(REPRINTED WITH ADOPTED AMENDMENTS) SECOND REPRINT
Assembly Bill No. 30-Committee on Health and Human Services
Prefiled on January 17, 1997
____________
Referred to Committee on Health and Human Services
SUMMARY--Requires dissemination of certain information regarding health care plans. (BDR 57-997)
FISCAL NOTE: Effect on Local Government: No.
Effect on the State or on Industrial Insurance: Yes.
EXPLANATION - Matter in italics is new; matter in brackets [ ] is material to be omitted.
AN ACT relating to health care; requiring the division of insurance of the department of business and industry to disseminate certain information regarding health care plans to insureds and consumers of health care; requiring the commissioner of insurance to establish an advisory committee to assist him in certain duties; and providing other matters properly relating thereto.
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1 Chapter 679B of NRS is hereby amended by adding thereto the provisions set forth as sections 2 to 7, inclusive, of this act.
Sec. 2. As used in sections 2 to 7, inclusive, of this act, unless the context otherwise requires, the words and terms defined in sections 3, 4 and 5 of this act have the meanings ascribed to them in those sections.
Sec. 3. "Health care plan" means a policy, contract, certificate or agreement offered or issued by an insurer to provide, deliver, arrange for, pay for or reimburse any of the costs of health care services.
Sec. 4. "Insured" means a person covered by a policy of health insurance issued in this state by an insurer.
Sec. 5. "Insurer" means any insurer or organization authorized pursuant to this Title to conduct business in this state that provides or arranges for the provision of health care services, including, without limitation, an insurer that issues a policy of health insurance, an insurer that issues a policy of group health insurance, a carrier serving small employers, a fraternal benefit society, a hospital or medical service corporation, a health maintenance organization, a plan for dental care and a prepaid limited health service organization.
Sec. 6. The division shall:
1. Establish a toll-free telephone service for receiving inquiries and complaints from consumers of health care in this state concerning health care plans;
2. Provide answers to inquiries of consumers of health care concerning health care plans, or refer the consumers to the appropriate agency, department or other entity that is responsible for addressing the specific type of inquiry;
3. Refer consumers of health care to the appropriate agency, department or other entity that is responsible for addressing the specific type of complaint of the consumer;
4. Provide counseling and assistance to consumers of health care concerning health care plans;
5. Educate consumers of health care concerning health care plans in this state; and
6. Take such actions as are necessary to ensure public awareness of the existence and purpose of the services provided by the division pursuant to this section.
Sec. 7. Each insurer shall provide to each insured in a written format that clearly stands out from any surrounding text:
1. The telephone number of the toll-free telephone service which is established pursuant to section 6 of this act; and
2. The name of the division and its hours of operation, including, but not limited to, the hours of operation of the toll-free telephone service.
Sec. 8. 1. The commissioner of insurance shall establish an advisory committee consisting of:
(a) The commissioner of insurance;
(b) A representative of the state board of health;
(c) One or more insureds as defined in section 4 of this act;
(d) One or more insurers as defined in section 5 of this act;
(e) One or more providers of health care; and
(f) Any other person who would help carry out the duties of the committee.
2. The commissioner of insurance, in consultation with the advisory committee, shall:
(a) Develop, print and distribute an educational pamphlet for consumers of health care concerning health care plans;
(b) Establish criteria for reporting, pursuant to subsection 3, the nature of the complaints that are received by the division pursuant to section 6 of this act; and
(c) Determine the form and content of the report required pursuant to subsection 3.
3. The division of insurance of the department of business and industry shall, on or before January 31, 1999, prepare and submit a report to the 70th session of the Nevada legislature concerning the number and nature of complaints that are received by the division pursuant to section 6 of this act. The form and content of the report must be approved by the commissioner of insurance.
4. As used in this section, "provider of health care" means a physician, dentist, licensed nurse, dispensing optician, optometrist, practitioner of respiratory care, physical therapist, podiatric physician, licensed psychologist, licensed marriage and family therapist, chiropractor, doctor of Oriental medicine in any form, medical laboratory director or technician, or pharmacist.
Sec. 9. The division of insurance of the department of business and industry is hereby authorized to expend from the money set aside for insurance education and research pursuant to NRS 679B.305 the following sums for the establishment and operation of the toll-free telephone service required pursuant to section 6 of this act and for the development, printing and distribution of the educational pamphlet required pursuant to section 8 of this act:
For the fiscal year 1997-1998 $55,000
For the fiscal year 1998-1999 $55,000
Sec. 10. This act becomes effective on July 1, 1997.