Section 687B.782 - Change to network plan resulting in failure to meet standards or requirements: Submission of corrective action plan by carrier; requirement to ensure covered persons receive covered services; exception1. A carrier shall, within 60 days after the effective date of a change to a network plan that results in the network plan failing to meet the standards adopted by reference in section 9 of this regulation or any other requirement of sections 2 to 18, inclusive, of this regulation, submit to the Commissioner for approval a written corrective action plan to bring the network plan into compliance with those standards and requirements.2. Except as otherwise provided in subsection 3, during the period in which the network plan does not meet the standards adopted by reference in section 9 of this regulation or any other requirement of sections 2 to 18, inclusive, of this regulation, the carrier shall, at no greater cost to the covered person: (a) Ensure that each covered person affected by the change may obtain any covered service from a qualified provider of health care who is: (1) Within the network plan; or (2) Not within the network plan by entering into an agreement with the nonparticipating provider of health care pursuant to NRS 695G.164; or (b) Make other arrangements approved by the Commissioner to ensure that each covered person affected by the change is able to obtain the covered service. 3. The provisions of subsection 2 do not apply to services received from a nonparticipating provider of health care without the prior authorization of the carrier unless the services received are medically necessary emergency services, as defined in subsection 3 of NRS NRS 695G.170.Nev. Admin. Code § 687B.782
Added to NAC by Comm'r of Insurance, by R049-14, eff. 4/4/2016NRS 679B.130, 687B.490, as amended by section 28 of Assembly Bill No. 292, chapter 153, Statutes of Nevada 2015, at page 636