NRS 679B.152
Review of fees for medical or dental care determined to be usual and customary

  • plans limiting selection of dentist.

1.

Every insurer or organization for dental care which pays claims on the basis of fees for medical or dental care which are “usual and customary” shall submit to the Commissioner a complete description of the method it uses to determine those fees. Except as otherwise provided in NRS 239.0115, this information must be kept confidential by the Commissioner. The fees determined by the insurer or organization to be the usual and customary fees for that care are subject to the approval of the Commissioner as being the usual and customary fees in that locality. The provisions of this subsection apply to medical or dental care provided to a claimant under any contract of insurance.

2.

Any contract for group, blanket or individual health insurance and any contract issued by a nonprofit hospital, medical or dental service corporation or organization for dental care, which provides a plan for dental care to its insureds or members which limits their choice of a dentist, under the plan to those in a preselected group, must offer its insureds or members the option of selecting a plan of benefits which does not restrict the choice of a dentist. The selection of that option does not entitle the insured or member to any increase in contributions by his or her employer or other organization toward the premium or cost of the optional plan over that contributed under the restricted plan.

Source: Section 679B.152 — Review of fees for medical or dental care determined to be usual and customary; plans limiting selection of dentist., https://www.­leg.­state.­nv.­us/NRS/NRS-679B.­html#NRS679BSec152.

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.152’s source at nv​.us