NRS 687B.693
Access to services and contractual discounts of a provider of health care: Inapplicability of provisions.


NRS 687B.693 to 687B.697, inclusive, do not apply:

1.

To provider network contracts for health care services provided to covered persons under Medicare or the State Plan for Medicaid, or the Children’s Health Insurance Program.

2.

In circumstances where access to the provider network contract is granted to an entity operating under the same brand license program as the contracting entity.

3.

To a health benefit plan which provides:

(a)

Coverage that is only for accident or disability income insurance, or any combination thereof.

(b)

Coverage issued as a supplement to liability insurance.

(c)

Coverage for on-site medical clinics.

(d)

Coverage under a blanket student accident and health insurance policy.

(e)

Other similar insurance coverage specified pursuant to the Health Insurance Portability and Accountability Act of 1996, Public Law 104-191, under which benefits for medical care are secondary or incidental to other insurance benefits.

4.

To credit insurance.

5.

To the following benefits if the benefits are provided under a separate policy, certificate or contract of insurance or are otherwise not an integral part of a health benefit plan:

(a)

Limited-scope vision benefits;

(b)

Benefits for long-term care, nursing home care, home health care or community-based care, or any combination thereof; and

(c)

Such other similar benefits as are specified in any federal regulations adopted pursuant to the Health Insurance Portability and Accountability Act of 1996, Public Law 104-191.

6.

To the following benefits if the benefits are provided under a separate policy, certificate or contract, there is no coordination between the provisions of the benefits and any exclusion of benefits under any group health plan maintained by the same plan sponsor, and the benefits are paid for a claim without regard to whether benefits are provided for such a claim under any group health plan maintained by the same plan sponsor:

(a)

Coverage that is only for a specified disease or illness; and

(b)

Hospital indemnity or other fixed indemnity insurance.

7.

To any of the following, if offered as a separate policy, certificate or contract of insurance:

(a)

Medicare supplemental health insurance as defined in section 1882(g)(1) of the Social Security Act, 42 U.S.C. § 1395ss, as that section existed on July 16, 1997;

(b)

Coverage supplemental to the coverage provided pursuant to the Civilian Health and Medical Program of Uniformed Services, TRICARE, 10 U.S.C. §§ 1071 et seq.; and

(c)

Similar supplemental coverage provided under a group health plan.

Source: Section 687B.693 — Access to services and contractual discounts of a provider of health care: Inapplicability of provisions., https://www.­leg.­state.­nv.­us/NRS/NRS-687B.­html#NRS687BSec693.

687B.600
Definitions.
687B.605
“Covered person” defined.
687B.607
“Direct notification” defined.
687B.610
“Evidence of coverage” defined.
687B.615
“Health benefit plan” defined.
687B.620
“Health care services” defined.
687B.625
“Health carrier” defined.
687B.630
“Intermediary” defined.
687B.635
“Medically necessary” defined.
687B.640
“Network” defined.
687B.645
“Network plan” defined.
687B.650
“Participating provider of health care” defined.
687B.655
“Primary care physician” defined.
687B.658
“Provider network contract” defined.
687B.660
“Provider of health care” defined.
687B.664
“Third party” defined.
687B.665
“Utilization review” defined.
687B.670
Requirements to offer or issue network plan.
687B.675
Provision of information to the Office for Consumer Health Assistance.
687B.680
Health carrier to notify participating providers of health care of services covered by network plan.
687B.690
Required provisions in contract between participating provider of health care and health carrier.
687B.693
Access to services and contractual discounts of a provider of health care: Inapplicability of provisions.
687B.694
Access to services and contractual discounts of a provider of health care: Requirements for granting access
687B.695
Access to services and contractual discounts of a provider of health care: Access by third parties.
687B.696
Access to services and contractual discounts of a provider of health care: Information required to be provided by third parties.
687B.697
Access to services and contractual discounts of a provider of health care: Obligations of health carrier and third parties concerning remittance advice or explanation of payment
687B.700
Participating provider of health care to continue delivery of services if health carrier or intermediary insolvent or ceases operations
687B.710
Provisions to be construed in favor of covered person, survive termination of contract and supersede certain contrary agreements.
687B.720
Notice of insolvency or cessation of operations of health carrier or intermediary.
687B.730
Health carrier to provide notice of administrative policies and programs.
687B.740
Inducement to provide less than medically necessary health care services prohibited.
687B.750
Health carrier not to prohibit certain actions by participating provider of health care.
687B.760
Health records
687B.770
Assignment or delegation of rights and responsibilities without prior written consent prohibited.
687B.780
Participating provider of health care to furnish covered services to all covered persons
687B.790
Health carrier to notify participating provider of health care of obligation to collect coinsurance, copayment or deductible or notify covered person of obligation for services not covered.
687B.800
Retaliation for good faith reporting to state or federal authority prohibited.
687B.810
Health carrier to allow participating provider of health care to determine whether a person is a covered person.
687B.820
Procedures for resolution of disputes.
687B.830
Contract for purposes of network plan prohibited from conflicting with network plan or law
687B.840
Health carrier to notify participating provider of health care of status and inclusion on certain lists maintained by health carrier.
687B.850
Regulations.
Last Updated

Jun. 24, 2021

§ 687B.693’s source at nv​.us