EXEMPT
(Reprinted with amendments adopted on April 21, 2025)
FIRST REPRINT A.B. 428
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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 3, 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 that is affiliated with a religious organization is 6
not required to provide the coverage required by subsection 1 if 7
the insurer objects on religious grounds. Such an insurer shall, 8
before the issuance of a policy of group health insurance that is 9
subject to the requirements of subsection 1 and before the renewal 10
of such a policy, provide to the group policyholder or prospective 11
insured, as applicable, written notice of the coverage that the 12
insurer refuses to provide pursuant to this subsection. 13
4. A policy of group health insurance that is subject to the 14
provisions of this chapter and is delivered, issued for delivery or 15
renewed on or after January 1, 2026, has the legal effect of 16
including the coverage required by subsection 1, and any 17
provision of the policy or the renewal that conflicts with the 18
provisions of this section is void. 19
Sec. 4. Chapter 689C of NRS is hereby amended by adding 20
thereto a new section to read as follows: 21
1. Except as otherwise provided in subsection 4, a carrier that 22
issues a health benefit plan shall include in the plan coverage for 23
any procedure or service for the preservation of fertility consistent 24
with established medical practice or any guidelines published by 25
the American Society for Reproductive Medicine or the American 26
Society of Clinical Oncology, or their successor organizations, that 27
is medically necessary to preserve fertility because the insured has 28
been diagnosed with breast or ovarian cancer and: 29
(a) The cancer may, in the judgment of a provider of health 30
care, directly or indirectly cause infertility; or 31
(b) The insured is expected to receive medical treatment for the 32
cancer and such treatment may directly or indirectly cause 33
infertility. 34
2. For the purposes of subsection 1, a medical treatment may 35
directly or indirectly cause infertility if the treatment has a 36
potential side effect of impaired fertility, as established by the 37
American Society of Clinical Oncology or the American Society 38
for Reproductive Medicine, or their successor organizations. 39
3. A carrier shall ensure that the benefits required by 40
subsection 1 are made available to an insured through a provider 41
of health care who participates in the network plan of the carrier. 42
4. A carrier that is affiliated with a religious organization is 43
not required to provide the coverage required by subsection 1 if 44
the carrier objects on religious grounds. Such a carrier shall, 45
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before the issuance of a health benefit plan that is subject to the 1
requirements of subsection 1 and before the renewal of such a 2
plan, provide to the insured or prospective insured, as applicable, 3
written notice of the coverage that the carrier refuses to provide 4
pursuant to this subsection. 5
5. A health benefit plan that is subject to the provisions of 6
this chapter and is delivered, issued for delivery or renewed on or 7
after January 1, 2026, has the legal effect of including the 8
coverage required by subsection 1, and any provision of the plan 9
or the renewal that conflicts with the provisions of this section is 10
void. 11
6. As used in this section: 12
(a) “Network plan” means a health benefit plan offered by a 13
carrier under which the financing and delivery of medical care, 14
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 carrier. 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. 5. NRS 689C.425 is hereby amended to read as follows: 21
689C.425 A voluntary purchasing group and any contract 22
issued to such a group pursuant to NRS 689C.360 to 689C.600, 23
inclusive, are subject to the provisions of NRS 689C.015 to 24
689C.355, inclusive, and section 4 of this act, to the extent 25
applicable and not in conflict with the express provisions of NRS 26
687B.408 and 689C.360 to 689C.600, inclusive. 27
Sec. 6. Chapter 695A of NRS is hereby amended by adding 28
thereto a new section to read as follows: 29
1. Except as otherwise provided in subsection 4, a society that 30
issues a benefit contract shall include in the contract coverage for 31
any procedure or service for the preservation of fertility consistent 32
with established medical practice or any guidelines published by 33
the American Society for Reproductive Medicine or the American 34
Society of Clinical Oncology, or their successor organizations, that 35
is medically necessary to preserve fertility because the insured has 36
been diagnosed with breast or ovarian cancer and: 37
(a) The cancer may, in the judgment of a provider of health 38
care, directly or indirectly cause infertility; or 39
(b) The insured is expected to receive medical treatment for the 40
cancer and such treatment may directly or indirectly cause 41
