Nevada § 695G.280 Basis for decision of independent review organization

Nevada Statutes

§ 695G.280 — Basis for decision of independent review organization

Nevada § 695G.280

Title 57INSURANCE

Ch. 695GManaged

EXTERNAL REVIEW OF ADVERSE DETERMINATION

This text of Nevada § 695G.280 (Basis for decision of independent review organization) 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.280 (2026).

Text

The decision of an independent review organization concerning a request for an external review must be based on: 1. Documentary evidence, including any recommendation of the physician of the insured submitted pursuant to NRS 695G.251 ; 2. Medical or scientific evidence, including, without limitation:

(a)Professional standards of safety and effectiveness for diagnosis, care and treatment that are generally recognized in the United States;

(b)Any report published in literature that is peer-reviewed;

(c)Evidence-based medicine, including, without limitation, reports and guidelines that are published by professional organizations that are recognized nationally and that include supporting scientific data; and

(d)An opinion of an independent physician who, as determined by the independent re

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The decision of an independent review organization concerning a request for an external review must be based on:
1. Documentary evidence, including any recommendation of the physician of the insured submitted pursuant to NRS 695G.251 ;
2. Medical or scientific evidence, including, without limitation:
(a) Professional standards of safety and effectiveness for diagnosis, care and treatment that are generally recognized in the United States;
(b) Any report published in literature that is peer-reviewed;
(c) Evidence-based medicine, including, without limitation, reports and guidelines that are published by professional organizations that are recognized nationally and that include supporting scientific data; and
(d) An opinion of an independent physician who, as determined by the independent review organization, is an expert in the health specialty that is the subject of the independent review; and
3. The terms and conditions for benefits set forth in the evidence of coverage issued to the insured by the health carrier.