NAC695C.335. Provider-sponsored organization: Procedure; appointment of examiner; maintenance and use of records.  


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  •      1. If the Commissioner examines a provider-sponsored organization pursuant to NAC 695C.330, he or she will designate one or more examiners and instruct them as to the scope of the examination. The examiner shall, upon demand, exhibit his or her official credentials to the provider-sponsored organization being examined.

         2. The Commissioner will conduct each examination in an expeditious, fair and impartial manner.

         3. The Commissioner, or the examiner if authorized in writing by the Commissioner, may administer oaths and examine under oath any person concerning any matter relevant to the examination.

         4. Each provider-sponsored organization and its officers, attorneys, employees, agents and representatives shall make available to the Commissioner or the examiners the accounts, records, documents, files, information, assets and matters of the provider-sponsored organization in his or her possession or control relating to the subject of the examination and shall facilitate the examination.

         5. If the Commissioner or examiner finds any accounts or records to be inadequate or inadequately kept or posted, he or she will so notify the provider-sponsored organization and give the provider-sponsored organization a reasonable opportunity to reconstruct, rewrite, post or balance the account or record. If the provider-sponsored organization fails to maintain, complete or correct the records or accounting after the Commissioner or examiner has given the provider-sponsored organization written notice and a reasonable opportunity to do so, the Commissioner may employ experts to reconstruct, rewrite, post or balance the account or record at the expense of the provider-sponsored organization being examined.

         6. The Commissioner or an examiner will not remove any record, account, document, file or other property of the provider-sponsored organization being examined from the office or place of business of the provider-sponsored organization unless the Commissioner or examiner has the written consent of an officer of the provider-sponsored organization before the removal or pursuant to an order of a court. This provision does not prohibit the Commissioner or examiner from making or removing copies or abstracts of a record, account, document or file.

     (Added to NAC by Comm’r of Insurance by R148-99, eff. 1-27-2000)