A.082, 645B.060, 645B.092, 645C.220, 645C.225, 645D.130, 645D.135, 645E.300, 645E.375, 645G.510, 645H.320, 645H.330, 647.0945, 647.0947, 648.033, 648.197, 649.065, 649.067, 652.228, 654.110, 656.105, 661.115, 665.130, 665.133, 669.275, 669.285, 669A.310, 671.170, 673.450, 673.480, 675.380, 676A.340, 676A.370, 677.243, 679B.122, 681A.440, 681B.260, 681B.410, 681B.540, 683A.0873, 685A.077, 686A.289, 686B.170, 686C.306, 687A.110, 687A.115, 687C.010, 688C.230, 688C.480, 688C.490, 689A.696, 692A.117, 692C.190, 692C.3507, 692C.3536, 692C.3538, 692C.354, 692C.420, 693A.480, 693A.615, 696B.550, 696C.120, 703.196, 704B.320, 704B.325, 706.1725, 706A.230, 710.159, 711.600, and sections 17 and 19 of this act, sections 35, 38 and 41 of chapter 478, Statutes of Nevada 2011 and section 2 of chapter 391, Statutes of Nevada 2013 and unless otherwise declared by law to be confidential, all public books and public records of a governmental entity must be open at all times during office hours to inspection by any person, and may be fully copied or an abstract or memorandum may be prepared from those public books and public records.
Any such copies, abstracts or memoranda may be used to supply the general public with copies, abstracts or memoranda of the records or may be used in any other way to the advantage of the governmental entity or of the general public.
Any such copies, - 80th Session (2019) – 13 – abstracts or memoranda may be used to supply the general public with copies, abstracts or memoranda of the records or may be used in any other way to the advantage of the governmental entity or of the general public.
This section does not supersede or in any manner - *AB469_R2* – 13 – affect the federal laws governing copyrights or enlarge, diminish or affect in any other manner the rights of a person in any written book or record which is copyrighted pursuant to federal law.
This section does not supersede or in any manner affect the federal laws governing copyrights or enlarge, diminish or affect in any other manner the rights of a person in any written book or record which is copyrighted pursuant to federal law.
3.
public book or record shall not deny a request made pursuant to of a subsection 1 to inspect or copy or receive a copy of a public book or record on the basis that the requested public book or record contains information that is confidential if the governmental entity can redact, delete, conceal or separate the confidential information from the information included in the public book or record that is not otherwise confidential.
A governmental entity that has legal custody or control of a public book or record shall not deny a request made pursuant to subsection 1 to inspect or copy or receive a copy of a public book or record on the basis that the requested public book or record contains information that is confidential if the governmental entity can redact, delete, conceal or separate the confidential information from the information included in the public book or record that is not otherwise confidential.
(b) Except as otherwise provided in NRS 239.030, shall, upon request, prepare the copy of the public record and shall not require or herself.who has requested the copy to prepare the copy himself Sec.
(b) Except as otherwise provided in NRS 239.030, shall, upon request, prepare the copy of the public record and shall not require the person who has requested the copy to prepare the copy himself or herself.
21.
follows:21.
NRS 683A.0879 is hereby amended to read as fol683A.0879 1.
NRS 683A.0879 is hereby amended to read as 683A.0879 1.
The interest must be calculated from 30 days after the date on which the claim is approved until the date on which the claim is paid.
- 80th Session (2019) – 14 – The interest must be calculated from 30 days after the date on which the claim is approved until the date on which the claim is paid.
The administrator shall notify the provider of health care of all the - *AB469_R2* – 14 – specific reasons for the delay in approving or denying the claim.
The administrator shall notify the provider of health care of all the specific reasons for the delay in approving or denying the claim.
The administrator shall approve or deny the claim within 30 days after receiving the additional information.
The administrator shall approve or deny the claim within 30 days the administrator shall pay the claim within 30 days after receiving, the additional information.
If the claim is approved, the administrator shall pay the claim within 30 days after receiving the additional information.
