1. An insurer shall
not perform utilization review for another person unless it registers with the
Commissioner as an agent who performs utilization review and has a medical
director who is a physician or, in the case of an agent who reviews dental
services, a dentist, licensed in any state.
An insurer may apply for registration by
filing with the Commissioner the following information on a form provided by
(a) The insurer's name,
address, telephone number and normal business hours;
(b) The name and telephone number of a person
the Commissioner may contact for information concerning the insurer;
(c) The name of the medical director of the
insurer and the state in which he or she is licensed to practice medicine or
(d) A summary of the
insurer's plan for utilization review, including procedures for appealing
determinations made through utilization review.
3. An insurer that registers as an agent who
performs utilization review shall file with the Commissioner any material
changes in the information provided pursuant to subsection 2 within 30 days
after the change occurs.
Commissioner will not evaluate the plan submitted pursuant to paragraph (d) of
subsection 2. The Commissioner will make the plan available upon request and
charge the fee set forth in NAC 683A.295
for providing a copy of the
5. Registration pursuant to
this section must be renewed on or before March 1 of each year by providing the
information specified in subsection 2.
Nev. Admin. Code § 683A.285
Added to NAC by Comm'r of
Insurance, eff. 1-24-92; A by R152-99, 1-28-2000