exempt

                                                                                                  

 

Senate Bill No. 573–Committee on Finance

 

May 16, 2001

____________

 

Referred to Committee on Finance

 

SUMMARY—Transfers office for hospital patients from department of business and industry to office of governor. (BDR 18‑1545)

 

FISCAL NOTE:    Effect on Local Government: No.

                                 Effect on the State: No.

 

~

 

EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted.

 

AN ACT relating to the office of the governor; transferring the office for hospital patients from the department of business and industry to the office of the governor; creating the bureau for hospital patients within the office for consumer health assistance in the office of the governor; and providing other matters properly relating thereto.

 

THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN

SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:

 

1-1    Section 1. Chapter 223 of NRS is hereby amended by adding thereto a

1-2  new section to read as follows:

1-3    1.  The bureau for hospital patients is hereby created within the office

1-4  for consumer health assistance in the office of the governor.

1-5    2.  The director:

1-6    (a) Is responsible for the operation of the bureau, which must be

1-7  easily accessible to the clientele of the bureau.

1-8    (b) Shall appoint and supervise such additional employees as are

1-9  necessary to carry out the duties of the bureau. The employees of the

1-10  bureau are in the unclassified service of the state.

1-11    (c) Shall submit a written report quarterly to the governor and the

1-12  legislative committee on health care concerning the activities of the

1-13  bureau, including, without limitation, the number of complaints received

1-14  by the bureau, the number and type of disputes heard, mediated,

1-15  arbitrated or resolved through alternative means of dispute resolution by

1-16  the director and the outcome of the mediation, arbitration or alternative

1-17  means of dispute resolution.

1-18    3.  The director may, upon request made by either party, hear,

1-19  mediate, arbitrate or resolve by alternative means of dispute resolution

1-20  disputes between patients and hospitals. The director may decline to hear

1-21  a case that in his opinion is trivial, without merit or beyond the scope of

2-1  his jurisdiction. The director may hear, mediate, arbitrate or resolve

2-2  through alternative means of dispute resolution disputes regarding:

2-3    (a) The accuracy or amount of charges billed to a patient;

2-4    (b) The reasonableness of arrangements made pursuant to

2-5  paragraph (c) of subsection 1 of NRS 439B.260; and

2-6    (c) Such other matters related to the charges for care provided to a

2-7  patient as the director determines appropriate for arbitration, mediation

2-8  or other alternative means of dispute resolution.

2-9    4.  The decision of the director is a final decision for the purpose of

2-10  judicial review.

2-11    5.  Each hospital, other than federal and state hospitals, with 49 or

2-12  more licensed or approved hospital beds shall pay an annual assessment

2-13  for the support of the bureau. On or before July 15 of each year, the

2-14  director shall notify each hospital of its assessment for the fiscal year.

2-15  Payment of the assessment is due on or before September 15. Late

2-16  payments bear interest at the rate of 1 percent per month or fraction

2-17  thereof.

2-18    6.  The total amount assessed pursuant to subsection 5 for a fiscal

2-19  year must be $100,000 adjusted by the percentage change between

2-20  January 1, 1991, and January 1 of the year in which the fees are

2-21  assessed, in the Consumer Price Index (All Items) published by the

2-22  United States Department of Labor.

2-23    7.  The total amount assessed must be divided by the total number of

2-24  patient days of care provided in the previous calendar year by the

2-25  hospitals subject to the assessment. For each hospital, the assessment

2-26  must be the result of this calculation multiplied by its number of patient

2-27  days of care for the preceding calendar year.

2-28    Sec. 2.  NRS 223.500 is hereby amended to read as follows:

2-29    223.500  As used in NRS 223.500 to 223.580, inclusive, and section 1

2-30  of this act, unless the context otherwise requires, the words and terms

2-31  defined in NRS 223.510, 223.520 and 223.530 have the meanings ascribed

2-32  to them in those sections.

2-33    Sec. 3.  NRS 223.540 is hereby amended to read as follows:

2-34    223.540  The provisions of NRS 223.085 do not apply to the provisions

2-35  of NRS 223.500 to 223.580, inclusive[.] , and section 1 of this act.

