By Cy Ryan

Fri, Mar 28, 2008 (2 a.m.)

Despite its financial troubles, Nevada has retained its good bond ratings.

Robin Reedy, chief deputy state treasurer, says she’s pleased the state maintained its bond rating “given the most recent economic news.”

The state this week sold $10 million in open space and parks bonds to UBS Securities and will pay an interest rate of 4.48 percent. UBS also purchased $22.5 million in parks and natural resources bonds at a 4.59 percent interest rate.

Reedy said Fitch and Standard and Poor’s both put the state’s bond rating at AA+, and Moody’s gives Nevada an Aa1 rating.

The state faces about an $800 million shortfall over the next 15 months. State agencies have cut more than 4 percent to help offset the $565 million budget cut Gov. Jim Gibbons imposed in January to compensate for smaller than predicted tax collections. Gibbons’ revelation this week that the shortfall has increased could force additional reductions.

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People with health insurance often are stunned to receive large bills after being treated in an emergency room or a hospital.

“It’s a major problem,” state Insurance Commissioner Alice Molasky-Arman said.

It usually occurs because treating physicians, surgeons, anesthesiologists or other doctors do not have contracts with the individual’s insurance company.

Bills have been introduced in several sessions of the Legislature to address the problem, but they have always died, said Jack Kim, a representative of insurance companies.

Molasky-Arman explained that a physician who is not under contract with the insurance company may be paid “significantly less” for treating a patient, who then must make up the difference.

The issue was aired at Tuesday’s meeting of Molasky-Arman’s advisory committee on health care and insurance.

Valerie Rosalin, chief ombudsman for consumer health, said her office tries to negotiate among insurance companies, patients and doctors. But it doesn’t have authority over physicians and their billing.

If there’s no progress in the negotiations, the issue is sometimes turned over to the state attorney general’s office to try to reach a settlement, Rosalin said.

Her office, she said, has authority over disputes involving hospitals, but not doctors. She said she can understand physicians not wanting others to have control over their billing, but that controls may be needed to remedy situations in which consumers get hit with large, unexpected medical bills.

There was a consensus at the meeting that patients should be informed of what is and is not covered by policies. But there was no agreement on whether doctors, hospitals or others should inform consumers about the limits of their policies.

Molasky-Arman directed a committee headed by Kim to study the problem and find a solution.

Kim’s committee will report back this summer.

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The 1995 Legislature passed a “Truth in Sentencing” law setting new maximum and minimum sentences for criminal behavior.

Since then scores of new laws have been approved creating new crimes and sentences.

But the judiciary committees of the Senate and Assembly, which fashion the laws, have never debated the lengths of those sentences, relying on their staffs for recommendations.

An independent study has not been done on how the 1995 law and subsequent ones affect the prison system — notably the costs, Nevada Supreme Court Justice Jim Hardesty said.

A subcommittee headed by Hardesty has decided to hire James Austin of Washington, D.C., who has worked on Nevada’s sentencing, parole and prison issues, to study the question.

“Has the state been as smart as it can be with its dollars to incarcerate individuals for that behavior?” Hardesty said. “Maybe it has, but rather than speculate, an impartial study will help evaluate this information.”

The state spends about 8 percent of its budget on the prison system, with one-third of the money for buildings going for new or expanded prisons.

The study’s results will provide information to the parent Advisory Commission on the Administration of Justice and to the 2009 Legislature “on any areas that may be out of whack or disproportionate,” Hardesty said.

Austin’s study is expected to cost about $100,000.