Nevada Revised Statutes 449A.162 – Limitations on efforts of hospital to collect when hospital has contractual agreement with third party that provides health coverage for care provided; return to patient of any excess amount collected; exception. [E…
1. Except as otherwise provided in subsection 3, if a hospital provides hospital care to a person who has a policy of health insurance issued by a third party that provides health coverage for care provided at that hospital and the hospital has a contractual agreement with the third party, the hospital:
Terms Used In Nevada Revised Statutes 449A.162
- Lien: A claim against real or personal property in satisfaction of a debt.
- person: means a natural person, any form of business or social organization and any other nongovernmental legal entity including, but not limited to, a corporation, partnership, association, trust or unincorporated organization. See Nevada Revised Statutes 0.039
(a) Shall proceed with any efforts to collect on any amount owed to the hospital for the hospital care in accordance with the provisions of NRS 449A.159.
(b) Shall not collect or attempt to collect from the patient or other responsible party more than the sum of the amounts of any deductible, copayment or coinsurance payable by or on behalf of the patient under the policy of health insurance.
(c) Shall not collect or attempt to collect that amount from:
(1) Any proceeds or potential proceeds of a civil action brought by or on behalf of the patient, including, without limitation, any amount awarded for medical expenses; or
(2) An insurer other than an insurer that provides coverage under a policy of health insurance or an insurer that provides coverage for medical payments under a policy of casualty insurance.
2. If the hospital collects or receives any payments from an insurer that provides coverage for medical payments under a policy of casualty insurance, the hospital shall, not later than 30 days after a determination is made concerning coverage, return to the patient any amount collected or received that is in excess of the deductible, copayment or coinsurance payable by or on behalf of the patient under the policy of health insurance.
3. This section does not apply to:
(a) Amounts owed to the hospital which are not covered under the policy of health insurance; or
(b) Medicaid, Medicare, the Children’s Health Insurance Program or any other public program which may pay all or part of the bill.
4. This section does not limit any rights of a patient to contest an attempt to collect an amount owed to a hospital, including, without limitation, contesting a lien obtained by a hospital.
5. As used in this section, ‘third party’ means:
(a) An insurer, as defined in NRS 679B.540;
(b) A health benefit plan, as defined in NRS 687B.470, for employees which provides coverage for services and care at a hospital;
(c) A participating public agency, as defined in NRS 287.04052, and any other local governmental agency of the State of Nevada which provides a system of health insurance for the benefit of its officers and employees, and the dependents of officers and employees, pursuant to chapter 287 of NRS; or
(d) Any other insurer or organization providing health coverage or benefits in accordance with state or federal law.