2001 REGULAR SESSION (71st)                                                                                A AB36 78

Amendment No. 78

 

 

 

     Amend section 1, page 1, by deleting lines 3 through 15 and inserting:

“administrator shall approve or deny a claim relating to health insurance coverage within 30 calendar days after the administrator receives the claim. If the claim is approved, the administrator shall pay the claim within 30 calendar days after it is approved. If the approved claim is not paid within that period, the administrator shall pay interest on the claim at the rate of interest established pursuant to NRS 99.040 . [unless a different rate of interest is established pursuant to an express written contract between the administrator and the provider of health care.] The interest must be calculated from 30 calendar days after the date on which the claim is approved until the claim is paid.”.

     Amend section 1, page 1, line 17, by deleting:

“or any part thereof,”.

     Amend section 1, page 1, line 18, after “20” by inserting “calendar”.

     Amend section 1, pages 1 and 2, by deleting lines 21 and 22 on page 1 and lines 1 through 10 on page 2, and inserting:

“the claim. If additional information is requested from the provider of health care, the provider shall furnish the additional information within 20 calendar days after receiving the request. If the provider of health care fails to furnish the additional information within that period, the provider is not entitled to any interest payment to which he would otherwise be entitled for the late payment of a claim. The administrator shall approve or deny the claim within [30] 20 calendar days after receiving the additional information. If the claim is approved, the administrator shall pay the claim within [30] 20 calendar days after he receives the additional information. If the approved claim is not paid within that period, the administrator shall pay interest on the claim in the manner prescribed in subsection 1[.] , except that the interest must be calculated from 20 calendar days after the date on which the additional information is received until the claim is paid.”.

     Amend section 1, page 2, lines 16 and 17, by deleting:

“[part] a portion of a claim or part thereof” and inserting:

“part of a claim”.

     Amend sec. 2, page 2, by deleting lines 22 through 34 and inserting:

“shall approve or deny a claim relating to a policy of health insurance within 30 calendar days after the insurer receives the claim. If the claim is approved, the insurer shall pay the claim within 30 calendar days after it is approved. If the approved claim is not paid within that period, the insurer shall pay interest on the claim at the rate of interest established pursuant to NRS 99.040 . [unless a different rate of interest is established pursuant to an express written contract between the insurer and the provider of health care.] The interest must be calculated from 30 calendar days after the date on which the claim is approved until the claim is paid.”.

     Amend sec. 2, page 2, line 36, by deleting:

“or any part thereof,”.

     Amend sec. 2, page 2, line 37, after “20” by inserting “calendar”.

     Amend sec. 2, pages 2 and 3, by deleting lines 39 through 48 on page 2 and lines 1 and 2 on page 3, and inserting:

“the specific reasons for the delay in approving or denying the claim. If additional information is requested from the provider of health care, the provider shall furnish the additional information within 20 calendar days after receiving the request. If the provider of health care fails to furnish the additional information within that period, the provider is not entitled to any interest payment to which he would otherwise be entitled for the late payment of a claim. The insurer shall approve or deny the claim within [30] 20 calendar days after receiving the additional information. If the claim is approved, the insurer shall pay the claim within [30] 20 calendar days after it receives the additional information. If the approved claim is not paid within that period, the insurer shall pay interest on the claim in the manner prescribed in subsection 1[.] , except that the interest must be calculated from 20 calendar days after the date on which the additional information is received until the claim is paid.”.

     Amend sec. 2, page 3, lines 8 and 9, by deleting:

“[part]a portion of a claim or part thereof” and inserting:

“part of a claim”.

     Amend sec. 3, page 3, by deleting lines 14 through 26 and inserting:

“shall approve or deny a claim relating to a policy of group health insurance or blanket insurance within 30 calendar days after the insurer receives the claim. If the claim is approved, the insurer shall pay the claim within 30 calendar days after it is approved. If the approved claim is not paid within that period, the insurer shall pay interest on the claim at the rate of interest established pursuant to NRS 99.040 . [unless a different rate of interest is established pursuant to an express written contract between the insurer and the provider of health care.] The interest must be calculated from 30 calendar days after the date on which the claim is approved until the claim is paid.”.

