NRS 598A.440 Provider of health care prohibited from entering into certain contracts; violation constitutes contract in restraint of trade; authorized provisions of contract; subcontracting or delegating performance of obligations under contract; penalty.

484 words·~2 min read·/nv/chapter-598a-unfair-trade-practices/598a-440·

A research copy — for the controlling text, always check the official state or federal source. Not legal advice.

1. A violation of this subsection constitutes a contract in restraint of trade. A provider of health care shall not willfully enter into, willfully offer to enter into or willfully solicit a contract with a third party that directly or indirectly:

(a)Restricts the third party from offering incentives to a covered person to use specific providers of health care or otherwise steering a covered person to a specific provider of health care;

(b)Restricts the third party from assigning providers of health care into tiers for the purpose of encouraging the use of certain providers of health care;

(c)Requires the third party to place all providers of health care affiliated with a business entity in the same tier;

(d)Requires the third party to contract with a business entity affiliated with a provider of health care as a condition of entering into a contract with the provider of health care; or

(e)Prohibits the third party from contracting with a provider of health care that is not a party to the contract or penalizes the third party for entering into such a contract.

2. A contract between a provider of health care and a third party may include any provisions not expressly prohibited by subsection 1 or otherwise prohibited by law.

3. The provisions of this section do not authorize a third party to subcontract for the performance of obligations under a contract with a provider of health care or delegate such obligations in a manner that is inconsistent with the terms of the contract.

4. Any provision of a contract that is described in paragraphs

(a)to (e), inclusive, of subsection 1 is void and severable from the contract.

5. Any person who conspires to, or does, violate any of the provisions of this section is guilty of a misdemeanor.

6. As used in this section:

(a)“Affiliated” means any entity or person who directly, or indirectly through one or more intermediaries, controls or is controlled by or is under common control with a specified entity or person.

(b)“Covered person” means a policyholder, subscriber, enrollee or other person covered by a third party.

(c)“Provider of health care” means:

(1)A physician or other health care practitioner who is licensed or otherwise authorized in this State to furnish any health care service; or

(2)An institution providing health care services or other setting in which health care services are provided, including, without limitation, a hospital, surgical center for ambulatory patients, facility for skilled nursing, residential facility for groups, laboratory and any other such licensed facility.

(d)“Third party” means any insurer, governmental entity or other organization providing health coverage or benefits in accordance with state or federal law.