EXEMPT
(Reprinted with amendments adopted on April 21, 2025)
FIRST REPRINT 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, 115 and 117 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 105 and 48
107 of this bill additionally require insurance for government employees to cover 49
certain additional diagnostic imaging if breast cancer is seen or suspected without 50
charging a higher deductible or imposing any copay or coinsurance for such 51
imaging. 52
Existing law requires certain policies of health insurance that provide coverage 53
for the treatment of colorectal cancer to additionally provide coverage for the 54
screening of colorectal cancer. (NRS 689A.04042, 689B.0367, 695B.1907, 55
695C.1731, 695G.168) Sections 7, 24, 35, 50, 65, 82, 95 and 111 of this bill: (1) 56
require all public and private policies of health insurance, including Medicaid, to 57
cover screening for colorectal cancer; and (2) prohibit insurers from charging a 58
higher deductible or any copay or coinsurance for such screenings. 59
Existing federal law requires all policies of health insurance to include 60
coverage for maternity and newborn care. (42 U.S.C. § 18022(b)) Sections 12, 15, 61
29, 41, 42, 51, 56, 64, 71, 78, 81, 94, 100 and 112 of this bill align Nevada law 62
with federal law in this manner and require public and private policies of health 63
insurance to include coverage for such care. 64
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Existing federal regulations prohibit certain health care entities from 65
discriminating on the basis of race, color, national origin, sex, age or disability. (45 66
C.F.R. §§ 92.101, 92.206, 92.208, 92.209) Existing law prohibits public and private 67
policies of health insurance from discriminating against any person with respect to 68
participation or coverage under the policy on the basis of actual or perceived gender 69
identity or expression. (NRS 287.010, 287.04335, 422.2701, 608.1555, 689A.033, 70
689B.0675, 689C.1975, 689C.425, 695A.198, 695B.3167, 695C.050, 695C.204, 71
695G.415) Sections 6, 28, 43, 58, 72, 87, 102 and 113 of this bill additionally 72
prohibit public and private policies of health insurance, including Medicaid, from 73
discriminating against any person on the basis of actual or perceived race, color, 74
national origin, sex, age or disability. Section 119 of this bill similarly prohibits a 75
provider of health care from discriminating against a person on the basis of those 76
characteristics, as well as gender identity or expression. Section 119 also authorizes 77
a board, agency or other entity in this State that licenses, certifies or regulates a 78
provider of health care to: (1) adopt regulations prescribing the types of 79
discrimination that are prohibited; and (2) discipline a provider of health care that 80
violates section 119. 81
Existing law prohibits an insurer that offers or issues a policy of group health 82
insurance from penalizing a provider of health care who provides the following 83
benefits that such an insurer is required to cover: (1) certain counseling and 84
screenings; (2) smoking cessation programs; (3) certain federally recommended 85
vaccinations; (4) federally recommended well-woman preventative visits; and (5) 86
care in a hospital for a prescribed length of time after a birth. (NRS 689B.03785, 87
689B.520) Sections 27 and 29 remove that prohibition, thereby authorizing such an 88
insurer to penalize a provider of health care for providing such benefits and the 89
additional benefits added by those sections. Section 104 exempts health plans for 90
retirees from local government employment from: (1) the requirements of this bill; 91
and (2) certain provisions of existing law requiring group health insurance plans to 92
provide certain coverage and prohibiting such plans from engaging in certain 93
discrimination. (NRS 689B.0314, 689B.0315, 689B.0316, 689B.0367 and 94
689B.0675) 95
Section 88 of this bill authorizes the Commissioner of Insurance to suspend or 96
revoke the certificate of a health maintenance organization that fails to provide the 97
coverage required by sections 74-78. The Commissioner would also be authorized 98
to take such action against other private health insurers who fail to provide the 99
coverage required by this bill. (NRS 680A.200) Section 103 of this bill requires 100
the Director of the Department of Health and Human Services to administer the 101
provisions of sections 109-112 in the same manner as other provisions relating to 102
Medicaid. 103
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
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2. Nothing in this section shall be construed as requiring an 1
insurer to make coverage available for a dependent of an adult 2
child of an insured. 3
Sec. 3. 1. An insurer that offers or issues a policy of health 4
insurance shall include in the policy coverage for: 5
