As used in NRS 439B.700 to 439B.760, inclusive, unless the context otherwise requires, the words and terms defined in NRS 439B.703 to 439B.739, inclusive, have the meanings ascribed to them in those sections. (Added to NRS by 2019, 320)
“Covered person” means a policyholder, subscriber, enrollee or other person covered by a third party. (Added to NRS by 2019, 320)
“Independent center for emergency medical care” has the meaning ascribed to it in NRS 449.013. (Added to NRS by 2019, 320)
“In-network emergency facility” means a hospital or independent center for emergency medical care that is an in-network provider. (Added to NRS by 2019, 320)
“In-network provider” means, for a particular covered person, a provider of health care that has entered into a provider contract with a third party for the provision of health care to the covered person. (Added to NRS by 2019, 320)
“Medically necessary emergency services” means health care services that are provided by a provider of health care to screen and to stabilize a covered person after the sudden onset of a medical condition that manifests itself by symptoms of such sufficient severity that a prudent person would believe that the absence of immediate medical attention […]
“Out-of-network emergency facility” means a hospital or independent center for emergency medical care that is an out-of-network provider. (Added to NRS by 2019, 320)
“Out-of-network provider” means, for a particular covered person, a provider of health care that has not entered into a provider contract with a third party for the provision of health care to the covered person. (Added to NRS by 2019, 320)
“Provider contract” means a contract between a third party and an in-network provider to provide health care services to a covered person. (Added to NRS by 2019, 320)
“Provider of health care” has the meaning ascribed to it in NRS 695G.070. (Added to NRS by 2019, 320)
“Prudent person” means a person who: 1. Is not a provider of health care; 2. Possesses an average knowledge of health and medicine; and 3. Is acting reasonably under the circumstances. (Added to NRS by 2019, 321)
“Screen” means to conduct the medical screening examination required to be provided to a patient in the emergency department of a hospital pursuant to 42 U.S.C. § 1395dd. (Added to NRS by 2019, 321)
1. “Third party” includes, without limitation: (a) The issuer of a health benefit plan, as defined in NRS 695G.019, which provides coverage for medically necessary emergency services; (b) The Public Employees’ Benefits Program established pursuant to subsection 1 of NRS 287.043; and (c) Any other entity or organization that elects pursuant to NRS 439B.757 for […]
“To stabilize” and “stabilized” have the meanings ascribed to them in 42 U.S.C. § 1395dd(e)(3). (Added to NRS by 2019, 321)
The provisions of NRS 439B.745 and 439B.748 do not apply to: 1. A hospital which has been certified as a critical access hospital by the Secretary of Health and Human Services pursuant to 42 U.S.C. § 1395i-4(e) or any medically necessary emergency services provided at such a hospital; 2. A person who is covered by […]
1. An out-of-network provider shall not collect from a covered person for medically necessary emergency services, and a covered person is not responsible for paying, an amount that exceeds the copayment, coinsurance or deductible required for such services provided by an in-network provider by the coverage for that person. 2. An out-of-network emergency facility that […]
1. If an out-of-network emergency facility had a provider contract as an in-network emergency facility within the 24 months immediately preceding the date on which the medically necessary emergency services were rendered to a covered person, the third party that provides coverage for the covered person shall pay to the out-of-network emergency facility for those […]
1. If an out-of-network provider, other than an out-of-network emergency facility, had a provider contract as an in-network provider within the 12 months immediately preceding the date on which the medically necessary emergency services were rendered to a covered person and: (a) The out-of-network provider terminated the most recent applicable provider contract between the third […]
1. An out-of-network provider shall accept or reject an amount paid pursuant to subsection 2 of NRS 439B.748 or paragraph (c) of subsection 1 or subsection 2 of NRS 439B.751 as payment in full for the medically necessary emergency services for which the payment was offered within 30 days after receiving the payment. If an […]
Any entity or organization, not otherwise subject to the provisions of NRS 439B.700 to 439B.760, inclusive, that provides coverage for emergency medical services, including, without limitation, a participating public agency, as defined in NRS 287.04052, and any other local governmental agency which provides a system of health insurance for the benefit of its officers and […]
