ASSEMBLY ACTION Initial and Date |SENATE ACTION Initial and Date
Adopted Lost | Adopted Lost
Concurred In Not |Concurred In Not
Receded Not | Receded Not
Amend the bill as a whole by deleting sections 2 through 6 and adding new sections designated sections 2 through 6, following section 1, to read as follows:
“Sec. 2. Chapter 616B of NRS is hereby amended by adding thereto the provisions set forth as sections 3 and 4 of this act.
Sec. 3. 1. A self-insured employer, an association of self-insured public or private employers or a private carrier shall not enter into a contract with an organization for managed care unless the organization’s proposed plan for providing medical and health care services ensures that, if medical or health care services are to be provided by the organization, an employee who is injured in the county in which he is employed may choose the services of any provider of health care located in that county or an adjacent county if the employee’s place of employment is not within a 20-mile radius of a provider of health care who has contracted with the organization to participate in the plan and provide the services required by the employee. If those services are not available, the injured employee may choose the services of any provider of health care located in this state.
2. The fees charged by a provider of health care chosen by an injured employee pursuant to this section may not exceed the fees established in accordance with NRS 616C.260 or the usual fee charged by that provider, whichever is less.
Sec. 4. 1. A self-insured employer, an association of self-insured public or private employers or a private carrier shall not enter into a contract with an organization for managed care unless the organization’s proposed plan for providing medical and health care services:
(a) Will provide all medical and health care services that may be required for industrial injuries and occupational diseases that are compensable under chapters 616A to 617, inclusive, of NRS in a manner that ensures the availability and accessibility of adequate treatment to injured employees;
(b) Provides to injured employees an adequate choice of providers of health care who have contracted with the organization to participate in the proposed plan; and
(c) Provides appropriate financial incentives to reduce costs of medical and health care services without affecting the quality of any care provided to an injured employee.
2. The Division may adopt regulations to ensure the adequacy of an insurer’s panel of providers of health care established pursuant to subsection 1.
Sec. 5. NRS 616B.003 is hereby amended to read as follows:
616B.003 1. The Administrator shall cause to be conducted at least every [3] 5 years an audit of all insurers who provide benefits to injured employees pursuant to chapters 616A to 616D, inclusive, or chapter 617 of NRS. The Administrator shall cause to be conducted each year on a random basis additional partial audits of any insurer who has a history of violations of the provisions of chapters 616A to 616D, inclusive, or chapter 617 of NRS, or the regulations adopted pursuant thereto, as determined by the Administrator.
2. The Administrator shall require the use of standard auditing procedures and shall establish a manual to describe the standard auditing procedures. The manual must include:
(a) Specific audit objectives;
(b) Standards for documentation;
(c) Policies for supervisory review;
(d) Policies for the training of auditors;
(e) The format for the audit report; and
(f) Procedures for the presentation, distribution and retention of the audit report.
3. The Commissioner and the Administrator shall establish a procedure for sharing information between the Division of Insurance of the Department of Business and Industry and the Division concerning the qualifications of employers as self-insured employers pursuant to NRS 616B.300 or as an association of self-insured public or private employers pursuant to NRS 616B.353.
4. On or before March 1 of each year, the Administrator shall make a report of each audit to the Legislature, if it is in session, or to the Interim Finance Committee if the Legislature is not in session.
Sec. 6. NRS 616B.527 is hereby amended to read as follows:
616B.527 1. A self-insured employer, an association of self-insured public or private employers or a private carrier may:
(a) [Enter] Except as otherwise provided in sections 3 and 4 of this act, enter into a contract or contracts with one or more organizations for managed care to provide comprehensive medical and health care services to employees for injuries and diseases that are compensable pursuant to chapters 616A to 617, inclusive, of NRS.
(b) Enter into a contract or contracts with providers of health care, including, without limitation, physicians who provide primary care, specialists, pharmacies, physical therapists, radiologists, nurses, diagnostic facilities, laboratories, hospitals and facilities that provide treatment to outpatients, to provide medical and health care services to employees for injuries and diseases that are compensable pursuant to chapters 616A to 617, inclusive, of NRS.
