(REPRINTED WITH ADOPTED AMENDMENTS)
FOURTH REPRINT A.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. If a claim filed in this state is open,
2-39 the records in the file must be reproduced and available for inspection
2-40 during regular business hours within 24 hours after requested by the
2-41 employee or his designated agent, the employer or his designated agent
2-42 [and] , or the administrator or his designated agent. If a claim filed in this
2-43 state is closed, the records in the file must be reproduced and available
2-44 for inspection during regular business hours within 14 days after
2-45 requested by such persons.
2-46 3. Upon request, the insurer shall make copies or other reproductions
2-47 of anything in the file and may charge a reasonable fee for this service.
2-48 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] claims that are open or
3-9 closed [claims;] ; and
3-10 (b) Preservation, examination and use of records which have been
3-11 [microphotographed or filmed] stored on computer or in a
3-12 microphotographic, electronic or similar format by an insurer . [; and
3-13 (c) Location of a file on a closed claim.
3-14 6.] 5. This section does not require an insurer to allow inspection or
3-15 reproduction of material regarding which a legal privilege against
3-16 disclosure has been conferred.
3-17 Sec. 3. NRS 616B.027 is hereby amended to read as follows:
3-18 616B.027 1. Every insurer shall [provide:
3-19 (a) An] :
3-20 (a) Provide an office in this state operated by the insurer or its third-
3-21 party administrator in which:
3-22 (1) A complete file of each claim is [kept;] accessible, in accordance
3-23 with the provisions of NRS 616B.021;
3-24 (2) Persons authorized to act for the insurer and, if necessary,
3-25 licensed pursuant to chapter 683A of NRS, may receive information related
3-26 to a claim and provide the services to an employer and his employees
3-27 required by chapters 616A to 617, inclusive, of NRS; and
3-28 (3) An employee or his employer, upon request, is provided with
3-29 information related to a claim filed by the employee or a copy or other
3-30 reproduction of the information from the file for that claim[.
3-31 (b) Statewide,] , in accordance with the provisions of NRS 616B.021.
3-32 (b) Provide statewide toll-free telephone service to [that] the office
3-33 maintained pursuant to paragraph (a) or accept collect calls from injured
3-34 employees.
3-35 2. Each private carrier shall provide:
3-36 (a) Adequate services to its insured employers in controlling losses; and
3-37 (b) Adequate information on the prevention of industrial accidents and
3-38 occupational diseases.
3-39 Sec. 4. (Deleted by amendment.)
3-40 Sec. 5. NRS 616C.260 is hereby amended to read as follows:
3-41 616C.260 1. All fees and charges for accident benefits must not:
3-42 (a) Exceed the [fees and charges] amounts usually billed and paid in
3-43 the state for similar treatment.
3-44 (b) Be unfairly discriminatory as between persons legally qualified to
3-45 provide the particular service for which the fees or charges are asked.
3-46 2. The administrator shall, giving consideration to the fees and charges
3-47 being billed and paid in the state, establish a schedule of reasonable fees
3-48 and charges allowable for accident benefits provided to injured employees
3-49 whose insurers have not contracted with an organization for managed care
4-1 or with providers of health care services pursuant to NRS 616B.527. The
4-2 administrator shall review and revise the schedule on or before [October]
4-3 February 1 of each year. [The administrator may increase or decrease ] In
4-4 the revision, the administrator shall adjust the schedule[, but shall not
4-5 increase the schedule by any factor greater than] by the corresponding
4-6 annual [increase] change in the Consumer Price Index, Medical Care
4-7 Component . [, unless the advisory council of the division approves such an
4-8 increase.]
4-9 3. The administrator [may request] shall designate a vendor who
4-10 compiles data on a national basis concerning fees and charges that are
4-11 billed and paid for treatment or services similar to the treatment and
4-12 services that qualify as accident benefits in this state to provide him with
4-13 such information as he deems necessary to carry out the provisions of
4-14 subsection 2. The designation must be made pursuant to reasonable
4-15 competitive bidding procedures established by the administrator. In
4-16 addition, the administrator may request a health insurer, health
4-17 maintenance organization or provider of accident benefits, an agent or
4-18 employee of such a person, or an agency of the state[,] to provide the
4-19 administrator with [such] information concerning fees and charges that are
4-20 billed and paid in this state for similar services as he deems necessary to
4-21 carry out the provisions of subsection 2. The administrator shall require a
4-22 [person or entity providing] health insurer, health maintenance
4-23 organization or provider of accident benefits, an agent or employee of
4-24 such a person, or an agency of the state that provides records or reports of
4-25 fees [charged] and charges billed and paid pursuant to this section to
4-26 provide interpretation and identification concerning the information
4-27 delivered. The administrator may impose an administrative fine of $500 on
4-28 a health insurer, health maintenance organization or provider of
4-29 accident benefits, or an agent or employee of such a person for each
4-30 refusal to provide the information requested pursuant to this subsection.
