Nevada 2023 Regular Session

Nevada Senate Bill SB330 Compare Versions

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1	1
2	2
3	3	- 82nd Session (2023)
4	4	Senate Bill No. 330–Senator Lange
5	5
6	6	CHAPTER..........
7	7
8	8	AN ACT relating to health care; revising requirements for certain
9	9	health insurance plans to provide certain benefits for
10	10	preventative health care relating to breast cancer; and
11	11	providing other matters properly relating thereto.
12	12	Legislative Counsel’s Digest:
13	13	Existing law requires most health insurance plans, including individual, group
14	14	and blanket health insurance policies, small employer plans, benefit contracts
15	15	provided by fraternal benefit societies, contracts for hospital or medical service,
16	16	health care plans of health maintenance organizations and plans issued by managed
17	17	care organizations to include coverage for mammograms. (NRS 689A.0405,
18	18	689B.0374, 689C.1674, 695A.1855, 695B.1912, 695C.1735, 695G.1713) Sections
19	19	1-5, 6 and 7 of this bill revise existing provisions requiring coverage for
20	20	mammograms to require such policies, plans and contracts of health care to
21	21	additionally provide coverage for imaging tests to screen for breast cancer and
22	22	diagnostic imaging tests for breast cancer for certain covered persons without
23	23	requiring any deductible, copayment, coinsurance or any other form of cost-
24	24	sharing, except under certain circumstances relating to the eligibility of health
25	25	savings accounts associated with policies, plans and contracts of health care that
26	26	have high deductibles. Sections 5.5, 6.5, 7.5 and 8 of this bill make various
27	27	changes to exclude the Public Employees’ Benefits Program and plans of self-
28	28	insurance for employees of local governments from the requirements of this bill
29	29	and, thus, the Program and such plans may, but are not required to, provide the
30	30	coverage set forth in this bill. Sections 7.2 and 7.3 of this bill make changes
31	31	necessary so that requirements concerning mammograms that currently apply to the
32	32	Program and plans of self-insurance for employees of local governments continue
33	33	to apply to the Program and such plans. Sections 7.7 and 7.9 of this bill make
34	34	conforming changes to indicate the proper placement of sections 7.2 and 7.3,
35	35	respectively, in the Nevada Revised Statutes.
36	36
37	37	EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted.
38	38
39	39
40	40	THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
41	41	SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
42	42
43	43	Section 1. NRS 689A.0405 is hereby amended to read as
44	44	follows:
45	45	689A.0405 1. A policy of health insurance must provide
46	46	coverage for benefits payable for expenses incurred for [a] :
47	47	(a) A mammogram [every 2 years, or] to screen for breast
48	48	cancer annually [if ordered by a provider of health care,] for
49	49	[women] insureds who are 40 years of age or older.
50	50	(b) An imaging test to screen for breast cancer on an interval
51	51	and at the age deemed most appropriate, when medically
52	52	necessary, as recommended by the insured’s provider of health
53	53	– 2 –
54	54
55	55
56	56	- 82nd Session (2023)
57	57	care based on personal or family medical history or additional
58	58	factors that may increase the risk of breast cancer for the insured.
59	59	(c) A diagnostic imaging test for breast cancer at the age
60	60	deemed most appropriate, when medically necessary, as
61	61	recommended by the insured’s provider of health care to evaluate
62	62	an abnormality which is:
63	63	(1) Seen or suspected from a mammogram described in
64	64	paragraph (a) or an imaging test described in paragraph (b); or
65	65	(2) Detected by other means of examination.
66	66	2. An insurer must ensure that the benefits required by
67	67	subsection 1 are made available to an insured through a provider of
68	68	health care who participates in the network plan of the insurer.
69	69	3. Except as otherwise provided in subsection 5, an insurer that
70	70	offers or issues a policy of health insurance shall not:
71	71	(a) [Require] Except as otherwise provided in subsection 6,
72	72	require an insured to pay a [higher] deductible, [any] copayment ,
73	73	[or] coinsurance or any other form of cost-sharing or require a
74	74	longer waiting period or other condition to obtain any benefit
75	75	provided in the policy of health insurance pursuant to subsection 1;
76	76	(b) Refuse to issue a policy of health insurance or cancel a
77	77	policy of health insurance solely because the person applying for or
78	78	covered by the policy uses or may use any such benefit;
79	79	(c) Offer or pay any type of material inducement or financial
80	80	incentive to an insured to discourage the insured from obtaining any
81	81	such benefit;
82	82	(d) Penalize a provider of health care who provides any such
83	83	benefit to an insured, including, without limitation, reducing the
84	84	reimbursement of the provider of health care;
85	85	(e) Offer or pay any type of material inducement, bonus or other
86	86	financial incentive to a provider of health care to deny, reduce,
87	87	withhold, limit or delay access to any such benefit to an insured; or
88	88	(f) Impose any other restrictions or delays on the access of an
89	89	insured to any such benefit.
90	90	4. A policy subject to the provisions of this chapter which is
91	91	delivered, issued for delivery or renewed on or after January 1,
92	92	[2018,] 2024, has the legal effect of including the coverage required
93	93	by subsection 1, and any provision of the policy or the renewal
94	94	which is in conflict with this section is void.
95	95	5. Except as otherwise provided in this section and federal law,
96	96	an insurer may use medical management techniques, including,
97	97	without limitation, any available clinical evidence, to determine the
98	98	frequency of or treatment relating to any benefit required by this
99	99	– 3 –
100	100
101	101
102	102	- 82nd Session (2023)
103	103	section or the type of provider of health care to use for such
104	104	treatment.
105	105	6. If the application of paragraph (a) of subsection 3 would
106	106	result in the ineligibility of a health savings account of an insured
107	107	pursuant to 26 U.S.C. § 223, the prohibitions of paragraph (a) of
108	108	subsection 3 shall apply only for a qualified policy of health
109	109	insurance with respect to the deductible of such a policy of health
110	110	insurance after the insured has satisfied the minimum deductible
111	111	pursuant to 26 U.S.C. § 223, except with respect to items or
112	112	services that constitute preventive care pursuant to 26 U.S.C. §
113	113	223(c)(2)(C), in which case the prohibitions of paragraph (a) of
114	114	subsection 3 shall apply regardless of whether the minimum
115	115	deductible under 26 U.S.C. § 223 has been satisfied.
116	116	7. As used in this section:
117	117	(a) “Medical management technique” means a practice which is
118	118	used to control the cost or utilization of health care services or
119	119	prescription drug use. The term includes, without limitation, the use
120	120	of step therapy, prior authorization or categorizing drugs and
121	121	devices based on cost, type or method of administration.
122	122	(b) “Network plan” means a policy of health insurance offered
123	123	by an insurer under which the financing and delivery of medical
124	124	care, including items and services paid for as medical care, are
125	125	provided, in whole or in part, through a defined set of providers
126	126	under contract with the insurer. The term does not include an
127	127	arrangement for the financing of premiums.
128	128	(c) “Provider of health care” has the meaning ascribed to it in
129	129	NRS 629.031.
130	130	(d) “Qualified policy of health insurance” means a policy of
131	131	health insurance that has a high deductible and is in compliance
132	132	with 26 U.S.C. § 223 for the purposes of establishing a health
133	133	savings account.