(a) Screening for anxiety for insureds who are at least 8 but 6
not more than 18 years of age; 7
(b) Assessments relating to height, weight, body mass index 8
and medical history for insureds who are less than 18 years of 9
age; 10
(c) Comprehensive and intensive behavioral interventions for 11
insureds who are at least 12 but not more than 18 years of age and 12
have a body mass index in the 95th percentile or greater for 13
persons of the same age and sex; 14
(d) The application of fluoride varnish to the primary teeth for 15
insureds who are less than 5 years of age; 16
(e) Oral fluoride supplements for insureds who are at least 6 17
months of age but less than 5 years of age and whose supply of 18
water is deficient in fluoride; 19
(f) Counseling and education pertaining to the minimization of 20
exposure to ultraviolet radiation for insureds who are less than 25 21
years of age and the parents or legal guardians of insureds who 22
are less than 18 years of age for the purpose of minimizing the 23
risk of skin cancer in those persons; 24
(g) Brief behavioral counseling and interventions to prevent 25
tobacco use for insureds who are less than 18 years of age; and 26
(h) At least one screening for the detection of amblyopia or the 27
risk factors of amblyopia for insureds who are at least 3 but not 28
more than 5 years of age. 29
2. An insurer must ensure that the benefits required by 30
subsection 1 are made available to an insured through a provider 31
of health care who participates in the network plan of the insurer. 32
3. Except as otherwise provided in subsection 5, an insurer 33
that offers or issues a policy of health 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, an insurer may use medical management techniques, 16
including, without limitation, any available clinical evidence, to 17
determine the frequency of or treatment relating to any benefit 18
required by this section or the type of provider of health care to 19
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 an insurer under which the financing and delivery of medical 28
care, including items and services paid for as medical care, are 29
provided, in whole or in part, through a defined set of providers of 30
health care under contract with the insurer. The term does not 31
include an arrangement for the financing of premiums. 32
(c) “Provider of health care” has the meaning ascribed to it in 33
NRS 629.031. 34
Sec. 4. 1. An insurer that offers or issues a policy of health 35
insurance shall include in the policy coverage for: 36
(a) A daily dose of 0.4 to 0.8 milligrams of folic acid for 37
insureds who are pregnant or are planning on becoming 38
pregnant; 39
(b) A low dose of aspirin for the prevention of preeclampsia 40
for insureds who are determined to be at a high risk of that 41
condition after 12 weeks of gestation; 42
(c) Prophylactic ocular tubal medication for the prevention of 43
gonococcal ophthalmia in newborns; 44
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(d) Screening for asymptomatic bacteriuria for insureds who 1
are pregnant; 2
(e) Counseling and behavioral interventions relating to the 3
promotion of healthy weight gain and the prevention of excessive 4
weight gain for insureds who are pregnant; 5
(f) Counseling for insureds who are pregnant or in the 6
postpartum stage of pregnancy and have an increased risk of 7
perinatal or postpartum depression; 8
(g) Screening for the presence of the rhesus D antigen and 9
antibodies in the blood of an insured who is pregnant during the 10
insured’s first visit for care relating to the pregnancy; 11
(h) Screening for rhesus D antibodies between 24 and 28 12
weeks of gestation for insureds who are negative for the rhesus D 13
antigen and have not been exposed to blood that is positive for the 14
rhesus D antigen; 15
(i) Behavioral counseling and intervention for tobacco 16
cessation for insureds who are pregnant; 17
(j) Screening for type 2 diabetes at such intervals as 18
recommended by the Health Resources and Services 19
Administration on January 1, 2025, for insureds who are in the 20
postpartum stage of pregnancy and who have a history of 21
gestational diabetes mellitus; 22
(k) Counseling relating to maintaining a healthy weight for 23
women who are at least 40 but not more than 60 years of age and 24
have a body mass index greater than 18.5; and 25
(l) Screening for osteoporosis for women who: 26
(1) Are 65 years of age or older; or 27
(2) Are less than 65 years of age and have a risk of 28
fracturing a bone equal to or greater than that of a woman who is 29
65 years of age without any additional risk factors. 30
2. An insurer must ensure that the benefits required by 31
subsection 1 are made available to an insured through a provider 32
of health care who participates in the network plan of the insurer. 33
3. Except as otherwise provided in subsection 5, an insurer 34
