A.B. 522
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ASSEMBLY BILL NO. 522–COMMITTEE ON
HEALTH AND HUMAN SERVICES
MARCH 24, 2025
____________
Referred to Committee on Health and Human Services
SUMMARY—Revises provisions relating to health care.
(BDR 57-1135)
FISCAL NOTE: Effect on Local Government: May have Fiscal Impact.
Effect on the State: Yes.
CONTAINS UNFUNDED MANDATE (§§ 21-24, 27-29, 101, 105 & NRS 287.010)
(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 health care; requiring health insurers to allow
the covered adult child of an insured to remain covered by
the health insurance of the insured until 26 years of age;
requiring health insurers to provide coverage for certain
preventive health care for children, persons who are
pregnant, women and adults; prohibiting insurers from
imposing certain costs and taking other actions with
respect to certain preventive health care; requiring health
insurers to provide coverage for screenings for colorectal
cancer; requiring health insurers to provide coverage for
maternity and newborn care; prohibiting health insurers
and providers of health care from engaging in certain
discriminatory actions; and providing other matters
properly relating thereto.
Legislative Counsel’s Digest:
Existing federal law requires all health insurers to extend coverage for the 1
covered adult child of an insured until such child reaches 26 years of age. (42 2
U.S.C. § 300gg-14) Sections 2, 17, 31, 44, 46, 60, 74, 79, 90, 104 and 106 of this 3
bill align Nevada law with federal law in this manner and require a policy of health 4
insurance that provides coverage for dependent children to continue to make such 5
coverage available until the dependent child reaches 26 years of age. 6
Existing federal law requires all health insurance plans to include coverage, 7
without a higher deductible, copay or coinsurance, for certain preventive health 8
care for women, adults and children based on the recommendations and guidelines 9
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of certain entities, including the United States Preventive Services Task Force and 10
the Health Resources and Services Administration of the United States Department 11
of Health and Human Services. (42 U.S.C. § 300gg-13; 45 C.F.R. § 147.130) 12
Existing Nevada law generally conforms with federal law in this manner and 13
requires public and private policies of health insurance, including Medicaid, to 14
cover certain preventive health care, including certain screenings, counseling, 15
vaccinations and contraceptive and other family planning drugs and devices. (NRS 16
287.010, 287.04335, 422.27172, 422.27174, 608.1555, 689A.0418, 689A.0419, 17
689B.0378, 689B.03785, 689C.1676, 689C.1678, 695A.1865, 695A.1875, 18
695B.1919, 695B.19195, 695C.1696, 695C.1698, 695G.1715, 695G.1717) 19
Sections 3-5, 11, 18-20, 27, 32-34, 40, 44, 47-49, 57, 61-63, 69, 75-77, 79, 80, 91-20
93, 101, 104, 106 and 115 of this bill require public and private policies of health 21
insurance, including Medicaid, to include certain additional preventive health care 22
services which are not currently required to be covered under existing law, but have 23
been recommended by the United States Preventive Services Task Force and the 24
Health Resources and Services Administration. Sections 3-5, 11, 18-20, 27, 32-34, 25
40, 44, 47-49, 57, 61-63, 69, 75-77, 79, 80, 91-93, 101, 104, 106 and 115 26
additionally prohibit an insurer from charging a higher deductible or any copay or 27
coinsurance for such preventive health care. 28
Existing law requires certain public and private policies of health insurance to 29
provide coverage for: (1) screening, genetic counseling and testing for harmful 30
mutations in the BRCA gene under certain circumstances; (2) examinations of 31
persons who are pregnant to detect certain diseases; and (3) testing for, treating and 32
preventing sexually transmitted diseases. (NRS 287.010, 287.04335, 422.27173, 33
422.27175, 608.1555, 689A.04049, 689A.0412, 689A.0438, 689B.0314, 34
689B.0315, 689B.0316, 689C.1653, 689C.1673, 689C.1675, 695A.1844, 35
695A.1853, 695A.1856, 695B.1911, 695B.1913, 695B.1926, 695C.17347, 36
695C.1736, 695C.1737, 695G.1707, 695G.1712, 695G.1714) Sections 8, 10, 13, 37
21-23, 36, 37, 39, 52, 53, 55, 66, 68, 70, 83, 85, 86, 96, 97, 99, 114 and 116 of this 38
bill prohibit an insurer from charging a higher deductible or any copay or 39
coinsurance for these services as well. Sections 10, 22, 39, 55, 68, 86, 99 and 114 40
additionally require such policies of health insurance to include coverage for the 41
detection of the human immunodeficiency virus in persons who are pregnant. 42
Existing law requires certain public and private policies of health insurance to 43
include coverage for certain screenings and tests for breast cancer. Existing law 44
also prohibits such policies of health insurance, other than Medicaid, from charging 45
a higher deductible or any copay or coinsurance for such screenings and tests. 46
(NRS 287.0273, 287.04337, 422.27176, 608.1555, 689A.0405, 689B.0374, 47
689C.1674, 695A.1855, 695B.1912, 695C.1735, 695G.1713) Sections 9, 25, 38, 48
54, 67, 84, 98, 105, 107 and 117 of this bill additionally require such policies of 49
health insurance to include coverage for medication to prevent breast cancer for 50
insureds who are at a high risk of developing breast cancer. Sections 9, 25, 38, 54, 51
67, 84, 98, 105, 107 and 117 also prohibit an insurer from charging a higher 52
deductible or any copay or coinsurance for any of these services. Sections 105 and 53
107 additionally require insurance for government employees to cover certain 54
additional diagnostic imaging if breast cancer is seen or suspected. 55
Existing law requires certain policies of health insurance that provide coverage 56
for the treatment of colorectal cancer to additionally provide coverage for the 57
screening of colorectal cancer. (NRS 689A.04042, 689B.0367, 695B.1907, 58
695C.1731, 695G.168) Sections 7, 24, 35, 50, 65, 82, 95 and 111 of this bill: (1) 59
require all public and private policies of health insurance, including Medicaid, to 60
cover screening for colorectal cancer; and (2) prohibit insurers from charging a 61
higher deductible or any copay or coinsurance for such screenings. 62
Existing federal law requires all policies of health insurance to include 63
coverage for maternity and newborn care. (42 U.S.C. § 18022(b)) Sections 12, 15, 64
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26, 29, 41, 42, 51, 56, 64, 71, 78, 81, 94, 100 and 112 of this bill align Nevada law 65
with federal law in this manner and require public and private policies of health 66
insurance to include coverage for such care. 67
Existing federal regulations prohibit certain health care entities from 68
discriminating on the basis of race, color, national origin, sex, age or disability. (45 69
C.F.R. §§ 92.101, 92.206, 92.208, 92.209) Existing law prohibits public and private 70
policies of health insurance from discriminating against any person with respect to 71
participation or coverage under the policy on the basis of actual or perceived gender 72
identity or expression. (NRS 287.010, 287.04335, 422.2701, 608.1555, 689A.033, 73
689B.0675, 689C.1975, 689C.425, 695A.198, 695B.3167, 695C.050, 695C.204, 74
695G.415) Sections 6, 28, 43, 58, 72, 87, 102 and 113 of this bill additionally 75
prohibit public and private policies of health insurance, including Medicaid, from 76
discriminating against any person on the basis of actual or perceived race, color, 77
national origin, sex, age or disability. Section 119 of this bill similarly prohibits a 78
provider of health care from discriminating against a person on the basis of those 79
characteristics, as well as gender identity or expression. Section 119 also authorizes 80
a board, agency or other entity in this State that licenses, certifies or regulates a 81
provider of health care to: (1) adopt regulations prescribing the types of 82
discrimination that are prohibited; and (2) discipline a provider of health care that 83
violates section 119. 84
Section 88 of this bill authorizes the Commissioner of Insurance to suspend or 85
revoke the certificate of a health maintenance organization that fails to provide the 86
coverage required by sections 74-78. The Commissioner would also be authorized 87
to take such action against other private health insurers who fail to provide the 88
coverage required by this bill. (NRS 680A.200) Section 103 of this bill requires 89
the Director of the Department of Health and Human Services to administer the 90
provisions of sections 109-112 in the same manner as other provisions relating to 91
Medicaid. 92
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 the provisions set forth as sections 2 to 5, inclusive, 2
of this act. 3
Sec. 2. 1. An insurer that offers or issues a policy of health 4
insurance which provides coverage for dependent children shall 5
continue to make such coverage available for an adult child of an 6
insured until such child reaches 26 years of age. 7
2. Nothing in this section shall be construed as requiring an 8
insurer to make coverage available for a dependent of an adult 9
child of an insured. 10
Sec. 3. 1. An insurer that offers or issues a policy of health 11
insurance shall include in the policy coverage for: 12
(a) Screening for anxiety for insureds who are at least 8 but 13
not more than 18 years of age; 14
(b) Assessments relating to height, weight, body mass index 15
and medical history for insureds who are less than 18 years of 16
age; 17
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(c) Comprehensive and intensive behavioral interventions for 1
insureds who are at least 12 but not more than 18 years of age and 2
have a body mass index in the 95th percentile or greater for 3
persons of the same age and sex; 4
(d) The application of fluoride varnish to the primary teeth for 5
insureds who are less than 5 years of age; 6
(e) Oral fluoride supplements for insureds who are at least 6 7
months of age but less than 5 years of age and whose supply of 8
water is deficient in fluoride; 9
(f) Counseling and education pertaining to the minimization of 10
exposure to ultraviolet radiation for insureds who are less than 25 11
years of age and have fair skin types and the parents or legal 12
guardians of insureds who are less than 18 years of age and have 13
fair skin types for the purpose of minimizing the risk of skin 14
cancer in those persons; 15
(g) Brief behavioral counseling and interventions to prevent 16
tobacco use for insureds who are less than 18 years of age; 17
(h) At least one screening for the detection of amblyopia or the 18
risk factors of amblyopia for insureds who are at least 3 but not 19
more than 5 years of age; and 20
(i) Screening, tests and counseling for such other health 21
conditions and diseases as recommended by the Health Resources 22
and Services Administration on January 1, 2025, for insureds who 23
are less than 18 years of age. 24
2. An insurer must ensure that the benefits required by 25
subsection 1 are made available to an insured through a provider 26
of health care who participates in the network plan of the insurer. 27
3. Except as otherwise provided in subsection 5, an insurer 28
that offers or issues a policy of health insurance shall not: 29
(a) Require an insured to pay a higher deductible, any 30
copayment or coinsurance or require a longer waiting period or 31
other condition to obtain any benefit provided in the policy of 32
health insurance pursuant to subsection 1; 33
(b) Refuse to issue a policy of health insurance or cancel a 34
policy of health insurance solely because the person applying for 35
or covered by the policy uses or may use any such benefit; 36
(c) Offer or pay any type of material inducement or financial 37
incentive to an insured to discourage the insured from obtaining 38
any such benefit; 39
(d) Penalize a provider of health care who provides any such 40
benefit to an insured, including, without limitation, reducing the 41
reimbursement of the provider of health care; 42
(e) Offer or pay any type of material inducement, bonus or 43
other financial incentive to a provider of health care to deny, 44
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reduce, withhold, limit or delay access to any such benefit to an 1
insured; or 2
(f) Impose any other restrictions or delays on the access of an 3
insured to any such benefit. 4
4. A policy of health insurance subject to the provisions of 5
this chapter that is delivered, issued for delivery or renewed on or 6
after October 1, 2025, has the legal effect of including the 7
coverage required by subsection 1, and any provision of the policy 8
or the renewal which is in conflict with this section is void. 9
5. Except as otherwise provided in this section and federal 10
law, an insurer may use medical management techniques, 11
including, without limitation, any available clinical evidence, to 12
determine the frequency of or treatment relating to any benefit 13
required by this section or the type of provider of health care to 14
use for such treatment. 15
6. As used in this section: 16
(a) “Medical management technique” means a practice which 17
is used to control the cost or utilization of health care services or 18
prescription drug use. The term includes, without limitation, the 19
use of step therapy, prior authorization or categorizing drugs and 20
devices based on cost, type or method of administration. 21
(b) “Network plan” means a policy of health insurance offered 22
by an insurer under which the financing and delivery of medical 23
care, including items and services paid for as medical care, are 24
provided, in whole or in part, through a defined set of providers of 25
health care under contract with the insurer. The term does not 26
include an arrangement for the financing of premiums. 27
(c) “Provider of health care” has the meaning ascribed to it in 28
NRS 629.031. 29
Sec. 4. 1. An insurer that offers or issues a policy of health 30
insurance shall include in the policy coverage for: 31
(a) A daily dose of 0.4 to 0.8 milligrams of folic acid for 32
insureds who are pregnant or are planning on becoming 33
pregnant; 34
(b) A low dose of aspirin for the prevention of preeclampsia 35
for insureds who are determined to be at a high risk of that 36
condition after 12 weeks of gestation; 37
(c) Prophylactic ocular tubal medication for the prevention of 38
gonococcal ophthalmia in newborns; 39
(d) Screening for asymptomatic bacteriuria for insureds who 40
are pregnant; 41
(e) Counseling and behavioral interventions relating to the 42
promotion of healthy weight gain and the prevention of excessive 43
weight gain for insureds who are pregnant; 44
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(f) Counseling for insureds who are pregnant or in the 1
postpartum stage of pregnancy and have an increased risk of 2
perinatal or postpartum depression; 3
(g) Screening for the presence of the rhesus D antigen and 4
antibodies in the blood of an insured who is pregnant during the 5
insured’s first visit for care relating to the pregnancy; 6
(h) Screening for rhesus D antibodies between 24 and 28 7
weeks of gestation for insureds who are negative for the rhesus D 8
antigen and have not been exposed to blood that is positive for the 9
rhesus D antigen; 10
(i) Behavioral counseling and intervention for tobacco 11
cessation for insureds who are pregnant; 12
(j) An annual screening for urinary incontinence for women; 13
(k) Screening for type 2 diabetes at such intervals as 14
recommended by the Health Resources and Services 15
Administration on January 1, 2025, for insureds who are in the 16
postpartum stage of pregnancy and who have a history of 17
gestational diabetes mellitus; 18
(l) Counseling relating to maintaining a healthy weight for 19
women who are at least 40 but not more than 60 years of age and 20
have a body mass index greater than 18.5; and 21
(m) Screening for osteoporosis for women who: 22
(1) Are 65 years of age or older; or 23
(2) Are less than 65 years of age and have a risk of 24
fracturing a bone equal to or greater than that of a woman who is 25
65 years of age without any additional risk factors. 26
2. An insurer must ensure that the benefits required by 27
subsection 1 are made available to an insured through a provider 28
of health care who participates in the network plan of the insurer. 29
3. Except as otherwise provided in subsection 5, an insurer 30
that offers or issues a policy of health insurance shall not: 31
(a) Require an insured to pay a higher deductible, any 32
copayment or coinsurance or require a longer waiting period or 33
other condition to obtain any benefit provided in the policy of 34
health insurance pursuant to subsection 1; 35
(b) Refuse to issue a policy of health insurance or cancel a 36
policy of health insurance solely because the person applying for 37
or covered by the policy uses or may use any such benefit; 38
(c) Offer or pay any type of material inducement or financial 39
incentive to an insured to discourage the insured from obtaining 40
any such benefit; 41
(d) Penalize a provider of health care who provides any such 42
benefit to an insured, including, without limitation, reducing the 43
reimbursement of the provider of health care; 44
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(e) Offer or pay any type of material inducement, bonus or 1
other financial incentive to a provider of health care to deny, 2
reduce, withhold, limit or delay access to any such benefit to an 3
insured; or 4
(f) Impose any other restrictions or delays on the access of an 5
insured to any such benefit. 6
4. A policy of health insurance subject to the provisions of 7
this chapter that is delivered, issued for delivery or renewed on or 8
after October 1, 2025, has the legal effect of including the 9
coverage required by subsection 1, and any provision of the policy 10
or the renewal which is in conflict with this section is void. 11
5. Except as otherwise provided in this section and federal 12
law, an insurer may use medical management techniques, 13
including, without limitation, any available clinical evidence, to 14
determine the frequency of or treatment relating to any benefit 15
required by this section or the type of provider of health care to 16
use for such treatment. 17
6. As used in this section: 18
(a) “Medical management technique” means a practice which 19
is used to control the cost or utilization of health care services or 20
prescription drug use. The term includes, without limitation, the 21
use of step therapy, prior authorization or categorizing drugs and 22
devices based on cost, type or method of administration. 23
(b) “Network plan” means a policy of health insurance offered 24
by an insurer under which the financing and delivery of medical 25
care, including items and services paid for as medical care, are 26
provided, in whole or in part, through a defined set of providers of 27
health care under contract with the insurer. The term does not 28
include an arrangement for the financing of premiums. 29
(c) “Provider of health care” has the meaning ascribed to it in 30
NRS 629.031. 31
Sec. 5. 1. An insurer that offers or issues a policy of health 32
insurance shall include in the policy coverage for: 33
(a) Behavioral counseling and interventions to promote 34
physical activity and a healthy diet for insureds with 35
cardiovascular risk factors; 36
(b) Statin preventive medication for insureds who are at least 37
40 but not more than 75 years of age and do not have a history of 38
cardiovascular disease, but who have: 39
(1) One or more risk factors for cardiovascular disease; 40
and 41
(2) A calculated risk of at least 10 percent of acquiring 42
cardiovascular disease within the next 10 years; 43
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(c) Interventions for exercise to prevent falls for insureds who 1
are 65 years of age or older and reside in a medical facility or 2
facility for the dependent; 3
(d) Screenings for latent tuberculosis infection in insureds 4
with an increased risk of contracting tuberculosis; 5
(e) Screening for hypertension; 6
(f) One abdominal aortic screening by ultrasound to detect 7
abdominal aortic aneurysms for men who are at least 65 but not 8
more than 75 years of age and have smoked during their lifetimes; 9
(g) Screening for drug and alcohol misuse for insureds who 10
are 18 years of age or older; 11
(h) If an insured engages in risky or hazardous consumption 12
of alcohol, as determined by the screening described in paragraph 13
(g), behavioral counseling to reduce such behavior; 14
(i) Screening for lung cancer using low-dose computed 15
tomography for insureds who are at least 50 but not more than 80 16
years of age and: 17
(1) Have a smoking history of 20 pack-years; 18
(2) Smoke or have stopped smoking within the immediately 19
preceding 15 years; and 20
(3) Do not suffer from a health problem that substantially 21
limits the life expectancy of the person or the willingness of the 22
person to undergo curative surgery; 23
(j) Screening for prediabetes and type 2 diabetes in insureds 24
who are at least 35 but not more than 70 years of age and have a 25
body mass index of 25 or greater; and 26
(k) Intensive behavioral interventions with multiple 27
components for insureds who are 18 years of age or older and 28
have a body mass index of 30 or greater. 29
2. The benefits provided pursuant to paragraph (h) of 30
subsection 1 are in addition to and separate from the benefits 31
provided pursuant to NRS 689A.046. 32
3. An insurer must ensure that the benefits required by 33
subsection 1 are made available to an insured through a provider 34
of health care who participates in the network plan of the insurer. 35
4. Except as otherwise provided in subsection 6, an insurer 36
that offers or issues a policy of health insurance shall not: 37
(a) Require an insured to pay a higher deductible, any 38
copayment or coinsurance or require a longer waiting period or 39
other condition to obtain any benefit provided in the policy of 40
health insurance pursuant to subsection 1; 41
(b) Refuse to issue a policy of health insurance or cancel a 42
policy of health insurance solely because the person applying for 43
or covered by the policy uses or may use any such benefit; 44
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(c) Offer or pay any type of material inducement or financial 1
incentive to an insured to discourage the insured from obtaining 2
any such benefit; 3
(d) Penalize a provider of health care who provides any such 4
benefit to an insured, including, without limitation, reducing the 5
reimbursement of the provider of health care; 6
(e) Offer or pay any type of material inducement, bonus or 7
other financial incentive to a provider of health care to deny, 8
reduce, withhold, limit or delay access to any such benefit to an 9
insured; or 10
(f) Impose any other restrictions or delays on the access of an 11
insured to any such benefit. 12
5. A policy of health insurance subject to the provisions of 13
this chapter that is delivered, issued for delivery or renewed on or 14
after October 1, 2025, has the legal effect of including the 15
coverage required by subsection 1, and any provision of the policy 16
or the renewal which is in conflict with this section is void. 17
6. Except as otherwise provided in this section and federal 18
law, an insurer may use medical management techniques, 19
including, without limitation, any available clinical evidence, to 20
determine the frequency of or treatment relating to any benefit 21
required by this section or the type of provider of health care to 22
use for such treatment. 23
7. As used in this section: 24
(a) “Computed tomography” means the process of producing 25
sectional and three-dimensional images using external ionizing 26
radiation. 27
(b) “Facility for the dependent” has the meaning ascribed to it 28
in NRS 449.0045. 29
(c) “Medical facility” has the meaning ascribed to it in 30
NRS 449.0151. 31
(d) “Medical management technique” means a practice which 32
is used to control the cost or utilization of health care services or 33
prescription drug use. The term includes, without limitation, the 34
use of step therapy, prior authorization or categorizing drugs and 35
devices based on cost, type or method of administration. 36
(e) “Network plan” means a policy of health insurance offered 37
by an insurer under which the financing and delivery of medical 38
care, including items and services paid for as medical care, are 39
provided, in whole or in part, through a defined set of providers of 40
health care under contract with the insurer. The term does not 41
include an arrangement for the financing of premiums. 42
(f) “Pack-year” means the product of the number of packs of 43
cigarettes smoked per day and the number of years that the person 44
has smoked. 45
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(g) “Provider of health care” has the meaning ascribed to it in 1
NRS 629.031. 2
Sec. 6. NRS 689A.033 is hereby amended to read as follows: 3
689A.033 1. An insurer that issues a policy of health 4
insurance shall not discriminate against any person with respect to 5
participation or coverage under the policy on the basis of an actual 6
or perceived [gender identity or expression.] protected 7
characteristic. 8
2. Prohibited discrimination includes, without limitation: 9
[1.] (a) Denying, cancelling, limiting or refusing to issue or 10
renew a policy of health insurance on the basis of [the] an actual or 11
perceived [gender identity or expression] protected characteristic of 12
a person or a family member of the person; 13
[2.] (b) Imposing a payment or premium that is based on [the] 14
an actual or perceived [gender identity or expression] protected 15
characteristic of an insured or a family member of the insured; 16
[3.] (c) Designating [the] an actual or perceived [gender 17
identity or expression] protected characteristic of a person or a 18
family member of the person as grounds to deny, cancel or limit 19
participation or coverage; and 20
[4.] (d) Denying, cancelling or limiting participation or 21
coverage on the basis of an actual or perceived [gender identity or 22
expression,] protected characteristic, including, without limitation, 23
by limiting or denying coverage for health care services that are: 24
[(a)] (1) Related to gender transition, provided that there is 25
coverage under the policy for the services when the services are not 26
related to gender transition; or 27
[(b)] (2) Ordinarily or exclusively available to persons of any 28
sex. 29
3. As used in this section, “protected characteristic” means: 30
(a) Race, color, national origin, age, physical or mental 31
disability, sexual orientation or gender identity or expression; or 32
(b) Sex, including, without limitation, sex characteristics, 33
intersex traits and pregnancy or related conditions. 34
Sec. 7. NRS 689A.04042 is hereby amended to read as 35
follows: 36
689A.04042 1. A policy of health insurance [that provides 37
coverage for the treatment of colorectal cancer] must provide 38
coverage for colorectal cancer screening in accordance with: 39
(a) The guidelines concerning colorectal cancer screening which 40
are published by the American Cancer Society; or 41
(b) Other guidelines or reports concerning colorectal cancer 42
screening which are published by nationally recognized professional 43
organizations and which include current or prevailing supporting 44
scientific data. 45
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2. An insurer must ensure that the benefits required by 1
subsection 1 are made available to an insured through a provider 2
of health care who participates in the network plan of the insurer. 3
3. An insurer that offers or issues a policy of health 4
insurance shall not: 5
(a) Require an insured to pay a higher deductible, any 6
copayment or coinsurance or require a longer waiting period or 7
other condition to obtain any benefit provided in the policy of 8
health insurance pursuant to subsection 1; 9
(b) Refuse to issue a policy of health insurance or cancel a 10
policy of health insurance solely because the person applying for 11
or covered by the policy uses or may use any such benefit; 12
(c) Offer or pay any type of material inducement or financial 13
incentive to an insured to discourage the insured from obtaining 14
any such benefit; 15
(d) Penalize a provider of health care who provides any such 16
benefit to an insured, including, without limitation, reducing the 17
reimbursement of the provider of health care; 18
(e) Offer or pay any type of material inducement, bonus or 19
other financial incentive to a provider of health care to deny, 20
reduce, withhold, limit or delay access to any such benefit to an 21
insured; or 22
(f) Impose any other restrictions or delays on the access of an 23
insured to any such benefit. 24
4. A policy of health insurance subject to the provisions of this 25
chapter that is delivered, issued for delivery or renewed on or after 26
October 1, [2003,] 2025, has the legal effect of including the 27
coverage required by this section, and any provision of the policy 28
that conflicts with the provisions of this section is void. 29
5. As used in this section: 30
(a) “Network plan” means a policy of health insurance offered 31
by an insurer under which the financing and delivery of medical 32
care, including items and services paid for as medical care, are 33
provided, in whole or in part, through a defined set of providers of 34
health care under contract with the insurer. The term does not 35
include an arrangement for the financing of premiums. 36
(b) “Provider of health care” has the meaning ascribed to it in 37
NRS 629.031. 38
Sec. 8. NRS 689A.04049 is hereby amended to read as 39
follows: 40
689A.04049 1. An insurer that issues a policy of health 41
insurance shall provide coverage for screening, genetic counseling 42
and testing for harmful mutations in the BRCA gene for women 43
under circumstances where such screening, genetic counseling or 44
testing, as applicable, is required by NRS 457.301. 45
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2. An insurer shall ensure that the benefits required by 1
subsection 1 are made available to an insured through a provider of 2
health care who participates in the network plan of the insurer. 3
3. An insurer that issues a policy of health insurance shall 4
not: 5
(a) Require an insured to pay a higher deductible, any 6
copayment or coinsurance or require a longer waiting period or 7
other condition to obtain any benefit provided in the policy of 8
health insurance pursuant to subsection 1; 9
(b) Refuse to issue a policy of health insurance or cancel a 10
policy of health insurance solely because the person applying for 11
or covered by the policy uses or may use any such benefit; 12
(c) Offer or pay any type of material inducement or financial 13
incentive to an insured to discourage the insured from obtaining 14
any such benefit; 15
(d) Penalize a provider of health care who provides any such 16
benefit to an insured, including, without limitation, reducing the 17
reimbursement of the provider of health care; 18
(e) Offer or pay any type of material inducement, bonus or 19
other financial incentive to a provider of health care to deny, 20
reduce, withhold, limit or delay access to any such benefit to an 21
insured; or 22
(f) Impose any other restrictions or delays on the access of an 23
insured to any such benefit. 24
4. A policy of health insurance subject to the provisions of this 25
chapter that is delivered, issued for delivery or renewed on or after 26
[January] October 1, [2022,] 2025, has the legal effect of including 27
the coverage required by subsection 1, and any provision of the 28
policy that conflicts with the provisions of this section is void. 29
[4.] 5. As used in this section: 30
(a) “Network plan” means a policy of health insurance offered 31
by an insurer under which the financing and delivery of medical 32
care, including items and services paid for as medical care, are 33
provided, in whole or in part, through a defined set of providers 34
under contract with the insurer. The term does not include an 35
arrangement for the financing of premiums. 36
(b) “Provider of health care” has the meaning ascribed to it in 37
NRS 629.031. 38
Sec. 9. NRS 689A.0405 is hereby amended to read as follows: 39
689A.0405 1. A policy of health insurance must provide 40
coverage for benefits payable for expenses incurred for: 41
(a) A mammogram to screen for breast cancer annually for 42
insureds who are 40 years of age or older. 43
(b) An imaging test to screen for breast cancer on an interval 44
and at the age deemed most appropriate, when medically necessary, 45
– 13 –
- *AB522*
as recommended by the insured’s provider of health care based on 1
personal or family medical history or additional factors that may 2
increase the risk of breast cancer for the insured. 3
(c) A diagnostic imaging test for breast cancer at the age deemed 4
most appropriate, when medically necessary, as recommended by 5
the insured’s provider of health care to evaluate an abnormality 6
which is: 7
(1) Seen or suspected from a mammogram described in 8
paragraph (a) or an imaging test described in paragraph (b); or 9
(2) Detected by other means of examination. 10
(d) Medication to prevent breast cancer for insureds who are 11
at a high risk of developing breast cancer and have a low risk of 12
adverse side effects from the medication. 13
2. An insurer must ensure that the benefits required by 14
subsection 1 are made available to an insured through a provider of 15
health care who participates in the network plan of the insurer. 16
3. Except as otherwise provided in subsection 5, an insurer that 17
offers or issues a policy of health insurance shall not: 18
(a) Except as otherwise provided in subsection 6, require an 19
insured to pay a deductible, copayment, coinsurance or any other 20
form of cost-sharing or require a longer waiting period or other 21
condition to obtain any benefit provided in the policy of health 22
insurance pursuant to subsection 1; 23
(b) Refuse to issue a policy of health insurance or cancel a 24
policy of health insurance solely because the person applying for or 25
covered by the policy uses or may use any such benefit; 26
(c) Offer or pay any type of material inducement or financial 27
incentive to an insured to discourage the insured from obtaining any 28
such benefit; 29
(d) Penalize a provider of health care who provides any such 30
benefit to an insured, including, without limitation, reducing the 31
reimbursement of the provider of health care; 32
(e) Offer or pay any type of material inducement, bonus or other 33
financial incentive to a provider of health care to deny, reduce, 34
withhold, limit or delay access to any such benefit to an insured; or 35
(f) Impose any other restrictions or delays on the access of an 36
insured to any such benefit. 37
4. A policy subject to the provisions of this chapter which is 38
delivered, issued for delivery or renewed on or after [January] 39
October 1, [2024,] 2025, has the legal effect of including the 40
coverage required by subsection 1, and any provision of the policy 41
or the renewal which is in conflict with this section is void. 42
5. Except as otherwise provided in this section and federal law, 43
an insurer may use medical management techniques, including, 44
without limitation, any available clinical evidence, to determine the 45
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frequency of or treatment relating to any benefit required by this 1
section or the type of provider of health care to use for such 2
treatment. 3
6. If the application of paragraph (a) of subsection 3 would 4
result in the ineligibility of a health savings account of an insured 5
pursuant to 26 U.S.C. § 223, the prohibitions of paragraph (a) of 6
subsection 3 shall apply only for a qualified policy of health 7
insurance with respect to the deductible of such a policy of health 8
insurance after the insured has satisfied the minimum deductible 9
pursuant to 26 U.S.C. § 223, except with respect to items or services 10
that constitute preventive care pursuant to 26 U.S.C. § 223(c)(2)(C), 11
in which case the prohibitions of paragraph (a) of subsection 3 shall 12
apply regardless of whether the minimum deductible under 26 13
U.S.C. § 223 has been satisfied. 14
7. As used in this section: 15
(a) “Medical management technique” means a practice which is 16
used to control the cost or utilization of health care services or 17
prescription drug use. The term includes, without limitation, the use 18
of step therapy, prior authorization or categorizing drugs and 19
devices based on cost, type or method of administration. 20
(b) “Network plan” means a policy of health insurance offered 21
by an insurer under which the financing and delivery of medical 22
care, including items and services paid for as medical care, are 23
provided, in whole or in part, through a defined set of providers 24
under contract with the insurer. The term does not include an 25
arrangement for the financing of premiums. 26
(c) “Provider of health care” has the meaning ascribed to it in 27
NRS 629.031. 28
(d) “Qualified policy of health insurance” means a policy of 29
health insurance that has a high deductible and is in compliance with 30
26 U.S.C. § 223 for the purposes of establishing a health savings 31
account. 32
Sec. 10. NRS 689A.0412 is hereby amended to read as 33
follows: 34
689A.0412 1. An insurer that issues a policy of health 35
insurance shall provide coverage for the examination of a person 36
who is pregnant for the discovery of: 37
(a) Chlamydia trachomatis, gonorrhea, hepatitis B and hepatitis 38
C in accordance with NRS 442.013. 39
(b) Syphilis in accordance with NRS 442.010. 40
(c) Human immunodeficiency virus. 41
2. The coverage required by this section must be provided: 42
(a) Regardless of whether the benefits are provided to the 43
insured by a provider of health care, facility or medical laboratory 44
that participates in the network plan of the insurer; and 45
– 15 –
- *AB522*
(b) Without prior authorization. 1
3. An insurer that issues a policy of health insurance shall 2
not: 3
(a) Require an insured to pay a higher deductible, any 4
copayment or coinsurance or require a longer waiting period or 5
other condition to obtain any benefit provided in the policy of 6
health insurance pursuant to subsection 1; 7
(b) Refuse to issue a policy of health insurance or cancel a 8
policy of health insurance solely because the person applying for 9
or covered by the policy uses or may use any such benefit; 10
(c) Offer or pay any type of material inducement or financial 11
incentive to an insured to discourage the insured from obtaining 12
any such benefit; 13
(d) Penalize a provider of health care who provides any such 14
benefit to an insured, including, without limitation, reducing the 15
reimbursement of the provider of health care; 16
(e) Offer or pay any type of material inducement, bonus or 17
other financial incentive to a provider of health care to deny, 18
reduce, withhold, limit or delay access to any such benefit to an 19
insured; or 20
(f) Impose any other restrictions or delays on the access of an 21
insured to any such benefit. 22
[3.] 4. A policy of health insurance subject to the provisions of 23
this chapter that is delivered, issued for delivery or renewed on or 24
after [July] October 1, [2021,] 2025, has the legal effect of including 25
the coverage required by subsection 1, and any provision of the 26
policy that conflicts with the provisions of this section is void. 27
[4.] 5. As used in this section: 28
(a) “Medical laboratory” has the meaning ascribed to it in 29
NRS 652.060. 30
(b) “Network plan” means a policy of health insurance offered 31
by an insurer under which the financing and delivery of medical 32
care, including items and services paid for as medical care, are 33
provided, in whole or in part, through a defined set of providers 34
under contract with the insurer. The term does not include an 35
arrangement for the financing of premiums. 36
(c) “Provider of health care” has the meaning ascribed to it in 37
NRS 629.031. 38
Sec. 11. NRS 689A.0419 is hereby amended to read as 39
follows: 40
689A.0419 1. An insurer that offers or issues a policy of 41
health insurance shall include in the policy coverage for: 42
(a) Counseling, support and supplies for breastfeeding, 43
including breastfeeding equipment, counseling and education during 44
– 16 –
- *AB522*
the antenatal, perinatal and postpartum period for not more than 1 1
year; 2
(b) Screening and counseling for interpersonal and domestic 3
violence for women at least annually with intervention services 4
consisting of education, strategies to reduce harm, supportive 5
services or a referral for any other appropriate services; 6
(c) Behavioral counseling concerning sexually transmitted 7
diseases from a provider of health care for sexually active [women] 8
insureds who are at increased risk for such diseases; 9
(d) Such prenatal screenings and tests as recommended by the 10
American College of Obstetricians and Gynecologists or its 11
successor organization; 12
(e) Screening for blood pressure abnormalities and diabetes, 13
including gestational diabetes, after at least 24 weeks of gestation or 14
as ordered by a provider of health care; 15
(f) Screening for cervical cancer at such intervals as are 16
recommended by the American College of Obstetricians and 17
Gynecologists or its successor organization; 18
(g) Screening for depression [;] for insureds who are 12 years 19
of age or older; 20
(h) Screening for anxiety disorders; 21
(i) Screening and counseling for the human immunodeficiency 22
virus consisting of a risk assessment, annual education relating to 23
prevention and at least one screening for the virus during the 24
lifetime of the insured or as ordered by a provider of health care; 25
[(i) Smoking] 26
(j) Tobacco cessation programs , including, without limitation, 27
pharmacotherapy approved by the United States Food and Drug 28
Administration, for an insured who is 18 years of age or older 29
consisting of not more than two cessation attempts per year and four 30
counseling sessions per year; 31
[(j)] (k) All vaccinations recommended by the Advisory 32
Committee on Immunization Practices of the Centers for Disease 33
Control and Prevention of the United States Department of Health 34
and Human Services or its successor organization; and 35
[(k)] (l) Such well-woman preventative visits as recommended 36
by the Health Resources and Services Administration [,] on 37
January 1, 2025, which must include at least one such visit per year 38
beginning at 14 years of age. 39
2. An insurer must ensure that the benefits required by 40
subsection 1 are made available to an insured through a provider of 41
health care who participates in the network plan of the insurer. 42
3. Except as otherwise provided in subsection 5, an insurer that 43
offers or issues a policy of health insurance shall not: 44
– 17 –
- *AB522*
(a) Require an insured to pay a higher deductible, any 1
copayment or coinsurance or require a longer waiting period or 2
other condition to obtain any benefit provided in the policy of health 3
insurance pursuant to subsection 1; 4
(b) Refuse to issue a policy of health insurance or cancel a 5
policy of health insurance solely because the person applying for or 6
covered by the policy uses or may use any such benefit; 7
(c) Offer or pay any type of material inducement or financial 8
incentive to an insured to discourage the insured from obtaining any 9
such benefit; 10
(d) Penalize a provider of health care who provides any such 11
benefit to an insured, including, without limitation, reducing the 12
reimbursement of the provider of health care; 13
(e) Offer or pay any type of material inducement, bonus or other 14
financial incentive to a provider of health care to deny, reduce, 15
withhold, limit or delay access to any such benefit to an insured; or 16
(f) Impose any other restrictions or delays on the access of an 17
insured to any such benefit. 18
4. A policy of health insurance subject to the provisions of this 19
chapter that is delivered, issued for delivery or renewed on or after 20
[January] October 1, [2018,] 2025, has the legal effect of including 21
the coverage required by subsection 1, and any provision of the 22
policy or the renewal which is in conflict with this section is void. 23
5. Except as otherwise provided in this section and federal law, 24
an insurer may use medical management techniques, including, 25
without limitation, any available clinical evidence, to determine the 26
frequency of or treatment relating to any benefit required by this 27
section or the type of provider of health care to use for such 28
treatment. 29
6. As used in this section: 30
(a) “Medical management technique” means a practice which is 31
used to control the cost or utilization of health care services or 32
prescription drug use. The term includes, without limitation, the use 33
of step therapy, prior authorization or categorizing drugs and 34
devices based on cost, type or method of administration. 35
(b) “Network plan” means a policy of health insurance offered 36
by an insurer under which the financing and delivery of medical 37
care, including items and services paid for as medical care, are 38
provided, in whole or in part, through a defined set of providers 39
under contract with the insurer. The term does not include an 40
arrangement for the financing of premiums. 41
(c) “Provider of health care” has the meaning ascribed to it in 42
NRS 629.031. 43
– 18 –
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Sec. 12. NRS 689A.0424 is hereby amended to read as 1
follows: 2
689A.0424 1. An insurer that offers or issues a policy of 3
health insurance [that includes coverage for maternity care] shall not 4
deny, limit or seek reimbursement for maternity care because the 5
insured is acting as a gestational carrier. 6
2. If an insured acts as a gestational carrier, the child shall be 7
deemed to be a child of the intended parent, as defined in NRS 8
