S 695C.325 Authorization to offer health care plan to small employer for purpose of establishing medical savings accounts. A health maintenance organization may offer to a small employer who has not less than 2 and not more than 50 employees, a health care plan that has a high deductible and that is in compliance with 26 U.S.C. § 220 for the purposes of establishing medical savings accounts for any person insured by the health care plan. (Added to NRS by 1997, 2957) NRS 695C.330 Disciplinary proceedings: Grounds; effect of suspension or revocation. 1. The Commissioner may suspend or revoke any certificate of authority issued to a health maintenance organization pursuant to the provisions of this chapter if he finds that any of the following conditions exist: (a) The health maintenance organization is operating significantly in contravention of its basic organizational document, its health care plan or in a manner contrary to that described in and reasonably inferred from any other information submitted pursuant to NRS 695C.060, 695C.070 and 695C.140, unless any amendments to those submissions have been filed with and approved by the Commissioner; (b) The health maintenance organization issues evidence of coverage or uses a schedule of charges for health care services which do not comply with the requirements of NRS 695C.1691 to 695C.200, inclusive, or 695C.207; (c) The health care plan does not furnish comprehensive health care services as provided for in NRS 695C.060; (d) The State Board of Health certifies to the Commissioner that the health maintenance organization: (1) Does not meet the requirements of subsection 2 of NRS 695C.080; or (2) Is unable to fulfill its obligations to furnish health care services as required under its health care plan; (e) The health maintenance organization is no longer financially responsible and may reasonably be expected to be unable to meet its obligations to enrollees or prospective enrollees; (f) The health maintenance organization has failed to put into effect a mechanism affording the enrollees an opportunity to participate in matters relating to the content of programs pursuant to NRS 695C.110; (g) The health maintenance organization has failed to put into effect the system required by NRS 695C.260 for: (1) Resolving complaints in a manner reasonably to dispose of valid complaints; and (2) Conducting external reviews of final adverse determinations that comply with the provisions of NRS 695G.241 to 695G.310, inclusive; (h) The health maintenance organization or any person on its behalf has advertised or merchandised its services in an untrue, misrepresentative, misleading, deceptive or unfair manner; (i) The continued operation of the health maintenance organization would be hazardous to its enrollees; (j) The health maintenance organization fails to provide the coverage required by NRS 695C.1691; or (k) The health maintenance organization has otherwise failed to comply substantially with the provisions of this chapter. 2. A certificate of authority must be suspended or revoked only after compliance with the requirements of NRS 695C.340. 3. If the certificate of authority of a health maintenance organization is suspended, the health maintenance organization shall not, during the period of that suspension, enroll any additional groups or new individual contracts, unless those groups or persons were contracted for before the date of suspension. 4. If the certificate of authority of a health maintenance organization is revoked, the organization shall proceed, immediately following the effective date of the order of revocation, to wind up its affairs and shall conduct no further business except as may be essential to the orderly conclusion of the affairs of the organization. It shall engage in no further advertising or solicitation of any kind. The Commissioner may, by written order, permit such further operation of the organization as he may find to be in the best interest of enrollees to the end that enrollees are afforded the greatest practical opportunity to obtain continuing coverage for health care. (Added to NRS by 1973, 1255; A 1985, 1448; 1997, 745, 1462, 1629; 1999, 417, 419, 761, 2004; 2001, 141, 144; 2003, 778, 1336, 3369, 3532) NRS 695C.340 Disciplinary proceedings: Notice; hearing; judicial review. 1. When the Commissioner has cause to believe that grounds for the denial of an application for a certificate of authority exist, or that grounds for the suspension or revocation of a certificate of authority exist, he shall notify the health maintenance organization and the State Board of Health in writing specifically stating the grounds for denial, suspension or revocation and fixing a time at least 30 days thereafter for a hearing on the matter. 2. The State Board of Health or its delegated representative shall be in attendance at the hearing and shall participate in the proceedings. The recommendation and findings of the State Board of Health with respect to matters relating to the quality of health maintenance services provided in connection with any decision regarding denial, suspension or revocation of a certificate of authority are conclusive and binding upon the Commissioner. After the hearing, or upon the failure of the health maintenance organization to appear at the hearing, the Commissioner shall take action as is deemed advisable on written findings which must be mailed to the health maintenance organization with a copy thereof to the State Board of Health. The action of the Commissioner and the recommendation and findings of the State Board of Health are subject to review by the First Judicial District Court of the State of Nevada in and for Carson City. The court may, in disposing of the issue before it, modify, affirm or reverse the order of the Commissioner in whole or in part. (Added to NRS by 1973, 1256; A 1981, 107) NRS 695C.350 Violations: Remedies; penalties. 1. The Commissioner may, in lieu of suspension or revocation of a certificate of authority under NRS 695C.330, levy an administrative penalty in an amount not more than $2,500 for each act or violation, if reasonable notice in writing is given of the intent to levy the penalty. 2. Any person who violates the provisions of this chapter is guilty of a misdemeanor. 3. If the Commissioner or the State Board of Health for any reason have cause to believe that any violation of this chapter has occurred or is threatened, the Commissioner or the State Board of Health may give notice to the health maintenance organization and to the representatives, or other persons who appear to be involved in the suspected violation, to arrange a conference with the alleged violators or their authorized representatives to attempt to determine the facts relating to the suspected violation, and, if it appears that any violation has occurred or is threatened, to arrive at an adequate and effective means of correcting or preventing the violation. 4. The proceedings conducted pursuant to the provisions of subsection 3 must not be governed by any formal procedural requirements, and may be conducted in such manner as the Commissioner or the State Board of Health may deem appropriate under the circumstances. 5. The Commissioner may issue an order directing a health maintenance organization or a representative of a health maintenance organization to cease and desist from engaging in any act or practice in violation of the provisions of this chapter. 6. Within 30 days after service of the order to cease and desist, the respondent may request a hearing on the question of whether acts or practices in violation of this chapter have occurred. The hearing must be conducted pursuant to the provisions of chapter 233B of NRS and judicial review must be available as provided therein. 7. In the case of any viola

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