     Amend sec. 3, page 3, line 28, by deleting:

“or any part thereof,”.

     Amend sec. 3, page 3, line 29, after “20” by inserting “calendar”.

     Amend sec. 3, page 3, by deleting lines 31 through 42 and inserting:

“the specific reasons for the delay in approving or denying the claim. If additional information is requested from the provider of health care, the provider shall furnish the additional information within 20 calendar days after receiving the request. If the provider of health care fails to furnish the additional information within that period, the provider is not entitled to any interest payment to which he would otherwise be entitled for the late payment of a claim. The insurer shall approve or deny the claim within [30] 20 calendar days after receiving the additional information. If the claim is approved, the insurer shall pay the claim within [30] 20 calendar days after it receives the additional information. If the approved claim is not paid within that period, the insurer shall pay interest on the claim in the manner prescribed in subsection 1[.] , except that the interest must be calculated from 20 calendar days after the date on which the additional information is received until the claim is paid.”.

     Amend sec. 3, page 3, lines 48 and 49, by deleting:

“[part]a portion of a claim or part thereof” and inserting:

“part of a claim”.

     Amend sec. 4, page 4, by deleting lines 6 through 18 and inserting:

“purchasing group shall approve or deny a claim relating to a policy of health insurance within 30 calendar days after the carrier receives the claim. If the claim is approved, the carrier shall pay the claim within 30 calendar days after it is approved. If the approved claim is not paid within that period, the carrier shall pay interest on the claim at the rate of interest established pursuant to NRS 99.040 . [unless a different rate of interest is established pursuant to an express written contract between the carrier and the provider of health care.] The interest must be calculated from 30 calendar days after the date on which the claim is approved until the claim is paid.”.

     Amend sec. 4, page 4, line 20, by deleting:

“or any part thereof,”.

     Amend sec. 4, page 4, line 21, after “20” by inserting “calendar”.

     Amend sec. 4, page 4, by deleting lines 23 through 34 and inserting:

“specific reasons for the delay in approving or denying the claim. If additional information is requested from the provider of health care, the provider shall furnish the additional information within 20 calendar days after receiving the request. If the provider of health care fails to furnish the additional information within that period, the provider is not entitled to any interest payment to which he would otherwise be entitled for the late payment of a claim. The carrier shall approve or deny the claim within [30] 20 calendar days after receiving the additional information. If the claim is approved, the carrier shall pay the claim within [30] 20 calendar days after it receives the additional information. If the approved claim is not paid within that period, the carrier shall pay interest on the claim in the manner prescribed in subsection 1[.] , except that the interest must be calculated from 20 calendar days after the date on which the additional information is received until the claim is paid.”.

     Amend sec. 4, page 4, lines 40 and 41, by deleting:

“[part]a portion of a claim or part thereof” and inserting:

“part of a claim”.

     Amend sec. 5, pages 4 and 5, by deleting lines 46 through 49 on page 4 and lines 1 through 9 on page 5, and inserting:

“shall approve or deny a claim relating to a certificate of health insurance within 30 calendar days after the society receives the claim. If the claim is approved, the society shall pay the claim within 30 calendar days after it is approved. If the approved claim is not paid within that period, the society shall pay interest on the claim at the rate of interest established pursuant to NRS 99.040 . [unless a different rate of interest is established pursuant to an express written contract between the society and the provider of health care.] The interest must be calculated from 30 calendar days after the date on which the claim is approved until the claim is paid.”.

     Amend sec. 5, page 5, line 11, by deleting:

“or any part thereof,”.

     Amend sec. 5, page 5, line 12, after “20” by inserting “calendar”.

     Amend sec. 5, page 5, by deleting lines 14 through 25 and inserting:

“the specific reasons for the delay in approving or denying the claim. If additional information is requested from the provider of health care, the provider shall furnish the additional information within 20 calendar days after receiving the request. If the provider of health care fails to furnish the additional information within that period, the provider is not entitled to any interest payment to which he would otherwise be entitled for the late payment of a claim. The society shall approve or deny the claim within [30] 20 calendar days after receiving the additional information. If the claim is approved, the society shall pay the claim within [30] 20 calendar days after it receives the additional information. If the approved claim is not paid within that period, the society shall pay interest on the claim in the manner prescribed in subsection 1[.] , except that the interest must be calculated from 20 calendar days after the date on which the additional information is received until the claim is paid.”.

