NAC616A.600. Application for initial issuance of certificate: Generally.

Except as otherwise provided in NAC 616A.610, an external review organization applying for the initial issuance of a certificate to conduct external reviews must submit to the Commissioner, on a form prescribed by the Commissioner, an application in writing and must provide to the Commissioner at the time of application:

     1. A written statement that identifies:

     (a) The number of external reviewers that the external review organization employs, contracts with or otherwise retains to conduct external reviews;

     (b) The specialty of each external reviewer;

     (c) Whether each external reviewer is certified by the entity that regulates his or her specialty; and

     (d) The schedule of fees that the external review organization will charge to conduct an external review.

     2. A written summary of the procedures that the external review organization will use to:

     (a) Ensure that an external reviewer employed, contracted with or otherwise retained by the external review organization is qualified to conduct a specific external review;

     (b) Ensure that the external review organization and any employee, agent or contractor of the external review organization does not have a conflict of interest as set forth in NRS 616A.469; and

     (c) Submit a copy of the determination regarding an external review to each party to the external review.

     3. A written affidavit that:

     (a) The information contained in the application and any accompanying materials are complete and correct;

     (b) The external review organization will conduct external reviews in accordance with NRS 616A.469 and 616C.363;

     (c) The external review organization and any employee, agent or contractor of the external review organization will avoid a conflict of interest as set forth in NRS 616A.469; and

     (d) The external review organization is not affiliated with:

          (1) An organization for managed care which provides comprehensive medical and health care services to employees for injuries or diseases pursuant to chapters 616A to 617, inclusive, of NRS;

          (2) An insurer;

          (3) A third-party administrator; or

          (4) A national, state or local trade association.

     4. All applicable fees required, including, without limitation, all applicable fees required pursuant to NAC 616A.640, for the initial issuance of a certificate to conduct external reviews.

     (Added to NAC by Comm’r of Insurance by R127-03, eff. 12-16-2003; A by R103-09, 1-28-2010)