126.590, for purposes related to the policy of health insurance. 9
3. As used in this section, “gestational carrier” has the meaning 10
ascribed to it in NRS 126.580. 11
Sec. 13. NRS 689A.0438 is hereby amended to read as 12
follows: 13
689A.0438 1. An insurer that offers or issues a policy of 14
health insurance shall include in the policy: 15
(a) Coverage of testing for and the treatment and prevention of 16
sexually transmitted diseases, including, without limitation, 17
Chlamydia trachomatis, gonorrhea, syphilis, human 18
immunodeficiency virus and hepatitis B and C, for all insureds, 19
regardless of age. Such coverage must include, without limitation, 20
the coverage required by NRS 689A.0412 and 689A.0437. 21
(b) Unrestricted coverage of condoms for insureds who are 13 22
years of age or older. 23
2. An insurer that offers or issues a policy of health 24
insurance shall not: 25
(a) Require an insured to pay a higher deductible, any 26
copayment or coinsurance or require a longer waiting period or 27
other condition to obtain any benefit provided in the policy of 28
health insurance pursuant to subsection 1; 29
(b) Refuse to issue a policy of health insurance or cancel a 30
policy of health insurance solely because the person applying for 31
or covered by the policy uses or may use any such benefit; 32
(c) Offer or pay any type of material inducement or financial 33
incentive to an insured to discourage the insured from obtaining 34
any such benefit; 35
(d) Penalize a provider of health care who provides any such 36
benefit to an insured, including, without limitation, reducing the 37
reimbursement of the provider of health care; 38
(e) Offer or pay any type of material inducement, bonus or 39
other financial incentive to a provider of health care to deny, 40
reduce, withhold, limit or delay access to any such benefit to an 41
insured; or 42
(f) Impose any other restrictions or delays on the access of an 43
insured to any such benefit. 44
– 19 –
- *AB522*
3. A policy of health insurance subject to the provisions of this 1
chapter that is delivered, issued for delivery or renewed on or after 2
[January] October 1, [2024,] 2025, has the legal effect of including 3
the coverage required by subsection 1, and any provision of the 4
policy that conflicts with the provisions of this section is void. 5
4. As used in this section, “provider of health care” has the 6
meaning ascribed to it in NRS 629.031. 7
Sec. 14. NRS 689A.330 is hereby amended to read as follows: 8
689A.330 If any policy is issued by a domestic insurer for 9
delivery to a person residing in another state, and if the insurance 10
commissioner or corresponding public officer of that other state has 11
informed the Commissioner that the policy is not subject to approval 12
or disapproval by that officer, the Commissioner may by ruling 13
require that the policy meet the standards set forth in NRS 689A.030 14
to 689A.320, inclusive [.] , and sections 2 to 5, inclusive, of this 15
act. 16
Sec. 15. NRS 689A.717 is hereby amended to read as follows: 17
689A.717 1. An insurer that offers or issues an individual 18
health benefit plan subject to the provisions of this chapter shall 19
include in the plan coverage for maternity care and pediatric care 20
for newborn infants. 21
2. Except as otherwise provided in this subsection, an 22
individual health benefit plan issued pursuant to this chapter [that 23
includes coverage for maternity care and pediatric care for newborn 24
infants] may not restrict benefits for any length of stay in a hospital 25
in connection with childbirth for a pregnant or postpartum 26
individual or newborn infant covered by the plan to: 27
(a) Less than 48 hours after a normal vaginal delivery; and 28
(b) Less than 96 hours after a cesarean section. 29
If a different length of stay is provided in the guidelines 30
established by the American College of Obstetricians and 31
Gynecologists, or its successor organization, and the American 32
Academy of Pediatrics, or its successor organization, the individual 33
health benefit plan may follow such guidelines in lieu of following 34
the length of stay set forth above. The provisions of this subsection 35
do not apply to any individual health benefit plan in any case in 36
which the decision to discharge the pregnant or postpartum 37
individual or newborn infant before the expiration of the minimum 38
length of stay set forth in this subsection is made by the attending 39
physician of the pregnant or postpartum individual or newborn 40
infant. 41
[2.] 3. Nothing in this section requires a pregnant or 42
postpartum individual to: 43
(a) Deliver the baby in a hospital; or 44
– 20 –
- *AB522*
(b) Stay in a hospital for a fixed period following the birth of the 1
child. 2
[3.] 4. An individual health benefit plan [that offers coverage 3
for maternity care and pediatric care of newborn infants] may not: 4
(a) Deny a pregnant or postpartum individual or the newborn 5
infant coverage or continued coverage under the terms of the plan 6
[or coverage] if the sole purpose of the denial of coverage or 7
continued coverage is to avoid the requirements of this section; 8
(b) Provide monetary payments or rebates to a pregnant or 9
postpartum individual to encourage the individual to accept less than 10
the minimum protection available pursuant to this section; 11
(c) Penalize, or otherwise reduce or limit, the reimbursement of 12
an attending provider of health care because the attending provider 13
of health care provided care to a pregnant or postpartum individual 14
or newborn infant in accordance with the provisions of this section; 15
(d) Provide incentives of any kind to an attending physician to 16
induce the attending physician to provide care to a pregnant or 17
postpartum individual or newborn infant in a manner that is 18
inconsistent with the provisions of this section; or 19
(e) Except as otherwise provided in subsection [4,] 5, restrict 20
benefits for any portion of a hospital stay required pursuant to the 21
provisions of this section in a manner that is less favorable than the 22
benefits provided for any preceding portion of that stay. 23
[4.] 5. Nothing in this section: 24
(a) Prohibits an individual health benefit plan from imposing a 25
deductible, coinsurance or other mechanism for sharing costs 26
relating to benefits for hospital stays in connection with childbirth 27
for a pregnant or postpartum individual or newborn child covered by 28
the plan, except that such coinsurance or other mechanism for 29
sharing costs for any portion of a hospital stay required by this 30
section may not be greater than the coinsurance or other mechanism 31
for any preceding portion of that stay. 32
(b) Prohibits an arrangement for payment between an individual 33
health benefit plan and a provider of health care that uses capitation 34
or other financial incentives, if the arrangement is designed to 35
provide services efficiently and consistently in the best interest of 36
the pregnant or postpartum individual and the newborn infant. 37
(c) Prevents an individual health benefit plan from negotiating 38
with a provider of health care concerning the level and type of 39
reimbursement to be provided in accordance with this section. 40
6. An individual health benefit plan subject to the provisions 41
of this chapter that is delivered, issued for delivery or renewed on 42
or after October 1, 2025, has the legal effect of including the 43
coverage required by this section, and any provision of the plan 44
that conflicts with the provisions of this section is void. 45
– 21 –
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Sec. 16. Chapter 689B of NRS is hereby amended by adding 1
thereto the provisions set forth as sections 17 to 20, inclusive, of this 2
act. 3
Sec. 17. 1. An insurer that offers or issues a policy of 4
group health insurance which provides coverage for dependent 5
children shall continue to make such coverage available for an 6
adult child of an insured until such child reaches 26 years of age. 7
2. Nothing in this section shall be construed as requiring an 8
insurer to make coverage available for a dependent of an adult 9
child of an insured. 10
Sec. 18. 1. An insurer that offers or issues a policy of 11
group health insurance shall include in the policy coverage for: 12
(a) Screening for anxiety for insureds who are at least 8 but 13
not more than 18 years of age; 14
(b) Assessments relating to height, weight, body mass index 15
and medical history for insureds who are less than 18 years of 16
age; 17
(c) Comprehensive and intensive behavioral interventions for 18
insureds who are at least 12 but not more than 18 years of age and 19
have a body mass index in the 95th percentile or greater for 20
persons of the same age and sex; 21
(d) The application of fluoride varnish to the primary teeth for 22
insureds who are less than 5 years of age; 23
(e) Oral fluoride supplements for insureds who are at least 6 24
months of age but less than 5 years of age and whose supply of 25
water is deficient in fluoride; 26
(f) Counseling and education pertaining to the minimization of 27
exposure to ultraviolet radiation for insureds who are less than 25 28
years of age and have fair skin types and the parents or legal 29
guardians of insureds who are less than 18 years of age and have 30
fair skin types for the purpose of minimizing the risk of skin 31
cancer in those persons; 32
(g) Brief behavioral counseling and interventions to prevent 33
tobacco use for insureds who are less than 18 years of age; 34
(h) At least one screening for the detection of amblyopia or the 35
risk factors of amblyopia for insureds who are at least 3 but not 36
more than 5 years of age; and 37
(i) Screening, tests and counseling for such other health 38
conditions and diseases as recommended by the Health Resources 39
and Services Administration on January 1, 2025, for insureds who 40
are less than 18 years of age. 41
2. An insurer must ensure that the benefits required by 42
subsection 1 are made available to an insured through a provider 43
of health care who participates in the network plan of the insurer. 44
– 22 –
- *AB522*
3. Except as otherwise provided in subsection 5, an insurer 1
that offers or issues a policy of group health insurance shall not: 2
(a) Require an insured to pay a higher deductible, any 3
copayment or coinsurance or require a longer waiting period or 4
other condition to obtain any benefit provided in the policy of 5
group health insurance pursuant to subsection 1; 6
(b) Refuse to issue a policy of group health insurance or 7
cancel a policy of group health insurance solely because the 8
person applying for or covered by the policy uses or may use any 9
such benefit; 10
(c) Offer or pay any type of material inducement or financial 11
incentive to an insured to discourage the insured from obtaining 12
any such benefit; 13
(d) Penalize a provider of health care who provides any such 14
benefit to an insured, including, without limitation, reducing the 15
reimbursement of the provider of health care; 16
(e) Offer or pay any type of material inducement, bonus or 17
other financial incentive to a provider of health care to deny, 18
reduce, withhold, limit or delay access to any such benefit to an 19
insured; or 20
(f) Impose any other restrictions or delays on the access of an 21
insured to any such benefit. 22
4. A policy of group health insurance subject to the 23
provisions of this chapter that is delivered, issued for delivery or 24
renewed on or after October 1, 2025, has the legal effect of 25
including the coverage required by subsection 1, and any 26
provision of the policy or the renewal which is in conflict with this 27
section is void. 28
5. Except as otherwise provided in this section and federal 29
law, an insurer may use medical management techniques, 30
including, without limitation, any available clinical evidence, to 31
determine the frequency of or treatment relating to any benefit 32
required by this section or the type of provider of health care to 33
use for such treatment. 34
6. As used in this section: 35
(a) “Medical management technique” means a practice which 36
is used to control the cost or utilization of health care services or 37
prescription drug use. The term includes, without limitation, the 38
use of step therapy, prior authorization or categorizing drugs and 39
devices based on cost, type or method of administration. 40
(b) “Network plan” means a policy of group health insurance 41
offered by an insurer under which the financing and delivery of 42
medical care, including items and services paid for as medical 43
care, are provided, in whole or in part, through a defined set of 44
– 23 –
- *AB522*
providers of health care under contract with the insurer. The term 1
does not include an arrangement for the financing of premiums. 2
(c) “Provider of health care” has the meaning ascribed to it in 3
NRS 629.031. 4
Sec. 19. 1. An insurer that offers or issues a policy of 5
group health insurance shall include in the policy coverage for: 6
(a) A daily dose of 0.4 to 0.8 milligrams of folic acid for 7
insureds who are pregnant or are planning on becoming 8
pregnant; 9
(b) A low dose of aspirin for the prevention of preeclampsia 10
for insureds who are determined to be at a high risk of that 11
condition after 12 weeks of gestation; 12
(c) Prophylactic ocular tubal medication for the prevention of 13
gonococcal ophthalmia in newborns; 14
(d) Screening for asymptomatic bacteriuria for insureds who 15
are pregnant; 16
(e) Counseling and behavioral interventions relating to the 17
promotion of healthy weight gain and the prevention of excessive 18
weight gain for insureds who are pregnant; 19
(f) Counseling for insureds who are pregnant or in the 20
postpartum stage of pregnancy and have an increased risk of 21
perinatal or postpartum depression; 22
(g) Screening for the presence of the rhesus D antigen and 23
antibodies in the blood of an insured who is pregnant during the 24
insured’s first visit for care relating to the pregnancy; 25
(h) Screening for rhesus D antibodies between 24 and 28 26
weeks of gestation for insureds who are negative for the rhesus D 27
antigen and have not been exposed to blood that is positive for the 28
rhesus D antigen; 29
(i) Behavioral counseling and intervention for tobacco 30
cessation for insureds who are pregnant; 31
(j) An annual screening for urinary incontinence for women; 32
(k) Screening for type 2 diabetes at such intervals as 33
recommended by the Health Resources and Services 34
Administration on January 1, 2025, for insureds who are in the 35
postpartum stage of pregnancy and who have a history of 36
gestational diabetes mellitus; 37
(l) Counseling relating to maintaining a healthy weight for 38
women who are at least 40 but not more than 60 years of age and 39
have a body mass index greater than 18.5; and 40
(m) Screening for osteoporosis for women who: 41
(1) Are 65 years of age or older; or 42
(2) Are less than 65 years of age and have a risk of 43
fracturing a bone equal to or greater than that of a woman who is 44
65 years of age without any additional risk factors. 45
– 24 –
- *AB522*
2. An insurer must ensure that the benefits required by 1
subsection 1 are made available to an insured through a provider 2
of health care who participates in the network plan of the insurer. 3
3. Except as otherwise provided in subsection 5, an insurer 4
that offers or issues a policy of group health insurance shall not: 5
(a) Require an insured to pay a higher deductible, any 6
copayment or coinsurance or require a longer waiting period or 7
other condition to obtain any benefit provided in the policy of 8
group health insurance pursuant to subsection 1; 9
(b) Refuse to issue a policy of group health insurance or 10
cancel a policy of group health insurance solely because the 11
person applying for or covered by the policy uses or may use any 12
such benefit; 13
(c) Offer or pay any type of material inducement or financial 14
incentive to an insured to discourage the insured from obtaining 15
any such benefit; 16
(d) Penalize a provider of health care who provides any such 17
benefit to an insured, including, without limitation, reducing the 18
reimbursement of the provider of health care; 19
(e) Offer or pay any type of material inducement, bonus or 20
other financial incentive to a provider of health care to deny, 21
reduce, withhold, limit or delay access to any such benefit to an 22
insured; or 23
(f) Impose any other restrictions or delays on the access of an 24
insured to any such benefit. 25
4. A policy of group health insurance subject to the 26
provisions of this chapter that is delivered, issued for delivery or 27
renewed on or after October 1, 2025, has the legal effect of 28
including the coverage required by subsection 1, and any 29
provision of the policy or the renewal which is in conflict with this 30
section is void. 31
5. Except as otherwise provided in this section and federal 32
law, an insurer may use medical management techniques, 33
including, without limitation, any available clinical evidence, to 34
determine the frequency of or treatment relating to any benefit 35
required by this section or the type of provider of health care to 36
use for such treatment. 37
6. As used in this section: 38
(a) “Medical management technique” means a practice which 39
is used to control the cost or utilization of health care services or 40
prescription drug use. The term includes, without limitation, the 41
use of step therapy, prior authorization or categorizing drugs and 42
devices based on cost, type or method of administration. 43
(b) “Network plan” means a policy of group health insurance 44
offered by an insurer under which the financing and delivery of 45
– 25 –
- *AB522*
medical care, including items and services paid for as medical 1
care, are provided, in whole or in part, through a defined set of 2
providers of health care under contract with the insurer. The term 3
does not include an arrangement for the financing of premiums. 4
(c) “Provider of health care” has the meaning ascribed to it in 5
NRS 629.031. 6
Sec. 20. 1. An insurer that offers or issues a policy of 7
group health insurance shall include in the policy coverage for: 8
(a) Behavioral counseling and interventions to promote 9
physical activity and a healthy diet for insureds with 10
cardiovascular risk factors; 11
(b) Statin preventive medication for insureds who are at least 12
40 but not more than 75 years of age and do not have a history of 13
cardiovascular disease, but who have: 14
(1) One or more risk factors for cardiovascular disease; 15
and 16
(2) A calculated risk of at least 10 percent of acquiring 17
cardiovascular disease within the next 10 years; 18
(c) Interventions for exercise to prevent falls for insureds who 19
are 65 years of age or older and reside in a medical facility or 20
facility for the dependent; 21
(d) Screenings for latent tuberculosis infection in insureds 22
with an increased risk of contracting tuberculosis; 23
(e) Screening for hypertension; 24
(f) One abdominal aortic screening by ultrasound to detect 25
abdominal aortic aneurysms for men who are at least 65 but not 26
more than 75 years of age and have smoked during their lifetimes; 27
(g) Screening for drug and alcohol misuse for insureds who 28
are 18 years of age or older; 29
(h) If an insured engages in risky or hazardous consumption 30
of alcohol, as determined by the screening described in paragraph 31
(g), behavioral counseling to reduce such behavior; 32
(i) Screening for lung cancer using low-dose computed 33
tomography for insureds who are at least 50 but not more than 80 34
years of age and: 35
(1) Have a smoking history of 20 pack-years; 36
(2) Smoke or have stopped smoking within the immediately 37
preceding 15 years; and 38
(3) Do not suffer from a health problem that substantially 39
limits the life expectancy of the person or the willingness of the 40
person to undergo curative surgery; 41
(j) Screening for prediabetes and type 2 diabetes in insureds 42
who are at least 35 but not more than 70 years of age and have a 43
body mass index of 25 or greater; and 44
– 26 –
- *AB522*
(k) Intensive behavioral interventions with multiple 1
components for insureds who are 18 years of age or older and 2
have a body mass index of 30 or greater. 3
2. An insurer must ensure that the benefits required by 4
subsection 1 are made available to an insured through a provider 5
of health care who participates in the network plan of the insurer. 6
3. Except as otherwise provided in subsection 5, an insurer 7
that offers or issues a policy of group health insurance shall not: 8
(a) Require an insured to pay a higher deductible, any 9
copayment or coinsurance or require a longer waiting period or 10
other condition to obtain any benefit provided in the policy of 11
group health insurance pursuant to subsection 1; 12
(b) Refuse to issue a policy of group health insurance or 13
cancel a policy of group health insurance solely because the 14
person applying for or covered by the policy uses or may use any 15
such benefit; 16
(c) Offer or pay any type of material inducement or financial 17
incentive to an insured to discourage the insured from obtaining 18
any such benefit; 19
(d) Penalize a provider of health care who provides any such 20
benefit to an insured, including, without limitation, reducing the 21
reimbursement of the provider of health care; 22
(e) Offer or pay any type of material inducement, bonus or 23
other financial incentive to a provider of health care to deny, 24
reduce, withhold, limit or delay access to any such benefit to an 25
insured; or 26
(f) Impose any other restrictions or delays on the access of an 27
insured to any such benefit. 28
4. A policy of group health insurance subject to the 29
provisions of this chapter that is delivered, issued for delivery or 30
renewed on or after October 1, 2025, has the legal effect of 31
including the coverage required by subsection 1, and any 32
provision of the policy or the renewal which is in conflict with this 33
section is void. 34
5. Except as otherwise provided in this section and federal 35
law, an insurer may use medical management techniques, 36
including, without limitation, any available clinical evidence, to 37
determine the frequency of or treatment relating to any benefit 38
required by this section or the type of provider of health care to 39
use for such treatment. 40
6. As used in this section: 41
(a) “Computed tomography” means the process of producing 42
sectional and three-dimensional images using external ionizing 43
radiation. 44
– 27 –
- *AB522*
(b) “Facility for the dependent” has the meaning ascribed to it 1
in NRS 449.0045. 2
(c) “Medical facility” has the meaning ascribed to it in 3
NRS 449.0151. 4
(d) “Medical management technique” means a practice which 5
is used to control the cost or utilization of health care services or 6
prescription drug use. The term includes, without limitation, the 7
use of step therapy, prior authorization or categorizing drugs and 8
devices based on cost, type or method of administration. 9
(e) “Network plan” means a policy of group health insurance 10
offered by an insurer under which the financing and delivery of 11
medical care, including items and services paid for as medical 12
care, are provided, in whole or in part, through a defined set of 13
providers of health care under contract with the insurer. The term 14
does not include an arrangement for the financing of premiums. 15
(f) “Pack-year” means the product of the number of packs of 16
cigarettes smoked per day and the number of years that the person 17
has smoked. 18
(g) “Provider of health care” has the meaning ascribed to it in 19
NRS 629.031. 20
Sec. 21. NRS 689B.0314 is hereby amended to read as 21
follows: 22
689B.0314 1. An insurer that issues a policy of group health 23
insurance shall provide coverage for screening, genetic counseling 24
and testing for harmful mutations in the BRCA gene for women 25
under circumstances where such screening, genetic counseling or 26
testing, as applicable, is required by NRS 457.301. 27
2. An insurer shall ensure that the benefits required by 28
subsection 1 are made available to an insured through a provider of 29
health care who participates in the network plan of the insurer. 30
3. An insurer that issues a policy of group health insurance 31
shall not: 32
(a) Require an insured to pay a higher deductible, any 33
copayment or coinsurance or require a longer waiting period or 34
other condition to obtain any benefit provided in the policy of 35
group health insurance pursuant to subsection 1; 36
(b) Refuse to issue a policy of group health insurance or 37
cancel a policy of group health insurance solely because the 38
person applying for or covered by the policy uses or may use any 39
such benefit; 40
(c) Offer or pay any type of material inducement or financial 41
incentive to an insured to discourage the insured from obtaining 42
any such benefit; 43
– 28 –
- *AB522*
(d) Penalize a provider of health care who provides any such 1
benefit to an insured, including, without limitation, reducing the 2
reimbursement of the provider of health care; 3
(e) Offer or pay any type of material inducement, bonus or 4
other financial incentive to a provider of health care to deny, 5
reduce, withhold, limit or delay access to any such benefit to an 6
insured; or 7
(f) Impose any other restrictions or delays on the access of an 8
insured to any such benefit. 9
4. A policy of group health insurance subject to the provisions 10
of this chapter that is delivered, issued for delivery or renewed on or 11
after [January] October 1, [2022,] 2025, has the legal effect of 12
including the coverage required by subsection 1, and any provision 13
of the policy that conflicts with the provisions of this section is void. 14
[4.] 5. As used in this section: 15
(a) “Network plan” means a policy of group health insurance 16
offered by an insurer under which the financing and delivery of 17
medical care, including items and services paid for as medical care, 18
are provided, in whole or in part, through a defined set of providers 19
under contract with the insurer. The term does not include an 20
arrangement for the financing of premiums. 21
(b) “Provider of health care” has the meaning ascribed to it in 22
NRS 629.031. 23
Sec. 22. NRS 689B.0315 is hereby amended to read as 24
follows: 25
689B.0315 1. An insurer that issues a policy of group health 26
insurance shall provide coverage for the examination of a person 27
who is pregnant for the discovery of: 28
(a) Chlamydia trachomatis, gonorrhea, hepatitis B and hepatitis 29
C in accordance with NRS 442.013. 30
(b) Syphilis in accordance with NRS 442.010. 31
(c) Human immunodeficiency virus. 32
2. The coverage required by this section must be provided: 33
(a) Regardless of whether the benefits are provided to the 34
insured by a provider of health care, facility or medical laboratory 35
that participates in the network plan of the insurer; and 36
(b) Without prior authorization. 37
3. An insurer that issues a policy of group health insurance 38
shall not: 39
(a) Require an insured to pay a higher deductible, any 40
copayment or coinsurance or require a longer waiting period or 41
other condition to obtain any benefit provided in the policy of 42
group health insurance pursuant to subsection 1; 43
(b) Refuse to issue a policy of group health insurance or 44
cancel a policy of group health insurance solely because the 45
– 29 –
- *AB522*
person applying for or covered by the policy uses or may use any 1
such benefit; 2
(c) Offer or pay any type of material inducement or financial 3
incentive to an insured to discourage the insured from obtaining 4
any such benefit; 5
(d) Penalize a provider of health care who provides any such 6
benefit to an insured, including, without limitation, reducing the 7
reimbursement of the provider of health care; 8
(e) Offer or pay any type of material inducement, bonus or 9
other financial incentive to a provider of health care to deny, 10
reduce, withhold, limit or delay access to any such benefit to an 11
insured; or 12
(f) Impose any other restrictions or delays on the access of an 13
insured to any such benefit. 14
4. A policy of health insurance subject to the provisions of this 15
chapter that is delivered, issued for delivery or renewed on or after 16
[July] October 1, [2021,] 2025, has the legal effect of including the 17
coverage required by subsection 1, and any provision of the policy 18
that conflicts with the provisions of this section is void. 19
[4.] 5. As used in this section: 20
(a) “Medical laboratory” has the meaning ascribed to it in 21
NRS 652.060. 22
(b) “Network plan” means a policy of group health insurance 23
offered by an insurer under which the financing and delivery of 24
medical care, including items and services paid for as medical care, 25
are provided, in whole or in part, through a defined set of providers 26
under contract with the insurer. The term does not include an 27
arrangement for the financing of premiums. 28
(c) “Provider of health care” has the meaning ascribed to it in 29
NRS 629.031. 30
Sec. 23. NRS 689B.0316 is hereby amended to read as 31
follows: 32
689B.0316 1. An insurer that offers or issues a policy of 33
group health insurance shall include in the policy: 34
(a) Coverage of testing for and the treatment of and prevention 35
of sexually transmitted diseases, including, without limitation, 36
Chlamydia trachomatis, gonorrhea, syphilis, human 37
immunodeficiency virus and hepatitis B and C, for all insureds, 38
regardless of age. Such coverage must include, without limitation, 39
the coverage required by NRS 689B.0312 and 689B.0315. 40
(b) Unrestricted coverage of condoms for insureds who are 13 41
years of age or older. 42
2. An insurer that offers or issues a policy of group health 43
insurance shall not: 44
– 30 –
- *AB522*
(a) Require an insured to pay a higher deductible, any 1
copayment or coinsurance or require a longer waiting period or 2
other condition to obtain any benefit provided in the policy of 3
group health insurance pursuant to subsection 1; 4
(b) Refuse to issue a policy of group health insurance or 5
cancel a policy of group health insurance solely because the 6
person applying for or covered by the policy uses or may use any 7
such benefit; 8
(c) Offer or pay any type of material inducement or financial 9
incentive to an insured to discourage the insured from obtaining 10
any such benefit; 11
(d) Penalize a provider of health care who provides any such 12
benefit to an insured, including, without limitation, reducing the 13
reimbursement of the provider of health care; 14
(e) Offer or pay any type of material inducement, bonus or 15
other financial incentive to a provider of health care to deny, 16
reduce, withhold, limit or delay access to any such benefit to an 17
insured; or 18
(f) Impose any other restrictions or delays on the access of an 19
insured to any such benefit. 20
3. A policy of group health insurance subject to the provisions 21
of this chapter that is delivered, issued for delivery or renewed on or 22
after [January] October 1, [2024,] 2025, has the legal effect of 23
including the coverage required by subsection 1, and any provision 24
of the policy that conflicts with the provisions of this section is void. 25
4. As used in this section, “provider of health care” has the 26
meaning ascribed to it in NRS 629.031. 27
Sec. 24. NRS 689B.0367 is hereby amended to read as 28
follows: 29
689B.0367 1. A policy of group health insurance [that 30
provides coverage for the treatment of colorectal cancer] must 31
provide coverage for colorectal cancer screening in accordance 32
with: 33
(a) The guidelines concerning colorectal cancer screening which 34
are published by the American Cancer Society; or 35
(b) Other guidelines or reports concerning colorectal cancer 36
screening which are published by nationally recognized professional 37
organizations and which include current or prevailing supporting 38
scientific data. 39
2. An insurer must 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 insurer. 42
3. An insurer that offers or issues a policy of group health 43
insurance shall not: 44
– 31 –
- *AB522*
(a) Require an insured to pay a higher deductible, any 1
copayment or coinsurance or require a longer waiting period or 2
other condition to obtain any benefit provided in the policy of 3
group health insurance pursuant to subsection 1; 4
(b) Refuse to issue a policy of group health insurance or 5
cancel a policy of group health insurance solely because the 6
person applying for or covered by the policy uses or may use any 7
such benefit; 8
(c) Offer or pay any type of material inducement or financial 9
incentive to an insured to discourage the insured from obtaining 10
any such benefit; 11
(d) Penalize a provider of health care who provides any such 12
benefit to an insured, including, without limitation, reducing the 13
reimbursement of the provider of health care; 14
(e) Offer or pay any type of material inducement, bonus or 15
other financial incentive to a provider of health care to deny, 16
reduce, withhold, limit or delay access to any such benefit to an 17
insured; or 18
(f) Impose any other restrictions or delays on the access of an 19
insured to any such benefit. 20
4. A policy of group health insurance subject to the provisions 21
of this chapter that is delivered, issued for delivery or renewed on or 22
after October 1, [2003,] 2025, has the legal effect of including the 23
coverage required by this section, and any provision of the policy 24
that conflicts with the provisions of this section is void. 25
5. As used in this section: 26
(a) “Network plan” means a policy of group health insurance 27
offered by an insurer under which the financing and delivery of 28
medical care, including items and services paid for as medical 29
care, are provided, in whole or in part, through a defined set of 30
providers of health care under contract with the insurer. The term 31
does not include an 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. 25. NRS 689B.0374 is hereby amended to read as 35
follows: 36
689B.0374 1. A policy of group health insurance must 37
provide coverage for benefits payable for expenses incurred for: 38
(a) A mammogram to screen for breast cancer annually for 39
insureds who are 40 years of age or older. 40
(b) An imaging test to screen for breast cancer on an interval 41
and at the age deemed most appropriate, when medically necessary, 42
as recommended by the insured’s provider of health care based on 43
personal or family medical history or additional factors that may 44
increase the risk of breast cancer for the insured. 45
– 32 –
- *AB522*
(c) A diagnostic imaging test for breast cancer at the age deemed 1
most appropriate, when medically necessary, as recommended by 2
the insured’s provider of health care to evaluate an abnormality 3
which is: 4
(1) Seen or suspected from a mammogram described in 5
paragraph (a) or an imaging test described in paragraph (b); or 6
(2) Detected by other means of examination. 7
(d) Medication to prevent breast cancer for insureds who are 8
at a high risk of developing breast cancer and have a low risk of 9
adverse side effects from the medication. 10
2. An insurer must ensure that the benefits required by 11
subsection 1 are made available to an insured through a provider of 12
health care who participates in the network plan of the insurer. 13
3. Except as otherwise provided in subsection 5, an insurer that 14
offers or issues a policy of group health insurance shall not: 15
(a) Except as otherwise provided in subsection 6, require an 16
insured to pay a deductible, copayment, coinsurance or any other 17
form of cost-sharing or require a longer waiting period or other 18
condition to obtain any benefit provided in the policy of group 19
health insurance pursuant to subsection 1; 20
(b) Refuse to issue a policy of group health insurance or cancel a 21
policy of group health insurance solely because the person applying 22
for or covered by the policy uses or may use any such benefit; 23
(c) Offer or pay any type of material inducement or financial 24
incentive to an insured to discourage the insured from obtaining any 25
such benefit; 26
(d) Penalize a provider of health care who provides any such 27
benefit to an insured, including, without limitation, reducing the 28
reimbursement of the provider of health care; 29
(e) Offer or pay any type of material inducement, bonus or other 30
financial incentive to a provider of health care to deny, reduce, 31
withhold, limit or delay access to any such benefit to an insured; or 32
(f) Impose any other restrictions or delays on the access of an 33
insured to any such benefit. 34
4. A policy subject to the provisions of this chapter which is 35
delivered, issued for delivery or renewed on or after [January] 36
October 1, [2024,] 2025, has the legal effect of including the 37
coverage required by subsection 1, and any provision of the policy 38
or the renewal which is in conflict with this section is void. 39
5. Except as otherwise provided in this section and federal law, 40
an insurer may use medical management techniques, including, 41
without limitation, any available clinical evidence, to determine the 42
frequency of or treatment relating to any benefit required by this 43
section or the type of provider of health care to use for such 44
treatment. 45
– 33 –
- *AB522*
6. If the application of paragraph (a) of subsection 3 would 1
result in the ineligibility of a health savings account of an insured 2
pursuant to 26 U.S.C. § 223, the prohibitions of paragraph (a) of 3
subsection 3 shall apply only for a qualified policy of group health 4
insurance with respect to the deductible of such a policy of group 5
health insurance after the insured has satisfied the minimum 6
deductible pursuant to 26 U.S.C. § 223, except with respect to items 7
or services that constitute preventive care pursuant to 26 U.S.C. § 8
223(c)(2)(C), in which case the prohibitions of paragraph (a) of 9
subsection 3 shall apply regardless of whether the minimum 10
deductible under 26 U.S.C. § 223 has been satisfied. 11
7. As used in this section: 12
(a) “Medical management technique” means a practice which is 13
used to control the cost or utilization of health care services or 14
prescription drug use. The term includes, without limitation, the use 15
of step therapy, prior authorization or categorizing drugs and 16
devices based on cost, type or method of administration. 17
(b) “Network plan” means a policy of group health insurance 18
offered by an insurer under which the financing and delivery of 19
medical care, including items and services paid for as medical care, 20
are provided, in whole or in part, through a defined set of providers 21
under contract with the insurer. The term does not include an 22
arrangement for the financing of premiums. 23
(c) “Provider of health care” has the meaning ascribed to it in 24
NRS 629.031. 25
(d) “Qualified policy of group health insurance” means a policy 26
of group health insurance that has a high deductible and is in 27
compliance with 26 U.S.C. § 223 for the purposes of establishing a 28
health savings account. 29
Sec. 26. NRS 689B.03766 is hereby amended to read as 30
follows: 31
689B.03766 1. An insurer that offers or issues a policy of 32
group health insurance [that includes coverage for maternity care] 33
shall not deny, limit or seek reimbursement for maternity care 34
because the insured is acting as a gestational carrier. 35
2. If an insured acts as a gestational carrier, the child shall be 36
deemed to be a child of the intended parent, as defined in NRS 37
126.590, for purposes related to the policy of group health 38
insurance. 39
3. As used in this section, “gestational carrier” has the meaning 40
ascribed to it in NRS 126.580. 41
Sec. 27. NRS 689B.03785 is hereby amended to read as 42
follows: 43
689B.03785 1. An insurer that offers or issues a policy of 44
group health insurance shall include in the policy coverage for: 45
– 34 –
- *AB522*
(a) Counseling, support and supplies for breastfeeding, 1
including breastfeeding equipment, counseling and education during 2
the antenatal, perinatal and postpartum period for not more than 1 3
year; 4
(b) Screening and counseling for interpersonal and domestic 5
violence for women at least annually with initial intervention 6
services consisting of education, strategies to reduce harm, 7
supportive services or a referral for any other appropriate services; 8
(c) Behavioral counseling concerning sexually transmitted 9
diseases from a provider of health care for sexually active [women] 10
insureds who are at increased risk for such diseases; 11
(d) Such prenatal screenings and tests as recommended by the 12
American College of Obstetricians and Gynecologists or its 13
successor organization; 14
(e) Screening for blood pressure abnormalities and diabetes, 15
including gestational diabetes, after at least 24 weeks of gestation or 16
as ordered by a provider of health care; 17
(f) Screening for cervical cancer at such intervals as are 18
recommended by the American College of Obstetricians and 19
Gynecologists or its successor organization; 20
(g) Screening for depression [;] for insureds who are 12 years 21
of age or older; 22
(h) Screening for anxiety disorders; 23
(i) Screening and counseling for the human immunodeficiency 24
virus consisting of a risk assessment, annual education relating to 25
prevention and at least one screening for the virus during the 26
lifetime of the insured or as ordered by a provider of health care; 27
[(i) Smoking] 28
(j) Tobacco cessation programs , including, without limitation, 29
pharmacotherapy approved by the United States Food and Drug 30
Administration, for an insured who is 18 years of age or older 31
consisting of not more than two cessation attempts per year and four 32
counseling sessions per year; 33
[(j)] (k) All vaccinations recommended by the Advisory 34
Committee on Immunization Practices of the Centers for Disease 35
Control and Prevention of the United States Department of Health 36
and Human Services or its successor organization; and 37
[(k)] (l) Such well-woman preventative visits as recommended 38
by the Health Resources and Services Administration [,] on 39
January 1, 2025, which must include at least one such visit per year 40
beginning at 14 years of age. 41
2. An insurer must ensure that the benefits required by 42
subsection 1 are made available to an insured through a provider of 43
health care who participates in the network plan of the insurer. 44
– 35 –
- *AB522*
3. Except as otherwise provided in subsection 5, an insurer that 1
offers or issues a policy of group health insurance shall not: 2
(a) Require an insured to pay a higher deductible, any 3
copayment or coinsurance or require a longer waiting period or 4
other condition to obtain any benefit provided in the policy of group 5
health insurance pursuant to subsection 1; 6
(b) Refuse to issue a policy of group health insurance or cancel a 7
policy of group health insurance solely because the person applying 8
for or covered by the policy uses or may use any such benefit; 9
(c) Offer or pay any type of material inducement or financial 10
incentive to an insured to discourage the insured from obtaining any 11
such benefit; 12
(d) Penalize a provider of health care who provides any such 13
benefit to an insured, including, without limitation, reducing the 14
reimbursement of the provider of health care; 15
(e) Offer or pay any type of material inducement, bonus or other 16
financial incentive to a provider of health care to deny, reduce, 17
withhold, limit or delay access to any such benefit to an insured; or 18
(f) Impose any other restrictions or delays on the access of an 19
insured to any such benefit. 20
4. A policy subject to the provisions of this chapter that is 21
delivered, issued for delivery or renewed on or after [January] 22
October 1, [2018,] 2025, has the legal effect of including the 23
coverage required by subsection 1, and any provision of the policy 24
or the renewal which is in conflict with this section is void. 25
5. Except as otherwise provided in this section and federal law, 26
an insurer may use medical management techniques, including, 27
without limitation, any available clinical evidence, to determine the 28
frequency of or treatment relating to any benefit required by this 29
section or the type of provider of health care to use for such 30
treatment. 31
6. As used in this section: 32
(a) “Medical management technique” means a practice which is 33
used to control the cost or utilization of health care services or 34
prescription drug use. The term includes, without limitation, the use 35
of step therapy, prior authorization or categorizing drugs and 36
devices based on cost, type or method of administration. 37
(b) “Network plan” means a policy of group health insurance 38
offered by an insurer under which the financing and delivery of 39
medical care, including items and services paid for as medical care, 40
are provided, in whole or in part, through a defined set of providers 41
under contract with the insurer. The term does not include an 42
arrangement for the financing of premiums. 43
(c) “Provider of health care” has the meaning ascribed to it in 44
NRS 629.031. 45
– 36 –
- *AB522*
Sec. 28. NRS 689B.0675 is hereby amended to read as 1
follows: 2
689B.0675 1. An insurer that issues a policy of group health 3
insurance shall not discriminate against any person with respect to 4
participation or coverage under the policy on the basis of an actual 5
or perceived [gender identity or expression.] protected 6
characteristic. 7
2. Prohibited discrimination includes, without limitation: 8
[1.] (a) Denying, cancelling, limiting or refusing to issue or 9
renew a policy of group health insurance on the basis of [the] an 10
actual or perceived [gender identity or expression] protected 11
characteristic of a person or a family member of the person; 12
[2.] (b) Imposing a payment or premium that is based on [the] 13
an actual or perceived [gender identity or expression] protected 14
characteristic of an insured or a family member of the insured; 15
