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 683A of NRS is hereby amended by adding thereto

1-2 a new section to read as follows:

1-3 1. Except as otherwise provided in subsection 2, an administrator

1-4 shall approve or deny a claim relating to health insurance coverage

1-5 within 30 days after the administrator receives the claim. If the claim is

1-6 approved, the administrator shall pay the claim within 30 days after it is

1-7 approved. If the approved claim is not paid within that period, the

1-8 administrator shall pay interest on the claim at the rate of interest

1-9 established pursuant to NRS 99.040 unless a different rate of interest is

1-10 established pursuant to an express written contract between the

1-11 administrator and the provider of health care. The interest must be

1-12 calculated from 30 days after the date on which the claim is approved

1-13 until the claim is paid.

1-14 2. If the administrator requires additional information to determine

1-15 whether to approve or deny the claim, he shall notify the claimant of his

1-16 request for the additional information within 20 days after he receives

1-17 the claim. The administrator shall notify the provider of health care of all

2-1 the specific reasons for the delay in approving or denying the claim. The

2-2 administrator shall approve or deny the claim within 30 days after

2-3 receiving the additional information. If the claim is approved, the

2-4 administrator shall pay the claim within 30 days after he receives the

2-5 additional information. If the approved claim is not paid within that

2-6 period, the administrator shall pay interest on the claim in the manner

2-7 prescribed in subsection 1.

2-8 3. An administrator shall not request a claimant to resubmit

2-9 information that the claimant has already provided to the administrator,

2-10 unless the administrator provides a legitimate reason for the request and

2-11 the purpose of the request is not to delay the payment of the claim, harass

2-12 the claimant or discourage the filing of claims.

2-13 4. An administrator shall not pay only part of a claim that has been

2-14 approved and is fully payable.

2-15 5. A court shall award costs and reasonable attorney’s fees to the

2-16 prevailing party in an action brought pursuant to this section.

2-17 Sec. 2. NRS 683A.086 is hereby amended to read as follows:

2-18 683A.086 1. No person may act as an administrator unless he has

2-32 functions an administrator may perform on behalf of an insurer.

2-33 Sec. 3. Chapter 689A of NRS is hereby amended by adding thereto a

2-34 new section to read as follows:

2-35 An insurer may charge a provider of health care a fee to include the

2-36 name of the provider on a list of providers of health care given by the

2-37 insurer to its insureds. The amount of the fee must be reasonable and

2-38 must not exceed an amount that is directly related to the administrative

2-39 costs of the insurer to include the provider on the list.

2-40 Sec. 4. NRS 689A.410 is hereby amended to read as follows:

2-41 689A.410 1. Except as otherwise provided in subsection 2, an insurer

2-43 30 days after the insurer receives the claim. If the claim is approved, the

3-1 insurer shall pay the claim within 30 days after it is approved. If the

3-2 approved claim is not paid within that period, the insurer shall pay interest

3-3 on the claim at the rate of interest established pursuant to NRS 99.040 [.]

3-4 unless a different rate of interest is established pursuant to an express

3-5 written contract between the insurer and the provider of health care. The

3-6 interest must be calculated from 30 days after the date [the payment is due]

3-7 on which the claim is approved until the claim is paid.

3-8 2. If the insurer requires additional information to determine whether to

3-9 approve or deny the claim, it shall notify the claimant of its request for the

3-10 additional information within 20 days after it receives the claim. The

3-11 insurer shall notify the provider of health care of all the [reason] specific

3-12 reasons for the delay in approving or denying the claim. The insurer shall

3-13 approve or deny the claim within 30 days after receiving the additional

3-14 information. If the claim is approved, the insurer shall pay the claim within

3-15 30 days after it receives the additional information. If the approved claim is

3-16 not paid within that period, the insurer shall pay interest on the claim in the

3-17 manner prescribed in subsection 1.

3-18 3. An insurer shall not request a claimant to resubmit information

3-19 that the claimant has already provided to the insurer, unless the insurer

3-20 provides a legitimate reason for the request and the purpose of the

3-21 request is not to delay the payment of the claim, harass the claimant or

3-22 discourage the filing of claims.

3-23 4. An insurer shall not pay only part of a claim that has been

3-24 approved and is fully payable.

3-25 5. A court shall award costs and reasonable attorney’s fees to the

3-26 prevailing party in an action brought pursuant to this section.

