EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted. Green numbers along left margin indicate location on the printed bill (e.g., 5-15 indicates page 5, line 15).

1-1 Section 1. Chapter 228 of NRS is hereby amended by adding thereto

1-2 the provisions set forth as sections 2 to 10, inclusive, of this act.

1-3 Sec. 2. As used in sections 2 to 10, inclusive, of this act, unless the

1-4 context otherwise requires, the words and terms defined in sections 3 and

1-5 4 of this act have the meanings ascribed to them in those sections.

1-6 Sec. 3. "Health insurance" has the meaning ascribed to it in NRS

1-7 681A.030.

1-8 Sec. 4. "Insurer" has the meaning ascribed to it in NRS 679A.100.

1-9 Sec. 5. 1. The office of ombudsman for consumers of health

1-10 insurance is hereby created within the office of the attorney general.

1-11 2. The attorney general shall appoint a person to serve in the position

1-12 of ombudsman for consumers of health insurance. The person so

1-13 appointed:

1-14 (a) Must be knowledgeable in the field of health care;

1-15 (b) Must be qualified by training and experience to perform the duties

1-16 and functions of his office; and

1-17 (c) Is in the unclassified service of the state.

2-1 3. The attorney general may remove the ombudsman for consumers

2-2 of health insurance from office for inefficiency, neglect of duty or

2-3 malfeasance in office.

2-4 Sec. 6. The ombudsman for consumers of health insurance shall:

2-5 1. Assist consumers of health insurance in selecting a plan of health

2-6 insurance by providing information, referrals and assistance concerning

2-7 health insurance coverage and services to consumers;

2-8 2. Assist consumers of health insurance to understand their rights

2-9 and responsibilities as set forth in their plans of health insurance;

2-10 3. Disseminate information to the public, state and local agencies,

2-11 legislators and other interested persons concerning the problems related

2-12 to health care encountered by consumers of health insurance and

2-13 solutions for resolving such problems;

2-14 4. Analyze and monitor the development, execution and enforcement

2-15 of federal, state and local laws, regulations and policies that affect

2-16 consumers of health insurance and make recommendations to any

2-17 responsible entity he deems appropriate;

2-18 5. Facilitate public comment during hearings concerning laws,

2-19 regulations and policies which affect consumers of health insurance,

2-20 including, without limitation, comments about the practices of insurers

2-21 that issue policies of health insurance;

2-22 6. Promote the development of organizations of citizens and

2-23 consumers of health insurance to address issues concerning health

2-24 insurance;

2-25 7. Ensure that the services provided by the office of ombudsman for

2-26 consumers of health insurance are easily accessible to consumers;

2-27 8. At the request of the interim finance committee or the legislative

2-28 committee on health care, report to either of those committees

2-29 concerning the activities of the office of ombudsman for consumers of

2-30 health insurance; and

2-31 9. On or before January 1 of each year, submit a report to the

2-32 governor and the director of the legislative counsel bureau for

2-33 transmittal to the legislature, or, if the legislature is not in session, to the

2-34 legislative commission. The report must include, without limitation, a

2-35 summary of the activities, fiscal accounts and recommendations of the

2-36 office of ombudsman for consumers of health insurance.

2-37 Sec. 7. The ombudsman for consumers of health insurance may:

2-38 1. Employ the staff necessary to carry out his duties and the

2-39 functions of his office in accordance with the practices and procedures

2-40 for personnel established for the office of the attorney general.

2-41 2. Prescribe the duties of the staff of the office of ombudsman for

2-42 consumers of health insurance.

3-1 3. Establish procedures and policies for the management of the

3-2 office of ombudsman for consumers of health insurance.

3-3 4. Assist consumers of health insurance in the pursuit of

3-4 administrative, judicial and other remedies concerning problems with

3-5 their health care insurance, including, without limitation, assisting

3-6 consumers in the investigation and resolution of complaints.

3-7 5. Examine any books, accounts, minutes, records or other papers or

3-8 property of an insurer that issues a policy of health insurance in this

3-9 state in the same manner and to the same extent as authorized by law for

3-10 the commissioner of insurance and the state board of health. An insurer

3-11 that issues a policy of health insurance shall, upon request, provide such

3-12 information to the ombudsman for consumers of health insurance within

3-13 30 days after receipt of the request. Any information obtained pursuant

3-14 to this subsection must be given the same level of confidentiality that

3-15 would be required if the information had been obtained by the

3-16 commissioner of insurance or the state board of health.

3-17 6. Delegate the performance of any of his powers or duties to any

3-18 person employed by his office.

3-19 7. Perform such other functions and make such other arrangements

3-20 as may be necessary to carry out his duties and the functions of his

3-21 office.

3-22 Sec. 8. Except as otherwise provided in this section, information

3-23 collected by the office of ombudsman for consumers of health insurance

3-24 concerning a consumer of health insurance is confidential and must not

3-25 be disclosed to any person under any circumstances other than with the

3-26 written consent of the consumer or his legal guardian, or pursuant to a

3-27 court order. Such information may be used for statistical purposes if the

3-28 identity of the consumer is not discernible from the information

3-29 disclosed.

3-30 Sec. 9. Each state agency or division having functions relating to

3-31 Title 57 of NRS shall cooperate with the ombudsman for consumers of

3-32 health insurance in the performance of his duties and shall provide the

3-33 ombudsman for consumers of health insurance with any information,

3-34 statistics or data in its records that he requires.

3-35 Sec. 10. 1. The ombudsman for consumers of health insurance

3-36 and a person employed by the office of ombudsman for consumers of

3-37 health insurance shall not:

3-38 (a) Participate directly in the licensing, certification or accreditation

3-39 of a health care facility, an insurer that issues policies of health

3-40 insurance or a provider of health care;

3-41 (b) Have a direct ownership interest or interest through an investment

3-42 in a health care facility, an insurer that issues policies of health

3-43 insurance or a provider of health care;

4-1 (c) Be employed by or participate in the management of a health care

4-2 facility, an insurer that issues policies of health insurance or a provider

4-3 of health care; or

4-4 (d) Receive or be entitled to receive, directly or indirectly,

4-5 remuneration pursuant to an agreement for compensation entered into

4-6 with a health care facility, an insurer that issues policies of health

4-7 insurance or a provider of health care.

4-8 2. As used in this section:

4-9 (a) "Health care facility" has the meaning ascribed to it in NRS

4-10 449.800.

4-11 (b) "Provider of health care" has the meaning ascribed to it in NRS

4-12 629.031.

4-13 Sec. 11. On or before September 15, 1999, the ombudsman for

4-14 consumers of health insurance shall submit a report to the interim finance

4-15 committee and the legislative committee on health care. The report must

4-16 include, without limitation, an update on the status of the office of

4-17 ombudsman for consumers of health insurance and a description of the

4-18 manner in which the activities of the office of ombudsman for consumers

4-19 of health insurance are being coordinated.

4-20 Sec. 12. This act becomes effective on July 1, 1999.