4-31 4. The division may adopt reasonable regulations necessary to carry
4-32 out the provisions of this section. The regulations must include provisions
4-33 concerning:
4-34 (a) Standards for the development of the schedule of fees and charges
4-35 [;] that are billed and paid; and
4-36 (b) The [periodic revision of the schedule; and
4-37 (c) The] monitoring of compliance by providers of benefits with the
4-38 [adopted] schedule of fees and charges.
4-39 5. The division shall adopt regulations requiring the [utilization] use of
4-40 a system of billing codes as recommended by the American Medical
4-41 Association.
4-42 Sec. 6. NRS 232.680 is hereby amended to read as follows:
4-43 232.680 1. The cost of carrying out the provisions of NRS 232.550
4-44 to 232.700, inclusive, and of supporting the division, a full-time employee
4-45 of the legislative counsel bureau[,] and the fraud control unit for industrial
4-46 insurance established pursuant to NRS 228.420 , [and the legislative
4-47 committee on workers’ compensation created pursuant to NRS 218.5375,]
4-48 and that portion of the cost of the office for consumer health assistance
4-49 established pursuant to NRS 223.550 that is related to providing assistance
5-1 to consumers and injured employees concerning workers’ compensation,
5-2 must be paid from assessments payable by each insurer, including each
5-3 employer who provides accident benefits for injured employees pursuant to
5-4 NRS 616C.265, based upon expected annual expenditures for claims for
5-5 injuries occurring on or after July 1, 1999. The division shall adopt
5-6 regulations [which] that establish formulas of assessment which result in
5-7 an equitable distribution of costs among the insurers and employers who
5-8 provide accident benefits for injured employees. The formulas may utilize
5-9 actual expenditures for claims.
5-10 2. Federal grants may partially defray the costs of the division.
5-11 3. Assessments made against insurers by the division after the
5-12 adoption of regulations must be used to defray all costs and expenses of
5-13 administering the program of workers’ compensation, including the
5-14 payment of:
5-15 (a) All salaries and other expenses in administering the division,
5-16 including the costs of the office and staff of the administrator.
5-17 (b) All salaries and other expenses of administering NRS 616A.435 to
5-18 616A.460, inclusive, the offices of the hearings division of the department
5-19 of administration and the programs of self-insurance and review of
5-20 premium rates by the commissioner of insurance.
5-21 (c) The salary and other expenses of a full-time employee of the
5-22 legislative counsel bureau whose principal duties are limited to conducting
5-23 research and reviewing and evaluating data related to industrial insurance.
5-24 (d) All salaries and other expenses of the fraud control unit for
5-25 industrial insurance established pursuant to NRS 228.420.
5-26 (e) Claims against uninsured employers arising from compliance with
5-27 NRS 616C.220 and 617.401.
5-28 (f) [All salaries and expenses of the members of the legislative
5-29 committee on workers’ compensation and any other expenses incurred by
5-30 the committee in carrying out its duties pursuant to NRS 218.5375 to
5-31 218.5378, inclusive.
5-32 (g)] That portion of the salaries and other expenses of the office for
5-33 consumer health assistance established pursuant to NRS 223.550 that is
5-34 related to providing assistance to consumers and injured employees
5-35 concerning workers’ compensation.
5-36 Sec. 7. NRS 233B.039 is hereby amended to read as follows:
5-37 233B.039 1. The following agencies are entirely exempted from the
5-38 requirements of this chapter:
5-39 (a) The governor.
5-40 (b) The department of prisons.
5-41 (c) The University and Community College System of Nevada.
5-42 (d) The office of the military.
5-43 (e) The state gaming control board.
5-44 (f) The Nevada gaming commission.
5-45 (g) The welfare division of the department of human resources.
5-46 (h) The division of health care financing and policy of the department of
5-47 human resources.