infertility. 42
2. For the purposes of subsection 1, a medical treatment may 43
directly or indirectly cause infertility if the treatment has a 44
potential side effect of impaired fertility, as established by the 45
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American Society of Clinical Oncology or the American Society 1
for Reproductive Medicine, or their successor organizations. 2
3. A society shall ensure that the benefits required by 3
subsection 1 are made available to an insured through a provider 4
of health care who participates in the network plan of the society. 5
4. A society that is affiliated with a religious organization is 6
not required to provide the coverage required by subsection 1 if 7
the society objects on religious grounds. Such a society shall, 8
before the issuance of a benefit contract that is subject to the 9
requirements of subsection 1 and before the renewal of such a 10
contract, provide to the insured or prospective insured, as 11
applicable, written notice of the coverage that the society refuses 12
to provide pursuant to this subsection. 13
5. A benefit contract that is subject to the provisions of this 14
chapter and is delivered, issued for delivery or renewed on or after 15
January 1, 2026, has the legal effect of including the coverage 16
required by subsection 1, and any provision of the contract or the 17
renewal that conflicts with the provisions of this section is void. 18
6. As used in this section: 19
(a) “Network plan” means a benefit contract offered by a 20
society under which the financing and delivery of medical care, 21
including items and services paid for as medical care, are 22
provided, in whole or in part, through a defined set of providers 23
under contract with the society. The term does not include an 24
arrangement for the financing of premiums. 25
(b) “Provider of health care” has the meaning ascribed to it in 26
NRS 629.031. 27
Sec. 7. Chapter 695B of NRS is hereby amended by adding 28
thereto a new section to read as follows: 29
1. Except as otherwise provided in subsection 4, a hospital or 30
medical services corporation that issues a policy of health 31
insurance shall include in the policy coverage for any procedure 32
or service for the preservation of fertility consistent with 33
established medical practice or any guidelines published by the 34
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 the insured has 37
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 insured is expected to receive medical treatment for the 41
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. A hospital or medical services corporation shall ensure 4
that the benefits required by subsection 1 are made available to an 5
insured through a provider of health care who participates in the 6
network plan of the hospital or medical services corporation. 7
4. A hospital or medical services corporation that is affiliated 8
with a religious organization is not required to provide the 9
coverage required by subsection 1 if the hospital or medical 10
services corporation objects on religious grounds. Such a hospital 11
or medical services corporation shall, before the issuance of a 12
policy of health insurance that is subject to the requirements of 13
subsection 1 and before the renewal of such a policy, provide to 14
the insured or prospective insured, as applicable, written notice of 15
the coverage that the hospital or medical services corporation 16
refuses to provide pursuant to this subsection. 17
5. A policy of health insurance that is subject to the 18
provisions of this chapter and is delivered, issued for delivery or 19
renewed on or after January 1, 2026, has the legal effect of 20
including the coverage required by subsection 1, and any 21
provision of the policy or the renewal that conflicts with the 22
provisions of this section is void. 23
6. As used in this section: 24
(a) “Network plan” means a policy of health insurance offered 25
by a hospital or medical services corporation under which the 26
financing and delivery of medical care, including items and 27
services paid for as medical care, are provided, in whole or in part, 28
through a defined set of providers under contract with the hospital 29
or medical services corporation. The term does not include an 30
arrangement for the financing of premiums. 31
(b) “Provider of health care” has the meaning ascribed to it in 32
NRS 629.031. 33
Sec. 8. Chapter 695C of NRS is hereby amended by adding 34
thereto a new section to read as follows: 35
1. Except as otherwise provided in subsection 4, a health 36
maintenance organization that issues a health care plan shall 37
include in the plan coverage for any procedure or service for the 38
preservation of fertility consistent with established medical 39
practice or any guidelines published by the American Society for 40
Reproductive Medicine or the American Society of Clinical 41
Oncology, or their successor organizations, that is medically 42