134	134	Sec. 2. NRS 689B.0374 is hereby amended to read as follows:
135	135	689B.0374 1. A policy of group health insurance must
136	136	provide coverage for benefits payable for expenses incurred for [a] :
137	137	(a) A mammogram [every 2 years, or] to screen for breast
138	138	cancer annually [if ordered by a provider of health care,] for
139	139	[women] insureds who are 40 years of age or older.
140	140	(b) An imaging test to screen for breast cancer on an interval
141	141	and at the age deemed most appropriate, when medically
142	142	necessary, as recommended by the insured’s provider of health
143	143	care based on personal or family medical history or additional
144	144	factors that may increase the risk of breast cancer for the insured.
145	145	– 4 –
146	146
147	147
148	148	- 82nd Session (2023)
149	149	(c) A diagnostic imaging test for breast cancer at the age
150	150	deemed most appropriate, when medically necessary, as
151	151	recommended by the insured’s provider of health care to evaluate
152	152	an abnormality which is:
153	153	(1) Seen or suspected from a mammogram described in
154	154	paragraph (a) or an imaging test described in paragraph (b); or
155	155	(2) Detected by other means of examination.
156	156	2. An insurer must ensure that the benefits required by
157	157	subsection 1 are made available to an insured through a provider of
158	158	health care who participates in the network plan of the insurer.
159	159	3. Except as otherwise provided in subsection 5, an insurer that
160	160	offers or issues a policy of group health insurance shall not:
161	161	(a) [Require] Except as otherwise provided in subsection 6,
162	162	require an insured to pay a [higher] deductible, [any] copayment ,
163	163	[or] coinsurance or any other form of cost-sharing or require a
164	164	longer waiting period or other condition to obtain any benefit
165	165	provided in the policy of group health insurance pursuant to
166	166	subsection 1;
167	167	(b) Refuse to issue a policy of group health insurance or cancel a
168	168	policy of group health insurance solely because the person applying
169	169	for or covered by the policy uses or may use any such benefit;
170	170	(c) Offer or pay any type of material inducement or financial
171	171	incentive to an insured to discourage the insured from obtaining any
172	172	such benefit;
173	173	(d) Penalize a provider of health care who provides any such
174	174	benefit to an insured, including, without limitation, reducing the
175	175	reimbursement of the provider of health care;
176	176	(e) Offer or pay any type of material inducement, bonus or other
177	177	financial incentive to a provider of health care to deny, reduce,
178	178	withhold, limit or delay access to any such benefit to an insured; or
179	179	(f) Impose any other restrictions or delays on the access of an
180	180	insured to any such benefit.
181	181	4. A policy subject to the provisions of this chapter which is
182	182	delivered, issued for delivery or renewed on or after January 1,
183	183	[2018,] 2024, has the legal effect of including the coverage required
184	184	by subsection 1, and any provision of the policy or the renewal
185	185	which is in conflict with this section is void.
186	186	5. Except as otherwise provided in this section and federal law,
187	187	an insurer may use medical management techniques, including,
188	188	without limitation, any available clinical evidence, to determine the
189	189	frequency of or treatment relating to any benefit required by this
190	190	section or the type of provider of health care to use for such
191	191	treatment.
192	192	– 5 –
193	193
194	194
195	195	- 82nd Session (2023)
196	196	6. If the application of paragraph (a) of subsection 3 would
197	197	result in the ineligibility of a health savings account of an insured
198	198	pursuant to 26 U.S.C. § 223, the prohibitions of paragraph (a) of
199	199	subsection 3 shall apply only for a qualified policy of group health
200	200	insurance with respect to the deductible of such a policy of group
201	201	health insurance after the insured has satisfied the minimum
202	202	deductible pursuant to 26 U.S.C. § 223, except with respect to
203	203	items or services that constitute preventive care pursuant to 26
204	204	U.S.C. § 223(c)(2)(C), in which case the prohibitions of paragraph
205	205	(a) of subsection 3 shall apply regardless of whether the minimum
206	206	deductible under 26 U.S.C. § 223 has been satisfied.
207	207	7. As used in this section:
208	208	(a) “Medical management technique” means a practice which is
209	209	used to control the cost or utilization of health care services or
210	210	prescription drug use. The term includes, without limitation, the use
211	211	of step therapy, prior authorization or categorizing drugs and
212	212	devices based on cost, type or method of administration.
213	213	(b) “Network plan” means a policy of group health insurance
214	214	offered by an insurer under which the financing and delivery of
215	215	medical care, including items and services paid for as medical care,
216	216	are provided, in whole or in part, through a defined set of providers
217	217	under contract with the insurer. The term does not include an
218	218	arrangement for the financing of premiums.
219	219	(c) “Provider of health care” has the meaning ascribed to it in
220	220	NRS 629.031.
221	221	(d) “Qualified policy of group health insurance” means a
222	222	policy of group health insurance that has a high deductible and is
223	223	in compliance with 26 U.S.C. § 223 for the purposes of
224	224	establishing a health savings account.
225	225	Sec. 3. NRS 689C.1674 is hereby amended to read as follows:
226	226	689C.1674 1. A health benefit plan must provide coverage
227	227	for benefits payable for expenses incurred for [a] :
228	228	(a) A mammogram [every 2 years, or] to screen for breast
229	229	cancer annually [if ordered by a provider of health care,] for
230	230	[women] insureds who are 40 years of age or older.
231	231	(b) An imaging test to screen for breast cancer on an interval
232	232	and at the age deemed most appropriate, when medically
233	233	necessary, as recommended by the insured’s provider of health
234	234	care based on personal or family medical history or additional
235	235	factors that may increase the risk of breast cancer for the insured.
236	236	(c) A diagnostic imaging test for breast cancer at the age
237	237	deemed most appropriate, when medically necessary, as
238	238	– 6 –
239	239
240	240
241	241	- 82nd Session (2023)
242	242	recommended by the insured’s provider of health care to evaluate
243	243	an abnormality which is:
244	244	(1) Seen or suspected from a mammogram described in
245	245	paragraph (a) or an imaging test described in paragraph (b); or
246	246	(2) Detected by other means of examination.
247	247	2. A carrier must ensure that the benefits required by
248	248	subsection 1 are made available to an insured through a provider of
249	249	health care who participates in the network plan of the carrier.
250	250	3. Except as otherwise provided in subsection 5, a carrier that
251	251	offers or issues a health benefit plan shall not:
252	252	(a) [Require] Except as otherwise provided in subsection 6,
253	253	require an insured to pay a [higher] deductible, [any] copayment ,
254	254	[or] coinsurance or any other form of cost-sharing or require a
255	255	longer waiting period or other condition to obtain any benefit
256	256	provided in the health benefit plan pursuant to subsection 1;
257	257	(b) Refuse to issue a health benefit plan or cancel a health
258	258	benefit plan solely because the person applying for or covered by
259	259	the plan uses or may use any such benefit;
260	260	(c) Offer or pay any type of material inducement or financial
261	261	incentive to an insured to discourage the insured from obtaining any
262	262	such benefit;
263	263	(d) Penalize a provider of health care who provides any such
264	264	benefit to an insured, including, without limitation, reducing the
265	265	reimbursement of the provider of health care;
266	266	(e) Offer or pay any type of material inducement, bonus or other
267	267	financial incentive to a provider of health care to deny, reduce,
268	268	withhold, limit or delay access to any such benefit to an insured; or
269	269	(f) Impose any other restrictions or delays on the access of an
270	270	insured to any such benefit.
