oxyribonucleic acid extracted from the cells of a person or a diagnostic test, to determine the presence of abnormalities or deficiencies, including carrier status, that: (1) Are linked to physical or mental disorders or impairments; or (2) Indicate a susceptibility to illness, disease, impairment or any other disorder, whether physical or mental. (Added to NRS by 1997, 1461) NRS 695C.210 Annual report and financial statement required; administrative penalty for failure to file report or statement. 1. Every health maintenance organization shall file with the Commissioner on or before March 1 of each year a report showing its financial condition on the last day of the preceding calendar year. The report must be verified by at least two principal officers of the organization. The organization shall file a copy of the report with the State Board of Health. 2. The report must be on forms prescribed by the Commissioner and must include: (a) A financial statement of the organization, including its balance sheet and receipts and disbursements for the preceding calendar year; (b) Any material changes in the information submitted pursuant to NRS 695C.070; (c) The number of persons enrolled during the year, the number of enrollees as of the end of the year, the number of enrollments terminated during the year and, if requested by the Commissioner, a compilation of the reasons for such terminations; (d) The number and amount of malpractice claims initiated against the health maintenance organization and any of the providers used by it during the year broken down into claims with and without form of legal process, and the disposition, if any, of each such claim, if requested by the Commissioner; (e) A summary of information compiled pursuant to paragraph (c) of subsection 2 of NRS 695C.080 in such form as required by the State Board of Health; and (f ) Such other information relating to the performance of the health maintenance organization as is necessary to enable the Commissioner to carry out his duties pursuant to this chapter. 3. Every health maintenance organization shall file with the Commissioner annually an audited financial statement of the organization prepared by an independent certified public accountant. The statement must cover the preceding 12-month period and must be filed with the Commissioner within 120 days after the end of the organization’s fiscal year. Upon written request, the Commissioner may grant a 30-day extension. 4. If an organization fails to file timely the report or financial statement required by this section, it shall pay an administrative penalty of $100 per day until the report or statement is filed, except that the total penalty must not exceed $3,000. The Attorney General shall recover the penalty in the name of the State of Nevada. 5. The Commissioner may grant a reasonable extension of time for filing the report or financial statement required by this section, if the request for an extension is submitted in writing and shows good cause. (Added to NRS by 1973, 1252; A 1991, 2204; 1995, 1632, 2681) NRS 695C.220 Applications, filings and reports open to public inspection. All applications, filings and reports required under this chapter shall be treated as public documents except as otherwise provided in this chapter. (Added to NRS by 1973, 1258) NRS 695C.230 Fees. 1. Every health maintenance organization subject to this chapter shall pay to the Commissioner the following fees: (a) For filing an application for a certificate of authority, $2,450. (b) For issuance of a certificate of authority, $250. (c) For an amendment to a certificate of authority, $100. (d) For the renewal of a certificate of authority, $2,450. (e) For filing each annual report, $25. 2. At the time of filing the annual report the health maintenance organization shall forward to the department of taxation the tax and any penalty for nonpayment or delinquent payment of the tax in accordance with the provisions of chapter 680B of NRS. 3. All fees paid pursuant to this section shall be deemed earned when paid and may not be refunded. (Added to NRS by 1973, 1257; A 1987, 470; 1991, 1634; 1993, 1923) NRS 695C.240 Information required to be available for inspection. Every health maintenance organization shall have available for inspection the following information: 1. A current statement of financial condition including a balance sheet and summary of receipts and disbursements; 2. A description of the organizational structure and operation of the health maintenance organization and a summary of any material changes since the issuance of the last report; 3. A description of services and information as to where and how to secure them; and 4. A clear and understandable description of the health maintenance organization’s method for resolving enrollee complaints. (Added to NRS by 1973, 1252) NRS 695C.250 Open enrollment. 1. After a health maintenance organization has been in operation 24 months, it shall have an annual open enrollment commensurate with common practices in the area in which it operates. 2. Health maintenance organizations providing services to a specified group or groups may limit the open enrollment to all members of such group or groups. “Specified groups” may include: (a) Employees of one or more specified employers; (b) Members of one or more specified employee organizations; (c) Members of one or more specified associations; and (d) Participants in one or more specified group policies issued by one or more specified insurers if the insurer is involved in the operation, management or conduct of the health maintenance organization. (Added to NRS by 1973, 1252) NRS 695C.260 Complaint system. Each health maintenance organization shall establish: 1. A system for resolving complaints which complies with the provisions of NRS 695G.200 to 695G.230, inclusive; and 2. A system for conducting external reviews of final adverse determinations that complies with the provisions of NRS 695G.241 to 695G.310, inclusive. (Added to NRS by 1973, 1253; A 1997, 311; 2003, 778) NRS 695C.265 Required procedure for arbitration of disputes concerning independent medical evaluations. 1. If a health maintenance organization, for any final determination of benefits or care, requires an independent evaluation of the medical or chiropractic care of any person for whom such care is provided under the evidence of coverage: (a) The evidence of coverage must include a procedure for binding arbitration to resolve disputes concerning independent medical evaluations pursuant to the rules of the American Arbitration Association; and (b) Only a physician or chiropractor who is certified to practice in the same field of practice as the primary treating physician or chiropractor or who is formally educated in that field may conduct the independent evaluation. 2. The independent evaluation must include a physical examination of the patient, unless he is deceased, and a personal review of all X rays and reports prepared by the primary treating physician or chiropractor. A certified copy of all reports of findings must be sent to the primary treating physician or chiropractor and the insured person within 10 working days after the evaluation. If the insured person disagrees with the finding of the evaluation, he must submit an appeal to the insurer pursuant to the procedure for binding arbitration set forth in the evidence of coverage within 30 days after he receives the finding of the evaluation. Upon its receipt of an appeal, the insurer shall so notify in writing the primary treating physician or chiropractor. 3. The insurer shall not limit or deny coverage for care relate

Vegas Law