2011 Nevada Revised Statutes
Chapter 695G - Managed Care
NRS 695G.405 - Managed care organization prohibited from denying coverage solely because insured was intoxicated or under the influence of controlled substance; exceptions.
1. Except as otherwise provided in subsection 2, a managed care organization shall not:
(a) Deny a claim under a health care plan solely because the claim involves an injury sustained by an insured as a consequence of being intoxicated or under the influence of a controlled substance.
(b) Cancel participation under a health care plan solely because an insured has made a claim involving an injury sustained by the insured as a consequence of being intoxicated or under the influence of a controlled substance.
(c) Refuse participation under a health care plan to an eligible applicant solely because the applicant has made a claim involving an injury sustained by the applicant as a consequence of being intoxicated or under the influence of a controlled substance.
2. The provisions of subsection 1 do not prohibit a managed care organization from enforcing a provision included in a health care plan to:
(a) Deny a claim which involves an injury to which a contributing cause was the insured s commission of or attempt to commit a felony;
(b) Cancel participation under a health care plan solely because of such a claim; or
(c) Refuse participation under a health care plan to an eligible applicant solely because of such a claim.
3. The provisions of this section do not apply to a managed care organization under a health care plan that provides coverage for long-term care or disability income.
(Added to NRS by 2005, 2347; A 2007, 87)
Disclaimer: These codes may not be the most recent version. Nevada may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
