Nevada Revised Statutes 616D.550 – Duty to report violations to Fraud Control Unit for Industrial Insurance
‘ 1. An insurer, organization for managed care, health care provider, employer, third-party administrator or public officer who believes, or has reason to believe, that:
Terms Used In Nevada Revised Statutes 616D.550
- Fraud: Intentional deception resulting in injury to another.
- 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) A fraudulent claim for benefits under a policy of insurance has been made, or is about to be made;
(b) An employer within the provisions of NRS 616B.633 has:
(1) Knowingly made a false statement or representation concerning the amount of payroll upon which a premium is based; or
(2) Failed to provide and secure compensation under the terms of chapters 616A to 616D, inclusive, or chapter 617 of NRS or has failed to maintain that compensation;
(c) A provider of health care has submitted an invoice for payment for accident benefits that contains information which the provider knows is false; or
(d) A person has committed any other fraudulent practice under this chapter or chapter 616A, 616B, 616C or 617 of NRS, shall report that belief to the Fraud Control Unit for Industrial Insurance established pursuant to NRS 228.420.
2. The Fraud Control Unit for Industrial Insurance established pursuant to NRS 228.420 may require a person who submits a report pursuant to subsection 1 to submit that report on a form prescribed by the Unit.