271	271	4. A plan subject to the provisions of this chapter which is
272	272	delivered, issued for delivery or renewed on or after January 1,
273	273	[2018,] 2024, has the legal effect of including the coverage required
274	274	by subsection 1, and any provision of the plan or the renewal which
275	275	is in conflict with this section is void.
276	276	5. Except as otherwise provided in this section and federal law,
277	277	a carrier may use medical management techniques, including,
278	278	without limitation, any available clinical evidence, to determine the
279	279	frequency of or treatment relating to any benefit required by this
280	280	section or the type of provider of health care to use for such
281	281	treatment.
282	282	6. If the application of paragraph (a) of subsection 3 would
283	283	result in the ineligibility of a health savings account of an insured
284	284	pursuant to 26 U.S.C. § 223, the prohibitions of paragraph (a) of
285	285	– 7 –
286	286
287	287
288	288	- 82nd Session (2023)
289	289	subsection 3 shall apply only for a qualified health benefit plan
290	290	with respect to the deductible of such a health benefit plan after
291	291	the insured has satisfied the minimum deductible pursuant to 26
292	292	U.S.C. § 223, except with respect to items or services that
293	293	constitute preventive care pursuant to 26 U.S.C. § 223(c)(2)(C), in
294	294	which case the prohibitions of paragraph (a) of subsection 3 shall
295	295	apply regardless of whether the minimum deductible under 26
296	296	U.S.C. § 223 has been satisfied.
297	297	7. As used in this section:
298	298	(a) “Medical management technique” means a practice which is
299	299	used to control the cost or utilization of health care services or
300	300	prescription drug use. The term includes, without limitation, the use
301	301	of step therapy, prior authorization or categorizing drugs and
302	302	devices based on cost, type or method of administration.
303	303	(b) “Network plan” means a health benefit plan offered by a
304	304	carrier under which the financing and delivery of medical care,
305	305	including items and services paid for as medical care, are provided,
306	306	in whole or in part, through a defined set of providers under contract
307	307	with the carrier. The term does not include an arrangement for the
308	308	financing of premiums.
309	309	(c) “Provider of health care” has the meaning ascribed to it in
310	310	NRS 629.031.
311	311	(d) “Qualified health benefit plan” means a health benefit
312	312	plan that has a high deductible and is in compliance with 26
313	313	U.S.C. § 223 for the purposes of establishing a health savings
314	314	account.
315	315	Sec. 4. NRS 695A.1855 is hereby amended to read as follows:
316	316	695A.1855 1. A benefit contract must provide coverage for
317	317	benefits payable for expenses incurred for [a] :
318	318	(a) A mammogram [every 2 years, or] to screen for breast
319	319	cancer annually [if ordered by a provider of health care,] for
320	320	[women] insureds who are 40 years of age or older.
321	321	(b) An imaging test to screen for breast cancer on an interval
322	322	and at the age deemed most appropriate, when medically
323	323	necessary, as recommended by the insured’s provider of health
324	324	care based on personal or family medical history or additional
325	325	factors that may increase the risk of breast cancer for the insured.
326	326	(c) A diagnostic imaging test for breast cancer at the age
327	327	deemed most appropriate, when medically necessary, as
328	328	recommended by the insured’s provider of health care to evaluate
329	329	an abnormality which is:
330	330	(1) Seen or suspected from a mammogram described in
331	331	paragraph (a) or an imaging test described in paragraph (b); or
332	332	– 8 –
333	333
334	334
335	335	- 82nd Session (2023)
336	336	(2) Detected by other means of examination.
337	337	2. A society must ensure that the benefits required by
338	338	subsection 1 are made available to an insured through a provider of
339	339	health care who participates in the network plan of the society.
340	340	3. Except as otherwise provided in subsection 5, a society that
341	341	offers or issues a benefit contract shall not:
342	342	(a) [Require] Except as otherwise provided in subsection 6,
343	343	require an insured to pay a [higher] deductible, [any] copayment ,
344	344	[or] coinsurance or any other form of cost-sharing or require a
345	345	longer waiting period or other condition for coverage to obtain any
346	346	benefit provided in a benefit contract pursuant to subsection 1;
347	347	(b) Refuse to issue a benefit contract or cancel a benefit contract
348	348	solely because the person applying for or covered by the contract
349	349	uses or may use any such benefit;
350	350	(c) Offer or pay any type of material inducement or financial
351	351	incentive to an insured to discourage the insured from obtaining any
352	352	such benefit;
353	353	(d) Penalize a provider of health care who provides any such
354	354	benefit to an insured, including, without limitation, reducing the
355	355	reimbursement of the provider of health care;
356	356	(e) Offer or pay any type of material inducement, bonus or other
357	357	financial incentive to a provider of health care to deny, reduce,
358	358	withhold, limit or delay access to any such benefit to an insured; or
359	359	(f) Impose any other restrictions or delays on the access of an
360	360	insured to any such benefit.
361	361	4. A benefit contract subject to the provisions of this chapter
362	362	which is delivered, issued for delivery or renewed on or after
363	363	January 1, [2018,] 2024, has the legal effect of including the
364	364	coverage required by subsection 1, and any provision of the benefit
365	365	contract or the renewal which is in conflict with this section is void.
366	366	5. Except as otherwise provided in this section and federal law,
367	367	a society may use medical management techniques, including,
368	368	without limitation, any available clinical evidence, to determine the
369	369	frequency of or treatment relating to any benefit required by this
370	370	section or the type of provider of health care to use for such
371	371	treatment.
372	372	6. If the application of paragraph (a) of subsection 3 would
373	373	result in the ineligibility of a health savings account of an insured
374	374	pursuant to 26 U.S.C. § 223, the prohibitions of paragraph (a) of
375	375	subsection 3 shall apply only for a qualified benefit contract with
376	376	respect to the deductible of such a benefit contract after the
377	377	insured has satisfied the minimum deductible pursuant to 26
378	378	U.S.C. § 223, except with respect to items or services that
379	379	– 9 –
380	380
381	381
382	382	- 82nd Session (2023)
383	383	constitute preventive care pursuant to 26 U.S.C. § 223(c)(2)(C), in
384	384	which case the prohibitions of paragraph (a) of subsection 3 shall
385	385	apply regardless of whether the minimum deductible under 26
386	386	U.S.C. § 223 has been satisfied.
387	387	7. As used in this section:
388	388	(a) “Medical management technique” means a practice which is
389	389	used to control the cost or utilization of health care services or
390	390	prescription drug use. The term includes, without limitation, the use
391	391	of step therapy, prior authorization or categorizing drugs and
392	392	devices based on cost, type or method of administration.
393	393	(b) “Network plan” means a benefit contract offered by a society
394	394	under which the financing and delivery of medical care, including
395	395	items and services paid for as medical care, are provided, in whole
396	396	or in part, through a defined set of providers under contract with the
397	397	society. The term does not include an arrangement for the financing
398	398	of premiums.
399	399	(c) “Provider of health care” has the meaning ascribed to it in
400	400	NRS 629.031.
401	401	(d) “Qualified benefit contract” means a benefit contract that
402	402	has a high deductible and is in compliance with 26 U.S.C. § 223
403	403	for the purposes of establishing a health savings account.
