written notice must be: (a) Sent by first-class mail addressed to the last known address of the claimant; and (b) A document that is separate from any other document or form that is used by the insurer. 4. The closure of a claim pursuant to subsection 2 is not effective unless notice is given as required by subsections 2 and 3. (Added to NRS by 1979, 707; A 1981, 1140, 1492; 1989, 333; 1991, 2421; 1993, 746; 1997, 1437; 1999, 1783, 2416; 2001, 115) ACCIDENT BENEFITS NRS 616C.245 Injured employee entitled to accident benefits; limitation on receipt of modified motor vehicle as accident benefit; regulations establishing maximum benefit. 1. Every injured employee within the provisions of chapters 616A to 616D, inclusive, of NRS is entitled to receive promptly such accident benefits as may reasonably be required at the time of the injury and within 6 months thereafter. Such benefits may be further extended for additional periods as may be required. 2. An injured employee is entitled to receive as an accident benefit a motor vehicle that is modified to allow the employee to operate the vehicle safely if: (a) As a result of an injury arising out of and in the course of his employment, he is quadriplegic, paraplegic or has had a part of his body amputated; and (b) He cannot be fitted with a prosthetic device which allows him to operate a motor vehicle safely. 3. If an injured employee is entitled to receive a motor vehicle pursuant to subsection 2, a motor vehicle must be modified to allow the employee to operate it safely in the following order of preference: (a) A motor vehicle owned by the injured employee must be so modified if the insurer or employer providing accident benefits determines that it is reasonably feasible to do so. (b) A used motor vehicle must be so modified if the insurer or employer providing accident benefits determines that it is reasonably feasible to do so. (c) A new motor vehicle must be so modified. 4. The Administrator shall adopt regulations establishing a maximum benefit to be paid under the provisions of this section. [Part 58:168:1947; 1943 NCL § 2680.58]—(NRS A 1957, 28; 1973, 605; 1993, 733; 2003, 2332) NRS 616C.250 Establishment, revision and compliance with standards of care for provision of accident benefits. 1. The Division shall, after consulting with and considering the advice of persons representative of organized labor groups, employers, insurers and providers of health care, adopt regulations establishing standards of care for the provision of accident benefits to employees who have suffered industrial injuries or occupational diseases. The standards must include, but are not limited to criteria and protocols to be used as minimal guides for evaluating and ensuring the quality of programs of treatment and for reviewing the: (a) Utilization of diagnostic procedures and the provision of other medical services; (b) Treatment and expected durations of industrial injuries and occupational diseases; (c) Utilization of narcotic drugs and other forms of medication; (d) Referral of patients to obtain a second opinion; and (e) Provision of care by more than one provider of health care. The standards must be consistent with national or regional guidelines and must be specific to medicine for industrial injuries and occupational diseases. 2. The Division shall, after consulting with and considering the advice of persons representative of organized labor groups, employers, insurers and providers of health care, periodically review and revise as necessary the standards established pursuant to subsection 1. 3. An insurer and each person who provides any accident benefit to an employee who has suffered an industrial injury or occupational disease shall comply with the regulations adopted pursuant to this section. (Added to NRS by 1991, 389; A 1993, 1858)—(Substituted in revision for NRS 616.188) NRS 616C.255 Premium for accident benefits paid by employer; accident benefits provided by private carrier; separate account for accident benefits. 1. Each private carrier shall collect a premium upon the total payroll of every employer insured by the private carrier at the rate filed with the Commissioner pursuant to chapter 686B of NRS. 2. Every employer paying this premium is relieved from furnishing accident benefits, and the accident benefits must be provided by the private carrier. 3. The private carrier is liable for any accident benefits provided in this section. The account provided for accident benefits must be kept as a separate account on the records of the private carrier. [Part 58:168:1947; 1943 NCL § 2680.58]—(NRS A 1973, 601; 1981, 1475; 1995, 2027; 1997, 1438; 1999, 444, 1784) NRS 616C.260 Fees and charges for accident benefits: Restrictions; establishment and revision of schedule; powers and duties of Administrator; penalty for refusal to provide information; regulations. 1. All fees and charges for accident benefits must not: (a) Exceed the amounts usually billed and paid in the State for similar treatment. (b) Be unfairly discriminatory as between persons legally qualified to provide the particular service for which the fees or charges are asked. 2. The Administrator shall, giving consideration to the fees and charges being billed and paid in the State, establish a schedule of reasonable fees and charges allowable for accident benefits provided to injured employees whose insurers have not contracted with an organization for managed care or with providers of health care services pursuant to NRS 616B.527. The Administrator shall review and revise the schedule on or before February 1 of each year. In the revision, the Administrator shall adjust the schedule by the corresponding annual change in the Consumer Price Index, Medical Care Component. 3. The Administrator shall designate a vendor who compiles data on a national basis concerning fees and charges that are billed and paid for treatment or services similar to the treatment and services that qualify as accident benefits in this State to provide him with such information as he deems necessary to carry out the provisions of subsection 2. The designation must be made pursuant to reasonable competitive bidding procedures established by the Administrator. In addition, the Administrator may request a health insurer, health maintenance organization or provider of accident benefits, an agent or employee of such a person, or an agency of the State to provide the Administrator with information concerning fees and charges that are billed and paid in this State for similar services as he deems necessary to carry out the provisions of subsection 2. The Administrator shall require a health insurer, health maintenance organization or provider of accident benefits, an agent or employee of such a person, or an agency of the State that provides records or reports of fees and charges billed and paid pursuant to this section to provide interpretation and identification concerning the information delivered. The Administrator may impose an administrative fine of $500 on a health insurer, health maintenance organization or provider of accident benefits, or an agent or employee of such a person for each refusal to provide the information requested pursuant to this subsection. 4. The Division may adopt reasonable regulations necessary to carry out the provisions of this section. The regulations must include provisions concerning: (a) Standards for the development of the schedule of fees and charges that are billed and paid; and (b) The monitoring of compliance by providers of benefits with the schedule of fees and charges. 5. The Division shall adopt regulations requiring the use of a system of billing codes as recommended by the American Medical Association. (Added to NRS by 1981, 1454; A

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