     Amend sec. 5, page 5, lines 31 and 32, by deleting:

“[part]a portion of a claim or part thereof” and inserting:

“part of a claim”.

     Amend sec. 6, pages 5 and 6, by deleting lines 38 through 48 on page 5 and lines 1 and 2 on page 6, and inserting:

“claim relating to a contract for dental, hospital or medical services within 30 calendar days after the corporation receives the claim. If the claim is approved, the corporation shall pay the claim within 30 calendar days after it is approved. If the approved claim is not paid within that period, the corporation shall pay interest on the claim at the rate of interest established pursuant to NRS 99.040 . [unless a different rate of interest is established pursuant to an express written contract between the corporation and the provider of health care.] The interest must be calculated from 30 calendar days after the date on which the claim is approved until the claim is paid.”.

     Amend sec. 6, page 6, line 4, by deleting:

“or any part thereof,”.

     Amend sec. 6, page 6, line 5, after “20” by inserting “calendar”.

     Amend sec. 6, page 6, by deleting lines 8 through 19 and inserting:

“in approving or denying the claim. If additional information is requested from the provider of dental, hospital or medical services, the provider shall furnish the additional information within 20 calendar days after receiving the request. If the provider of dental, hospital or medical services fails to furnish the additional information within that period, the provider is not entitled to any interest payment to which he would otherwise be entitled for the late payment of a claim. The corporation shall approve or deny the claim within [30] 20 calendar days after receiving the additional information. If the claim is approved, the corporation shall pay the claim within [30] 20 calendar days after it receives the additional information. If the approved claim is not paid within that period, the corporation shall pay interest on the claim in the manner prescribed in subsection 1[.] , except that the interest must be calculated from 20 calendar days after the date on which the additional information is received until the claim is paid.”.

     Amend sec. 6, page 6, lines 25 and 26, by deleting:

“[part]a portion of a claim or part thereof” and inserting:

“part of a claim”.

     Amend sec. 7, page 6, by deleting lines 31 through 44 and inserting:

“maintenance organization shall approve or deny a claim relating to a health care plan within 30 calendar days after the health maintenance organization receives the claim. If the claim is approved, the health maintenance organization shall pay the claim within 30 calendar days after it is approved. If the approved claim is not paid within that period, the health maintenance organization shall pay interest on the claim at the rate of interest established pursuant to NRS 99.040 . [unless a different rate of interest is established pursuant to an express written contract between the corporation and the provider of health care.] The interest must be calculated from 30 calendar days after the date on which the claim is approved until the claim is paid.”.

     Amend sec. 7, page 6, lines 46 and 47, by deleting:

“or any part thereof,”.

     Amend sec. 7, page 6, line 48, after “20” by inserting “calendar”.

     Amend sec. 7, page 7, line 1,by deleting “claim” and inserting “claim.”.

     Amend sec. 7, page 7, by deleting lines 2 through 14 and inserting:

“If additional information is requested from the provider of health care services, the provider shall furnish the additional information within 20 calendar days after receiving the request. If the provider of health care services fails to furnish the additional information within that period, the provider is not entitled to any interest payment to which he would otherwise be entitled for the late payment of a claim. The health maintenance organization shall approve or deny the claim within [30] 20 calendar days after receiving the additional information. If the claim is approved, the health maintenance organization shall pay the claim within [30] 20 calendar days after it receives the additional information. If the approved claim is not paid within that period, the health maintenance organization shall pay interest on the claim in the manner prescribed in subsection 1[.] , except that the interest must be calculated from 20 calendar days after the date on which the additional information is received until the claim is paid.”.

     Amend sec. 7, page 7, lines 21 and 22, by deleting:

“[part]a portion of a claim or part thereof” and inserting:

“part of a claim”.

     Amend the bill as a whole by renumbering sec. 8 as sec. 9 and adding a new section designated sec. 8, following sec.7, to read as follows:

     “Sec. 8.  The amendatory provisions of this act apply only to contracts entered into, amended, extended or renewed after the effective date of this act.”.