404	404	Sec. 5. NRS 695B.1912 is hereby amended to read as follows:
405	405	695B.1912 1. An insurer that offers or issues a contract for
406	406	hospital or medical service must provide coverage for benefits
407	407	payable for expenses incurred for [a] :
408	408	(a) A mammogram [every 2 years, or] to screen for breast
409	409	cancer annually [if ordered by a provider of health care,] for
410	410	[women] insureds who are 40 years of age or older.
411	411	(b) An imaging test to screen for breast cancer on an interval
412	412	and at the age deemed most appropriate, when medically
413	413	necessary, as recommended by the insured’s provider of health
414	414	care based on personal or family medical history or additional
415	415	factors that may increase the risk of breast cancer for the insured.
416	416	(c) A diagnostic imaging test for breast cancer at the age
417	417	deemed most appropriate, when medically necessary, as
418	418	recommended by the insured’s provider of health care to evaluate
419	419	an abnormality which is:
420	420	(1) Seen or suspected from a mammogram described in
421	421	paragraph (a) or an imaging test described in paragraph (b); or
422	422	(2) Detected by other means of examination.
423	423	2. An insurer must ensure that the benefits required by
424	424	subsection 1 are made available to an insured through a provider of
425	425	health care who participates in the network plan of the insurer.
426	426	– 10 –
427	427
428	428
429	429	- 82nd Session (2023)
430	430	3. Except as otherwise provided in subsection 5, an insurer that
431	431	offers or issues a contract for hospital or medical service shall not:
432	432	(a) [Require] Except as otherwise provided in subsection 6,
433	433	require an insured to pay a [higher] deductible, [any] copayment ,
434	434	[or] coinsurance or any other form of cost-sharing or require a
435	435	longer waiting period or other condition to obtain any benefit
436	436	provided in a contract for hospital or medical service pursuant to
437	437	subsection 1;
438	438	(b) Refuse to issue a contract for hospital or medical service or
439	439	cancel a contract for hospital or medical service solely because the
440	440	person applying for or covered by the contract uses or may use any
441	441	such benefit;
442	442	(c) Offer or pay any type of material inducement or financial
443	443	incentive to an insured to discourage the insured from obtaining any
444	444	such benefit;
445	445	(d) Penalize a provider of health care who provides any such
446	446	benefit to an insured, including, without limitation, reducing the
447	447	reimbursement of the provider of health care;
448	448	(e) Offer or pay any type of material inducement, bonus or other
449	449	financial incentive to a provider of health care to deny, reduce,
450	450	withhold, limit or delay access to any such benefit to an insured; or
451	451	(f) Impose any other restrictions or delays on the access of an
452	452	insured to any such benefit.
453	453	4. A contract for hospital or medical service subject to the
454	454	provisions of this chapter which is delivered, issued for delivery or
455	455	renewed on or after January 1, [2018,] 2024, has the legal effect of
456	456	including the coverage required by subsection 1, and any provision
457	457	of the contract or the renewal which is in conflict with this section is
458	458	void.
459	459	5. Except as otherwise provided in this section and federal law,
460	460	an insurer may use medical management techniques, including,
461	461	without limitation, any available clinical evidence, to determine the
462	462	frequency of or treatment relating to any benefit required by this
463	463	section or the type of provider of health care to use for such
464	464	treatment.
465	465	6. If the application of paragraph (a) of subsection 3 would
466	466	result in the ineligibility of a health savings account of an insured
467	467	pursuant to 26 U.S.C. § 223, the prohibitions of paragraph (a) of
468	468	subsection 3 shall apply only for a qualified contract for hospital
469	469	or medical service with respect to the deductible of such a contract
470	470	for hospital or medical service after the insured has satisfied the
471	471	minimum deductible pursuant to 26 U.S.C. § 223, except with
472	472	respect to items or services that constitute preventive care
473	473	– 11 –
474	474
475	475
476	476	- 82nd Session (2023)
477	477	pursuant to 26 U.S.C. § 223(c)(2)(C), in which case the
478	478	prohibitions of paragraph (a) of subsection 3 shall apply
479	479	regardless of whether the minimum deductible under 26 U.S.C. §
480	480	223 has been satisfied.
481	481	7. As used in this section:
482	482	(a) “Medical management technique” means a practice which is
483	483	used to control the cost or utilization of health care services or
484	484	prescription drug use. The term includes, without limitation, the use
485	485	of step therapy, prior authorization or categorizing drugs and
486	486	devices based on cost, type or method of administration.
487	487	(b) “Network plan” means a contract for hospital or medical
488	488	service offered by an insurer under which the financing and delivery
489	489	of medical care, including items and services paid for as medical
490	490	care, are provided, in whole or in part, through a defined set of
491	491	providers under contract with the insurer. The term does not include
492	492	an arrangement for the financing of premiums.
493	493	(c) “Provider of health care” has the meaning ascribed to it in
494	494	NRS 629.031.
495	495	(d) “Qualified contract for hospital or medical service” means
496	496	a contract for hospital or medical service that has a high
497	497	deductible and is in compliance with 26 U.S.C. § 223 for the
498	498	purposes of establishing a health savings account.
499	499	Sec. 5.5. NRS 695C.050 is hereby amended to read as follows:
500	500	695C.050 1. Except as otherwise provided in this chapter or
501	501	in specific provisions of this title, the provisions of this title are not
502	502	applicable to any health maintenance organization granted a
503	503	certificate of authority under this chapter. This provision does not
504	504	apply to an insurer licensed and regulated pursuant to this title
505	505	except with respect to its activities as a health maintenance
506	506	organization authorized and regulated pursuant to this chapter.
507	507	2. Solicitation of enrollees by a health maintenance
508	508	organization granted a certificate of authority, or its representatives,
509	509	must not be construed to violate any provision of law relating to
510	510	solicitation or advertising by practitioners of a healing art.
511	511	3. Any health maintenance organization authorized under this
512	512	chapter shall not be deemed to be practicing medicine and is exempt
513	513	from the provisions of chapter 630 of NRS.
514	514	4. The provisions of NRS 695C.110, 695C.125, 695C.1691,
515	515	695C.1693, 695C.170, 695C.1703, 695C.1705, 695C.1709 to
516	516	695C.173, inclusive, 695C.1733, 695C.17335, 695C.1734,
517	517	695C.1751, 695C.1755, 695C.1759, 695C.176 to 695C.200,
518	518	inclusive, and 695C.265 do not apply to a health maintenance
519	519	organization that provides health care services through managed
520	520	– 12 –
521	521
522	522
523	523	- 82nd Session (2023)
524	524	care to recipients of Medicaid under the State Plan for Medicaid or
525	525	insurance pursuant to the Children’s Health Insurance Program
526	526	pursuant to a contract with the Division of Health Care Financing
527	527	and Policy of the Department of Health and Human Services. This
528	528	subsection does not exempt a health maintenance organization from
529	529	any provision of this chapter for services provided pursuant to any
530	530	other contract.
531	531	5. The provisions of NRS 695C.1694 to 695C.1698, inclusive,
532	532	695C.1701, 695C.1708, 695C.1728, 695C.1731, 695C.17333,
533	533	695C.17345, 695C.17347, 695C.1735, 695C.1737, 695C.1743,
534	534	695C.1745 and 695C.1757 apply to a health maintenance
535	535	organization that provides health care services through managed
536	536	care to recipients of Medicaid under the State Plan for Medicaid.