necessary to preserve fertility because the enrollee has been 43
diagnosed with breast or ovarian cancer and: 44
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(a) The cancer may, in the judgment of a provider of health 1
care, directly or indirectly cause infertility; or 2
(b) The enrollee is expected to receive medical treatment for 3
the cancer and such treatment may directly or indirectly cause 4
infertility. 5
2. For the purposes of subsection 1, a medical treatment may 6
directly or indirectly cause infertility if the treatment has a 7
potential side effect of impaired fertility, as established by the 8
American Society of Clinical Oncology or the American Society 9
for Reproductive Medicine, or their successor organizations. 10
3. A health maintenance organization shall ensure that the 11
benefits required by subsection 1 are made available to an enrollee 12
through a provider of health care who participates in the network 13
plan of the health maintenance organization. 14
4. A health maintenance organization that is affiliated with a 15
religious organization is not required to provide the coverage 16
required by subsection 1 if the health maintenance organization 17
objects on religious grounds. Such a health maintenance 18
organization shall, before the issuance of a health care plan that is 19
subject to the requirements of subsection 1 and before the renewal 20
of such a plan, provide to the enrollee or prospective enrollee, as 21
applicable, written notice of the coverage that the health 22
maintenance organization refuses to provide pursuant to this 23
subsection. 24
5. A health care plan that is subject to the provisions of this 25
chapter and is delivered, issued for delivery or renewed on or after 26
January 1, 2026, has the legal effect of including the coverage 27
required by subsection 1, and any provision of the plan or the 28
renewal that conflicts with the provisions of this section is void. 29
6. As used in this section: 30
(a) “Network plan” means a health care plan offered by a 31
health maintenance organization under which the financing and 32
delivery of medical care, including items and services paid for as 33
medical care, are provided, in whole or in part, through a defined 34
set of providers under contract with the health maintenance 35
organization. The term does not include an arrangement for the 36
financing of premiums. 37
(b) “Provider of health care” has the meaning ascribed to it in 38
NRS 629.031. 39
Sec. 9. NRS 695C.050 is hereby amended to read as follows: 40
695C.050 1. Except as otherwise provided in this chapter or 41
in specific provisions of this title, the provisions of this title are not 42
applicable to any health maintenance organization granted a 43
certificate of authority under this chapter. This provision does not 44
apply to an insurer licensed and regulated pursuant to this title 45
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except with respect to its activities as a health maintenance 1
organization authorized and regulated pursuant to this chapter. 2
2. Solicitation of enrollees by a health maintenance 3
organization granted a certificate of authority, or its representatives, 4
must not be construed to violate any provision of law relating to 5
solicitation or advertising by practitioners of a healing art. 6
3. Any health maintenance organization authorized under this 7
chapter shall not be deemed to be practicing medicine and is exempt 8
from the provisions of chapter 630 of NRS. 9
4. The provisions of NRS 695C.110, 695C.125, 695C.1691, 10
695C.1693, 695C.170, 695C.1703, 695C.1705, 695C.1709 to 11
695C.173, inclusive, 695C.1733, 695C.17335, 695C.1734, 12
695C.1751, 695C.1755, 695C.1759, 695C.176 to 695C.200, 13
inclusive, and 695C.265 do not apply to a health maintenance 14
organization that provides health care services through managed 15
care to recipients of Medicaid under the State Plan for Medicaid or 16
insurance pursuant to the Children’s Health Insurance Program 17
pursuant to a contract with the Division of Health Care Financing 18
and Policy of the Department of Health and Human Services. This 19
subsection does not exempt a health maintenance organization from 20
any provision of this chapter for services provided pursuant to any 21
other contract. 22
5. The provisions of NRS 695C.16932 to 695C.1699, 23
inclusive, 695C.1701, 695C.1708, 695C.1728, 695C.1731, 24
695C.17333, 695C.17345, 695C.17347, 695C.1736 to 695C.1745, 25
inclusive, 695C.1757 and 695C.204 and section 8 of this act apply 26
to a health maintenance organization that provides health care 27
services through managed care to recipients of Medicaid under the 28
State Plan for Medicaid. 29
6. The provisions of NRS 695C.17095 do not apply to a health 30
maintenance organization that provides health care services to 31
members of the Public Employees’ Benefits Program. 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
7. The provisions of NRS 695C.1735 do not apply to a health 36
maintenance organization that provides health care services to: 37
