S.B. 376
- *SB376*
SENATE BILL NO. 376–SENATOR DALY
MARCH 17, 2025
____________
Referred to Committee on Commerce and Labor
SUMMARY—Revises provisions governing industrial insurance.
(BDR 53-629)
FISCAL NOTE: Effect on Local Government: May have Fiscal Impact.
Effect on the State: Yes.
~
EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted.
AN ACT relating to industrial insurance; authorizing an injured
employee with a claim for an occupational lung disease or
occupational heart disease to seek treatment or services
from a physician or chiropractic physician which is not on
the panel of physicians and chiropractic physicians
maintained by the Administrator of the Division of
Industrial Relations of the Department of Business and
Industry under certain circumstances; setting forth certain
requirements for the reimbursement of the costs for such
treatment or services; providing for a penalty for failure to
comply with those requirements; and providing other
matters properly relating thereto.
Legislative Counsel’s Digest:
Existing law establishes the Nevada Industrial Insurance Act and the Nevada 1
Occupational Diseases Act, which provide for the payment of compensation to 2
employees who are injured or disabled as a result of an occupational injury or 3
occupational disease. (Chapters 616A-616D and 617 of NRS) Existing law 4
provides for the payment of compensation for claims for the occupational diseases 5
of lung disease and heart disease for certain firefighters, arson investigators and 6
police officers. (NRS 617.455, 617.457) 7
Existing law requires the Administrator of the Division of Industrial Relations 8
of the Department of Business and Industry to maintain a panel of physicians and 9
chiropractic physicians to treat the injured employees of certain employers under 10
the Nevada Industrial Insurance Act and the Nevada Occupational Diseases Act. 11
(NRS 616C.087, 616C.090) Existing law authorizes an injured employee to choose 12
a treating physician or chiropractic physician from the panel unless the insurer of 13
the injured employee’s employer has entered into certain contracts with an 14
organization for managed care or with providers of health care, in which case the 15
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injured employee is required to choose a physician or chiropractic physician in 16
accordance with the provisions of the contract. (NRS 616C.090) 17
Sections 1, 2 and 4 of this bill provide an exception from those requirements to 18
authorize certain injured employees who have filed a claim for the occupational 19
diseases of lung disease or heart disease to seek treatment or other services from a 20
physician or chiropractic physician of his or her own choice if the panel of treating 21
physicians or chiropractic physicians maintained by the Administrator contains 22
fewer than 12 physicians or chiropractic physicians who accept and treat injured 23
employees in a discipline or specialization appropriate for the treatment of or the 24
provision of other services related to the occupational disease of the injured 25
employee. 26
Section 2 also provides that the injured employee or certain other persons who 27
pay for the treatment or services may seek full reimbursement for the costs of the 28
treatment or services from the employer of the injured employee or certain other 29
persons who are obligated to provide applicable coverage or benefits to the injured 30
employee by providing a request for reimbursement, which includes certain 31
specified contents. Section 2 requires a person from whom reimbursement is 32
sought to fully reimburse the requester not later than 30 days after receiving notice 33
of the request for reimbursement. Under section 2, if the person fails to fully 34
reimburse the requester within that time, the Administrator is required to order the 35
person to pay to the requester an amount that is equal to three times the amount of 36
the reimbursement for each day the reimbursement remains unpaid beginning on 37
the date on which the person received the request for reimbursement. 38
Sections 3 and 5 of this bill revise provisions of existing law relating to the 39
selection of a treating physician or chiropractic physician to reflect the selection of 40
a physician or chiropractic physician pursuant to section 2. 41
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1. NRS 616B.527 is hereby amended to read as 1
follows: 2
616B.527 1. A self-insured employer, an association of self-3
insured public or private employers or a private carrier may: 4
(a) Except as otherwise provided in NRS 616B.5273, enter into 5
a contract or contracts with one or more organizations for managed 6
care to provide comprehensive medical and health care services to 7
employees for injuries and diseases that are compensable pursuant 8
