{"data":{"id":"us-nv/nrs-695g.280","jurisdiction":"us-nv","citation":"NRS 695G.280","heading":"Basis for decision of independent review organization.","body":"The decision of an independent review organization concerning a request for an external review must be based on:\n1. Documentary evidence, including any recommendation of the physician or dentist of the insured submitted pursuant to NRS 695G.251;\n2. Medical or scientific evidence, including, without limitation:\n(a) Professional standards of safety and effectiveness for diagnosis, care and treatment that are generally recognized in the United States;\n(b) Any report published in literature that is peer-reviewed;\n(c) Evidence-based medicine, including, without limitation, reports and guidelines that are published by professional organizations that are recognized nationally and that include supporting scientific data; and\n(d) An opinion of an independent physician or dentist who, as determined by the independent review organization, is an expert in the health specialty that is the subject of the independent review; and\n3. The terms and conditions for benefits set forth in the evidence of coverage issued to the insured by the health carrier.","path":["TITLE 57 — INSURANCE","CHAPTER 695G - MANAGED CARE","EXTERNAL REVIEW OF ADVERSE DETERMINATION"],"source_url":"https://www.leg.state.nv.us/NRS/NRS-695G.html#NRS695GSec280","current_through":"2025 session (NRS as revised 2026-08-25)","vintage":"","retrieved_at":"2026-09-03T05:51:46Z","sha256":"33d0b22eb939b994e1c8aaef85e174d96e54e995ce8106ad824e465e683dc97e","source_id":"us-nv","stale":true,"prev":"us-nv/nrs-695g.275","next":"us-nv/nrs-695g.290"},"notice":"GroundRules: Original legal text. Not legal advice."}