Assembly Bill No. 44–Committee on Commerce and Labor

 

CHAPTER..........

 

AN ACT relating to industrial insurance; abolishing the legislative committee on workers’ compensation; revising the provisions governing maintenance of files of claims at the office of an insurer; requiring the administrator of the division of industrial relations of the department of business and industry to designate a vendor of certain data to assist the administrator in the establishment and revision of a schedule of reasonable fees for accident benefits; and providing other matters properly relating thereto.

 

THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN

SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:

 

   Section 1. NRS 616A.425 is hereby amended to read as follows:

   616A.425  1.  There is hereby established in the state treasury the fund

for workers’ compensation and safety as a special revenue fund. All money

received from assessments levied on insurers and employers by the

administrator pursuant to NRS 232.680 must be deposited in this fund.

   2.  All assessments, penalties, bonds, securities and all other properties

received, collected or acquired by the division for functions supported in

whole or in part from the fund must be delivered to the custody of the state

treasurer for deposit to the credit of the fund.

   3.  All money and securities in the fund must be used to defray all costs

and expenses of administering the program of workmen’s compensation,

including the payment of:

   (a) All salaries and other expenses in administering the division of

industrial relations, including the costs of the office and staff of the

administrator.

   (b) All salaries and other expenses of administering NRS 616A.435 to

616A.460, inclusive, the offices of the hearings division of the department

of administration and the programs of self-insurance and review of

premium rates by the commissioner.

   (c) The salary and other expenses of a full-time employee of the

legislative counsel bureau whose principal duties are limited to conducting

research and reviewing and evaluating data related to industrial insurance.

   (d) All salaries and other expenses of the fraud control unit for

industrial insurance established pursuant to NRS 228.420.

   (e) Claims against uninsured employers arising from compliance with

NRS 616C.220 and 617.401.

   (f) [All salaries and expenses of the members of the legislative

committee on workers’ compensation and any other expenses incurred by

the committee in carrying out its duties pursuant to NRS 218.5375 to

218.5378, inclusive.

   (g)] That portion of the salaries and other expenses of the office for

consumer health assistance established pursuant to NRS 223.550 that is

related to providing assistance to consumers and injured employees

concerning workers’ compensation.

   4.  The state treasurer may disburse money from the fund only upon

written order of the controller.

   5.  The state treasurer shall invest money of the fund in the same

manner and in the same securities in which he is authorized to invest state


general funds which are in his custody. Income realized from the

investment of the assets of the fund must be credited to the fund.

   6.  The commissioner shall assign an actuary to review the

establishment of assessment rates. The rates must be filed with the

commissioner 30 days before their effective date. Any insurer or employer

who wishes to appeal the rate so filed must do so pursuant to NRS

679B.310.

   Sec. 2.  NRS 616B.021 is hereby amended to read as follows:

   616B.021  1.  An insurer shall provide access to the files of claims in

its offices.

   2.  [A file is] The physical records in a file concerning a claim filed in

this state may be kept at an office located outside this state if all records

in the file are accessible at offices located in this state on computer in a

microphotographic, electronic or other similar format that produces an

accurate reproduction of the original. If a claim filed in this state is open,

the records in the file must be reproduced and available for inspection

during regular business hours within 24 hours after requested by the

employee or his designated agent, the employer or his designated agent

[and] , or the administrator or his designated agent. If a claim filed in this

state is closed, the records in the file must be reproduced and available

for inspection during regular business hours within 14 days after

requested by such persons.

   3.  Upon request, the insurer shall make copies or other reproductions

of anything in the file and may charge a reasonable fee for this service.

Copies or other reproductions of materials in the file which are requested

by the administrator or his designated agent, or the Nevada attorney for

injured workers or his designated agent must be provided free of charge.

   4.  [If a claim has been closed for at least 1 year, the insurer may

microphotograph or film any of its records relating to that claim. The

microphotographs or films must be placed in convenient and accessible

files.

   5.] The administrator [shall] may adopt regulations concerning the:

   (a) Maintenance of records in a file on [current] claims that are open or

closed [claims;] ; and

   (b) Preservation, examination and use of records which have been

[microphotographed or filmed] stored on computer or in a

microphotographic, electronic or similar  format by an insurer . [; and

   (c) Location of a file on a closed claim.

   6.] 5. This section does not require an insurer to allow inspection or

reproduction of material regarding which a legal privilege against

disclosure has been conferred.

   Sec. 3.  NRS 616B.027 is hereby amended to read as follows:

   616B.027  1.  Every insurer shall [provide:

   (a) An] :

   (a) Provide an office in this state operated by the insurer or its third-

party administrator in which:

     (1) A complete file of each claim is [kept;] accessible, in accordance

with the provisions of NRS 616B.021;

     (2) Persons authorized to act for the insurer and, if necessary,

licensed pursuant to chapter 683A of NRS, may receive information related


to a claim and provide the services to an employer and his employees

required by chapters 616A to 617, inclusive, of NRS; and

     (3) An employee or his employer, upon request, is provided with

information related to a claim filed by the employee or a copy or other

reproduction of the information from the file for that claim[.

