A.B. 428
- *AB428*
ASSEMBLY BILL NO. 428–ASSEMBLYMEMBERS FLANAGAN,
MONROE-MORENO, ROTH, ANDERSON, MOORE; BROWN-
MAY, CARTER, CONSIDINE, D’SILVA, GONZÁLEZ, HUNT,
JAUREGUI, KARRIS, LA RUE HATCH, MARZOLA, MILLER,
NADEEM, TORRES-FOSSETT AND YEAGER
MARCH 13, 2025
____________
Referred to Committee on Commerce and Labor
SUMMARY—Requires certain health plans to include coverage for
fertility preservation services. (BDR 57-915)
FISCAL NOTE: Effect on Local Government: May have Fiscal Impact.
Effect on the State: Yes.
CONTAINS UNFUNDED MANDATE (§ 13)
(NOT REQUESTED BY AFFECTED LOCAL GOVERNMENT)
~
EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted.
AN ACT relating to insurance; requiring certain health plans to
include coverage for certain procedures or services for the
preservation of fertility of insureds who have been
diagnosed with breast or ovarian cancer; providing certain
exceptions for insurers affiliated with religious
organizations; and providing other matters properly
relating thereto.
Legislative Counsel’s Digest:
Existing law requires public and private policies of insurance to include certain 1
coverage. (NRS 287.010, 287.04335, 422.2717-422.272428, 689A.04033-2
689A.0465, 689B.030-689B.0379, 689C.1652-689C.169, 689C.425, 695A.184-3
695A.1875, 695A.255-695A.265, 695B.1901-695B.1949, 695C.050, 695C.1691-4
695C.176, 695G.162-695G.177) Existing law also requires employers to provide 5
certain benefits to employees, including the coverage required of health insurers, if 6
the employer provides health benefits for its employees. (NRS 608.1555) Sections 7
1, 3-9, 11 and 13-15 of this bill require public and private health plans, including 8
Medicaid and insurance for state and local government employees, to provide 9
coverage for certain procedures or services that are medically necessary to preserve 10
fertility for an insured who has been diagnosed with breast or ovarian cancer if: (1) 11
the cancer may directly or indirectly cause infertility; or (2) the insured is expected 12
to receive medical treatment for the cancer and the treatment could directly or 13
indirectly cause infertility. An insurer that is affiliated with a religious organization 14
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is not required to provide the coverage required by sections 1, 3-8 and 11 if the 15
insurer: (1) objects to providing the coverage on religious grounds; and (2) provides 16
a written notice to insureds or prospective insureds disclosing that the insurer 17
refuses to provide such coverage. 18
Section 2 of this bill authorizes the Commissioner of Insurance to require a 19
policy of individual health insurance issued by a domestic insurer to a person 20
residing in another state to contain the coverage required by section 1 in certain 21
circumstances. Section 12 of this bill makes a conforming change to require the 22
Director of the Department of Health and Human Services to administer the 23
provisions of section 15 in the same manner as other provisions relating to 24
Medicaid. 25
Section 10 of this bill authorizes the Commissioner to suspend or revoke the 26
certificate of a health maintenance organization that fails to provide the coverage 27
required by section 8. The Commissioner is also authorized to take such action 28
against other health insurers who fail to provide the coverage required by sections 29
1, 3-8 and 11. (NRS 680A.200) 30
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1. Chapter 689A of NRS is hereby amended by 1
adding thereto a new section to read as follows: 2
1. Except as otherwise provided in subsection 4, an insurer 3
that issues a policy of health insurance shall include in the policy 4
coverage for any procedure or service for the preservation of 5
fertility consistent with established medical practice or any 6
guidelines published by the American Society for Reproductive 7
Medicine or the American Society of Clinical Oncology, or their 8
successor organizations, that is medically necessary to preserve 9
fertility because the insured has been diagnosed with breast or 10
ovarian cancer and: 11
(a) The cancer may, in the judgment of a provider of health 12
care, directly or indirectly cause infertility; or 13
(b) The insured is expected to receive medical treatment for the 14
cancer and such treatment may directly or indirectly cause 15
infertility. 16
2. For the purposes of subsection 1, a medical treatment may 17
directly or indirectly cause infertility if the treatment has a 18
potential side effect of impaired fertility, as established by the 19
American Society of Clinical Oncology or the American Society 20
for Reproductive Medicine, or their successor organizations. 21
3. An insurer shall ensure that the benefits required by 22
subsection 1 are made available to an insured through a provider 23
of health care who participates in the network plan of the insurer. 24
4. An insurer that is affiliated with a religious organization is 25
not required to provide the coverage required by subsection 1 if 26
the insurer objects on religious grounds. Such an insurer shall, 27
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before the issuance of a policy of health insurance that is subject 1
to the requirements of subsection 1 and before the renewal of such 2
a policy, provide to the insured or prospective insured, as 3
applicable, written notice of the coverage that the insurer refuses 4
to provide pursuant to this subsection. 5
5. A policy of health insurance that is subject to the 6
provisions of this chapter and is delivered, issued for delivery or 7
