Nevada Revised Statutes 695C.060 – Establishment of health maintenance organization
1. Any person may apply to the Commissioner for and obtain a certificate of authority to establish and operate a health maintenance organization in compliance with this chapter. No person shall operate a health maintenance organization without obtaining a certificate of authority under this chapter. A foreign corporation may qualify under this chapter, subject to its qualification to do business in this state as a foreign corporation.
Terms Used In Nevada Revised Statutes 695C.060
- Comprehensive health care services: means medical services, dentistry, drugs, psychiatric and optometric and all other care necessary for the delivery of services to the consumer. See Nevada Revised Statutes 695C.030
- Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
- Health care services: means any services included in the furnishing to any natural person of medical or dental care or hospitalization or incident to the furnishing of such care or hospitalization, as well as the furnishing to any person of any other services for the purpose of preventing, alleviating, curing or healing human illness or injury. See Nevada Revised Statutes 695C.030
- Health maintenance organization: means any person which provides or arranges for provision of a health care service or services and is responsible for the availability and accessibility of such service or services to its enrollees, which services are paid for or on behalf of the enrollees on a periodic prepaid basis without regard to the dates health services are rendered and without regard to the extent of services actually furnished to the enrollees, except that supplementing the fixed prepayments by nominal additional payments for services in accordance with regulations adopted by the Commissioner shall not be deemed to render the arrangement not to be on a prepaid basis. See Nevada Revised Statutes 695C.030
- 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
2. No person shall be certified to establish or operate a health maintenance organization in this state, nor sell or offer to sell, or solicit offers to purchase or receive advance or periodic consideration in conjunction with health care plans unless such health maintenance organization provides or arranges for the provision of comprehensive health care services.
3. Every health maintenance organization or person operating a health maintenance organization shall submit an application for a certificate of authority under NRS 695C.070 within 30 days after July 1, 1973. Each such applicant may continue to operate until the Commissioner acts upon the application. In the event that an application is denied under NRS 695C.090 and 695C.100, the applicant shall thereafter be treated as a health maintenance organization whose certificate of authority has been revoked. For purposes of this subsection, a health maintenance organization shall be deemed to be in operation only if health care services are being provided to the public generally or to some group or groups thereof.