NRS 687B.690
Required provisions in contract between participating provider of health care and health carrier.

Each contract entered into for the purposes of a network plan between a participating provider of health care and the health carrier must include, without limitation, a provision which is substantially similar to the following:
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Provider of health care agrees that in no event, including but not limited to, nonpayment by the health carrier or intermediary, insolvency of the health carrier or intermediary or breach of this agreement, shall the provider of health care bill, charge, collect a deposit from, seek compensation, remuneration or reimbursement from, or have any recourse against, a covered person or a person (other than the health carrier or intermediary) acting on behalf of the covered person for health care services provided pursuant to this agreement. This agreement does not prohibit the provider of health care from collecting coinsurance, deductibles or copayments, as specifically provided in the evidence of coverage, or fees for uncovered services delivered on a fee-for-service basis to covered persons. This agreement does not prohibit a provider of health care (except for a provider of health care who is employed full-time on the staff of the health carrier and has agreed to provide health care services exclusively to the health carrier’s covered persons and no others) and a covered person from agreeing to continue health care services solely at the expense of the covered person, as long as the provider of health care has clearly informed the covered person that the health carrier may not cover or continue to cover a specific health care service or health care services. Except as provided herein, this agreement does not prohibit the provider of health care from pursuing any available legal remedy.
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Source: Section 687B.690 — Required provisions in contract between participating provider of health care and health carrier., https://www.­leg.­state.­nv.­us/NRS/NRS-687B.­html#NRS687BSec690.

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.690’s source at nv​.us