that offers or issues a policy of health insurance shall not: 35
(a) Require an insured to pay a higher deductible, any 36
copayment or coinsurance or require a longer waiting period or 37
other condition to obtain any benefit provided in the policy of 38
health insurance pursuant to subsection 1; 39
(b) Refuse to issue a policy of health insurance or cancel a 40
policy of health insurance solely because the person applying for 41
or covered by the policy uses or may use any such benefit; 42
(c) Offer or pay any type of material inducement or financial 43
incentive to an insured to discourage the insured from obtaining 44
any such benefit; 45
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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, an insurer may use medical management techniques, 16
including, without limitation, any available clinical evidence, to 17
determine the frequency of or treatment relating to any benefit 18
required by this section or the type of provider of health care to 19
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 an insurer under which the financing and delivery of medical 28
care, including items and services paid for as medical care, are 29
provided, in whole or in part, through a defined set of providers of 30
health care under contract with the insurer. The term does not 31
include an arrangement for the financing of premiums. 32
(c) “Provider of health care” has the meaning ascribed to it in 33
NRS 629.031. 34
Sec. 5. 1. An insurer that offers or issues a policy of health 35
insurance shall include in the policy coverage for: 36
(a) Behavioral counseling and interventions to promote 37
physical activity and a healthy diet for insureds with 38
cardiovascular risk factors; 39
(b) Statin preventive medication for insureds who are at least 40
40 but not more than 75 years of age and do not have a history of 41
cardiovascular disease, but who have: 42
(1) One or more risk factors for cardiovascular disease; 43
and 44
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(2) A calculated risk of at least 10 percent of acquiring 1
cardiovascular disease within the next 10 years; 2
(c) Interventions for exercise to prevent falls for insureds who 3
are 65 years of age or older and reside in a medical facility or 4
facility for the dependent; 5
(d) Screenings for latent tuberculosis infection in insureds 6
with an increased risk of contracting tuberculosis; 7
(e) Screening for hypertension; 8
(f) One abdominal aortic screening by ultrasound to detect 9
abdominal aortic aneurysms for men who are at least 65 but not 10
more than 75 years of age and have smoked during their lifetimes; 11
(g) Screening for drug and alcohol misuse for insureds who 12
are 18 years of age or older; 13
(h) If an insured engages in risky or hazardous consumption 14
of alcohol, as determined by the screening described in paragraph 15
(g), behavioral counseling to reduce such behavior; 16
(i) Screening for lung cancer using low-dose computed 17
tomography for insureds who are at least 50 but not more than 80 18
years of age in accordance with the most recent guidelines 19
published by the American Cancer Society or the 20
recommendations of the United States Preventive Services Task 21
Force in effect on January 1, 2025; 22
(j) Screening for prediabetes and type 2 diabetes in insureds 23
who are at least 35 but not more than 70 years of age and have a 24
body mass index of 25 or greater; and 25
(k) Intensive behavioral interventions with multiple 26
components for insureds who are 18 years of age or older and 27
have a body mass index of 30 or greater. 28
2. The benefits provided pursuant to paragraph (h) of 29
subsection 1 are in addition to and separate from the benefits 30
provided pursuant to NRS 689A.046. 31
3. An insurer 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 insurer. 34
4. Except as otherwise provided in subsection 6, an insurer 35
that offers or issues a policy of health insurance 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 policy of 39
health insurance pursuant to subsection 1; 40
(b) Refuse to issue a policy of health insurance or cancel a 41
policy of health insurance solely because the person applying for 42
or covered by the policy 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 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) “Provider of health care” has the meaning ascribed to it in 43
NRS 629.031. 44
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Sec. 6. NRS 689A.033 is hereby amended to read as follows: 1
689A.033 1. An insurer that issues a policy of health 2
insurance shall not discriminate against any person with respect to 3
participation or coverage under the policy on the basis of an actual 4
or perceived [gender identity or expression.] protected 5
characteristic. 6
2. Prohibited discrimination includes, without limitation: 7
[1.] (a) Denying, cancelling, limiting or refusing to issue or 8
