NAC695D.190. Contract between organization and provider.

     1. Each contract between an organization and a provider must:

     (a) Contain a complete description of the duties of each party under the agreement.

     (b) Require the provider to release each member of the organization from all liability for the cost of services rendered under the plan, except for uncovered expenditures and any copayments or deductibles made by a member.

     (c) Be effective for not less than 1 year, subject to any mutual right of termination provided by the agreement.

     (d) Require the provider to comply with the organization’s program to assure the quality of dental care provided to members.

     (e) If the organization becomes insolvent, require the provider to provide to each member all the services specified by the plan and the agreement during the period for which a premium has been paid by or on behalf of the member.

     (f) Require the provider to furnish the organization with evidence of:

          (1) A contract of insurance against liability to third persons for any injury caused by professional malpractice; or

          (2) A reasonable substitute for such insurance, as determined by the organization.

     (g) Require a provider, if he or she leaves the panel of dentists associated with the organization, to transfer or arrange for the maintenance of the records of members who are his or her patients.

     2. An organization may require a provider to indemnify it against liability to third persons resulting from services rendered by the provider.

     3. As used in this section, “uncovered expenditures” means the cost of any services, including services provided during an emergency:

     (a) That are rendered by a provider and paid for by the organization;

     (b) Concerning which there is no agreement between the provider and organization to release the member from liability; and

     (c) For which the member may be liable if the organization becomes insolvent.

     (Added to NAC by Comm’r of Insurance, eff. 12-2-88)