renewed on or after January 1, 2026, has the legal effect of 8
including the coverage required by subsection 1, and any 9
provision of the policy or the renewal that conflicts with the 10
provisions of this section is void. 11
6. As used in this section: 12
(a) “Network plan” means a policy of health insurance offered 13
by an insurer under which the financing and delivery of medical 14
care, including items and services paid for as medical care, are 15
provided, in whole or in part, through a defined set of providers 16
under contract with the insurer. The term does not include an 17
arrangement for the financing of premiums. 18
(b) “Provider of health care” has the meaning ascribed to it in 19
NRS 629.031. 20
Sec. 2. NRS 689A.330 is hereby amended to read as follows: 21
689A.330 If any policy is issued by a domestic insurer for 22
delivery to a person residing in another state, and if the insurance 23
commissioner or corresponding public officer of that other state has 24
informed the Commissioner that the policy is not subject to approval 25
or disapproval by that officer, the Commissioner may by ruling 26
require that the policy meet the standards set forth in NRS 689A.030 27
to 689A.320, inclusive [.] , and section 1 of this act. 28
Sec. 3. Chapter 689B of NRS is hereby amended by adding 29
thereto a new section to read as follows: 30
1. Except as otherwise provided in subsection 4, an insurer 31
that issues a policy of group health insurance shall include in the 32
policy coverage for any procedure or service for the preservation 33
of fertility consistent with established medical practice or any 34
guidelines published by the American Society for Reproductive 35
Medicine or the American Society of Clinical Oncology, or their 36
successor organizations, that is medically necessary to preserve 37
fertility because the insured has been diagnosed with breast or 38
ovarian cancer and: 39
(a) The cancer may, in the judgment of a provider of health 40
care, directly or indirectly cause infertility; or 41
(b) The insured is expected to receive medical treatment for the 42
cancer and such treatment may directly or indirectly cause 43
infertility. 44
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2. For the purposes of subsection 1, a medical treatment may 1
directly or indirectly cause infertility if the treatment has a 2
potential side effect of impaired fertility, as established by the 3
American Society of Clinical Oncology or the American Society 4
for Reproductive Medicine, or their successor organizations. 5
3. An insurer shall ensure that the benefits required by 6
subsection 1 are made available to an insured through a provider 7
of health care who participates in the network plan of the insurer. 8
4. An insurer that is affiliated with a religious organization is 9
not required to provide the coverage required by subsection 1 if 10
the insurer objects on religious grounds. Such an insurer shall, 11
before the issuance of a policy of group health insurance that is 12
subject to the requirements of subsection 1 and before the renewal 13
of such a policy, provide to the group policyholder or prospective 14
insured, as applicable, written notice of the coverage that the 15
insurer refuses to provide pursuant to this subsection. 16
5. A policy of group health insurance that is subject to the 17
provisions of this chapter and is delivered, issued for delivery or 18
renewed on or after January 1, 2026, has the legal effect of 19
including the coverage required by subsection 1, and any 20
provision of the policy or the renewal that conflicts with the 21
provisions of this section is void. 22
6. As used in this section: 23
(a) “Network plan” means a policy of group health insurance 24
offered by an insurer under which the financing and delivery of 25
medical care, including items and services paid for as medical 26
care, are provided, in whole or in part, through a defined set of 27
providers under contract with the insurer. The term does not 28
include an arrangement for the financing of premiums. 29
(b) “Provider of health care” has the meaning ascribed to it in 30
NRS 629.031. 31
Sec. 4. Chapter 689C of NRS is hereby amended by adding 32
thereto a new section to read as follows: 33
1. Except as otherwise provided in subsection 4, a carrier that 34
issues a health benefit plan shall include in the plan coverage for 35
any procedure or service for the preservation of fertility consistent 36
with established medical practice or any guidelines published by 37
the American Society for Reproductive Medicine or the American 38
Society of Clinical Oncology, or their successor organizations, that 39
is medically necessary to preserve fertility because the insured has 40
been diagnosed with breast or ovarian cancer and: 41
(a) The cancer may, in the judgment of a provider of health 42
care, directly or indirectly cause infertility; or 43
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(b) The insured is expected to receive medical treatment for the 1
cancer and such treatment may directly or indirectly cause 2
infertility. 3
2. For the purposes of subsection 1, a medical treatment may 4
directly or indirectly cause infertility if the treatment has a 5
potential side effect of impaired fertility, as established by the 6
American Society of Clinical Oncology or the American Society 7
for Reproductive Medicine, or their successor organizations. 8
3. A carrier shall ensure that the benefits required by 9
subsection 1 are made available to an insured through a provider 10
of health care who participates in the network plan of the carrier. 11