The Commissioner may require an administrator to provide evidence which demonstrates that the administrator has substantially without limitation, payment within 30 days of at least 95 percent of approved claims or at least 90 percent of the total dollar amount for app8.vedIf the Commissioner determines that an administrator is not in substantial compliance with the requirements set forth in this section, the Commissioner may require the administrator to pay an administrative fine in an amount to be determined by the Commissioner.
The Commissioner may require an administrator to provide complied with the requirements set forth in this section, including, without limitation, payment within 30 days of at least 95 percent of approved claims or at least 90 percent of the total dollar amount for approved claims.
8.
If the Commissioner determines that an administrator is not in substantial compliance with the requirements set forth in this section, the Commissioner may require the administrator to pay an administrative fine in an amount to be determined by the Commissioner.
Sec.
- 80th Session (2019) – 15 – Sec.
Except as otherwise provided in this section, if the approved claim is not paid within that period, the insurer shall pay interest on the claim at a rate of interest equal to the prime rate at the largest bank in Nevada, as ascertained by the Commissioner of Financial Institutions, on - *AB469_R2* – 15 – January 1 or July 1, as the case may be, immediately preceding the date on which the payment was due, plus 6 percent.
Except as otherwise provided in this section, if the approved claim is not paid within that period, the insurer shall pay interest on the claim at a rate of interest equal to the prime rate at the largest bank in Nevada, as January 1 or July 1, as the case may be, immediately preceding the date on which the payment was due, plus 6 percent.
An insurer shall not request a claimant to resubmit information that the claimant has already provided to the insurer, unless the insurer provides a legitimate reason for the request and the purpose of the request is not to delay the payment of the claim, harass the claimant or discourage the filing of claims.
An insurer shall not request a claimant to resubmit information that the claimant has already provided to the insurer, unless the insurer provides a legitimate reason for the request and the purpose of the request is not to delay the payment of the claim, har4.s tAn insurer shall not pay only part of a claim that has been approved and is fully payable.
4.
An insurer shall not pay only part of a claim that has been approved and is fully payable.
A court shall award costs and reasonable attorney’s fees to the6.
A court shall award costs and reasonable attorney’s fees to the prevailing party in an action brought pursuant to this section.
The payment of interest provided for in this section for the.
6.
late payment of an approved claim may be waived only if the beyond the control of the insurer.act of God or another cause 7.
The payment of interest provided for in this section for the late payment of an approved claim may be waived only if the payment was delayed because of an act of God or another cause beyond the control of the insurer.
The Commissioner may require an insurer to provide evidence which demonstrates that the insurer has substantially complied with the requirements set forth in this section, including, without limitation, payment within 30 days of at least 95 percent of approved claims or at least 90 percent of the total dollar amount for approved claims.
7.
The Commissioner may require an insurer to provide evidence which demonstrates that the insurer has substantially complied with the requirements set forth in this section, including, without limitation, payment within 30 days of at least 95 percent of - 80th Session (2019) – 16 – approved claims or at least 90 percent of the total dollar amount for approved claims.
Upon a second or subsequent determination that an insurer is not in substantial compliance with the requirements set forth in this section, the Commissioner may suspend or revoke the certificate of authority of the insurer.
Upon a second or subsequent determination that an insurer is not in substantial compliance with the requirements set forth in this section, the Commissioner may suspend or revoke the cerSec.
Sec.
Except as otherwise provided in subsection 2 [,] and section 17 of this act, an insurer shall approve or deny a claim - *AB469_R2* – 16 – relating to a policy of group health insurance or blanket insurance within 30 days after the insurer receives the claim.
Except as otherwise provided in subsection 2 [,] and section 17 of this act, an insurer shall approve or deny a claim relating to a policy of group health insurance or blanket insurance within 30 days after the insurer receives the claim.
Except as otherwise provided in this section, if the approved claim is not paid within that period, the insurer shall pay interest on the claim at a rate of interest equal to the prime rate at the largest bank in Nevada, as ascertained by the Commissioner of Financial Institutions, on January 1 or July 1, as the case may be, immediately preceding the date on which the payment was due, plus 6 percent.
Except as otherwise provided in this section, if the approved claim is not paid within that period, the insurer shall pay interest on the claim at a rate of interest equal to the prime rate at the largest bank in Nevada, as ascertained by the Commissioner of Financial Institutions, on January 1 or July 1, as the case may be, immediately preceding the date on which the payment was due, plus percent.
