695G.130 - Report regarding methods for reviewing quality of health care services: Requirements; availability for public inspection. - Nevada Statutes

695G.130  Report regarding methods for reviewing quality of health care services: Requirements; availability for public inspection.

      1.  In addition to any other report which is required to be filed with the Commissioner or the State Board of Health, each managed care organization shall file with the Commissioner and the State Board of Health, on or before March 1 of each year, a report regarding its methods for reviewing the quality of health care services provided to its insureds.

      2.  Each managed care organization shall include in its report the criteria, data, benchmarks or studies used to:

      (a) Assess the nature, scope, quality and accessibility of health care services provided to insureds; or

      (b) Determine any reduction or modification of the provision of health care services to insureds.

      3.  Except as already required to be filed with the Commissioner or the State Board of Health, if the managed care organization is not owned and operated by a public entity and has more than 100 insureds, the report filed pursuant to subsection 1 must include:

      (a) A copy of all of its quarterly and annual financial reports;

      (b) A statement of any financial interest it has in any other business which is related to health care that is greater than 5 percent of that business or $5,000, whichever is less; and

      (c) A description of each complaint filed with or against it that resulted in arbitration, a lawsuit or other legal proceeding, unless disclosure is prohibited by law or a court order.

      4.  A report filed pursuant to this section must be made available for public inspection within a reasonable time after it is received by the Commissioner.

      (Added to NRS by 1997, 305; A 1997, 3041)

      NRS 695G.140  Responsibility for money in fiduciary relationship to insured.  Any person who receives, collects, disburses or invests money for a managed care organization is responsible for such money in a fiduciary relationship to the insured.

      (Added to NRS by 1997, 305)