537	537	6. The provisions of NRS 695C.1735 do not apply to a health
538	538	maintenance organization that provides health care services to:
539	539	(a) The officers and employees, and the dependents of officers
540	540	and employees, of the governing body of any county, school
541	541	district, municipal corporation, political subdivision, public
542	542	corporation or other local governmental agency of this State; or
543	543	(b) Members of the Public Employees’ Benefits Program.
544	544	 This subsection does not exempt a health maintenance
545	545	organization from any provision of this chapter for services
546	546	provided pursuant to any other contract.
547	547	Sec. 6. NRS 695C.1735 is hereby amended to read as follows:
548	548	695C.1735 1. A health care plan of a health maintenance
549	549	organization must provide coverage for benefits payable for
550	550	expenses incurred for [a] :
551	551	(a) A mammogram [every 2 years, or] to screen for breast
552	552	cancer annually [if ordered by a provider of health care,] for
553	553	[women] enrollees who are 40 years of age or older.
554	554	(b) An imaging test to screen for breast cancer on an interval
555	555	and at the age deemed most appropriate, when medically
556	556	necessary, as recommended by the enrollee’s provider of health
557	557	care based on personal or family medical history or additional
558	558	factors that may increase the risk of breast cancer for the enrollee.
559	559	(c) A diagnostic imaging test for breast cancer at the age
560	560	deemed most appropriate, when medically necessary, as
561	561	recommended by the enrollee’s provider of health care to evaluate
562	562	an abnormality which is:
563	563	(1) Seen or suspected from a mammogram described in
564	564	paragraph (a) or an imaging test described in paragraph (b); or
565	565	(2) Detected by other means of examination.
566	566	– 13 –
567	567
568	568
569	569	- 82nd Session (2023)
570	570	2. A health maintenance organization must ensure that the
571	571	benefits required by subsection 1 are made available to an enrollee
572	572	through a provider of health care who participates in the network
573	573	plan of the health maintenance organization.
574	574	3. Except as otherwise provided in subsection 5, a health
575	575	maintenance organization that offers or issues a health care plan
576	576	shall not:
577	577	(a) [Require] Except as otherwise provided in subsection 6,
578	578	require an enrollee to pay a [higher] deductible, [any] copayment ,
579	579	[or] coinsurance or any other form of cost-sharing or require a
580	580	longer waiting period or other condition to obtain any benefit
581	581	provided in the health care plan pursuant to subsection 1;
582	582	(b) Refuse to issue a health care plan or cancel a health care plan
583	583	solely because the person applying for or covered by the plan uses
584	584	or may use any such benefit;
585	585	(c) Offer or pay any type of material inducement or financial
586	586	incentive to an enrollee to discourage the enrollee from obtaining
587	587	any benefit provided in the health care plan pursuant to
588	588	subsection 1;
589	589	(d) Penalize a provider of health care who provides any such
590	590	benefit to an enrollee, including, without limitation, reducing the
591	591	reimbursement of the provider of health care;
592	592	(e) Offer or pay any type of material inducement, bonus or other
593	593	financial incentive to a provider of health care to deny, reduce,
594	594	withhold, limit or delay access to any such benefit to an enrollee; or
595	595	(f) Impose any other restrictions or delays on the access of an
596	596	enrollee to any such benefit.
597	597	4. A health care plan subject to the provisions of this chapter
598	598	which is delivered, issued for delivery or renewed on or after
599	599	January 1, [2018,] 2024, has the legal effect of including the
600	600	coverage required by subsection 1, and any provision of the plan or
601	601	the renewal which is in conflict with this section is void.
602	602	5. Except as otherwise provided in this section and federal law,
603	603	a health maintenance organization may use medical management
604	604	techniques, including, without limitation, any available clinical
605	605	evidence, to determine the frequency of or treatment relating to any
606	606	benefit required by this section or the type of provider of health care
607	607	to use for such treatment.
608	608	6. If the application of paragraph (a) of subsection 3 would
609	609	result in the ineligibility of a health savings account of an enrollee
610	610	pursuant to 26 U.S.C. § 223, the prohibitions of paragraph (a) of
611	611	subsection 3 shall apply only for a qualified health care plan with
612	612	respect to the deductible of such a health care plan after the
613	613	– 14 –
614	614
615	615
616	616	- 82nd Session (2023)
617	617	enrollee has satisfied the minimum deductible pursuant to 26
618	618	U.S.C. § 223, except with respect to items or services that
619	619	constitute preventive care pursuant to 26 U.S.C. § 223(c)(2)(C), in
620	620	which case the prohibitions of paragraph (a) of subsection 3 shall
621	621	apply regardless of whether the minimum deductible under 26
622	622	U.S.C. § 223 has been satisfied.
623	623	7. As used in this section:
624	624	(a) “Medical management technique” means a practice which is
625	625	used to control the cost or utilization of health care services or
626	626	prescription drug use. The term includes, without limitation, the use
627	627	of step therapy, prior authorization or categorizing drugs and
628	628	devices based on cost, type or method of administration.
629	629	(b) “Network plan” means a health care plan offered by a health
630	630	maintenance organization under which the financing and delivery of
631	631	medical care, including items and services paid for as medical care,
632	632	are provided, in whole or in part, through a defined set of providers
633	633	under contract with the health maintenance organization. The term
634	634	does not include an arrangement for the financing of premiums.
635	635	(c) “Provider of health care” has the meaning ascribed to it in
636	636	NRS 629.031.
637	637	(d) “Qualified health care plan” means a health care plan of a
638	638	health maintenance organization that has a high deductible and is
639	639	in compliance with 26 U.S.C. § 223 for the purposes of
640	640	establishing a health savings account.
641	641	Sec. 6.5. NRS 695G.090 is hereby amended to read as
642	642	follows:
643	643	695G.090 1. Except as otherwise provided in subsection 3,
644	644	the provisions of this chapter apply to each organization and insurer
645	645	that operates as a managed care organization and may include,
646	646	without limitation, an insurer that issues a policy of health
647	647	insurance, an insurer that issues a policy of individual or group
648	648	health insurance, a carrier serving small employers, a fraternal
649	649	benefit society, a hospital or medical service corporation and a
650	650	health maintenance organization.
651	651	2. In addition to the provisions of this chapter, each managed
652	652	care organization shall comply with:
653	653	(a) The provisions of chapter 686A of NRS, including all
654	654	obligations and remedies set forth therein; and
655	655	(b) Any other applicable provision of this title.
656	656	3. The provisions of NRS 695G.127, 695G.164, 695G.1645,
657	657	695G.167 and 695G.200 to 695G.230, inclusive, do not apply to a
658	658	managed care organization that provides health care services to
659	659	recipients of Medicaid under the State Plan for Medicaid or
660	660	– 15 –
661	661
662	662
663	663	- 82nd Session (2023)
664	664	insurance pursuant to the Children’s Health Insurance Program
665	665	pursuant to a contract with the Division of Health Care Financing
666	666	and Policy of the Department of Health and Human Services. [This
667	667	subsection does]
668	668	4. The provisions of NRS 695C.1735 do not apply to a
669	669	managed care organization that provides health care services to
670	670	members of the Public Employees’ Benefits Program.
671	671	5. Subsections 3 and 4 do not exempt a managed care
672	672	organization from any provision of this chapter for services
673	673	provided pursuant to any other contract.
