NRS 616C.087
Selection of physician or chiropractor: Legislative declaration regarding rights of injured employee
- requirements for lists maintained and updated by Administrator and insurer
- duties of Administrator
- removal of physician or chiropractor from list
- continuation of treatment with same physician or chiropractor under certain circumstances.
1.
The Legislature hereby declares that:(a)
The choice of a treating physician or chiropractor is a substantive right and substantive benefit of an injured employee who has a claim under the Nevada Industrial Insurance Act or the Nevada Occupational Diseases Act.(b)
The injured employees of this State have a substantive right to an adequate choice of physicians and chiropractors to treat their industrial injuries and occupational diseases.2.
Except as otherwise provided in this subsection and subsections 3 and 4, an insurer’s list of physicians and chiropractors from which an injured employee may choose pursuant to NRS 616C.090 must include not less than 12 physicians or chiropractors, as applicable, in each of the following disciplines and specializations, without limitation, from the panel of physicians and chiropractors maintained by the Administrator pursuant to NRS 616C.090:(a)
Orthopedic surgery on spines;(b)
Orthopedic surgery on shoulders;(c)
Orthopedic surgery on elbows;(d)
Orthopedic surgery on wrists;(e)
Orthopedic surgery on hands;(f)
Orthopedic surgery on hips;(g)
Orthopedic surgery on knees;(h)
Orthopedic surgery on ankles;(i)
Orthopedic surgery on feet;(j)
Neurosurgery;(k)
Neurology;(l)
Cardiology;(m)
Pulmonology;(n)
Psychiatry;(o)
Pain management;(p)
Occupational medicine;(q)
Physiatry or physical medicine;(r)
General practice or family medicine; and(s)
Chiropractic medicine.3.
For any other discipline or specialization not specifically identified in subsection 2, the insurer’s list must include not fewer than 8 physicians or chiropractors, as applicable, unless the panel of physicians and chiropractors maintained by the Administrator pursuant to NRS 616C.090 contains fewer than 8 physicians or chiropractors, as applicable, for that discipline or specialization, in which case all of the physicians or chiropractors, as applicable, on the panel for that discipline or specialization must be included on the insurer’s list.4.
For each county whose population is 100,000 or more, an insurer’s list of physicians and chiropractors must include for that county a number of physicians and chiropractors, as applicable, that is not less than the number required pursuant to subsections 2 and 3 and that also maintain in that county:(a)
An active practice; and(b)
A physical office.5.
If an insurer fails to maintain a list of physicians and chiropractors that complies with the requirements of subsections 2, 3 and 4, an injured employee may choose a physician or chiropractor from the panel of physicians and chiropractors maintained by the Administrator pursuant to NRS 616C.090.6.
Each insurer shall, not later than October 1 of each year, update the list of physicians and chiropractors and file the list with the Administrator. The list must be certified by an adjuster who is licensed pursuant to chapter 684A of NRS.7.
Upon receipt of a list of physicians and chiropractors that is filed pursuant to subsection 6, the Administrator shall:(a)
Stamp the list as having been filed; and(b)
Indicate on the list the date on which it was filed.8.
The Administrator shall:(a)
Provide a copy of an insurer’s list of physicians and chiropractors to any member of the public who requests a copy; or(b)
Post a copy of each insurer’s list of physicians and chiropractors on an Internet website maintained by the Administrator and accessible to the public for viewing, printing or downloading.9.
At any time, a physician or chiropractor may request in writing that he or she be removed from an insurer’s list of physicians and chiropractors. The insurer must comply with the request and omit the physician or chiropractor from the next list which the insurer files with the Administrator.10.
A physician or chiropractor may not be involuntarily removed from an insurer’s list of physicians and chiropractors except for good cause. As used in this subsection, “good cause” means that one or more of the following circumstances apply:(a)
The physician or chiropractor has died or is disabled.(b)
The license of the physician or chiropractor has been revoked or suspended.(c)
The physician or chiropractor has been convicted of:(1)
A felony; or(2)
A crime for a violation of a provision of chapter 616D of NRS.(d)
The physician or chiropractor has been removed from the panel of physicians and chiropractors maintained by the Administrator pursuant to NRS 616C.090 by the Administrator upon a finding that the physician or chiropractor has failed to comply with the standards for treatment of industrial injuries or occupational diseases as established by the Administrator.11.
Unless a physician or chiropractor, as applicable, is removed from an insurer’s list of physicians and chiropractors pursuant to subsection 10, an injured employee may continue to receive treatment from that physician or chiropractor even if:(a)
The employer of the injured employee changes insurers or administrators.(b)
The physician or chiropractor is no longer included in the applicable insurer’s list of physicians and chiropractors, provided that the physician or chiropractor agrees to continue to accept compensation for that treatment at the rates which:(1)
Were previously agreed upon when the physician or chiropractor was most recently included in the list; or(2)
Are newly negotiated but do not exceed the amounts provided under the fee schedule adopted by the Administrator.
Source:
Section 616C.087 — Selection of physician or chiropractor: Legislative declaration regarding rights of injured employee; requirements for lists maintained and updated by Administrator and insurer; duties of Administrator; removal of physician or chiropractor from list; continuation of treatment with same physician or chiropractor under certain circumstances., https://www.leg.state.nv.us/NRS/NRS-616C.html#NRS616CSec087.