to chapters 616A to 617, inclusive, of NRS. 9
(b) Enter into a contract or contracts with providers of health 10
care, including, without limitation, physicians who provide primary 11
care, specialists, pharmacies, physical therapists, radiologists, 12
nurses, diagnostic facilities, laboratories, hospitals and facilities that 13
provide treatment to outpatients, to provide medical and health care 14
services to employees for injuries and diseases that are compensable 15
pursuant to chapters 616A to 617, inclusive, of NRS. 16
(c) Require employees to obtain medical and health care 17
services for their industrial injuries from those organizations and 18
persons with whom the self-insured employer, association or private 19
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carrier has contracted pursuant to paragraphs (a) and (b), or as the 1
self-insured employer, association or private carrier otherwise 2
prescribes. 3
(d) Except as otherwise provided in subsection 4 of NRS 4
616C.090 [,] and subsection 1 of section 2 of this act, require 5
employees to obtain the approval of the self-insured employer, 6
association or private carrier before obtaining medical and health 7
care services for their industrial injuries from a provider of health 8
care who has not been previously approved by the self-insured 9
employer, association or private carrier. 10
2. An organization for managed care with whom a self-insured 11
employer, association of self-insured public or private employers or 12
a private carrier has contracted pursuant to this section shall comply 13
with the provisions of NRS 616B.528, 616B.5285 and 616B.529. 14
Sec. 2. Chapter 616C of NRS is hereby amended by adding 15
thereto a new section to read as follows: 16
1. If an injured employee has filed a claim pursuant to NRS 17
617.455 or 617.457 and, at the time the claim is filed, the panel of 18
physicians or chiropractic physicians maintained by the 19
Administrator pursuant to NRS 616C.090 contains fewer than 12 20
physicians or chiropractic physicians who accept and treat injured 21
employees in a discipline or specialization appropriate for the 22
treatment of or the provision of other services relating to the 23
occupational disease of the injured employee, the injured 24
employee may seek treatment or other services related to the 25
occupational disease of the injured employee from a physician or 26
chiropractic physician of his or her choice. 27
2. If an injured employee seeks treatment or services 28
pursuant to subsection 1, the treatment or services may be paid for 29
by the injured employee or a health insurer or casualty insurer on 30
behalf of the injured employee. 31
3. Full reimbursement of the amount paid by: 32
(a) The injured employee who paid for his or her own 33
treatment or services; or 34
(b) A health insurer or casualty insurer who paid for treatment 35
or services on behalf of the injured employee, 36
pursuant to subsection 2 may be sought by the injured 37
employee, health insurer or casualty insurer, as applicable, from 38
the employer of the injured employee or an insurer, organization 39
for managed care or third-party administrator, as applicable, who 40
is obligated to provide applicable coverage or benefits to the 41
injured employee. 42
4. To seek reimbursement as described in subsection 3, the 43
injured employee, health insurer or casualty insurer must submit a 44
request for reimbursement to the employer of the injured employee 45
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or the employer’s insurer, organization for managed care or third-1
party administrator, as applicable. The request for reimbursement 2
must include, without limitation: 3
(a) The identity of the injured employee for whom the costs of 4
treatment and services was paid. 5
(b) A description of the treatment and services provided to the 6
injured employee. 7
(c) The identity of the person who paid for the treatment and 8
services for the injured employee. 9
(d) The costs of treatment and services for which 10
reimbursement is being requested. 11
5. Not later than 30 days after receipt of a request for 12
reimbursement submitted pursuant to subsection 4, the employer 13
of the injured employee or the employer’s insurer, organization 14
for managed care or third-party administrator, as applicable, from 15
whom reimbursement is sought shall fully reimburse the injured 16
employee, health insurer or casualty insurer, as applicable, who 17
paid for treatment and services on behalf of the injured employee 18
for the amount paid for the treatment or services as set forth in the 19
request for reimbursement. 20
6. If the Administrator determines that an insurer, 21
organization for managed care or third-party administrator has 22