3-27 Sec. 5. Chapter 689B of NRS is hereby amended by adding thereto a

3-28 new section to read as follows:

3-29 An insurer that issues a policy of group health insurance may charge a

3-30 provider of health care a fee to include the name of the provider on a list

3-31 of providers of health care given by the insurer to its insureds. The

3-32 amount of the fee must be reasonable and must not exceed an amount

3-33 that is directly related to the administrative costs of the insurer to include

3-34 the provider on the list.

3-35 Sec. 6. NRS 689B.255 is hereby amended to read as follows:

3-36 689B.255 1. Except as otherwise provided in subsection 2, an insurer

3-43 to an express written contract between the insurer and the provider of

4-1 health care. The interest must be calculated from 30 days after the date

4-2 [the payment is due] on which the claim is approved until the claim is

4-3 paid.

4-4 2. If the insurer requires additional information to determine whether to

4-5 approve or deny the claim, it shall notify the claimant of its request for the

4-6 additional information within 20 days after it receives the claim. The

4-7 insurer shall notify the provider of health care of all the [reason] specific

4-8 reasons for the delay in approving or denying the claim. The insurer shall

4-9 approve or deny the claim within 30 days after receiving the additional

4-10 information. If the claim is approved, the insurer shall pay the claim within

4-11 30 days after it receives the additional information. If the approved claim is

4-12 not paid within that period, the insurer shall pay interest on the claim in the

4-13 manner prescribed in subsection 1.

4-14 3. An insurer shall not request a claimant to resubmit information

4-15 that the claimant has already provided to the insurer, unless the insurer

4-16 provides a legitimate reason for the request and the purpose of the

4-17 request in not to delay the payment of the claim, harass the claimant or

4-18 discourage the filing of claims.

4-19 4. An insurer shall not pay only part of a claim that has been

4-20 approved and is fully payable.

4-21 5. A court shall award costs and reasonable attorney’s fees to the

4-22 prevailing party in an action brought pursuant to this section.

4-23 Sec. 7. Chapter 689C of NRS is hereby amended by adding thereto the

4-24 provisions set forth as sections 8 and 9 of this act.

4-25 Sec. 8. A carrier serving small employers and a carrier that offers a

4-26 contract to a voluntary purchasing group may charge a provider of

4-27 health care a fee to include the name of the provider on a list of providers

4-28 of health care given by the carrier to its insureds. The amount of the fee

4-29 must be reasonable and must not exceed an amount that is directly

4-30 related to the administrative costs of the carrier to include the provider

4-31 on the list.

4-32 Sec. 9. 1. Except as otherwise provided in subsection 2, a carrier

4-33 serving small employers and a carrier that offers a contract to a

4-34 voluntary purchasing group shall approve or deny a claim relating to a

4-35 policy of health insurance within 30 days after the carrier receives the

4-36 claim. If the claim is approved, the carrier shall pay the claim within 30

4-37 days after it is approved. If the approved claim is not paid within that

4-38 period, the carrier shall pay interest on the claim at the rate of interest

4-39 established pursuant to NRS 99.040 unless a different rate of interest is

4-40 established pursuant to an express written contract between the carrier

4-41 and the provider of health care. The interest must be calculated from 30

4-42 days after the date on which the claim is approved until the claim is paid.

5-1 2. If the carrier requires additional information to determine

5-2 whether to approve or deny the claim, it shall notify the claimant of its

5-3 request for the additional information within 20 days after it receives the

5-4 claim. The carrier shall notify the provider of health care of all the

5-5 specific reasons for the delay in approving or denying the claim. The

5-6 carrier shall approve or deny the claim within 30 days after receiving the

5-7 additional information. If the claim is approved, the carrier shall pay the

5-8 claim within 30 days after it receives the additional information. If the

5-9 approved claim is not paid within that period, the carrier shall pay

5-10 interest on the claim in the manner prescribed in subsection 1.

5-11 3. A carrier shall not request a claimant to resubmit information that

5-12 the claimant has already provided to the carrier, unless the carrier

5-13 provides a legitimate reason for the request and the purpose of the

5-14 request is not to delay the payment of the claim, harass the claimant or

5-15 discourage the filing of claims.

5-16 4. A carrier shall not pay only part of a claim that has been approved

5-17 and is fully payable.

