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. NRS 616B.527 is hereby amended to read as follows:

1-2 616B.527 A self-insured employer, an association of self-insured

1-17 not required to use such services.

2-1 4. [Require] Except as otherwise provided in section 2 of this act,

2-2 require employees to obtain medical and health care services for their

2-3 industrial injuries from those organizations and persons with whom the

2-4 self-insured employer, association or private carrier has contracted pursuant

2-5 to subsections 1 and 2, or as the self-insured employer, association or

2-6 private carrier otherwise prescribes.

2-7 5. [Require] Except as otherwise provided in section 2 of this act,

2-8 require employees to obtain the approval of the self-insured employer,

2-9 association or private carrier before obtaining medical and health care

2-10 services for their industrial injuries from a provider of health care who has

2-11 not been previously approved by the self-insured employer, association or

2-12 private carrier.

2-13 Sec. 2. Chapter 616C of NRS is hereby amended by adding thereto a

2-14 new section to read as follows:

2-15 Notwithstanding the provisions of NRS 616B.518, 616B.524, 616B.527

2-16 and 616C.090 that limit the physicians and chiropractors from whom an

2-17 injured employee may select his treating physician or chiropractor or

2-18 otherwise indicate a limitation in the choice of providers of health care

2-19 for the injured employee, if:

2-20 1. The insurer of an injured employee’s employer has entered into a

2-21 contract with an organization for managed care; and

2-22 2. The injured employee’s treating physician or chiropractor

2-23 determines that the injured employee requires certain medical or health

2-24 care services that the treating physician or chiropractor does not provide

2-25 and orders the provision of such treatment,

2-26 the injured employee may select a provider of health care who provides

2-27 such services but who is not a member of the organization for managed

2-28 care, if the provider agrees to accept the terms of that organization’s plan

2-29 for managed care.

2-30 Sec. 3. NRS 616C.090 is hereby amended to read as follows:

2-31 616C.090 1. The administrator shall establish a panel of physicians

2-43 from the panel if the choice is made within 90 days after his injury. The

3-1 insurer shall notify the first physician or chiropractor in writing. The notice

3-2 must be postmarked within 3 working days after the insurer receives

3-3 knowledge of the change. The first physician or chiropractor must be

3-4 reimbursed only for the services he rendered to the injured employee up to

3-5 and including the date of notification. Any further change is subject to the

3-6 approval of the insurer, which must be granted or denied within 10 days

3-7 after a written request for such a change is received from the injured

3-8 employee. If no action is taken on the request within 10 days, the request

3-9 shall be deemed granted. Any request for a change of physician or

3-10 chiropractor must include the name of the new physician or chiropractor

3-11 chosen by the injured employee.

3-12 3. An injured employee employed or residing in any county in this state

3-13 whose insurer has entered into a contract with an organization for managed

3-14 care must choose his treating physician or chiropractor pursuant to the

3-15 terms of that contract. If the employee, after choosing his treating physician

3-16 or chiropractor, moves to a county which is not served by the organization

3-17 for managed care and the insurer determines that it is impractical for the

3-18 employee to continue treatment with the physician or chiropractor, the

3-19 employee must choose a treating physician or chiropractor who has agreed

3-20 to the terms of that contract unless the insurer authorizes the employee to

3-21 choose another physician or chiropractor.

3-22 4. Except when emergency medical care is required and except as

3-23 otherwise provided in NRS 616C.055, and section 2 of this act, the insurer

3-24 is not responsible for any charges for medical treatment or other accident

3-25 benefits furnished or ordered by any physician, chiropractor or other person

3-26 selected by the employee in disregard of the provisions of this section or

3-27 for any compensation for any aggravation of the employee’s injury

3-28 attributable to improper treatments by such physician, chiropractor or other

3-29 person.

3-30 5. The administrator may order necessary changes in a panel of

3-31 physicians and chiropractors and shall suspend or remove any physician or

3-32 chiropractor from a panel for good cause shown.

3-33 6. An injured employee may receive treatment by more than one

3-34 physician or chiropractor if , except as otherwise provided in section 2 of

3-35 this act, the insurer provides written authorization for such treatment.

3-36 Sec. 4. NRS 616C.135 is hereby amended to read as follows:

3-37 616C.135 1. A provider of health care who accepts a patient as a

3-42 requested in writing by the patient.

4-1 2. The insurer is liable for the charges for approved services if the

4-2 charges do not exceed:

4-3 (a) The fees established in accordance with NRS 616C.260 or the usual

4-4 fee charged by that person or institution, whichever is less; and

4-5 (b) The charges provided for by the contract between the provider of

4-6 health care and the [insurer or the contract between the provider of health

4-7 care and the organization] :

4-8 (1) Insurer; or

4-9 (2) Organization for managed care [.] , whether the provider of

4-10 health care is a member of that organization or is not a member but has

4-11 agreed to accept the terms of that organization’s plan for managed care.

4-12 3. If a provider of health care, an organization for managed care, an

4-13 insurer or an employer violates the provisions of this section, the

4-14 administrator shall impose an administrative fine of not more than $250 for

4-15 each violation.