failed to fully reimburse an injured employee, health insurer or 23
casualty insurer, as applicable, within the time required by 24
subsection 5, the Administrator shall order the insurer, 25
organization for managed care or third-party administrator to pay 26
to the injured employee, health insurer or casualty insurer, as 27
applicable, an amount equal to three times the amount of 28
reimbursement required for each day that the reimbursement 29
remains unpaid beginning on the date on which the insurer, 30
organization for managed care or third-party administrator 31
received the request for reimbursement submitted pursuant to 32
subsection 4. 33
7. Any amount ordered by the Administrator to be paid 34
pursuant to subsection 6 is in addition to any amounts for: 35
(a) Benefits to which the injured employee is entitled under the 36
claim for the occupational disease set forth in NRS 617.455 or 37
617.457, as applicable; and 38
(b) Any fines and penalties imposed by the Administrator 39
pursuant to NRS 616D.120. 40
8. As used in this section: 41
(a) “Casualty insurer” means an insurer or other organization 42
providing coverage or benefits under a policy or contract of 43
casualty insurance in the manner described in subsection 2 of 44
NRS 681A.020. 45
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(b) “Health insurer” means an insurer or other organization 1
providing health coverage or benefits in accordance with state or 2
federal law. 3
Sec. 3. NRS 616C.050 is hereby amended to read as follows: 4
616C.050 1. An insurer shall provide to each claimant: 5
(a) Upon written request, one copy of any medical information 6
concerning the claimant’s injury or illness. 7
(b) A statement which contains information concerning the 8
claimant’s right to: 9
(1) Receive the information and forms necessary to file a 10
claim; 11
(2) Select a treating physician or chiropractic physician and 12
an alternative treating physician or chiropractic physician in 13
accordance with the provisions of NRS 616C.090 [;] and section 2 14
of this act; 15
(3) Request the appointment of the Nevada Attorney for 16
Injured Workers to represent the claimant before the appeals officer; 17
(4) File a complaint with the Administrator; 18
(5) When applicable, receive compensation for: 19
(I) Permanent total disability; 20
(II) Temporary total disability; 21
(III) Permanent partial disability; 22
(IV) Temporary partial disability; 23
(V) All medical costs related to the claimant’s injury or 24
disease; or 25
(VI) The hours the claimant is absent from the place of 26
employment to receive medical treatment pursuant to 27
NRS 616C.477; 28
(6) Receive services for rehabilitation if the claimant’s injury 29
prevents him or her from returning to gainful employment; 30
(7) Review by a hearing officer of any determination or 31
rejection of a claim by the insurer within the time specified by 32
statute; and 33
(8) Judicial review of any final decision within the time 34
specified by statute. 35
2. The insurer’s statement must include a copy of the form 36
designed by the Administrator pursuant to subsection 12 of NRS 37
616C.090 that notifies injured employees of their right to select an 38
alternative treating physician or chiropractic physician. The 39
Administrator shall adopt regulations for the manner of compliance 40
by an insurer with the other provisions of subsection 1. 41
Sec. 4. NRS 616C.090 is hereby amended to read as follows: 42
616C.090 1. The Administrator shall establish, maintain and 43
update not less frequently than annually on or before July 1 of each 44
year, a panel of physicians and chiropractic physicians who have 45
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demonstrated special competence and interest in industrial health to 1
treat injured employees under chapters 616A to 616D, inclusive, or 2
chapter 617 of NRS. The Administrator shall maintain the following 3
information relating to each physician and chiropractic physician on 4
the panel: 5
(a) The name of the physician or chiropractic physician. 6
(b) The title or degree of the physician or chiropractic physician. 7
(c) The legal name of the practice of the physician or 8
chiropractic physician and the name under which the practice does 9
business. 10
(d) The street address of the location of every office of the 11
physician or chiropractic physician. 12
(e) The telephone number of every office of the physician or 13
chiropractic physician. 14
(f) Every discipline and specialization practiced by the physician 15
or chiropractic physician. 16
(g) Every condition and part of the body which the physician or 17
chiropractic physician will treat. 18
2. Every employer whose insurer has not entered into a 19
contract with an organization for managed care or with providers of 20
health care pursuant to NRS 616B.527 shall maintain a list of those 21
