Existing law establishes the Nevada Industrial Insurance Act and the Nevada Occupational Diseases Act, which provide for the payment of compensation to employees who are injured or disabled as the result of an occupational injury or occupational disease. (Chapters 616A-616D and 617 of NRS) Existing law requires certain insurers to maintain an office in this State that is operated by the insurer or its third-party administrator and to provide access to files relating to industrial insurance claims at that office. (NRS 616B.021, 616B.027) Section 3 of this bill requires the insurer to make such files available for inspection and reproduction by electronic means or at an office operated by the insurer or its third-party administrator located in this State. Section 3 also authorizes the insurer to keep physical records concerning a claim filed in this State at a location outside this State if those records are made available for inspection and reproduction in certain electronic forms or at an office located in this State. Section 4 of this bill permits an insurer to keep reproductions of certain files rather than original copies at an office in this State operated by the insurer or its third-party administrator. Section 4 also removes the requirement that an insurer accept collect calls from injured employees. Existing law requires a person who acts as a third-party administrator pursuant to the Nevada Industrial Insurance Act or the Nevada Occupational Diseases Act to administer claims arising under each plan of insurance that the person administers from one or more offices located in this State and maintain in those offices all records concerning those claims. (NRS 616B.503) Section 5 of this bill removes that requirement. Instead, section 2 of this bill establishes certain authorizations and requirements concerning the administration of claims arising under the Nevada Industrial Insurance Act or the Nevada Occupational Diseases Act. Section 2 authorizes certain employees and third-party administrators of private carriers to administer such claims from a location outside this State and stipulates how records concerning such claims must be maintained. Section 2 also authorizes certain other employees of a private carrier and certain third-party administrators to administer such claims only from one or more offices located in this State and requires that records relating to such claims be maintained at those offices. Section 4 requires certain employees and third-party administrators who administer a claim from a location outside this State to make themselves available to communicate in real time with a claimant or a representative of the claimant at certain times. Existing law requires the Commissioner of Insurance to take certain disciplinary action against a third-party administrator for certain violations. (NRS 616B.506) Section 6 of this bill requires the Commissioner to also take such disciplinary action against a third-party administrator who violates the provisions of section 2. Existing law requires an insurer to keep a list of physicians and chiropractic physicians from which an injured employee may choose to receive treatment from a panel established and maintained by the Administrator of the Division of Industrial Relations of the Department of Business and Industry. Existing law also sets forth procedures and limitations governing the removal of a physician or chiropractic physician from an insurer's list. (NRS 616C.087, 616C.090) Section 9 of this bill expands the circumstances under which a physician or chiropractic physician may be involuntarily removed from an insurer's list and requires the Administrator to adopt certain regulations. Section 10 of this bill revises the reasons for which a physician or chiropractic physician may be removed from a panel and authorizes a physician or chiropractic physician who has been removed from a panel to reapply for inclusion under certain circumstances. Existing law provides that an employee who is injured by an accident arising out of and in the course of employment is entitled to receive compensation under the Nevada Industrial Insurance Act for a permanent partial disability which is rated during an evaluation by certain physicians or chiropractic physicians. (NRS 616C.490) Section 17 of this bill revises the methodology by which those physicians or chiropractic physicians are selected to perform such an evaluation and authorizes such a physician or chiropractic physician to decline to perform an evaluation under certain circumstances. Sections 7 and 17 require the Administrator to prepare annual and quarterly reports relating to the frequency with which those physicians and chiropractic physicians perform such evaluations and certain other examinations. Existing law authorizes an injured employee, subject to various requirements and restrictions, to obtain an independent medical examination concerning an injury that is the subject of a claim filed pursuant to the Nevada Industrial Insurance Act. (NRS 616C.145) Section 12 of this bill provides that such an injured employee is entitled to request such an independent examination for a permanent partial disability under certain circumstances. Section 12 also identifies the method by which the rate of reimbursement relating to certain independent medical examinations must be determined and authorizes an insurer to recover the cost of certain examinations under certain circumstances. Existing law sets forth the method by which a physician or chiropractic physician is selected under certain