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NRS 616B.5273

Adequacy of medical and health care services, choice of providers of health care and cost controls; regulations

Applied in 2 court decisions — leading case Valdez v. Employers Ins. Co. of Nev. (2007)

Most recently applied in Valdez v. Employers Ins. Co. of Nev. (June 2007)

(Added to NRS by 2003, 1669)

1. A self-insured employer, an association of self-insured public or private employers or a private carrier shall not enter into a contract with an organization for managed care unless the organization’s proposed plan for providing medical and health care services:

(a) Will provide all medical and health care services that may be required for industrial injuries and occupational diseases that are compensable under chapters 616A to 617, inclusive, of NRS in a manner that ensures the availability and accessibility of adequate treatment to injured employees;

(b) Provides to injured employees an adequate choice of providers of health care who have contracted with the organization to participate in the proposed plan; and

(c) Provides appropriate financial incentives to reduce costs of medical and health care services without affecting the quality of any care provided to an injured employee.

2. The Division may adopt regulations to ensure the adequacy of an insurer’s panel of providers of health care established pursuant to subsection 1.

Official source: Nevada Legislature. Reproduced from public-domain Nevada statutes; confirm against the official source for the current text. Not legal advice.