physicians and chiropractic physicians on the panel who are 22
reasonably accessible to his or her employees. 23
3. [An] Except as otherwise provided in section 2 of this act, 24
an injured employee whose employer’s insurer has not entered into 25
a contract with an organization for managed care or with providers 26
of health care pursuant to NRS 616B.527 may choose a treating 27
physician or chiropractic physician from the panel of physicians and 28
chiropractic physicians. If the injured employee is not satisfied with 29
the first physician or chiropractic physician he or she so chooses, the 30
injured employee may make an alternative choice of physician or 31
chiropractic physician from the panel if the choice is made within 90 32
days after his or her injury. The insurer shall notify the first 33
physician or chiropractic physician in writing. The notice must be 34
postmarked within 3 working days after the insurer receives 35
knowledge of the change. The first physician or chiropractic 36
physician must be reimbursed only for the services the physician or 37
chiropractic physician, as applicable, rendered to the injured 38
employee up to and including the date of notification. Except as 39
otherwise provided in this subsection, any further change is subject 40
to the approval of the insurer or by order of a hearing officer or 41
appeals officer. A request for a change of physician or chiropractic 42
physician must be granted or denied within 10 days after a written 43
request for such a change is received from the injured employee. If 44
the insurer takes no action on the request within 10 days, the request 45
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shall be deemed granted. Any request for a change of physician or 1
chiropractic physician must include the name of the new physician 2
or chiropractic physician chosen by the injured employee. If the 3
treating physician or chiropractic physician refers the injured 4
employee to a specialist for treatment, the insurer shall provide to 5
the injured employee a list that includes the name of each physician 6
or chiropractic physician with that specialization who is on the 7
panel. Not later than 14 days after receiving the list, the injured 8
employee shall select a physician or chiropractic physician from the 9
list. 10
4. [An] Except as otherwise provided in section 2 of this act, 11
an injured employee whose employer’s insurer has entered into a 12
contract with an organization for managed care or with providers of 13
health care pursuant to NRS 616B.527 must choose a treating 14
physician or chiropractic physician pursuant to the terms of that 15
contract. If the injured employee is not satisfied with the first 16
physician or chiropractic physician he or she so chooses, the injured 17
employee may make an alternative choice of physician or 18
chiropractic physician pursuant to the terms of the contract without 19
the approval of the insurer if the choice is made within 90 days after 20
his or her injury. Except as otherwise provided in this subsection, 21
any further change is subject to the approval of the insurer or by 22
order of a hearing officer or appeals officer. A request for a change 23
of physician or chiropractic physician must be granted or denied 24
within 10 days after a written request for such a change is received 25
from the injured employee. If the insurer takes no action on the 26
request within 10 days, the request shall be deemed granted. If the 27
injured employee, after choosing a treating physician or chiropractic 28
physician, moves to a county which is not served by the 29
organization for managed care or providers of health care named in 30
the contract and the insurer determines that it is impractical for the 31
injured employee to continue treatment with the physician or 32
chiropractic physician, the injured employee must choose a treating 33
physician or chiropractic physician who has agreed to the terms of 34
that contract unless the insurer authorizes the injured employee to 35
choose another physician or chiropractic physician. If the treating 36
physician or chiropractic physician refers the injured employee to a 37
specialist for treatment, the insurer shall provide to the injured 38
employee a list that includes the name of each physician or 39
chiropractic physician with that specialization who is available 40
pursuant to the terms of the contract with the organization for 41
managed care or with providers of health care pursuant to NRS 42
616B.527, as appropriate. Not later than 14 days after receiving the 43
list, the injured employee shall select a physician or chiropractic 44
physician from the list. If the employee fails to select a physician or 45
