Nev. Admin. Code § 695C.510 - Health service contract to be filed with Commissioner; certain documentation to be included in contract

1. An organization which enters into a health service contract with a delivery system intermediary shall file a copy of the health service contract with the Commissioner as a material modification of operations pursuant to NRS 695C.140 or NAC 695C.350.

2. In addition to complying with the provisions of NAC 695C.505, the contract must be signed by the organization and the delivery system intermediary and include:

(a) All exhibits, attachments, addenda, schedules or any other documents relating to the contract; and

(b) A statement of a qualified actuary that the contract:

(1) Is a financially sound transaction;

(2) Does not cause excessive payments to the delivery system intermediary;

(3) Provides for reasonable incentives to the delivery system intermediary for the containment of costs; and

(4) Does not substantially or unreasonably contribute to the increase in the cost of providing health care services to enrollees or subscribers.

3. The information required by subsection 2 is not required to include the monetary value of the services which will be provided pursuant to the health service contract, but that information must be made available to the Commissioner upon request.

4. As used in this section, "qualified actuary" has the meaning ascribed to it in NAC 681B.155.

Notes

Nev. Admin. Code § 695C.510

Added to NAC by Comm'r of Insurance by R129-96, eff. 10-29-97; A by R148-99, 1-27-2000

NRS 679B.130, 695C.275