   (b) Statewide,] , in accordance with the provisions of NRS 616B.021.

   (b) Provide statewide toll-free telephone service to [that] the office

maintained pursuant to paragraph (a) or accept collect calls from injured

employees.

   2.  Each private carrier shall provide:

   (a) Adequate services to its insured employers in controlling losses; and

   (b) Adequate information on the prevention of industrial accidents and

occupational diseases.

   Sec. 4.  (Deleted by amendment.)

   Sec. 5.  NRS 616C.260 is hereby amended to read as follows:

   616C.260  1.  All fees and charges for accident benefits must not:

   (a) Exceed the [fees and charges] amounts usually billed and paid in

the state for similar treatment.

   (b) Be unfairly discriminatory as between persons legally qualified to

provide the particular service for which the fees or charges are asked.

   2.  The administrator shall, giving consideration to the fees and charges

being billed and paid in the state, establish a schedule of reasonable fees

and charges allowable for accident benefits provided to injured employees

whose insurers have not contracted with an organization for managed care

or with providers of health care services pursuant to NRS 616B.527. The

administrator shall review and revise the schedule on or before [October]

February 1 of each year. [The administrator may increase or decrease ] In

the revision, the administrator shall adjust the schedule[, but shall not

increase the schedule by any factor greater than] by the corresponding

annual [increase] change in the Consumer Price Index, Medical Care

Component . [, unless the advisory council of the division approves such an

increase.]

   3.  The administrator [may request] shall designate a vendor who

compiles data on a national basis concerning fees and charges that are

billed and paid for treatment or services similar to the treatment and

services that qualify as accident benefits in this state to provide him with

such information as he deems necessary to carry out the provisions of

subsection 2. The designation must be made pursuant to reasonable

competitive bidding procedures established by the administrator. In

addition, the administrator may request a health insurer, health

maintenance organization or provider of accident benefits, an agent or

employee of such a person, or an agency of the state[,] to provide the

administrator with [such] information concerning fees and charges that are

billed and paid in this state for similar services as he deems necessary to

carry out the provisions of subsection 2. The administrator shall require a

[person or entity providing] health insurer, health maintenance

organization or provider of accident benefits, an agent or employee of

such a person, or an agency of the state that provides records or reports of

fees [charged] and charges billed and paid pursuant to this section to

provide interpretation and identification concerning the information


delivered. The administrator may impose an administrative fine of $500 on

a health insurer, health maintenance organization or provider of

accident benefits, or an agent or employee of such a person for each

refusal to provide the information requested pursuant to this subsection.

   4.  The division may adopt reasonable regulations necessary to carry

out the provisions of this section. The regulations must include provisions

concerning:

   (a) Standards for the development of the schedule of fees and charges

[;] that are billed and paid; and

   (b) The [periodic revision of the schedule; and

   (c) The] monitoring of compliance by providers of benefits with the

[adopted] schedule of fees and charges.

   5.  The division shall adopt regulations requiring the [utilization] use of

a system of billing codes as recommended by the American Medical

Association.

   Sec. 6.  NRS 232.680 is hereby amended to read as follows:

   232.680  1.  The cost of carrying out the provisions of NRS 232.550

to 232.700, inclusive, and of supporting the division, a full-time employee

of the legislative counsel bureau[,] and the fraud control unit for industrial

insurance established pursuant to NRS 228.420 , [and the legislative

committee on workers’ compensation created pursuant to NRS 218.5375,]

and that portion of the cost of the office for consumer health assistance

established pursuant to NRS 223.550 that is related to providing assistance

to consumers and injured employees concerning workers’ compensation,

must be paid from assessments payable by each insurer, including each

employer who provides accident benefits for injured employees pursuant to

NRS 616C.265, based upon expected annual expenditures for claims for

injuries occurring on or after July 1, 1999. The division shall adopt

regulations [which] that establish formulas of assessment which result in

an equitable distribution of costs among the insurers and employers who

provide accident benefits for injured employees. The formulas may utilize

actual expenditures for claims.

   2.  Federal grants may partially defray the costs of the division.

   3.  Assessments made against insurers by the division after the

adoption of regulations must be used to defray all costs and expenses of

administering the program of workers’ compensation, including the

payment of:

   (a) All salaries and other expenses in administering the division,

including the costs of the office and staff of the administrator.

   (b) All salaries and other expenses of administering NRS 616A.435 to

616A.460, inclusive, the offices of the hearings division of the department

of administration and the programs of self-insurance and review of

premium rates by the commissioner of insurance.