renew a policy of health insurance on the basis of [the] an actual or 9
perceived [gender identity or expression] protected characteristic of 10
a person or a family member of the person; 11
[2.] (b) Imposing a payment or premium that is based on [the] 12
an actual or perceived [gender identity or expression] protected 13
characteristic of an insured or a family member of the insured; 14
[3.] (c) Designating [the] an actual or perceived [gender 15
identity or expression] protected characteristic of a person or a 16
family member of the person as grounds to deny, cancel or limit 17
participation or coverage; and 18
[4.] (d) Denying, cancelling or limiting participation or 19
coverage on the basis of an actual or perceived [gender identity or 20
expression,] protected characteristic, including, without limitation, 21
by limiting or denying coverage for health care services that are: 22
[(a)] (1) Related to gender transition, provided that there is 23
coverage under the policy for the services when the services are not 24
related to gender transition; or 25
[(b)] (2) Ordinarily or exclusively available to persons of any 26
sex. 27
3. As used in this section, “protected characteristic” means: 28
(a) Race, color, national origin, age, physical or mental 29
disability, sexual orientation or gender identity or expression; or 30
(b) Sex, including, without limitation, sex characteristics, 31
intersex traits and pregnancy or related conditions. 32
Sec. 7. NRS 689A.04042 is hereby amended to read as 33
follows: 34
689A.04042 1. A policy of health insurance [that provides 35
coverage for the treatment of colorectal cancer] must provide 36
coverage for colorectal cancer screening in accordance with: 37
(a) The guidelines concerning colorectal cancer screening which 38
are published by the American Cancer Society; or 39
(b) Other guidelines or reports concerning colorectal cancer 40
screening which are published by nationally recognized professional 41
organizations and which include current or prevailing supporting 42
scientific data. 43
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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. (Deleted by amendment.) 39
Sec. 10. NRS 689A.0412 is hereby amended to read as 40
follows: 41
689A.0412 1. An insurer that issues a policy of health 42
insurance shall provide coverage for the examination of a person 43
who is pregnant for the discovery of: 44
– 13 –
- *AB522_R1*
(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 insurer; and 8
(b) Without prior authorization. 9
3. An insurer that issues a policy of health insurance shall 10
not: 11
(a) Require an insured to pay a higher deductible, any 12
copayment or coinsurance or require a longer waiting period or 13
other condition to obtain any benefit provided in the policy of 14
health insurance pursuant to subsection 1; 15
(b) Refuse to issue a policy of health insurance or cancel a 16
policy of health insurance solely because the person applying for 17
or covered by the policy uses or may use any such benefit; 18
(c) Offer or pay any type of material inducement or financial 19
incentive to an insured to discourage the insured from obtaining 20
any such benefit; 21
(d) Penalize a provider of health care who provides any such 22
benefit to an insured, including, without limitation, reducing the 23
reimbursement of the provider of health care; 24
(e) Offer or pay any type of material inducement, bonus or 25
other financial incentive to a provider of health care to deny, 26
reduce, withhold, limit or delay access to any such benefit to an 27
insured; or 28
(f) Impose any other restrictions or delays on the access of an 29
insured to any such benefit. 30
[3.] 4. A policy of health insurance subject to the provisions of 31
this chapter that is delivered, issued for delivery or renewed on or 32
after [July] October 1, [2021,] 2025, has the legal effect of including 33
the coverage required by subsection 1, and any provision of the 34
policy that conflicts with the provisions of this section is void. 35
[4.] 5. As used in this section: 36
(a) “Medical laboratory” has the meaning ascribed to it in 37
NRS 652.060. 38
(b) “Network plan” means a policy of health insurance offered 39
by an insurer under which the financing and delivery of medical 40
care, including items and services paid for as medical care, are 41
provided, in whole or in part, through a defined set of providers 42
under contract with the insurer. The term does not include an 43
arrangement for the financing of premiums. 44
– 14 –
- *AB522_R1*
(c) “Provider of health care” has the meaning ascribed to it in 1
NRS 629.031. 2
Sec. 11. NRS 689A.0419 is hereby amended to read as 3
follows: 4
689A.0419 1. An insurer that offers or issues a policy of 5
health insurance shall include in the policy coverage for: 6
(a) Counseling, support and supplies for breastfeeding, 7
