uncture. If any evidence of coverage provides coverage for acupuncture performed by a physician, the insured is entitled to reimbursement for acupuncture performed by a person who is licensed pursuant to chapter 634A of NRS. (Added to NRS by 1991, 1134) NRS 695C.177 Reimbursement for treatments by licensed psychologist. If any evidence of coverage provides coverage for treatment of an illness which is within the authorized scope of the practice of a qualified psychologist, the insured is entitled to reimbursement for treatments by a psychologist who is licensed pursuant to chapter 641 of NRS. (Added to NRS by 1981, 576; A 1989, 1553) NRS 695C.1773 Reimbursement for treatment by licensed marriage and family therapist. If any evidence of coverage provides coverage for treatment of an illness which is within the authorized scope of the practice of a licensed marriage and family therapist, the insured is entitled to reimbursement for treatment by a marriage and family therapist who is licensed pursuant to chapter 641A of NRS. (Added to NRS by 1987, 2134) NRS 695C.1775 Reimbursement for treatment by licensed associate in social work, social worker, independent social worker or clinical social worker. If any evidence of coverage provides coverage for treatment of an illness which is within the authorized scope of the practice of a licensed associate in social work, social worker, independent social worker or clinical social worker, the insured is entitled to reimbursement for treatment by an associate in social work, social worker, independent social worker or clinical social worker who is licensed pursuant to chapter 641B of NRS. (Added to NRS by 1987, 1123) NRS 695C.178 Reimbursement for treatment by chiropractor. 1. If any evidence of coverage provides coverage for treatment of an illness which is within the authorized scope of practice of a qualified chiropractor, the insured is entitled to reimbursement for treatments by a chiropractor who is licensed pursuant to chapter 634 of NRS. 2. The terms of the policy must not limit: (a) Coverage for treatments by a chiropractor to a number less than for treatments by other physicians. (b) Reimbursement for treatments by a chiropractor to an amount less than that charged for similar treatments by other physicians. (Added to NRS by 1981, 930; A 1983, 328) NRS 695C.179 Reimbursement for services provided by certain nurses; prohibited limitations; exceptions. 1. If any evidence of coverage provides coverage for services which are within the authorized scope of practice of a registered nurse who is authorized pursuant to chapter 632 of NRS to perform additional acts in an emergency or under other special conditions as prescribed by the State Board of Nursing, and which are reimbursed when provided by another provider of health care, the insured is entitled to reimbursement for services provided by such a registered nurse. 2. The terms of the evidence of coverage must not limit: (a) Coverage for services provided by such a registered nurse to a number of occasions less than for services provided by another provider of health care. (b) Reimbursement for services provided by such a registered nurse to an amount less than that reimbursed for similar services provided by another provider of health care. 3. An insurer is not required to pay for services provided by such a registered nurse which duplicate services provided by another provider of health care. (Added to NRS by 1985, 1448) NRS 695C.1795 Reimbursement to provider of medical transportation. 1. Except as otherwise provided in subsection 3, every evidence of coverage amended, delivered or issued for delivery in this State after October 1, 1989, that provides coverage for medical transportation, must contain a provision for the direct reimbursement of a provider of medical transportation for covered services if that provider does not receive reimbursement from any other source. 2. The enrollee or the provider may submit the claim for reimbursement. The provider shall not demand payment from the enrollee until after that reimbursement has been granted or denied. 3. Subsection 1 does not apply to any agreement between a health maintenance organization and a provider of medical transportation for the direct payment by the organization for the provider’s services. (Added to NRS by 1989, 1274) NRS 695C.180 Schedule of charges. 1. No schedule of charges for enrollee coverage for health care services or amendment thereto may be used in conjunction with any health care plan until a copy of such schedule or amendment thereto has been filed with and approved by the Commissioner. 2. Such charges may be established in accordance with actuarial principles for various categories of enrollees. However the charges shall not be excessive, inadequate nor unfairly discriminatory. A certification by a qualified actuary to the adequacy of the charges shall accompany the filing along with adequate supporting information. (Added to NRS by 1973, 1251) NRS 695C.185 Approval or denial of claims; payment of claims and interest; requests for additional information; award of costs and attorney’s fees; compliance with requirements. 1. Except as otherwise provided in subsection 2, a health maintenance organization shall approve or deny a claim relating to a health care plan within 30 days after the health maintenance organization receives the claim. If the claim is approved, the health maintenance organization shall pay the claim within 30 days after it is approved. Except as otherwise provided in this section, if the approved claim is not paid within that period, the health maintenance organization shall pay interest on the claim at a rate of interest equal to the prime rate at the largest bank in Nevada, as ascertained by the Commissioner of Financial Institutions, on January 1 or July 1, as the case may be, immediately preceding the date on which the payment was due, plus 6 percent. The interest must be calculated from 30 days after the date on which the claim is approved until the date on which the claim is paid. 2. If the health maintenance organization requires additional information to determine whether to approve or deny the claim, it shall notify the claimant of its request for the additional information within 20 days after it receives the claim. The health maintenance organization shall notify the provider of health care services of all the specific reasons for the delay in approving or denying the claim. The health maintenance organization shall approve or deny the claim within 30 days after receiving the additional information. If the claim is approved, the health maintenance organization shall pay the claim within 30 days after it receives the additional information. If the approved claim is not paid within that period, the health maintenance organization shall pay interest on the claim in the manner prescribed in subsection 1. 3. A health maintenance organization shall not request a claimant to resubmit information that the claimant has already provided to the health maintenance organization, unless the health maintenance organization provides a legitimate reason for the request and the purpose of the request is not to delay the payment of the claim, harass the claimant or discourage the filing of claims. 4. A health maintenance organization shall not pay only part of a claim that has been approved and is fully payable. 5. A court shall award costs and reasonable attorney’s fees to the prevailing party in an action brought pursuant to this section. 6. The payment of interest provided for in this section for the late payment of an approved claim may be waived only if the payment was delayed because of an act of God or another cause beyond the control of the health maintenance organization. 7. The Commissioner

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