[3.] (c) Designating [the] an actual or perceived [gender 16
identity or expression] protected characteristic of a person or a 17
family member of the person as grounds to deny, cancel or limit 18
participation or coverage; and 19
[4.] (d) Denying, cancelling or limiting participation or 20
coverage on the basis of an actual or perceived [gender identity or 21
expression,] protected characteristic, including, without limitation, 22
by limiting or denying coverage for health care services that are: 23
[(a)] (1) Related to gender transition, provided that there is 24
coverage under the policy for the services when the services are not 25
related to gender transition; or 26
[(b)] (2) Ordinarily or exclusively available to persons of any 27
sex. 28
3. As used in this section, “protected characteristic” means: 29
(a) Race, color, national origin, age, physical or mental 30
disability, sexual orientation or gender identity or expression; or 31
(b) Sex, including, without limitation, sex characteristics, 32
intersex traits and pregnancy or related conditions. 33
Sec. 29. NRS 689B.520 is hereby amended to read as follows: 34
689B.520 1. An insurer that offers or issues a group health 35
plan subject to the provisions of this chapter shall include in the 36
plan coverage for maternity care and pediatric care for newborn 37
infants. 38
2. Except as otherwise provided in this subsection, a group 39
health plan or coverage offered under group health insurance issued 40
pursuant to this chapter [that includes coverage for maternity care 41
and pediatric care for newborn infants] may not restrict benefits for 42
any length of stay in a hospital in connection with childbirth for a 43
pregnant or postpartum individual or newborn infant covered by the 44
plan or coverage to: 45
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(a) Less than 48 hours after a normal vaginal delivery; and 1
(b) Less than 96 hours after a cesarean section. 2
If a different length of stay is provided in the guidelines 3
established by the American College of Obstetricians and 4
Gynecologists, or its successor organization, and the American 5
Academy of Pediatrics, or its successor organization, the group 6
health plan or health insurance coverage may follow such guidelines 7
in lieu of following the length of stay set forth above. The 8
provisions of this subsection do not apply to any group health plan 9
or health insurance coverage in any case in which the decision to 10
discharge the pregnant or postpartum individual or newborn infant 11
before the expiration of the minimum length of stay set forth in this 12
subsection is made by the attending physician of the pregnant or 13
postpartum individual or newborn infant. 14
[2.] 3. Nothing in this section requires a pregnant or 15
postpartum individual to: 16
(a) Deliver the baby in a hospital; or 17
(b) Stay in a hospital for a fixed period following the birth of the 18
child. 19
[3.] 4. A group health plan or coverage under group health 20
insurance [that offers coverage for maternity care and pediatric care 21
of newborn infants] may not: 22
(a) Deny a pregnant or postpartum individual or the newborn 23
infant coverage or continued coverage under the terms of the plan 24
[or coverage] if the sole purpose of the denial of coverage or 25
continued coverage is to avoid the requirements of this section; 26
(b) Provide monetary payments or rebates to a pregnant or 27
postpartum individual to encourage the individual to accept less than 28
the minimum protection available pursuant to this section; 29
(c) Penalize, or otherwise reduce or limit, the reimbursement of 30
an attending provider of health care because the attending provider 31
of health care provided care to a pregnant or postpartum individual 32
or newborn infant in accordance with the provisions of this section; 33
(d) Provide incentives of any kind to an attending physician to 34
induce the attending physician to provide care to a pregnant or 35
postpartum individual or newborn infant in a manner that is 36
inconsistent with the provisions of this section; or 37
(e) Except as otherwise provided in subsection [4,] 5, restrict 38
benefits for any portion of a hospital stay required pursuant to the 39
provisions of this section in a manner that is less favorable than the 40
benefits provided for any preceding portion of that stay. 41
[4.] 5. Nothing in this section: 42
(a) Prohibits a group health plan or carrier from imposing a 43
deductible, coinsurance or other mechanism for sharing costs 44
relating to benefits for hospital stays in connection with childbirth 45
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- *AB522*
for a pregnant or postpartum individual or newborn child covered by 1
the plan, except that such coinsurance or other mechanism for 2
sharing costs for any portion of a hospital stay required by this 3
section may not be greater than the coinsurance or other mechanism 4
for any preceding portion of that stay. 5
(b) Prohibits an arrangement for payment between a group 6
health plan or carrier and a provider of health care that uses 7
capitation or other financial incentives, if the arrangement is 8
designed to provide services efficiently and consistently in the best 9
interest of the pregnant or postpartum individual and the newborn 10
infant. 11
(c) Prevents a group health plan or carrier from negotiating with 12
a provider of health care concerning the level and type of 13
reimbursement to be provided in accordance with this section. 14
6. A group health plan subject to the provisions of this 15
chapter that is delivered, issued for delivery or renewed on or after 16
October 1, 2025, has the legal effect of including the coverage 17
required by this section, and any provision of the plan that 18
conflicts with the provisions of this section is void. 19
Sec. 30. Chapter 689C of NRS is hereby amended by adding 20
thereto the provisions set forth as sections 31 to 35, inclusive, of this 21
act. 22
Sec. 31. 1. A carrier that offers or issues a health benefit 23
plan which provides coverage for dependent children shall 24
continue to make such coverage available for an adult child of an 25
insured until such child reaches 26 years of age. 26
2. Nothing in this section shall be construed as requiring a 27
carrier to make coverage available for a dependent of an adult 28
child of an insured. 29
Sec. 32. 1. A carrier that offers or issues a health benefit 30
plan shall include in the plan coverage for: 31
(a) Screening for anxiety for insureds who are at least 8 but 32
not more than 18 years of age; 33
(b) Assessments relating to height, weight, body mass index 34
and medical history for insureds who are less than 18 years of 35
age; 36
(c) Comprehensive and intensive behavioral interventions for 37
insureds who are at least 12 but not more than 18 years of age and 38
have a body mass index in the 95th percentile or greater for 39
persons of the same age and sex; 40
(d) The application of fluoride varnish to the primary teeth for 41
insureds who are less than 5 years of age; 42
(e) Oral fluoride supplements for insureds who are at least 6 43
months of age but less than 5 years of age and whose supply of 44
water is deficient in fluoride; 45
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(f) Counseling and education pertaining to the minimization of 1
exposure to ultraviolet radiation for insureds who are less than 25 2
years of age and have fair skin types and the parents or legal 3
guardians of insureds who are less than 18 years of age and have 4
fair skin types for the purpose of minimizing the risk of skin 5
cancer in those persons; 6
(g) Brief behavioral counseling and interventions to prevent 7
tobacco use for insureds who are less than 18 years of age; 8
(h) At least one screening for the detection of amblyopia or the 9
risk factors of amblyopia for insureds who are at least 3 but not 10
more than 5 years of age; and 11
(i) Screening, tests and counseling for such other health 12
conditions and diseases as recommended by the Health Resources 13
and Services Administration on January 1, 2025, for insureds who 14
are less than 18 years of age. 15
2. A carrier must ensure that the benefits required by 16
subsection 1 are made available to an insured through a provider 17
of health care who participates in the network plan of the carrier. 18
3. Except as otherwise provided in subsection 5, a carrier that 19
offers or issues a health benefit plan shall not: 20
(a) Require an insured to pay a higher deductible, any 21
copayment or coinsurance or require a longer waiting period or 22
other condition to obtain any benefit provided in the health benefit 23
plan pursuant to subsection 1; 24
(b) Refuse to issue a health benefit plan or cancel a health 25
benefit plan solely because the person applying for or covered by 26
the plan uses or may use any such benefit; 27
(c) Offer or pay any type of material inducement or financial 28
incentive to an insured to discourage the insured from obtaining 29
any such benefit; 30
(d) Penalize a provider of health care who provides any such 31
benefit to an insured, including, without limitation, reducing the 32
reimbursement of the provider of health care; 33
(e) Offer or pay any type of material inducement, bonus or 34
other financial incentive to a provider of health care to deny, 35
reduce, withhold, limit or delay access to any such benefit to an 36
insured; or 37
(f) Impose any other restrictions or delays on the access of an 38
insured to any such benefit. 39
4. A health benefit plan subject to the provisions of this 40
chapter that is delivered, issued for delivery or renewed on or after 41
October 1, 2025, has the legal effect of including the coverage 42
required by subsection 1, and any provision of the plan or the 43
renewal which is in conflict with this section is void. 44
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5. Except as otherwise provided in this section and federal 1
law, a carrier may use medical management techniques, 2
including, without limitation, any available clinical evidence, to 3
determine the frequency of or treatment relating to any benefit 4
required by this section or the type of provider of health care to 5
use for such treatment. 6
6. As used in this section: 7
(a) “Medical management technique” means a practice which 8
is used to control the cost or utilization of health care services or 9
prescription drug use. The term includes, without limitation, the 10
use of step therapy, prior authorization or categorizing drugs and 11
devices based on cost, type or method of administration. 12
(b) “Provider of health care” has the meaning ascribed to it in 13
NRS 629.031. 14
Sec. 33. 1. A carrier that offers or issues a health benefit 15
plan shall include in the plan coverage for: 16
(a) A daily dose of 0.4 to 0.8 milligrams of folic acid for 17
insureds who are pregnant or are planning on becoming 18
pregnant; 19
(b) A low dose of aspirin for the prevention of preeclampsia 20
for insureds who are determined to be at a high risk of that 21
condition after 12 weeks of gestation; 22
(c) Prophylactic ocular tubal medication for the prevention of 23
gonococcal ophthalmia in newborns; 24
(d) Screening for asymptomatic bacteriuria for insureds who 25
are pregnant; 26
(e) Counseling and behavioral interventions relating to the 27
promotion of healthy weight gain and the prevention of excessive 28
weight gain for insureds who are pregnant; 29
(f) Counseling for insureds who are pregnant or in the 30
postpartum stage of pregnancy and have an increased risk of 31
perinatal or postpartum depression; 32
(g) Screening for the presence of the rhesus D antigen and 33
antibodies in the blood of an insured who is pregnant during the 34
insured’s first visit for care relating to the pregnancy; 35
(h) Screening for rhesus D antibodies between 24 and 28 36
weeks of gestation for insureds who are negative for the rhesus D 37
antigen and have not been exposed to blood that is positive for the 38
rhesus D antigen; 39
(i) Behavioral counseling and intervention for tobacco 40
cessation for insureds who are pregnant; 41
(j) An annual screening for urinary incontinence for women; 42
(k) Screening for type 2 diabetes at such intervals as 43
recommended by the Health Resources and Services 44
Administration on January 1, 2025, for insureds who are in the 45
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postpartum stage of pregnancy and who have a history of 1
gestational diabetes mellitus; 2
(l) Counseling relating to maintaining a healthy weight for 3
women who are at least 40 but not more than 60 years of age and 4
have a body mass index greater than 18.5; and 5
(m) Screening for osteoporosis for women who: 6
(1) Are 65 years of age or older; or 7
(2) Are less than 65 years of age and have a risk of 8
fracturing a bone equal to or greater than that of a woman who is 9
65 years of age without any additional risk factors. 10
2. A carrier must ensure that the benefits required by 11
subsection 1 are made available to an insured through a provider 12
of health care who participates in the network plan of the carrier. 13
3. Except as otherwise provided in subsection 5, a carrier that 14
offers or issues a health benefit plan shall not: 15
(a) Require an insured to pay a higher deductible, any 16
copayment or coinsurance or require a longer waiting period or 17
other condition to obtain any benefit provided in the health benefit 18
plan pursuant to subsection 1; 19
(b) Refuse to issue a health benefit plan or cancel a health 20
benefit plan solely because the person applying for or covered by 21
the plan uses or may use any such benefit; 22
(c) Offer or pay any type of material inducement or financial 23
incentive to an insured to discourage the insured from obtaining 24
any such benefit; 25
(d) Penalize a provider of health care who provides any such 26
benefit to an insured, including, without limitation, reducing the 27
reimbursement of the provider of health care; 28
(e) Offer or pay any type of material inducement, bonus or 29
other financial incentive to a provider of health care to deny, 30
reduce, withhold, limit or delay access to any such benefit to an 31
insured; or 32
(f) Impose any other restrictions or delays on the access of an 33
insured to any such benefit. 34
4. A health benefit plan subject to the provisions of this 35
chapter that is delivered, issued for delivery or renewed on or after 36
October 1, 2025, has the legal effect of including the coverage 37
required by subsection 1, and any provision of the plan or the 38
renewal which is in conflict with this section is void. 39
5. Except as otherwise provided in this section and federal 40
law, a carrier may use medical management techniques, 41
including, without limitation, any available clinical evidence, to 42
determine the frequency of or treatment relating to any benefit 43
required by this section or the type of provider of health care to 44
use for such treatment. 45
– 42 –
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6. As used in this section: 1
(a) “Medical management technique” means a practice which 2
is used to control the cost or utilization of health care services or 3
prescription drug use. The term includes, without limitation, the 4
use of step therapy, prior authorization or categorizing drugs and 5
devices based on cost, type or method of administration. 6
(b) “Provider of health care” has the meaning ascribed to it in 7
NRS 629.031. 8
Sec. 34. 1. A carrier that offers or issues a health benefit 9
plan shall include in the plan coverage for: 10
(a) Behavioral counseling and interventions to promote 11
physical activity and a healthy diet for insureds with 12
cardiovascular risk factors; 13
(b) Statin preventive medication for insureds who are at least 14
40 but not more than 75 years of age and do not have a history of 15
cardiovascular disease, but who have: 16
(1) One or more risk factors for cardiovascular disease; 17
and 18
(2) A calculated risk of at least 10 percent of acquiring 19
cardiovascular disease within the next 10 years; 20
(c) Interventions for exercise to prevent falls for insureds who 21
are 65 years of age or older and reside in a medical facility or 22
facility for the dependent; 23
(d) Screenings for latent tuberculosis infection in insureds 24
with an increased risk of contracting tuberculosis; 25
(e) Screening for hypertension; 26
(f) One abdominal aortic screening by ultrasound to detect 27
abdominal aortic aneurysms for men who are at least 65 but not 28
more than 75 years of age and have smoked during their lifetimes; 29
(g) Screening for drug and alcohol misuse for insureds who 30
are 18 years of age or older; 31
(h) If an insured engages in risky or hazardous consumption 32
of alcohol, as determined by the screening described in paragraph 33
(g), behavioral counseling to reduce such behavior; 34
(i) Screening for lung cancer using low-dose computed 35
tomography for insureds who are at least 50 but not more than 80 36
years of age and: 37
(1) Have a smoking history of 20 pack-years; 38
(2) Smoke or have stopped smoking within the immediately 39
preceding 15 years; and 40
(3) Do not suffer from a health problem that substantially 41
limits the life expectancy of the person or the willingness of the 42
person to undergo curative surgery; 43
– 43 –
- *AB522*
(j) Screening for prediabetes and type 2 diabetes in insureds 1
who are at least 35 but not more than 70 years of age and have a 2
body mass index of 25 or greater; and 3
(k) Intensive behavioral interventions with multiple 4
components for insureds who are 18 years of age or older and 5
have a body mass index of 30 or greater. 6
2. The benefits provided pursuant to paragraph (h) of 7
subsection 1 are in addition to and separate from the benefits 8
provided pursuant to NRS 689C.167. 9
3. A carrier must ensure that the benefits required by 10
subsection 1 are made available to an insured through a provider 11
of health care who participates in the network plan of the carrier. 12
4. Except as otherwise provided in subsection 6, a carrier that 13
offers or issues a health benefit plan shall not: 14
(a) Require an insured to pay a higher deductible, any 15
copayment or coinsurance or require a longer waiting period or 16
other condition to obtain any benefit provided in the health benefit 17
plan pursuant to subsection 1; 18
(b) Refuse to issue a health benefit plan or cancel a health 19
benefit plan solely because the person applying for or covered by 20
the plan uses or may use any such benefit; 21
(c) Offer or pay any type of material inducement or financial 22
incentive to an insured to discourage the insured from obtaining 23
any such benefit; 24
(d) Penalize a provider of health care who provides any such 25
benefit to an insured, including, without limitation, reducing the 26
reimbursement of the provider of health care; 27
(e) Offer or pay any type of material inducement, bonus or 28
other financial incentive to a provider of health care to deny, 29
reduce, withhold, limit or delay access to any such benefit to an 30
insured; or 31
(f) Impose any other restrictions or delays on the access of an 32
insured to any such benefit. 33
5. A health benefit plan subject to the provisions of this 34
chapter that is delivered, issued for delivery or renewed on or after 35
October 1, 2025, has the legal effect of including the coverage 36
required by subsection 1, and any provision of the plan or the 37
renewal which is in conflict with this section is void. 38
6. Except as otherwise provided in this section and federal 39
law, a carrier may use medical management techniques, 40
including, without limitation, any available clinical evidence, to 41
determine the frequency of or treatment relating to any benefit 42
required by this section or the type of provider of health care to 43
use for such treatment. 44
7. As used in this section: 45
– 44 –
- *AB522*
(a) “Computed tomography” means the process of producing 1
sectional and three-dimensional images using external ionizing 2
radiation. 3
(b) “Facility for the dependent” has the meaning ascribed to it 4
in NRS 449.0045. 5
(c) “Medical facility” has the meaning ascribed to it in 6
NRS 449.0151. 7
(d) “Medical management technique” means a practice which 8
is used to control the cost or utilization of health care services or 9
prescription drug use. The term includes, without limitation, the 10
use of step therapy, prior authorization or categorizing drugs and 11
devices based on cost, type or method of administration. 12
(e) “Pack-year” means the product of the number of packs of 13
cigarettes smoked per day and the number of years that the person 14
has smoked. 15
(f) “Provider of health care” has the meaning ascribed to it in 16
NRS 629.031. 17
Sec. 35. 1. A health benefit plan must provide coverage for 18
colorectal cancer screening in accordance with: 19
(a) The guidelines concerning colorectal cancer screening 20
which are published by the American Cancer Society; or 21
(b) Other guidelines or reports concerning colorectal cancer 22
screening which are published by nationally recognized 23
professional organizations and which include current or 24
prevailing supporting scientific data. 25
2. A carrier must ensure that the benefits required by 26
subsection 1 are made available to an insured through a provider 27
of health care who participates in the network plan of the carrier. 28
3. A carrier that offers or issues a health benefit plan shall 29
not: 30
(a) Require an insured to pay a higher deductible, any 31
copayment or coinsurance or require a longer waiting period or 32
other condition to obtain any benefit provided in the health benefit 33
plan pursuant to subsection 1; 34
(b) Refuse to issue a health benefit plan or cancel a health 35
benefit plan solely because the person applying for or covered by 36
the plan uses or may use any such benefit; 37
(c) Offer or pay any type of material inducement or financial 38
incentive to an insured to discourage the insured from obtaining 39
any such benefit; 40
(d) Penalize a provider of health care who provides any such 41
benefit to an insured, including, without limitation, reducing the 42
reimbursement of the provider of health care; 43
(e) Offer or pay any type of material inducement, bonus or 44
other financial incentive to a provider of health care to deny, 45
– 45 –
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reduce, withhold, limit or delay access to any such benefit to an 1
insured; or 2
(f) Impose any other restrictions or delays on the access of an 3
insured to any such benefit. 4
4. A health benefit plan subject to the provisions of this 5
chapter that is delivered, issued for delivery or renewed on or after 6
October 1, 2025, has the legal effect of including the coverage 7
required by this section, and any provision of the policy that 8
conflicts with the provisions of this section is void. 9
5. As used in this section, “provider of health care” has the 10
meaning ascribed to it in NRS 629.031. 11
Sec. 36. NRS 689C.1653 is hereby amended to read as 12
follows: 13
689C.1653 1. A carrier that offers or issues a health benefit 14
plan shall include in the plan: 15
(a) Coverage of testing for and the treatment and prevention of 16
sexually transmitted diseases, including, without limitation, 17
Chlamydia trachomatis, gonorrhea, syphilis, human 18
immunodeficiency virus and hepatitis B and C, for all insureds, 19
regardless of age. Such coverage must include, without limitation, 20
the coverage required by NRS 689C.1671 and 689C.1675. 21
(b) Unrestricted coverage of condoms for insureds who are 13 22
years of age or older. 23
2. A carrier that offers or issues a health benefit plan shall 24
not: 25
(a) Require an insured to pay a higher deductible, any 26
copayment or coinsurance or require a longer waiting period or 27
other condition to obtain any benefit provided in the health benefit 28
plan pursuant to subsection 1; 29
(b) Refuse to issue a health benefit plan or cancel a health 30
benefit plan solely because the person applying for or covered by 31
the plan uses or may use any such benefit; 32
(c) Offer or pay any type of material inducement or financial 33
incentive to an insured to discourage the insured from obtaining 34
any such benefit; 35
(d) Penalize a provider of health care who provides any such 36
benefit to an insured, including, without limitation, reducing the 37
reimbursement of the provider of health care; 38
(e) Offer or pay any type of material inducement, bonus or 39
other financial incentive to a provider of health care to deny, 40
reduce, withhold, limit or delay access to any such benefit to an 41
insured; or 42
(f) Impose any other restrictions or delays on the access of an 43
insured to any such benefit. 44
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3. A health benefit plan subject to the provisions of this chapter 1
that is delivered, issued for delivery or renewed on or after [January] 2
October 1, [2024,] 2025, has the legal effect of including the 3
coverage required by subsection 1, and any provision of the plan 4
that conflicts with the provisions of this section is void. 5
4. As used in this section, “provider of health care” has the 6
meaning ascribed to it in NRS 629.031. 7
Sec. 37. NRS 689C.1673 is hereby amended to read as 8
follows: 9
689C.1673 1. A carrier that issues a health benefit plan shall 10
provide coverage for screening, genetic counseling and testing for 11
harmful mutations in the BRCA gene for women under 12
circumstances where such screening, genetic counseling or testing, 13
as applicable, is required by NRS 457.301. 14
2. A carrier shall ensure that the benefits required by 15
subsection 1 are made available to an insured through a provider of 16
health care who participates in the network plan of the carrier. 17
3. A carrier that issues a health benefit plan shall not: 18
(a) Require an insured to pay a higher deductible, any 19
copayment or coinsurance or require a longer waiting period or 20
other condition to obtain any benefit provided in the health benefit 21
plan pursuant to subsection 1; 22
(b) Refuse to issue a health benefit plan or cancel a health 23
benefit plan solely because the person applying for or covered by 24
the plan uses or may use any such benefit; 25
(c) Offer or pay any type of material inducement or financial 26
incentive to an insured to discourage the insured from obtaining 27
any such benefit; 28
(d) Penalize a provider of health care who provides any such 29
benefit to an insured, including, without limitation, reducing the 30
reimbursement of the provider of health care; 31
(e) Offer or pay any type of material inducement, bonus or 32
other financial incentive to a provider of health care to deny, 33
reduce, withhold, limit or delay access to any such benefit to an 34
insured; or 35
(f) Impose any other restrictions or delays on the access of an 36
insured to any such benefit. 37
4. A health benefit plan subject to the provisions of this chapter 38
that is delivered, issued for delivery or renewed on or after [January] 39
October 1, [2022,] 2025, has the legal effect of including the 40
coverage required by subsection 1, and any provision of the plan 41
that conflicts with the provisions of this section is void. 42
[4.] 5. As used in this section, “provider of health care” has the 43
meaning ascribed to it in NRS 629.031. 44
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Sec. 38. NRS 689C.1674 is hereby amended to read as 1
follows: 2
689C.1674 1. A health benefit plan must provide coverage 3
for benefits payable for expenses incurred for: 4
(a) A mammogram to screen for breast cancer annually for 5
insureds who are 40 years of age or older. 6
(b) An imaging test to screen for breast cancer on an interval 7
and at the age deemed most appropriate, when medically necessary, 8
as recommended by the insured’s provider of health care based on 9
personal or family medical history or additional factors that may 10
increase the risk of breast cancer for the insured. 11
(c) A diagnostic imaging test for breast cancer at the age deemed 12
most appropriate, when medically necessary, as recommended by 13
the insured’s provider of health care to evaluate an abnormality 14
which is: 15
(1) Seen or suspected from a mammogram described in 16
paragraph (a) or an imaging test described in paragraph (b); or 17
(2) Detected by other means of examination. 18
(d) Medication to prevent breast cancer for insureds who are 19
at a high risk of developing breast cancer and have a low risk of 20
adverse side effects from the medication. 21
2. A carrier must ensure that the benefits required by 22
subsection 1 are made available to an insured through a provider of 23
health care who participates in the network plan of the carrier. 24
3. Except as otherwise provided in subsection 5, a carrier that 25
offers or issues a health benefit plan shall not: 26
(a) Except as otherwise provided in subsection 6, require an 27
insured to pay a deductible, copayment, coinsurance or any other 28
form of cost-sharing or require a longer waiting period or other 29
condition to obtain any benefit provided in the health benefit plan 30
pursuant to subsection 1; 31
(b) Refuse to issue a health benefit plan or cancel a health 32
benefit plan solely because the person applying for or covered by 33
the plan uses or may use any such benefit; 34
(c) Offer or pay any type of material inducement or financial 35
incentive to an insured to discourage the insured from obtaining any 36
such benefit; 37
(d) Penalize a provider of health care who provides any such 38
benefit to an insured, including, without limitation, reducing the 39
reimbursement of the provider of health care; 40
(e) Offer or pay any type of material inducement, bonus or other 41
financial incentive to a provider of health care to deny, reduce, 42
withhold, limit or delay access to any such benefit to an insured; or 43
(f) Impose any other restrictions or delays on the access of an 44
insured to any such benefit. 45
– 48 –
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4. A plan subject to the provisions of this chapter which is 1
delivered, issued for delivery or renewed on or after [January] 2
October 1, [2024,] 2025, has the legal effect of including the 3
coverage required by subsection 1, and any provision of the plan or 4
the renewal which is in conflict with this section is void. 5
5. Except as otherwise provided in this section and federal law, 6
a carrier may use medical management techniques, including, 7
without limitation, any available clinical evidence, to determine the 8
frequency of or treatment relating to any benefit required by this 9
section or the type of provider of health care to use for such 10
treatment. 11
6. If the application of paragraph (a) of subsection 3 would 12
result in the ineligibility of a health savings account of an insured 13
pursuant to 26 U.S.C. § 223, the prohibitions of paragraph (a) of 14
subsection 3 shall apply only for a qualified health benefit plan with 15
respect to the deductible of such a health benefit plan after the 16
insured has satisfied the minimum deductible pursuant to 26 U.S.C. 17
§ 223, except with respect to items or services that constitute 18
preventive care pursuant to 26 U.S.C. § 223(c)(2)(C), in which case 19
the prohibitions of paragraph (a) of subsection 3 shall apply 20
regardless of whether the minimum deductible under 26 U.S.C. § 21
223 has been satisfied. 22
7. As used in this section: 23
(a) “Medical management technique” means a practice which is 24
used to control the cost or utilization of health care services or 25
prescription drug use. The term includes, without limitation, the use 26
of step therapy, prior authorization or categorizing drugs and 27
devices based on cost, type or method of administration. 28
(b) “Network plan” means a health benefit plan offered by a 29
carrier under which the financing and delivery of medical care, 30
including items and services paid for as medical care, are provided, 31
in whole or in part, through a defined set of providers under contract 32
with the carrier. The term does not include an arrangement for the 33
financing of premiums. 34
(c) “Provider of health care” has the meaning ascribed to it in 35
NRS 629.031. 36
(d) “Qualified health benefit plan” means a health benefit plan 37
that has a high deductible and is in compliance with 26 U.S.C. § 223 38
for the purposes of establishing a health savings account. 39
Sec. 39. NRS 689C.1675 is hereby amended to read as 40
follows: 41
689C.1675 1. A carrier that issues a health benefit plan shall 42
provide coverage for the examination of a person who is pregnant 43
for the discovery of: 44
– 49 –
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(a) Chlamydia trachomatis, gonorrhea, hepatitis B and hepatitis 1
C in accordance with NRS 442.013. 2
(b) Syphilis in accordance with NRS 442.010. 3
(c) Human immunodeficiency virus. 4
2. The coverage required by this section must be provided: 5
(a) Regardless of whether the benefits are provided to the 6
insured by a provider of health care, facility or medical laboratory 7
that participates in the network plan of the carrier; and 8
(b) Without prior authorization. 9
3. A carrier that issues a health benefit plan shall not: 10
(a) Require an insured to pay a higher deductible, any 11
copayment or coinsurance or require a longer waiting period or 12
other condition to obtain any benefit provided in the health benefit 13
plan pursuant to subsection 1; 14
(b) Refuse to issue a health benefit plan or cancel a health 15
benefit plan solely because the person applying for or covered by 16
the plan uses or may use any such benefit; 17
(c) Offer or pay any type of material inducement or financial 18
incentive to an insured to discourage the insured from obtaining 19
any such benefit; 20
(d) Penalize a provider of health care who provides any such 21
benefit to an insured, including, without limitation, reducing the 22
reimbursement of the provider of health care; 23
(e) Offer or pay any type of material inducement, bonus or 24
other financial incentive to a provider of health care to deny, 25
reduce, withhold, limit or delay access to any such benefit to an 26
insured; or 27
(f) Impose any other restrictions or delays on the access of an 28
insured to any such benefit. 29
4. A health benefit plan subject to the provisions of this chapter 30
that is delivered, issued for delivery or renewed on or after [July] 31
October 1, [2021,] 2025, has the legal effect of including the 32
coverage required by subsection 1, and any provision of the plan 33
that conflicts with the provisions of this section is void. 34
[4.] 5. As used in this section: 35
(a) “Medical laboratory” has the meaning ascribed to it in 36
NRS 652.060. 37
(b) “Provider of health care” has the meaning ascribed to it in 38
NRS 629.031. 39
Sec. 40. NRS 689C.1678 is hereby amended to read as 40
follows: 41
689C.1678 1. A carrier that offers or issues a health benefit 42
plan shall include in the plan coverage for: 43
(a) Counseling, support and supplies for breastfeeding, 44
including breastfeeding equipment, counseling and education during 45
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the antenatal, perinatal and postpartum period for not more than 1 1
year; 2
(b) Screening and counseling for interpersonal and domestic 3
violence for women at least annually, with initial intervention 4
services consisting of education, strategies to reduce harm, 5
supportive services or a referral for any other appropriate services; 6
(c) Behavioral counseling concerning sexually transmitted 7
diseases from a provider of health care for sexually active [women] 8
insureds who are at increased risk for such diseases; 9
(d) Hormone replacement therapy; 10
(e) Such prenatal screenings and tests as recommended by the 11
American College of Obstetricians and Gynecologists or its 12
successor organization; 13
(f) Screening for blood pressure abnormalities and diabetes, 14
including gestational diabetes, after at least 24 weeks of gestation or 15
as ordered by a provider of health care; 16
(g) Screening for cervical cancer at such intervals as are 17
recommended by the American College of Obstetricians and 18
Gynecologists or its successor organization; 19
(h) Screening for depression [;] for insureds who are 12 years 20
of age or older; 21
(i) Screening for anxiety disorders; 22
(j) Screening and counseling for the human immunodeficiency 23
virus consisting of a risk assessment, annual education relating to 24
prevention and at least one screening for the virus during the 25
lifetime of the insured or as ordered by a provider of health care; 26
[(j) Smoking] 27
(k) Tobacco cessation programs , including, without limitation, 28
pharmacotherapy approved by the United States Food and Drug 29
Administration, for an insured who is 18 years of age or older 30
consisting of not more than two cessation attempts per year and four 31
counseling sessions per year; 32
[(k)] (l) All vaccinations recommended by the Advisory 33
Committee on Immunization Practices of the Centers for Disease 34
Control and Prevention of the United States Department of Health 35
and Human Services or its successor organization; and 36
[(l)] (m) Such well-woman preventative visits as recommended 37
by the Health Resources and Services Administration [,] on 38
January 1, 2025, which must include at least one such visit per year 39
beginning at 14 years of age. 40
2. A carrier must ensure that the benefits required by 41
subsection 1 are made available to an insured through a provider of 42
health care who participates in the network plan of the carrier. 43
3. Except as otherwise provided in subsection 5, a carrier that 44
offers or issues a health benefit plan shall not: 45
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(a) Require an insured to pay a higher deductible, any 1
copayment or coinsurance or require a longer waiting period or 2
other condition to obtain any benefit provided in the health benefit 3
plan pursuant to subsection 1; 4
(b) Refuse to issue a health benefit plan or cancel a health 5
benefit plan solely because the person applying for or covered by 6
the plan uses or may use any such benefit; 7
(c) Offer or pay any type of material inducement or financial 8
incentive to an insured to discourage the insured from obtaining any 9
such benefit; 10
(d) Penalize a provider of health care who provides any such 11
benefit to an insured, including, without limitation, reducing the 12
reimbursement of the provider of health care; 13
(e) Offer or pay any type of material inducement, bonus or other 14
financial incentive to a provider of health care to deny, reduce, 15
withhold, limit or delay access to any such benefit to an insured; or 16
(f) Impose any other restrictions or delays on the access of an 17
insured to any such benefit. 18
4. A plan subject to the provisions of this chapter that is 19
delivered, issued for delivery or renewed on or after [January] 20
October 1, [2018,] 2025, has the legal effect of including the 21
coverage required by subsection 1, and any provision of the plan or 22
the renewal which is in conflict with this section is void. 23
5. Except as otherwise provided in this section and federal law, 24
a carrier may use medical management techniques, including, 25
without limitation, any available clinical evidence, to determine the 26
frequency of or treatment relating to any benefit required by this 27
section or the type of provider of health care to use for such 28
treatment. 29
6. As used in this section: 30
(a) “Medical management technique” means a practice which is 31
used to control the cost or utilization of health care services or 32
prescription drug use. The term includes, without limitation, the use 33
of step therapy, prior authorization or categorizing drugs and 34
devices based on cost, type or method of administration. 35
(b) “Network plan” means a health benefit plan offered by a 36
carrier under which the financing and delivery of medical care, 37
including items and services paid for as medical care, are provided, 38
in whole or in part, through a defined set of providers under contract 39
with the carrier. The term does not include an arrangement for the 40
financing of premiums. 41
(c) “Provider of health care” has the meaning ascribed to it in 42
NRS 629.031. 43
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Sec. 41. NRS 689C.194 is hereby amended to read as follows: 1
689C.194 1. A carrier that offers or issues a health benefit 2
plan subject to the provisions of this chapter shall include in the 3
plan coverage for maternity care and pediatric care for newborn 4
infants. 5
2. Except as otherwise provided in this subsection, a health 6
benefit plan issued pursuant to this chapter [that includes coverage 7
for maternity care and pediatric care for newborn infants] may not 8
restrict benefits for any length of stay in a hospital in connection 9
with childbirth for a pregnant or postpartum individual or newborn 10
infant covered by the plan to: 11
(a) Less than 48 hours after a normal vaginal delivery; and 12
(b) Less than 96 hours after a cesarean section. 13
If a different length of stay is provided in the guidelines 14
established by the American College of Obstetricians and 15
Gynecologists, or its successor organization, and the American 16
Academy of Pediatrics, or its successor organization, the health 17
benefit plan may follow such guidelines in lieu of following the 18
length of stay set forth above. The provisions of this subsection do 19
not apply to any health benefit plan in any case in which the 20
decision to discharge the pregnant or postpartum individual or 21
newborn infant before the expiration of the minimum length of stay 22
set forth in this subsection is made by the attending physician of the 23
pregnant or postpartum individual or newborn infant. 24
[2.] 3. Nothing in this section requires a pregnant or 25
postpartum individual to: 26
(a) Deliver the baby in a hospital; or 27
(b) Stay in a hospital for a fixed period following the birth of the 28
child. 29
[3.] 4. A health benefit plan [that offers coverage for maternity 30
care and pediatric care of newborn infants] may not: 31
(a) Deny a pregnant or postpartum individual or the newborn 32
infant coverage or continued coverage under the terms of the plan if 33
the sole purpose of the denial of coverage or continued coverage is 34
to avoid the requirements of this section; 35
(b) Provide monetary payments or rebates to a pregnant or 36
postpartum individual to encourage the individual to accept less than 37
the minimum protection available pursuant to this section; 38
(c) Penalize, or otherwise reduce or limit, the reimbursement of 39
an attending provider of health care because the attending provider 40
of health care provided care to a pregnant or postpartum individual 41
or newborn infant in accordance with the provisions of this section; 42
(d) Provide incentives of any kind to an attending physician to 43
induce the attending physician to provide care to a pregnant or 44
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postpartum individual or newborn infant in a manner that is 1
inconsistent with the provisions of this section; or 2
(e) Except as otherwise provided in subsection [4,] 5, restrict 3
benefits for any portion of a hospital stay required pursuant to the 4
provisions of this section in a manner that is less favorable than the 5
benefits provided for any preceding portion of that stay. 6
[4.] 5. Nothing in this section: 7
(a) Prohibits a health benefit plan or carrier from imposing a 8
deductible, coinsurance or other mechanism for sharing costs 9
relating to benefits for hospital stays in connection with childbirth 10
for a pregnant or postpartum individual or newborn child covered by 11
the plan, except that such coinsurance or other mechanism for 12
sharing costs for any portion of a hospital stay required by this 13
section may not be greater than the coinsurance or other mechanism 14
for any preceding portion of that stay. 15
(b) Prohibits an arrangement for payment between a health 16
benefit plan or carrier and a provider of health care that uses 17
capitation or other financial incentives, if the arrangement is 18
designed to provide services efficiently and consistently in the best 19
interest of the pregnant or postpartum individual and the newborn 20
infant. 21
(c) Prevents a health benefit plan or carrier from negotiating 22
with a provider of health care concerning the level and type of 23
reimbursement to be provided in accordance with this section. 24
6. A health benefit plan subject to the provisions of this 25
chapter that is delivered, issued for delivery or renewed on or after 26
October 1, 2025, has the legal effect of including the coverage 27
required by this section, and any provision of the plan that 28
conflicts with the provisions of this section is void. 29
Sec. 42. NRS 689C.1945 is hereby amended to read as 30
follows: 31
689C.1945 1. A carrier that offers or issues a health benefit 32
plan [that includes coverage for maternity care] shall not deny, limit 33
or seek reimbursement for maternity care because the insured is 34
acting as a gestational carrier. 35
2. If an insured acts as a gestational carrier, the child shall be 36
deemed to be a child of the intended parent, as defined in NRS 37
126.590, for purposes related to the health benefit plan. 38
3. As used in this section, “gestational carrier” has the meaning 39
ascribed to it in NRS 126.580. 40
Sec. 43. NRS 689C.1975 is hereby amended to read as 41
follows: 42
689C.1975 1. A carrier that issues a health benefit plan shall 43
not discriminate against any person with respect to participation or 44
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coverage under the plan on the basis of an actual or perceived 1
[gender identity or expression.] protected characteristic. 2
2. Prohibited discrimination includes, without limitation: 3
[1.] (a) Denying, cancelling, limiting or refusing to issue or 4
renew a health benefit plan on the basis of [the] an actual or 5
perceived [gender identity or expression] protected characteristic of 6
a person or a family member of the person; 7
