Assembly Bill No. 277–Assemblymen Collins, Gibbons, Anderson, Conklin, Giunchigliani, Grady, Hardy, Koivisto, McClain, Mortenson, Parks, Pierce and Williams (by request)

 

March 11, 2003

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Referred to Committee on Commerce and Labor

 

SUMMARY—Prohibits self-insured employer, association of self-insured public or private employers or private carrier from entering into contract with organization for managed care to provide medical and health care services to injured employees under certain circumstances. (BDR 53‑792)

 

FISCAL NOTE:  Effect on Local Government: No.

                           Effect on the State: No.

 

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

 

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 to provide medical and health care services to injured employees under certain circumstances; 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. NRS 616B.527 is hereby amended to read as

1-2  follows:

1-3  616B.527  1.  [A] Except as otherwise provided in subsection

1-4  3, a self-insured employer, an association of self-insured public or

1-5  private employers or a private carrier may:

1-6  (a) Enter into a contract or contracts with one or more

1-7  organizations for managed care to provide comprehensive medical

1-8  and health care services to employees for injuries and diseases that

2-1  are compensable pursuant to chapters 616A to 617, inclusive, of

2-2  NRS.

2-3  (b) Enter into a contract or contracts with providers of health

2-4  care, including, without limitation, physicians who provide primary

2-5  care, specialists, pharmacies, physical therapists, radiologists,

2-6  nurses, diagnostic facilities, laboratories, hospitals and facilities that

2-7  provide treatment to outpatients, to provide medical and health care

2-8  services to employees for injuries and diseases that are compensable

2-9  pursuant to chapters 616A to 617, inclusive, of NRS.

2-10      (c) Require employees to obtain medical and health care

2-11  services for their industrial injuries from those organizations and

2-12  persons with whom the self-insured employer, association or private

2-13  carrier has contracted pursuant to paragraphs (a) and (b), or as the

2-14  self-insured employer, association or private carrier otherwise

2-15  prescribes.

2-16      (d) Except as otherwise provided in subsection 3 of NRS

2-17  616C.090, require employees to obtain the approval of the self-

2-18  insured employer, association or private carrier before obtaining

2-19  medical and health care services for their industrial injuries from a

2-20  provider of health care who has not been previously approved by the

2-21  self-insured employer, association or private carrier.

2-22      2.  An organization for managed care with whom a self-insured

2-23  employer, an association of self-insured public or private employers

2-24  or a private carrier has contracted pursuant to this section shall

2-25  comply with the provisions of NRS 616B.528, 616B.5285 and

2-26  616B.529.

2-27      3.  A self-insured employer, an association of self-insured

2-28  public or private employers or a private carrier shall not enter into

2-29  a contract with an organization for managed care pursuant to this

2-30  section unless the organization’s proposed plan for providing

2-31  medical and health care services ensures that, if medical and

2-32  health care services will be provided by the organization:

2-33      (a) In a county whose population is 100,000 or more, an

2-34  injured employee residing or employed in that county may choose

2-35  the services of any provider of health care located in that county

2-36  or an adjacent county if the employee’s residence is not within a

2-37  20-mile radius of a provider of health care who has contracted

2-38  with the organization to participate in the plan and provide the

2-39  services required by the employee.

2-40      (b) In a county whose population is less than 100,000, an

2-41  injured employee residing or employed in that county may choose

2-42  the services of any provider of health care located in that county

2-43  or an adjacent county if the services are available. If the services

2-44  are not available, the injured employee may choose the services of

2-45  any provider of health care located in this state.

3-1  4.  The fees charged by a provider of health care chosen by an

3-2  injured employee pursuant to subsection 3 must not exceed the

3-3  fees established in accordance with NRS 616C.260 or the usual

3-4  fee charged by the provider of health care, whichever is less.

 

3-5  H