including breastfeeding equipment, counseling and education during 8
the antenatal, perinatal and postpartum period for not more than 1 9
year; 10
(b) Screening and counseling for interpersonal and domestic 11
violence for women at least annually with intervention services 12
consisting of education, strategies to reduce harm, supportive 13
services or a referral for any other appropriate services; 14
(c) Behavioral counseling concerning sexually transmitted 15
diseases from a provider of health care for sexually active [women] 16
insureds who are at increased risk for such diseases; 17
(d) Such prenatal screenings and tests as recommended by the 18
American College of Obstetricians and Gynecologists or its 19
successor organization; 20
(e) Screening for blood pressure abnormalities and diabetes, 21
including gestational diabetes, after at least 24 weeks of gestation or 22
as ordered by a provider of health care; 23
(f) Screening for cervical cancer at such intervals as are 24
recommended by the American College of Obstetricians and 25
Gynecologists or its successor organization; 26
(g) Screening for depression [;] for insureds who are 12 years 27
of age or older; 28
(h) Screening for anxiety disorders; 29
(i) Screening and counseling for the human immunodeficiency 30
virus consisting of a risk assessment, annual education relating to 31
prevention and at least one screening for the virus during the 32
lifetime of the insured or as ordered by a provider of health care; 33
[(i) Smoking] 34
(j) Tobacco cessation programs , including, without limitation, 35
pharmacotherapy approved by the United States Food and Drug 36
Administration, for an insured who is 18 years of age or older ; 37
[consisting of not more than two cessation attempts per year and 38
four counseling sessions per year; 39
(j)] (k) All vaccinations recommended by the Advisory 40
Committee on Immunization Practices of the Centers for Disease 41
Control and Prevention of the United States Department of Health 42
and Human Services or its successor organization; and 43
[(k)] (l) Such well-woman preventative visits as recommended 44
by the Health Resources and Services Administration [,] on 45
– 15 –
- *AB522_R1*
January 1, 2025, which must include at least one such visit per year 1
beginning at 14 years of age. 2
2. An insurer must ensure that the benefits required by 3
subsection 1 are made available to an insured through a provider of 4
health care who participates in the network plan of the insurer. 5
3. Except as otherwise provided in subsection 5, an insurer that 6
offers or issues a policy of health insurance shall not: 7
(a) Require an insured to pay a higher deductible, any 8
copayment or coinsurance or require a longer waiting period or 9
other condition to obtain any benefit provided in the policy of health 10
insurance pursuant to subsection 1; 11
(b) Refuse to issue a policy of health insurance or cancel a 12
policy of health insurance solely because the person applying for or 13
covered by the policy uses or may use any such benefit; 14
(c) Offer or pay any type of material inducement or financial 15
incentive to an insured to discourage the insured from obtaining any 16
such benefit; 17
(d) Penalize a provider of health care who provides any such 18
benefit to an insured, including, without limitation, reducing the 19
reimbursement of the provider of health care; 20
(e) Offer or pay any type of material inducement, bonus or other 21
financial incentive to a provider of health care to deny, reduce, 22
withhold, limit or delay access to any such benefit to an 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 health insurance subject to the provisions of this 26
chapter that is delivered, issued for delivery or renewed on or after 27
[January] October 1, [2018,] 2025, has the legal effect of including 28
the coverage required by subsection 1, and any provision of the 29
policy or the renewal which is in conflict with this section is void. 30
5. Except as otherwise provided in this section and federal law, 31
an insurer 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. 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 policy of health insurance offered 43
by an insurer under which the financing and delivery of medical 44
care, including items and services paid for as medical care, are 45
– 16 –
- *AB522_R1*
provided, in whole or in part, through a defined set of providers 1
under contract with the insurer. The term does not include an 2
arrangement for the financing of premiums. 3
(c) “Provider of health care” has the meaning ascribed to it in 4
NRS 629.031. 5
Sec. 12. NRS 689A.0424 is hereby amended to read as 6
follows: 7
689A.0424 1. An insurer that offers or issues a policy of 8
health insurance [that includes coverage for maternity care] shall not 9
deny, limit or seek reimbursement for maternity care because the 10
insured is acting as a gestational carrier. 11
