(REPRINTED WITH ADOPTED AMENDMENTS)
SECOND REPRINTA.B. 44
Assembly Bill No. 44–Committee on Commerce and Labor
Prefiled January 26, 2001
(On Behalf of Legislative Committee on
Workers’ Compensation (NRS 218.5375))
____________
Referred to Committee on Commerce and Labor
SUMMARY—Makes various changes concerning industrial insurance. (BDR 53‑772)
FISCAL NOTE: Effect on Local Government: No.
~
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).
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
1-1 Section 1. NRS 616A.425 is hereby amended to read as follows:
1-2 616A.425 1. There is hereby established in the state treasury the fund
1-3 for workers’ compensation and safety as a special revenue fund. All money
1-4 received from assessments levied on insurers and employers by the
1-5 administrator pursuant to NRS 232.680 must be deposited in this fund.
1-6 2. All assessments, penalties, bonds, securities and all other properties
1-7 received, collected or acquired by the division for functions supported in
1-8 whole or in part from the fund must be delivered to the custody of the state
1-9 treasurer for deposit to the credit of the fund.
1-10 3. All money and securities in the fund must be used to defray all costs
1-11 and expenses of administering the program of workmen’s compensation,
1-12 including the payment of:
1-13 (a) All salaries and other expenses in administering the division of
1-14 industrial relations, including the costs of the office and staff of the
1-15 administrator.
2-1 (b) All salaries and other expenses of administering NRS 616A.435 to
2-2 616A.460, inclusive, the offices of the hearings division of the department
2-3 of administration and the programs of self-insurance and review of
2-4 premium rates by the commissioner.
2-5 (c) The salary and other expenses of a full-time employee of the
2-6 legislative counsel bureau whose principal duties are limited to conducting
2-7 research and reviewing and evaluating data related to industrial insurance.
2-8 (d) All salaries and other expenses of the fraud control unit for
2-9 industrial insurance established pursuant to NRS 228.420.
2-10 (e) Claims against uninsured employers arising from compliance with
2-11 NRS 616C.220 and 617.401.
2-12 (f) [All salaries and expenses of the members of the legislative
2-13 committee on workers’ compensation and any other expenses incurred by
2-14 the committee in carrying out its duties pursuant to NRS 218.5375 to
2-15 218.5378, inclusive.
2-16 (g)] That portion of the salaries and other expenses of the office for
2-17 consumer health assistance established pursuant to NRS 223.550 that is
2-18 related to providing assistance to consumers and injured employees
2-19 concerning workers’ compensation.
2-20 4. The state treasurer may disburse money from the fund only upon
2-21 written order of the controller.
2-22 5. The state treasurer shall invest money of the fund in the same
2-23 manner and in the same securities in which he is authorized to invest state
2-24 general funds which are in his custody. Income realized from the
2-25 investment of the assets of the fund must be credited to the fund.
2-26 6. The commissioner shall assign an actuary to review the
2-27 establishment of assessment rates. The rates must be filed with the
2-28 commissioner 30 days before their effective date. Any insurer or employer
2-29 who wishes to appeal the rate so filed must do so pursuant to NRS
2-30 679B.310.
2-31 Sec. 2. NRS 616B.021 is hereby amended to read as follows:
2-32 616B.021 1. An insurer shall provide access to the files of claims in
2-33 its offices.
2-34 2. [A file is] The physical records in a file concerning a claim filed in
2-35 this state may be kept at an office located outside this state if all records
2-36 in the file are accessible at offices located in this state on computer in a
2-37 microphotographic, electronic or other similar format that produces an
2-38 accurate reproduction of the original. Except as otherwise provided in
2-39 this subsection, the records in a file concerning a claim filed in this state
2-40 must be reproduced and available for inspection during regular business
2-41 hours within 24 hours after requested by the employee or his designated
2-42 agent, the employer or his designated agent [and] , or the administrator or
2-43 his designated agent. If a claim filed in this state has been closed, the
2-44 records in the file must be reproduced and available for inspection
2-45 during regular business hours within 7 calendar days after requested by
2-46 such persons.
2-47 3. Upon request, the insurer shall make copies or other reproductions
2-48 of anything in the file and may charge a reasonable fee for this service.
2-49 Copies or other reproductions of materials in the file which are requested
3-1 by the administrator or his designated agent, or the Nevada attorney for
3-2 injured workers or his designated agent must be provided free of charge.
3-3 4. [If a claim has been closed for at least 1 year, the insurer may
3-4 microphotograph or film any of its records relating to that claim. The
3-5 microphotographs or films must be placed in convenient and accessible
3-6 files.
3-7 5.] The administrator [shall] may adopt regulations concerning the:
3-8 (a) Maintenance of records in a file on current or closed claims; and
3-9 (b) Preservation, examination and use of records which have been
3-10 [microphotographed or filmed] stored on computer or in a
3-11 microphotographic, electronic or similar format by an insurer . [; and
3-12 (c) Location of a file on a closed claim.
