Certification as an Insurer Authorization to operate as a certified vendor in the State of Nevada with the projected number of Medicaid and Nevada Check Up Members by the United States Secretary of Health and Human Services and the Insurance Commissioner of the State of Nevada are conditions precedent to the Contract and shall continue as conditions during the term of any Contract. The Contractor must hold a current certificate of authority from the Nevada State Insurance Commissioner for the applicable Contract period and throughout the Contract period, or have a written opinion from the Insurance Commissioner that such a certificate is not required. The Contractor must provide proof of a valid certificate of authority to the State in accordance with the Reporting Requirements exhibit, Section 1903(m)(1) of the Act, and 42 CFR 438.116(b). Required Insurance Coverages The Contractor must maintain, for the duration of its contract, insurance coverages as set forth in the Insurance Schedule attachment and the Contract Form attachment. Work on the Contract shall not begin until after the Awarded Vendor has submitted acceptable evidence of the required insurance coverages in accordance with the Reporting Requirements exhibit. Failure to maintain any required insurance coverage or acceptable alternative method of insurance will be deemed a breach of contract. Accreditation The Contractor must be accredited by the National Committee for Quality Assurance (NCQA), a nationally recognized organization that provides an independent assessment of the quality of care provided by the Contractor. Accredited organizations must meet quality standards related to various aspects such as consumer protection, care management, and quality improvement activities and facilitates comparison of Contractors due to consistent data requirements. The Contractor must authorize the NCQA to provide the State with all information specified in 42 Code of Federal Regulations (CFR) 438.332(b) and 42 CFR 457.1240(c). NCQA accreditation must be obtained within one (1) year of the Go-Live date of the Contract, which is January 1, 2026. The Contractor must notify the State prior to January 1, 2027 of its accreditation status by NCQA. If NCQA accreditation is not achieved by January 1, 2027 and the State does not grant an extension of the timeframe, the Contractor will be considered in breach of the Contract and the State will have the option to terminate the Contract in accordance with Section 17.5 and the Contract Form attachment.
