Senate Amendment to Senate Bill No. 145 (BDR 57-834)
Proposed by: Committee on Commerce and Labor
Amendment Box: Replaces Amendment No. 141.
Amends: Summary: Title: Preamble: Joint Sponsorship:
ASSEMBLY ACTION
Initial and Date | SENATE ACTION Initial and DateAdopted Lost | Adopted Lost
Concurred In Not | Concurred In Not
Receded Not | Receded Not
Amend the bill as a whole by renumbering sections 1 through 14 as sections 3 through 16 and adding new sections designated sections 1 and 2, following the enacting clause, to read as follows:
"Section 1. Chapter 683A of NRS is hereby amended by adding thereto a new section to read as follows:
1. Except as otherwise provided in subsection 2, an administrator shall approve or deny a claim relating to health insurance coverage within 30 days after the administrator receives the claim. If the claim is approved, the administrator shall pay the claim within 30 days after it is approved. If the approved claim is not paid within that period, the administrator shall pay interest on the claim at the rate of interest established pursuant to NRS 99.040 unless a different rate of interest is established pursuant to an express written contract between the administrator and the provider of health care. The interest must be calculated from 30 days after the date on which the claim is approved until the claim is paid.
2. If the administrator requires additional information to determine whether to approve or deny the claim, he shall notify the claimant of his request for the additional information within 20 days after he receives the claim. The administrator shall notify the provider of health care of all the specific reasons for the delay in approving or denying the claim. The administrator shall approve or deny the claim within 30 days after receiving the additional information. If the claim is approved, the administrator shall pay the claim within 30 days after he receives the additional information. If the approved claim is not paid within that period, the administrator shall pay interest on the claim in the manner prescribed in subsection 1.
3. An administrator shall not request a claimant to resubmit information that the claimant has already provided to the administrator, unless the administrator provides a legitimate reason for the request and the purpose of the request is not to delay the payment of the claim, harass the claimant or discourage the filing of claims.
4. An administrator shall not pay only part of a claim that has been approved and is fully payable.
5. A court shall award costs and reasonable attorney’s fees to the prevailing party in an action brought pursuant to this section.
Sec. 2. NRS 683A.086 is hereby amended to read as follows:
and section 1 of this act which apply to the duties of the administrator.2. A copy of an agreement entered into under the provisions of this section must be retained in the records of the administrator and of the insurer for a period of 5 years after the termination of the agreement.
3. When a policy is issued to a trustee or trustees, a copy of the trust agreement and amendments must be obtained by the administrator and a copy forwarded to the insurer. Each agreement must be retained by the administrator and by the insurer for a period of 5 years after the termination of the policy.
4. The commissioner may adopt regulations which specify the functions an administrator may perform on behalf of an insurer.".
Amend sec. 2, page 1, line 16, by deleting "
claimant." and inserting:"
provider of health care.".Amend sec. 2, page 2, by deleting lines 16 and 17 and inserting:
"
4. An insurer shall not pay only part of a claim that has been approved and is fully payable.".Amend sec. 4, page 2, line 36, by deleting "
claimant." and inserting:"
provider of health care.".Amend sec. 4, page 3, by deleting lines 11 and 12 and inserting:
"
4. An insurer shall not pay only part of a claim that has been approved and is fully payable.".Amend sec. 5, page 3, line 16, by deleting:
"6 and 7" and inserting:
"8 and 9".
Amend sec. 7, page 3, line 33, by deleting "
claimant." and inserting:"
provider of health care.".Amend sec. 7, page 4, by deleting lines 8 and 9 and inserting:
"
4. A carrier shall not pay only part of a claim that has been approved and is fully payable.".Amend sec. 9, page 4, line 27, by deleting "
claimant." and inserting:"
provider of health care.".Amend sec. 9, page 5, by deleting lines 3 and 4 and inserting:
"
4. A society shall not pay only part of a claim that has been approved and is fully payable.".Amend sec. 11, page 5, line 24, by deleting "
claimant." and inserting:"
provider of health care.".Amend sec. 11, page 6, by deleting lines 1 and 2 and inserting:
"
4. A corporation shall not pay only part of a claim that has been approved and is fully payable.".Amend sec. 13, page 6, line 23, by deleting:
"
claimant fixing a different rate of interest." and inserting:"
provider of health care.".Amend sec. 13, page 7, by deleting lines 1 and 2 and inserting:
"
4. A health maintenance organization shall not pay only part of a claim that has been approved and is fully payable.".Amend sec. 14, page 7, line 22, by deleting "
1" and inserting "3".Amend the title of the bill, first line, after "insurance;" by inserting:
"requiring an administrator to pay claims relating to health insurance coverage in a certain manner;".
Amend the summary of the bill by deleting "insurers." and inserting:
"insurers and administrators.".