Current through 82nd (2023) Legislative Session Chapter 535 and 34th (2023) Special Session Chapter 1 and 35th (2023) Special Session Chapter 1
Section 695G.405 - Managed care organization prohibited from denying coverage solely because applicant or insured was intoxicated or under the influence of controlled substance; exceptions1. 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, 87Added to NRS by 2005, 2347; A 2007, 87