circumstances to determine the percentage of disability of an injured employee. (NRS 616C.100, 616C.330, 616C.360) Sections 11, 15 and 16 of this bill require, with certain exceptions, that such physicians and chiropractic physicians be selected at random from a list maintained by the Administrator. Existing law provides that a claimant under the Nevada Industrial Insurance Act may elect to receive payment for a permanent partial disability in a lump sum under certain circumstances. (NRS 616C.495) Section 18 of this bill requires an insurer to use the actuarial annuity tables adopted by the Division that are in effect on the date on which the claimant elects payment in a lump sum to calculate the present value of the lump sum payable. Existing law authorizes an insurer or employer who pays an annual increase in compensation for a permanent total disability to a claimant or dependent who is entitled to such compensation due to certain industrial injuries or disablements to obtain reimbursement from the Administrator and sets forth the procedure for obtaining such reimbursement. (NRS 616C.266) Similarly, existing law entitles an insurer who pays an increase in certain death benefits to be reimbursed annually for the amount of that increase and sets forth procedures for obtaining such reimbursement. (NRS 616C.268) Sections 13 and 14 of this bill revise the procedures governing the issuance of such reimbursement to an insurer and impose various requirements on the Administrator with respect to such reimbursement. Existing law requires the Administrator under certain circumstances to order an insurer, organization for managed care, health care provider, third-party administrator, employer or professional employer organization to pay a claimant a benefit penalty in an amount not less than $5,000 and not greater than $50,000 for refusing to process a claim for compensation or committing certain other violations of the Nevada Industrial Insurance Act or the Nevada Occupational Diseases Act. (NRS 616D.120) Section 20 of this bill increases the amount of that benefit penalty to not less than $17,000 and not greater than $120,000. Section 20 also extends from 10 days to 15 days the time in which a benefit penalty must be paid to a claimant after the Administrator determines the amount of the benefit penalty. Section 19 of this bill requires the Administrator to publish, maintain and make available to the public on the Internet website of the Division certain information relating to benefit penalties imposed by the Administrator. Existing law sets forth procedures by which a person may contest a decision of the Administrator to impose or refuse to impose a benefit penalty. Under existing law, a person who is aggrieved by a failure of the Administrator to respond to a written request for a determination within 90 days after the request is mailed to the Administrator may appeal the failure to respond by filing a request for a hearing within 100 days after the unanswered written request was mailed to the Administrator. (NRS 616D.140) Section 22 of this bill revises those provisions to instead authorize a person who is aggrieved by the failure of the Administrator to respond to a complaint alleging that an insurer, organization for managed care, health care provider, third-party administrator, employer or professional employer organization has committed certain violations within 120 days after the Administrator receives the complaint to appeal the failure to respond by filing a request for a hearing within 150 days after the receipt of the complaint. Section 22 also: (1) requires a party who unsuccessfully appeals the imposition of a benefit penalty to pay a claimant double the amount of the benefit penalty initially imposed; (2) establishes certain requirements for when a benefit penalty must be paid; and (3) authorizes the Commissioner of Insurance to suspend a certification issued to an insurer, organization for managed care, health care provider, third-party administrator, employer or professional employer organization under certain circumstances. Existing law requires the Administrator, upon receipt of a complaint or if the Administrator has reason to believe that certain provisions of the Nevada Industrial Insurance Act have been violated, to cause an investigation to be conducted and render a determination concerning those violations. (NRS 616D.130) Section 21 of this bill broadens the circumstances under which the Administrator is required to cause an investigation to be conducted and requires the Administrator to: (1) provide the Commissioner and the suspected violator with a copy of the complaint or an explanation of the reason why the Administrator believes a violation has occurred and a copy of the determination rendered on the matter; and (2) include with the Administrator's determination any settlement agreement relating to the violation. Section 21 also revises the time in which the Administrator must complete certain actions pursuant to the investigation.

Statutes affected:
As Introduced: 616D.030, 616D.120
Reprint 1: 616D.120, 616D.130, 616D.140
Reprint 2: 616D.120, 616D.130, 616D.140
Reprint 3: 616B.021, 616B.027, 616B.503, 616B.506, 616C.050, 616C.087, 616C.090, 616C.100, 616C.145, 616C.266, 616C.268, 616C.330, 616C.360, 616C.490, 616C.495, 616D.120, 616D.130, 616D.140
As Enrolled: 616B.021, 616B.027, 616B.503, 616B.506, 616C.050, 616C.087, 616C.090, 616C.100, 616C.145, 616C.266, 616C.268, 616C.330, 616C.360, 616C.490, 616C.495, 616D.120, 616D.130, 616D.140
BDR: 616D.030, 616D.120