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 17, inclusive, of this act.

1-3 Sec. 2. As used in sections 2 to 17, inclusive, of this act, unless the

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

1-5 6, inclusive, of this act have the meanings ascribed to them in those

1-6 sections.

1-7 Sec. 3. "Consumer" means a natural person who has or is in need

1-8 of coverage under a health care plan.

2-1 Sec. 4. "Health care plan" has the meaning ascribed to it in NRS

2-2 679B.520.

2-3 Sec. 5. "Insurer" has the meaning ascribed to it in NRS 679B.540.

2-4 Sec. 6. "Ombudsman" means the ombudsman for health care

2-5 appointed pursuant to section 7 of this act.

2-6 Sec. 7. The office of the ombudsman for health care is hereby

2-7 established within the bureau of consumer protection in the office of the

2-8 attorney general. The attorney general shall appoint the ombudsman.

2-9 The person so appointed must have expertise and experience in the fields

2-10 of health care and advocacy.

2-11 Sec. 8. The ombudsman shall:

2-12 1. Assist consumers with the selection of health care plans by

2-13 providing information, referral services and assistance to consumers

2-14 relating to obtaining coverage and services under health care plans;

2-15 2. Assist consumers in understanding their rights and responsibilities

2-16 under health care plans;

2-17 3. Provide information to the general public, agencies, legislators

2-18 and other persons concerning the problems and concerns of consumers

2-19 relating to health insurance, and make recommendations as appropriate

2-20 for solving those problems and concerns;

2-21 4. To the extent possible, identify, investigate and resolve complaints

2-22 on behalf of consumers and assist those consumers with the filing and

2-23 pursuit of complaints and appeals;

2-24 5. Analyze and monitor the development and implementation of

2-25 federal, state and local laws, regulations and policies relating to health

2-26 insurance in this state, and recommend such changes concerning the

2-27 development and implementation of those laws, regulations and policies

2-28 as the ombudsman deems appropriate;

2-29 6. Facilitate and encourage public comment on laws, regulations

2-30 and policies relating to health insurance in this state, including, without

2-31 limitation, the policies and actions of insurers who issue or deliver for

2-32 issuance health care plans in this state;

2-33 7. Promote the development of organizations of consumers and other

2-34 residents of this state relating to the provision of health care plans in this

2-35 state; and

2-36 8. Ensure that consumers have timely access to the services offered

2-37 by the office of the ombudsman.

2-38 Sec. 9. The ombudsman may:

2-39 1. Hire or enter into contracts with persons as necessary to carry out

2-40 the provisions of sections 2 to 17, inclusive, of this act;

3-1 2. Pursue administrative, judicial and other remedies on behalf of a

3-2 consumer or group of consumers;

3-3 3. Delegate any of his duties and responsibilities to his employees or

3-4 persons with whom he has contracted pursuant to subsection 1;

3-5 4. Adopt policies and procedures necessary to carry out the

3-6 provisions of sections 2 to 17, inclusive, of this act; and

3-7 5. Take any other action necessary to carry out the provisions of

3-8 sections 2 to 17, inclusive, of this act.

3-9 Sec. 10. The ombudsman may review the health insurance records

3-10 of a consumer if the consumer, his legal guardian or legal representative

3-11 has given written consent for the release of the records to the

3-12 ombudsman. If the consumer, his legal guardian or legal representative

3-13 has given such consent, the insurer shall provide the ombudsman with

3-14 access to the records relating to that consumer.

3-15 Sec. 11. All state agencies shall comply with reasonable requests

3-16 from the ombudsman for information and assistance.

3-17 Sec. 12. The ombudsman shall not disclose the identity of a

3-18 consumer who has filed with the ombudsman a complaint concerning an

3-19 insurer, or who is otherwise using the services of the ombudsman, in the

3-20 absence of the written consent of the consumer, his legal guardian or

3-21 legal representative, or a court order for the disclosure.

3-22 Sec. 13. 1. The ombudsman, his employees and contractors shall

3-23 not have any conflict of interest relating to the performance of their

3-24 duties pursuant to sections 2 to 17, inclusive, of this act. For the purposes

3-25 of this section, a conflict of interest shall be deemed to exist if the

3-26 ombudsman, employee or contractor, or any person affiliated with the

3-27 ombudsman, employee or contractor:

3-28 (a) Has direct involvement in the licensing, certification or

3-29 accreditation of a health care facility, insurer or provider of health care;

3-30 (b) Has a direct ownership interest or investment interest in a health

3-31 care facility, insurer or provider of health care;

3-32 (c) Is employed by, or participating in, the management of a health

3-33 care facility, insurer or provider of health care; or

3-34 (d) Receives or has the right to receive, directly or indirectly,

3-35 remuneration pursuant to any arrangement for compensation with a

3-36 health care facility, insurer or provider of health care.