3-13 6.] 5. This section does not require an insurer to allow inspection or
3-14 reproduction of material regarding which a legal privilege against
3-15 disclosure has been conferred.
3-16 Sec. 3. NRS 616B.027 is hereby amended to read as follows:
3-17 616B.027 1. Every insurer shall [provide:
3-18 (a) An] :
3-19 (a) Provide an office in this state operated by the insurer or its third-
3-20 party administrator in which:
3-21 (1) A complete file of each claim is [kept;] accessible, in accordance
3-22 with the provisions of NRS 616B.021;
3-23 (2) Persons authorized to act for the insurer and, if necessary,
3-24 licensed pursuant to chapter 683A of NRS, may receive information related
3-25 to a claim and provide the services to an employer and his employees
3-26 required by chapters 616A to 617, inclusive, of NRS; and
3-27 (3) An employee or his employer, upon request, is provided with
3-28 information related to a claim filed by the employee or a copy or other
3-29 reproduction of the information from the file for that claim[.
3-30 (b) Statewide,] , in accordance with the provisions of NRS 616B.021.
3-31 (b) Provide statewide toll-free telephone service to [that] the office
3-32 maintained pursuant to paragraph (a) or accept collect calls from injured
3-33 employees.
3-34 2. Each private carrier shall provide:
3-35 (a) Adequate services to its insured employers in controlling losses; and
3-36 (b) Adequate information on the prevention of industrial accidents and
3-37 occupational diseases.
3-38 Sec. 4. NRS 616C.135 is hereby amended to read as follows:
3-39 616C.135 1. A provider of health care who accepts a patient as a
3-40 referral for the treatment of an industrial injury or an occupational disease
3-41 may not charge the patient for any treatment related to the industrial injury
3-42 or occupational disease, but must charge the insurer. The provider of health
3-43 care may charge the patient for any [other unrelated services which are
3-44 requested in writing by the patient.] services that are not related to the
3-45 employee’s industrial injury or occupational disease.
3-46 2. The insurer is liable for the charges for approved services related to
3-47 the industrial injury or occupational disease if the charges do not exceed:
3-48 (a) The fees established in accordance with NRS 616C.260 or the usual
3-49 fee charged by that person or institution, whichever is less; and
4-1 (b) The charges provided for by the contract between the provider of
4-2 health care and the insurer or the contract between the provider of health
4-3 care and the organization for managed care.
4-4 3. If a provider of health care, an organization for managed care, an
4-5 insurer or an employer violates the provisions of this section, the
4-6 administrator shall impose an administrative fine of not more than $250 for
4-7 each violation.
4-8 Sec. 5. NRS 616C.260 is hereby amended to read as follows:
4-9 616C.260 1. All fees and charges for accident benefits must not:
4-10 (a) Exceed the [fees and charges] amounts usually billed and paid in
4-11 the state for similar treatment.
4-12 (b) Be unfairly discriminatory as between persons legally qualified to
4-13 provide the particular service for which the fees or charges are asked.
4-14 2. The administrator shall, giving consideration to the fees and charges
4-15 being billed and paid in the state, establish a schedule of reasonable fees
4-16 and charges allowable for accident benefits provided to injured employees
4-17 whose insurers have not contracted with an organization for managed care
4-18 or with providers of health care services pursuant to NRS 616B.527. The
4-19 administrator shall review and revise the schedule on or before [October]
4-20 February 1 of each year. [The administrator may increase or decrease ] In
4-21 the revision, the administrator shall adjust the schedule[, but shall not
4-22 increase the schedule by any factor greater than] by the corresponding
4-23 annual [increase] change in the Consumer Price Index, Medical Care
4-24 Component . [, unless the advisory council of the division approves such an
4-25 increase.]
4-26 3. The administrator [may request] shall designate a vendor who
4-27 compiles data on a national basis concerning fees and charges that are
4-28 billed and paid for treatment or services similar to the treatment and
4-29 services that qualify as accident benefits in this state to provide him with
4-30 such information as he deems necessary to carry out the provisions of
4-31 subsection 2. The designation must be made pursuant to reasonable
4-32 competitive bidding procedures established by the administrator. In
4-33 addition, the administrator may request a health insurer, health
4-34 maintenance organization or provider of accident benefits, an agent or
4-35 employee of such a person, or an agency of the state[,] to provide the
4-36 administrator with [such] information concerning fees and charges that are
4-37 billed and paid in this state for similar services as he deems necessary to
4-38 carry out the provisions of subsection 2. The administrator shall require a
4-39 [person or entity providing] health insurer, health maintenance
4-40 organization or provider of accident benefits, an agent or employee of
4-41 such a person, or an agency of the state that provides records or reports of
4-42 fees [charged] and charges billed and paid pursuant to this section to
4-43 provide interpretation and identification concerning the information
4-44 delivered. The administrator may impose an administrative fine of $500 on
4-45 a health insurer, health maintenance organization or provider of
4-46 accident benefits, or an agent or employee of such a person for each
4-47 refusal to provide the information requested pursuant to this subsection.
