Nevada § 616D.130 - Investigation of alleged violation; determination of Administrator

§ 616D.130. Investigation of alleged violation; determination of Administrator

1. Upon receipt of a complaint for a violation of subsection 1, 2 or 3 of NRS 616D.120 , or if the Administrator has reason to believe that such a violation has occurred,

the Administrator shall: (a) Promptly provide a copy of the complaint, or an explanation of the reason the

Administrator believes that a violation has occurred to: (1) The Commissioner; and (2) The insurer, organization for managed care, health care provider, third-party

administrator, employer or professional employer organization that allegedly committed

the violation; and (b) Cause to be conducted an investigation of the alleged violation. 2. The Administrator shall: (a) Within 30 days after receipt of a complaint pursuant to subsection 1, initiate

an investigation; (b) Within 60 days after the date on which the investigation is initiated, complete

the investigation; and (c) Within 30 days after the investigation is completed, render a determination and

deliver a copy of the determination to: (1) The Commissioner; and (2) The insurer, organization for managed care, health care provider, third-party

administrator, employer or professional employer organization that was the subject

of the investigation. 3. The determination rendered pursuant to subsection 2 must include the Administrator's

findings of fact, any settlement agreement on the matter and, if the Administrator

determines that a violation has occurred, one or more of the following: (a) The amount of any fine required to be paid pursuant to NRS 616D.120 . (b) The amount of any benefit penalty required to be paid to a claimant pursuant to NRS 616D.120 . (c) A plan of corrective action to be taken by the insurer, organization for managed

care, health care provider, third-party administrator or employer, including the manner

and time within which the violation must be corrected. (d) A requirement that notice of the violation be given to the appropriate agency

that regulates the activities of the violator. 4. If, based upon the Administrator's findings of fact, the Administrator determines

that a violation has not occurred, the Administrator shall issue a determination to

that effect.