3-37 2. As used in this section, "provider of health care" has the meaning

3-38 ascribed to it in NRS 629.031.

3-39 Sec. 14. The ombudsman may speak on behalf of the public interest

3-40 and the interest of consumers, and may carry out his duties prescribed in

3-41 sections 2 to 17, inclusive, of this act, without being subject to any

3-42 disciplinary or retaliatory action.

4-1 Sec. 15. On or before January 1 of each year, the ombudsman shall

4-2 submit to the governor, and to the director of the legislative counsel

4-3 bureau for transmittal to the legislative committee on health care, a

4-4 report on the activities, performance and fiscal accounts of the office of

4-5 the ombudsman during the preceding year.

4-6 Sec. 16. Upon the request of the interim finance committee or

4-7 legislative committee on health care, the attorney general and the

4-8 ombudsman shall provide to the interim finance committee or legislative

4-9 committee on health care, as appropriate, a report concerning the office

4-10 of the ombudsman for health care. The report must include:

4-11 1. An update on the status of the implementation of the provisions of

4-12 sections 2 to 17, inclusive, of this act;

4-13 2. A description of the manner in which the ombudsman is and will

4-14 be coordinating his efforts and activities with other ombudsmen in this

4-15 state, including, without limitation, the ombudsman for aging persons;

4-16 and

4-17 3. Such other information as the interim finance committee or

4-18 legislative committee on health care, as appropriate, requests.

4-19 Sec. 17. The provisions of sections 2 to 17, inclusive, of this act, do

4-20 not limit the exclusive jurisdiction of the commissioner otherwise granted

4-21 by statute to investigate or take administrative or civil action:

4-22 1. For any violation of Title 57 of NRS by any person or entity who is

4-23 or has been licensed by the commissioner pursuant to Title 57 of NRS;

4-24 2. Against any person or entity who is or has been engaged in the

4-25 business of insurance without a license as required by Title 57 of NRS;

4-26 or

4-27 3. Against any person or entity as the commissioner deems

4-28 appropriate.

4-29 Sec. 18. NRS 228.330 is hereby amended to read as follows:

4-30 228.330 [The] Except as otherwise provided in sections 2 to 17,

4-43 he is a party or intervener, in the same manner as any other party or

5-1 intervener, and make arrangements for and pay the fees or costs of any

5-2 witnesses and consultants necessary to the proceeding. If any person

5-3 ordered by the public utilities commission of Nevada to appear before it as

5-4 a witness pursuant to this subsection fails to obey the order, the

5-5 commission shall apply for a subpoena commanding the attendance of the

5-6 witness.

5-7 5. Perform such other functions and make such other arrangements as

5-8 may be necessary to carry out his duties and the functions of his office.

5-9 Sec. 19. Chapter 695G of NRS is hereby amended by adding thereto a

5-10 new section to read as follows:

5-11 1. A managed care organization shall, on or before March 1 of each

5-12 year:

5-13 (a) Submit to the commissioner a report containing the number of

5-14 patients treated by the managed care organization during the next

5-15 preceding calendar year and any other information required by the

5-16 commissioner; and

5-17 (b) Remit to the commissioner an amount equal to $1 for each such

5-18 patient.

5-19 2. The money remitted to the commissioner pursuant to this section

5-20 must be:

5-21 (a) Transmitted to the state treasurer for deposit in the state general

5-22 fund;

5-23 (b) Accounted for separately; and

5-24 (c) Used to pay the expenses of the office of the ombudsman for

5-25 health care pursuant to sections 2 to 17, inclusive, of this act, including

5-26 any expenses incident to or associated with the requirements of those

5-27 sections.

5-28 Sec. 20. The attorney general and the ombudsman for health care

5-29 appointed pursuant to section 7 of this act shall submit a report pursuant to

5-30 section 16 of this act to the interim finance committee on or before

5-31 September 15, 2000.

5-32 Sec. 21. 1. This section and sections 1 to 6, inclusive, and 19 of this

5-33 act become effective on October 1, 1999.

5-34 2. Sections 7 to 18, inclusive, and 20 of this act become effective on

5-35 July 1, 2000.