4. A carrier that is affiliated with a religious organization is 12
not required to provide the coverage required by subsection 1 if 13
the carrier objects on religious grounds. Such a carrier shall, 14
before the issuance of a health benefit plan that is subject to the 15
requirements of subsection 1 and before the renewal of such a 16
plan, provide to the insured or prospective insured, as applicable, 17
written notice of the coverage that the carrier refuses to provide 18
pursuant to this subsection. 19
5. A health benefit plan that is subject to the provisions of 20
this chapter and is delivered, issued for delivery or renewed on or 21
after January 1, 2026, has the legal effect of including the 22
coverage required by subsection 1, and any provision of the plan 23
or the renewal that conflicts with the provisions of this section is 24
void. 25
6. As used in this section: 26
(a) “Network plan” means a health benefit plan offered by a 27
carrier under which the financing and delivery of medical care, 28
including items and services paid for as medical care, are 29
provided, in whole or in part, through a defined set of providers 30
under contract with the carrier. The term does not include an 31
arrangement for the financing of premiums. 32
(b) “Provider of health care” has the meaning ascribed to it in 33
NRS 629.031. 34
Sec. 5. NRS 689C.425 is hereby amended to read as follows: 35
689C.425 A voluntary purchasing group and any contract 36
issued to such a group pursuant to NRS 689C.360 to 689C.600, 37
inclusive, are subject to the provisions of NRS 689C.015 to 38
689C.355, inclusive, and section 4 of this act, to the extent 39
applicable and not in conflict with the express provisions of NRS 40
687B.408 and 689C.360 to 689C.600, inclusive. 41
Sec. 6. Chapter 695A of NRS is hereby amended by adding 42
thereto a new section to read as follows: 43
1. Except as otherwise provided in subsection 4, a society that 44
issues a benefit contract shall include in the contract coverage for 45
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any procedure or service for the preservation of fertility consistent 1
with established medical practice or any guidelines published by 2
the American Society for Reproductive Medicine or the American 3
Society of Clinical Oncology, or their successor organizations, that 4
is medically necessary to preserve fertility because the insured has 5
been diagnosed with breast or ovarian cancer and: 6
(a) The cancer may, in the judgment of a provider of health 7
care, directly or indirectly cause infertility; or 8
(b) The insured is expected to receive medical treatment for the 9
cancer and such treatment may directly or indirectly cause 10
infertility. 11
2. For the purposes of subsection 1, a medical treatment may 12
directly or indirectly cause infertility if the treatment has a 13
potential side effect of impaired fertility, as established by the 14
American Society of Clinical Oncology or the American Society 15
for Reproductive Medicine, or their successor organizations. 16
3. A society shall ensure that the benefits required by 17
subsection 1 are made available to an insured through a provider 18
of health care who participates in the network plan of the society. 19
4. A society that is affiliated with a religious organization is 20
not required to provide the coverage required by subsection 1 if 21
the society objects on religious grounds. Such a society shall, 22
before the issuance of a benefit contract that is subject to the 23
requirements of subsection 1 and before the renewal of such a 24
contract, provide to the insured or prospective insured, as 25
applicable, written notice of the coverage that the society refuses 26
to provide pursuant to this subsection. 27
5. A benefit contract that is subject to the provisions of this 28
chapter and is delivered, issued for delivery or renewed on or after 29
January 1, 2026, has the legal effect of including the coverage 30
required by subsection 1, and any provision of the contract or the 31
renewal that conflicts with the provisions of this section is void. 32
6. As used in this section: 33
(a) “Network plan” means a benefit contract offered by a 34
society under which the financing and delivery of medical care, 35
including items and services paid for as medical care, are 36
provided, in whole or in part, through a defined set of providers 37
under contract with the society. The term does not include an 38
arrangement for the financing of premiums. 39
(b) “Provider of health care” has the meaning ascribed to it in 40
NRS 629.031. 41
Sec. 7. Chapter 695B of NRS is hereby amended by adding 42
thereto a new section to read as follows: 43
1. Except as otherwise provided in subsection 4, a hospital or 44
medical services corporation that issues a policy of health 45
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insurance shall include in the policy coverage for any procedure 1
or service for the preservation of fertility consistent with 2
established medical practice or any guidelines published by the 3
American Society for Reproductive Medicine or the American 4
Society of Clinical Oncology, or their successor organizations, that 5
is medically necessary to preserve fertility because the insured has 6
been diagnosed with breast or ovarian cancer and: 7
(a) The cancer may, in the judgment of a provider of health 8
care, directly or indirectly cause infertility; or 9
(b) The insured is expected to receive medical treatment for the 10
cancer and such treatment may directly or indirectly cause 11
infertility. 12