(c) Require employees to obtain medical and health care services for their industrial injuries from those organizations and persons with whom the self-insured employer, association or private carrier has contracted pursuant to paragraphs (a) and (b), or as the self-insured employer, association or private carrier otherwise prescribes.
(d) Except as otherwise provided in subsection 3 of NRS 616C.090, require employees to obtain the approval of the self-insured employer, association or private carrier before obtaining medical and health care services for their industrial injuries from a provider of health care who has not been previously approved by the self-insured employer, association or private carrier.
2. An organization for managed care with whom a self-insured employer, association of self-insured public or private employers or a private carrier has contracted pursuant to this section shall comply with the provisions of NRS 616B.528, 616B.5285 and 616B.529.”.
Amend the bill as a whole by deleting sec. 8 and renumbering sections 9 through 13 as sections 8 through 12.
Amend sec. 11, page 11, by deleting lines 25 and 26 and inserting:
“pursuant to subsection 3 of NRS 616C.090.”.
Amend sec. 11, page 11, by deleting lines 31 and 32 and inserting:
“employer makes such an offer, the employer shall confirm the offer in writing within 10 days after making the offer. The making”.
Amend sec. 11, page 11, line 34, after “not” by inserting:
“affect the eligibility of the employee to receive compensation or vocational rehabilitation services and does not”.
Amend sec. 11, page 11, by deleting lines 39 and 40 and inserting:
“temporary, light-duty employment made by the employer must”.
Amend sec. 11, page 12, line 7, after “and” by inserting “employment”.
Amend sec. 12, page 13, line 5, by deleting “and” and inserting “[and]”.
Amend sec. 12, page 13, line 7, by deleting “insurer.” and inserting:
“insurer [.] ; and
(c) His right to receive a benefit penalty in accordance with NRS 616D.120.”.
Amend sec. 12, page 13, by deleting lines 12 through 14 and inserting:
“made and his election becomes final.”.
Amend sec. 13, page 14, line 6, after “and” by inserting “employment”.
Amend the bill as a whole by adding a new section designated sec. 13, following sec. 13, to read as follows:
“Sec. 13. Chapter 616D is hereby amended by adding thereto a new section to read as follows:
1. If a person wishes to contest a decision of the Administrator to impose or refuse to impose an administrative fine pursuant to this chapter or chapter 616A, 616B, 616C or 617 of NRS, he must file a notice of appeal with the district court in accordance with this section. The notice of appeal must set forth the reasons the proposed administrative fine should or should not be imposed.
2. A person who is aggrieved by:
(a) A written determination of the Administrator; or
(b) The failure of the Administrator to respond within 70 days to a written request mailed to the Administrator by the person who is aggrieved,
FLUSH
may appeal from the
determination or failure to respond by filing a request for a hearing before
the district court. The request must be filed within 30 days after the date on
which the notice of the Administrator’s determination was mailed by the
Administrator or within 100 days after the date on which the unanswered written
request was mailed to the Administrator, as applicable. The failure of the
Administrator to respond to a written request for a determination within 70
days after receipt of the request shall be deemed by the district court to be a
denial of the request.
3. If a notice of appeal is not filed as required by this section, the imposition of or refusal to impose the administrative fine shall be deemed a final order and is not subject to review by any court or agency.
4. An administrative fine imposed pursuant to this chapter or chapter 616A, 616B, 616C or 617 of NRS must be paid to the Division. If the violation for which the fine is levied was committed by a person while acting within the course and scope of his agency or employment, the fine must be paid by his principal or employer. The fine may be recovered in a civil action brought in the name of the Division in a court of competent jurisdiction in the county in which the violation occurred or in which the person against whom the fine is levied has his principal place of business.”.
Amend sec. 14, page 15, by deleting line 16 and inserting:
“[(2) Persuaded]
(b) Without justification, persuaded a claimant to [settle] :”.
Amend sec. 14, page 15, line 28, after “compensation” by inserting:
“or other relief”.
Amend sec. 14, page 15, by deleting lines 32 and 33 and inserting:
“of NRS, if the refusal or delay occurs:”.
