NAC686A.270. Payment for services rendered.

     1. If a benefit or medical service is otherwise covered by a policy, the insurer shall pay for the service without regard to the type of health care practitioner providing the service, if the practitioner is:

     (a) Licensed in accordance with the law of this State; and

     (b) Operating within the scope of the practitioner’s authority.

     2. If the fee or charge for the service is otherwise payable as a benefit pursuant to a policy or contract of health insurance, any exclusion or denial of payment for a service rendered by a health care practitioner, solely because the service is rendered by a particular type of practitioner, shall be deemed to be an unfair practice in the business of insurance within the meaning of NRS 686A.020.

     3. Nothing contained in this section shall be construed to allow an insured to expand the field of health care practitioners if the insurer has limited or restricted the field to a preselected group pursuant to NRS 679B.152, 689B.061, 695B.180 or 695B.185 or NAC 695C.205.

     4. As used in this section:

     (a) “Health care practitioner” means any physician, any medical or other related facility, or any other person licensed or otherwise authorized to provide health care services in this State.

     (b) “Insurer” means any:

          (1) Insurance company;

          (2) Nonprofit corporation for hospital, medical or dental service;

          (3) Health maintenance organization;

          (4) Organization for dental care; or

          (5) Fraternal benefit society.

     (Added to NAC by Comm’r of Insurance, eff. 6-20-90)