695F.170 - Procedure for modification of rates, charges, benefits, organization, operations, documents or services. - Nevada Statutes

695F.170  Procedure for modification of rates, charges, benefits, organization, operations, documents or services.

      1.  A prepaid limited health service organization shall file with the Commissioner a notice of any change in the rates, charges, benefits or any material change of any matter or document furnished pursuant to NRS 695F.110. The organization shall submit any proof necessary to justify the change. No such change is effective unless it is approved by the Commissioner. If the Commissioner does not disapprove of the change within 60 days after the notice is filed, the change shall be deemed approved.

      2.  If a prepaid limited health service organization wishes to add a limited health service, it shall submit:

      (a) An application to the Commissioner;

      (b) The information required by NRS 695F.110, if the information is different from the information filed with the prepaid limited health service organization’s application; and

      (c) Proof of compliance with NRS 695F.200, 695F.220 and 695F.340.

Ê A prepaid limited health service organization may not add a limited health service if the Commissioner determines that adding the service would qualify the organization as a health maintenance organization pursuant to chapter 695C of NRS or as an offeror of a health care plan for which a certificate of authority is required by any other provisions of this title.

      3.  If the Commissioner does not deny the application within 60 days after it is filed, the application shall be deemed approved.

      4.  If the application is denied, the Commissioner shall send a written notice to the prepaid limited health service organization. The notice must include the reason for the denial. The prepaid limited health service organization may request a hearing in the manner set forth in NRS 695F.140.

      (Added to NRS by 1991, 1116; A 1993, 2402)