[2.] (b) Imposing a payment or premium that is based on [the] 8
an actual or perceived [gender identity or expression] protected 9
characteristic of an insured or a family member of the insured; 10
[3.] (c) Designating [the] an actual or perceived [gender 11
identity or expression] protected characteristic of a person or a 12
family member of the person as grounds to deny, cancel or limit 13
participation or coverage; and 14
[4.] (d) Denying, cancelling or limiting participation or 15
coverage on the basis of an actual or perceived [gender identity or 16
expression,] protected characteristic, including, without limitation, 17
by limiting or denying coverage for health care services that are: 18
[(a)] (1) Related to gender transition, provided that there is 19
coverage under the plan for the services when the services are not 20
related to gender transition; or 21
[(b)] (2) Ordinarily or exclusively available to persons of any 22
sex. 23
3. As used in this section, “protected characteristic” means: 24
(a) Race, color, national origin, age, physical or mental 25
disability, sexual orientation or gender identity or expression; or 26
(b) Sex, including, without limitation, sex characteristics, 27
intersex traits and pregnancy or related conditions. 28
Sec. 44. NRS 689C.425 is hereby amended to read as follows: 29
689C.425 A voluntary purchasing group and any contract 30
issued to such a group pursuant to NRS 689C.360 to 689C.600, 31
inclusive, are subject to the provisions of NRS 689C.015 to 32
689C.355, inclusive, and sections 31 to 35, inclusive, of this act to 33
the extent applicable and not in conflict with the express provisions 34
of NRS 687B.408 and 689C.360 to 689C.600, inclusive. 35
Sec. 45. Chapter 695A of NRS is hereby amended by adding 36
thereto the provisions set forth as sections 46 to 51, inclusive, of this 37
act. 38
Sec. 46. 1. A society that offers or issues a benefit contract 39
which provides coverage for dependent children shall continue to 40
make such coverage available for an adult child of an insured 41
until such child reaches 26 years of age. 42
2. Nothing in this section shall be construed as requiring a 43
society to make coverage available for a dependent of an adult 44
child of an insured. 45
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Sec. 47. 1. A society that offers or issues a benefit contract 1
shall include in the benefit contract coverage for: 2
(a) Screening for anxiety for insureds who are at least 8 but 3
not more than 18 years of age; 4
(b) Assessments relating to height, weight, body mass index 5
and medical history for insureds who are less than 18 years of 6
age; 7
(c) Comprehensive and intensive behavioral interventions for 8
insureds who are at least 12 but not more than 18 years of age and 9
have a body mass index in the 95th percentile or greater for 10
persons of the same age and sex; 11
(d) The application of fluoride varnish to the primary teeth for 12
insureds who are less than 5 years of age; 13
(e) Oral fluoride supplements for insureds who are at least 6 14
months of age but less than 5 years of age and whose supply of 15
water is deficient in fluoride; 16
(f) Counseling and education pertaining to the minimization of 17
exposure to ultraviolet radiation for insureds who are less than 25 18
years of age and have fair skin types and the parents or legal 19
guardians of insureds who are less than 18 years of age and have 20
fair skin types for the purpose of minimizing the risk of skin 21
cancer in those persons; 22
(g) Brief behavioral counseling and interventions to prevent 23
tobacco use for insureds who are less than 18 years of age; 24
(h) At least one screening for the detection of amblyopia or the 25
risk factors of amblyopia for insureds who are at least 3 but not 26
more than 5 years of age; and 27
(i) Screening, tests and counseling for such other health 28
conditions and diseases as recommended by the Health Resources 29
and Services Administration on January 1, 2025, for insureds who 30
are less than 18 years of age. 31
2. A society must ensure that the benefits required by 32
subsection 1 are made available to an insured through a provider 33
of health care who participates in the network plan of the society. 34
3. Except as otherwise provided in subsection 5, a society that 35
offers or issues a benefit contract shall not: 36
(a) Require an insured to pay a higher deductible, any 37
copayment or coinsurance or require a longer waiting period or 38
other condition to obtain any benefit provided in the benefit 39
contract pursuant to subsection 1; 40
(b) Refuse to issue a benefit contract or cancel a benefit 41
contract solely because the person applying for or covered by the 42
benefit contract uses or may use any such benefit; 43
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- *AB522*
(c) Offer or pay any type of material inducement or financial 1
incentive to an insured to discourage the insured from obtaining 2
any such benefit; 3
(d) Penalize a provider of health care who provides any such 4
benefit to an insured, including, without limitation, reducing the 5
reimbursement of the provider of health care; 6
(e) Offer or pay any type of material inducement, bonus or 7
other financial incentive to a provider of health care to deny, 8
reduce, withhold, limit or delay access to any such benefit to an 9
insured; or 10
(f) Impose any other restrictions or delays on the access of an 11
insured to any such benefit. 12
4. A benefit contract subject to the provisions of this chapter 13
that is delivered, issued for delivery or renewed on or after 14
October 1, 2025, has the legal effect of including the coverage 15
required by subsection 1, and any provision of the contract or the 16
renewal which is in conflict with this section is void. 17
5. Except as otherwise provided in this section and federal 18
law, a society may use medical management techniques, 19
including, without limitation, any available clinical evidence, to 20
determine the frequency of or treatment relating to any benefit 21
required by this section or the type of provider of health care to 22
use for such treatment. 23
6. As used in this section: 24
(a) “Medical management technique” means a practice which 25
is used to control the cost or utilization of health care services or 26
prescription drug use. The term includes, without limitation, the 27
use of step therapy, prior authorization or categorizing drugs and 28
devices based on cost, type or method of administration. 29
(b) “Network plan” means a benefit contract offered by a 30
society under which the financing and delivery of medical care, 31
including items and services paid for as medical care, are 32
provided, in whole or in part, through a defined set of providers of 33
health care under contract with the society. The term does not 34
include an arrangement for the financing of premiums. 35
(c) “Provider of health care” has the meaning ascribed to it in 36
NRS 629.031. 37
Sec. 48. 1. A society that offers or issues a benefit contract 38
shall include in the benefit contract coverage for: 39
(a) A daily dose of 0.4 to 0.8 milligrams of folic acid for 40
insureds who are pregnant or are planning on becoming 41
pregnant; 42
(b) A low dose of aspirin for the prevention of preeclampsia 43
for insureds who are determined to be at a high risk of that 44
condition after 12 weeks of gestation; 45
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- *AB522*
(c) Prophylactic ocular tubal medication for the prevention of 1
gonococcal ophthalmia in newborns; 2
(d) Screening for asymptomatic bacteriuria for insureds who 3
are pregnant; 4
(e) Counseling and behavioral interventions relating to the 5
promotion of healthy weight gain and the prevention of excessive 6
weight gain for insureds who are pregnant; 7
(f) Counseling for insureds who are pregnant or in the 8
postpartum stage of pregnancy and have an increased risk of 9
perinatal or postpartum depression; 10
(g) Screening for the presence of the rhesus D antigen and 11
antibodies in the blood of an insured who is pregnant during the 12
insured’s first visit for care relating to the pregnancy; 13
(h) Screening for rhesus D antibodies between 24 and 28 14
weeks of gestation for insureds who are negative for the rhesus D 15
antigen and have not been exposed to blood that is positive for the 16
rhesus D antigen; 17
(i) Behavioral counseling and intervention for tobacco 18
cessation for insureds who are pregnant; 19
(j) An annual screening for urinary incontinence for women; 20
(k) Screening for type 2 diabetes at such intervals as 21
recommended by the Health Resources and Services 22
Administration on January 1, 2025, for insureds who are in the 23
postpartum stage of pregnancy and who have a history of 24
gestational diabetes mellitus; 25
(l) Counseling relating to maintaining a healthy weight for 26
women who are at least 40 but not more than 60 years of age and 27
have a body mass index greater than 18.5; and 28
(m) Screening for osteoporosis for women who: 29
(1) Are 65 years of age or older; or 30
(2) Are less than 65 years of age and have a risk of 31
fracturing a bone equal to or greater than that of a woman who is 32
65 years of age without any additional risk factors. 33
2. A society must ensure that the benefits required by 34
subsection 1 are made available to an insured through a provider 35
of health care who participates in the network plan of the society. 36
3. Except as otherwise provided in subsection 5, a society that 37
offers or issues a benefit contract shall not: 38
(a) Require an insured to pay a higher deductible, any 39
copayment or coinsurance or require a longer waiting period or 40
other condition to obtain any benefit provided in the benefit 41
contract pursuant to subsection 1; 42
(b) Refuse to issue a benefit contract or cancel a benefit 43
contract solely because the person applying for or covered by the 44
benefit contract uses or may use any such benefit; 45
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(c) Offer or pay any type of material inducement or financial 1
incentive to an insured to discourage the insured from obtaining 2
any such benefit; 3
(d) Penalize a provider of health care who provides any such 4
benefit to an insured, including, without limitation, reducing the 5
reimbursement of the provider of health care; 6
(e) Offer or pay any type of material inducement, bonus or 7
other financial incentive to a provider of health care to deny, 8
reduce, withhold, limit or delay access to any such benefit to an 9
insured; or 10
(f) Impose any other restrictions or delays on the access of an 11
insured to any such benefit. 12
4. A benefit contract subject to the provisions of this chapter 13
that is delivered, issued for delivery or renewed on or after 14
October 1, 2025, has the legal effect of including the coverage 15
required by subsection 1, and any provision of the contract or the 16
renewal which is in conflict with this section is void. 17
5. Except as otherwise provided in this section and federal 18
law, a society may use medical management techniques, 19
including, without limitation, any available clinical evidence, to 20
determine the frequency of or treatment relating to any benefit 21
required by this section or the type of provider of health care to 22
use for such treatment. 23
6. As used in this section: 24
(a) “Medical management technique” means a practice which 25
is used to control the cost or utilization of health care services or 26
prescription drug use. The term includes, without limitation, the 27
use of step therapy, prior authorization or categorizing drugs and 28
devices based on cost, type or method of administration. 29
(b) “Network plan” means a benefit contract offered by a 30
society under which the financing and delivery of medical care, 31
including items and services paid for as medical care, are 32
provided, in whole or in part, through a defined set of providers of 33
health care under contract with the society. The term does not 34
include an arrangement for the financing of premiums. 35
(c) “Provider of health care” has the meaning ascribed to it in 36
NRS 629.031. 37
Sec. 49. 1. A society that offers or issues a benefit contract 38
shall include in the benefit contract coverage for: 39
(a) Behavioral counseling and interventions to promote 40
physical activity and a healthy diet for insureds with 41
cardiovascular risk factors; 42
(b) Statin preventive medication for insureds who are at least 43
40 but not more than 75 years of age and do not have a history of 44
cardiovascular disease, but who have: 45
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- *AB522*
(1) One or more risk factors for cardiovascular disease; 1
and 2
(2) A calculated risk of at least 10 percent of acquiring 3
cardiovascular disease within the next 10 years; 4
(c) Interventions for exercise to prevent falls for insureds who 5
are 65 years of age or older and reside in a medical facility or 6
facility for the dependent; 7
(d) Screenings for latent tuberculosis infection in insureds 8
with an increased risk of contracting tuberculosis; 9
(e) Screening for hypertension; 10
(f) One abdominal aortic screening by ultrasound to detect 11
abdominal aortic aneurysms for men who are at least 65 but not 12
more than 75 years of age and have smoked during their lifetimes; 13
(g) Screening for drug and alcohol misuse for insureds who 14
are 18 years of age or older; 15
(h) If an insured engages in risky or hazardous consumption 16
of alcohol, as determined by the screening described in paragraph 17
(g), behavioral counseling to reduce such behavior; 18
(i) Screening for lung cancer using low-dose computed 19
tomography for insureds who are at least 50 but not more than 80 20
years of age and: 21
(1) Have a smoking history of 20 pack-years; 22
(2) Smoke or have stopped smoking within the immediately 23
preceding 15 years; and 24
(3) Do not suffer from a health problem that substantially 25
limits the life expectancy of the person or the willingness of the 26
person to undergo curative surgery; 27
(j) Screening for prediabetes and type 2 diabetes in insureds 28
who are at least 35 but not more than 70 years of age and have a 29
body mass index of 25 or greater; and 30
(k) Intensive behavioral interventions with multiple 31
components for insureds who are 18 years of age or older and 32
have a body mass index of 30 or greater. 33
2. A society must ensure that the benefits required by 34
subsection 1 are made available to an insured through a provider 35
of health care who participates in the network plan of the society. 36
3. Except as otherwise provided in subsection 5, a society that 37
offers or issues a benefit contract shall not: 38
(a) Require an insured to pay a higher deductible, any 39
copayment or coinsurance or require a longer waiting period or 40
other condition to obtain any benefit provided in the benefit 41
contract pursuant to subsection 1; 42
(b) Refuse to issue a benefit contract or cancel a benefit 43
contract solely because the person applying for or covered by the 44
benefit contract uses or may use any such benefit; 45
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(c) Offer or pay any type of material inducement or financial 1
incentive to an insured to discourage the insured from obtaining 2
any such benefit; 3
(d) Penalize a provider of health care who provides any such 4
benefit to an insured, including, without limitation, reducing the 5
reimbursement of the provider of health care; 6
(e) Offer or pay any type of material inducement, bonus or 7
other financial incentive to a provider of health care to deny, 8
reduce, withhold, limit or delay access to any such benefit to an 9
insured; or 10
(f) Impose any other restrictions or delays on the access of an 11
insured to any such benefit. 12
4. A benefit contract subject to the provisions of this chapter 13
that is delivered, issued for delivery or renewed on or after 14
October 1, 2025, has the legal effect of including the coverage 15
required by subsection 1, and any provision of the contract or the 16
renewal which is in conflict with this section is void. 17
5. Except as otherwise provided in this section and federal 18
law, a society may use medical management techniques, 19
including, without limitation, any available clinical evidence, to 20
determine the frequency of or treatment relating to any benefit 21
required by this section or the type of provider of health care to 22
use for such treatment. 23
6. As used in this section: 24
(a) “Computed tomography” means the process of producing 25
sectional and three-dimensional images using external ionizing 26
radiation. 27
(b) “Facility for the dependent” has the meaning ascribed to it 28
in NRS 449.0045. 29
(c) “Medical facility” has the meaning ascribed to it in 30
NRS 449.0151. 31
(d) “Medical management technique” means a practice which 32
is used to control the cost or utilization of health care services or 33
prescription drug use. The term includes, without limitation, the 34
use of step therapy, prior authorization or categorizing drugs and 35
devices based on cost, type or method of administration. 36
(e) “Network plan” means a benefit contract offered by a 37
society under which the financing and delivery of medical care, 38
including items and services paid for as medical care, are 39
provided, in whole or in part, through a defined set of providers of 40
health care under contract with the society. The term does not 41
include an arrangement for the financing of premiums. 42
(f) “Pack-year” means the product of the number of packs of 43
cigarettes smoked per day and the number of years that the person 44
has smoked. 45
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(g) “Provider of health care” has the meaning ascribed to it in 1
NRS 629.031. 2
Sec. 50. 1. A benefit contract must provide coverage for 3
colorectal cancer screening in accordance with: 4
(a) The guidelines concerning colorectal cancer screening 5
which are published by the American Cancer Society; or 6
(b) Other guidelines or reports concerning colorectal cancer 7
screening which are published by nationally recognized 8
professional organizations and which include current or 9
prevailing supporting scientific data. 10
2. A society must ensure that the benefits required by 11
subsection 1 are made available to an insured through a provider 12
of health care who participates in the network plan of the society. 13
3. A society that offers or issues a benefit contract shall not: 14
(a) Require an insured to pay a higher deductible, any 15
copayment or coinsurance or require a longer waiting period or 16
other condition to obtain any benefit provided in the benefit 17
contract pursuant to subsection 1; 18
(b) Refuse to issue a benefit contract or cancel a benefit 19
contract solely because the person applying for or covered by the 20
benefit contract uses or may use any such benefit; 21
(c) Offer or pay any type of material inducement or financial 22
incentive to an insured to discourage the insured from obtaining 23
any such benefit; 24
(d) Penalize a provider of health care who provides any such 25
benefit to an insured, including, without limitation, reducing the 26
reimbursement of the provider of health care; 27
(e) Offer or pay any type of material inducement, bonus or 28
other financial incentive to a provider of health care to deny, 29
reduce, withhold, limit or delay access to any such benefit to an 30
insured; or 31
(f) Impose any other restrictions or delays on the access of an 32
insured to any such benefit. 33
4. A benefit contract subject to the provisions of this chapter 34
that is delivered, issued for delivery or renewed on or after 35
October 1, 2025, has the legal effect of including the coverage 36
required by this section, and any provision of the benefit contract 37
that conflicts with the provisions of this section is void. 38
5. As used in this section: 39
(a) “Network plan” means a benefit contract offered by a 40
society under which the financing and delivery of medical care, 41
including items and services paid for as medical care, are 42
provided, in whole or in part, through a defined set of providers of 43
health care under contract with the society. The term does not 44
include an 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. 51. 1. A society that offers or issues a benefit contract 3
subject to the provisions of this chapter shall include in the benefit 4
contract coverage for maternity care and pediatric care for 5
newborn infants. 6
2. Except as otherwise provided in this subsection, a benefit 7
contract issued pursuant to this chapter may not restrict benefits 8
for any length of stay in a hospital in connection with childbirth 9
for a pregnant or postpartum individual or newborn infant 10
covered by the benefit contract to: 11
(a) Less than 48 hours after a normal vaginal delivery; and 12
(b) Less than 96 hours after a cesarean section. 13
If a different length of stay is provided in the guidelines 14
established by the American College of Obstetricians and 15
Gynecologists, or its successor organization, and the American 16
Academy of Pediatrics, or its successor organization, the benefit 17
contract may follow such guidelines in lieu of following the length 18
of stay set forth above. The provisions of this subsection do not 19
apply to any benefit contract in any case in which the decision to 20
discharge the pregnant or postpartum individual or newborn 21
infant before the expiration of the minimum length of stay set 22
forth in this subsection is made by the attending physician of the 23
pregnant or postpartum individual or newborn infant. 24
3. Nothing in this section requires a pregnant or postpartum 25
individual to: 26
(a) Deliver the baby in a hospital; or 27
(b) Stay in a hospital for a fixed period following the birth of 28
the child. 29
4. A benefit contract may not: 30
(a) Deny a pregnant or postpartum individual or the newborn 31
infant coverage or continued coverage under the terms of the 32
contract if the sole purpose of the denial of coverage or continued 33
coverage is to avoid the requirements of this section; 34
(b) Provide monetary payments or rebates to a pregnant or 35
postpartum individual to encourage the individual to accept less 36
than the minimum protection available pursuant to this section; 37
(c) Penalize, or otherwise reduce or limit, the reimbursement 38
of an attending provider of health care because the attending 39
provider of health care provided care to a pregnant or postpartum 40
individual or newborn infant in accordance with the provisions of 41
this section; 42
(d) Provide incentives of any kind to an attending physician to 43
induce the attending physician to provide care to a pregnant or 44
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postpartum individual or newborn infant in a manner that is 1
inconsistent with the provisions of this section; or 2
(e) Except as otherwise provided in subsection 5, restrict 3
benefits for any portion of a hospital stay required pursuant to the 4
provisions of this section in a manner that is less favorable than 5
the benefits provided for any preceding portion of that stay. 6
5. Nothing in this section: 7
(a) Prohibits a society from imposing a deductible, 8
coinsurance or other mechanism for sharing costs relating to 9
benefits for hospital stays in connection with childbirth for a 10
pregnant or postpartum individual or newborn child covered by 11
the benefit contract, except that such coinsurance or other 12
mechanism for sharing costs for any portion of a hospital stay 13
required by this section may not be greater than the coinsurance 14
or other mechanism for any preceding portion of that stay. 15
(b) Prohibits an arrangement for payment between a society 16
and a provider of health care that uses capitation or other 17
financial incentives, if the arrangement is designed to provide 18
services efficiently and consistently in the best interest of the 19
pregnant or postpartum individual and the newborn infant. 20
(c) Prevents a society from negotiating with a provider of 21
health care concerning the level and type of reimbursement to be 22
provided in accordance with this section. 23
6. A benefit contract subject to the provisions of this chapter 24
that is delivered, issued for delivery or renewed on or after 25
October 1, 2025, has the legal effect of including the coverage 26
required by this section, and any provision of the contract that 27
conflicts with the provisions of this section is void. 28
Sec. 52. NRS 695A.1844 is hereby amended to read as 29
follows: 30
695A.1844 1. A society that offers or issues a benefit 31
contract shall include in the contract: 32
(a) Coverage of testing for and the treatment and prevention of 33
sexually transmitted diseases, including, without limitation, 34
Chlamydia trachomatis, gonorrhea, syphilis, human 35
immunodeficiency virus and hepatitis B and C, for all insureds, 36
regardless of age. Such coverage must include, without limitation, 37
the coverage required by NRS 695A.1843 and 695A.1856. 38
(b) Unrestricted coverage of condoms for insureds who are 13 39
years of age or older. 40
2. A society that offers or issues a benefit contract shall not: 41
(a) Require an insured to pay a higher deductible, any 42
copayment or coinsurance or require a longer waiting period or 43
other condition to obtain any benefit provided in the benefit 44
contract pursuant to subsection 1; 45
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(b) Refuse to issue a benefit contract or cancel a benefit 1
contract solely because the person applying for or covered by the 2
benefit contract uses or may use any such benefit; 3
(c) Offer or pay any type of material inducement or financial 4
incentive to an insured to discourage the insured from obtaining 5
any such benefit; 6
(d) Penalize a provider of health care who provides any such 7
benefit to an insured, including, without limitation, reducing the 8
reimbursement of the provider of health care; 9
(e) Offer or pay any type of material inducement, bonus or 10
other financial incentive to a provider of health care to deny, 11
reduce, withhold, limit or delay access to any such benefit to an 12
insured; or 13
(f) Impose any other restrictions or delays on the access of an 14
insured to any such benefit. 15
3. A benefit contract subject to the provisions of this chapter 16
that is delivered, issued for delivery or renewed on or after [January] 17
October 1, [2024,] 2025, has the legal effect of including the 18
coverage required by subsection 1, and any provision of the contract 19
that conflicts with the provisions of this section is void. 20
4. As used in this section, “provider of health care” has the 21
meaning ascribed to it in NRS 629.031. 22
Sec. 53. NRS 695A.1853 is hereby amended to read as 23
follows: 24
695A.1853 1. A society that issues a benefit contract shall 25
provide coverage for screening, genetic counseling and testing for 26
harmful mutations in the BRCA gene for women under 27
circumstances where such screening, genetic counseling or testing, 28
as applicable, is required by NRS 457.301. 29
2. A society shall ensure that the benefits required by 30
subsection 1 are made available to an insured through a provider of 31
health care who participates in the network plan of the society. 32
3. A society that issues a benefit contract shall not: 33
(a) Require an insured to pay a higher deductible, any 34
copayment or coinsurance or require a longer waiting period or 35
other condition to obtain any benefit provided in the benefit 36
contract pursuant to subsection 1; 37
(b) Refuse to issue a benefit contract or cancel a benefit 38
contract solely because the person applying for or covered by the 39
benefit contract uses or may use any such benefit; 40
(c) Offer or pay any type of material inducement or financial 41
incentive to an insured to discourage the insured from obtaining 42
any such benefit; 43
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(d) Penalize a provider of health care who provides any such 1
benefit to an insured, including, without limitation, reducing the 2
reimbursement of the provider of health care; 3
(e) Offer or pay any type of material inducement, bonus or 4
other financial incentive to a provider of health care to deny, 5
reduce, withhold, limit or delay access to any such benefit to an 6
insured; or 7
(f) Impose any other restrictions or delays on the access of an 8
insured to any such benefit. 9
4. A benefit contract subject to the provisions of this chapter 10
that is delivered, issued for delivery or renewed on or after [January] 11
October 1, [2022,] 2025, has the legal effect of including the 12
coverage required by subsection 1, and any provision of the plan 13
that conflicts with the provisions of this section is void. 14
[4.] 5. As used in this section: 15
(a) “Network plan” means a benefit contract offered by a society 16
under which the financing and delivery of medical care, including 17
items and services paid for as medical care, are provided, in whole 18
or in part, through a defined set of providers under contract with the 19
society. The term does not include an arrangement for the financing 20
of premiums. 21
(b) “Provider of health care” has the meaning ascribed to it in 22
NRS 629.031. 23
Sec. 54. NRS 695A.1855 is hereby amended to read as 24
follows: 25
695A.1855 1. A benefit contract must provide coverage for 26
benefits payable for expenses incurred for: 27
(a) A mammogram to screen for breast cancer annually for 28
insureds who are 40 years of age or older. 29
(b) An imaging test to screen for breast cancer on an interval 30
and at the age deemed most appropriate, when medically necessary, 31
as recommended by the insured’s provider of health care based on 32
personal or family medical history or additional factors that may 33
increase the risk of breast cancer for the insured. 34
(c) A diagnostic imaging test for breast cancer at the age deemed 35
most appropriate, when medically necessary, as recommended by 36
the insured’s provider of health care to evaluate an abnormality 37
which is: 38
(1) Seen or suspected from a mammogram described in 39
paragraph (a) or an imaging test described in paragraph (b); or 40
(2) Detected by other means of examination. 41
(d) Medication to prevent breast cancer for insureds who are 42
at a high risk of developing breast cancer and have a low risk of 43
adverse side effects from the medication. 44
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2. A society must ensure that the benefits required by 1
subsection 1 are made available to an insured through a provider of 2
health care who participates in the network plan of the society. 3
3. Except as otherwise provided in subsection 5, a society that 4
offers or issues a benefit contract shall not: 5
(a) Except as otherwise provided in subsection 6, require an 6
insured to pay a deductible, copayment, coinsurance or any other 7
form of cost-sharing or require a longer waiting period or other 8
condition for coverage to obtain any benefit provided in a benefit 9
contract pursuant to subsection 1; 10
(b) Refuse to issue a benefit contract or cancel a benefit contract 11
solely because the person applying for or covered by the contract 12
uses or may use any such benefit; 13
(c) Offer or pay any type of material inducement or financial 14
incentive to an insured to discourage the insured from obtaining any 15
such benefit; 16
(d) Penalize a provider of health care who provides any such 17
benefit to an insured, including, without limitation, reducing the 18
reimbursement of the provider of health care; 19
(e) Offer or pay any type of material inducement, bonus or other 20
financial incentive to a provider of health care to deny, reduce, 21
withhold, limit or delay access to any such benefit to an insured; or 22
(f) Impose any other restrictions or delays on the access of an 23
insured to any such benefit. 24
4. A benefit contract subject to the provisions of this chapter 25
which is delivered, issued for delivery or renewed on or after 26
[January] October 1, [2024,] 2025, has the legal effect of including 27
the coverage required by subsection 1, and any provision of the 28
benefit contract or the renewal which is in conflict with this section 29
is void. 30
5. Except as otherwise provided in this section and federal law, 31
a society may use medical management techniques, including, 32
without limitation, any available clinical evidence, to determine the 33
frequency of or treatment relating to any benefit required by this 34
section or the type of provider of health care to use for such 35
treatment. 36
6. If the application of paragraph (a) of subsection 3 would 37
result in the ineligibility of a health savings account of an insured 38
pursuant to 26 U.S.C. § 223, the prohibitions of paragraph (a) of 39
subsection 3 shall apply only for a qualified benefit contract with 40
respect to the deductible of such a benefit contract after the insured 41
has satisfied the minimum deductible pursuant to 26 U.S.C. § 223, 42
except with respect to items or services that constitute preventive 43
care pursuant to 26 U.S.C. § 223(c)(2)(C), in which case the 44
prohibitions of paragraph (a) of subsection 3 shall apply regardless 45
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of whether the minimum deductible under 26 U.S.C. § 223 has been 1
satisfied. 2
7. As used in this section: 3
(a) “Medical management technique” means a practice which is 4
used to control the cost or utilization of health care services or 5
prescription drug use. The term includes, without limitation, the use 6
of step therapy, prior authorization or categorizing drugs and 7
devices based on cost, type or method of administration. 8
(b) “Network plan” means a benefit contract offered by a society 9
under which the financing and delivery of medical care, including 10
items and services paid for as medical care, are provided, in whole 11
or in part, through a defined set of providers under contract with the 12
society. The term does not include an arrangement for the financing 13
of premiums. 14
(c) “Provider of health care” has the meaning ascribed to it in 15
NRS 629.031. 16
(d) “Qualified benefit contract” means a benefit contract that has 17
a high deductible and is in compliance with 26 U.S.C. § 223 for the 18
purposes of establishing a health savings account. 19
Sec. 55. NRS 695A.1856 is hereby amended to read as 20
follows: 21
695A.1856 1. A society that issues a benefit contract shall 22
provide coverage for the examination of a person who is pregnant 23
for the discovery of: 24
(a) Chlamydia trachomatis, gonorrhea, hepatitis B and hepatitis 25
C in accordance with NRS 442.013. 26
(b) Syphilis in accordance with NRS 442.010. 27
(c) Human immunodeficiency virus. 28
2. The coverage required by this section must be provided: 29
(a) Regardless of whether the benefits are provided to the 30
insured by a provider of health care, facility or medical laboratory 31
that participates in the network plan of the society; and 32
(b) Without prior authorization. 33
3. A society that issues a benefit contract shall not: 34
(a) Require an insured to pay a higher deductible, any 35
copayment or coinsurance or require a longer waiting period or 36
other condition to obtain any benefit provided in the benefit 37
contract pursuant to subsection 1; 38
(b) Refuse to issue a benefit contract or cancel a benefit 39
contract solely because the person applying for or covered by the 40
benefit contract uses or may use any such benefit; 41
(c) Offer or pay any type of material inducement or financial 42
incentive to an insured to discourage the insured from obtaining 43
any such benefit; 44
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(d) Penalize a provider of health care who provides any such 1
benefit to an insured, including, without limitation, reducing the 2
reimbursement of the provider of health care; 3
(e) Offer or pay any type of material inducement, bonus or 4
other financial incentive to a provider of health care to deny, 5
reduce, withhold, limit or delay access to any such benefit to an 6
insured; or 7
(f) Impose any other restrictions or delays on the access of an 8
insured to any such benefit. 9
4. A benefit contract subject to the provisions of this chapter 10
that is delivered, issued for delivery or renewed on or after [July] 11
October 1, [2021,] 2025, has the legal effect of including the 12
coverage required by subsection 1, and any provision of the contract 13
that conflicts with the provisions of this section is void. 14
[4.] 5. As used in this section: 15
(a) “Medical laboratory” has the meaning ascribed to it in 16
NRS 652.060. 17
(b) “Network plan” means a benefit contract offered by a society 18
under which the financing and delivery of medical care, including 19
items and services paid for as medical care, are provided, in whole 20
or in part, through a defined set of providers under contract with the 21
society. The term does not include an arrangement for the financing 22
of premiums. 23
(c) “Provider of health care” has the meaning ascribed to it in 24
NRS 629.031. 25
Sec. 56. NRS 695A.1857 is hereby amended to read as 26
follows: 27
695A.1857 1. A society that offers or issues a benefit 28
contract [that includes coverage for maternity care] shall not deny, 29
limit or seek reimbursement for maternity care because the insured 30
is acting as a gestational carrier. 31
2. If an insured acts as a gestational carrier, the child shall be 32
deemed to be a child of the intended parent, as defined in NRS 33
126.590, for purposes related to the benefit contract. 34
3. As used in this section, “gestational carrier” has the meaning 35
ascribed to it in NRS 126.580. 36
Sec. 57. NRS 695A.1875 is hereby amended to read as 37
follows: 38
695A.1875 1. A society that offers or issues a benefit 39
contract shall include in the contract coverage for: 40
(a) Counseling, support and supplies for breastfeeding, 41
including breastfeeding equipment, counseling and education during 42
the antenatal, perinatal and postpartum period for not more than 1 43
year; 44
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(b) Screening and counseling for interpersonal and domestic 1
violence for women at least annually with initial intervention 2
services consisting of education, strategies to reduce harm, 3
supportive services or a referral for any other appropriate services; 4
(c) Behavioral counseling concerning sexually transmitted 5
diseases from a provider of health care for sexually active [women] 6
insureds who are at increased risk for such diseases; 7
(d) Hormone replacement therapy; 8
(e) Such prenatal screenings and tests as recommended by the 9
American College of Obstetricians and Gynecologists or its 10
successor organization; 11
(f) Screening for blood pressure abnormalities and diabetes, 12
including gestational diabetes, after at least 24 weeks of gestation or 13
as ordered by a provider of health care; 14
(g) Screening for cervical cancer at such intervals as are 15
recommended by the American College of Obstetricians and 16
Gynecologists or its successor organization; 17
(h) Screening for depression [;] for insureds who are 12 years 18
of age or older; 19
(i) Screening for anxiety disorders; 20
(j) Screening and counseling for the human immunodeficiency 21
virus consisting of a risk assessment, annual education relating to 22
prevention and at least one screening for the virus during the 23
lifetime of the insured or as ordered by a provider of health care; 24
[(j) Smoking] 25
(k) Tobacco cessation programs , including, without limitation, 26
pharmacotherapy approved by the United States Food and Drug 27
Administration, for an insured who is 18 years of age or older 28
consisting of not more than two cessation attempts per year and four 29
counseling sessions per year; 30
[(k)] (l) All vaccinations recommended by the Advisory 31
Committee on Immunization Practices of the Centers for Disease 32
Control and Prevention of the United States Department of Health 33
and Human Services or its successor organization; and 34
[(l)] (m) Such well-woman preventative visits as recommended 35
by the Health Resources and Services Administration [,] on 36
January 1, 2025, which must include at least one such visit per year 37
beginning at 14 years of age. 38
2. A society must ensure that the benefits required by 39
subsection 1 are made available to an insured through a provider of 40
health care who participates in the network plan of the society. 41
3. Except as otherwise provided in subsection 5, a society that 42
offers or issues a benefit contract shall not: 43
(a) Require an insured to pay a higher deductible, any 44
copayment or coinsurance or require a longer waiting period or 45
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other condition to obtain any benefit provided in the benefit contract 1
pursuant to subsection 1; 2
(b) Refuse to issue a benefit contract or cancel a benefit contract 3
solely because the person applying for or covered by the contract 4
uses or may use any such benefit; 5
(c) Offer or pay any type of material inducement or financial 6
incentive to an insured to discourage the insured from obtaining any 7
such benefit; 8
(d) Penalize a provider of health care who provides any such 9
benefit to an insured, including, without limitation, reducing the 10
reimbursement of the provider of health care; 11
(e) Offer or pay any type of material inducement, bonus or other 12
financial incentive to a provider of health care to deny, reduce, 13
withhold, limit or delay access to any such benefit to an insured; or 14
(f) Impose any other restrictions or delays on the access of an 15
insured to any such benefit. 16
4. A benefit contract subject to the provisions of this chapter 17
that is delivered, issued for delivery or renewed on or after [January] 18
October 1, [2018,] 2025, has the legal effect of including the 19
coverage required by subsection 1, and any provision of the benefit 20
contract or the renewal which is in conflict with this section is void. 21
5. Except as otherwise provided in this section and federal law, 22
a society may use medical management techniques, including, 23
without limitation, any available clinical evidence, to determine the 24
frequency of or treatment relating to any benefit required by this 25
section or the type of provider of health care to use for such 26
treatment. 27
6. As used in this section: 28
(a) “Medical management technique” means a practice which is 29
used to control the cost or utilization of health care services or 30
prescription drug use. The term includes, without limitation, the use 31
of step therapy, prior authorization or categorizing drugs and 32
devices based on cost, type or method of administration. 33
(b) “Network plan” means a benefit contract offered by a society 34
under which the financing and delivery of medical care, including 35
items and services paid for as medical care, are provided, in whole 36
or in part, through a defined set of providers under contract with the 37
society. The term does not include an arrangement for the financing 38
of premiums. 39
(c) “Provider of health care” has the meaning ascribed to it in 40
NRS 629.031. 41
Sec. 58. NRS 695A.198 is hereby amended to read as follows: 42
695A.198 1. A society that issues a benefit contract shall not 43
discriminate against any person with respect to participation or 44
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coverage under the contract on the basis of an actual or perceived 1
[gender identity or expression.] protected characteristic. 2
2. Prohibited discrimination includes, without limitation: 3
[1.] (a) Denying, cancelling, limiting or refusing to issue or 4
renew a benefit contract on the basis of [the] an actual or perceived 5
[gender identity or expression] protected characteristic of a person 6
or a family member of the person; 7
[2.] (b) Imposing a payment or premium that is based on [the] 8
an actual or perceived [gender identity or expression] protected 9
characteristic of an insured or a family member of the insured; 10
[3.] (c) Designating [the] an actual or perceived [gender 11
identity or expression] protected characteristic of a person or a 12
family member of the person as grounds to deny, cancel or limit 13
participation or coverage; and 14
[4.] (d) Denying, cancelling or limiting participation or 15
coverage on the basis of an actual or perceived [gender identity or 16
expression,] protected characteristic, including, without limitation, 17
by limiting or denying coverage for health care services that are: 18
[(a)] (1) Related to gender transition, provided that there is 19
coverage under the contract for the services when the services are 20
not related to gender transition; or 21
[(b)] (2) Ordinarily or exclusively available to persons of any 22
sex. 23
3. As used in this section, “protected characteristic” means: 24
(a) Race, color, national origin, age, physical or mental 25
disability, sexual orientation or gender identity or expression; or 26
(b) Sex, including, without limitation, sex characteristics, 27
intersex traits and pregnancy or related conditions. 28
Sec. 59. Chapter 695B of NRS is hereby amended by adding 29
thereto the provisions set forth as sections 60 to 64, inclusive, of this 30
act. 31
Sec. 60. 1. A hospital or medical services corporation that 32
offers or issues a policy of health insurance which provides 33
coverage for dependent children shall continue to make such 34
coverage available for an adult child of an insured until such 35
child reaches 26 years of age. 36
2. Nothing in this section shall be construed as requiring a 37
hospital or medical services corporation to make coverage 38
available for a dependent of an adult child of an insured. 39
Sec. 61. 1. A hospital or medical services corporation that 40
offers or issues a policy of health insurance shall include in the 41
policy coverage for: 42
(a) Screening for anxiety for insureds who are at least 8 but 43
not more than 18 years of age; 44
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(b) Assessments relating to height, weight, body mass index 1
and medical history for insureds who are less than 18 years of 2
age; 3
