NRS 687B.225
Requirements for contracts for payment of cost of medical or dental care which require prior authorization of care.

1.

Except as otherwise provided in NRS 689A.0405, 689A.0413, 689A.044, 689A.0445, 689B.031, 689B.0313, 689B.0317, 689B.0374, 695B.1912, 695B.1914, 695B.1925, 695B.1942, 695C.1713, 695C.1735, 695C.1745, 695C.1751, 695G.170, 695G.171 and 695G.177, any contract for group, blanket or individual health insurance or any contract by a nonprofit hospital, medical or dental service corporation or organization for dental care which provides for payment of a certain part of medical or dental care may require the insured or member to obtain prior authorization for that care from the insurer or organization. The insurer or organization shall:

(a)

File its procedure for obtaining approval of care pursuant to this section for approval by the Commissioner; and

(b)

Respond to any request for approval by the insured or member pursuant to this section within 20 days after it receives the request.

2.

The procedure for prior authorization may not discriminate among persons licensed to provide the covered care.

Source: Section 687B.225 — Requirements for contracts for payment of cost of medical or dental care which require prior authorization of care., https://www.­leg.­state.­nv.­us/NRS/NRS-687B.­html#NRS687BSec225.

687B.010
Scope. 687B.015
“Binder” defined. 687B.021
Signatures. 687B.030
Waiver of payment of premium. 687B.040
Insurable interest: Personal insurance. 687B.050
Insurable interest: Exception when certain institutions designated beneficiary. 687B.060
Insurable interest: Property. 687B.070
Power to contract: Purchase of insurance and annuities by minors. 687B.080
Consent of insured to life or health insurance required 687B.090
Alteration of application: Life and health insurance. 687B.100
Application as evidence. 687B.110
Representations in applications. 687B.113
Control of cost of health care: Provisions encouraging use of certain services and facilities. 687B.117
Control of cost of health care: Insurer required to use three or more practices that control cost in administering benefits. 687B.120
Filing and approval of forms 687B.122
Readability of policies: Applicability of requirements. 687B.124
Readability of policies: Flesch test 687B.126
Readability of policies: Filing policy for Commissioner’s approval 687B.128
Readability of policies: Approval by Commissioner. 687B.130
Grounds for disapproval. 687B.140
Standard provisions. 687B.145
Provisions in policies of casualty insurance: Proration of recovery or benefits 687B.147
Exclusion, reduction or limitation of certain coverage in motor vehicle insurance policies allowed 687B.150
Inclusion of portion of charter or bylaws. 687B.160
Execution of policies. 687B.170
Underwriters’ and combination policies. 687B.180
Validity and construction of noncomplying forms. 687B.182
Binders: Issuance 687B.183
Binders: Forms 687B.184
Binders: Form and premium for policy issued as replacement. 687B.185
Binders: Prohibition of use to lower premiums. 687B.186
Binders: Proof of insurance coverage. 687B.187
Binders: Disapproval of insurer. 687B.190
Delivery of policy. 687B.200
Assignability. 687B.210
Payment discharges insurer. 687B.220
Forms for proof of loss to be furnished. 687B.225
Requirements for contracts for payment of cost of medical or dental care which require prior authorization of care. 687B.240
Administration of claims not waiver. 687B.250
Payment not to constitute admission of liability or waiver of defenses. 687B.255
Insurer to pay claim with negotiable instrument. 687B.260
Exemption of proceeds of certain policies. 687B.270
Exemption of proceeds: Health insurance. 687B.280
Exemption of proceeds: Group insurance. 687B.290
Exemption of proceeds: Annuities 687B.300
Retention of proceeds of policy by insurer. 687B.310
Cancellations and nonrenewals 687B.320
Midterm cancellation 687B.325
Industrial insurance policies: Midterm cancellation 687B.330
Anniversary cancellation. 687B.340
Nonrenewals. 687B.345
Annual review of coverage and benefits provided in policy. 687B.350
Renewal with altered terms. 687B.355
Information about claims paid on behalf of policyholder 687B.360
Information about grounds. 687B.370
Information about applying for insurance through certain plans 687B.380
Immunity. 687B.385
Refusal to issue, cancellation, nonrenewal or increase in premium due to claims for which insured was not at fault, claims for which insurer made no payment or recovered entirety of payment or inquiries relating to a claim prohibited. 687B.390
Cancellation or nonrenewal on sole basis of age, residence, race, color, creed, national origin, ancestry, sexual orientation, gender identity or expression or occupation prohibited. 687B.400
Discrimination on sole basis of age prohibited 687B.402
Compliance with certain federal laws regarding genetic information. 687B.404
Compliance with certain federal laws regarding mental health and addiction. 687B.406
Compliance with certain federal laws regarding dependent students. 687B.407
Authority of nonprofit health benefit plan regarding prescription drugs. 687B.408
Notifications required concerning changes related to prescription drugs used for transplanted organs. 687B.409
Payments to out-of-network providers for treatment of mental health or alcohol or substance use disorder. 687B.410
Withdrawal of insurance for particular class of insureds: Notice 687B.420
Notice of proposed cancellation, nonrenewal or alteration of terms of certain policies, contracts or plans of insurance. 687B.430
Regulations: Policies which provide for payment of expenses not covered by Medicare 687B.440
Umbrella policies: Disclosure statement indicating whether policy includes uninsured or underinsured motorist coverage 687B.450
Required medical examination 687B.460
Certificates of insurance for property or casualty insurance. 687B.4095
Policies of health insurance including prescription drug coverage: Restrictions on moving prescription drug from lower-cost tier to higher-cost tier.
Last Updated

Feb. 5, 2021

§ 687B.225’s source at nv​.us