NRS 695G.405
Managed care organization prohibited from denying coverage solely because insured was intoxicated or under the influence of controlled substance

  • exceptions.

1.

Except as otherwise provided in subsection 2, a managed care organization shall not:

(a)

Deny a claim under a health care plan solely because the claim involves an injury sustained by an insured as a consequence of being intoxicated or under the influence of a controlled substance.

(b)

Cancel participation under a health care plan solely because an insured has made a claim involving an injury sustained by the insured as a consequence of being intoxicated or under the influence of a controlled substance.

(c)

Refuse participation under a health care plan to an eligible applicant solely because the applicant has made a claim involving an injury sustained by the applicant as a consequence of being intoxicated or under the influence of a controlled substance.

2.

The provisions of subsection 1 do not prohibit a managed care organization from enforcing a provision included in a health care plan to:

(a)

Deny a claim which involves an injury to which a contributing cause was the insured’s commission of or attempt to commit a felony;

(b)

Cancel participation under a health care plan solely because of such a claim; or

(c)

Refuse participation under a health care plan to an eligible applicant solely because of such a claim.

3.

The provisions of this section do not apply to a managed care organization under a health care plan that provides coverage for long-term care or disability income.

Source: Section 695G.405 — Managed care organization prohibited from denying coverage solely because insured was intoxicated or under the influence of controlled substance; exceptions., https://www.­leg.­state.­nv.­us/NRS/NRS-695G.­html#NRS695GSec405.

Last Updated

Jun. 24, 2021

§ 695G.405’s source at nv​.us