SUMMARY--Requires state plan for assistance to medically indigent to allow eligible person to choose whether to enroll in health care plan that provides services through primary care case management. (BDR 38-939)
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 public welfare; requiring the state plan for assistance to the medically indigent to offer at least one health care plan that does not provide health care services through primary care case management; requiring the state plan to allow eligible persons to choose whether to enroll in a health care plan that provides health care services through primary care case management; 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 422 of NRS is hereby amended by adding thereto the provisions set forth as sections 2 to 5, inclusive, of this act.
Sec. 2 "Health care plan" means an arrangement whereby a person undertakes to provide, arrange for, pay for or reimburse part of the cost of any health care services for another person.
Sec. 3 "Primary care case management" means a method for providing health care services in which the welfare division contracts with an organization that employs or contracts with primary care physicians who are paid on a capitated basis to provide health care services to recipients of Medicaid.
Sec. 4 "Primary care physician" means a physician who:
1. Provides initial and primary health care services to an insured;
2. Maintains the continuity of care for the insured; and
3. Refers the insured to a specialized provider of health care.
Sec. 5 If the state plan for assistance to the medically indigent offers a health care plan that provides health care services through primary care case management, the state plan must:
1. Offer at least one other health care plan which does not provide health care services through primary care case management; and
2. Allow each person who is eligible to enroll in a health care plan under the state plan to choose whether to enroll in the health care plan which provides health care services through primary care case management.
Sec. 6 NRS 422.001 is hereby amended to read as follows:
422.001As used in this chapter, unless the context otherwise requires, the words and terms defined in NRS 422.005 to 422.055, inclusive, and sections 2, 3 and 4 of this act, have the meanings ascribed to them in those sections.
Sec. 7 The provisions of subsection 1 of NRS 354.599 do not apply to any additional expenses of a local government that are related to the provisions of this act.