(a) The officers and employees, and the dependents of officers 38
and employees, of the governing body of any county, school district, 39
municipal corporation, political subdivision, public corporation or 40
other local governmental agency of this State; or 41
(b) Members of the Public Employees’ Benefits Program. 42
This subsection does not exempt a health maintenance 43
organization from any provision of this chapter for services 44
provided pursuant to any other contract. 45
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Sec. 10. NRS 695C.330 is hereby amended to read as follows: 1
695C.330 1. The Commissioner may suspend or revoke any 2
certificate of authority issued to a health maintenance organization 3
pursuant to the provisions of this chapter if the Commissioner finds 4
that any of the following conditions exist: 5
(a) The health maintenance organization is operating 6
significantly in contravention of its basic organizational document, 7
its health care plan or in a manner contrary to that described in and 8
reasonably inferred from any other information submitted pursuant 9
to NRS 695C.060, 695C.070 and 695C.140, unless any amendments 10
to those submissions have been filed with and approved by the 11
Commissioner; 12
(b) The health maintenance organization issues evidence of 13
coverage or uses a schedule of charges for health care services 14
which do not comply with the requirements of NRS 695C.1691 to 15
695C.200, inclusive, and section 8 of this act, 695C.204 or 16
695C.207; 17
(c) The health care plan does not furnish comprehensive health 18
care services as provided for in NRS 695C.060; 19
(d) The Commissioner certifies that the health maintenance 20
organization: 21
(1) Does not meet the requirements of subsection 1 of NRS 22
695C.080; or 23
(2) Is unable to fulfill its obligations to furnish health care 24
services as required under its health care plan; 25
(e) The health maintenance organization is no longer financially 26
responsible and may reasonably be expected to be unable to meet its 27
obligations to enrollees or prospective enrollees; 28
(f) The health maintenance organization has failed to put into 29
effect a mechanism affording the enrollees an opportunity to 30
participate in matters relating to the content of programs pursuant to 31
NRS 695C.110; 32
(g) The health maintenance organization has failed to put into 33
effect the system required by NRS 695C.260 for: 34
(1) Resolving complaints in a manner reasonably to dispose 35
of valid complaints; and 36
(2) Conducting external reviews of adverse determinations 37
that comply with the provisions of NRS 695G.241 to 695G.310, 38
inclusive; 39
(h) The health maintenance organization or any person on its 40
behalf has advertised or merchandised its services in an untrue, 41
misrepresentative, misleading, deceptive or unfair manner; 42
(i) The continued operation of the health maintenance 43
organization would be hazardous to its enrollees or creditors or to 44
the general public; 45
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(j) The health maintenance organization fails to provide the 1
coverage required by NRS 695C.1691; or 2
(k) The health maintenance organization has otherwise failed to 3
comply substantially with the provisions of this chapter. 4
2. A certificate of authority must be suspended or revoked only 5
after compliance with the requirements of NRS 695C.340. 6
3. If the certificate of authority of a health maintenance 7
organization is suspended, the health maintenance organization shall 8
not, during the period of that suspension, enroll any additional 9
groups or new individual contracts, unless those groups or persons 10
were contracted for before the date of suspension. 11
4. If the certificate of authority of a health maintenance 12
organization is revoked, the organization shall proceed, immediately 13
following the effective date of the order of revocation, to wind up its 14
affairs and shall conduct no further business except as may be 15
essential to the orderly conclusion of the affairs of the organization. 16
It shall engage in no further advertising or solicitation of any kind. 17
The Commissioner may, by written order, permit such further 18
operation of the organization as the Commissioner may find to be in 19
the best interest of enrollees to the end that enrollees are afforded 20
the greatest practical opportunity to obtain continuing coverage for 21
health care. 22
Sec. 11. Chapter 695G of NRS is hereby amended by adding 23
thereto a new section to read as follows: 24
1. Except as otherwise provided in subsection 4, a managed 25
care organization that issues a health care plan shall include in 26
the plan coverage for any procedure or service for the preservation 27
of fertility consistent with established medical practice or any 28
guidelines published by the American Society for Reproductive 29
Medicine or the American Society of Clinical Oncology, or their 30
successor organizations, that is medically necessary to preserve 31
