Nev. Rev. Stat. § 616C.087

Current through 82nd (2023) Legislative Session Chapter 535 and 34th (2023) Special Session Chapter 1 and 35th (2023) Special Session Chapter 1
Section 616C.087 - Selection of physician or chiropractic physician: Legislative declaration regarding rights of injured employee; requirements for lists maintained and updated by Administrator and insurer; duties of Administrator; removal of physician or chiropractic physician from list; continuation of treatment with same physician or chiropractic physician under certain circumstances; regulations prescribing form for employer's list of physicians and chiropractic physicians
1. The Legislature hereby declares that:
(a) The choice of a treating physician or chiropractic physician is a substantive right and substantive benefit of an injured employee who has a claim under the Nevada Industrial Insurance Act or the Nevada Occupational Diseases Act.
(b) The injured employees of this State have a substantive right to an adequate choice of physicians and chiropractic physicians to treat their industrial injuries and occupational diseases.
2. Except as otherwise provided in this subsection and subsections 3 and 4:
(a) The panel maintained by the Administrator pursuant to NRS 616C.090 must not include a physician or chiropractic physician in a discipline or specialization if the physician or chiropractic physician does not accept and treat injured employees for industrial injuries or occupational diseases in that discipline or specialization; and
(b) An insurer's list of physicians and chiropractic physicians from which an injured employee may choose pursuant to NRS 616C.090 must include not less than 12 physicians or chiropractic physicians, as applicable, in each of the following disciplines and specializations, without limitation, from the panel of physicians and chiropractic physicians maintained by the Administrator pursuant to NRS 616C.090:
(1) Orthopedic surgery on spines;
(2) Orthopedic surgery on shoulders;
(3) Orthopedic surgery on elbows;
(4) Orthopedic surgery on wrists;
(5) Orthopedic surgery on hands;
(6) Orthopedic surgery on hips;
(7) Orthopedic surgery on knees;
(8) Orthopedic surgery on ankles;
(9) Orthopedic surgery on feet;
(10) Neurosurgery;
(11) Neurology;
(12) Cardiology;
(13) Pulmonology;
(14) Psychiatry;
(15) Pain management;
(16) Occupational medicine;
(17) Physiatry or physical medicine;
(18) General practice or family medicine; and
(19) Chiropractic medicine.

If the panel of physicians and chiropractic physicians maintained by the Administrator pursuant to NRS 616C.090 contains fewer than 12 physicians or chiropractic physicians, as applicable, for a discipline or specialization specifically identified in this subsection, all of the physicians or chiropractic physicians, as applicable, on the panel for that discipline or specialization must be included on the insurer's list.

3. For any other discipline or specialization not specifically identified in subsection 2, the insurer's list must include not fewer than 8 physicians or chiropractic physicians, as applicable, unless the panel of physicians and chiropractic physicians maintained by the Administrator pursuant to NRS 616C.090 contains fewer than 8 physicians or chiropractic physicians, as applicable, for that discipline or specialization, in which case all of the physicians or chiropractic physicians, as applicable, on the panel for that discipline or specialization must be included on the insurer's list.
4. For each county whose population is 100,000 or more, an insurer's list of physicians and chiropractic physicians must include for that county a number of physicians and chiropractic physicians, as applicable, that is not less than the number required pursuant to subsections 2 and 3 and that also maintain in that county:
(a) An active practice; and
(b) A physical office.
5. If an insurer fails to maintain a list of physicians and chiropractic physicians that complies with the requirements of subsections 2, 3 and 4, an injured employee may choose a physician or chiropractic physician from the panel of physicians and chiropractic physicians maintained by the Administrator pursuant to NRS 616C.090.
6. Each insurer shall, not later than October 1 of each year, update the list of physicians and chiropractic physicians and file the list with the Administrator. The list must be certified by an adjuster who is licensed pursuant to chapter 684A of NRS.
7. Upon receipt of a list of physicians and chiropractic physicians that is filed pursuant to subsection 6, the Administrator shall:
(a) Stamp the list as having been filed; and
(b) Indicate on the list the date on which it was filed.
8. The Administrator shall:
(a) Provide a copy of an insurer's list of physicians and chiropractic physicians to any member of the public who requests a copy; or
(b) Post a copy of each insurer's list of physicians and chiropractic physicians on an Internet website maintained by the Administrator and accessible to the public for viewing, printing or downloading.
9. At any time, a physician or chiropractic physician may request in writing that he or she be removed from an insurer's list of physicians and chiropractic physicians. The insurer must comply with the request and omit the physician or chiropractic physician from the next list which the insurer files with the Administrator.
10. A physician or chiropractic physician may not be involuntarily removed from an insurer's list of physicians and chiropractic physicians except for good cause. As used in this subsection, "good cause" means that one or more of the following circumstances apply:
(a) The physician or chiropractic physician has died or is disabled.
(b) The license of the physician or chiropractic physician has been revoked or suspended.
(c) The physician or chiropractic physician has been convicted of:
(1) A felony; or
(2) A crime for a violation of a provision of chapter 616D of NRS.
(d) The physician or chiropractic physician has been removed from the panel of physicians and chiropractic physicians maintained by the Administrator pursuant to NRS 616C.090 by the Administrator upon a finding that the physician or chiropractic physician:
(1) Has failed to comply with the standards for treatment of industrial injuries or occupational diseases as established by the Administrator; or
(2) Does not accept and treat injured employees under chapters 616A to 616D, inclusive, or chapter 617 of NRS.
11. Unless a physician or chiropractic physician, as applicable, is removed from an insurer's list of physicians and chiropractic physicians pursuant to subsection 10, an injured employee may continue to receive treatment from that physician or chiropractic physician even if:
(a) The employer of the injured employee changes insurers or administrators.
(b) The physician or chiropractic physician is no longer included in the applicable insurer's list of physicians and chiropractic physicians, provided that the physician or chiropractic physician agrees to continue to accept compensation for that treatment at the rates which:
(1) Were previously agreed upon when the physician or chiropractic physician was most recently included in the list; or
(2) Are newly negotiated but do not exceed the amounts provided under the fee schedule adopted by the Administrator.
12. The Administrator shall adopt regulations prescribing the form in which a list of physicians and chiropractic physicians created by an employer, insurer or third-party administrator pursuant to this section must be maintained. The Administrator shall require that any such list be in a format which is easily searchable, including, without limitation, an indexed database, a portable document format, a spreadsheet with data that may be filtered, a comma-separated values file or any other comparable format.

NRS 616C.087

Added to NRS by 2019, 3442; A 2023, 3617
Amended by 2023, Ch. 535,§9, eff. 1/1/2024.
Added by 2019, Ch. 550,§2, eff. 1/1/2020.