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chiropractic physician, the insurer may select a physician 1
or chiropractic physician with that specialization. If a physician or 2
chiropractic physician with that specialization is not available 3
pursuant to the terms of the contract, the organization for managed 4
care or the provider of health care may select a physician or 5
chiropractic physician with that specialization. 6
5. If the injured employee is not satisfied with the physician or 7
chiropractic physician selected by himself or herself or by the 8
insurer, the organization for managed care or the provider of health 9
care pursuant to subsection 4, the injured employee may make an 10
alternative choice of physician or chiropractic physician pursuant to 11
the terms of the contract. A change in the treating physician or 12
chiropractic physician may be made at any time but is subject to the 13
approval of the insurer or by order of a hearing officer or appeals 14
officer. A request for a change of physician or chiropractic 15
physician must be granted or denied within 10 days after a written 16
request for such a change is received from the injured employee. If 17
no action is taken on the request within 10 days, the request shall be 18
deemed granted. Any request for a change of physician or 19
chiropractic physician must include the name of the new physician 20
or chiropractic physician chosen by the injured employee. If the 21
insurer denies a request for a change in the treating physician or 22
chiropractic physician under this subsection, the insurer must 23
include in a written notice of denial to the injured employee the 24
specific reason for the denial of the request. 25
6. Except when emergency medical care is required and except 26
as otherwise provided in NRS 616C.055, the insurer is not 27
responsible for any charges for medical treatment or other accident 28
benefits furnished or ordered by any physician, chiropractic 29
physician or other person selected by the injured employee in 30
disregard of the provisions of this section or for any compensation 31
for any aggravation of the injured employee’s injury attributable to 32
improper treatments by such physician, chiropractic physician or 33
other person. 34
7. The Administrator may order necessary changes in a panel 35
of physicians and chiropractic physicians and shall: 36
(a) Suspend or remove any physician or chiropractic physician 37
from a panel for good cause shown in accordance with NRS 38
616C.087; and 39
(b) Remove from being included on a panel as a practitioner of a 40
discipline or specialization any physician or chiropractic physician 41
who does not accept and treat injured employees for industrial 42
injuries or occupational diseases in that discipline or specialization. 43
8. Any interested person may notify the Administrator, on a 44
form prescribed by the Administrator, if the person believes that a 45
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physician or chiropractic physician does not accept and treat injured 1
employees: 2
(a) Under chapters 616A to 616D, inclusive, or chapter 617 of 3
NRS for industrial injuries or occupational diseases; or 4
(b) For industrial injuries or occupational diseases in a discipline 5
or specialization for which the physician or chiropractic physician is 6
included on a panel of physicians and chiropractic physicians 7
maintained by the Administrator pursuant to this section. 8
9. If the Administrator receives notice pursuant to subsection 8, 9
the Administrator shall: 10
(a) Conduct an investigation to determine whether the physician 11
or chiropractic physician may remain on the panel for a discipline or 12
specialization; and 13
(b) Publish or cause to be published on the Internet website of 14
the Division not later than 90 days after receiving the notice the 15
results of the investigation. 16
10. A physician or chiropractic physician who is removed from 17
a panel as a practitioner of a discipline or specialization pursuant to 18
paragraph (b) of subsection 7 may request, on a form prescribed by 19
the Administrator, to be reinstated on a panel for that discipline or 20
specialization if the physician or chiropractic physician 21
demonstrates to the satisfaction of the Administrator that he or she 22
accepts and treats injured employees for that discipline or 23
specialization. 24
11. An injured employee may receive treatment by more than 25
one physician or chiropractic physician: 26
(a) If the insurer provides written authorization for such 27
treatment; or 28
(b) By order of a hearing officer or appeals officer. 29
12. The Administrator shall design a form that notifies injured 30
employees of their right pursuant to subsections 3, 4 and 5 to select 31
an alternative treating physician or chiropractic physician and make 32