fertility because the insured has been diagnosed with breast or 32
ovarian cancer and: 33
(a) The cancer may, in the judgment of a provider of health 34
care, directly or indirectly cause infertility; or 35
(b) The insured is expected to receive medical treatment for the 36
cancer and such treatment may directly or indirectly cause 37
infertility. 38
2. For the purposes of subsection 1, a medical treatment may 39
directly or indirectly cause infertility if the treatment has a 40
potential side effect of impaired fertility, as established by the 41
American Society of Clinical Oncology or the American Society 42
for Reproductive Medicine, or their successor organizations. 43
3. A managed care organization shall ensure that the benefits 44
required by subsection 1 are made available to an insured through 45
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a provider of health care who participates in the network plan of 1
the managed care organization. 2
4. A managed care organization that is affiliated with a 3
religious organization is not required to provide the coverage 4
required by subsection 1 if the managed care organization objects 5
on religious grounds. Such a managed care organization shall, 6
before the issuance of a health care plan that is subject to the 7
requirements of subsection 1 and before the renewal of such a 8
plan, provide to the insured or prospective insured, as applicable, 9
written notice of the coverage that the managed care organization 10
refuses to provide pursuant to this subsection. 11
5. A health care plan that is subject to the provisions of this 12
chapter and is delivered, issued for delivery or renewed on or after 13
January 1, 2026, has the legal effect of including the coverage 14
required by subsection 1, and any provision of the plan or the 15
renewal that conflicts with the provisions of this section is void. 16
6. As used in this section: 17
(a) “Network plan” means a health care plan offered by a 18
managed care organization under which the financing and 19
delivery of medical care, including items and services paid for as 20
medical care, are provided, in whole or in part, through a defined 21
set of providers under contract with the managed care 22
organization. The term does not include an arrangement for the 23
financing of premiums. 24
(b) “Provider of health care” has the meaning ascribed to it in 25
NRS 629.031. 26
Sec. 12. NRS 232.320 is hereby amended to read as follows: 27
232.320 1. The Director: 28
(a) Shall appoint, with the consent of the Governor, 29
administrators of the divisions of the Department, who are 30
respectively designated as follows: 31
(1) The Administrator of the Aging and Disability Services 32
Division; 33
(2) The Administrator of the Division of Welfare and 34
Supportive Services; 35
(3) The Administrator of the Division of Child and Family 36
Services; 37
(4) The Administrator of the Division of Health Care 38
Financing and Policy; and 39
(5) The Administrator of the Division of Public and 40
Behavioral Health. 41
(b) Shall administer, through the divisions of the Department, 42
the provisions of chapters 63, 424, 425, 427A, 432A to 442, 43
inclusive, 446 to 450, inclusive, 458A and 656A of NRS, NRS 44
127.220 to 127.310, inclusive, 422.001 to 422.410, inclusive, and 45
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section 15 of this act, 422.580, 432.010 to 432.133, inclusive, 1
432B.6201 to 432B.626, inclusive, 444.002 to 444.430, inclusive, 2
and 445A.010 to 445A.055, inclusive, and all other provisions of 3
law relating to the functions of the divisions of the Department, but 4
is not responsible for the clinical activities of the Division of Public 5
and Behavioral Health or the professional line activities of the other 6
divisions. 7
(c) Shall administer any state program for persons with 8
developmental disabilities established pursuant to the 9
Developmental Disabilities Assistance and Bill of Rights Act of 10
2000, 42 U.S.C. §§ 15001 et seq. 11
(d) Shall, after considering advice from agencies of local 12
governments and nonprofit organizations which provide social 13
services, adopt a master plan for the provision of human services in 14
this State. The Director shall revise the plan biennially and deliver a 15
copy of the plan to the Governor and the Legislature at the 16
beginning of each regular session. The plan must: 17
(1) Identify and assess the plans and programs of the 18
Department for the provision of human services, and any 19
duplication of those services by federal, state and local agencies; 20
(2) Set forth priorities for the provision of those services; 21
(3) Provide for communication and the coordination of those 22
services among nonprofit organizations, agencies of local 23
government, the State and the Federal Government; 24
(4) Identify the sources of funding for services provided by 25
the Department and the allocation of that funding; 26
(5) Set forth sufficient information to assist the Department 27