The insurer shall notify the provider of health care of all the specific reasons for the delay in approving or denying the claim.
The insurer shall notify the provider of health the claim.
The insurer shall approve or deny the claim within 30 days after receiving the additional information.
The insurer shall approve or deny the claim within 30enying days after receiving the additional information.
information that the claimant has already provided to the insurer, unless the insurer provides a legitimate reason for the request and harass the claimant or discourage the filing of claims.of the claim, 4.
3.
An insurer shall not request a claimant to resubmit information that the claimant has already provided to the insurer, unless the insurer provides a legitimate reason for the request and the purpose of the request is not to delay the payment of the claim, harass the claimant or discourage the filing of claims.
4.
5.
- 80th Session (2019) – 17 – 5.
The Commissioner may require an insurer to provide evidence which demonstrates that the insurer has substantially complied with the requirements set forth in this section, including, without limitation, payment within 30 days of at least 95 percent of approved claims or at least 90 percent of the total dollar amount for approved claims.
The Commissioner may require an insurer to provide evidence which demonstrates that the insurer has substantially complied with the requirements set forth in this section, including, approved claims or at least 90 percent of the total dollar amount for approved claims.
If the Commissioner determines that an insurer is not in substantial compliance with the requirements set forth in this section, the Commissioner may require the insurer to pay an - *AB469_R2* – 17 – administrative fine in an amount to be determined by the Commissioner.
If the Commissioner determines that an insurer is not in substantial compliance with the requirements set forth in this section, the Commissioner may require the insurer to pay an administrative fine in an amount to be determined by the Commissioner.
Except as otherwise provided in this section, if the approved claim is not paid within that period, the carrier shall pay interest on the claim at a rate of interest equal to the prime rate at the largest bank in Nevada, as ascertained by the Commissioner of Financial Institutions, on January 1 or July 1, as the case may be, immediately preceding the date on which the payment was due, plus 6 percent.
Except as otherwise provided in this section, if the approved claim is not paid within that period, the carrier shall pay largest bank in Nevada, as ascertained by the Commissioner ofe rate at the Financial Institutions, on January 1 or July 1, as the case may be, immediately preceding the date on which the payment was due, plus percent.
If the carrier requires additional information to determine whether to approve or deny the claim, it shall notify the claimant of receives the claim.
If the carrier requires additional information to determine whether to approve or deny the claim, it shall notify the claimant of its request for the additional information within 20 days after it receives the claim.
The carrier shall notify the provider of health care of all the specific reasons for the delay in approving or denying days after receiving the additional information.
The carrier shall notify the provider of health care of all the specific reasons for the delay in approving or denying the claim.
If the claim is approved, the carrier shall pay the claim within 30 days after it receives the additional information.
The carrier shall approve or deny the claim within 30 days after receiving the additional information.
If the claim is - 80th Session (2019) – 18 – approved, the carrier shall pay the claim within 30 days after it receives the additional information.
4.
approved and is fully payable.y only part of a claim that has been 5.
A carrier shall not pay only part of a claim that has been approved and is fully payable.
5.
- *AB469_R2* – 18 – 7.
7.
Upon a second or subsequent determination that a carrier is not in substantial compliance with the requirements set forth in this section, the Commissioner may suspend or revoke the certificate of authority of the carrier.
Upon a second or subsequent determination that a carrier is not in substantial compliance with the requirements set certificate of authority of the carrier.may suspend or revoke the Sec.
Sec.
If the approved claim is not paid within that period, the society shall pay interest on the claim at the rate of interest established pursuant to NRS 99.040 unless a different rate of interest is established pursuant to an health care.
If the approved claim is not paid within that period, the society shall pay interest on the claim at the rate of interest established pursuant to NRS 99.040 unless a different rate of interest is established pursuant to an express written contract between the society and the provider of health care.
whether to approve or deny the claim, it shall notify the claimant of its request for the additional information within 20 days after it receives the claim.
- 80th Session (2019) – 19 – 2.
If the society requires additional information to determine whether to approve or deny the claim, it shall notify the claimant of its request for the additional information within 20 days after it receives the claim.