2-36    Sec. 4.  NRS 223.550 is hereby amended to read as follows:

2-37    223.550  1.  The office for consumer health assistance is hereby

2-38  established in the office of the governor. The governor shall appoint the

2-39  director. The director must:

2-40    (a) Be:

2-41      (1) A physician, as that term is defined in NRS 0.040;

2-42      (2) A registered nurse, as that term is defined in NRS 632.019;

2-43      (3) An advanced practitioner of nursing, as that term is defined in

2-44  NRS 453.023; or

2-45      (4) A physician’s assistant, as that term is defined in NRS 630.015;

2-46  and

2-47    (b) Have expertise and experience in the field of advocacy.

2-48    2.  The cost of carrying out the provisions of NRS 223.500 to 223.580,

2-49  inclusive, and section 1 of this act must be paid as follows:

3-1    (a) That portion of the cost related to providing assistance to consumers

3-2  and injured employees concerning workers’ compensation must be paid

3-3  from the assessments levied pursuant to NRS 232.680.

3-4    (b) That portion of the cost related to the operation of the bureau for

3-5  hospital patients created pursuant to section 1 of this act must be paid

3-6  from the assessments levied pursuant to that section.

3-7    (c) The remaining cost must be provided by direct legislative

3-8  appropriation from the state general fund and be paid out on claims as

3-9  other claims against the state are paid.

3-10    Sec. 5.  NRS 223.570 is hereby amended to read as follows:

3-11    223.570  1.  The director may:

3-12    (a) Within the limits of available money, employ:

3-13      (1) Such persons in the unclassified service of the state as he

3-14  determines to be necessary to carry out the provisions of NRS [223.500 to

3-15  223.580, inclusive,] 223.560 and 223.580 and this section, including,

3-16  without limitation, a provider of health care, as that term is defined in NRS

3-17  449.581.

3-18      (2) Such additional personnel as may be required to carry out the

3-19  provisions of NRS [223.500 to 223.580, inclusive,] 223.560 and 223.580

3-20  and this section, who must be in the classified service of the

3-21  state.

3-22  A person employed pursuant to the authority set forth in this subsection

3-23  must be qualified by training and experience to perform the duties for

3-24  which the director employs him.

3-25    (b) To the extent not otherwise prohibited by law, obtain such

3-26  information from consumers, injured employees, health care plans and

3-27  policies of industrial insurance as he determines to be necessary to carry

3-28  out the provisions of NRS [223.500 to 223.580, inclusive.] 223.560 and

3-29  223.580 and this section.

3-30    (c) Adopt such regulations as he determines to be necessary to carry out

3-31  the provisions of NRS [223.500 to 223.580, inclusive.] 223.560 and

3-32  223.580 and this section.

3-33    2.  The director and his employees shall not have any conflict of

3-34  interest relating to the performance of their duties pursuant to NRS

3-35  [223.500 to 223.580, inclusive.] 223.560 and 223.580 and this section. For

3-36  the purposes of this subsection, a conflict of interest shall be deemed to

3-37  exist if the director or employee, or any person affiliated with the director

3-38  or employee:

3-39    (a) Has direct involvement in the licensing, certification or accreditation

3-40  of a health care facility, insurer or provider of health care;

3-41    (b) Has a direct ownership interest or investment interest in a health

3-42  care facility, insurer or provider of health care;

3-43    (c) Is employed by, or participating in, the management of a health care

3-44  facility, insurer or provider of health care; or

3-45    (d) Receives or has the right to receive, directly or indirectly,

3-46  remuneration pursuant to any arrangement for compensation with a health

3-47  care facility, insurer or provider of health care.

 

 

4-1    Sec. 6.  NRS 439B.260 is hereby amended to read as follows:

4-2    439B.260  1.  A major hospital shall reduce or discount the total billed

4-3  charge by at least 30 percent for hospital services provided to an inpatient

4-4  who:

4-5    (a) Has no insurance or other contractual provision for the payment of

4-6  the charge by a third party;

4-7    (b) Is not eligible for coverage by a state or federal program of public

4-8  assistance that would provide for the payment of the charge; and

4-9    (c) Makes reasonable arrangements within 30 days after discharge to

4-10  pay his hospital bill.