5-48 (i) The state board of examiners acting pursuant to chapter 217 of NRS.
6-1 (j) Except as otherwise provided in NRS 533.365, the office of the state
6-2 engineer.
6-3 (k) The division of industrial relations of the department of business and
6-4 industry in acting to enforce the provisions of NRS 618.375.
6-5 (l) The administrator of the division in establishing and adjusting the
6-6 schedule of fees and charges for accident benefits pursuant to subsection
6-7 2 of NRS 616C.260.
6-8 (m) The board to review claims in adopting resolutions to carry out its
6-9 duties pursuant to NRS 590.830.
6-10 2. Except as otherwise provided in NRS 391.323, the department of
6-11 education, the board of the public employees’ benefits program and the
6-12 commission on professional standards in education are subject to the
6-13 provisions of this chapter for the purpose of adopting regulations but not
6-14 with respect to any contested case.
6-15 3. The special provisions of:
6-16 (a) Chapter 612 of NRS for the distribution of regulations by and the
6-17 judicial review of decisions of the employment security division of the
6-18 department of employment, training and rehabilitation;
6-19 (b) Chapters 616A to 617, inclusive, of NRS for the determination of
6-20 contested claims;
6-21 (c) Chapter 703 of NRS for the judicial review of decisions of the
6-22 public utilities commission of Nevada;
6-23 (d) Chapter 91 of NRS for the judicial review of decisions of the
6-24 administrator of the securities division of the office of the secretary of
6-25 state; and
6-26 (e) NRS 90.800 for the use of summary orders in contested
6-27 cases,
6-28 prevail over the general provisions of this chapter.
6-29 4. The provisions of NRS 233B.122, 233B.124, 233B.125 and
6-30 233B.126 do not apply to the department of human resources in the
6-31 adjudication of contested cases involving the issuance of letters of approval
6-32 for health facilities and agencies.
6-33 5. The provisions of this chapter do not apply to:
6-34 (a) Any order for immediate action, including, but not limited to,
6-35 quarantine and the treatment or cleansing of infected or infested animals,
6-36 objects or premises, made under the authority of the state board of
6-37 agriculture, the state board of health, the state board of sheep
6-38 commissioners or any other agency of this state in the discharge of a
6-39 responsibility for the preservation of human or animal health or for insect
6-40 or pest control; or
6-41 (b) An extraordinary regulation of the state board of pharmacy adopted
6-42 pursuant to NRS 453.2184.
6-43 6. The state board of parole commissioners is subject to the provisions
6-44 of this chapter for the purpose of adopting regulations but not with respect
6-45 to any contested case.
6-46 Sec. 8. NRS 218.5375, 218.5376, 218.5377 and 218.5378 are hereby
6-47 repealed.
6-48 Sec. 9. Notwithstanding the amendatory provisions of section 5 of this
6-49 act, the administrator of the division of industrial relations of the
7-1 department of business and industry is not required to designate a vendor
7-2 that compiles data on a national basis concerning fees and charges that are
7-3 billed and paid for certain treatment and services pursuant to section 5 of
7-4 this act in sufficient time to ensure that the schedule of reasonable fees and
7-5 charges allowable for accident benefits that must be revised on or before
7-6 February 1, 2002, includes the data obtained from that vendor, but shall use
7-7 his best efforts to do so.
7-8 Sec. 10. 1. This section becomes effective upon passage and
7-9 approval.
7-10 2. Section 5 of this act becomes effective:
7-11 (a) Upon passage and approval for the purpose of requiring the
7-12 administrator to designate a vendor whocompiles data on a national basis
7-13 concerning fees and charges that are billed and paid for treatment or
7-14 services similar to the treatment and services that qualify as accident
7-15 benefits in this state to provide the administrator with such information as
7-16 he deems necessary to carry out the provisions of subsection 2 of section 5
7-17 of this act.
7-18 (b) On July 1, 2001, for all other purposes.
7-19 3. Sections 1 to 4, inclusive, and 6 to 9, inclusive, of this act become
7-20 effective on July 1, 2001.
7-21 LEADLINES OF REPEALED SECTIONS
7-22 218.5375 Creation; membership; chairman and vice chairman;
7-23 vacancies.
7-24 218.5376 Meetings; compensation of members.
7-25 218.5377 Powers of committee.
7-26 218.5378 Fees and mileage for witnesses.
7-27 H