674	674	Sec. 7. NRS 695G.1713 is hereby amended to read as follows:
675	675	695G.1713 1. A health care plan issued by a managed care
676	676	organization must provide coverage for benefits payable for
677	677	expenses incurred for [a] :
678	678	(a) A mammogram [every 2 years, or] to screen for breast
679	679	cancer annually [if ordered by a provider of health care,] for
680	680	[women] insureds who are 40 years of age or older.
681	681	(b) An imaging test to screen for breast cancer on an interval
682	682	and at the age deemed most appropriate, when medically
683	683	necessary, as recommended by the insured’s provider of health
684	684	care based on personal or family medical history or additional
685	685	factors that may increase the risk of breast cancer for the insured.
686	686	(c) A diagnostic imaging test for breast cancer at the age
687	687	deemed most appropriate, when medically necessary, as
688	688	recommended by the insured’s provider of health care to evaluate
689	689	an abnormality which is:
690	690	(1) Seen or suspected from a mammogram described in
691	691	paragraph (a) or an imaging test described in paragraph (b); or
692	692	(2) Detected by other means of examination.
693	693	2. A managed care organization must ensure that the benefits
694	694	required by subsection 1 are made available to an insured through a
695	695	provider of health care who participates in the network plan of the
696	696	managed care organization.
697	697	3. Except as otherwise provided in subsection 5, a managed
698	698	care organization that offers or issues a health care plan which
699	699	provides coverage for prescription drugs shall not:
700	700	(a) [Require] Except as otherwise provided in subsection 6,
701	701	require an insured to pay a [higher] deductible, [any] copayment ,
702	702	[or] coinsurance or any other form of cost-sharing or require a
703	703	longer waiting period or other condition to obtain any benefit
704	704	provided in the health care plan pursuant to subsection 1;
705	705	– 16 –
706	706
707	707
708	708	- 82nd Session (2023)
709	709	(b) Refuse to issue a health care plan or cancel a health care plan
710	710	solely because the person applying for or covered by the plan uses
711	711	or may use any such benefit;
712	712	(c) Offer or pay any type of material inducement or financial
713	713	incentive to an insured to discourage the insured from obtaining any
714	714	such benefit;
715	715	(d) Penalize a provider of health care who provides any such
716	716	benefit to an insured, including, without limitation, reducing the
717	717	reimbursement of the provider of health care;
718	718	(e) Offer or pay any type of material inducement, bonus or other
719	719	financial incentive to a provider of health care to deny, reduce,
720	720	withhold, limit or delay access to any such benefit to an insured; or
721	721	(f) Impose any other restrictions or delays on the access of an
722	722	insured to any such benefit.
723	723	4. A health care plan subject to the provisions of this chapter
724	724	that is delivered, issued for delivery or renewed on or after
725	725	January 1, [2018,] 2024, has the legal effect of including the
726	726	coverage required by subsection 1, and any provision of the plan or
727	727	the renewal which is in conflict with this section is void.
728	728	5. Except as otherwise provided in this section and federal law,
729	729	a managed care organization may use medical management
730	730	techniques, including, without limitation, any available clinical
731	731	evidence, to determine the frequency of or treatment relating to any
732	732	benefit required by this section or the type of provider of health care
733	733	to use for such treatment.
734	734	6. If the application of paragraph (a) of subsection 3 would
735	735	result in the ineligibility of a health savings account of an insured
736	736	pursuant to 26 U.S.C. § 223, the prohibitions of paragraph (a) of
737	737	subsection 3 shall apply only for a qualified health care plan with
738	738	respect to the deductible of such a health care plan after the
739	739	insured has satisfied the minimum deductible pursuant to 26
740	740	U.S.C. § 223, except with respect to items or services that
741	741	constitute preventive care pursuant to 26 U.S.C. § 223(c)(2)(C), in
742	742	which case the prohibitions of paragraph (a) of subsection 3 shall
743	743	apply regardless of whether the minimum deductible under 26
744	744	U.S.C. § 223 has been satisfied.
745	745	7. As used in this section:
746	746	(a) “Medical management technique” means a practice which is
747	747	used to control the cost or utilization of health care services or
748	748	prescription drug use. The term includes, without limitation, the use
749	749	of step therapy, prior authorization or categorizing drugs and
750	750	devices based on cost, type or method of administration.
751	751	– 17 –
752	752
753	753
754	754	- 82nd Session (2023)
755	755	(b) “Network plan” means a health care plan offered by a
756	756	managed care organization under which the financing and delivery
757	757	of medical care, including items and services paid for as medical
758	758	care, are provided, in whole or in part, through a defined set of
759	759	providers under contract with the managed care organization. The
760	760	term does not include an arrangement for the financing of
761	761	premiums.
762	762	(c) “Provider of health care” has the meaning ascribed to it in
763	763	NRS 629.031.
764	764	(d) “Qualified health care plan” means a health care plan
765	765	issued by a managed care organization that has a high deductible
766	766	and is in compliance with 26 U.S.C. § 223 for the purposes of
767	767	establishing a health savings account.
768	768	Sec. 7.1. Chapter 287 of NRS is hereby amended by adding
769	769	thereto the provisions set forth as sections 7.2 and 7.3 of this act.
770	770	Sec. 7.2. 1. The governing body of any county, school
771	771	district, municipal corporation, political subdivision, public
772	772	corporation or other local governmental agency of the State of
773	773	Nevada that provides health insurance through a plan of self-
774	774	insurance shall provide coverage for benefits payable for expenses
775	775	incurred for a mammogram every 2 years, or annually if ordered
776	776	by a provider of health care, for women 40 years of age or older.
777	777	2. The governing body of any county, school district,
778	778	municipal corporation, political subdivision, public corporation or
779	779	other local governmental agency of the State of Nevada that
780	780	provides health insurance through a plan of self-insurance must
781	781	ensure that the benefits required by subsection 1 are made
782	782	available to an insured through a provider of health care who
783	783	participates in the network plan of the governing body.
784	784	3. Except as otherwise provided in subsection 5, the
785	785	governing body of any county, school district, municipal
786	786	corporation, political subdivision, public corporation or other
787	787	local governmental agency of the State of Nevada that provides
788	788	health insurance through a plan of self-insurance shall not:
789	789	(a) Except as otherwise provided in subsection 6, require an
790	790	insured to pay a higher deductible, any copayment or coinsurance
791	791	or require a longer waiting period or other condition to obtain any
792	792	benefit provided in the plan of self-insurance pursuant to
793	793	subsection 1;
794	794	(b) Refuse to issue a plan of self-insurance or cancel a plan of
795	795	self-insurance solely because the person applying for or covered
796	796	by the policy uses or may use any such benefit;
797	797	– 18 –
798	798
799	799
800	800	- 82nd Session (2023)
801	801	(c) Offer or pay any type of material inducement or financial
802	802	incentive to an insured to discourage the insured from obtaining
803	803	any such benefit;
804	804	(d) Penalize a provider of health care who provides any such
805	805	benefit to an insured, including, without limitation, reducing the
806	806	reimbursement of the provider of health care;
807	807	(e) Offer or pay any type of material inducement, bonus or
808	808	other financial incentive to a provider of health care to deny,
809	809	reduce, withhold, limit or delay access to any such benefit to an
810	810	insured; or
811	811	(f) Impose any other restrictions or delays on the access of an
812	812	insured to any such benefit.