(c) Comprehensive and intensive behavioral interventions for 4
insureds who are at least 12 but not more than 18 years of age and 5
have a body mass index in the 95th percentile or greater for 6
persons of the same age and sex; 7
(d) The application of fluoride varnish to the primary teeth for 8
insureds who are less than 5 years of age; 9
(e) Oral fluoride supplements for insureds who are at least 6 10
months of age but less than 5 years of age and whose supply of 11
water is deficient in fluoride; 12
(f) Counseling and education pertaining to the minimization of 13
exposure to ultraviolet radiation for insureds who are less than 25 14
years of age and have fair skin types and the parents or legal 15
guardians of insureds who are less than 18 years of age and have 16
fair skin types for the purpose of minimizing the risk of skin 17
cancer in those persons; 18
(g) Brief behavioral counseling and interventions to prevent 19
tobacco use for insureds who are less than 18 years of age; 20
(h) At least one screening for the detection of amblyopia or the 21
risk factors of amblyopia for insureds who are at least 3 but not 22
more than 5 years of age; and 23
(i) Screening, tests and counseling for such other health 24
conditions and diseases as recommended by the Health Resources 25
and Services Administration on January 1, 2025, for insureds who 26
are less than 18 years of age. 27
2. A hospital or medical services corporation must ensure 28
that the benefits required by subsection 1 are made available to an 29
insured through a provider of health care who participates in the 30
network plan of the hospital or medical services corporation. 31
3. Except as otherwise provided in subsection 5, a hospital or 32
medical services corporation that offers or issues a policy of health 33
insurance shall not: 34
(a) Require an insured to pay a higher deductible, any 35
copayment or coinsurance or require a longer waiting period or 36
other condition to obtain any benefit provided in the policy of 37
health insurance pursuant to subsection 1; 38
(b) Refuse to issue a policy of health insurance or cancel a 39
policy of health insurance solely because the person applying for 40
or covered by the policy uses or may use any such benefit; 41
(c) Offer or pay any type of material inducement or financial 42
incentive to an insured to discourage the insured from obtaining 43
any such benefit; 44
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(d) Penalize a provider of health care who provides any such 1
benefit to an insured, including, without limitation, reducing the 2
reimbursement of the provider of health care; 3
(e) Offer or pay any type of material inducement, bonus or 4
other financial incentive to a provider of health care to deny, 5
reduce, withhold, limit or delay access to any such benefit to an 6
insured; or 7
(f) Impose any other restrictions or delays on the access of an 8
insured to any such benefit. 9
4. A policy of health insurance subject to the provisions of 10
this chapter that is delivered, issued for delivery or renewed on or 11
after October 1, 2025, has the legal effect of including the 12
coverage required by subsection 1, and any provision of the policy 13
or the renewal which is in conflict with this section is void. 14
5. Except as otherwise provided in this section and federal 15
law, a hospital or medical services corporation may use medical 16
management techniques, including, without limitation, any 17
available clinical evidence, to determine the frequency of or 18
treatment relating to any benefit required by this section or the 19
type of provider of health care to use for such treatment. 20
6. As used in this section: 21
(a) “Medical management technique” means a practice which 22
is used to control the cost or utilization of health care services or 23
prescription drug use. The term includes, without limitation, the 24
use of step therapy, prior authorization or categorizing drugs and 25
devices based on cost, type or method of administration. 26
(b) “Network plan” means a policy of health insurance offered 27
by a hospital or medical services corporation under which the 28
financing and delivery of medical care, including items and 29
services paid for as medical care, are provided, in whole or in part, 30
through a defined set of providers of health care under contract 31
with the hospital or medical services corporation. The term does 32
not include an arrangement for the financing of premiums. 33
(c) “Provider of health care” has the meaning ascribed to it in 34
NRS 629.031. 35
Sec. 62. 1. A hospital or medical services corporation that 36
offers or issues a policy of health insurance shall include in the 37
policy coverage for: 38
(a) A daily dose of 0.4 to 0.8 milligrams of folic acid for 39
insureds who are pregnant or are planning on becoming 40
pregnant; 41
(b) A low dose of aspirin for the prevention of preeclampsia 42
for insureds who are determined to be at a high risk of that 43
condition after 12 weeks of gestation; 44
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(c) Prophylactic ocular tubal medication for the prevention of 1
gonococcal ophthalmia in newborns; 2
(d) Screening for asymptomatic bacteriuria for insureds who 3
are pregnant; 4
(e) Counseling and behavioral interventions relating to the 5
promotion of healthy weight gain and the prevention of excessive 6
weight gain for insureds who are pregnant; 7
(f) Counseling for insureds who are pregnant or in the 8
postpartum stage of pregnancy and have an increased risk of 9
perinatal or postpartum depression; 10
(g) Screening for the presence of the rhesus D antigen and 11
antibodies in the blood of an insured who is pregnant during the 12
insured’s first visit for care relating to the pregnancy; 13
(h) Screening for rhesus D antibodies between 24 and 28 14
weeks of gestation for insureds who are negative for the rhesus D 15
antigen and have not been exposed to blood that is positive for the 16
rhesus D antigen; 17
(i) Behavioral counseling and intervention for tobacco 18
cessation for insureds who are pregnant; 19
(j) An annual screening for urinary incontinence for women; 20
(k) Screening for type 2 diabetes at such intervals as 21
recommended by the H ealth Resources and Services 22
Administration on January 1, 2025, for insureds who are in the 23
postpartum stage of pregnancy and who have a history of 24
gestational diabetes mellitus; 25
(l) Counseling relating to maintaining a healthy weight for 26
women who are 40 but not more than 60 years of age and have a 27
body mass index greater than 18.5; and 28
(m) Screening for osteoporosis for women who: 29
(1) Are 65 years of age or older; or 30
(2) Are less than 65 years of age and have a risk of 31
fracturing a bone equal to or greater than that of a woman who is 32
65 years of age without any additional risk factors. 33
2. A hospital or medical services corporation must ensure 34
that the benefits required by subsection 1 are made available to an 35
insured through a provider of health care who participates in the 36
network plan of the hospital or medical services corporation. 37
3. Except as otherwise provided in subsection 5, hospital or 38
medical services corporation that offers or issues a policy of health 39
insurance shall not: 40
(a) Require an insured to pay a higher deductible, any 41
copayment or coinsurance or require a longer waiting period or 42
other condition to obtain any benefit provided in the policy of 43
health insurance pursuant to subsection 1; 44
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(b) Refuse to issue a policy of health insurance or cancel a 1
policy of health insurance solely because the person applying for 2
or covered by the policy uses or may use any such benefit; 3
(c) Offer or pay any type of material inducement or financial 4
incentive to an insured to discourage the insured from obtaining 5
any such benefit; 6
(d) Penalize a provider of health care who provides any such 7
benefit to an insured, including, without limitation, reducing the 8
reimbursement of the provider of health care; 9
(e) Offer or pay any type of material inducement, bonus or 10
other financial incentive to a provider of health care to deny, 11
reduce, withhold, limit or delay access to any such benefit to an 12
insured; or 13
(f) Impose any other restrictions or delays on the access of an 14
insured to any such benefit. 15
4. A policy of health insurance subject to the provisions of 16
this chapter that is delivered, issued for delivery or renewed on or 17
after October 1, 2025, has the legal effect of including the 18
coverage required by subsection 1, and any provision of the policy 19
or the renewal which is in conflict with this section is void. 20
5. Except as otherwise provided in this section and federal 21
law, a hospital or medical services corporation may use medical 22
management techniques, including, without limitation, any 23
available clinical evidence, to determine the frequency of or 24
treatment relating to any benefit required by this section or the 25
type of provider of health care to use for such treatment. 26
6. As used in this section: 27
(a) “Medical management technique” means a practice which 28
is used to control the cost or utilization of health care services or 29
prescription drug use. The term includes, without limitation, the 30
use of step therapy, prior authorization or categorizing drugs and 31
devices based on cost, type or method of administration. 32
(b) “Network plan” means a policy of health insurance offered 33
by a hospital or medical services corporation under which the 34
financing and delivery of medical care, including items and 35
services paid for as medical care, are provided, in whole or in part, 36
through a defined set of providers of health care under contract 37
with the hospital or medical services corporation. The term does 38
not include an arrangement for the financing of premiums. 39
(c) “Provider of health care” has the meaning ascribed to it in 40
NRS 629.031. 41
Sec. 63. 1. A hospital or medical services corporation that 42
offers or issues a policy of health insurance shall include in the 43
policy coverage for: 44
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(a) Behavioral counseling and interventions to promote 1
physical activity and a healthy diet for insureds with 2
cardiovascular risk factors; 3
(b) Statin preventive medication for insureds who are at least 4
40 but not more than 75 years of age and do not have a history of 5
cardiovascular disease, but who have: 6
(1) One or more risk factors for cardiovascular disease; 7
and 8
(2) A calculated risk of at least 10 percent of acquiring 9
cardiovascular disease within the next 10 years; 10
(c) Interventions for exercise to prevent falls for insureds who 11
are 65 years of age or older and reside in a medical facility or 12
facility for the dependent; 13
(d) Screenings for latent tuberculosis infection in insureds 14
with an increased risk of contracting tuberculosis; 15
(e) Screening for hypertension; 16
(f) One abdominal aortic screening by ultrasound to detect 17
abdominal aortic aneurysms for men who are at least 65 but not 18
more than 75 years of age and have smoked during their lifetimes; 19
(g) Screening for drug and alcohol misuse for insureds who 20
are 18 years of age or older; 21
(h) If an insured engages in risky or hazardous consumption 22
of alcohol, as determined by the screening described in paragraph 23
(g), behavioral counseling to reduce such behavior; 24
(i) Screening for lung cancer using low-dose computed 25
tomography for insureds who are at least 50 but not more than 80 26
years of age and: 27
(1) Have a smoking history of 20 pack-years; 28
(2) Smoke or have stopped smoking within the immediately 29
preceding 15 years; and 30
(3) Do not suffer from a health problem that substantially 31
limits the life expectancy of the person or the willingness of the 32
person to undergo curative surgery; 33
(j) Screening for prediabetes and type 2 diabetes in insureds 34
who are at least 35 but not more than 70 years of age and have a 35
body mass index of 25 or greater; and 36
(k) Intensive behavioral interventions with multiple 37
components for insureds who are 18 years of age or older and 38
have a body mass index of 30 or greater. 39
2. A hospital or medical services corporation must ensure 40
that the benefits required by subsection 1 are made available to an 41
insured through a provider of health care who participates in the 42
network plan of the hospital or medical services corporation. 43
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3. Except as otherwise provided in subsection 5, a hospital or 1
medical services corporation that offers or issues a policy of health 2
insurance shall not: 3
(a) Require an insured to pay a higher deductible, any 4
copayment or coinsurance or require a longer waiting period or 5
other condition to obtain any benefit provided in the policy of 6
health insurance pursuant to subsection 1; 7
(b) Refuse to issue a policy of health insurance or cancel a 8
policy of health insurance solely because the person applying for 9
or covered by the policy uses or may use any such benefit; 10
(c) Offer or pay any type of material inducement or financial 11
incentive to an insured to discourage the insured from obtaining 12
any such benefit; 13
(d) Penalize a provider of health care who provides any such 14
benefit to an insured, including, without limitation, reducing the 15
reimbursement of the provider of health care; 16
(e) Offer or pay any type of material inducement, bonus or 17
other financial incentive to a provider of health care to deny, 18
reduce, withhold, limit or delay access to any such benefit to an 19
insured; or 20
(f) Impose any other restrictions or delays on the access of an 21
insured to any such benefit. 22
4. A policy of health insurance subject to the provisions of 23
this chapter that is delivered, issued for delivery or renewed on or 24
after October 1, 2025, has the legal effect of including the 25
coverage required by subsection 1, and any provision of the policy 26
or the renewal which is in conflict with this section is void. 27
5. Except as otherwise provided in this section and federal 28
law, a hospital or medical services corporation may use medical 29
management techniques, including, without limitation, any 30
available clinical evidence, to determine the frequency of or 31
treatment relating to any benefit required by this section or the 32
type of provider of health care to use for such treatment. 33
6. As used in this section: 34
(a) “Computed tomography” means the process of producing 35
sectional and three-dimensional images using external ionizing 36
radiation. 37
(b) “Facility for the dependent” has the meaning ascribed to it 38
in NRS 449.0045. 39
(c) “Medical facility” has the meaning ascribed to it in 40
NRS 449.0151. 41
(d) “Medical management technique” means a practice which 42
is used to control the cost or utilization of health care services or 43
prescription drug use. The term includes, without limitation, the 44
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use of step therapy, prior authorization or categorizing drugs and 1
devices based on cost, type or method of administration. 2
(e) “Network plan” means a policy of health insurance offered 3
by a hospital or medical services corporation under which the 4
financing and delivery of medical care, including items and 5
services paid for as medical care, are provided, in whole or in part, 6
through a defined set of providers of health care under contract 7
with the hospital or medical services corporation. The term does 8
not include an arrangement for the financing of premiums. 9
(f) “Pack-year” means the product of the number of packs of 10
cigarettes smoked per day and the number of years that the person 11
has smoked. 12
(g) “Provider of health care” has the meaning ascribed to it in 13
NRS 629.031. 14
Sec. 64. 1. A hospital or medical services corporation that 15
offers or issues a policy of health insurance subject to the 16
provisions of this chapter shall include in the policy coverage for 17
maternity care and pediatric care for newborn infants. 18
2. Except as otherwise provided in this subsection, a policy of 19
health insurance issued pursuant to this chapter may not restrict 20
benefits for any length of stay in a hospital in connection with 21
childbirth for a pregnant or postpartum individual or newborn 22
infant covered by the policy to: 23
(a) Less than 48 hours after a normal vaginal delivery; and 24
(b) Less than 96 hours after a cesarean section. 25
If a different length of stay is provided in the guidelines 26
established by the American College of Obstetricians and 27
Gynecologists, or its successor organization, and the American 28
Academy of Pediatrics, or its successor organization, the policy of 29
health insurance may follow such guidelines in lieu of following 30
the length of stay set forth above. The provisions of this subsection 31
do not apply to any policy of health insurance in any case in 32
which the decision to discharge the pregnant or postpartum 33
individual or newborn infant before the expiration of the 34
minimum length of stay set forth in this subsection is made by the 35
attending physician of the pregnant or postpartum individual or 36
newborn infant. 37
3. Nothing in this section requires a pregnant or postpartum 38
individual to: 39
(a) Deliver the baby in a hospital; or 40
(b) Stay in a hospital for a fixed period following the birth of 41
the child. 42
4. A policy of health insurance may not: 43
(a) Deny a pregnant or postpartum individual or the newborn 44
infant coverage or continued coverage under the terms of the 45
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policy if the sole purpose of the denial of coverage or continued 1
coverage is to avoid the requirements of this section; 2
(b) Provide monetary payments or rebates to a pregnant or 3
postpartum individual to encourage the individual to accept less 4
than the minimum protection available pursuant to this section; 5
(c) Penalize, or otherwise reduce or limit, the reimbursement 6
of an attending provider of health care because the attending 7
provider of health care provided care to a pregnant or postpartum 8
individual or newborn infant in accordance with the provisions of 9
this section; 10
(d) Provide incentives of any kind to an attending physician to 11
induce the attending physician to provide care to a pregnant or 12
postpartum individual or newborn infant in a manner that is 13
inconsistent with the provisions of this section; or 14
(e) Except as otherwise provided in subsection 5, restrict 15
benefits for any portion of a hospital stay required pursuant to the 16
provisions of this section in a manner that is less favorable than 17
the benefits provided for any preceding portion of that stay. 18
5. Nothing in this section: 19
(a) Prohibits a hospital or medical services corporation from 20
imposing a deductible, coinsurance or other mechanism for 21
sharing costs relating to benefits for hospital stays in connection 22
with childbirth for a pregnant or postpartum individual or 23
newborn child covered by the policy, except that such coinsurance 24
or other mechanism for sharing costs for any portion of a hospital 25
stay required by this section may not be greater than the 26
coinsurance or other mechanism for any preceding portion of that 27
stay. 28
(b) Prohibits an arrangement for payment between a hospital 29
or medical services corporation and a provider of health care that 30
uses capitation or other financial incentives, if the arrangement is 31
designed to provide services efficiently and consistently in the best 32
interest of the pregnant or postpartum individual and the newborn 33
infant. 34
(c) Prevents a hospital or medical services corporation from 35
negotiating with a provider of health care concerning the level and 36
type of reimbursement to be provided in accordance with this 37
section. 38
6. A policy of health insurance subject to the provisions of 39
this chapter that is delivered, issued for delivery or renewed on or 40
after October 1, 2025, has the legal effect of including the 41
coverage required by this section, and any provision of the policy 42
that conflicts with the provisions of this section is void. 43
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Sec. 65. NRS 695B.1907 is hereby amended to read as 1
follows: 2
695B.1907 1. A policy of health insurance issued by a 3
hospital or medical service corporation [that provides coverage for 4
the treatment of colorectal cancer] must provide coverage for 5
colorectal cancer screening in accordance with: 6
(a) The guidelines concerning colorectal cancer screening which 7
are published by the American Cancer Society; or 8
(b) Other guidelines or reports concerning colorectal cancer 9
screening which are published by nationally recognized professional 10
organizations and which include current or prevailing supporting 11
scientific data. 12
2. A hospital or medical services corporation must ensure 13
that the benefits required by subsection 1 are made available to an 14
insured through a provider of health care who participates in the 15
network plan of the hospital or medical services corporation. 16
3. A hospital or medical services corporation that offers or 17
issues a policy of health insurance shall not: 18
(a) Require an insured to pay a higher deductible, any 19
copayment or coinsurance or require a longer waiting period or 20
other condition to obtain any benefit provided in the policy of 21
health insurance pursuant to subsection 1; 22
(b) Refuse to issue a policy of health insurance or cancel a 23
policy of health insurance solely because the person applying for 24
or covered by the policy uses or may use any such benefit; 25
(c) Offer or pay any type of material inducement or financial 26
incentive to an insured to discourage the insured from obtaining 27
any such benefit; 28
(d) Penalize a provider of health care who provides any such 29
benefit to an insured, including, without limitation, reducing the 30
reimbursement of the provider of health care; 31
(e) Offer or pay any type of material inducement, bonus or 32
other financial incentive to a provider of health care to deny, 33
reduce, withhold, limit or delay access to any such benefit to an 34
insured; or 35
(f) Impose any other restrictions or delays on the access of an 36
insured to any such benefit. 37
4. A policy of health insurance subject to the provisions of this 38
chapter that is delivered, issued for delivery or renewed on or after 39
October 1, [2003,] 2025, has the legal effect of including the 40
coverage required by this section, and any provision of the policy 41
that conflicts with the provisions of this section is void. 42
5. As used in this section: 43
(a) “Network plan” means a policy of health insurance offered 44
by a hospital or medical services corporation under which the 45
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financing and delivery of medical care, including items and 1
services paid for as medical care, are provided, in whole or in part, 2
through a defined set of providers of health care under contract 3
with the hospital or medical services corporation. The term does 4
not include an arrangement for the financing of premiums. 5
(b) “Provider of health care” has the meaning ascribed to it in 6
NRS 629.031. 7
Sec. 66. NRS 695B.1911 is hereby amended to read as 8
follows: 9
695B.1911 1. A hospital or medical services corporation that 10
issues a policy of health insurance shall provide coverage for 11
screening, genetic counseling and testing for harmful mutations in 12
the BRCA gene for women under circumstances where such 13
screening, genetic counseling or testing, as applicable, is required by 14
NRS 457.301. 15
2. A hospital or medical services corporation shall ensure that 16
the benefits required by subsection 1 are made available to an 17
insured through a provider of health care who participates in the 18
network plan of the hospital or medical services corporation. 19
3. A hospital or medical services corporation that issues a 20
policy of health insurance shall not: 21
(a) Require an insured to pay a higher deductible, any 22
copayment or coinsurance or require a longer waiting period or 23
other condition to obtain any benefit provided in the policy of 24
health insurance pursuant to subsection 1; 25
(b) Refuse to issue a policy of health insurance or cancel a 26
policy of health insurance solely because the person applying for 27
or covered by the policy uses or may use any such benefit; 28
(c) Offer or pay any type of material inducement or financial 29
incentive to an insured to discourage the insured from obtaining 30
any such benefit; 31
(d) Penalize a provider of health care who provides any such 32
benefit to an insured, including, without limitation, reducing the 33
reimbursement of the provider of health care; 34
(e) Offer or pay any type of material inducement, bonus or 35
other financial incentive to a provider of health care to deny, 36
reduce, withhold, limit or delay access to any such benefit to an 37
insured; or 38
(f) Impose any other restrictions or delays on the access of an 39
insured to any such benefit. 40
4. A policy of health insurance subject to the provisions of this 41
chapter that is delivered, issued for delivery or renewed on or after 42
[January] October 1, [2022,] 2025, has the legal effect of including 43
the coverage required by subsection 1, and any provision of the 44
policy that conflicts with the provisions of this section is void. 45
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[4.] 5. As used in this section: 1
(a) “Network plan” means a policy of health insurance offered 2
by a hospital or medical services corporation under which the 3
financing and delivery of medical care, including items and services 4
paid for as medical care, are provided, in whole or in part, through a 5
defined set of providers under contract with the hospital or medical 6
services corporation. The term does not include an arrangement for 7
the financing of premiums. 8
(b) “Provider of health care” has the meaning ascribed to it in 9
NRS 629.031. 10
Sec. 67. NRS 695B.1912 is hereby amended to read as 11
follows: 12
695B.1912 1. An insurer that offers or issues a contract for 13
hospital or medical service must provide coverage for benefits 14
payable for expenses incurred for: 15
(a) A mammogram to screen for breast cancer annually for 16
insureds who are 40 years of age or older. 17
(b) An imaging test to screen for breast cancer on an interval 18
and at the age deemed most appropriate, when medically necessary, 19
as recommended by the insured’s provider of health care based on 20
personal or family medical history or additional factors that may 21
increase the risk of breast cancer for the insured. 22
(c) A diagnostic imaging test for breast cancer at the age deemed 23
most appropriate, when medically necessary, as recommended by 24
the insured’s provider of health care to evaluate an abnormality 25
which is: 26
(1) Seen or suspected from a mammogram described in 27
paragraph (a) or an imaging test described in paragraph (b); or 28
(2) Detected by other means of examination. 29
(d) Medication to prevent breast cancer for insureds who are 30
at a high risk of developing breast cancer and have a low risk of 31
adverse side effects from the medication. 32
2. An insurer must ensure that the benefits required by 33
subsection 1 are made available to an insured through a provider of 34
health care who participates in the network plan of the insurer. 35
3. Except as otherwise provided in subsection 5, an insurer that 36
offers or issues a contract for hospital or medical service shall not: 37
(a) Except as otherwise provided in subsection 6, require an 38
insured to pay a deductible, copayment, coinsurance or any other 39
form of cost-sharing or require a longer waiting period or other 40
condition to obtain any benefit provided in a contract for hospital or 41
medical service pursuant to subsection 1; 42
(b) Refuse to issue a contract for hospital or medical service or 43
cancel a contract for hospital or medical service solely because the 44
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person applying for or covered by the contract uses or may use any 1
such benefit; 2
(c) Offer or pay any type of material inducement or financial 3
incentive to an insured to discourage the insured from obtaining any 4
such benefit; 5
(d) Penalize a provider of health care who provides any such 6
benefit to an insured, including, without limitation, reducing the 7
reimbursement of the provider of health care; 8
(e) Offer or pay any type of material inducement, bonus or other 9
financial incentive to a provider of health care to deny, reduce, 10
withhold, limit or delay access to any such benefit to an insured; or 11
(f) Impose any other restrictions or delays on the access of an 12
insured to any such benefit. 13
4. A contract for hospital or medical service subject to the 14
provisions of this chapter which is delivered, issued for delivery or 15
renewed on or after [January] October 1, [2024,] 2025, has the legal 16
effect of including the coverage required by subsection 1, and any 17
provision of the contract or the renewal which is in conflict with this 18
section is void. 19
5. Except as otherwise provided in this section and federal law, 20
an insurer may use medical management techniques, including, 21
without limitation, any available clinical evidence, to determine the 22
frequency of or treatment relating to any benefit required by this 23
section or the type of provider of health care to use for such 24
treatment. 25
6. If the application of paragraph (a) of subsection 3 would 26
result in the ineligibility of a health savings account of an insured 27
pursuant to 26 U.S.C. § 223, the prohibitions of paragraph (a) of 28
subsection 3 shall apply only for a qualified contract for hospital or 29
medical service with respect to the deductible of such a contract for 30
hospital or medical service after the insured has satisfied the 31
minimum deductible pursuant to 26 U.S.C. § 223, except with 32
respect to items or services that constitute preventive care pursuant 33
to 26 U.S.C. § 223(c)(2)(C), in which case the prohibitions of 34
paragraph (a) of subsection 3 shall apply regardless of whether the 35
minimum deductible under 26 U.S.C. § 223 has been satisfied. 36
7. As used in this section: 37
(a) “Medical management technique” means a practice which is 38
used to control the cost or utilization of health care services or 39
prescription drug use. The term includes, without limitation, the use 40
of step therapy, prior authorization or categorizing drugs and 41
devices based on cost, type or method of administration. 42
(b) “Network plan” means a contract for hospital or medical 43
service offered by an insurer under which the financing and delivery 44
of medical care, including items and services paid for as medical 45
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care, are provided, in whole or in part, through a defined set of 1
providers under contract with the insurer. The term does not include 2
an arrangement for the financing of premiums. 3
(c) “Provider of health care” has the meaning ascribed to it in 4
NRS 629.031. 5
(d) “Qualified contract for hospital or medical service” means a 6
contract for hospital or medical service that has a high deductible 7
and is in compliance with 26 U.S.C. § 223 for the purposes of 8
establishing a health savings account. 9
Sec. 68. NRS 695B.1913 is hereby amended to read as 10
follows: 11
695B.1913 1. A hospital or medical services corporation that 12
issues a policy of health insurance shall provide coverage for the 13
examination of a person who is pregnant for the discovery of: 14
(a) Chlamydia trachomatis, gonorrhea, hepatitis B and hepatitis 15
C in accordance with NRS 442.013. 16
(b) Syphilis in accordance with NRS 442.010. 17
(c) Human immunodeficiency virus. 18
2. The coverage required by this section must be provided: 19
(a) Regardless of whether the benefits are provided to the 20
insured by a provider of health care, facility or medical laboratory 21
that participates in the network plan of the hospital or medical 22
services corporation; and 23
(b) Without prior authorization. 24
3. A hospital or medical services corporation that issues a 25
policy of health insurance shall not: 26
(a) Require an insured to pay a higher deductible, any 27
copayment or coinsurance or require a longer waiting period or 28
other condition to obtain any benefit provided in the policy of 29
health insurance pursuant to subsection 1; 30
(b) Refuse to issue a policy of health insurance or cancel a 31
policy of health insurance solely because the person applying for 32
or covered by the policy uses or may use any such benefit; 33
(c) Offer or pay any type of material inducement or financial 34
incentive to an insured to discourage the insured from obtaining 35
any such benefit; 36
(d) Penalize a provider of health care who provides any such 37
benefit to an insured, including, without limitation, reducing the 38
reimbursement of the provider of health care; 39
(e) Offer or pay any type of material inducement, bonus or 40
other financial incentive to a provider of health care to deny, 41
reduce, withhold, limit or delay access to any such benefit to an 42
insured; or 43
(f) Impose any other restrictions or delays on the access of an 44
insured to any such benefit. 45
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4. A policy of health insurance subject to the provisions of this 1
chapter that is delivered, issued for delivery or renewed on or after 2
[July] October 1, [2021,] 2025, has the legal effect of including the 3
coverage required by subsection 1, and any provision of the policy 4
that conflicts with the provisions of this section is void. 5
[4.] 5. As used in this section: 6
(a) “Medical laboratory” has the meaning ascribed to it in 7
NRS 652.060. 8
(b) “Network plan” means a policy of health insurance offered 9
by a hospital or medical services corporation under which the 10
financing and delivery of medical care, including items and services 11
paid for as medical care, are provided, in whole or in part, through a 12
defined set of providers under contract with the hospital or medical 13
services corporation. The term does not include an arrangement for 14
the financing of premiums. 15
(c) “Provider of health care” has the meaning ascribed to it in 16
NRS 629.031. 17
Sec. 69. NRS 695B.19195 is hereby amended to read as 18
follows: 19
695B.19195 1. An insurer that offers or issues a contract for 20
hospital or medical service shall include in the contract coverage 21
for: 22
(a) Counseling, support and supplies for breastfeeding, 23
including breastfeeding equipment, counseling and education during 24
the antenatal, perinatal and postpartum period for not more than 1 25
year; 26
(b) Screening and counseling for interpersonal and domestic 27
violence for women at least annually with initial intervention 28
services consisting of education, strategies to reduce harm, 29
supportive services or a referral for any other appropriate services; 30
(c) Behavioral counseling concerning sexually transmitted 31
diseases from a provider of health care for sexually active [women] 32
insureds who are at increased risk for such diseases; 33
(d) Such prenatal screenings and tests as recommended by the 34
American College of Obstetricians and Gynecologists or its 35
successor organization; 36
(e) Screening for blood pressure abnormalities and diabetes, 37
including gestational diabetes, after at least 24 weeks of gestation or 38
as ordered by a provider of health care; 39
(f) Screening for cervical cancer at such intervals as are 40
recommended by the American College of Obstetricians and 41
Gynecologists or its successor organization; 42
(g) Screening for depression [;] for insureds who are 12 years 43
of age or older; 44
(h) Screening for anxiety disorders; 45
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(i) Screening and counseling for the human immunodeficiency 1
virus consisting of a risk assessment, annual education relating to 2
prevention and at least one screening for the virus during the 3
lifetime of the insured or as ordered by a provider of health care; 4
[(i) Smoking] 5
(j) Tobacco cessation programs , including, without limitation, 6
pharmacotherapy approved by the United States Food and Drug 7
Administration, for an insured who is 18 years of age or older 8
consisting of not more than two cessation attempts per year and four 9
counseling sessions per year; 10
[(j)] (k) All vaccinations recommended by the Advisory 11
Committee on Immunization Practices of the Centers for Disease 12
Control and Prevention of the United States Department of Health 13
and Human Services or its successor organization; and 14
[(k)] (l) Such well-woman preventative visits as recommended 15
by the Health Resources and Services Administration [,] on 16
January 1, 2025, which must include at least one such visit per year 17
beginning at 14 years of age. 18
2. An insurer must ensure that the benefits required by 19
subsection 1 are made available to an insured through a provider of 20
health care who participates in the network plan of the insurer. 21
3. Except as otherwise provided in subsection 5, an insurer that 22
offers or issues a contract for hospital or medical service shall not: 23
(a) Require an insured to pay a higher deductible, any 24
copayment or coinsurance or require a longer waiting period or 25
other condition to obtain any benefit provided in the contract for 26
hospital or medical service pursuant to subsection 1; 27
(b) Refuse to issue a contract for hospital or medical service or 28
cancel a contract for hospital or medical service solely because the 29
person applying for or covered by the contract uses or may use any 30
such benefit; 31
(c) Offer or pay any type of material inducement or financial 32
incentive to an insured to discourage the insured from obtaining any 33
such benefit; 34
(d) Penalize a provider of health care who provides any such 35
benefit to an insured, including, without limitation, reducing the 36
reimbursement of the provider of health care; 37
(e) Offer or pay any type of material inducement, bonus or other 38
financial incentive to a provider of health care to deny, reduce, 39
withhold, limit or delay access to any such benefit to an insured; or 40
(f) Impose any other restrictions or delays on the access of an 41
insured to any such benefit. 42
4. A contract for hospital or medical service subject to the 43
provisions of this chapter that is delivered, issued for delivery or 44
renewed on or after [January] October 1, [2018,] 2025, has the legal 45
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effect of including the coverage required by subsection 1, and any 1
provision of the contract or the renewal which is in conflict with this 2
section is void. 3
5. Except as otherwise provided in this section and federal law, 4
an insurer may use medical management techniques, including, 5
without limitation, any available clinical evidence, to determine the 6
frequency of or treatment relating to any benefit required by this 7
section or the type of provider of health care to use for such 8
treatment. 9
6. As used in this section: 10
(a) “Medical management technique” means a practice which is 11
used to control the cost or utilization of health care services or 12
prescription drug use. The term includes, without limitation, the use 13
of step therapy, prior authorization or categorizing drugs and 14
devices based on cost, type or method of administration. 15
(b) “Network plan” means a contract for hospital or medical 16
service offered by an insurer under which the financing and delivery 17
of medical care, including items and services paid for as medical 18
care, are provided, in whole or in part, through a defined set of 19
providers under contract with the insurer. The term does not include 20
an arrangement for the financing of premiums. 21
(c) “Provider of health care” has the meaning ascribed to it in 22
NRS 629.031. 23
Sec. 70. NRS 695B.1926 is hereby amended to read as 24
follows: 25
695B.1926 1. A hospital or medical services corporation that 26
offers or issues a policy of health insurance shall include in the 27
policy: 28
(a) Coverage of testing for and the treatment and prevention of 29
sexually transmitted diseases, including, without limitation, 30
Chlamydia trachomatis, gonorrhea, syphilis, human 31
immunodeficiency virus and hepatitis B and C, for all insureds, 32
regardless of age. Such coverage must include, without limitation, 33
the coverage required by NRS 695B.1913 and 695B.1924. 34
(b) Unrestricted coverage of condoms for insureds who are 13 35
years of age or older. 36
2. A hospital or medical services corporation that offers or 37
issues a policy of health insurance shall not: 38
(a) Require an insured to pay a higher deductible, any 39
copayment or coinsurance or require a longer waiting period or 40
other condition to obtain any benefit provided in the policy of 41
health insurance pursuant to subsection 1; 42
(b) Refuse to issue a policy of health insurance or cancel a 43
policy of health insurance solely because the person applying for 44
or covered by the policy uses or may use any such benefit; 45
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(c) Offer or pay any type of material inducement or financial 1
incentive to an insured to discourage the insured from obtaining 2
any such benefit; 3
(d) Penalize a provider of health care who provides any such 4
benefit to an insured, including, without limitation, reducing the 5
reimbursement of the provider of health care; 6
(e) Offer or pay any type of material inducement, bonus or 7
other financial incentive to a provider of health care to deny, 8
reduce, withhold, limit or delay access to any such benefit to an 9
insured; or 10
(f) Impose any other restrictions or delays on the access of an 11
insured to any such benefit. 12
3. A policy of health insurance subject to the provisions of this 13
chapter that is delivered, issued for delivery or renewed on or after 14
[January] October 1, [2024,] 2025, has the legal effect of including 15
the coverage required by subsection 1, and any provision of the 16
policy that conflicts with the provisions of this section is void. 17
4. As used in this section “provider of health care” has the 18
meaning ascribed to it in NRS 629.031. 19
Sec. 71. NRS 695B.1948 is hereby amended to read as 20
follows: 21
695B.1948 1. An insurer that offers or issues a contract for 22
hospital or medical services [that includes coverage for maternity 23
care] shall not deny, limit or seek reimbursement for maternity care 24
because the insured is acting as a gestational carrier. 25
2. If an insured acts as a gestational carrier, the child shall be 26
deemed to be a child of the intended parent, as defined in NRS 27
126.590, for purposes related to the contract for hospital or medical 28
services. 29
3. As used in this section, “gestational carrier” has the meaning 30
ascribed to it in NRS 126.580. 31
Sec. 72. NRS 695B.3167 is hereby amended to read as 32
follows: 33
695B.3167 1. A hospital or medical services corporation that 34
issues a policy of health insurance shall not discriminate against any 35
person with respect to participation or coverage under the policy on 36
the basis of an actual or perceived [gender identity or expression.] 37
protected characteristic. 38
2. Prohibited discrimination includes, without limitation: 39
[1.] (a) Denying, cancelling, limiting or refusing to issue or 40
renew a policy of health insurance on the basis of [the] an actual or 41
perceived [gender identity or expression] protected characteristic of 42
a person or a family member of the person; 43
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[2.] (b) Imposing a payment or premium that is based on [the] 1
an actual or perceived [gender identity or expression] protected 2
characteristic of an insured or a family member of the insured; 3
[3.] (c) Designating [the] an actual or perceived [gender 4
identity or expression] protected characteristic of a person or a 5
family member of the person as grounds to deny, cancel or limit 6
participation or coverage; and 7
[4.] (d) Denying, cancelling or limiting participation or 8
coverage on the basis of an actual or perceived [gender identity or 9
expression,] protected characteristic including, without limitation, 10
by limiting or denying coverage for health care services that are: 11
[(a)] (1) Related to gender transition, provided that there is 12
coverage under the policy for the services when the services are not 13
related to gender transition; or 14
[(b)] (2) Ordinarily or exclusively available to persons of any 15
sex. 16
3. As used in this section, “protected characteristic” means: 17
(a) Race, color, national origin, age, physical or mental 18
disability, sexual orientation or gender identity or expression; or 19
(b) Sex, including, without limitation, sex characteristics, 20
intersex traits and pregnancy or related conditions. 21
Sec. 73. Chapter 695C of NRS is hereby amended by adding 22
thereto the provisions set forth as sections 74 to 78, inclusive, of this 23
act. 24
Sec. 74. 1. A health maintenance organization that offers 25
or issues a health care plan which provides coverage for 26
dependent children shall continue to make such coverage 27
available for an adult child of an enrollee until such child reaches 28
26 years of age. 29
2. Nothing in this section shall be construed as requiring a 30
health maintenance organization to make coverage available for a 31
dependent of an adult child of an enrollee. 32
Sec. 75. 1. A health maintenance organization that offers 33
or issues a health care plan shall include in the plan coverage for: 34
(a) Screening for anxiety for enrollees who are at least 8 but 35
not more than 18 years of age; 36
(b) Assessments relating to height, weight, body mass index 37
and medical history for enrollees who are less than 18 years of 38
age; 39
(c) Comprehensive and intensive behavioral interventions for 40