the form available to insurers for distribution pursuant to subsection 33
2 of NRS 616C.050. 34
Sec. 5. NRS 616C.475 is hereby amended to read as follows: 35
616C.475 1. Except as otherwise provided in this section, 36
NRS 616C.175 and 616C.390, every employee in the employ of an 37
employer, within the provisions of chapters 616A to 616D, 38
inclusive, of NRS, who is injured by accident arising out of and in 39
the course of employment, or his or her dependents, is entitled to 40
receive for the period of temporary total disability, 66 2/3 percent of 41
the average monthly wage. 42
2. Except as otherwise provided in NRS 616B.028 and 43
616B.029, an injured employee or his or her dependents are not 44
entitled to accrue or be paid any benefits for a temporary total 45
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disability during the time the injured employee is incarcerated. The 1
injured employee or his or her dependents are entitled to receive 2
such benefits when the injured employee is released from 3
incarceration if the injured employee is certified as temporarily 4
totally disabled by a physician or chiropractic physician. 5
3. If a claim for the period of temporary total disability is 6
allowed, the first payment pursuant to this section must be issued by 7
the insurer within 14 working days after receipt of the initial 8
certification of disability and regularly thereafter. 9
4. Any increase in compensation and benefits effected by the 10
amendment of subsection 1 is not retroactive. 11
5. Payments for a temporary total disability must cease when: 12
(a) A physician or chiropractic physician determines that the 13
employee is physically capable of any gainful employment for 14
which the employee is suited, after giving consideration to the 15
employee’s education, training and experience; 16
(b) The employer offers the employee light-duty employment or 17
employment that is modified according to the limitations or 18
restrictions imposed by a physician or chiropractic physician 19
pursuant to subsection 7; or 20
(c) Except as otherwise provided in NRS 616B.028 and 21
616B.029, the employee is incarcerated. 22
6. Each insurer may, with each check that it issues to an injured 23
employee for a temporary total disability, include a form approved 24
by the Division for the injured employee to request continued 25
compensation for the temporary total disability. 26
7. A certification of disability issued by a physician or 27
chiropractic physician must: 28
(a) Include the period of disability and a description of any 29
physical limitations or restrictions imposed upon the work of the 30
employee; 31
(b) Specify whether the limitations or restrictions are permanent 32
or temporary; and 33
(c) Be signed by the treating physician or chiropractic physician 34
authorized pursuant to NRS 616B.527 or appropriately chosen 35
pursuant to subsection 4 or 5 of NRS 616C.090 [.] or subsection 1 36
of section 2 of this act. 37
8. If the certification of disability specifies that the physical 38
limitations or restrictions are temporary, the employer of the 39
employee at the time of the employee’s accident may offer 40
temporary, light-duty employment to the employee. If the employer 41
makes such an offer, the employer shall confirm the offer in writing 42
within 10 days after making the offer. The making, acceptance or 43
rejection of an offer of temporary, light-duty employment pursuant 44
to this subsection does not affect the eligibility of the employee to 45
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receive vocational rehabilitation services, including compensation, 1
and does not exempt the employer from complying with NRS 2
616C.545 to 616C.575, inclusive, and 616C.590 or the regulations 3
adopted by the Division governing vocational rehabilitation 4
services. Any offer of temporary, light-duty employment made by 5
the employer must specify a position that: 6
(a) Is substantially similar to the employee’s position at the time 7
of his or her injury in relation to the location of the employment and 8
the hours the employee is required to work; 9
(b) Provides a gross wage that is: 10
(1) If the position is in the same classification of 11
employment, equal to the gross wage the employee was earning at 12
the time of his or her injury; or 13
(2) If the position is not in the same classification of 14
employment, substantially similar to the gross wage the employee 15
was earning at the time of his or her injury; and 16
(c) Has the same employment benefits as the position of the 17
employee at the time of his or her injury. 18
Sec. 6. The amendatory provisions of this act apply 19
prospectively with regard to any claim filed pursuant to chapters 20
616A to 616D, inclusive, or 617 of NRS which is filed on or after 21
October 1, 2025. 22
H