   (c) The salary and other expenses of a full-time employee of the

legislative counsel bureau whose principal duties are limited to conducting

research and reviewing and evaluating data related to industrial insurance.

   (d) All salaries and other expenses of the fraud control unit for

industrial insurance established pursuant to NRS 228.420.

   (e) Claims against uninsured employers arising from compliance with

NRS 616C.220 and 617.401.


   (f) [All salaries and expenses of the members of the legislative

committee on workers’ compensation and any other expenses incurred by

the committee in carrying out its duties pursuant to NRS 218.5375 to

218.5378, inclusive.

   (g)] That portion of the salaries and other expenses of the office for

consumer health assistance established pursuant to NRS 223.550 that is

related to providing assistance to consumers and injured employees

concerning workers’ compensation.

   Sec. 7.  NRS 233B.039 is hereby amended to read as follows:

   233B.039  1.  The following agencies are entirely exempted from the

requirements of this chapter:

   (a) The governor.

   (b) The department of prisons.

   (c) The University and Community College System of Nevada.

   (d) The office of the military.

   (e) The state gaming control board.

   (f) The Nevada gaming commission.

   (g) The welfare division of the department of human resources.

   (h) The division of health care financing and policy of the department of

human resources.

   (i) The state board of examiners acting pursuant to chapter 217 of NRS.

   (j) Except as otherwise provided in NRS 533.365, the office of the state

engineer.

   (k) The division of industrial relations of the department of business and

industry in acting to enforce the provisions of NRS 618.375.

   (l) The administrator of the division in establishing and adjusting the

schedule of fees and charges for accident benefits pursuant to subsection

2 of NRS 616C.260.

   (m) The board to review claims in adopting resolutions to carry out its

duties pursuant to NRS 590.830.

   2.  Except as otherwise provided in NRS 391.323, the department of

education, the board of the public employees’ benefits program and the

commission on professional standards in education are subject to the

provisions of this chapter for the purpose of adopting regulations but not

with respect to any contested case.

   3.  The special provisions of:

   (a) Chapter 612 of NRS for the distribution of regulations by and the

judicial review of decisions of the employment security division of the

department of employment, training and rehabilitation;

   (b) Chapters 616A to 617, inclusive, of NRS for the determination of

contested claims;

   (c) Chapter 703 of NRS for the judicial review of decisions of the

public utilities commission of Nevada;

   (d) Chapter 91 of NRS for the judicial review of decisions of the

administrator of the securities division of the office of the secretary of

state; and

   (e) NRS 90.800 for the use of summary orders in contested

cases,

prevail over the general provisions of this chapter.


   4.  The provisions of NRS 233B.122, 233B.124, 233B.125 and

233B.126 do not apply to the department of human resources in the

adjudication of contested cases involving the issuance of letters of approval

for health facilities and agencies.

   5.  The provisions of this chapter do not apply to:

   (a) Any order for immediate action, including, but not limited to,

quarantine and the treatment or cleansing of infected or infested animals,

objects or premises, made under the authority of the state board of

agriculture, the state board of health, the state board of sheep

commissioners or any other agency of this state in the discharge of a

responsibility for the preservation of human or animal health or for insect

or pest control; or

   (b) An extraordinary regulation of the state board of pharmacy adopted

pursuant to NRS 453.2184.

   6.  The state board of parole commissioners is subject to the provisions

of this chapter for the purpose of adopting regulations but not with respect

to any contested case.

   Sec. 8.  NRS 218.5375, 218.5376, 218.5377 and 218.5378 are hereby

repealed.

   Sec. 9.  Notwithstanding the amendatory provisions of section 5 of this

act, the administrator of the division of industrial relations of the

department of business and industry is not required to designate a vendor

that compiles data on a national basis concerning fees and charges that are

billed and paid for certain treatment and services pursuant to section 5 of

this act in sufficient time to ensure that the schedule of reasonable fees and

charges allowable for accident benefits that must be revised on or before

February 1, 2002, includes the data obtained from that vendor, but shall use

his best efforts to do so.

   Sec. 10.  1.  This section becomes effective upon passage and

approval.

   2.  Section 5 of this act becomes effective:

   (a) Upon passage and approval for the purpose of requiring the

administrator to designate a vendor whocompiles data on a national basis

concerning fees and charges that are billed and paid for treatment or

services similar to the treatment and services that qualify as accident

benefits in this state to provide the administrator with such information as

he deems necessary to carry out the provisions of subsection 2 of section 5

of this act.

   (b) On July 1, 2001, for all other purposes.

   3.  Sections 1 to 4, inclusive, and 6 to 9, inclusive, of this act become

effective on July 1, 2001.

 

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