Amend sec. 14, page 16, by deleting lines 10 through 15 and inserting:
“NRS 616C.165; or
[(g)] (h) Intentionally failed to comply with any provision of, or”.
Amend sec. 15, page 19, line 10, by deleting “120” and inserting “[120] 90”.
Amend sec. 16, page 19, by deleting lines 20 through 22 and inserting:
“Administrator to impose [an administrative fine] or refuse to impose a benefit penalty pursuant to [this chapter or chapter 616A, 616B, 616C or 617 of NRS,] NRS 616D.120, he must file a notice of appeal with [the”.
Amend sec. 16, page 19, line 26, by deleting “fine or” and inserting “[fine or]”.
Amend sec. 16, page 19, line 35, by deleting “30” and inserting “70”.
Amend sec. 16, page 19, line 40, by deleting “70” and inserting “30”.
Amend sec. 16, page 19, line 42, after “or” by inserting:
“within 100 days after the date on which”.
Amend sec. 16, page 19, line 44, by deleting “30” and inserting “70”.
Amend sec. 16, page 20, line 4, by deleting “fine or” and inserting “[fine or]”.
Amend sec. 16, page 20, by deleting lines 18 through 26 and inserting:
“5. [An administrative fine imposed pursuant to this chapter or chapter 616A, 616B, 616C or 617 of NRS must be paid to the Division. If the violation for which the fine is levied was committed by a person while acting within the course and scope of his agency or employment, the fine must be paid by his principal or employer. The fine may be recovered in a civil action brought in the name of the Division in a court of competent jurisdiction in the county in which the violation occurred or in which the person against whom the fine is levied has his principal place of business.”.
Amend sec. 16, page 20, line 27, by deleting “6.” and inserting “6.]”.
Amend sec. 16, page 20, line 35, by deleting “7.” and inserting “[7.] 6.”.
Amend the bill as a whole by deleting sections 17 and 18 and adding a new section designated sec. 17, and the text of the repealed section, following sec. 16, to read as follows:
“Sec. 17. NRS 616D.280 is hereby repealed.
TEXT OF REPEALED SECTION
616D.280 Injury to employee caused by absence of safety device.
1. If any workman is injured because of the absence of any safeguard or protection required to be provided or maintained by, or pursuant to, any statute, ordinance, or any divisional regulation under any statute, the employer is liable to the Division for a penalty of not less than $300 nor more than $2,000, to be collected in a civil action at law by the Division.
2. The provisions of subsection 1 do not apply if the absence of the safeguard or protection is due to the removal thereof by the injured workman himself, or with his knowledge by any fellow workman, unless the removal is by order or direction of the employer or superintendent or foreman of the employer.
3. If the safeguard or protection is removed by the workman himself, or with his consent is removed by any of his fellow workmen, unless done by order or direction of the employer or superintendent or foreman of the employer, the compensation of the injured workman, as provided for by NRS 616C.405, 616C.425, 616C.435, 616C.440, 616C.445 and 616C.475 to 616C.505, inclusive, must be reduced 25 percent.”.
Amend the title of the bill to read as follows:
“AN ACT relating to industrial insurance; prohibiting a self-insured employer, an association of self-insured public or private employers or a private carrier from entering into a contract with an organization for managed care under certain circumstances; increasing the period during which the Administrator of the Division of Industrial Relations of the Department of Business and Industry must cause an audit of certain insurers to be conducted; revising the requirements for determining the percentage of disability for certain injuries and occupational diseases; requiring an employer who offers temporary, light-duty employment to an injured employee to confirm the offer within a certain period under certain circumstances; providing that such an offer must specify a position that has the same seniority and employment benefits as the position of the employee at the time of his injury; requiring a person who wishes to contest a decision of the Administrator to impose or refuse to impose an administrative fine to file a notice of appeal in the district court; authorizing a person who is aggrieved by a written determination of the Administrator or the failure of the Administrator to respond to a written request to appeal the determination or failure to respond to an appeals officer under certain circumstances; and providing other matters properly relating thereto.”.