5-18 5. A court shall award costs and reasonable attorney’s fees to the

5-19 prevailing party in an action brought pursuant to this section.

5-20 Sec. 10. Chapter 695A of NRS is hereby amended by adding thereto a

5-21 new section to read as follows:

5-22 A society may charge a provider of health care a fee to include the

5-23 name of the provider on a list of providers of health care given by the

5-24 society to its insureds. The amount of the fee must be reasonable and

5-25 must not exceed an amount that is directly related to the administrative

5-26 costs of the society to include the provider on the list.

5-27 Sec. 11. NRS 695A.188 is hereby amended to read as follows:

5-28 695A.188 1. Except as otherwise provided in subsection 2, a society

5-43 approve or deny the claim within 30 days after receiving the additional

6-1 information. If the claim is approved, the society shall pay the claim within

6-2 30 days after it receives the additional information. If the approved claim is

6-3 not paid within that period, the society shall pay interest on the claim in the

6-4 manner prescribed in subsection 1.

6-5 3. A society shall not request a claimant to resubmit information that

6-6 the claimant has already provided to the society, unless the society

6-7 provides a legitimate reason for the request and the purpose of the

6-8 request is not to delay the payment of the claim, harass the claimant or

6-9 discourage the filing of claims.

6-10 4. A society shall not pay only part of a claim that has been approved

6-11 and is fully payable.

6-12 5. A court shall award costs and reasonable attorney’s fees to the

6-13 prevailing party in an action brought pursuant to this section.

6-14 Sec. 12. Chapter 695B of NRS is hereby amended by adding thereto a

6-15 new section to read as follows:

6-16 A corporation subject to the provisions of this chapter may charge a

6-17 provider of health care a fee to include the name of the provider on a list

6-18 of providers of health care given by the corporation to its insureds. The

6-19 amount of the fee must be reasonable and must not exceed an amount

6-20 that is directly related to the administrative costs of the corporation to

6-21 include the provider on the list.

6-22 Sec. 13. NRS 695B.2505 is hereby amended to read as follows:

6-23 695B.2505 1. Except as otherwise provided in subsection 2, a

6-43 receives the additional information. If the approved claim is not paid within

7-1 that period, the corporation shall pay interest on the claim in the manner

7-2 prescribed in subsection 1.

7-3 3. A corporation shall not request a claimant to resubmit

7-4 information that the claimant has already provided to the corporation,

7-5 unless the corporation provides a legitimate reason for the request and

7-6 the purpose of the request is not to delay the payment of the claim, harass

7-7 the claimant or discourage the filing of claims.

7-8 4. A corporation shall not pay only part of a claim that has been

7-9 approved and is fully payable.

7-10 5. A court shall award costs and reasonable attorney’s fees to the

7-11 prevailing party in an action brought pursuant to this section.

7-12 Sec. 14. Chapter 695C of NRS is hereby amended by adding thereto a

7-13 new section to read as follows:

7-14 A health maintenance organization may charge a provider of health

7-15 care a fee to include the name of the provider on a list of providers of

7-16 health care given by the health maintenance organization to its enrollees.

7-17 The amount of the fee must be reasonable and must not exceed an

7-18 amount that is directly related to the administrative costs of the health

7-19 maintenance organization to include the provider on the list.

7-20 Sec. 15. NRS 695C.185 is hereby amended to read as follows:

7-21 695C.185 1. Except as otherwise provided in subsection 2, a health

7-42 receives the additional information. If the approved claim is not paid within

8-1 that period, the health maintenance organization shall pay interest on the

8-2 claim in the manner prescribed in subsection 1.

8-3 3. A health maintenance organization shall not request a claimant to

8-4 resubmit information that the claimant has already provided to the

8-5 health maintenance organization, unless the health maintenance

8-6 organization provides a legitimate reason for the request and the purpose

8-7 of the request is not to delay the payment of the claim, harass the

8-8 claimant or discourage the filing of claims.

8-9 4. A health maintenance organization shall not pay only part of a

8-10 claim that has been approved and is fully payable.

8-11 5. A court shall award costs and reasonable attorney’s fees to the

8-12 prevailing party in an action brought pursuant to this section.

8-13 Sec. 16. NRS 695F.090 is hereby amended to read as follows:

8-14 695F.090 Prepaid limited health service organizations are subject to