Nev. Admin. Code § 695C.320 - Health maintenance organization: Division of Public and Behavioral Health to notify organization of its findings; objections to findings; dispute resolution; distribution of proposed findings

1. Not less than 90 days after an examination is completed, the Division of Public and Behavioral Health shall mail to the health maintenance organization by certified mail, return receipt requested, the proposed findings of its review. The proposed findings must include, without limitation, any deficiencies discovered within the health maintenance organization and its proposed recommendations to be given by the State Board of Health to the Commissioner regarding the certification of the health maintenance organization.

2. The health maintenance organization may mail to the Division of Public and Behavioral Health any written objections to the proposed findings of the examination not later than 30 days after the date upon which the proposed findings were mailed pursuant to subsection 1.

3. If the health maintenance organization objects to the proposed findings, the Division of Public and Behavioral Health shall attempt to resolve the dispute. If the dispute is not resolved within 30 days from the date upon which the objections were mailed pursuant to subsection 2, the Division of Public and Behavioral Health shall inform the Board of the dispute. The Board will then provide for a hearing as soon as practicable. A written copy of any final decision of a hearing must be sent to the Commissioner.

4. If the health maintenance organization does not object to the proposed findings of the Division of Public and Behavioral Health or if any dispute has been resolved, the Division of Public and Behavioral Health shall provide its proposed findings to the Board. After reviewing the proposed findings, the Board will mail its proposed findings and recommendations to the Commissioner.

Notes

Nev. Admin. Code § 695C.320

Added to NAC by Bd. of Health, eff. 11-1-95; A by Comm'r of Insurance by R148-99, 1-27-2000

NRS 439.200, 679B.130, 695C.310