2. For the purposes of subsection 1, a medical treatment may 13
directly or indirectly cause infertility if the treatment has a 14
potential side effect of impaired fertility, as established by the 15
American Society of Clinical Oncology or the American Society 16
for Reproductive Medicine, or their successor organizations. 17
3. A hospital or medical services corporation shall ensure 18
that the benefits required by subsection 1 are made available to an 19
insured through a provider of health care who participates in the 20
network plan of the hospital or medical services corporation. 21
4. A hospital or medical services corporation that is affiliated 22
with a religious organization is not required to provide the 23
coverage required by subsection 1 if the hospital or medical 24
services corporation objects on religious grounds. Such a hospital 25
or medical services corporation shall, before the issuance of a 26
policy of health insurance that is subject to the requirements of 27
subsection 1 and before the renewal of such a policy, provide to 28
the insured or prospective insured, as applicable, written notice of 29
the coverage that the hospital or medical services corporation 30
refuses to provide pursuant to this subsection. 31
5. A policy of health insurance that is subject to the 32
provisions of this chapter and is delivered, issued for delivery or 33
renewed on or after January 1, 2026, has the legal effect of 34
including the coverage required by subsection 1, and any 35
provision of the policy or the renewal that conflicts with the 36
provisions of this section is void. 37
6. As used in this section: 38
(a) “Network plan” means a policy of health insurance offered 39
by a hospital or medical services corporation under which the 40
financing and delivery of medical care, including items and 41
services paid for as medical care, are provided, in whole or in part, 42
through a defined set of providers under contract with the hospital 43
or medical services corporation. The term does not include an 44
arrangement for the financing of premiums. 45
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(b) “Provider of health care” has the meaning ascribed to it in 1
NRS 629.031. 2
Sec. 8. Chapter 695C of NRS is hereby amended by adding 3
thereto a new section to read as follows: 4
1. Except as otherwise provided in subsection 4, a health 5
maintenance organization that issues a health care plan shall 6
include in the plan coverage for any procedure or service for the 7
preservation of fertility consistent with established medical 8
practice or any guidelines published by the American Society for 9
Reproductive Medicine or the American Society of Clinical 10
Oncology, or their successor organizations, that is medically 11
necessary to preserve fertility because the enrollee has been 12
diagnosed with breast or ovarian cancer and: 13
(a) The cancer may, in the judgment of a provider of health 14
care, directly or indirectly cause infertility; or 15
(b) The enrollee is expected to receive medical treatment for 16
the cancer and such treatment may directly or indirectly cause 17
infertility. 18
2. For the purposes of subsection 1, a medical treatment may 19
directly or indirectly cause infertility if the treatment has a 20
potential side effect of impaired fertility, as established by the 21
American Society of Clinical Oncology or the American Society 22
for Reproductive Medicine, or their successor organizations. 23
3. A health maintenance organization shall ensure that the 24
benefits required by subsection 1 are made available to an enrollee 25
through a provider of health care who participates in the network 26
plan of the health maintenance organization. 27
4. A health maintenance organization that is affiliated with a 28
religious organization is not required to provide the coverage 29
required by subsection 1 if the health maintenance organization 30
objects on religious grounds. Such a health maintenance 31
organization shall, before the issuance of a health care plan that is 32
subject to the requirements of subsection 1 and before the renewal 33
of such a plan, provide to the enrollee or prospective enrollee, as 34
applicable, written notice of the coverage that the health 35
maintenance organization refuses to provide pursuant to this 36
subsection. 37
5. A health care plan that is subject to the provisions of this 38
chapter and is delivered, issued for delivery or renewed on or after 39
January 1, 2026, has the legal effect of including the coverage 40
required by subsection 1, and any provision of the plan or the 41
renewal that conflicts with the provisions of this section is void. 42
6. As used in this section: 43
(a) “Network plan” means a health care plan offered by a 44
health maintenance organization under which the financing and 45
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delivery of medical care, including items and services paid for as 1
medical care, are provided, in whole or in part, through a defined 2
set of providers under contract with the health maintenance 3
organization. The term does not include an arrangement for the 4
financing of premiums. 5
(b) “Provider of health care” has the meaning ascribed to it in 6
NRS 629.031. 7
Sec. 9. NRS 695C.050 is hereby amended to read as follows: 8
695C.050 1. Except as otherwise provided in this chapter or 9
in specific provisions of this title, the provisions of this title are not 10
applicable to any health maintenance organization granted a 11
certificate of authority under this chapter. This provision does not 12