5-1 4. The division may adopt reasonable regulations necessary to carry
5-2 out the provisions of this section. The regulations must include provisions
5-3 concerning:
5-4 (a) Standards for the development of the schedule of fees and charges
5-5 [;] that are billed and paid;
5-6 (b) The periodic revision of the schedule; and
5-7 (c) The monitoring of compliance by providers of benefits with the
5-8 adopted schedule of fees and charges.
5-9 5. The division shall adopt regulations requiring the [utilization] use of
5-10 a system of billing codes as recommended by the American Medical
5-11 Association.
5-12 Sec. 6. NRS 232.680 is hereby amended to read as follows:
5-13 232.680 1. The cost of carrying out the provisions of NRS 232.550
5-14 to 232.700, inclusive, and of supporting the division, a full-time employee
5-15 of the legislative counsel bureau[,] and the fraud control unit for industrial
5-16 insurance established pursuant to NRS 228.420 , [and the legislative
5-17 committee on workers’ compensation created pursuant to NRS 218.5375,]
5-18 and that portion of the cost of the office for consumer health assistance
5-19 established pursuant to NRS 223.550 that is related to providing assistance
5-20 to consumers and injured employees concerning workers’ compensation,
5-21 must be paid from assessments payable by each insurer, including each
5-22 employer who provides accident benefits for injured employees pursuant to
5-23 NRS 616C.265, based upon expected annual expenditures for claims for
5-24 injuries occurring on or after July 1, 1999. The division shall adopt
5-25 regulations [which] that establish formulas of assessment which result in
5-26 an equitable distribution of costs among the insurers and employers who
5-27 provide accident benefits for injured employees. The formulas may utilize
5-28 actual expenditures for claims.
5-29 2. Federal grants may partially defray the costs of the division.
5-30 3. Assessments made against insurers by the division after the
5-31 adoption of regulations must be used to defray all costs and expenses of
5-32 administering the program of workers’ compensation, including the
5-33 payment of:
5-34 (a) All salaries and other expenses in administering the division,
5-35 including the costs of the office and staff of the administrator.
5-36 (b) All salaries and other expenses of administering NRS 616A.435 to
5-37 616A.460, inclusive, the offices of the hearings division of the department
5-38 of administration and the programs of self-insurance and review of
5-39 premium rates by the commissioner of insurance.
5-40 (c) The salary and other expenses of a full-time employee of the
5-41 legislative counsel bureau whose principal duties are limited to conducting
5-42 research and reviewing and evaluating data related to industrial insurance.
5-43 (d) All salaries and other expenses of the fraud control unit for
5-44 industrial insurance established pursuant to NRS 228.420.
5-45 (e) Claims against uninsured employers arising from compliance with
5-46 NRS 616C.220 and 617.401.
5-47 (f) [All salaries and expenses of the members of the legislative
5-48 committee on workers’ compensation and any other expenses incurred by
6-1 the committee in carrying out its duties pursuant to NRS 218.5375 to
6-2 218.5378, inclusive.
6-3 (g)] That portion of the salaries and other expenses of the office for
6-4 consumer health assistance established pursuant to NRS 223.550 that is
6-5 related to providing assistance to consumers and injured employees
6-6 concerning workers’ compensation.
6-7 Sec. 7. NRS 218.5375, 218.5376, 218.5377 and 218.5378 are hereby
6-8 repealed.
6-9 Sec. 8. Notwithstanding the amendatory provisions of section 1 of this
6-10 act, the administrator of the division of industrial relations of the
6-11 department of business and industry is not required to designate a vendor
6-12 that compiles data on a national basis concerning fees and charges that are
6-13 billed and paid for certain treatment and services pursuant to section 1 of
6-14 this act in sufficient time to ensure that the schedule of reasonable fees and
6-15 charges allowable for accident benefits that must be revised on or before
6-16 February 1, 2002, includes the data obtained from that vendor, but shall use
6-17 his best efforts to do so.
6-18 Sec. 9. 1. This section becomes effective upon passage and
6-19 approval.
6-20 2. Section 1 of this act becomes effective:
6-21 (a) Upon passage and approval for the purpose of requiring the
6-22 administrator to designate a vendor whocompiles data on a national basis
6-23 concerning fees and charges that are billed and paid for treatment or
6-24 services similar to the treatment and services that qualify as accident
6-25 benefits in this state to provide the administrator with such information as
6-26 he deems necessary to carry out the provisions of subsection 2 of section 1
6-27 of this act.
6-28 (b) On July 1, 2001, for all other purposes.
6-29 3. Sections 2 to 8, inclusive, of this act become effective on July 1,
6-30 2001.
6-31 LEADLINES OF REPEALED SECTIONS
6-32 218.5375 Creation; membership; chairman and vice chairman;
6-33 vacancies.
6-34 218.5376 Meetings; compensation of members.
6-35 218.5377 Powers of committee.
6-36 218.5378 Fees and mileage for witnesses.
6-37 H