enrollees who are at least 12 but not more than 18 years of age 41
and have a body mass index in the 95th percentile or greater for 42
persons of the same age and sex; 43
(d) The application of fluoride varnish to the primary teeth for 44
enrollees who are less than 5 years of age; 45
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(e) Oral fluoride supplements for enrollees who are at least 6 1
months of age but less than 5 years of age and whose supply of 2
water is deficient in fluoride; 3
(f) Counseling and education pertaining to the minimization of 4
exposure to ultraviolet radiation for enrollees who are less than 25 5
years of age and have fair skin types and the parents or legal 6
guardians of enrollees who are less than 18 years of age and have 7
fair skin types for the purpose of minimizing the risk of skin 8
cancer in those persons; 9
(g) Brief behavioral counseling and interventions to prevent 10
tobacco use for enrollees who are less than 18 years of age; 11
(h) At least one screening for the detection of amblyopia or the 12
risk factors of amblyopia for enrollees who are at least 3 but not 13
more than 5 years of age; and 14
(i) Screening, tests and counseling for such other health 15
conditions and diseases as recommended by the Health Resources 16
and Services Administration on January 1, 2025, for enrollees 17
who are less than 18 years of age. 18
2. A health maintenance organization must ensure that the 19
benefits required by subsection 1 are made available to an enrollee 20
through a provider of health care who participates in the network 21
plan of the health maintenance organization. 22
3. Except as otherwise provided in subsection 5, a health 23
maintenance organization that offers or issues a health care plan 24
shall not: 25
(a) Require an enrollee to pay a higher deductible, any 26
copayment or coinsurance or require a longer waiting period or 27
other condition to obtain any benefit provided in the health care 28
plan pursuant to subsection 1; 29
(b) Refuse to issue a health care plan or cancel a health care 30
plan solely because the person applying for or covered by the plan 31
uses or may use any such benefit; 32
(c) Offer or pay any type of material inducement or financial 33
incentive to an enrollee to discourage the enrollee from obtaining 34
any such benefit; 35
(d) Penalize a provider of health care who provides any such 36
benefit to an enrollee, including, without limitation, reducing the 37
reimbursement of the provider of health care; 38
(e) Offer or pay any type of material inducement, bonus or 39
other financial incentive to a provider of health care to deny, 40
reduce, withhold, limit or delay access to any such benefit to an 41
enrollee; or 42
(f) Impose any other restrictions or delays on the access of an 43
enrollee to any such benefit. 44
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4. A health care plan subject to the provisions of this chapter 1
that is delivered, issued for delivery or renewed on or after 2
October 1, 2025, has the legal effect of including the coverage 3
required by subsection 1, and any provision of the plan or the 4
renewal which is in conflict with this section is void. 5
5. Except as otherwise provided in this section and federal 6
law, a health maintenance organization may use medical 7
management techniques, including, without limitation, any 8
available clinical evidence, to determine the frequency of or 9
treatment relating to any benefit required by this section or the 10
type of provider of health care to use for such treatment. 11
6. As used in this section: 12
(a) “Medical management technique” means a practice which 13
is used to control the cost or utilization of health care services or 14
prescription drug use. The term includes, without limitation, the 15
use of step therapy, prior authorization or categorizing drugs and 16
devices based on cost, type or method of administration. 17
(b) “Network plan” means a health care plan offered by a 18
health maintenance 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 of health care under contract with the health 22
maintenance organization. The term does not include an 23
arrangement for the financing of premiums. 24
(c) “Provider of health care” has the meaning ascribed to it in 25
NRS 629.031. 26
Sec. 76. 1. A health maintenance organization that offers 27
or issues a health care plan shall include in the plan coverage for: 28
(a) A daily dose of 0.4 to 0.8 milligrams of folic acid for 29
enrollees who are pregnant or are planning on becoming 30
pregnant; 31
(b) A low dose of aspirin for the prevention of preeclampsia 32
for enrollees who are determined to be at a high risk of that 33
condition after 12 weeks of gestation; 34
(c) Prophylactic ocular tubal medication for the prevention of 35
gonococcal ophthalmia in newborns; 36
(d) Screening for asymptomatic bacteriuria for enrollees who 37
are pregnant; 38
(e) Counseling and behavioral interventions relating to the 39
promotion of healthy weight gain and the prevention of excessive 40
weight gain for enrollees who are pregnant; 41
(f) Counseling for enrollees who are pregnant or in the 42
postpartum stage of pregnancy and have an increased risk of 43
perinatal or postpartum depression; 44
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(g) Screening for the presence of the rhesus D antigen and 1
antibodies in the blood of an enrollee who is pregnant during the 2
enrollee’s first visit for care relating to the pregnancy; 3
(h) Screening for rhesus D antibodies between 24 and 28 4
weeks of gestation for enrollees who are negative for the rhesus D 5
antigen and have not been exposed to blood that is positive for the 6
rhesus D antigen; 7
(i) Behavioral counseling and intervention for tobacco 8
cessation for enrollees who are pregnant; 9
(j) An annual screening for urinary incontinence for women; 10
(k) Screening for type 2 diabetes at such intervals as 11
recommended by the Health Resources and Services 12
Administration on January 1, 2025, for enrollees who are in the 13
postpartum stage of pregnancy and who have a history of 14
gestational diabetes mellitus; 15
(l) Counseling relating to maintaining a healthy weight for 16
women who are at least 40 but not more than 60 years of age and 17
have a body mass index greater than 18.5; and 18
(m) Screening for osteoporosis for women who: 19
(1) Are 65 years of age or older; or 20
(2) Are less than 65 years of age and have a risk of 21
fracturing a bone equal to or greater than that of a woman who is 22
65 years of age without any additional risk factors. 23
2. A health maintenance organization must 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
3. Except as otherwise provided in subsection 5, a health 28
maintenance organization that offers or issues a health care plan 29
shall not: 30
(a) Require an enrollee to pay a higher deductible, any 31
copayment or coinsurance or require a longer waiting period or 32
other condition to obtain any benefit provided in the health care 33
plan pursuant to subsection 1; 34
(b) Refuse to issue a health care plan or cancel a health care 35
plan solely because the person applying for or covered by the plan 36
uses or may use any such benefit; 37
(c) Offer or pay any type of material inducement or financial 38
incentive to an enrollee to discourage the enrollee from obtaining 39
any such benefit; 40
(d) Penalize a provider of health care who provides any such 41
benefit to an enrollee, including, without limitation, reducing the 42
reimbursement of the provider of health care; 43
(e) Offer or pay any type of material inducement, bonus or 44
other financial incentive to a provider of health care to deny, 45
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reduce, withhold, limit or delay access to any such benefit to an 1
enrollee; or 2
(f) Impose any other restrictions or delays on the access of an 3
enrollee to any such benefit. 4
4. A health care plan subject to the provisions of this chapter 5
that is delivered, issued for delivery or renewed on or after 6
October 1, 2025, has the legal effect of including the coverage 7
required by subsection 1, and any provision of the plan or the 8
renewal which is in conflict with this section is void. 9
5. Except as otherwise provided in this section and federal 10
law, a health maintenance organization may use medical 11
management techniques, including, without limitation, any 12
available clinical evidence, to determine the frequency of or 13
treatment relating to any benefit required by this section or the 14
type of provider of health care to use for such treatment. 15
6. As used in this section: 16
(a) “Medical management technique” means a practice which 17
is used to control the cost or utilization of health care services or 18
prescription drug use. The term includes, without limitation, the 19
use of step therapy, prior authorization or categorizing drugs and 20
devices based on cost, type or method of administration. 21
(b) “Network plan” means a health care plan offered by a 22
health maintenance organization under which the financing and 23
delivery of medical care, including items and services paid for as 24
medical care, are provided, in whole or in part, through a defined 25
set of providers of health care under contract with the health 26
maintenance organization. The term does not include an 27
arrangement for the financing of premiums. 28
(c) “Provider of health care” has the meaning ascribed to it in 29
NRS 629.031. 30
Sec. 77. 1. A health maintenance organization that offers 31
or issues a health care plan shall include in the plan coverage for: 32
(a) Behavioral counseling and interventions to promote 33
physical activity and a healthy diet for enrollees with 34
cardiovascular risk factors; 35
(b) Statin preventive medication for enrollees who are at least 36
40 but not more than 75 years of age and do not have a history of 37
cardiovascular disease, but who have: 38
(1) One or more risk factors for cardiovascular disease; 39
and 40
(2) A calculated risk of at least 10 percent of acquiring 41
cardiovascular disease within the next 10 years; 42
(c) Interventions for exercise to prevent falls for enrollees who 43
are 65 years of age or older and reside in a medical facility or 44
facility for the dependent; 45
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(d) Screenings for latent tuberculosis infection in enrollees 1
with an increased risk of contracting tuberculosis; 2
(e) Screening for hypertension; 3
(f) One abdominal aortic screening by ultrasound to detect 4
abdominal aortic aneurysms for men who are at least 65 but not 5
more than 75 years of age and have smoked during their lifetimes; 6
(g) Screening for drug and alcohol misuse for enrollees who 7
are 18 years of age or older; 8
(h) If an enrollee engages in risky or hazardous consumption 9
of alcohol, as determined by the screening described in paragraph 10
(g), behavioral counseling to reduce such behavior; 11
(i) Screening for lung cancer using low-dose computed 12
tomography for enrollees who are at least 50 but not more than 80 13
years of age and: 14
(1) Have a smoking history of 20 pack-years; 15
(2) Smoke or have stopped smoking within the immediately 16
preceding 15 years; and 17
(3) Do not suffer from a health problem that substantially 18
limits the life expectancy of the person or the willingness of the 19
person to undergo curative surgery; 20
(j) Screening for prediabetes and type 2 diabetes in enrollees 21
who are at least 35 but not more than 70 years of age and have a 22
body mass index of 25 or greater; and 23
(k) Intensive behavioral interventions with multiple 24
components for enrollees who are 18 years of age or older and 25
have a body mass index of 30 or greater. 26
2. A health maintenance organization must ensure that the 27
benefits required by subsection 1 are made available to an enrollee 28
through a provider of health care who participates in the network 29
plan of the health maintenance organization. 30
3. Except as otherwise provided in subsection 5, a health 31
maintenance organization that offers or issues a health care plan 32
shall not: 33
(a) Require an enrollee to pay a higher deductible, any 34
copayment or coinsurance or require a longer waiting period or 35
other condition to obtain any benefit provided in the health care 36
plan pursuant to subsection 1; 37
(b) Refuse to issue a health care plan or cancel a health care 38
plan solely because the person applying for or covered by the plan 39
uses or may use any such benefit; 40
(c) Offer or pay any type of material inducement or financial 41
incentive to an enrollee to discourage the enrollee from obtaining 42
any such benefit; 43
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(d) Penalize a provider of health care who provides any such 1
benefit to an enrollee, including, without limitation, reducing the 2
reimbursement of the provider of health care; 3
(e) Offer or pay any type of material inducement, bonus or 4
other financial incentive to a provider of health care to deny, 5
reduce, withhold, limit or delay access to any such benefit to an 6
enrollee; or 7
(f) Impose any other restrictions or delays on the access of an 8
enrollee to any such benefit. 9
4. A health care plan subject to the provisions of this chapter 10
that is delivered, issued for delivery or renewed on or after 11
October 1, 2025, has the legal effect of including the coverage 12
required by subsection 1, and any provision of the plan or the 13
renewal which is in conflict with this section is void. 14
5. Except as otherwise provided in this section and federal 15
law, a health maintenance organization may use medical 16
management techniques, including, without limitation, any 17
available clinical evidence, to determine the frequency of or 18
treatment relating to any benefit required by this section or the 19
type of provider of health care to use for such treatment. 20
6. As used in this section: 21
(a) “Computed tomography” means the process of producing 22
sectional and three-dimensional images using external ionizing 23
radiation. 24
(b) “Facility for the dependent” has the meaning ascribed to it 25
in NRS 449.0045. 26
(c) “Medical facility” has the meaning ascribed to it in 27
NRS 449.0151. 28
(d) “Medical management technique” means a practice which 29
is used to control the cost or utilization of health care services or 30
prescription drug use. The term includes, without limitation, the 31
use of step therapy, prior authorization or categorizing drugs and 32
devices based on cost, type or method of administration. 33
(e) “Network plan” means a health care plan offered by a 34
health maintenance organization under which the financing and 35
delivery of medical care, including items and services paid for as 36
medical care, are provided, in whole or in part, through a defined 37
set of providers of health care under contract with the health 38
maintenance organization. The term does not include an 39
arrangement for the financing of premiums. 40
(f) “Pack-year” means the product of the number of packs of 41
cigarettes smoked per day and the number of years that the person 42
has smoked. 43
(g) “Provider of health care” has the meaning ascribed to it in 44
NRS 629.031. 45
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Sec. 78. 1. A health maintenance organization that offers 1
or issues a health care plan subject to the provisions of this 2
chapter shall include in the health care plan coverage for 3
maternity care and pediatric care for newborn infants. 4
2. Except as otherwise provided in this subsection, a health 5
care plan issued pursuant to this chapter may not restrict benefits 6
for any length of stay in a hospital in connection with childbirth 7
for a pregnant or postpartum individual or newborn infant 8
covered by the plan to: 9
(a) Less than 48 hours after a normal vaginal delivery; and 10
(b) Less than 96 hours after a cesarean section. 11
If a different length of stay is provided in the guidelines 12
established by the American College of Obstetricians and 13
Gynecologists, or its successor organization, and the American 14
Academy of Pediatrics, or its successor organization, the health 15
care plan may follow such guidelines in lieu of following the 16
length of stay set forth above. The provisions of this subsection do 17
not apply to any health care plan in any case in which the decision 18
to discharge the pregnant or postpartum individual or newborn 19
infant before the expiration of the minimum length of stay set 20
forth in this subsection is made by the attending physician of the 21
pregnant or postpartum individual or newborn infant. 22
3. Nothing in this section requires a pregnant or postpartum 23
individual to: 24
(a) Deliver the baby in a hospital; or 25
(b) Stay in a hospital for a fixed period following the birth of 26
the child. 27
4. A health care plan may not: 28
(a) Deny a pregnant or postpartum individual or the newborn 29
infant coverage or continued coverage under the terms of the plan 30
if the sole purpose of the denial of coverage or continued coverage 31
is to avoid the requirements of this section; 32
(b) Provide monetary payments or rebates to a pregnant or 33
postpartum individual to encourage the individual to accept less 34
than the minimum protection available pursuant to this section; 35
(c) Penalize, or otherwise reduce or limit, the reimbursement 36
of an attending provider of health care because the attending 37
provider of health care provided care to a pregnant or postpartum 38
individual or newborn infant in accordance with the provisions of 39
this section; 40
(d) Provide incentives of any kind to an attending physician to 41
induce the attending physician to provide care to a pregnant or 42
postpartum individual or newborn infant in a manner that is 43
inconsistent with the provisions of this section; or 44
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(e) Except as otherwise provided in subsection 5, restrict 1
benefits for any portion of a hospital stay required pursuant to the 2
provisions of this section in a manner that is less favorable than 3
the benefits provided for any preceding portion of that stay. 4
5. Nothing in this section: 5
(a) Prohibits a health maintenance organization from 6
imposing a deductible, coinsurance or other mechanism for 7
sharing costs relating to benefits for hospital stays in connection 8
with childbirth for a pregnant or postpartum individual or 9
newborn child covered by the plan, except that such coinsurance 10
or other mechanism for sharing costs for any portion of a hospital 11
stay required by this section may not be greater than the 12
coinsurance or other mechanism for any preceding portion of that 13
stay. 14
(b) Prohibits an arrangement for payment between a health 15
maintenance organization and a provider of health care that uses 16
capitation or other financial incentives, if the arrangement is 17
designed to provide services efficiently and consistently in the best 18
interest of the pregnant or postpartum individual and the newborn 19
infant. 20
(c) Prevents a health maintenance organization from 21
negotiating with a provider of health care concerning the level and 22
type of reimbursement to be provided in accordance with this 23
section. 24
6. A health care plan subject to the provisions of this chapter 25
that is delivered, issued for delivery or renewed on or after 26
October 1, 2025, has the legal effect of including the coverage 27
required by this section, and any provision of the plan that 28
conflicts with the provisions of this section is void. 29
Sec. 79. NRS 695C.050 is hereby amended to read as follows: 30
695C.050 1. Except as otherwise provided in this chapter or 31
in specific provisions of this title, the provisions of this title are not 32
applicable to any health maintenance organization granted a 33
certificate of authority under this chapter. This provision does not 34
apply to an insurer licensed and regulated pursuant to this title 35
except with respect to its activities as a health maintenance 36
organization authorized and regulated pursuant to this chapter. 37
2. Solicitation of enrollees by a health maintenance 38
organization granted a certificate of authority, or its representatives, 39
must not be construed to violate any provision of law relating to 40
solicitation or advertising by practitioners of a healing art. 41
3. Any health maintenance organization authorized under this 42
chapter shall not be deemed to be practicing medicine and is exempt 43
from the provisions of chapter 630 of NRS. 44
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4. The provisions of NRS 695C.110, 695C.125, 695C.1691, 1
695C.1693, 695C.170, 695C.1703, 695C.1705, 695C.1709 to 2
695C.173, inclusive, 695C.1733, 695C.17335, 695C.1734, 3
695C.1751, 695C.1755, 695C.1759, 695C.176 to 695C.200, 4
inclusive, and 695C.265 do not apply to a health maintenance 5
organization that provides health care services through managed 6
care to recipients of Medicaid under the State Plan for Medicaid or 7
insurance pursuant to the Children’s Health Insurance Program 8
pursuant to a contract with the Division of Health Care Financing 9
and Policy of the Department of Health and Human Services. This 10
subsection does not exempt a health maintenance organization from 11
any provision of this chapter for services provided pursuant to any 12
other contract. 13
5. The provisions of NRS 695C.16932 to 695C.1699, 14
inclusive, 695C.1701, 695C.1708, 695C.1728, 695C.1731, 15
695C.17333, 695C.17345, 695C.17347, 695C.1736 to 695C.1745, 16
inclusive, 695C.1757 and 695C.204 and sections 74 to 78, 17
inclusive, of this act apply to a health maintenance organization that 18
provides health care services through managed care to recipients of 19
Medicaid under the State Plan for Medicaid. 20
6. The provisions of NRS 695C.17095 do not apply to a health 21
maintenance organization that provides health care services to 22
members of the Public Employees’ Benefits Program. This 23
subsection does not exempt a health maintenance organization from 24
any provision of this chapter for services provided pursuant to any 25
other contract. 26
7. The provisions of NRS 695C.1735 do not apply to a health 27
maintenance organization that provides health care services to: 28
(a) The officers and employees, and the dependents of officers 29
and employees, of the governing body of any county, school district, 30
municipal corporation, political subdivision, public corporation or 31
other local governmental agency of this State; or 32
(b) Members of the Public Employees’ Benefits Program. 33
This subsection does not exempt a health maintenance 34
organization from any provision of this chapter for services 35
provided pursuant to any other contract. 36
Sec. 80. NRS 695C.1698 is hereby amended to read as 37
follows: 38
695C.1698 1. A health maintenance organization that offers 39
or issues a health care plan shall include in the plan coverage for: 40
(a) Counseling, support and supplies for breastfeeding, 41
including breastfeeding equipment, counseling and education during 42
the antenatal, perinatal and postpartum period for not more than 1 43
year; 44
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(b) Screening and counseling for interpersonal and domestic 1
violence for women at least annually with initial intervention 2
services consisting of education, strategies to reduce harm, 3
supportive services or a referral for any other appropriate services; 4
(c) Behavioral counseling concerning sexually transmitted 5
diseases from a provider of health care for sexually active [women] 6
enrollees who are at increased risk for such diseases; 7
(d) Such prenatal screenings and tests as recommended by the 8
American College of Obstetricians and Gynecologists or its 9
successor organization; 10
(e) Screening for blood pressure abnormalities and diabetes, 11
including gestational diabetes, after at least 24 weeks of gestation or 12
as ordered by a provider of health care; 13
(f) Screening for cervical cancer at such intervals as are 14
recommended by the American College of Obstetricians and 15
Gynecologists or its successor organization; 16
(g) Screening for depression [;] for enrollees who are 12 years 17
of age or older; 18
(h) Screening for anxiety disorders; 19
(i) Screening and counseling for the human immunodeficiency 20
virus consisting of a risk assessment, annual education relating to 21
prevention and at least one screening for the virus during the 22
lifetime of the enrollee or as ordered by a provider of health care; 23
[(i) Smoking] 24
(j) Tobacco cessation programs , including, without limitation, 25
pharmacotherapy approved by the United States Food and Drug 26
Administration, for an enrollee who is 18 years of age or older not 27
more than two cessation attempts per year and four counseling 28
sessions per year; 29
[(j)] (k) All vaccinations recommended by the Advisory 30
Committee on Immunization Practices of the Centers for Disease 31
Control and Prevention of the United States Department of Health 32
and Human Services or its successor organization; and 33
[(k)] (l) Such well-woman preventative visits as recommended 34
by the Health Resources and Services Administration [,] on 35
January 1, 2025, which must include at least one such visit per year 36
beginning at 14 years of age. 37
2. A health maintenance organization must ensure that the 38
benefits required by subsection 1 are made available to an enrollee 39
through a provider of health care who participates in the network 40
plan of the health maintenance organization. 41
3. Except as otherwise provided in subsection 5, a health 42
maintenance organization that offers or issues a health care plan 43
shall not: 44
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(a) Require an enrollee to pay a higher deductible, any 1
copayment or coinsurance or require a longer waiting period or 2
other condition to obtain any benefit provided in the health care plan 3
pursuant to subsection 1; 4
(b) Refuse to issue a health care plan or cancel a health care plan 5
solely because the person applying for or covered by the plan uses 6
or may use any such benefit; 7
(c) Offer or pay any type of material inducement or financial 8
incentive to an enrollee to discourage the enrollee from obtaining 9
any such benefit; 10
(d) Penalize a provider of health care who provides any such 11
benefit to an enrollee, including, without limitation, reducing the 12
reimbursement of the provider of health care; 13
(e) Offer or pay any type of material inducement, bonus or other 14
financial incentive to a provider of health care to deny, reduce, 15
withhold, limit or delay access to any such benefit to an enrollee; or 16
(f) Impose any other restrictions or delays on the access of an 17
enrollee to any such benefit. 18
4. A health care plan subject to the provisions of this chapter 19
that is delivered, issued for delivery or renewed on or after [January] 20
October 1, [2018,] 2025, has the legal effect of including the 21
coverage required by subsection 1, and any provision of the plan or 22
the renewal which is in conflict with this section is void. 23
5. Except as otherwise provided in this section and federal law, 24
a health maintenance organization may use medical management 25
techniques, including, without limitation, any available clinical 26
evidence, to determine the frequency of or treatment relating to any 27
benefit required by this section or the type of provider of health care 28
to use for such treatment. 29
6. As used in this section: 30
(a) “Medical management technique” means a practice which is 31
used to control the cost or utilization of health care services or 32
prescription drug use. The term includes, without limitation, the use 33
of step therapy, prior authorization or categorizing drugs and 34
devices based on cost, type or method of administration. 35
(b) “Network plan” means a health care plan offered by a health 36
maintenance organization under which the financing and delivery of 37
medical care, including items and services paid for as medical care, 38
are provided, in whole or in part, through a defined set of providers 39
under contract with the health maintenance organization. The term 40
does not include an arrangement for the financing of premiums. 41
(c) “Provider of health care” has the meaning ascribed to it in 42
NRS 629.031. 43
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Sec. 81. NRS 695C.1712 is hereby amended to read as 1
follows: 2
695C.1712 1. A health maintenance organization that offers 3
or issues a health care plan [that includes coverage for maternity 4
care] shall not deny, limit or seek reimbursement for maternity care 5
because the enrollee is acting as a gestational carrier. 6
2. If an enrollee acts as a gestational carrier, the child shall be 7
deemed to be a child of the intended parent, as defined in NRS 8
126.590, for purposes related to the health care plan. 9
3. As used in this section, “gestational carrier” has the meaning 10
ascribed to it in NRS 126.580. 11
Sec. 82. NRS 695C.1731 is hereby amended to read as 12
follows: 13
695C.1731 1. A health care plan issued by a health 14
maintenance organization [that provides coverage for the treatment 15
of colorectal cancer] must provide coverage for colorectal cancer 16
screening in accordance with: 17
(a) The guidelines concerning colorectal cancer screening which 18
are published by the American Cancer Society; or 19
(b) Other guidelines or reports concerning colorectal cancer 20
screening which are published by nationally recognized professional 21
organizations and which include current or prevailing supporting 22
scientific data. 23
2. A health maintenance organization must 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
3. A health maintenance organization that offers or issues a 28
health care plan shall not: 29
(a) Require an enrollee to pay a higher deductible, any 30
copayment or coinsurance or require a longer waiting period or 31
other condition to obtain any benefit provided in the health care 32
plan pursuant to subsection 1; 33
(b) Refuse to issue a health care plan or cancel a health care 34
plan solely because the person applying for or covered by the plan 35
uses or may use any such benefit; 36
(c) Offer or pay any type of material inducement or financial 37
incentive to an enrollee to discourage the enrollee from obtaining 38
any such benefit; 39
(d) Penalize a provider of health care who provides any such 40
benefit to an enrollee, including, without limitation, reducing the 41
reimbursement of the provider of health care; 42
(e) Offer or pay any type of material inducement, bonus or 43
other financial incentive to a provider of health care to deny, 44
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reduce, withhold, limit or delay access to any such benefit to an 1
enrollee; or 2
(f) Impose any other restrictions or delays on the access of an 3
enrollee to any such benefit. 4
4. An evidence of coverage for a health care plan subject to the 5
provisions of this chapter that is delivered, issued for delivery or 6
renewed on or after October 1, [2003,] 2025, has the legal effect of 7
including the coverage required by this section, and any provision of 8
the evidence of coverage that conflicts with the provisions of this 9
section is void. 10
5. As used in this section: 11
(a) “Network plan” means a health care plan offered by a 12
health maintenance organization under which the financing and 13
delivery of medical care, including items and services paid for as 14
medical care, are provided, in whole or in part, through a defined 15
set of providers of health care under contract with the health 16
maintenance organization. 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. 83. NRS 695C.17347 is hereby amended to read as 21
follows: 22
695C.17347 1. A health maintenance organization that issues 23
a health care plan shall provide coverage for screening, genetic 24
counseling and testing for harmful mutations in the BRCA gene for 25
women under circumstances where such screening, genetic 26
counseling or testing, as applicable, is required by NRS 457.301. 27
2. A health maintenance organization shall ensure that the 28
benefits required by subsection 1 are made available to an enrollee 29
through a provider of health care who participates in the network 30
plan of the health maintenance organization. 31
3. A health maintenance organization that issues a health 32
care plan shall not: 33
(a) Require an enrollee to pay a higher deductible, any 34
copayment or coinsurance or require a longer waiting period or 35
other condition to obtain any benefit provided in the health care 36
plan pursuant to subsection 1; 37
(b) Refuse to issue a health care plan or cancel a health care 38
plan solely because the person applying for or covered by the plan 39
uses or may use any such benefit; 40
(c) Offer or pay any type of material inducement or financial 41
incentive to an enrollee to discourage the enrollee from obtaining 42
any such benefit; 43
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(d) Penalize a provider of health care who provides any such 1
benefit to an enrollee, including, without limitation, reducing the 2
reimbursement of the provider of health care; 3
(e) Offer or pay any type of material inducement, bonus or 4
other financial incentive to a provider of health care to deny, 5
reduce, withhold, limit or delay access to any such benefit to an 6
enrollee; or 7
(f) Impose any other restrictions or delays on the access of an 8
enrollee to any such benefit. 9
4. A health care plan subject to the provisions of this chapter 10
that is delivered, issued for delivery or renewed on or after [January] 11
October 1, [2022,] 2025, has the legal effect of including the 12
coverage required by subsection 1, and any provision of the plan 13
that conflicts with the provisions of this section is void. 14
[4.] 5. As used in this section: 15
(a) “Network plan” means a health care plan offered by a health 16
maintenance organization under which the financing and delivery of 17
medical care, including items and services paid for as medical care, 18
are provided, in whole or in part, through a defined set of providers 19
under contract with the health maintenance organization. The term 20
does not include an arrangement for the financing of premiums. 21
(b) “Provider of health care” has the meaning ascribed to it in 22
NRS 629.031. 23
Sec. 84. NRS 695C.1735 is hereby amended to read as 24
follows: 25
695C.1735 1. A health care plan of a health maintenance 26
organization must provide coverage for benefits payable for 27
expenses incurred for: 28
(a) A mammogram to screen for breast cancer annually for 29
enrollees who are 40 years of age or older. 30
(b) An imaging test to screen for breast cancer on an interval 31
and at the age deemed most appropriate, when medically necessary, 32
as recommended by the enrollee’s provider of health care based on 33
personal or family medical history or additional factors that may 34
increase the risk of breast cancer for the enrollee. 35
(c) A diagnostic imaging test for breast cancer at the age deemed 36
most appropriate, when medically necessary, as recommended by 37
the enrollee’s provider of health care to evaluate an abnormality 38
which is: 39
(1) Seen or suspected from a mammogram described in 40
paragraph (a) or an imaging test described in paragraph (b); or 41
(2) Detected by other means of examination. 42
(d) Medication to prevent breast cancer for enrollees who are 43
at a high risk of developing breast cancer and have a low risk of 44
adverse side effects from the medication. 45
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2. A health maintenance organization must ensure that the 1
benefits required by subsection 1 are made available to an enrollee 2
through a provider of health care who participates in the network 3
plan of the health maintenance organization. 4
3. Except as otherwise provided in subsection 5, a health 5
maintenance organization that offers or issues a health care plan 6
shall not: 7
(a) Except as otherwise provided in subsection 6, require an 8
enrollee to pay a deductible, copayment, coinsurance or any other 9
form of cost-sharing or require a longer waiting period or other 10
condition to obtain any benefit provided in the health care plan 11
pursuant to subsection 1; 12
(b) Refuse to issue a health care plan or cancel a health care plan 13
solely because the person applying for or covered by the plan uses 14
or may use any such benefit; 15
(c) Offer or pay any type of material inducement or financial 16
incentive to an enrollee to discourage the enrollee from obtaining 17
any benefit provided in the health care plan pursuant to 18
subsection 1; 19
(d) Penalize a provider of health care who provides any such 20
benefit to an enrollee, including, without limitation, reducing the 21
reimbursement of the provider of health care; 22
(e) Offer or pay any type of material inducement, bonus or other 23
financial incentive to a provider of health care to deny, reduce, 24
withhold, limit or delay access to any such benefit to an enrollee; or 25
(f) Impose any other restrictions or delays on the access of an 26
enrollee to any such benefit. 27
4. A health care plan subject to the provisions of this chapter 28
which is delivered, issued for delivery or renewed on or after 29
[January] October 1, [2024,] 2025, has the legal effect of including 30
the coverage required by subsection 1, and any provision of the plan 31
or the renewal which is in conflict with this section is void. 32
5. Except as otherwise provided in this section and federal law, 33
a health maintenance organization may use medical management 34
techniques, including, without limitation, any available clinical 35
evidence, to determine the frequency of or treatment relating to any 36
benefit required by this section or the type of provider of health care 37
to use for such treatment. 38
6. If the application of paragraph (a) of subsection 3 would 39
result in the ineligibility of a health savings account of an enrollee 40
pursuant to 26 U.S.C. § 223, the prohibitions of paragraph (a) of 41
subsection 3 shall apply only for a qualified health care plan with 42
respect to the deductible of such a health care plan after the enrollee 43
has satisfied the minimum deductible pursuant to 26 U.S.C. § 223, 44
except with respect to items or services that constitute preventive 45
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care pursuant to 26 U.S.C. § 223(c)(2)(C), in which case the 1
prohibitions of paragraph (a) of subsection 3 shall apply regardless 2
of whether the minimum deductible under 26 U.S.C. § 223 has been 3
satisfied. 4
7. As used in this section: 5
(a) “Medical management technique” means a practice which is 6
used to control the cost or utilization of health care services or 7
prescription drug use. The term includes, without limitation, the use 8
of step therapy, prior authorization or categorizing drugs and 9
devices based on cost, type or method of administration. 10
(b) “Network plan” means a health care plan offered by a health 11
maintenance organization under which the financing and delivery of 12
medical care, including items and services paid for as medical care, 13
are provided, in whole or in part, through a defined set of providers 14
under contract with the health maintenance organization. The term 15
does not include an arrangement for the financing of premiums. 16
(c) “Provider of health care” has the meaning ascribed to it in 17
NRS 629.031. 18
(d) “Qualified health care plan” means a health care plan of a 19
health maintenance organization that has a high deductible and is in 20
compliance with 26 U.S.C. § 223 for the purposes of establishing a 21
health savings account. 22
Sec. 85. NRS 695C.1736 is hereby amended to read as 23
follows: 24
695C.1736 1. A health maintenance organization that offers 25
or issues a health care plan shall include in the plan: 26
(a) Coverage of testing for and the treatment and prevention of 27
sexually transmitted diseases, including, without limitation, 28
Chlamydia trachomatis, gonorrhea, syphilis, human 29
immunodeficiency virus and hepatitis B and C, for all enrollees, 30
regardless of age. Such coverage must include, without limitation, 31
the coverage required by NRS 695C.1737 and 695C.1743. 32
(b) Unrestricted coverage of condoms for enrollees who are 13 33
years of age or older. 34
2. A health maintenance organization that offers or issues a 35
health care plan shall not: 36
(a) Require an enrollee to pay a higher deductible, any 37
copayment or coinsurance or require a longer waiting period or 38
other condition to obtain any benefit provided in the health care 39
plan pursuant to subsection 1; 40
(b) Refuse to issue a health care plan or cancel a health care 41
plan solely because the person applying for or covered by the plan 42
uses or may use any such benefit; 43
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(c) Offer or pay any type of material inducement or financial 1
incentive to an enrollee to discourage the enrollee from obtaining 2
any such benefit; 3
(d) Penalize a provider of health care who provides any such 4
benefit to an enrollee, including, without limitation, reducing the 5
reimbursement of the provider of health care; 6
(e) Offer or pay any type of material inducement, bonus or 7
other financial incentive to a provider of health care to deny, 8
reduce, withhold, limit or delay access to any such benefit to an 9
enrollee; or 10
(f) Impose any other restrictions or delays on the access of an 11
enrollee to any such benefit. 12
3. A health care plan subject to the provisions of this chapter 13
that is delivered, issued for delivery or renewed on or after [January] 14
October 1, [2024,] 2025, has the legal effect of including the 15
coverage required by subsection 1, and any provision of the plan 16
that conflicts with the provisions of this section is void. 17
4. As used in this section, “provider of health care” has the 18
meaning ascribed to it in NRS 629.031. 19
Sec. 86. NRS 695C.1737 is hereby amended to read as 20
follows: 21
695C.1737 1. A health maintenance organization that issues 22
a health care plan shall provide coverage for the examination of a 23
person who is pregnant for the discovery of: 24
(a) Chlamydia trachomatis, gonorrhea, hepatitis B and hepatitis 25
C in accordance with NRS 442.013. 26
(b) Syphilis in accordance with NRS 442.010. 27
(c) Human immunodeficiency virus. 28
2. The coverage required by this section must be provided: 29
(a) Regardless of whether the benefits are provided to the 30
enrollee by a provider of health care, facility or medical laboratory 31
that participates in the network plan of the health maintenance 32
organization; and 33
(b) Without prior authorization. 34
3. A health maintenance organization that issues a health 35
care plan shall not: 36
(a) Require an enrollee to pay a higher deductible, any 37
copayment or coinsurance or require a longer waiting period or 38
other condition to obtain any benefit provided in the health care 39
plan pursuant to subsection 1; 40
(b) Refuse to issue a health care plan or cancel a health care 41
plan solely because the person applying for or covered by the plan 42
uses or may use any such benefit; 43
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(c) Offer or pay any type of material inducement or financial 1
incentive to an enrollee to discourage the enrollee from obtaining 2
any such benefit; 3
(d) Penalize a provider of health care who provides any such 4
benefit to an enrollee, including, without limitation, reducing the 5
reimbursement of the provider of health care; 6
(e) Offer or pay any type of material inducement, bonus or 7
other financial incentive to a provider of health care to deny, 8
reduce, withhold, limit or delay access to any such benefit to an 9
enrollee; or 10
(f) Impose any other restrictions or delays on the access of an 11
enrollee to any such benefit. 12
4. A health care plan subject to the provisions of this chapter 13
that is delivered, issued for delivery or renewed on or after [July] 14
October 1, [2021,] 2025, has the legal effect of including the 15
coverage required by subsection 1, and any provision of the plan 16
that conflicts with the provisions of this section is void. 17
[4.] 5. As used in this section: 18
(a) “Medical laboratory” has the meaning ascribed to it in 19
NRS 652.060. 20
(b) “Network plan” means a health care plan offered by a health 21
maintenance organization under which the financing and delivery of 22
medical care, including items and services paid for as medical care, 23
are provided, in whole or in part, through a defined set of providers 24
under contract with the health maintenance organization. The term 25
does not include an arrangement for the financing of premiums. 26
(c) “Provider of health care” has the meaning ascribed to it in 27
NRS 629.031. 28
Sec. 87. NRS 695C.204 is hereby amended to read as follows: 29
695C.204 1. A health maintenance organization that issues a 30
health care plan shall not discriminate against any person with 31
respect to participation or coverage under the plan on the basis of an 32
actual or perceived [gender identity or expression.] protected 33
characteristic. 34
2. Prohibited discrimination includes, without limitation: 35
[1.] (a) Denying, cancelling, limiting or refusing to issue or 36
renew a health care plan on the basis of [the] an actual or perceived 37
[gender identity or expression] protected characteristic of a person 38
or a family member of the person; 39
[2.] (b) Imposing a payment or premium that is based on [the] 40
an actual or perceived [gender identity or expression] protected 41
characteristic of an enrollee or a family member of the enrollee; 42
[3.] (c) Designating [the] an actual or perceived [gender 43
identity or expression] protected characteristic of a person or a 44
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family member of the person as grounds to deny, cancel or limit 1
participation or coverage; and 2
[4.] (d) Denying, cancelling or limiting participation or 3
coverage on the basis of an actual or perceived [gender identity or 4