apply to an insurer licensed and regulated pursuant to this title 13
except with respect to its activities as a health maintenance 14
organization authorized and regulated pursuant to this chapter. 15
2. Solicitation of enrollees by a health maintenance 16
organization granted a certificate of authority, or its representatives, 17
must not be construed to violate any provision of law relating to 18
solicitation or advertising by practitioners of a healing art. 19
3. Any health maintenance organization authorized under this 20
chapter shall not be deemed to be practicing medicine and is exempt 21
from the provisions of chapter 630 of NRS. 22
4. The provisions of NRS 695C.110, 695C.125, 695C.1691, 23
695C.1693, 695C.170, 695C.1703, 695C.1705, 695C.1709 to 24
695C.173, inclusive, 695C.1733, 695C.17335, 695C.1734, 25
695C.1751, 695C.1755, 695C.1759, 695C.176 to 695C.200, 26
inclusive, and 695C.265 do not apply to a health maintenance 27
organization that provides health care services through managed 28
care to recipients of Medicaid under the State Plan for Medicaid or 29
insurance pursuant to the Children’s Health Insurance Program 30
pursuant to a contract with the Division of Health Care Financing 31
and Policy of the Department of Health and Human Services. This 32
subsection does not exempt a health maintenance organization from 33
any provision of this chapter for services provided pursuant to any 34
other contract. 35
5. The provisions of NRS 695C.16932 to 695C.1699, 36
inclusive, 695C.1701, 695C.1708, 695C.1728, 695C.1731, 37
695C.17333, 695C.17345, 695C.17347, 695C.1736 to 695C.1745, 38
inclusive, 695C.1757 and 695C.204 and section 8 of this act apply 39
to a health maintenance organization that provides health care 40
services through managed care to recipients of Medicaid under the 41
State Plan for Medicaid. 42
6. The provisions of NRS 695C.17095 do not apply to a health 43
maintenance organization that provides health care services to 44
members of the Public Employees’ Benefits Program. This 45
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subsection does not exempt a health maintenance organization from 1
any provision of this chapter for services provided pursuant to any 2
other contract. 3
7. The provisions of NRS 695C.1735 do not apply to a health 4
maintenance organization that provides health care services to: 5
(a) The officers and employees, and the dependents of officers 6
and employees, of the governing body of any county, school district, 7
municipal corporation, political subdivision, public corporation or 8
other local governmental agency of this State; or 9
(b) Members of the Public Employees’ Benefits Program. 10
This subsection does not exempt a health maintenance 11
organization from any provision of this chapter for services 12
provided pursuant to any other contract. 13
Sec. 10. NRS 695C.330 is hereby amended to read as follows: 14
695C.330 1. The Commissioner may suspend or revoke any 15
certificate of authority issued to a health maintenance organization 16
pursuant to the provisions of this chapter if the Commissioner finds 17
that any of the following conditions exist: 18
(a) The health maintenance organization is operating 19
significantly in contravention of its basic organizational document, 20
its health care plan or in a manner contrary to that described in and 21
reasonably inferred from any other information submitted pursuant 22
to NRS 695C.060, 695C.070 and 695C.140, unless any amendments 23
to those submissions have been filed with and approved by the 24
Commissioner; 25
(b) The health maintenance organization issues evidence of 26
coverage or uses a schedule of charges for health care services 27
which do not comply with the requirements of NRS 695C.1691 to 28
695C.200, inclusive, and section 8 of this act, 695C.204 or 29
695C.207; 30
(c) The health care plan does not furnish comprehensive health 31
care services as provided for in NRS 695C.060; 32
(d) The Commissioner certifies that the health maintenance 33
organization: 34
(1) Does not meet the requirements of subsection 1 of NRS 35
695C.080; or 36
(2) Is unable to fulfill its obligations to furnish health care 37
services as required under its health care plan; 38
(e) The health maintenance organization is no longer financially 39
responsible and may reasonably be expected to be unable to meet its 40
obligations to enrollees or prospective enrollees; 41
(f) The health maintenance organization has failed to put into 42
effect a mechanism affording the enrollees an opportunity to 43
participate in matters relating to the content of programs pursuant to 44
NRS 695C.110; 45
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(g) The health maintenance organization has failed to put into 1
effect the system required by NRS 695C.260 for: 2
(1) Resolving complaints in a manner reasonably to dispose 3
of valid complaints; and 4
(2) Conducting external reviews of adverse determinations 5
that comply with the provisions of NRS 695G.241 to 695G.310, 6
inclusive; 7
(h) The health maintenance organization or any person on its 8
behalf has advertised or merchandised its services in an untrue, 9
misrepresentative, misleading, deceptive or unfair manner; 10
(i) The continued operation of the health maintenance 11
organization would be hazardous to its enrollees or creditors or to 12
the general public; 13
(j) The health maintenance organization fails to provide the 14
coverage required by NRS 695C.1691; or 15
(k) The health maintenance organization has otherwise failed to 16
comply substantially with the provisions of this chapter. 17