4-11    2.  A major hospital or patient who disputes the reasonableness of

4-12  arrangements made pursuant to paragraph (c) of subsection 1 may submit

4-13  the dispute to the [office] bureau for hospital patients for resolution as

4-14  provided in [NRS 232.543.] section 1 of this act.

4-15    3.  A major hospital shall reduce or discount the total billed charge of

4-16  its outpatient pharmacy by at least 30 percent to a patient who is eligible

4-17  for Medicare.

4-18    Sec. 7.  NRS 232.543 is hereby repealed.

4-19    Sec. 8.  This act becomes effective on July 1, 2001.

 

4-20  TEXT OF REPEALED SECTION

 

4-21    232.543 Office for hospital patients: Creation within consumer

4-22   affairs division; appointment, classification, powers and duties of

4-23   administrator; annual assessment of hospitals.

4-24    1.  There is hereby created within the consumer affairs division of the

4-25   department an office for hospital patients.

4-26    2.  The administrator of the office:

4-27    (a) Is responsible for the operation of the office, which must be easily

4-28   accessible to the clientele of the office.

4-29    (b) Must be appointed by the director.

4-30    (c) Is in the unclassified service of the state.

4-31    (d) Shall appoint and supervise such additional employees as are

4-32   necessary to carry out the duties of the office. The employees of the office

4-33   are in the classified service of the state.

4-34    (e) Shall submit a written report quarterly to the department of human

4-35   resources and the legislative committee on health care concerning the

4-36   activities of the office, including, but not limited to, the number of

4-37   complaints received by the office, the number and type of disputes heard,

4-38   mediated, arbitrated or resolved through alternative means of dispute

4-39   resolution by the administrator and the outcome of the mediation,

4-40   arbitration or alternative means of dispute resolution.

4-41    3.  The administrator of the office may, upon request made by either

4-42   party, hear, mediate, arbitrate or resolve by alternative means of dispute

4-43   resolution disputes between patients and hospitals. The administrator may

4-44   decline to hear a case which in his opinion is trivial, without merit or

5-1  beyond the scope of his jurisdiction. The administrator may hear, mediate,

5-2  arbitrate or resolve through alternative means of dispute resolution disputes

5-3   regarding:

5-4    (a) The accuracy or amount of charges billed to the patient;

5-5    (b) The reasonableness of arrangements made pursuant to paragraph (c)

5-6   of subsection 1 of NRS 439B.260; and

5-7    (c) Such other matters related to the charges for care provided to a

5-8   patient as the administrator determines appropriate for arbitration,

5-9   mediation or other alternative means of dispute resolution.

5-10    4.  The decision of the administrator is a final decision for the purpose

5-11   of judicial review.

5-12    5.  Each hospital, other than federal and state hospitals, with 49 or more

5-13   licensed or approved hospital beds shall pay an annual assessment for the

5-14   support of the office. On or before July 15 of each year, the director of the

5-15   department of human resources shall notify each hospital of its assessment

5-16   for the fiscal year. Payment of the assessment is due on or before

5-17   September 15. Late payments bear interest at the rate of 1 percent per

5-18   month or fraction thereof.

5-19    6.  The total amount assessed pursuant to subsection 5 for a fiscal year

5-20   must be $100,000 adjusted by the percentage change between January 1,

5-21   1991, and January 1 of the year in which the fees are assessed, in the

5-22   Consumer Price Index (All Items) published by the United States

5-23   Department of Labor.

5-24    7.  The total amount assessed must be divided by the total number of

5-25   patient days of care provided in the previous calendar year by the hospitals

5-26   subject to the assessment. For each hospital, the assessment must be the

5-27   result of this calculation multiplied by its number of patient days of care

5-28   for the preceding calendar year.

 

5-29  H