If the approved claim is not paid within that period, the society shall pay interest on the claim in the manner prescribed in subsection 1.
If the approved claim is not paid manner prescribed in subsection 1.all pay interest on the claim in the 3.
3.
- *AB469_R2* – 19 – 5.
5.
Except as otherwise provided in this section, if the approved claim is not paid within that period, the corporation shall pay interest on the claim at a rate of interest equal to the prime rate at the largest bank in Nevada, as ascertained by the Commissioner of Financial Institutions, on January 1 or July 1, as the case may be, immediately preceding the date on which the payment was due, plus 6 percent.
Except as otherwise provided in this section, if the approved claim the claim at a rate of interest equal to the prime rate at the largest bank in Nevada, as ascertained by the Commissioner of Financial Institutions, on January 1 or July 1, as the case may be, immediately preceding the date on which the payment was due, plus 6 percent.
The corporation shall notify the provider of dental, hospital or medical services of all the specific reasons for approve or deny the claim within 30 days after receiving the shall additional information.
The corporation shall notify the provider of dental, hospital or medical services of all the specific reasons for the delay in approving or denying the claim.
If the claim is approved, the corporation information.
The corporation shall approve or deny the claim within 30 days after receiving the - 80th Session (2019) – 20 – additional information.
If the claim is approved, the corporation shall pay the claim within 30 days after it receives the additional information.
A corporation shall not request a claimant to resubmit information that the claimant has already provided to the corporation, unless the corporation provides a legitimate reason for the request and the purpose of the request is not to delay the payment of the claim, harass the claimant or discourage the filing of claims.
A corporation shall not request a claimant to resubmit information that the claimant has already provided to the corporation, unless the corporation provides a legitimate reason for the request and the purpose of the request is not to delay the claims.
4.
of the claim, harass the claimant or discourage the filing of 4.
- *AB469_R2* – 20 – 7.
7.
If the Commissioner determines that a corporation is not in substantial compliance with the requirements set forth in this section, the Commissioner may require the corporation to pay an administrative fine in an amount to be determined by the Commissioner.
If the Commissioner determines that a corporation is not in substantial compliance with the requirements set forth in this section, the Commissioner may require the corporation to pay an administrative fine in an amount to be determined by the corporation is not in substantial compliance with the requirements set forth in this section, the Commissioner may suspend or revoke the certificate of authority of the corporation.
Upon a second or subsequent determination that a corporation is not in substantial compliance with the requirements set forth in this section, the Commissioner may suspend or revoke the certificate of authority of the corporation.
Except as otherwise provided in this section, if the approved claim is not paid within that period, the health maintenance organization shall pay interest on the in Nevada, as ascertained by the Commissioner of Financial largest bank Institutions, on January 1 or July 1, as the case may be, immediately The interest must be calculated from 30 days after the date on which the claim is approved until the date on which the claim is paid.
Except as otherwise provided in this section, if the approved claim is not paid within that period, the health maintenance organization shall pay interest on the claim at a rate of interest equal to the prime rate at the largest bank - 80th Session (2019) – 21 – in Nevada, as ascertained by the Commissioner of Financial Institutions, on January 1 or July 1, as the case may be, immediately preceding the date on which the payment was due, plus 6 percent.
The interest must be calculated from 30 days after the date on which the claim is approved until the date on which the claim is paid.
The health maintenance organization shall notify the provider of health care services of all the specific reasons for the delay in approving or denying the claim.
The health maintenance the specific reasons for the delay in approving or denying the claim.
A health maintenance organization shall not request a claimant to resubmit information that the claimant has already provided to the health maintenance organization, unless the health - *AB469_R2* – 21 – maintenance organization provides a legitimate reason for the request and the purpose of the request is not to delay the payment of the claim, harass the claimant or discourage the filing of claims.
A health maintenance organization shall not request a claimant to resubmit information that the claimant has already provided to the health maintenance organization, unless the health maintenance organization provides a legitimate reason for the request and the purpose of the request is not to delay the payment of the claim, harass the claimant or discourage the filing of claims.
