NRS 679B.124
Denial of application of provider of health care to be included in network of providers of a health carrier: Form letter for notification by health carrier

  • copy of form letter to Commissioner
  • annual report.

1.

The Commissioner shall:

(a)

Develop, prescribe and make available on an Internet website maintained by the Division a form letter that a health carrier must use to notify a provider of health care of the denial of his or her application to be included in the network of providers of the health carrier. The form letter must include, without limitation, a place for the health carrier to explain the reason for the denial of the application.

(b)

Hold hearings to solicit public input when developing the form letter described in paragraph (a) and consider such input when developing the form letter.

2.

A health carrier shall submit to the Commissioner a copy of each form letter sent to a provider of health care pursuant to subsection 1 at the same time the letter is sent to the provider of health care. Except as otherwise provided in subsection 3, the forms submitted pursuant to the Commissioner pursuant to this subsection and the information contained therein are confidential.

3.

The Commissioner shall:

(a)

Annually compile a report using aggregated data from the forms collected pursuant to subsection 2 concerning trends in the denial of applications of providers of health care to be included in the network of providers of a health carrier. The report must include, without limitation, the number of total denials, the number of denials for different types of providers of health care, the number of denials by different carriers and the reasons for such denials.

(b)

Post the report on an Internet website maintained by the Division.

(c)

Submit the report to the Governor and the Director of the Legislative Counsel Bureau for transmittal to the Legislature.

4.

As used in this section, “health carrier” means an entity subject to the insurance laws and regulations of this State, or subject to the jurisdiction of the Commissioner, that contracts or offers to contract to provide, deliver, arrange for, pay for or reimburse any of the costs of health care services, including, without limitation, a sickness and accident health insurance company, a health maintenance organization, a nonprofit hospital and health service corporation or any other entity providing a plan of health insurance, health benefits or health care services.

Source: Section 679B.124 — Denial of application of provider of health care to be included in network of providers of a health carrier: Form letter for notification by health carrier; copy of form letter to Commissioner; annual report., https://www.­leg.­state.­nv.­us/NRS/NRS-679B.­html#NRS679BSec124.

679B.020
Appointment 679B.030
Qualifications. 679B.050
Official seal. 679B.060
Office space. 679B.080
Designation of acting Commissioner 679B.090
Employment of assistants and examiners 679B.100
Prohibited interests of Commissioner, deputy or employee 679B.110
Delegation of powers. 679B.115
Limitation on civil liability. 679B.120
Authority of Commissioner: General powers and duties. 679B.122
Authority of Commissioner: Cooperative or coordination agreements 679B.123
Authority of Commissioner: Reciprocal licenses for health carriers licensed in certain other states 679B.124
Denial of application of provider of health care to be included in network of providers of a health carrier: Form letter for notification by health carrier 679B.125
Observation of conduct of persons in insurance business 679B.127
Counseling elderly persons concerning health insurance 679B.130
Regulations: Adoption 679B.133
Regulations: Requirements regarding use of identification cards and devices to process claims for prescription drugs and devices. 679B.135
Regulations: Protections to purchasers, prospective purchasers, holders and former holders of policies. 679B.136
Regulations: Use of electronic signatures, records and payments 679B.137
Regulations: Method for maintaining records. 679B.138
Regulations: Use of uniform claim forms and billing codes 679B.139
Regulations: Plans for providing welfare benefits to employees of more than one employer. 679B.140
Orders and notices. 679B.142
Orders prohibiting insurer from transacting insurance 679B.144
Commissioner required to collect information regarding closed claims for medical malpractice 679B.145
Publication, maintenance and distribution of guide to rates for policies of insurance for motor vehicles. 679B.150
Measures to enhance public understanding of coverages and to encourage competition 679B.152
Review of fees for medical or dental care determined to be usual and customary 679B.159
Report of violation to Commissioner 679B.160
Advisory councils. 679B.170
Private ombudsmen. 679B.180
Enforcement. 679B.185
Administrative fine for willfully engaging in unauthorized transaction of insurance: Limitation 679B.187
Person who invests or handles money or assets of insurer designated fiduciary 679B.190
Maintenance, inspection and destruction of records 679B.200
Evidentiary effect of Commissioner’s certificates and certified copies of documents. 679B.220
Interstate and international cooperation. 679B.225
Inspection of insurance policies. 679B.227
Statute of limitations for commencing proceedings to collect premium tax. 679B.228
Fee for returned check or other dishonored payment.
Last Updated

Jun. 24, 2021

§ 679B.124’s source at nv​.us