2. A certificate of authority must be suspended or revoked only 18
after compliance with the requirements of NRS 695C.340. 19
3. If the certificate of authority of a health maintenance 20
organization is suspended, the health maintenance organization shall 21
not, during the period of that suspension, enroll any additional 22
groups or new individual contracts, unless those groups or persons 23
were contracted for before the date of suspension. 24
4. If the certificate of authority of a health maintenance 25
organization is revoked, the organization shall proceed, immediately 26
following the effective date of the order of revocation, to wind up its 27
affairs and shall conduct no further business except as may be 28
essential to the orderly conclusion of the affairs of the organization. 29
It shall engage in no further advertising or solicitation of any kind. 30
The Commissioner may, by written order, permit such further 31
operation of the organization as the Commissioner may find to be in 32
the best interest of enrollees to the end that enrollees are afforded 33
the greatest practical opportunity to obtain continuing coverage for 34
health care. 35
Sec. 11. Chapter 695G of NRS is hereby amended by adding 36
thereto a new section to read as follows: 37
1. Except as otherwise provided in subsection 4, a managed 38
care organization that issues a health care plan shall include in 39
the plan coverage for any procedure or service for the preservation 40
of fertility consistent with established medical practice or any 41
guidelines published by the American Society for Reproductive 42
Medicine or the American Society of Clinical Oncology, or their 43
successor organizations, that is medically necessary to preserve 44
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fertility because the insured has been diagnosed with breast or 1
ovarian cancer and: 2
(a) The cancer may, in the judgment of a provider of health 3
care, directly or indirectly cause infertility; or 4
(b) The insured is expected to receive medical treatment for the 5
cancer and such treatment may directly or indirectly cause 6
infertility. 7
2. For the purposes of subsection 1, a medical treatment may 8
directly or indirectly cause infertility if the treatment has a 9
potential side effect of impaired fertility, as established by the 10
American Society of Clinical Oncology or the American Society 11
for Reproductive Medicine, or their successor organizations. 12
3. A managed care organization shall ensure that the benefits 13
required by subsection 1 are made available to an insured through 14
a provider of health care who participates in the network plan of 15
the managed care organization. 16
4. A managed care organization that is affiliated with a 17
religious organization is not required to provide the coverage 18
required by subsection 1 if the managed care organization objects 19
on religious grounds. Such a managed care organization shall, 20
before the issuance of a health care plan that is subject to the 21
requirements of subsection 1 and before the renewal of such a 22
plan, provide to the insured or prospective insured, as applicable, 23
written notice of the coverage that the managed care organization 24
refuses to provide pursuant to this subsection. 25
5. A health care plan that is subject to the provisions of this 26
chapter and is delivered, issued for delivery or renewed on or after 27
January 1, 2026, has the legal effect of including the coverage 28
required by subsection 1, and any provision of the plan or the 29
renewal that conflicts with the provisions of this section is void. 30
6. As used in this section: 31
(a) “Network plan” means a health care plan offered by a 32
managed care organization under which the financing and 33
delivery of medical care, including items and services paid for as 34
medical care, are provided, in whole or in part, through a defined 35
set of providers under contract with the managed care 36
organization. The term does not include an arrangement for the 37
financing of premiums. 38
(b) “Provider of health care” has the meaning ascribed to it in 39
NRS 629.031. 40
Sec. 12. NRS 232.320 is hereby amended to read as follows: 41
232.320 1. The Director: 42
(a) Shall appoint, with the consent of the Governor, 43
administrators of the divisions of the Department, who are 44
respectively designated as follows: 45
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(1) The Administrator of the Aging and Disability Services 1
Division; 2
(2) The Administrator of the Division of Welfare and 3
Supportive Services; 4
(3) The Administrator of the Division of Child and Family 5
Services; 6
(4) The Administrator of the Division of Health Care 7
Financing and Policy; and 8
(5) The Administrator of the Division of Public and 9
Behavioral Health. 10
(b) Shall administer, through the divisions of the Department, 11
the provisions of chapters 63, 424, 425, 427A, 432A to 442, 12
inclusive, 446 to 450, inclusive, 458A and 656A of NRS, NRS 13
127.220 to 127.310, inclusive, 422.001 to 422.410, inclusive, and 14
section 15 of this act, 422.580, 432.010 to 432.133, inclusive, 15
432B.6201 to 432B.626, inclusive, 444.002 to 444.430, inclusive, 16
and 445A.010 to 445A.055, inclusive, and all other provisions of 17
law relating to the functions of the divisions of the Department, but 18
is not responsible for the clinical activities of the Division of Public 19
and Behavioral Health or the professional line activities of the other 20
divisions. 21
(c) Shall administer any state program for persons with 22
developmental disabilities established pursuant to the 23