The payment of interest provided for in this section for the late payment of an approved claim may be waived only if the payment was delayed because of an act of God or another cause beyond the control of the health maintenance organization.
The payment of interest provided for in this section for the payment was delayed because of an act of God or another cause beyond the control of the health maintenance organization.
Upon a second or subsequent determination that a health maintenance organization is not in substantial compliance with the requirements set forth in this section, the Commissioner may suspend or revoke the certificate of authority of the health maintenance organization.
Upon a second or - 80th Session (2019) – 22 – subsequent determination that a health maintenance organization is not in substantial compliance with the requirements set forth in this section, the Commissioner may suspend or revoke the certificate of authority of the health maintenance organization.
Upon passage and approval for the purpose of adopting any regulations and performing any other preparatory administrative tasks that are necessary to carry out the provisions of this act;
Upon passage and approval for the purpose of adopting any tasks that are necessary to carry out the provisions of this act;
H - *AB469_R2*
~~~~~ 19 - 80th Session (2019)
⬇ Download PDF
View plain text versions (4)

Amendments

2 amendments

Click Show changes on an amendment above to see how it modifies the bill.

Action History

  1. Enrolled and delivered to Governor. Approved by the Governor. Chapter 62.

  2. From printer. To re-engrossment. Re-engrossed. Second reprint. Read third time. Passed, as amended. Title approved. (Yeas: 21, Nays: None.) To Assembly. In Assembly. Senate Amendment No. 694 concurred in. To enrollment.

  3. From committee: Amend, and do pass as amended. Placed on Second Reading File. Read second time. Amended. (Amend. No. 694.) To printer.

  4. In Senate. Read first time. Referred to Committee on Health and Human Services. To committee.

  5. From printer. To engrossment. Engrossed. First reprint. Read third time. Passed, as amended. Title approved, as amended. (Yeas: 38, Nays: 3, Excused: 1.) To Senate.

  6. From committee: Amend, and do pass as amended. Placed on Second Reading File. Read second time. Amended. (Amend. No. 587.) To printer.

  7. Notice of eligibility for exemption.

  8. From printer. To committee.

  9. Read first time. Referred to Committee on Health and Human Services. To printer.

Sponsors

  • Assembly Committee on Health and Human Services · Primary

Sponsorship breakdown

Export CSV (upgrade) →

1 sponsors · 0 co-sponsors · 66 not signed on

Sponsors (1)

  • Assembly Committee on Health and Human Services

Co-sponsors (0)

None.

Not signed on (66)

66 members have not signed on to this bill.

Show all 66 →

"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.

Whip count is in markup. Polling the chamber and every recorded vote this session. Only the first open is slow. It’s instant for you after this. Calling the roll · Tallying · Engrossing

Subjects

healthcare health-insurance
Cross-referencing the record. Reading this bill against every other bill in the corpus by meaning, not keywords. Only the first open is slow. It’s instant for you after this. Matching · Ranking · Engrossing

Frequently asked questions

What does AB 469 do?
AN ACT relating to health care; limiting the amount a provider of health care may charge a person who has health insurance for certain medically necessary emergency services provided when the provider is out-of-network; requiring an insurer to arrange for the transfer of a person who has health insurance to an in-network facility under certain circumstances; prescribing procedures for determining the amount that an insurer is required to pay a provider of health care which is out-of-network for certain medically necessary emergency services provided to an insured; requiring the reporting of certain information related to that process; and providing other matters properly relating thereto.
Who sponsors AB 469?
AB 469 is sponsored by Assembly Committee on Health and Human Services.
What is the current status of AB 469?
This bill died with 2019 Regular Session. It reached “To Executive” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.
Where can I track AB 469?
Track AB 469 free on One Click Politics — get push/email alerts when it moves.

Make your voice heard on AB 469

Find the representatives who decide this bill and tell them where you stand — for yourself, or mobilize your whole list in one click with One Click Politics advocacy software.

Find my representatives → Run a campaign

Stay ahead of AB 469

Last checked for changes 2 months ago · updated continuously

One Click Politics tracks every bill in Congress and all 50 states.

Track this bill →