Nev. Admin. Code § 679B.Sec. 15 - NEW
1. A carrier shall, within 60 days after the
effective date of a change to a network plan that results in the network plan
failing to meet the standards required pursuant to section 9 of this regulation
or any other requirement of sections 2 to 18, inclusive, submit to the
Commissioner for approval a written corrective action plan to bring the network
plan into compliance with those standards and requirements.
2. Except as otherwise provided in subsection
3, during the period in which the network plan does not meet the standards
required pursuant to section 9 of this regulation or any other requirement of
sections 2 to 18, inclusive, the carrier shall, at no greater cost to the
covered person:
(a) Ensure that each covered
person affected by the change may obtain any covered service from a qualified
provider of health care who is:
(1) Within
the network plan; or
(2) Not within
the network plan by entering into an agreement with the nonparticipating
provider of health care pursuant to
NRS
695G.164; or
(b) Make other arrangements approved by the
Commissioner to ensure that each covered person affected by the change is able
to obtain the covered service.
3. The provisions of subsection 2 do not
apply to services received from a nonparticipating provider of health care
without the prior authorization of the carrier unless the services received are
medically necessary emergency services, as defined in subsection 3 of
NRS
695G.170.
Notes
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