Developmental Disabilities Assistance and Bill of Rights Act of 24
2000, 42 U.S.C. §§ 15001 et seq. 25
(d) Shall, after considering advice from agencies of local 26
governments and nonprofit organizations which provide social 27
services, adopt a master plan for the provision of human services in 28
this State. The Director shall revise the plan biennially and deliver a 29
copy of the plan to the Governor and the Legislature at the 30
beginning of each regular session. The plan must: 31
(1) Identify and assess the plans and programs of the 32
Department for the provision of human services, and any 33
duplication of those services by federal, state and local agencies; 34
(2) Set forth priorities for the provision of those services; 35
(3) Provide for communication and the coordination of those 36
services among nonprofit organizations, agencies of local 37
government, the State and the Federal Government; 38
(4) Identify the sources of funding for services provided by 39
the Department and the allocation of that funding; 40
(5) Set forth sufficient information to assist the Department 41
in providing those services and in the planning and budgeting for the 42
future provision of those services; and 43
(6) Contain any other information necessary for the 44
Department to communicate effectively with the Federal 45
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Government concerning demographic trends, formulas for the 1
distribution of federal money and any need for the modification of 2
programs administered by the Department. 3
(e) May, by regulation, require nonprofit organizations and state 4
and local governmental agencies to provide information regarding 5
the programs of those organizations and agencies, excluding 6
detailed information relating to their budgets and payrolls, which the 7
Director deems necessary for the performance of the duties imposed 8
upon him or her pursuant to this section. 9
(f) Has such other powers and duties as are provided by law. 10
2. Notwithstanding any other provision of law, the Director, or 11
the Director’s designee, is responsible for appointing and removing 12
subordinate officers and employees of the Department. 13
Sec. 13. NRS 287.010 is hereby amended to read as follows: 14
287.010 1. The governing body of any county, school 15
district, municipal corporation, political subdivision, public 16
corporation or other local governmental agency of the State of 17
Nevada may: 18
(a) Adopt and carry into effect a system of group life, accident 19
or health insurance, or any combination thereof, for the benefit of its 20
officers and employees, and the dependents of officers and 21
employees who elect to accept the insurance and who, where 22
necessary, have authorized the governing body to make deductions 23
from their compensation for the payment of premiums on the 24
insurance. 25
(b) Purchase group policies of life, accident or health insurance, 26
or any combination thereof, for the benefit of such officers and 27
employees, and the dependents of such officers and employees, as 28
have authorized the purchase, from insurance companies authorized 29
to transact the business of such insurance in the State of Nevada, 30
and, where necessary, deduct from the compensation of officers and 31
employees the premiums upon insurance and pay the deductions 32
upon the premiums. 33
(c) Provide group life, accident or health coverage through a 34
self-insurance reserve fund and, where necessary, deduct 35
contributions to the maintenance of the fund from the compensation 36
of officers and employees and pay the deductions into the fund. The 37
money accumulated for this purpose through deductions from the 38
compensation of officers and employees and contributions of the 39
governing body must be maintained as an internal service fund as 40
defined by NRS 354.543. The money must be deposited in a state or 41
national bank or credit union authorized to transact business in the 42
State of Nevada. Any independent administrator of a fund created 43
under this section is subject to the licensing requirements of chapter 44
683A of NRS, and must be a resident of this State. Any contract 45
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with an independent administrator must be approved by the 1
Commissioner of Insurance as to the reasonableness of 2
administrative charges in relation to contributions collected and 3
benefits provided. The provisions of NRS 439.581 to 439.597, 4
inclusive, 686A.135, 687B.352, 687B.408, 687B.692, 687B.723, 5
687B.725, 687B.805, 689B.030 to 689B.0317, inclusive, and 6
section 3 of this act, paragraphs (b) and (c) of subsection 1 of NRS 7
689B.0319, subsections 2, 4, 6 and 7 of NRS 689B.0319, 689B.033 8
to 689B.0369, inclusive, 689B.0375 to 689B.050, inclusive, 9
689B.0675, 689B.265, 689B.287 and 689B.500 apply to coverage 10
provided pursuant to this paragraph, except that the provisions of 11
NRS 689B.0378, 689B.03785 and 689B.500 only apply to coverage 12
for active officers and employees of the governing body, or the 13
dependents of such officers and employees. 14
(d) Defray part or all of the cost of maintenance of a self-15
insurance fund or of the premiums upon insurance. The money for 16
contributions must be budgeted for in accordance with the laws 17
governing the county, school district, municipal corporation, 18
political subdivision, public corporation or other local governmental 19
agency of the State of Nevada. 20
2. If a school district offers group insurance to its officers and 21
