NAC439B.325. Major hospital to provide disclosure to patient who does not have medical insurance; effect of discount on prior arrangement to pay; circumstances entitling hospital to recover discount.

     1. A major hospital which is required to reduce or discount the total billed charge for hospital services provided to an inpatient pursuant to NRS 439B.260 shall provide each patient who informs the hospital that he does not have medical insurance or other coverage to pay for inpatient services with a written disclosure approved by the director explaining:

     (a) That the patient may be entitled to receive a reduction or discount on his total billed charge; and

     (b) How to apply for such a reduction or discount.

     2. For the purposes of NRS 439B.260:

     (a) A person who “has no insurance or other contractual provision for the payment of the charge” includes a person who discovers after he is discharged from the hospital that he has no insurance or other contractual provision for the payment of the charge.

     (b) “Total billed charge” means the itemized billing required pursuant to NRS 449.243 for each stay of a patient and any additional charges for inpatient hospital services for that stay which are discovered after the submission of the itemized billing.

     3. A patient who qualifies for a discount must receive the discount regardless of any prior arrangement to pay, unless the prior arrangement would result in a lower total cost to the patient.

     4. A major hospital may require a patient who requests a discount to sign an agreement which assigns to the hospital all benefits that are payable to the patient from medical insurance or other coverage with regard to the total billed charge. Regardless of whether the patient signs such an agreement, if either the hospital or the patient receives payment from a payer with regard to the total billed charge, the discount becomes void and the hospital is entitled to recover the amount of the discount from the patient or payer according to the terms of the coverage.

     5. In addition to the right of recovery pursuant to subsection 4, if a patient fraudulently represents to a hospital that he does not have a payer, the hospital is entitled to any additional remedies provided by law.

     6. For the purposes of this section, “payer” means an insurance company or other third-party organization which has a contractual obligation to pay for hospital services provided to a patient, including, without limitation, a program of public assistance provided by an agency of the local, state or Federal Government.

     (Added to NAC by Dep’t of Human Resources, eff. 8-1-94)