813	813	4. A plan of self-insurance subject to the provisions of this
814	814	chapter which is delivered, issued for delivery or renewed on or
815	815	after January 1, 2024, has the legal effect of including the
816	816	coverage required by subsection 1, and any provision of the policy
817	817	or the renewal which is in conflict with this section is void.
818	818	5. Except as otherwise provided in this section and federal
819	819	law, the governing body of any county, school district, municipal
820	820	corporation, political subdivision, public corporation or other
821	821	local governmental agency of the State of Nevada that provides
822	822	health insurance through a plan of self-insurance may use
823	823	medical management techniques, including, without limitation,
824	824	any available clinical evidence, to determine the frequency of or
825	825	treatment relating to any benefit required by this section or the
826	826	type of provider of health care to use for such treatment.
827	827	6. If the application of paragraph (a) of subsection 3 would
828	828	result in the ineligibility of a health savings account of an insured
829	829	pursuant to 26 U.S.C. § 223, the prohibitions of paragraph (a) of
830	830	subsection 3 shall apply only for a qualified plan of self-insurance
831	831	with respect to the deductible of such a plan of self-insurance after
832	832	the insured has satisfied the minimum deductible pursuant to 26
833	833	U.S.C. § 223, except with respect to items or services that
834	834	constitute preventive care pursuant to 26 U.S.C. § 223(c)(2)(C), in
835	835	which case the prohibitions of paragraph (a) of subsection 3 shall
836	836	apply regardless of whether the minimum deductible under 26
837	837	U.S.C. § 223 has been satisfied.
838	838	7. As used in this section:
839	839	(a) “Medical management technique” means a practice which
840	840	is used to control the cost or utilization of health care services or
841	841	prescription drug use. The term includes, without limitation, the
842	842	use of step therapy, prior authorization or categorizing drugs and
843	843	devices based on cost, type or method of administration.
844	844	– 19 –
845	845
846	846
847	847	- 82nd Session (2023)
848	848	(b) “Network plan” means a plan of self-insurance provided
849	849	by the governing body of a local governmental agency under
850	850	which the financing and delivery of medical care, including items
851	851	and services paid for as medical care, are provided, in whole or in
852	852	part, through a defined set of providers under contract with the
853	853	governing body. The term does not include an arrangement for the
854	854	financing of premiums.
855	855	(c) “Provider of health care” has the meaning ascribed to it in
856	856	NRS 629.031.
857	857	(d) “Qualified plan of self-insurance” means a plan of self-
858	858	insurance that has a high deductible and is in compliance with 26
859	859	U.S.C. § 223 for the purposes of establishing a health savings
860	860	account.
861	861	Sec. 7.3. 1. If the Board provides health insurance through
862	862	a plan of self-insurance, it shall provide coverage for benefits
863	863	payable for expenses incurred for a mammogram every 2 years, or
864	864	annually if ordered by a provider of health care, for women 40
865	865	years of age or older.
866	866	2. If the Board provides health insurance through a plan of
867	867	self-insurance, it must ensure that the benefits required by
868	868	subsection 1 are made available to an insured through a provider
869	869	of health care who participates in the network plan of the Board.
870	870	3. Except as otherwise provided in subsection 5, if the Board
871	871	provides health insurance through a plan of self-insurance, it
872	872	shall not:
873	873	(a) Except as otherwise provided in subsection 6, require an
874	874	insured to pay a higher deductible, any copayment or coinsurance
875	875	or require a longer waiting period or other condition to obtain any
876	876	benefit provided in the plan of self-insurance pursuant to
877	877	subsection 1;
878	878	(b) Refuse to issue a plan of self-insurance or cancel a plan of
879	879	self-insurance solely because the person applying for or covered
880	880	by the plan uses or may use any such benefit;
881	881	(c) Offer or pay any type of material inducement or financial
882	882	incentive to an insured to discourage the insured from obtaining
883	883	any such benefit;
884	884	(d) Penalize a provider of health care who provides any such
885	885	benefit to an insured, including, without limitation, reducing the
886	886	reimbursement of the provider of health care;
887	887	(e) Offer or pay any type of material inducement, bonus or
888	888	other financial incentive to a provider of health care to deny,
889	889	reduce, withhold, limit or delay access to any such benefit to an
890	890	insured; or
891	891	– 20 –
892	892
893	893
894	894	- 82nd Session (2023)
895	895	(f) Impose any other restrictions or delays on the access of an
896	896	insured to any such benefit.
897	897	4. A plan of self-insurance described in subsection 1 which is
898	898	delivered, issued for delivery or renewed on or after January 1,
899	899	2024, has the legal effect of including the coverage required by
900	900	subsection 1, and any provision of the policy or the renewal which
901	901	is in conflict with this section is void.
902	902	5. Except as otherwise provided in this section and federal
903	903	law, if the Board provides health insurance through a plan of self-
904	904	insurance, the Board may use medical management techniques,
905	905	including, without limitation, any available clinical evidence, to
906	906	determine the frequency of or treatment relating to any benefit
907	907	required by this section or the type of provider of health care to
908	908	use for such treatment.
909	909	6. If the application of paragraph (a) of subsection 3 would
910	910	result in the ineligibility of a health savings account of an insured
911	911	pursuant to 26 U.S.C. § 223, the prohibitions of paragraph (a) of
912	912	subsection 3 shall apply only for a qualified plan of self-insurance
913	913	with respect to the deductible of such a plan of self-insurance after
914	914	the insured has satisfied the minimum deductible pursuant to 26
915	915	U.S.C. § 223, except with respect to items or services that
916	916	constitute preventive care pursuant to 26 U.S.C. § 223(c)(2)(C), in
917	917	which case the prohibitions of paragraph (a) of subsection 3 shall
918	918	apply regardless of whether the minimum deductible under 26
919	919	U.S.C. § 223 has been satisfied.
920	920	7. As used in this section:
921	921	(a) “Medical management technique” means a practice which
922	922	is used to control the cost or utilization of health care services or
923	923	prescription drug use. The term includes, without limitation, the
924	924	use of step therapy, prior authorization or categorizing drugs and
925	925	devices based on cost, type or method of administration.
926	926	(b) “Network plan” means a plan of self-insurance provided
927	927	by the Board under which the financing and delivery of medical
928	928	care, including items and services paid for as medical care, are
929	929	provided, in whole or in part, through a defined set of providers
930	930	under contract with the Board. The term does not include an
931	931	arrangement for the financing of premiums.
932	932	(c) “Provider of health care” has the meaning ascribed to it in
933	933	NRS 629.031.
934	934	(d) “Qualified plan of self-insurance” means a plan of self-
935	935	insurance that has a high deductible and is in compliance with 26
936	936	U.S.C. § 223 for the purposes of establishing a health savings
937	937	account.
938	938	– 21 –
939	939
940	940
941	941	- 82nd Session (2023)
942	942	Sec. 7.5. NRS 287.010 is hereby amended to read as follows:
943	943	287.010 1. The governing body of any county, school
944	944	district, municipal corporation, political subdivision, public
945	945	corporation or other local governmental agency of the State of
946	946	Nevada may:
947	947	(a) Adopt and carry into effect a system of group life, accident
948	948	or health insurance, or any combination thereof, for the benefit of its
949	949	officers and employees, and the dependents of officers and
950	950	employees who elect to accept the insurance and who, where
951	951	necessary, have authorized the governing body to make deductions
952	952	from their compensation for the payment of premiums on the
953	953	insurance.
