Nevada § 695G.160 Written criteria concerning coverage of health care services and standards for quality of health care services

Nevada Statutes

§ 695G.160 — Written criteria concerning coverage of health care services and standards for quality of health care services

Nevada § 695G.160

Title 57INSURANCE

Ch. 695GManaged

COVERAGE BY MANAGED CARE ORGANIZATIONS

This text of Nevada § 695G.160 (Written criteria concerning coverage of health care services and standards for quality of health care services) is published on Counsel Stack Legal Research, covering Nevada primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook

Nev. Rev. Stat. § 695G.160 (2026).

Text

1. Each managed care organization shall establish written criteria:

(a)Setting forth the manner in which it determines whether to authorize coverage of a health care service; and

(b)Setting forth its method for reviewing standards for the quality of health care services provided to an insured. 2. Such written criteria must be:

(a)Developed with the assistance of practicing providers of health care;

(b)Developed using generally recognized and, if appropriate, specialized clinical principles and processes;

(c)Reviewed at least one time each year and, if appropriate, updated; and

(d)Made available to an insured for review upon request of the insured any time that the managed care organization denies coverage of a specific health care service to the insured.

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1. Each managed care organization shall establish written criteria:
(a) Setting forth the manner in which it determines whether to authorize coverage of a health care service; and
(b) Setting forth its method for reviewing standards for the quality of health care services provided to an insured.
2. Such written criteria must be:
(a) Developed with the assistance of practicing providers of health care;
(b) Developed using generally recognized and, if appropriate, specialized clinical principles and processes;
(c) Reviewed at least one time each year and, if appropriate, updated; and
(d) Made available to an insured for review upon request of the insured any time that the managed care organization denies coverage of a specific health care service to the insured.