expression,] protected characteristic, including, without limitation, 5
by limiting or denying coverage for health care services that are: 6
[(a)] (1) Related to gender transition, provided that there is 7
coverage under the plan for the services when the services are not 8
related to gender transition; or 9
[(b)] (2) Ordinarily or exclusively available to persons of any 10
sex. 11
3. As used in this section, “protected characteristic” means: 12
(a) Race, color, national origin, age, physical or mental 13
disability, sexual orientation or gender identity or expression; or 14
(b) Sex, including, without limitation, sex characteristics, 15
intersex traits and pregnancy or related conditions. 16
Sec. 88. NRS 695C.330 is hereby amended to read as follows: 17
695C.330 1. The Commissioner may suspend or revoke any 18
certificate of authority issued to a health maintenance organization 19
pursuant to the provisions of this chapter if the Commissioner finds 20
that any of the following conditions exist: 21
(a) The health maintenance organization is operating 22
significantly in contravention of its basic organizational document, 23
its health care plan or in a manner contrary to that described in and 24
reasonably inferred from any other information submitted pursuant 25
to NRS 695C.060, 695C.070 and 695C.140, unless any amendments 26
to those submissions have been filed with and approved by the 27
Commissioner; 28
(b) The health maintenance organization issues evidence of 29
coverage or uses a schedule of charges for health care services 30
which do not comply with the requirements of NRS 695C.1691 to 31
695C.200, inclusive, and sections 74 to 78, inclusive, of this act, 32
695C.204 or 695C.207; 33
(c) The health care plan does not furnish comprehensive health 34
care services as provided for in NRS 695C.060; 35
(d) The Commissioner certifies that the health maintenance 36
organization: 37
(1) Does not meet the requirements of subsection 1 of NRS 38
695C.080; or 39
(2) Is unable to fulfill its obligations to furnish health care 40
services as required under its health care plan; 41
(e) The health maintenance organization is no longer financially 42
responsible and may reasonably be expected to be unable to meet its 43
obligations to enrollees or prospective enrollees; 44
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(f) The health maintenance organization has failed to put into 1
effect a mechanism affording the enrollees an opportunity to 2
participate in matters relating to the content of programs pursuant to 3
NRS 695C.110; 4
(g) The health maintenance organization has failed to put into 5
effect the system required by NRS 695C.260 for: 6
(1) Resolving complaints in a manner reasonably to dispose 7
of valid complaints; and 8
(2) Conducting external reviews of adverse determinations 9
that comply with the provisions of NRS 695G.241 to 695G.310, 10
inclusive; 11
(h) The health maintenance organization or any person on its 12
behalf has advertised or merchandised its services in an untrue, 13
misrepresentative, misleading, deceptive or unfair manner; 14
(i) The continued operation of the health maintenance 15
organization would be hazardous to its enrollees or creditors or to 16
the general public; 17
(j) The health maintenance organization fails to provide the 18
coverage required by NRS 695C.1691; or 19
(k) The health maintenance organization has otherwise failed to 20
comply substantially with the provisions of this chapter. 21
2. A certificate of authority must be suspended or revoked only 22
after compliance with the requirements of NRS 695C.340. 23
3. If the certificate of authority of a health maintenance 24
organization is suspended, the health maintenance organization shall 25
not, during the period of that suspension, enroll any additional 26
groups or new individual contracts, unless those groups or persons 27
were contracted for before the date of suspension. 28
4. If the certificate of authority of a health maintenance 29
organization is revoked, the organization shall proceed, immediately 30
following the effective date of the order of revocation, to wind up its 31
affairs and shall conduct no further business except as may be 32
essential to the orderly conclusion of the affairs of the organization. 33
It shall engage in no further advertising or solicitation of any kind. 34
The Commissioner may, by written order, permit such further 35
operation of the organization as the Commissioner may find to be in 36
the best interest of enrollees to the end that enrollees are afforded 37
the greatest practical opportunity to obtain continuing coverage for 38
health care. 39
Sec. 89. Chapter 695G of NRS is hereby amended by adding 40
thereto the provisions set forth as sections 90 to 94, inclusive, of this 41
act. 42
Sec. 90. 1. A managed care organization that offers or 43
issues a health care plan which provides coverage for dependent 44
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children shall continue to make such coverage available for an 1
adult child of an insured until such child reaches 26 years of age. 2
2. Nothing in this section shall be construed as requiring a 3
managed care organization to make coverage available for a 4
dependent of an adult child of an insured. 5
Sec. 91. 1. A managed care organization that offers or 6
issues a health care plan shall include in the plan coverage for: 7
(a) Screening for anxiety for insureds who are at least 8 but 8
not more than 18 years of age; 9
(b) Assessments relating to height, weight, body mass index 10
and medical history for insureds who are less than 18 years of 11
age; 12
(c) Comprehensive and intensive behavioral interventions for 13
insureds who are at least 12 but not more than 18 years of age and 14
have a body mass index in the 95th percentile or greater for 15
persons of the same age and sex; 16
(d) The application of fluoride varnish to the primary teeth for 17
insureds who are less than 5 years of age; 18
(e) Oral fluoride supplements for insureds who are at least 6 19
months of age but less than 5 years of age and whose supply of 20
water is deficient in fluoride; 21
(f) Counseling and education pertaining to the minimization of 22
exposure to ultraviolet radiation for insureds who are less than 25 23
years of age and have fair skin types and the parents or legal 24
guardians of insureds who are less than 18 years of age and have 25
fair skin types for the purpose of minimizing the risk of skin 26
cancer in those persons; 27
(g) Brief behavioral counseling and interventions to prevent 28
tobacco use for insureds who are less than 18 years of age; 29
(h) At least one screening for the detection of amblyopia or the 30
risk factors of amblyopia for insureds who are at least 3 but not 31
more than 5 years of age; and 32
(i) Screening, tests and counseling for such other health 33
conditions and diseases as recommended by the Health Resources 34
and Services Administration on January 1, 2025, for insureds who 35
are less than 18 years of age. 36
2. A managed care organization must ensure that the benefits 37
required by subsection 1 are made available to an insured through 38
a provider of health care who participates in the network plan of 39
the managed care organization. 40
3. Except as otherwise provided in subsection 5, a managed 41
care organization that offers or issues a health care plan shall not: 42
(a) Require an insured to pay a higher deductible, any 43
copayment or coinsurance or require a longer waiting period or 44
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other condition to obtain any benefit provided in the health care 1
plan pursuant to subsection 1; 2
(b) Refuse to issue a health care plan or cancel a health care 3
plan solely because the person applying for or covered by the plan 4
uses or may use any such benefit; 5
(c) Offer or pay any type of material inducement or financial 6
incentive to an insured to discourage the insured from obtaining 7
any such benefit; 8
(d) Penalize a provider of health care who provides any such 9
benefit to an insured, including, without limitation, reducing the 10
reimbursement of the provider of health care; 11
(e) Offer or pay any type of material inducement, bonus or 12
other financial incentive to a provider of health care to deny, 13
reduce, withhold, limit or delay access to any such benefit to an 14
insured; or 15
(f) Impose any other restrictions or delays on the access of an 16
insured to any such benefit. 17
4. A health care plan subject to the provisions of this chapter 18
that is delivered, issued for delivery or renewed on or after 19
October 1, 2025, has the legal effect of including the coverage 20
required by subsection 1, and any provision of the plan or the 21
renewal which is in conflict with this section is void. 22
5. Except as otherwise provided in this section and federal 23
law, a managed care organization may use medical management 24
techniques, including, without limitation, any available clinical 25
evidence, to determine the frequency of or treatment relating to 26
any benefit required by this section or the type of provider of 27
health care to use for such treatment. 28
6. As used in this section: 29
(a) “Medical management technique” means a practice which 30
is used to control the cost or utilization of health care services or 31
prescription drug use. The term includes, without limitation, the 32
use of step therapy, prior authorization or categorizing drugs and 33
devices based on cost, type or method of administration. 34
(b) “Network plan” means a health care plan offered by a 35
managed care organization under which the financing and 36
delivery of medical care, including items and services paid for as 37
medical care, are provided, in whole or in part, through a defined 38
set of providers of health care under contract with the managed 39
care organization. The term does not include an arrangement for 40
the financing of premiums. 41
(c) “Provider of health care” has the meaning ascribed to it in 42
NRS 629.031. 43
Sec. 92. 1. A managed care organization that offers or 44
issues a health care plan shall include in the plan coverage for: 45
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(a) A daily dose of 0.4 to 0.8 milligrams of folic acid for 1
insureds who are pregnant or are planning on becoming 2
pregnant; 3
(b) A low dose of aspirin for the prevention of preeclampsia 4
for insureds who are determined to be at a high risk of that 5
condition after 12 weeks of gestation; 6
(c) Prophylactic ocular tubal medication for the prevention of 7
gonococcal ophthalmia in newborns; 8
(d) Screening for asymptomatic bacteriuria for insureds who 9
are pregnant; 10
(e) Counseling and behavioral interventions relating to the 11
promotion of healthy weight gain and the prevention of excessive 12
weight gain for insureds who are pregnant; 13
(f) Counseling for insureds who are pregnant or in the 14
postpartum stage of pregnancy and have an increased risk of 15
perinatal or postpartum depression; 16
(g) Screening for the presence of the rhesus D antigen and 17
antibodies in the blood of an insured who is pregnant during the 18
insured’s first visit for care relating to the pregnancy; 19
(h) Screening for rhesus D antibodies between 24 and 28 20
weeks of gestation for insureds who are negative for the rhesus D 21
antigen and have not been exposed to blood that is positive for the 22
rhesus D antigen; 23
(i) Behavioral counseling and intervention for tobacco 24
cessation for insureds who are pregnant; 25
(j) An annual screening for urinary incontinence for women; 26
(k) Screening for type 2 diabetes at such intervals as 27
recommended by the Health Resources and Services 28
Administration on January 1, 2025, for insureds who are in the 29
postpartum stage of pregnancy and who have a history of 30
gestational diabetes mellitus; 31
(l) Counseling relating to maintaining a healthy weight for 32
women who are at least 40 but not more than 60 years of age and 33
have a body mass index greater than 18.5; and 34
(m) Screening for osteoporosis for women who: 35
(1) Are 65 years of age or older; or 36
(2) Are less than 65 years of age and have a risk of 37
fracturing a bone equal to or greater than that of a woman who is 38
65 years of age without any additional risk factors. 39
2. A managed care organization must ensure that the benefits 40
required by subsection 1 are made available to an insured through 41
a provider of health care who participates in the network plan of 42
the managed care organization. 43
3. Except as otherwise provided in subsection 5, a managed 44
care organization that offers or issues a health care plan shall not: 45
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(a) Require an insured to pay a higher deductible, any 1
copayment or coinsurance or require a longer waiting period or 2
other condition to obtain any benefit provided in the health care 3
plan pursuant to subsection 1; 4
(b) Refuse to issue a health care plan or cancel a health care 5
plan solely because the person applying for or covered by the plan 6
uses or may use any such benefit; 7
(c) Offer or pay any type of material inducement or financial 8
incentive to an insured to discourage the insured from obtaining 9
any such benefit; 10
(d) Penalize a provider of health care who provides any such 11
benefit to an insured, including, without limitation, reducing the 12
reimbursement of the provider of health care; 13
(e) Offer or pay any type of material inducement, bonus or 14
other financial incentive to a provider of health care to deny, 15
reduce, withhold, limit or delay access to any such benefit to an 16
insured; or 17
(f) Impose any other restrictions or delays on the access of an 18
insured to any such benefit. 19
4. A health care plan subject to the provisions of this chapter 20
that is delivered, issued for delivery or renewed on or after 21
October 1, 2025, has the legal effect of including the coverage 22
required by subsection 1, and any provision of the plan or the 23
renewal which is in conflict with this section is void. 24
5. Except as otherwise provided in this section and federal 25
law, a managed care organization may use medical management 26
techniques, including, without limitation, any available clinical 27
evidence, to determine the frequency of or treatment relating to 28
any benefit required by this section or the type of provider of 29
health care to use for such treatment. 30
6. As used in this section: 31
(a) “Medical management technique” means a practice which 32
is used to control the cost or utilization of health care services or 33
prescription drug use. The term includes, without limitation, the 34
use of step therapy, prior authorization or categorizing drugs and 35
devices based on cost, type or method of administration. 36
(b) “Network plan” means a health care plan offered by a 37
managed care organization under which the financing and 38
delivery of medical care, including items and services paid for as 39
medical care, are provided, in whole or in part, through a defined 40
set of providers of health care under contract with the managed 41
care organization. The term does not include an arrangement for 42
the financing of premiums. 43
(c) “Provider of health care” has the meaning ascribed to it in 44
NRS 629.031. 45
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Sec. 93. 1. A managed care organization that offers or 1
issues a health care plan shall include in the plan coverage for: 2
(a) Behavioral counseling and interventions to promote 3
physical activity and a healthy diet for insureds with 4
cardiovascular risk factors; 5
(b) Statin preventive medication for insureds who are at least 6
40 but not more than 75 years of age and do not have a history of 7
cardiovascular disease, but who have: 8
(1) One or more risk factors for cardiovascular disease; 9
and 10
(2) A calculated risk of at least 10 percent of acquiring 11
cardiovascular disease within the next 10 years; 12
(c) Interventions for exercise to prevent falls for insureds who 13
are 65 years of age or older and reside in a medical facility or 14
facility for the dependent; 15
(d) Screenings for latent tuberculosis infection in insureds 16
with an increased risk of contracting tuberculosis; 17
(e) Screening for hypertension; 18
(f) One abdominal aortic screening by ultrasound to detect 19
abdominal aortic aneurysms for men who are at least 65 but not 20
more than 75 years of age and have smoked during their lifetimes; 21
(g) Screening for drug and alcohol misuse for insureds who 22
are 18 years of age or older; 23
(h) If an insured engages in risky or hazardous consumption 24
of alcohol, as determined by the screening described in paragraph 25
(g), behavioral counseling to reduce such behavior; 26
(i) Screening for lung cancer using low-dose computed 27
tomography for insureds who are at least 50 but not more than 80 28
years of age and: 29
(1) Have a smoking history of 20 pack-years; 30
(2) Smoke or have stopped smoking within the immediately 31
preceding 15 years; and 32
(3) Do not suffer from a health problem that substantially 33
limits the life expectancy of the person or the willingness of the 34
person to undergo curative surgery; 35
(j) Screening for prediabetes and type 2 diabetes in insureds 36
who are at least 35 but not more than 70 years of age and have a 37
body mass index of 25 or greater; and 38
(k) Intensive behavioral interventions with multiple 39
components for insureds who are 18 years of age or older and 40
have a body mass index of 30 or greater. 41
2. A managed care organization must ensure that the benefits 42
required by subsection 1 are made available to an insured through 43
a provider of health care who participates in the network plan of 44
the managed care organization. 45
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3. Except as otherwise provided in subsection 5, a managed 1
care organization that offers or issues a health care plan shall not: 2
(a) Require an insured to pay a higher deductible, any 3
copayment or coinsurance or require a longer waiting period or 4
other condition to obtain any benefit provided in the health care 5
plan pursuant to subsection 1; 6
(b) Refuse to issue a health care plan or cancel a health care 7
plan solely because the person applying for or covered by the plan 8
uses or may use any such benefit; 9
(c) Offer or pay any type of material inducement or financial 10
incentive to an insured to discourage the insured from obtaining 11
any such benefit; 12
(d) Penalize a provider of health care who provides any such 13
benefit to an insured, including, without limitation, reducing the 14
reimbursement of the provider of health care; 15
(e) Offer or pay any type of material inducement, bonus or 16
other financial incentive to a provider of health care to deny, 17
reduce, withhold, limit or delay access to any such benefit to an 18
insured; or 19
(f) Impose any other restrictions or delays on the access of an 20
insured to any such benefit. 21
4. A health care plan subject to the provisions of this chapter 22
that is delivered, issued for delivery or renewed on or after 23
October 1, 2025, has the legal effect of including the coverage 24
required by subsection 1, and any provision of the plan or the 25
renewal which is in conflict with this section is void. 26
5. Except as otherwise provided in this section and federal 27
law, a managed care organization may use medical management 28
techniques, including, without limitation, any available clinical 29
evidence, to determine the frequency of or treatment relating to 30
any benefit required by this section or the type of provider of 31
health care to use for such treatment. 32
6. As used in this section: 33
(a) “Computed tomography” means the process of producing 34
sectional and three-dimensional images using external ionizing 35
radiation. 36
(b) “Facility for the dependent” has the meaning ascribed to it 37
in NRS 449.0045. 38
(c) “Medical facility” has the meaning ascribed to it in 39
NRS 449.0151. 40
(d) “Medical management technique” means a practice which 41
is used to control the cost or utilization of health care services or 42
prescription drug use. The term includes, without limitation, the 43
use of step therapy, prior authorization or categorizing drugs and 44
devices based on cost, type or method of administration. 45
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(e) “Network plan” means a health care plan offered by a 1
managed care organization under which the financing and 2
delivery of medical care, including items and services paid for as 3
medical care, are provided, in whole or in part, through a defined 4
set of providers of health care under contract with the managed 5
care organization. The term does not include an arrangement for 6
the financing of premiums. 7
(f) “Pack-year” means the product of the number of packs of 8
cigarettes smoked per day and the number of years that the person 9
has smoked. 10
(g) “Provider of health care” has the meaning ascribed to it in 11
NRS 629.031. 12
Sec. 94. 1. A managed care organization that offers or 13
issues a health care plan subject to the provisions of this chapter 14
shall include in the health care plan coverage for maternity care 15
and pediatric care for newborn infants. 16
2. Except as otherwise provided in this subsection, a health 17
care plan issued pursuant to this chapter may not restrict benefits 18
for any length of stay in a hospital in connection with childbirth 19
for a pregnant or postpartum individual or newborn infant 20
covered by the plan to: 21
(a) Less than 48 hours after a normal vaginal delivery; and 22
(b) Less than 96 hours after a cesarean section. 23
If a different length of stay is provided in the guidelines 24
established by the American College of Obstetricians and 25
Gynecologists, or its successor organization, and the American 26
Academy of Pediatrics, or its successor organization, the health 27
care plan may follow such guidelines in lieu of following the 28
length of stay set forth above. The provisions of this subsection do 29
not apply to any health care plan in any case in which the decision 30
to discharge the pregnant or postpartum individual or newborn 31
infant before the expiration of the minimum length of stay set 32
forth in this subsection is made by the attending physician of the 33
pregnant or postpartum individual or newborn infant. 34
3. Nothing in this section requires a pregnant or postpartum 35
individual to: 36
(a) Deliver the baby in a hospital; or 37
(b) Stay in a hospital for a fixed period following the birth of 38
the child. 39
4. A health care plan may not: 40
(a) Deny a pregnant or postpartum individual or the newborn 41
infant coverage or continued coverage under the terms of the plan 42
if the sole purpose of the denial of coverage or continued coverage 43
is to avoid the requirements of this section; 44
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(b) Provide monetary payments or rebates to a pregnant or 1
postpartum individual to encourage the individual to accept less 2
than the minimum protection available pursuant to this section; 3
(c) Penalize, or otherwise reduce or limit, the reimbursement 4
of an attending provider of health care because the attending 5
provider of health care provided care to a pregnant or postpartum 6
individual or newborn infant in accordance with the provisions of 7
this section; 8
(d) Provide incentives of any kind to an attending physician to 9
induce the attending physician to provide care to a pregnant or 10
postpartum individual or newborn infant in a manner that is 11
inconsistent with the provisions of this section; or 12
(e) Except as otherwise provided in subsection 5, restrict 13
benefits for any portion of a hospital stay required pursuant to the 14
provisions of this section in a manner that is less favorable than 15
the benefits provided for any preceding portion of that stay. 16
5. Nothing in this section: 17
(a) Prohibits a managed care organization from imposing a 18
deductible, coinsurance or other mechanism for sharing costs 19
relating to benefits for hospital stays in connection with childbirth 20
for a pregnant or postpartum individual or newborn child covered 21
by the plan, except that such coinsurance or other mechanism for 22
sharing costs for any portion of a hospital stay required by this 23
section may not be greater than the coinsurance or other 24
mechanism for any preceding portion of that stay. 25
(b) Prohibits an arrangement for payment between a managed 26
care organization and a provider of health care that uses 27
capitation or other financial incentives, if the arrangement is 28
designed to provide services efficiently and consistently in the best 29
interest of the pregnant or postpartum individual and the newborn 30
infant. 31
(c) Prevents a managed care organization from negotiating 32
with a provider of health care concerning the level and type of 33
reimbursement to be provided in accordance with this section. 34
6. A health care plan subject to the provisions of this chapter 35
that is delivered, issued for delivery or renewed on or after 36
October 1, 2025, has the legal effect of including the coverage 37
required by this section, and any provision of the plan that 38
conflicts with the provisions of this section is void. 39
Sec. 95. NRS 695G.168 is hereby amended to read as follows: 40
695G.168 1. A health care plan issued by a managed care 41
organization [that provides coverage for the treatment of colorectal 42
cancer] must provide coverage for colorectal cancer screening in 43
accordance with: 44
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(a) The guidelines concerning colorectal cancer screening which 1
are published by the American Cancer Society; or 2
(b) Other guidelines or reports concerning colorectal cancer 3
screening which are published by nationally recognized professional 4
organizations and which include current or prevailing supporting 5
scientific data. 6
2. A managed care organization must ensure that the benefits 7
required by subsection 1 are made available to an insured through 8
a provider of health care who participates in the network plan of 9
the managed care organization. 10
3. A managed care organization that offers or issues a health 11
care plan shall not: 12
(a) Require an insured to pay a higher deductible, any 13
copayment or coinsurance or require a longer waiting period or 14
other condition to obtain any benefit provided in the health care 15
plan pursuant to subsection 1; 16
(b) Refuse to issue a health care plan or cancel a health care 17
plan solely because the person applying for or covered by the plan 18
uses or may use any such benefit; 19
(c) Offer or pay any type of material inducement or financial 20
incentive to an insured to discourage the insured from obtaining 21
any such benefit; 22
(d) Penalize a provider of health care who provides any such 23
benefit to an insured, including, without limitation, reducing the 24
reimbursement of the provider of health care; 25
(e) Offer or pay any type of material inducement, bonus or 26
other financial incentive to a provider of health care to deny, 27
reduce, withhold, limit or delay access to any such benefit to an 28
insured; or 29
(f) Impose any other restrictions or delays on the access of an 30
insured to any such benefit. 31
4. An evidence of coverage for a health care plan subject to the 32
provisions of this chapter that is delivered, issued for delivery or 33
renewed on or after [October] October 1, [2003,] 2025, has the legal 34
effect of including the coverage required by this section, and any 35
provision of the evidence of coverage that conflicts with the 36
provisions of this section is void. 37
5. As used in this section: 38
(a) “Network plan” means a health care plan offered by a 39
managed care organization under which the financing and 40
delivery of medical care, including items and services paid for as 41
medical care, are provided, in whole or in part, through a defined 42
set of providers of health care under contract with the managed 43
care organization. The term does not include an arrangement for 44
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. 96. NRS 695G.1707 is hereby amended to read as 3
follows: 4
695G.1707 1. A managed care organization that offers or 5
issues a health care plan shall include in the plan: 6
(a) Coverage of testing for, treatment of and prevention of 7
sexually transmitted diseases, including, without limitation, 8
Chlamydia trachomatis, gonorrhea, syphilis, human 9
immunodeficiency virus and hepatitis B and C, for all insureds, 10
regardless of age. Such coverage must include, without limitation, 11
the coverage required by NRS 695G.1705 and 695G.1714. 12
(b) Unrestricted coverage of condoms for insureds who are 13 13
years of age or older. 14
2. A managed care organization that offers or issues a health 15
care plan shall not: 16
(a) Require an insured to pay a higher deductible, any 17
copayment or coinsurance or require a longer waiting period or 18
other condition to obtain any benefit provided in the health care 19
plan pursuant to subsection 1; 20
(b) Refuse to issue a health care plan or cancel a health care 21
plan solely because the person applying for or covered by the plan 22
uses or may use any such benefit; 23
(c) Offer or pay any type of material inducement or financial 24
incentive to an insured to discourage the insured from obtaining 25
any such benefit; 26
(d) Penalize a provider of health care who provides any such 27
benefit to an insured, including, without limitation, reducing the 28
reimbursement of the provider of health care; 29
(e) Offer or pay any type of material inducement, bonus or 30
other financial incentive to a provider of health care to deny, 31
reduce, withhold, limit or delay access to any such benefit to an 32
insured; or 33
(f) Impose any other restrictions or delays on the access of an 34
insured to any such benefit. 35
3. A health care plan subject to the provisions of this chapter 36
that is delivered, issued for delivery or renewed on or after [January] 37
October 1, [2024,] 2025, has the legal effect of including the 38
coverage required by subsection 1, and any provision of the plan 39
that conflicts with the provisions of this section is void. 40
4. As used in this section, “provider of health care” has the 41
meaning ascribed to it in NRS 629.031. 42
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Sec. 97. NRS 695G.1712 is hereby amended to read as 1
follows: 2
695G.1712 1. A managed care organization that issues a 3
health care plan shall provide coverage for screening, genetic 4
counseling and testing for harmful mutations in the BRCA gene for 5
women under circumstances where such screening, genetic 6
counseling or testing, as applicable, is required by NRS 457.301. 7
2. A managed care organization shall ensure that the benefits 8
required by subsection 1 are made available to an insured through a 9
provider of health care who participates in the network plan of the 10
managed care organization. 11
3. A managed care organization that issues a health care 12
plan shall not: 13
(a) Require an insured to pay a higher deductible, any 14
copayment or coinsurance or require a longer waiting period or 15
other condition to obtain any benefit provided in the health care 16
plan pursuant to subsection 1; 17
(b) Refuse to issue a health care plan or cancel a health care 18
plan solely because the person applying for or covered by the plan 19
uses or may use any such benefit; 20
(c) Offer or pay any type of material inducement or financial 21
incentive to an insured to discourage the insured from obtaining 22
any such benefit; 23
(d) Penalize a provider of health care who provides any such 24
benefit to an insured, including, without limitation, reducing the 25
reimbursement of the provider of health care; 26
(e) Offer or pay any type of material inducement, bonus or 27
other financial incentive to a provider of health care to deny, 28
reduce, withhold, limit or delay access to any such benefit to an 29
insured; or 30
(f) Impose any other restrictions or delays on the access of an 31
insured to any such benefit. 32
4. A health care plan subject to the provisions of this chapter 33
that is delivered, issued for delivery or renewed on or after [January] 34
October 1, [2022,] 2025, has the legal effect of including the 35
coverage required by subsection 1, and any provision of the plan 36
that conflicts with the provisions of this section is void. 37
[4.] 5. As used in this section: 38
(a) “Network plan” means a health care plan offered by a 39
managed care organization under which the financing and delivery 40
of medical care, including items and services paid for as medical 41
care, are provided, in whole or in part, through a defined set of 42
providers under contract with the managed care organization. The 43
term does not include an arrangement for the financing of 44
premiums. 45
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(b) “Provider of health care” has the meaning ascribed to it in 1
NRS 629.031. 2
Sec. 98. NRS 695G.1713 is hereby amended to read as 3
follows: 4
695G.1713 1. A health care plan issued by a managed care 5
organization must provide coverage for benefits payable for 6
expenses incurred for: 7
(a) A mammogram to screen for breast cancer annually for 8
insureds who are 40 years of age or older. 9
(b) An imaging test to screen for breast cancer on an interval 10
and at the age deemed most appropriate, when medically necessary, 11
as recommended by the insured’s provider of health care based on 12
personal or family medical history or additional factors that may 13
increase the risk of breast cancer for the insured. 14
(c) A diagnostic imaging test for breast cancer at the age deemed 15
most appropriate, when medically necessary, as recommended by 16
the insured’s provider of health care to evaluate an abnormality 17
which is: 18
(1) Seen or suspected from a mammogram described in 19
paragraph (a) or an imaging test described in paragraph (b); or 20
(2) Detected by other means of examination. 21
(d) Medication to prevent breast cancer for insureds who are 22
at a high risk of developing breast cancer and have a low risk of 23
adverse side effects from the medication. 24
2. A managed care organization must ensure that the benefits 25
required by subsection 1 are made available to an insured through a 26
provider of health care who participates in the network plan of the 27
managed care organization. 28
3. Except as otherwise provided in subsection 5, a managed 29
care organization that offers or issues a health care plan which 30
provides coverage for prescription drugs shall not: 31
(a) Except as otherwise provided in subsection 6, require an 32
insured to pay a deductible, copayment, coinsurance or any other 33
form of cost-sharing or require a longer waiting period or other 34
condition to obtain any benefit provided in the health care plan 35
pursuant to subsection 1; 36
(b) Refuse to issue a health care plan or cancel a health care plan 37
solely because the person applying for or covered by the plan uses 38
or may use any such benefit; 39
(c) Offer or pay any type of material inducement or financial 40
incentive to an insured to discourage the insured from obtaining any 41
such benefit; 42
(d) Penalize a provider of health care who provides any such 43
benefit to an insured, including, without limitation, reducing the 44
reimbursement of the provider of health care; 45
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(e) Offer or pay any type of material inducement, bonus or other 1
financial incentive to a provider of health care to deny, reduce, 2
withhold, limit or delay access to any such benefit to an insured; or 3
(f) Impose any other restrictions or delays on the access of an 4
insured to any such benefit. 5
4. A health care plan subject to the provisions of this chapter 6
that is delivered, issued for delivery or renewed on or after [January] 7
October 1, [2024,] 2025, has the legal effect of including the 8
coverage required by subsection 1, and any provision of the plan or 9
the renewal which is in conflict with this section is void. 10
5. Except as otherwise provided in this section and federal law, 11
a managed care organization may use medical management 12
techniques, including, without limitation, any available clinical 13
evidence, to determine the frequency of or treatment relating to any 14
benefit required by this section or the type of provider of health care 15
to use for such treatment. 16
6. If the application of paragraph (a) of subsection 3 would 17
result in the ineligibility of a health savings account of an insured 18
pursuant to 26 U.S.C. § 223, the prohibitions of paragraph (a) of 19
subsection 3 shall apply only for a qualified health care plan with 20
respect to the deductible of such a health care plan after the insured 21
has satisfied the minimum deductible pursuant to 26 U.S.C. § 223, 22
except with respect to items or services that constitute preventive 23
care pursuant to 26 U.S.C. § 223(c)(2)(C), in which case the 24
prohibitions of paragraph (a) of subsection 3 shall apply regardless 25
of whether the minimum deductible under 26 U.S.C. § 223 has been 26
satisfied. 27
7. As used in this section: 28
(a) “Medical management technique” means a practice which is 29
used to control the cost or utilization of health care services or 30
prescription drug use. The term includes, without limitation, the use 31
of step therapy, prior authorization or categorizing drugs and 32
devices based on cost, type or method of administration. 33
(b) “Network plan” means a health care plan offered by a 34
managed care organization under which the financing and delivery 35
of medical care, including items and services paid for as medical 36
care, are provided, in whole or in part, through a defined set of 37
providers under contract with the managed care organization. The 38
term does not include an arrangement for the financing of 39
premiums. 40
(c) “Provider of health care” has the meaning ascribed to it in 41
NRS 629.031. 42
(d) “Qualified health care plan” means a health care plan issued 43
by a managed care organization that has a high deductible and is in 44
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compliance with 26 U.S.C. § 223 for the purposes of establishing a 1
health savings account. 2
Sec. 99. NRS 695G.1714 is hereby amended to read as 3
follows: 4
695G.1714 1. A managed care organization that issues a 5
health care plan shall provide coverage for the examination of a 6
person who is pregnant for the discovery of: 7
(a) Chlamydia trachomatis, gonorrhea, hepatitis B and hepatitis 8
C in accordance with NRS 442.013. 9
(b) Syphilis in accordance with NRS 442.010. 10
(c) Human immunodeficiency virus. 11
2. The coverage required by this section must be provided: 12
(a) Regardless of whether the benefits are provided to the 13
insured by a provider of health care, facility or medical laboratory 14
that participates in the network plan of the managed care 15
organization; and 16
(b) Without prior authorization. 17
3. A managed care organization that issues a health care 18
plan shall not: 19
(a) Require an insured to pay a higher deductible, any 20
copayment or coinsurance or require a longer waiting period or 21
other condition to obtain any benefit provided in the health care 22
plan pursuant to subsection 1; 23
(b) Refuse to issue a health care plan or cancel a health care 24
plan solely because the person applying for or covered by the plan 25
uses or may use any such benefit; 26
(c) Offer or pay any type of material inducement or financial 27
incentive to an insured to discourage the insured from obtaining 28
any such benefit; 29
(d) Penalize a provider of health care who provides any such 30
benefit to an insured, including, without limitation, reducing the 31
reimbursement of the provider of health care; 32
(e) Offer or pay any type of material inducement, bonus or 33
other financial incentive to a provider of health care to deny, 34
reduce, withhold, limit or delay access to any such benefit to an 35
insured; or 36
(f) Impose any other restrictions or delays on the access of an 37
insured to any such benefit. 38
4. A health care plan subject to the provisions of this chapter 39
that is delivered, issued for delivery or renewed on or after [July] 40
October 1, [2021,] 2025, has the legal effect of including the 41
coverage required by subsection 1, and any provision of the plan 42
that conflicts with the provisions of this section is void. 43
[4.] 5. As used in this section: 44
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(a) “Medical laboratory” has the meaning ascribed to it in 1
NRS 652.060. 2
(b) “Network plan” means a health care plan offered by a 3
managed care organization under which the financing and delivery 4
of medical care, including items and services paid for as medical 5
care, are provided, in whole or in part, through a defined set of 6
providers under contract with the managed care organization. The 7
term does not include an arrangement for the financing of 8
premiums. 9
(c) “Provider of health care” has the meaning ascribed to it in 10
NRS 629.031. 11
Sec. 100. NRS 695G.1716 is hereby amended to read as 12
follows: 13
695G.1716 1. A managed care organization that offers or 14
issues a health care plan [that includes coverage for maternity care] 15
shall not deny, limit or seek reimbursement for maternity care 16
because the insured is acting as a gestational carrier. 17
2. If an insured acts as a gestational carrier, the child shall be 18
deemed to be a child of the intended parent, as defined in NRS 19
126.590, for purposes related to the health care plan. 20
3. As used in this section, “gestational carrier” has the meaning 21
ascribed to it in NRS 126.580. 22
Sec. 101. NRS 695G.1717 is hereby amended to read as 23
follows: 24
695G.1717 1. A managed care organization that offers or 25
issues a health care plan shall include in the plan coverage for: 26
(a) Counseling, support and supplies for breastfeeding, 27
including breastfeeding equipment, counseling and education during 28
the antenatal, perinatal and postpartum period for not more than 1 29
year; 30
(b) Screening and counseling for interpersonal and domestic 31
violence for women at least annually with initial intervention 32
services consisting of education, strategies to reduce harm, 33
supportive services or a referral for any other appropriate services; 34
(c) Behavioral counseling concerning sexually transmitted 35
diseases from a provider of health care for sexually active [women] 36
insureds who are at increased risk for such diseases; 37
(d) Hormone replacement therapy; 38
(e) Such prenatal screenings and tests as recommended by the 39
American College of Obstetricians and Gynecologists or its 40
successor organization; 41
(f) Screening for blood pressure abnormalities and diabetes, 42
including gestational diabetes, after at least 24 weeks of gestation or 43
as ordered by a provider of health care; 44
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(g) Screening for cervical cancer at such intervals as are 1
recommended by the American College of Obstetricians and 2
Gynecologists or its successor organization; 3
(h) Screening for depression [;] for insureds who are 12 years 4
of age or older; 5
(i) Screening for anxiety disorders; 6
(j) Screening and counseling for the human immunodeficiency 7
virus consisting of a risk assessment, annual education relating to 8
prevention and at least one screening for the virus during the 9
lifetime of the insured or as ordered by a provider of health care; 10
[(j) Smoking] 11
(k) Tobacco cessation programs , including, without limitation, 12
pharmacotherapy approved by the United States Food and Drug 13
Administration, for an insured who is 18 years of age or older 14
consisting of not more than two cessation attempts per year and four 15
counseling sessions per year; 16
[(k)] (l) All vaccinations recommended by the Advisory 17
Committee on Immunization Practices of the Centers for Disease 18
Control and Prevention of the United States Department of Health 19
and Human Services or its successor organization; and 20
[(l)] (m) Such well-woman preventative visits as recommended 21
by the Health Resources and Services Administration [,] on 22
January 1, 2025, which must include at least one such visit per year 23
beginning at 14 years of age. 24
2. A managed care organization must ensure that the benefits 25
required by subsection 1 are made available to an insured through a 26
provider of health care who participates in the network plan of the 27
managed care organization. 28
3. Except as otherwise provided in subsection 5, a managed 29
care organization that offers or issues a health care plan shall not: 30
(a) Require an insured to pay a higher deductible, any 31
copayment or coinsurance or require a longer waiting period or 32
other condition to obtain any benefit provided in the health care plan 33
pursuant to subsection 1; 34
(b) Refuse to issue a health care plan or cancel a health care plan 35
solely because the person applying for or covered by the plan uses 36
or may use any such benefit; 37
(c) Offer or pay any type of material inducement or financial 38
incentive to an insured to discourage the insured from obtaining any 39
such benefit; 40
(d) Penalize a provider of health care who provides any such 41
benefit to an insured, including, without limitation, reducing the 42
reimbursement of the provider of health care; 43
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(e) Offer or pay any type of material inducement, bonus or other 1
financial incentive to a provider of health care to deny, reduce, 2
withhold, limit or delay access to any such benefit to an insured; or 3
(f) Impose any other restrictions or delays on the access of an 4
insured to any such benefit. 5
4. A health care plan subject to the provisions of this chapter 6
that is delivered, issued for delivery or renewed on or after [January] 7
October 1, [2018,] 2025, has the legal effect of including the 8
coverage required by subsection 1, and any provision of the plan or 9
the renewal which is in conflict with this section is void. 10