954	954	(b) Purchase group policies of life, accident or health insurance,
955	955	or any combination thereof, for the benefit of such officers and
956	956	employees, and the dependents of such officers and employees, as
957	957	have authorized the purchase, from insurance companies authorized
958	958	to transact the business of such insurance in the State of Nevada,
959	959	and, where necessary, deduct from the compensation of officers and
960	960	employees the premiums upon insurance and pay the deductions
961	961	upon the premiums.
962	962	(c) Provide group life, accident or health coverage through a
963	963	self-insurance reserve fund and, where necessary, deduct
964	964	contributions to the maintenance of the fund from the compensation
965	965	of officers and employees and pay the deductions into the fund. The
966	966	money accumulated for this purpose through deductions from the
967	967	compensation of officers and employees and contributions of the
968	968	governing body must be maintained as an internal service fund as
969	969	defined by NRS 354.543. The money must be deposited in a state or
970	970	national bank or credit union authorized to transact business in the
971	971	State of Nevada. Any independent administrator of a fund created
972	972	under this section is subject to the licensing requirements of chapter
973	973	683A of NRS, and must be a resident of this State. Any contract
974	974	with an independent administrator must be approved by the
975	975	Commissioner of Insurance as to the reasonableness of
976	976	administrative charges in relation to contributions collected and
977	977	benefits provided. The provisions of NRS 686A.135, 687B.352,
978	978	687B.408, 687B.723, 687B.725, 689B.030 to 689B.0369, inclusive,
979	979	689B.0375 to 689B.050, inclusive, 689B.265, 689B.287 and
980	980	689B.500 apply to coverage provided pursuant to this paragraph,
981	981	except that the provisions of NRS 689B.0378, 689B.03785 and
982	982	689B.500 only apply to coverage for active officers and employees
983	983	of the governing body, or the dependents of such officers and
984	984	employees.
985	985	– 22 –
986	986
987	987
988	988	- 82nd Session (2023)
989	989	(d) Defray part or all of the cost of maintenance of a self-
990	990	insurance fund or of the premiums upon insurance. The money for
991	991	contributions must be budgeted for in accordance with the laws
992	992	governing the county, school district, municipal corporation,
993	993	political subdivision, public corporation or other local governmental
994	994	agency of the State of Nevada.
995	995	2. If a school district offers group insurance to its officers and
996	996	employees pursuant to this section, members of the board of trustees
997	997	of the school district must not be excluded from participating in the
998	998	group insurance. If the amount of the deductions from compensation
999	999	required to pay for the group insurance exceeds the compensation to
1000	1000	which a trustee is entitled, the difference must be paid by the trustee.
1001	1001	3. In any county in which a legal services organization exists,
1002	1002	the governing body of the county, or of any school district,
1003	1003	municipal corporation, political subdivision, public corporation or
1004	1004	other local governmental agency of the State of Nevada in the
1005	1005	county, may enter into a contract with the legal services
1006	1006	organization pursuant to which the officers and employees of the
1007	1007	legal services organization, and the dependents of those officers and
1008	1008	employees, are eligible for any life, accident or health insurance
1009	1009	provided pursuant to this section to the officers and employees, and
1010	1010	the dependents of the officers and employees, of the county, school
1011	1011	district, municipal corporation, political subdivision, public
1012	1012	corporation or other local governmental agency.
1013	1013	4. If a contract is entered into pursuant to subsection 3, the
1014	1014	officers and employees of the legal services organization:
1015	1015	(a) Shall be deemed, solely for the purposes of this section, to be
1016	1016	officers and employees of the county, school district, municipal
1017	1017	corporation, political subdivision, public corporation or other local
1018	1018	governmental agency with which the legal services organization has
1019	1019	contracted; and
1020	1020	(b) Must be required by the contract to pay the premiums or
1021	1021	contributions for all insurance which they elect to accept or of which
1022	1022	they authorize the purchase.
1023	1023	5. A contract that is entered into pursuant to subsection 3:
1024	1024	(a) Must be submitted to the Commissioner of Insurance for
1025	1025	approval not less than 30 days before the date on which the contract
1026	1026	is to become effective.
1027	1027	(b) Does not become effective unless approved by the
1028	1028	Commissioner.
1029	1029	(c) Shall be deemed to be approved if not disapproved by the
1030	1030	Commissioner within 30 days after its submission.
1031	1031	– 23 –
1032	1032
1033	1033
1034	1034	- 82nd Session (2023)
1035	1035	6. As used in this section, “legal services organization” means
1036	1036	an organization that operates a program for legal aid and receives
1037	1037	money pursuant to NRS 19.031.
1038	1038	Sec. 7.7. NRS 287.040 is hereby amended to read as follows:
1039	1039	287.040 The provisions of NRS 287.010 to 287.040, inclusive,
1040	1040	and section 7.2 of this act do not make it compulsory upon any
1041	1041	governing body of any county, school district, municipal
1042	1042	corporation, political subdivision, public corporation or other local
1043	1043	governmental agency of the State of Nevada, except as otherwise
1044	1044	provided in NRS 287.021 or subsection 4 of NRS 287.023 or in an
1045	1045	agreement entered into pursuant to subsection 3 of NRS 287.015, to
1046	1046	pay any premiums, contributions or other costs for group insurance,
1047	1047	a plan of benefits or medical or hospital services established
1048	1048	pursuant to NRS 287.010, 287.015, 287.020 or paragraph (b), (c) or
1049	1049	(d) of subsection 1 of NRS 287.025, for coverage under the Public
1050	1050	Employees’ Benefits Program, or to make any contributions to a
1051	1051	trust fund established pursuant to NRS 287.017, or upon any officer
1052	1052	or employee of any county, school district, municipal corporation,
1053	1053	political subdivision, public corporation or other local governmental
1054	1054	agency of this State to accept any such coverage or to assign his or
1055	1055	her wages or salary in payment of premiums or contributions
1056	1056	therefor.
1057	1057	Sec. 7.9. NRS 287.0402 is hereby amended to read as follows:
1058	1058	287.0402 As used in NRS 287.0402 to 287.049, inclusive, and
1059	1059	section 7.3 of this act, unless the context otherwise requires, the
1060	1060	words and terms defined in NRS 287.0404 to 287.04064, inclusive,
1061	1061	have the meanings ascribed to them in those sections.
1062	1062	Sec. 8. NRS 287.04335 is hereby amended to read as follows:
1063	1063	287.04335 If the Board provides health insurance through a
1064	1064	plan of self-insurance, it shall comply with the provisions of NRS
1065	1065	686A.135, 687B.352, 687B.409, 687B.723, 687B.725, 689B.0353,
1066	1066	689B.255, 695C.1723, 695G.150, 695G.155, 695G.160, 695G.162,
1067	1067	695G.1635, 695G.164, 695G.1645, 695G.1665, 695G.167,
1068	1068	695G.1675, 695G.170 to 695G.1712, inclusive, 695G.1714 to
1069	1069	695G.174, inclusive, 695G.176, 695G.177, 695G.200 to 695G.230,
1070	1070	inclusive, 695G.241 to 695G.310, inclusive, and 695G.405, in the
1071	1071	same manner as an insurer that is licensed pursuant to title 57 of
1072	1072	NRS is required to comply with those provisions.
1073	1073	Sec. 9. This act becomes effective on January 1, 2024.
1074	1074
1075	1075	20 ~~~~~ 23
1076	1076
1077	1077
1078	1078