employees pursuant to this section, members of the board of trustees 22
of the school district must not be excluded from participating in the 23
group insurance. If the amount of the deductions from compensation 24
required to pay for the group insurance exceeds the compensation to 25
which a trustee is entitled, the difference must be paid by the trustee. 26
3. In any county in which a legal services organization exists, 27
the governing body of the county, or of any school district, 28
municipal corporation, political subdivision, public corporation or 29
other local governmental agency of the State of Nevada in the 30
county, may enter into a contract with the legal services 31
organization pursuant to which the officers and employees of the 32
legal services organization, and the dependents of those officers and 33
employees, are eligible for any life, accident or health insurance 34
provided pursuant to this section to the officers and employees, and 35
the dependents of the officers and employees, of the county, school 36
district, municipal corporation, political subdivision, public 37
corporation or other local governmental agency. 38
4. If a contract is entered into pursuant to subsection 3, the 39
officers and employees of the legal services organization: 40
(a) Shall be deemed, solely for the purposes of this section, to be 41
officers and employees of the county, school district, municipal 42
corporation, political subdivision, public corporation or other local 43
governmental agency with which the legal services organization has 44
contracted; and 45
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(b) Must be required by the contract to pay the premiums or 1
contributions for all insurance which they elect to accept or of which 2
they authorize the purchase. 3
5. A contract that is entered into pursuant to subsection 3: 4
(a) Must be submitted to the Commissioner of Insurance for 5
approval not less than 30 days before the date on which the contract 6
is to become effective. 7
(b) Does not become effective unless approved by the 8
Commissioner. 9
(c) Shall be deemed to be approved if not disapproved by the 10
Commissioner within 30 days after its submission. 11
6. As used in this section, “legal services organization” means 12
an organization that operates a program for legal aid and receives 13
money pursuant to NRS 19.031. 14
Sec. 14. NRS 287.04335 is hereby amended to read as 15
follows: 16
287.04335 If the Board provides health insurance through a 17
plan of self-insurance, it shall comply with the provisions of NRS 18
439.581 to 439.597, inclusive, 686A.135, 687B.352, 687B.409, 19
687B.692, 687B.723, 687B.725, 687B.805, 689B.0353, 689B.255, 20
695C.1723, 695G.150, 695G.155, 695G.160, 695G.162, 21
695G.1635, 695G.164, 695G.1645, 695G.1665, 695G.167, 22
695G.1675, 695G.170 to 695G.1712, inclusive, 695G.1714 to 23
695G.174, inclusive, and section 11 of this act, 695G.176, 24
695G.177, 695G.200 to 695G.230, inclusive, 695G.241 to 25
695G.310, inclusive, 695G.405 and 695G.415, in the same manner 26
as an insurer that is licensed pursuant to title 57 of NRS is required 27
to comply with those provisions. 28
Sec. 15. Chapter 422 of NRS is hereby amended by adding 29
thereto a new section to read as follows: 30
1. To the extent that federal financial participation is 31
available, the Director shall include under Medicaid coverage for 32
any procedure or service for the preservation of fertility consistent 33
with established medical practice or any guidelines published by 34
the American Society for Reproductive Medicine or the American 35
Society of Clinical Oncology, or their successor organizations, that 36
is medically necessary to preserve fertility because a recipient of 37
Medicaid has been diagnosed with breast or ovarian cancer and: 38
(a) The cancer may, in the judgment of a provider of health 39
care, directly or indirectly cause infertility; or 40
(b) The recipient is expected to receive medical treatment for 41
the cancer and such treatment may directly or indirectly cause 42
infertility. 43
2. For the purposes of subsection 1, a medical treatment may 44
directly or indirectly cause infertility if the treatment has a 45
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potential side effect of impaired fertility, as established by the 1
American Society of Clinical Oncology or the American Society 2
for Reproductive Medicine, or their successor organizations. 3
3. The Department shall: 4
(a) Apply to the Secretary of Health and Human Services for 5
any waiver of federal law or apply for any amendment of the State 6
Plan for Medicaid that is necessary for the Department to receive 7
federal funding to provide the coverage described in subsection 1. 8
(b) Fully cooperate in good faith with the Federal Government 9
during the application process to satisfy the requirements of the 10
Federal Government for obtaining a waiver or amendment 11
pursuant to paragraph (a). 12
4. As used in this section, “provider of health care” has the 13
meaning ascribed to it in NRS 629.031. 14
Sec. 16. The provisions of NRS 354.599 do not apply to any 15
additional expenses of a local government that are related to the 16
provisions of this act. 17
Sec. 17. 1. This section becomes effective upon passage and 18
approval. 19
2. Sections 1 to 16, inclusive, of this act become effective: 20
(a) Upon passage and approval for the purpose of adopting any 21
regulations and performing any other preparatory administrative 22
tasks that are necessary to carry out the provisions of this act; and 23
(b) On January 1, 2026, for all other purposes. 24
H