NAC695C.160. Geographic area of service: Definition.

     1. An organization shall clearly define the geographic area it intends to serve which:

     (a) In a county having a population of 100,000 or more, must have a radius of not more than 25 miles between the subscriber or individual enrollee and a primary physician and the hospital used by the organization. This subsection does not apply to services rendered pursuant to Medicaid or Nevada Check Up.

     (b) In any other county, must be defined by the organization under a plan for the provision of health care services if the organization receives the written approval of the Division for such a geographic area by:

          (1) Demonstrating the availability and accessibility of services to its enrollees, including reasonable access to primary physicians, a hospital and to medically necessary services or services in an emergency; and

          (2) Submitting a statement concerning the standards within that community regarding the availability and accessibility of other health care services and demonstrating that the organization will meet the community’s standards for such services.

     2. As used in this section, “Nevada Check Up” has the meaning ascribed to it in NAC 442.688.

     (Added to NAC by Comm’r of Insurance, eff. 6-11-86; A 5-27-92; R025-08, 6-17-2008)