Amendment No. 649

Senate Amendment to Senate Bill No. 196 (BDR 57-1147)

Proposed by: Committee on Commerce and Labor

Amendment Box: Replaces Amendment No. 305.

Resolves Conflicts with: N/A

Amends: Summary: Title: Preamble: Joint Sponsorship:

ASSEMBLY ACTION Initial and Date | SENATE ACTION Initial and Date

Adopted Lost | Adopted Lost

Concurred In Not | Concurred In Not

Receded Not | Receded Not

Amend section 1, page 1, line 2, by deleting "9," and inserting "6,".

Amend the bill as a whole by deleting sections 2 through 6, renumbering sec. 7 as sec. 5 and adding new sections designated sections 2 through 4, following section 1, to read as follows:

"Sec. 2. "Office" means the office of consumer health assistance.

Sec. 3. 1. The office of consumer health assistance is hereby created within the division. The commissioner shall appoint such personnel as are necessary to perform the duties of the office, including, without limitation, providers of health care. The personnel so appointed:

(a) Must be qualified by training and experience to perform the duties and functions of the office; and

(b) Are in the classified service of the state.

2. As used in this section, "provider of health care" has the meaning ascribed to it in NRS 629.031.

Sec. 4. 1. The office shall report annually to the commissioner concerning the information collected and maintained pursuant to paragraph (g) of subsection 1 of NRS 679B.550. The information must be reported at the time and in the form and manner required by the commissioner.

2. On or before February 1 of each year, the commissioner shall submit a written report to the director of the legislative counsel bureau for transmittal to the appropriate legislative committees. The report must include, without limitation:

(a) A statement of the number and geographic origin of the written and telephonic inquiries received by the office and the issues to which those inquiries related;

(b) A statement of the type of assistance provided, including, without limitation, the number of referrals made and the agencies, departments and other entities to which those referrals were made; and

(c) The disposition of all inquiries and complaints received by the office.".

Amend sec. 7, page 2, by deleting line 35 and inserting:

"commissioner, the office shall refer a complaint or the results of an investigation conducted pursuant to subsection 2 of NRS 679B.550".

Amend sec. 7, page 2, by deleting lines 37 and 38 and inserting:

"and regulations. If, pursuant to a complaint received by the office or the results of an investigation conducted pursuant to subsection 2 of NRS 679B.550, the office has reasonable cause to believe that fraud was or is being committed, the".

Amend sec. 7, page 2, line 39, by deleting "ombudsman" and inserting "office".

Amend sec. 7, page 3, by deleting lines 1 through 8 and inserting:

"2. The office shall provide the commissioner with any information he requests that is within the scope of the duties of the office pursuant to sections 3 to 6, inclusive, of this act.".

Amend the bill as a whole by deleting sec. 8 and renumbering sec. 9 as sec. 6.

Amend sec. 9, page 3, line 28, by deleting:

"2 to 9," and inserting:

"3 to 6,".

Amend the bill as a whole by deleting sec. 10 and adding new sections designated sections 7 through 9, following sec. 9, to read as follows:

"Sec. 7. NRS 679B.510 is hereby amended to read as follows:

679B.510 As used in NRS 679B.510 to 679B.560, inclusive, and sections 2 to 6, inclusive, of this act, unless the context otherwise requires, the words and terms defined in NRS 679B.520, 679B.530 and 679B.540 and section 2 of this act have the meanings ascribed to them in those sections.

Sec. 8. NRS 679B.550 is hereby amended to read as follows:

679B.550 1. The division , through the office of consumer health assistance, shall:

[1.] (a) Establish a toll-free telephone service for receiving inquiries and complaints from consumers of health care in this state concerning health care plans;

[2.] (b) Provide answers to written and telephonic inquiries of consumers of health care concerning health care plans, or refer the consumers to the appropriate agency, department or other entity that is responsible for addressing the specific type of inquiry;

[3.] (c) Refer consumers of health care to the appropriate agency, department or other entity that is responsible for addressing the specific type of complaint of the consumer;

[4.] (d) Provide counseling and assistance to consumers of health care concerning health care plans;

[5. Educate]

(e) Provide education to consumers of health care concerning health care plans in this state [; and

6.] , including, without limitation:

(1) Explaining:

(I) The terms of health care plans;

(II) The rights and responsibilities of consumers of health care relating to health care plans, including, without limitation, any complaint, grievance or appeal procedures; and

(III) The fundamentals of advocating their own cases;

(2) Preparing and obtaining educational materials relating to health care plans for distribution to consumers of health care; and

(3) Offering other educational activities relating to health care plans;

(f) Maintain and make available, upon request, to the general public, governmental agencies or the legislature, copies of current federal and state statutes and regulations relating to health care;

(g) Adopt and maintain a system for the collection and maintenance of information relating to the written and telephonic inquiries received by the office pursuant to paragraphs (a) and (b); and

(h) Take such actions as are necessary to ensure public awareness of the existence and purpose of the services provided by the division , through the office of consumer health assistance, pursuant to this section.

2. The division, through the office of consumer health assistance, may:

(a) Obtain such information from consumers of health care as is necessary to carry out the duties of the office; and

(b) Investigate and attempt to resolve complaints made by or on behalf of consumers of health care.

Sec. 9. 1. This section and sections 1, 2, 3 and 5 to 8, inclusive, of this act become effective on July 1, 1999.

2. Section 4 of this act becomes effective on January 1, 2000.".

Amend the title of the bill to read as follows:

"AN ACT relating to insurance; creating the office of consumer health assistance within the division of insurance of the department of business and industry; defining the duties of the office; requiring the commissioner of insurance to report to the legislature; requiring the division to adopt necessary regulations; and providing other matters properly relating thereto.".

Amend the summary of the bill, first line, by deleting:

"ombudsman for insurance" and inserting:

"consumer health assistance".

Amend the bill as a whole by removing the following assemblywoman as primary joint sponsor:

Assemblywoman Buckley.