5. Except as otherwise provided in this section and federal law, 11
a managed care organization may use medical management 12
techniques, including, without limitation, any available clinical 13
evidence, to determine the frequency of or treatment relating to any 14
benefit required by this section or the type of provider of health care 15
to use for such treatment. 16
6. As used in this section: 17
(a) “Medical management technique” means a practice which is 18
used to control the cost or utilization of health care services or 19
prescription drug use. The term includes, without limitation, the use 20
of step therapy, prior authorization or categorizing drugs and 21
devices based on cost, type or method of administration. 22
(b) “Network plan” means a health care plan offered by a 23
managed care organization under which the financing and delivery 24
of medical care, including items and services paid for as medical 25
care, are provided, in whole or in part, through a defined set of 26
providers under contract with the managed care organization. The 27
term does not include an arrangement for the financing of 28
premiums. 29
(c) “Provider of health care” has the meaning ascribed to it in 30
NRS 629.031. 31
Sec. 102. NRS 695G.415 is hereby amended to read as 32
follows: 33
695G.415 1. A managed care organization that issues a 34
health care plan shall not discriminate against any person with 35
respect to participation or coverage under the plan on the basis of an 36
actual or perceived [gender identity or expression.] protected 37
characteristic. 38
2. Prohibited discrimination includes, without limitation: 39
[1.] (a) Denying, cancelling, limiting or refusing to issue or 40
renew a health care plan on the basis of [the] an actual or perceived 41
[gender identity or expression] protected characteristic of a person 42
or a family member of the person; 43
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[2.] (b) Imposing a payment or premium that is based on [the] 1
an actual or perceived [gender identity or expression] protected 2
characteristic of an insured or a family member of the insured; 3
[3.] (c) Designating [the] an actual or perceived [gender 4
identity or expression] protected characteristic of a person or a 5
family member of the person as grounds to deny, cancel or limit 6
participation or coverage; and 7
[4.] (d) Denying, cancelling or limiting participation or 8
coverage on the basis of an actual or perceived [gender identity or 9
expression,] protected characteristic, including, without limitation, 10
by limiting or denying coverage for health care services that are: 11
[(a)] (1) Related to gender transition, provided that there is 12
coverage under the plan for the services when the services are not 13
related to gender transition; or 14
[(b)] (2) Ordinarily or exclusively available to persons of any 15
sex. 16
3. As used in this section, “protected characteristic” means: 17
(a) Race, color, national origin, age, physical or mental 18
disability, sexual orientation or gender identity or expression; or 19
(b) Sex, including, without limitation, sex characteristics, 20
intersex traits and pregnancy or related conditions. 21
Sec. 103. NRS 232.320 is hereby amended to read as follows: 22
232.320 1. The Director: 23
(a) Shall appoint, with the consent of the Governor, 24
administrators of the divisions of the Department, who are 25
respectively designated as follows: 26
(1) The Administrator of the Aging and Disability Services 27
Division; 28
(2) The Administrator of the Division of Welfare and 29
Supportive Services; 30
(3) The Administrator of the Division of Child and Family 31
Services; 32
(4) The Administrator of the Division of Health Care 33
Financing and Policy; and 34
(5) The Administrator of the Division of Public and 35
Behavioral Health. 36
(b) Shall administer, through the divisions of the Department, 37
the provisions of chapters 63, 424, 425, 427A, 432A to 442, 38
inclusive, 446 to 450, inclusive, 458A and 656A of NRS, NRS 39
127.220 to 127.310, inclusive, 422.001 to 422.410, inclusive, and 40
sections 109 to 112, inclusive, of this act, 422.580, 432.010 to 41
432.133, inclusive, 432B.6201 to 432B.626, inclusive, 444.002 to 42
444.430, inclusive, and 445A.010 to 445A.055, inclusive, and all 43
other provisions of law relating to the functions of the divisions of 44
the Department, but is not responsible for the clinical activities of 45
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the Division of Public and Behavioral Health or the professional line 1
activities of the other divisions. 2
(c) Shall administer any state program for persons with 3
developmental disabilities established pursuant to the 4
Developmental Disabilities Assistance and Bill of Rights Act of 5
2000, 42 U.S.C. §§ 15001 et seq. 6
(d) Shall, after considering advice from agencies of local 7
governments and nonprofit organizations which provide social 8
services, adopt a master plan for the provision of human services in 9
this State. The Director shall revise the plan biennially and deliver a 10
copy of the plan to the Governor and the Legislature at the 11
beginning of each regular session. The plan must: 12
(1) Identify and assess the plans and programs of the 13
Department for the provision of human services, and any 14
duplication of those services by federal, state and local agencies; 15
(2) Set forth priorities for the provision of those services; 16
(3) Provide for communication and the coordination of those 17
services among nonprofit organizations, agencies of local 18
government, the State and the Federal Government; 19
(4) Identify the sources of funding for services provided by 20
the Department and the allocation of that funding; 21
(5) Set forth sufficient information to assist the Department 22
in providing those services and in the planning and budgeting for the 23
future provision of those services; and 24
(6) Contain any other information necessary for the 25
Department to communicate effectively with the Federal 26
Government concerning demographic trends, formulas for the 27
distribution of federal money and any need for the modification of 28
programs administered by the Department. 29
(e) May, by regulation, require nonprofit organizations and state 30
and local governmental agencies to provide information regarding 31
the programs of those organizations and agencies, excluding 32
detailed information relating to their budgets and payrolls, which the 33
Director deems necessary for the performance of the duties imposed 34
upon him or her pursuant to this section. 35
(f) Has such other powers and duties as are provided by law. 36
2. Notwithstanding any other provision of law, the Director, or 37
the Director’s designee, is responsible for appointing and removing 38
subordinate officers and employees of the Department. 39
Sec. 104. NRS 287.010 is hereby amended to read as follows: 40
287.010 1. The governing body of any county, school 41
district, municipal corporation, political subdivision, public 42
corporation or other local governmental agency of the State of 43
Nevada may: 44
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(a) Adopt and carry into effect a system of group life, accident 1
or health insurance, or any combination thereof, for the benefit of its 2
officers and employees, and the dependents of officers and 3
employees who elect to accept the insurance and who, where 4
necessary, have authorized the governing body to make deductions 5
from their compensation for the payment of premiums on the 6
insurance. 7
(b) Purchase group policies of life, accident or health insurance, 8
or any combination thereof, for the benefit of such officers and 9
employees, and the dependents of such officers and employees, as 10
have authorized the purchase, from insurance companies authorized 11
to transact the business of such insurance in the State of Nevada, 12
and, where necessary, deduct from the compensation of officers and 13
employees the premiums upon insurance and pay the deductions 14
upon the premiums. 15
(c) Provide group life, accident or health coverage through a 16
self-insurance reserve fund and, where necessary, deduct 17
contributions to the maintenance of the fund from the compensation 18
of officers and employees and pay the deductions into the fund. The 19
money accumulated for this purpose through deductions from the 20
compensation of officers and employees and contributions of the 21
governing body must be maintained as an internal service fund as 22
defined by NRS 354.543. The money must be deposited in a state or 23
national bank or credit union authorized to transact business in the 24
State of Nevada. Any independent administrator of a fund created 25
under this section is subject to the licensing requirements of chapter 26
683A of NRS, and must be a resident of this State. Any contract 27
with an independent administrator must be approved by the 28
Commissioner of Insurance as to the reasonableness of 29
administrative charges in relation to contributions collected and 30
benefits provided. The provisions of NRS 439.581 to 439.597, 31
inclusive, 686A.135, 687B.352, 687B.408, 687B.692, 687B.723, 32
687B.725, 687B.805, 689B.030 to 689B.0317, inclusive, paragraphs 33
(b) and (c) of subsection 1 of NRS 689B.0319, subsections 2, 4, 6 34
and 7 of NRS 689B.0319, 689B.033 to 689B.0369, inclusive, 35
689B.0375 to 689B.050, inclusive, 689B.0675, 689B.265, 689B.287 36
and 689B.500 and sections 17 to 20, inclusive, of this act apply to 37
coverage provided pursuant to this paragraph, except that the 38
provisions of NRS 689B.0378, 689B.03785 and 689B.500 and 39
sections 17 to 20, inclusive, of this act only apply to coverage for 40
active officers and employees of the governing body, or the 41
dependents of such officers and employees. 42
(d) Defray part or all of the cost of maintenance of a self-43
insurance fund or of the premiums upon insurance. The money for 44
contributions must be budgeted for in accordance with the laws 45
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governing the county, school district, municipal corporation, 1
political subdivision, public corporation or other local governmental 2
agency of the State of Nevada. 3
2. If a school district offers group insurance to its officers and 4
employees pursuant to this section, members of the board of trustees 5
of the school district must not be excluded from participating in the 6
group insurance. If the amount of the deductions from compensation 7
required to pay for the group insurance exceeds the compensation to 8
which a trustee is entitled, the difference must be paid by the trustee. 9
3. In any county in which a legal services organization exists, 10
the governing body of the county, or of any school district, 11
municipal corporation, political subdivision, public corporation or 12
other local governmental agency of the State of Nevada in the 13
county, may enter into a contract with the legal services 14
organization pursuant to which the officers and employees of the 15
legal services organization, and the dependents of those officers and 16
employees, are eligible for any life, accident or health insurance 17
provided pursuant to this section to the officers and employees, and 18
the dependents of the officers and employees, of the county, school 19
district, municipal corporation, political subdivision, public 20
corporation or other local governmental agency. 21
4. If a contract is entered into pursuant to subsection 3, the 22
officers and employees of the legal services organization: 23
(a) Shall be deemed, solely for the purposes of this section, to be 24
officers and employees of the county, school district, municipal 25
corporation, political subdivision, public corporation or other local 26
governmental agency with which the legal services organization has 27
contracted; and 28
(b) Must be required by the contract to pay the premiums or 29
contributions for all insurance which they elect to accept or of which 30
they authorize the purchase. 31
5. A contract that is entered into pursuant to subsection 3: 32
(a) Must be submitted to the Commissioner of Insurance for 33
approval not less than 30 days before the date on which the contract 34
is to become effective. 35
(b) Does not become effective unless approved by the 36
Commissioner. 37
(c) Shall be deemed to be approved if not disapproved by the 38
Commissioner within 30 days after its submission. 39
6. As used in this section, “legal services organization” means 40
an organization that operates a program for legal aid and receives 41
money pursuant to NRS 19.031. 42
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Sec. 105. NRS 287.0273 is hereby amended to read as 1
follows: 2
287.0273 1. The governing body of any county, school 3
district, municipal corporation, political subdivision, public 4
corporation or other local governmental agency of the State of 5
Nevada that provides health insurance through a plan of self-6
insurance shall provide coverage for benefits payable for expenses 7
incurred for [a] : 8
(a) A mammogram every 2 years, or annually if ordered by a 9
provider of health care, for women 40 years of age or older [.] ; 10
(b) A diagnostic imaging test for breast cancer at the age 11
deemed most appropriate, when medically necessary, as 12
recommended by the insured’s provider of health care to evaluate 13
an abnormality which is: 14
(1) Seen or suspected from the mammogram described in 15
paragraph (a) or the imaging test described in paragraph (b); or 16
(2) Detected by other means of examination; and 17
(c) Medication to prevent breast cancer for insureds who are at 18
a high risk of developing breast cancer and have a low risk of 19
adverse side effects from the medication. 20
2. The governing body of any county, school district, 21
municipal corporation, political subdivision, public corporation or 22
other local governmental agency of the State of Nevada that 23
provides health insurance through a plan of self-insurance must 24
ensure that the benefits required by subsection 1 are made available 25
to an insured through a provider of health care who participates in 26
the network plan of the governing body. 27
3. Except as otherwise provided in subsection 5, the governing 28
body of any county, school district, municipal corporation, political 29
subdivision, public corporation or other local governmental agency 30
of the State of Nevada that provides health insurance through a plan 31
of self-insurance shall not: 32
(a) Except as otherwise provided in subsection 6, require an 33
insured to pay a higher deductible, any copayment or coinsurance or 34
require a longer waiting period or other condition to obtain any 35
benefit provided in the plan of self-insurance pursuant to 36
subsection 1; 37
(b) Refuse to issue a plan of self-insurance or cancel a plan of 38
self-insurance solely because the person applying for or covered by 39
the policy uses or may use any such benefit; 40
(c) Offer or pay any type of material inducement or financial 41
incentive to an insured to discourage the insured from obtaining any 42
such benefit; 43
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(d) Penalize a provider of health care who provides any such 1
benefit to an insured, including, without limitation, reducing the 2
reimbursement of the provider of health care; 3
(e) Offer or pay any type of material inducement, bonus or other 4
financial incentive to a provider of health care to deny, reduce, 5
withhold, limit or delay access to any such benefit to an insured; or 6
(f) Impose any other restrictions or delays on the access of an 7
insured to any such benefit. 8
4. A plan of self-insurance subject to the provisions of this 9
chapter which is delivered, issued for delivery or renewed on or 10
after January 1, 2024, has the legal effect of including the coverage 11
required by subsection 1, and any provision of the policy or the 12
renewal which is in conflict with this section is void. 13
5. Except as otherwise provided in this section and federal law, 14
the governing body of any county, school district, municipal 15
corporation, political subdivision, public corporation or other local 16
governmental agency of the State of Nevada that provides health 17
insurance through a plan of self-insurance may use medical 18
management techniques, including, without limitation, any available 19
clinical evidence, to determine the frequency of or treatment relating 20
to any benefit required by this section or the type of provider of 21
health care to use for such treatment. 22
6. If the application of paragraph (a) of subsection 3 would 23
result in the ineligibility of a health savings account of an insured 24
pursuant to 26 U.S.C. § 223, the prohibitions of paragraph (a) of 25
subsection 3 shall apply only for a qualified plan of self-insurance 26
with respect to the deductible of such a plan of self-insurance after 27
the insured has satisfied the minimum deductible pursuant to 26 28
U.S.C. § 223, except with respect to items or services that constitute 29
preventive care pursuant to 26 U.S.C. § 223(c)(2)(C), in which case 30
the prohibitions of paragraph (a) of subsection 3 shall apply 31
regardless of whether the minimum deductible under 26 U.S.C. § 32
223 has been satisfied. 33
7. As used in this section: 34
(a) “Medical management technique” means a practice which is 35
used to control the cost or utilization of health care services or 36
prescription drug use. The term includes, without limitation, the use 37
of step therapy, prior authorization or categorizing drugs and 38
devices based on cost, type or method of administration. 39
(b) “Network plan” means a plan of self-insurance provided by 40
the governing body of a local governmental agency under which the 41
financing and delivery of medical care, including items and services 42
paid for as medical care, are provided, in whole or in part, through a 43
defined set of providers under contract with the governing body. 44
– 133 –
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The term does not include an arrangement for the financing of 1
premiums. 2
(c) “Provider of health care” has the meaning ascribed to it in 3
NRS 629.031. 4
(d) “Qualified plan of self-insurance” means a plan of self-5
insurance that has a high deductible and is in compliance with 26 6
U.S.C. § 223 for the purposes of establishing a health savings 7
account. 8
Sec. 106. NRS 287.04335 is hereby amended to read as 9
follows: 10
287.04335 If the Board provides health insurance through a 11
plan of self-insurance, it shall comply with the provisions of NRS 12
439.581 to 439.597, inclusive, 686A.135, 687B.352, 687B.409, 13
687B.692, 687B.723, 687B.725, 687B.805, 689B.0353, 689B.255, 14
695C.1723, 695G.150, 695G.155, 695G.160, 695G.162, 15
695G.1635, 695G.164, 695G.1645, 695G.1665 [, 695G.167, 16
695G.1675, 695G.170] to 695G.1712, inclusive, 695G.1714 to 17
695G.174, inclusive, 695G.176, 695G.177, 695G.200 to 695G.230, 18
inclusive, 695G.241 to 695G.310, inclusive, 695G.405 and 19
695G.415, and sections 90 to 94, inclusive, of this act in the same 20
manner as an insurer that is licensed pursuant to title 57 of NRS is 21
required to comply with those provisions. 22
Sec. 107. NRS 287.04337 is hereby amended to read as 23
follows: 24
287.04337 1. If the Board provides health insurance through 25
a plan of self-insurance, it shall provide coverage for benefits 26
payable for expenses incurred for [a] 27
(a) A mammogram every 2 years, or annually if ordered by a 28
provider of health care, for women 40 years of age or older [.] ; 29
(b) A diagnostic imaging test for breast cancer at the age 30
deemed most appropriate, when medically necessary, as 31
recommended by the insured’s provider of health care to evaluate 32
an abnormality which is: 33
(1) Seen or suspected from the mammogram described in 34
paragraph (a) or the imaging test described in paragraph (b); or 35
(2) Detected by other means of examination; and 36
(c) Medication to prevent breast cancer for insureds who are at 37
a high risk of developing breast cancer and have a low risk of 38
adverse side effects from the medication. 39
2. If the Board provides health insurance through a plan of self-40
insurance, it must ensure that the benefits required by subsection 1 41
are made available to an insured through a provider of health care 42
who participates in the network plan of the Board. 43
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3. Except as otherwise provided in subsection 5, if the Board 1
provides health insurance through a plan of self-insurance, it shall 2
not: 3
(a) Except as otherwise provided in subsection 6, require an 4
insured to pay a higher deductible, any copayment or coinsurance or 5
require a longer waiting period or other condition to obtain any 6
benefit provided in the plan of self-insurance pursuant to 7
subsection 1; 8
(b) Refuse to issue a plan of self-insurance or cancel a plan of 9
self-insurance solely because the person applying for or covered by 10
the plan uses or may use any such benefit; 11
(c) Offer or pay any type of material inducement or financial 12
incentive to an insured to discourage the insured from obtaining any 13
such benefit; 14
(d) Penalize a provider of health care who provides any such 15
benefit to an insured, including, without limitation, reducing the 16
reimbursement of the provider of health care; 17
(e) Offer or pay any type of material inducement, bonus or other 18
financial incentive to a provider of health care to deny, reduce, 19
withhold, limit or delay access to any such benefit to an insured; or 20
(f) Impose any other restrictions or delays on the access of an 21
insured to any such benefit. 22
4. A plan of self-insurance described in subsection 1 which is 23
delivered, issued for delivery or renewed on or after January 1, 24
2024, has the legal effect of including the coverage required by 25
subsection 1, and any provision of the policy or the renewal which is 26
in conflict with this section is void. 27
5. Except as otherwise provided in this section and federal law, 28
if the Board provides health insurance through a plan of self-29
insurance, the Board may use medical management techniques, 30
including, without limitation, any available clinical evidence, to 31
determine the frequency of or treatment relating to any benefit 32
required by this section or the type of provider of health care to use 33
for such treatment. 34
6. If the application of paragraph (a) of subsection 3 would 35
result in the ineligibility of a health savings account of an insured 36
pursuant to 26 U.S.C. § 223, the prohibitions of paragraph (a) of 37
subsection 3 shall apply only for a qualified plan of self-insurance 38
with respect to the deductible of such a plan of self-insurance after 39
the insured has satisfied the minimum deductible pursuant to 26 40
U.S.C. § 223, except with respect to items or services that constitute 41
preventive care pursuant to 26 U.S.C. § 223(c)(2)(C), in which case 42
the prohibitions of paragraph (a) of subsection 3 shall apply 43
regardless of whether the minimum deductible under 26 U.S.C. § 44
223 has been satisfied. 45
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7. As used in this section: 1
(a) “Medical management technique” means a practice which is 2
used to control the cost or utilization of health care services or 3
prescription drug use. The term includes, without limitation, the use 4
of step therapy, prior authorization or categorizing drugs and 5
devices based on cost, type or method of administration. 6
(b) “Network plan” means a plan of self-insurance provided by 7
the Board under which the financing and delivery of medical care, 8
including items and services paid for as medical care, are provided, 9
in whole or in part, through a defined set of providers under contract 10
with the Board. The term does not include an arrangement for the 11
financing of premiums. 12
(c) “Provider of health care” has the meaning ascribed to it in 13
NRS 629.031. 14
(d) “Qualified plan of self-insurance” means a plan of self-15
insurance that has a high deductible and is in compliance with 26 16
U.S.C. § 223 for the purposes of establishing a health savings 17
account. 18
Sec. 108. Chapter 422 of NRS is hereby amended by adding 19
thereto the provisions set forth as sections 109 to 112, inclusive, of 20
this act. 21
Sec. 109. 1. The Director shall include under Medicaid a 22
requirement that the State pay the nonfederal share of 23
expenditures incurred for: 24
(a) Screening for major depressive disorder for recipients of 25
Medicaid who are at least 12 but less than 18 years of age; 26
(b) Screening for anxiety for recipients of Medicaid who are at 27
least 8 but less than 18 years of age; 28
(c) Assessments relating to height, weight, body mass index 29
and medical history for recipients of Medicaid who are less than 30
18 years of age; 31
(d) Comprehensive and intensive behavioral interventions for 32
recipients of Medicaid who are at least 6 but less than 18 years of 33
age and have a body mass index in the 95th percentile or greater 34
for persons of the same age and sex; 35
(e) The application of fluoride varnish to the primary teeth for 36
recipients of Medicaid who are less than 5 years of age; 37
(f) Oral fluoride supplements for recipients of Medicaid who 38
are at least 6 months of age but less than 5 years of age whose 39
supply of water is deficient in fluoride; 40
(g) Counseling and education pertaining to the minimization 41
of exposure to ultraviolet radiation for recipients of Medicaid who 42
are less than 25 years of age who have fair skin types and the 43
parents or legal guardians of recipients of Medicaid who are less 44
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than 18 years of age and have fair skin types for the purpose of 1
minimizing the risk of skin cancer in those persons; 2
(h) Brief behavioral counseling and interventions prevent 3
tobacco use for recipients of Medicaid who are less than 18 years 4
of age; 5
(i) At least one screening for the detection of amblyopia or the 6
risk factors of amblyopia for recipients of Medicaid who are at 7
least 3 but not more than 5 years of age; and 8
(j) Screening, tests and counseling for such other health 9
conditions and diseases as recommended by the Health Resources 10
and Services Administration on January 1, 2025, for recipients of 11
Medicaid who are less than 18 years of age. 12
2. To obtain any benefit provided under Medicaid pursuant to 13
subsection 1, a recipient of Medicaid must not be required to: 14
(a) Pay a higher deductible or any copayment or coinsurance; 15
or 16
(b) Be subject to a longer waiting period or any other 17
condition. 18
3. The Department shall: 19
(a) Apply to the Secretary of Health and Human Services for 20
any waiver of federal law or apply for any amendment of the State 21
Plan for Medicaid that is necessary for the Department to receive 22
federal funding to provide the coverage described in subsection 1. 23
(b) Fully cooperate with the Federal Government during the 24
application process to satisfy the requirements of the Federal 25
Government for obtaining a waiver or amendment pursuant to 26
paragraph (a). 27
Sec. 110. 1. The Director shall include under Medicaid a 28
requirement that the State pay the nonfederal share of 29
expenditures incurred for: 30
(a) A daily dose of 0.4 to 0.8 milligrams of folic acid for 31
recipients of Medicaid who are pregnant or are planning on 32
becoming pregnant; 33
(b) A low dose of aspirin for the prevention of preeclampsia 34
for recipients of Medicaid who are determined to be at a high risk 35
of that condition after 12 weeks of gestation; 36
(c) Prophylactic ocular tubal medication for the prevention of 37
gonococcal ophthalmia in newborns; 38
(d) Screening for asymptomatic bacteriuria for recipients of 39
Medicaid who are pregnant; 40
(e) Counseling and behavioral interventions relating to the 41
promotion of healthy weight gain and the prevention of excessive 42
weight gain for recipients of Medicaid who are pregnant; 43
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(f) Counseling for recipients of Medicaid who are pregnant or 1
in the postpartum stage of pregnancy and have an increased risk 2
of perinatal or postpartum depression; 3
(g) Screening for the presence of the rhesus D antigen and 4
antibodies in the blood of a recipient of Medicaid who is pregnant 5
during the recipient’s first visit for care relating to the pregnancy; 6
(h) Screening for rhesus D antibodies between 24 and 28 7
weeks of gestation for recipients of Medicaid who are negative for 8
the rhesus D antigen and have not been exposed to blood that is 9
positive for the rhesus D antigen; 10
(i) Behavioral counseling and intervention for tobacco 11
cessation for recipients of Medicaid who are pregnant; 12
(j) Screening for diabetes after at least 24 weeks of gestation or 13
as ordered by a provider of health care; 14
(k) An annual screening for urinary incontinence for women; 15
(l) Counseling relating to maintaining a healthy weight for 16
women who are at least 40 but not more than 60 years of age and 17
have a body mass index of 18.5 or greater; and 18
(m) Screening for osteoporosis for women who: 19
(1) Are 65 years of age or older; or 20
(2) Are less than 65 years of age and have a risk of 21
fracturing a bone equal to or greater than that of a woman who is 22
65 years of age without any additional risk factors. 23
2. To obtain any benefit provided under Medicaid pursuant to 24
subsection 1, a recipient of Medicaid must not be required to: 25
(a) Pay a higher deductible or any copayment or coinsurance; 26
or 27
(b) Be subject to a longer waiting period or any other 28
condition. 29
3. The Department shall: 30
(a) Apply to the Secretary of Health and Human Services for 31
any waiver of federal law or apply for any amendment of the State 32
Plan for Medicaid that is necessary for the Department to receive 33
federal funding to provide the coverage described in subsection 1. 34
(b) Fully cooperate with the Federal Government during the 35
application process to satisfy the requirements of the Federal 36
Government for obtaining a waiver or amendment pursuant to 37
paragraph (a). 38
Sec. 111. 1. The Director shall include under Medicaid a 39
requirement that the State pay the nonfederal share of 40
expenditures incurred for: 41
(a) Behavioral counseling and interventions to promote 42
physical activity and a heathy diet for recipients of Medicaid with 43
cardiovascular risk factors; 44
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(b) Statin preventive medication for recipients of Medicaid 1
who are at least 40 but not more than 75 years of age and do not 2
have a history of cardiovascular disease, but who have: 3
(1) One or more risk factors for cardiovascular disease; 4
and 5
(2) A calculated risk of at least 10 percent of acquiring 6
cardiovascular disease within the next 10 years; 7
(c) Interventions for exercise to prevent falls for recipients of 8
Medicaid who are 65 years of age or older and reside in a medical 9
facility or facility for the dependent; 10
(d) Screenings for latent tuberculosis infection in recipients of 11
Medicaid with an increased risk of contracting tuberculosis; 12
(e) One abdominal aortic screening by ultrasound to detect 13
abdominal aortic aneurysms for men who are at least 65 but not 14
more than 75 years of age and have smoked during their lifetimes; 15
(f) Screening for drug and alcohol misuse for persons who are 16
at least 18 years of age; 17
(g) If a recipient of Medicaid engages in risky or hazardous 18
consumption of alcohol, as determined by the screening described 19
in paragraph (f), behavioral counseling to reduce such behavior; 20
(h) Screening for lung cancer using low-dose computed 21
tomography for recipients of Medicaid who are at least 50 but not 22
more than 80 years of age and: 23
(1) Have a smoking history of 20 pack-years; 24
(2) Smoke or have stopped smoking within the immediately 25
preceding 15 years; and 26
(3) Do not suffer from a health problem that substantially 27
limits the life expectancy of the person or the willingness of the 28
person to undergo curative surgery; 29
(i) Screening for colorectal cancer for persons who are at least 30
45 but not more than 85 years of age; and 31
(j) Intensive behavioral interventions with multiple 32
components for recipients of Medicaid who are 18 years of age or 33
older and have a body mass index of 30 or greater. 34
2. To obtain any benefit provided under Medicaid pursuant to 35
subsection 1, a recipient of Medicaid must not be required to: 36
(a) Pay a higher deductible or any copayment or coinsurance; 37
or 38
(b) Be subject to a longer waiting period or any other 39
condition. 40
3. The Department shall: 41
(a) Apply to the Secretary of Health and Human Services for 42
any waiver of federal law or apply for any amendment of the State 43
Plan for Medicaid that is necessary for the Department to receive 44
federal funding to provide the coverage described in subsection 1. 45
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(b) Fully cooperate with the Federal Government during the 1
application process to satisfy the requirements of the Federal 2
Government for obtaining a waiver or amendment pursuant to 3
paragraph (a). 4
4. As used in this section: 5
(a) “Computed tomography” means the process of producing 6
sectional and three-dimensional images using external ionizing 7
radiation. 8
(b) “Facility for the dependent” has the meaning ascribed to it 9
in NRS 449.0045. 10
(c) “Medical facility” has the meaning ascribed to it in 11
NRS 449.0151. 12
(d) “Pack-year” means the product of the number of packs of 13
cigarettes smoked per day and the number of years that the person 14
has smoked. 15
Sec. 112. 1. To the extent that federal financial 16
participation is available, the Director shall include under 17
Medicaid coverage for maternity care and pediatric care for 18
newborn infants. 19
2. Except as otherwise provided in this subsection, Medicaid 20
may not restrict benefits for any length of stay in a hospital in 21
connection with childbirth for a pregnant or postpartum 22
individual or newborn infant who is a recipient of Medicaid to: 23
(a) Less than 48 hours after a normal vaginal delivery; and 24
(b) Less than 96 hours after a cesarean section. 25
If a different length of stay is provided in the guidelines 26
established by the American College of Obstetricians and 27
Gynecologists, or its successor organization, and the American 28
Academy of Pediatrics, or its successor organization, Medicaid 29
may follow such guidelines in lieu of following the length of stay 30
set forth above. The provisions of this subsection do not apply in 31
any case in which the decision to discharge the pregnant or 32
postpartum individual or newborn infant before the expiration of 33
the minimum length of stay set forth in this subsection is made by 34
the attending physician of the pregnant or postpartum individual 35
or newborn infant. 36
3. Nothing in this section requires a pregnant or postpartum 37
individual to: 38
(a) Deliver the baby in a hospital; or 39
(b) Stay in a hospital for a fixed period following the birth of 40
the child. 41
4. Nothing in this section: 42
(a) Prohibits Medicaid from imposing a deductible, 43
coinsurance or other mechanism for sharing costs relating to 44
benefits for hospital stays in connection with childbirth for a 45
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pregnant or postpartum individual or newborn child who is a 1
recipient of Medicaid, except that such coinsurance or other 2
mechanism for sharing costs for any portion of a hospital stay 3
required by this section may not be greater than the coinsurance 4
or other mechanism for any preceding portion of that stay. 5
(b) Prohibits an arrangement for payment between the 6
Department and a provider of health care that uses capitation or 7
other financial incentives, if the arrangement is designed to 8
provide services efficiently and consistently in the best interest of 9
the pregnant or postpartum individual and the newborn infant. 10
(c) Prevents the Department from negotiating with a provider 11
of health care concerning the level and type of reimbursement to 12
be provided in accordance with this section. 13
Sec. 113. NRS 422.2701 is hereby amended to read as 14
follows: 15
422.2701 1. The Department shall not discriminate against 16
any person with respect to participation or coverage under Medicaid 17
on the basis of an actual or perceived [gender identity or 18
expression.] protected characteristic. 19
2. Prohibited discrimination includes, without limitation: 20
[1.] (a) Denying, cancelling, limiting or refusing to issue a 21
payment or coverage on the basis of [the] an actual or perceived 22
[gender identity or expression] protected characteristic of a person 23
or a family member of the person; 24
[2.] (b) Imposing a payment that is based on [the] an actual or 25
perceived [gender identity or expression] protected characteristic of 26
a recipient of Medicaid or a family member of the recipient; 27
[3.] (c) Designating [the] an actual or perceived [gender 28
identity or expression] protected characteristic of a person or a 29
family member of the person as grounds to deny, cancel or limit 30
participation or coverage; and 31
[4.] (d) Denying, cancelling or limiting participation or 32
coverage on the basis of an actual or perceived [gender identity or 33
expression,] protected characteristic, including, without limitation, 34
by limiting or denying payment or coverage for health care services 35
that are: 36
[(a)] (1) Related to gender transition, provided that there is 37
coverage under Medicaid for the services when the services are not 38
related to gender transition; or 39
[(b)] (2) Ordinarily or exclusively available to persons of any 40
sex. 41
3. As used in this section, “protected characteristic” means: 42
(a) Race, color, national origin, age, physical or mental 43
disability, sexual orientation or gender identity or expression; or 44
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(b) Sex, including, without limitation, sex characteristics, 1
intersex traits and pregnancy or related conditions. 2
Sec. 114. NRS 422.27173 is hereby amended to read as 3
follows: 4
422.27173 1. The Director shall include in the State Plan for 5
Medicaid a requirement that the State must pay the nonfederal share 6
of expenditures incurred for: 7
[1.] (a) Testing for and the treatment and prevention of sexually 8
transmitted diseases, including, without limitation, Chlamydia 9
trachomatis, gonorrhea, syphilis, human immunodeficiency virus 10
and hepatitis B and C, for all recipients of Medicaid, regardless of 11
age. Services covered pursuant to this section must include, without 12
limitation, the examination of a pregnant woman for the discovery 13
of: 14
[(a)] (1) Chlamydia trachomatis, gonorrhea, hepatitis B and 15
hepatitis C in accordance with NRS 442.013. 16
[(b)] (2) Syphilis in accordance with NRS 442.010. 17
[2.] (3) Human immunodeficiency virus. 18
(b) Condoms for recipients of Medicaid. 19
2. To obtain any benefit provided pursuant to subsection 1, a 20
recipient of Medicaid must not be required to: 21
(a) Pay a higher deductible or any copayment or coinsurance; 22
or 23
(b) Be subject to a longer waiting period or any other 24
condition. 25
Sec. 115. NRS 422.27174 is hereby amended to read as 26
follows: 27
422.27174 1. The Director shall include in the State Plan for 28
Medicaid a requirement that the State pay the nonfederal share of 29
expenditures incurred for: 30
(a) Counseling and support for breastfeeding; 31
(b) Screening and counseling for interpersonal and domestic 32
violence; 33
(c) Counseling for sexually transmitted diseases; 34
(d) Screening for blood pressure abnormalities and diabetes, 35
including gestational diabetes; 36
(e) Screening for prediabetes in recipients of Medicaid who 37
are at least 35 but not more than 70 years of age and have a body 38
mass index of 25 or greater; 39
(f) An annual screening for cervical cancer; 40
[(f)] (g) Screening for anxiety and depression; 41
[(g)] (h) Screening and counseling for the human 42
immunodeficiency virus; 43
[(h)] (i) Smoking cessation programs; 44
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[(i)] (j) All vaccinations recommended by the Advisory 1
Committee on Immunization Practices of the Centers for Disease 2
Control and Prevention of the United States Department of Health 3
and Human Services or its successor organization; and 4
[(j)] (k) Such well-woman preventative visits as recommended 5
by the Health Resources and Services Administration [.] on 6
January 1, 2025, and any additional well-woman preventative 7
visits that may be so recommended thereafter. 8
2. To obtain any benefit provided in the Plan pursuant to 9
subsection 1, a recipient of Medicaid must not be required to: 10
(a) Pay a higher deductible [,] or any copayment or coinsurance; 11
or 12
(b) Be subject to a longer waiting period or any other condition. 13
Sec. 116. NRS 422.27175 is hereby amended to read as 14
follows: 15
422.27175 1. The Director shall include in the State Plan for 16
Medicaid a requirement that the State, to the extent authorized by 17
federal law, must pay the nonfederal share of expenditures incurred 18
for screening, genetic counseling and testing for harmful mutations 19
in the BRCA gene for women under circumstances where such 20
screening, genetic counseling or testing, as applicable, is required by 21
NRS 457.301. 22
2. To obtain any benefit provided pursuant to subsection 1, a 23
recipient of Medicaid must not be required to: 24
(a) Pay a higher deductible or any copayment or coinsurance; 25
or 26
(b) Be subject to a longer waiting period or any other 27
condition. 28
Sec. 117. NRS 422.27176 is hereby amended to read as 29
follows: 30
422.27176 1. The Director shall include in the State Plan for 31
Medicaid a requirement that the State pay the nonfederal share of 32
expenditures incurred for [a] : 33
(a) A mammogram [.] ; and 34
(b) Medication to prevent breast cancer for women who are at 35
a high risk of developing breast cancer and have a low risk of 36
adverse side effects from the medication. 37
2. To obtain any benefit provided pursuant to subsection 1, a 38
recipient of Medicaid must not be required to: 39
(a) Pay a higher deductible or any copayment or coinsurance; 40
or 41
(b) Be subject to a longer waiting period or any other 42
condition. 43
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Sec. 118. NRS 422.27179 is hereby amended to read as 1
follows: 2
422.27179 1. To the extent that money is available, the 3
Director shall include in the State Plan for Medicaid a requirement 4
that the State pay the nonfederal share of expenditures incurred for: 5
(a) Supplies for breastfeeding a child until the child’s first 6
birthday. Such supplies include, without limitation, electric or 7
hospital-grade breast pumps that: 8
(1) Have been prescribed or ordered by a qualified provider 9
of health care; and 10
(2) Are medically necessary for the mother or the child. 11
(b) Such prenatal screenings and tests as are recommended by 12
the American College of Obstetricians and Gynecologists, or its 13
successor organization. 14
2. The Director shall include in the State Plan for Medicaid a 15
requirement that, to the extent that money and federal financial 16
participation are available, the State must pay the nonfederal share 17
of expenditures incurred for lactation consultation and support. 18
3. To obtain any benefit provided pursuant to subsection 1, a 19
recipient of Medicaid must not be required to: 20
(a) Pay a higher deductible or any copayment or coinsurance; 21
or 22
(b) Be subject to a longer waiting period or any other 23
condition. 24
4. As used in this section: 25
(a) “Medically necessary” has the meaning ascribed to it in 26
NRS 695G.055. 27
(b) “Provider of health care” has the meaning ascribed to it in 28
NRS 629.031. 29
Sec. 119. Chapter 629 of NRS is hereby amended by adding 30
thereto a new section to read as follows: 31
1. A provider of health care shall not discriminate in the 32
provision of services to a person seeking to receive or receiving 33
services from the provider of health care based wholly or partially 34
on the actual or perceived: 35
(a) Race, color, national origin, age, physical or mental 36
disability, sexual orientation or gender identity or expression of 37
the person or a person with whom the person associates; or 38
(b) Sex, including, without limitation, sex characteristics, 39
intersex traits and pregnancy or related conditions. 40
2. A health care licensing board may adopt regulations 41
prescribing the specific types of discrimination prohibited by 42
subsection 1. 43
3. A provider of health care who violates any provision of this 44
section or any regulation adopted pursuant thereto is guilty of 45
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unprofessional conduct and is subject to disciplinary action by the 1
health care licensing board by which he or she is licensed, 2
certified or regulated. 3
4. The provisions of this section shall not be construed to: 4
(a) Require a provider of health care to take or refrain from 5
taking any action in violation of medical standards; or 6
(b) Prohibit a provider of health care from adopting a policy 7
that is applied uniformly and in a nondiscriminatory manner. 8
5. As used in this section, “health care licensing board” 9
means a board created pursuant to chapter 630, 630A, 631, 632, 10
633, 634, 634A, 634B, 636, 637, 637B, 639, 640, 640A, 640B, 11
640C, 640D, 640E, 641, 641A, 641B, 641C or 641D of NRS. 12
Sec. 120. The provisions of NRS 354.599 do not apply to any 13
additional expenses of a local government that are related to the 14
provisions of this act. 15
Sec. 121. 1. This section becomes effective upon passage 16
and approval. 17
2. Sections 1 to 119, inclusive, of this act become effective: 18
(a) Upon passage and approval for the purpose of adopting any 19
regulations and performing any other preparatory administrative 20
tasks that are necessary to carry out the provisions of this act; and 21
(b) On October 1, 2025, for all other purposes. 22
H