in providing those services and in the planning and budgeting for the 28
future provision of those services; and 29
(6) Contain any other information necessary for the 30
Department to communicate effectively with the Federal 31
Government concerning demographic trends, formulas for the 32
distribution of federal money and any need for the modification of 33
programs administered by the Department. 34
(e) May, by regulation, require nonprofit organizations and state 35
and local governmental agencies to provide information regarding 36
the programs of those organizations and agencies, excluding 37
detailed information relating to their budgets and payrolls, which the 38
Director deems necessary for the performance of the duties imposed 39
upon him or her pursuant to this section. 40
(f) Has such other powers and duties as are provided by law. 41
2. Notwithstanding any other provision of law, the Director, or 42
the Director’s designee, is responsible for appointing and removing 43
subordinate officers and employees of the Department. 44
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Sec. 13. NRS 287.010 is hereby amended to read as follows: 1
287.010 1. The governing body of any county, school 2
district, municipal corporation, political subdivision, public 3
corporation or other local governmental agency of the State of 4
Nevada may: 5
(a) Adopt and carry into effect a system of group life, accident 6
or health insurance, or any combination thereof, for the benefit of its 7
officers and employees, and the dependents of officers and 8
employees who elect to accept the insurance and who, where 9
necessary, have authorized the governing body to make deductions 10
from their compensation for the payment of premiums on the 11
insurance. 12
(b) Purchase group policies of life, accident or health insurance, 13
or any combination thereof, for the benefit of such officers and 14
employees, and the dependents of such officers and employees, as 15
have authorized the purchase, from insurance companies authorized 16
to transact the business of such insurance in the State of Nevada, 17
and, where necessary, deduct from the compensation of officers and 18
employees the premiums upon insurance and pay the deductions 19
upon the premiums. 20
(c) Provide group life, accident or health coverage through a 21
self-insurance reserve fund and, where necessary, deduct 22
contributions to the maintenance of the fund from the compensation 23
of officers and employees and pay the deductions into the fund. The 24
money accumulated for this purpose through deductions from the 25
compensation of officers and employees and contributions of the 26
governing body must be maintained as an internal service fund as 27
defined by NRS 354.543. The money must be deposited in a state or 28
national bank or credit union authorized to transact business in the 29
State of Nevada. Any independent administrator of a fund created 30
under this section is subject to the licensing requirements of chapter 31
683A of NRS, and must be a resident of this State. Any contract 32
with an independent administrator must be approved by the 33
Commissioner of Insurance as to the reasonableness of 34
administrative charges in relation to contributions collected and 35
benefits provided. The provisions of NRS 439.581 to 439.597, 36
inclusive, 686A.135, 687B.352, 687B.408, 687B.692, 687B.723, 37
687B.725, 687B.805, 689B.030 to 689B.0317, inclusive, and 38
section 3 of this act, paragraphs (b) and (c) of subsection 1 of NRS 39
689B.0319, subsections 2, 4, 6 and 7 of NRS 689B.0319, 689B.033 40
to 689B.0369, inclusive, 689B.0375 to 689B.050, inclusive, 41
689B.0675, 689B.265, 689B.287 and 689B.500 apply to coverage 42
provided pursuant to this paragraph, except that the provisions of 43
NRS 689B.0378, 689B.03785 and 689B.500 only apply to coverage 44
– 15 –
- *AB428_R1*
for active officers and employees of the governing body, or the 1
dependents of such officers and employees. 2
(d) Defray part or all of the cost of maintenance of a self-3
insurance fund or of the premiums upon insurance. The money for 4
contributions must be budgeted for in accordance with the laws 5
governing the county, school district, municipal corporation, 6
political subdivision, public corporation or other local governmental 7
agency of the State of Nevada. 8
2. If a school district offers group insurance to its officers and 9
employees pursuant to this section, members of the board of trustees 10
of the school district must not be excluded from participating in the 11
group insurance. If the amount of the deductions from compensation 12
required to pay for the group insurance exceeds the compensation to 13
which a trustee is entitled, the difference must be paid by the trustee. 14
3. In any county in which a legal services organization exists, 15
the governing body of the county, or of any school district, 16
municipal corporation, political subdivision, public corporation or 17
other local governmental agency of the State of Nevada in the 18
county, may enter into a contract with the legal services 19
organization pursuant to which the officers and employees of the 20
legal services organization, and the dependents of those officers and 21
employees, are eligible for any life, accident or health insurance 22
provided pursuant to this section to the officers and employees, and 23
the dependents of the officers and employees, of the county, school 24
district, municipal corporation, political subdivision, public 25
corporation or other local governmental agency. 26
4. If a contract is entered into pursuant to subsection 3, the 27
officers and employees of the legal services organization: 28
(a) Shall be deemed, solely for the purposes of this section, to be 29
officers and employees of the county, school district, municipal 30
corporation, political subdivision, public corporation or other local 31
governmental agency with which the legal services organization has 32
contracted; and 33
(b) Must be required by the contract to pay the premiums or 34
contributions for all insurance which they elect to accept or of which 35
they authorize the purchase. 36
5. A contract that is entered into pursuant to subsection 3: 37
(a) Must be submitted to the Commissioner of Insurance for 38
approval not less than 30 days before the date on which the contract 39
is to become effective. 40
(b) Does not become effective unless approved by the 41
Commissioner. 42
(c) Shall be deemed to be approved if not disapproved by the 43
Commissioner within 30 days after its submission. 44
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- *AB428_R1*
6. As used in this section, “legal services organization” means 1
an organization that operates a program for legal aid and receives 2
money pursuant to NRS 19.031. 3
Sec. 14. NRS 287.04335 is hereby amended to read as 4
follows: 5
287.04335 If the Board provides health insurance through a 6
plan of self-insurance, it shall comply with the provisions of NRS 7
439.581 to 439.597, inclusive, 686A.135, 687B.352, 687B.409, 8
687B.692, 687B.723, 687B.725, 687B.805, 689B.0353, 689B.255, 9
695C.1723, 695G.150, 695G.155, 695G.160, 695G.162, 10
695G.1635, 695G.164, 695G.1645, 695G.1665, 695G.167, 11
695G.1675, 695G.170 to 695G.1712, inclusive, 695G.1714 to 12
695G.174, inclusive, and section 11 of this act, 695G.176, 13
695G.177, 695G.200 to 695G.230, inclusive, 695G.241 to 14
695G.310, inclusive, 695G.405 and 695G.415, in the same manner 15
as an insurer that is licensed pursuant to title 57 of NRS is required 16
to comply with those provisions. 17
Sec. 15. Chapter 422 of NRS is hereby amended by adding 18
thereto a new section to read as follows: 19
1. To the extent that federal financial participation is 20
available, the Director shall include under Medicaid coverage for 21
any procedure or service for the preservation of fertility consistent 22
with established medical practice or any guidelines published by 23
the American Society for Reproductive Medicine or the American 24
Society of Clinical Oncology, or their successor organizations, that 25
is medically necessary to preserve fertility because a recipient of 26
Medicaid has been diagnosed with breast or ovarian cancer and: 27
(a) The cancer may, in the judgment of a provider of health 28
care, directly or indirectly cause infertility; or 29
(b) The recipient is expected to receive medical treatment for 30
the cancer and such treatment may directly or indirectly cause 31
infertility. 32
2. For the purposes of subsection 1, a medical treatment may 33
directly or indirectly cause infertility if the treatment has a 34
potential side effect of impaired fertility, as established by the 35
American Society of Clinical Oncology or the American Society 36
for Reproductive Medicine, or their successor organizations. 37
3. The Department shall: 38
(a) Apply to the Secretary of Health and Human Services for 39
any waiver of federal law or apply for any amendment of the State 40
Plan for Medicaid that is necessary for the Department to receive 41
federal funding to provide the coverage described in subsection 1. 42
(b) Fully cooperate in good faith with the Federal Government 43
during the application process to satisfy the requirements of the 44
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- *AB428_R1*
Federal Government for obtaining a waiver or amendment 1
pursuant to paragraph (a). 2
4. As used in this section, “provider of health care” has the 3
meaning ascribed to it in NRS 629.031. 4
Sec. 16. The provisions of NRS 354.599 do not apply to any 5
additional expenses of a local government that are related to the 6
provisions of this act. 7
Sec. 17. 1. This section becomes effective upon passage and 8
approval. 9
2. Sections 1 to 16, inclusive, of this act become effective: 10
(a) Upon passage and approval for the purpose of adopting any 11
regulations and performing any other preparatory administrative 12
tasks that are necessary to carry out the provisions of this act; and 13
(b) On January 1, 2026, for all other purposes. 14
H