2. If an insured acts as a gestational carrier, the child shall be 12
deemed to be a child of the intended parent, as defined in NRS 13
126.590, for purposes related to the policy of health insurance. 14
3. As used in this section, “gestational carrier” has the meaning 15
ascribed to it in NRS 126.580. 16
Sec. 13. NRS 689A.0438 is hereby amended to read as 17
follows: 18
689A.0438 1. An insurer that offers or issues a policy of 19
health insurance shall include in the policy: 20
(a) Coverage of testing for and the treatment and prevention of 21
sexually transmitted diseases, including, without limitation, 22
Chlamydia trachomatis, gonorrhea, syphilis, human 23
immunodeficiency virus and hepatitis B and C, for all insureds, 24
regardless of age. Such coverage must include, without limitation, 25
the coverage required by NRS 689A.0412 and 689A.0437. 26
(b) Unrestricted coverage of condoms for insureds who are 13 27
years of age or older. 28
2. An insurer that offers or issues a policy of health 29
insurance 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 policy of 33
health insurance pursuant to subsection 1; 34
(b) Refuse to issue a policy of health insurance or cancel a 35
policy of health insurance solely because the person applying for 36
or covered by the policy 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
– 17 –
- *AB522_R1*
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
3. A policy of health insurance subject to the provisions of this 5
chapter that is delivered, issued for delivery or renewed on or after 6
[January] October 1, [2024,] 2025, has the legal effect of including 7
the coverage required by subsection 1, and any provision of the 8
policy that conflicts with the provisions of this section is void. 9
4. As used in this section, “provider of health care” has the 10
meaning ascribed to it in NRS 629.031. 11
Sec. 14. NRS 689A.330 is hereby amended to read as follows: 12
689A.330 If any policy is issued by a domestic insurer for 13
delivery to a person residing in another state, and if the insurance 14
commissioner or corresponding public officer of that other state has 15
informed the Commissioner that the policy is not subject to approval 16
or disapproval by that officer, the Commissioner may by ruling 17
require that the policy meet the standards set forth in NRS 689A.030 18
to 689A.320, inclusive [.] , and sections 2 to 5, inclusive, of this 19
act. 20
Sec. 15. NRS 689A.717 is hereby amended to read as follows: 21
689A.717 1. An insurer that offers or issues an individual 22
health benefit plan subject to the provisions of this chapter shall 23
include in the plan coverage for maternity care and pediatric care 24
for newborn infants. 25
2. Except as otherwise provided in this subsection, an 26
individual health benefit plan issued pursuant to this chapter [that 27
includes coverage for maternity care and pediatric care for newborn 28
infants] may not restrict benefits for any length of stay in a hospital 29
in connection with childbirth for a pregnant or postpartum 30
individual or newborn infant covered by the plan to: 31
(a) Less than 48 hours after a normal vaginal delivery; and 32
(b) Less than 96 hours after a cesarean section. 33
If a different length of stay is provided in the guidelines 34
established by the American College of Obstetricians and 35
Gynecologists, or its successor organization, and the American 36
Academy of Pediatrics, or its successor organization, the individual 37
health benefit plan may follow such guidelines in lieu of following 38
the length of stay set forth above. The provisions of this subsection 39
do not apply to any individual health benefit plan in any case in 40
which the decision to discharge the pregnant or postpartum 41
individual or newborn infant before the expiration of the minimum 42
length of stay set forth in this subsection is made by the attending 43
physician of the pregnant or postpartum individual or newborn 44
infant. 45
– 18 –
- *AB522_R1*
[2.] 3. Nothing in this section requires a pregnant or 1
postpartum individual to: 2
(a) Deliver the baby in a hospital; or 3
(b) Stay in a hospital for a fixed period following the birth of the 4
child. 5
[3.] 4. An individual health benefit plan [that offers coverage 6
for maternity care and pediatric care of newborn infants] may not: 7
(a) Deny a pregnant or postpartum individual or the newborn 8
infant coverage or continued coverage under the terms of the plan 9
[or coverage] if the sole purpose of the denial of coverage or 10
continued coverage is to avoid the requirements of this section; 11
(b) Provide monetary payments or rebates to a pregnant or 12
postpartum individual to encourage the individual to accept less than 13
the minimum protection available pursuant to this section; 14
(c) Penalize, or otherwise reduce or limit, the reimbursement of 15
an attending provider of health care because the attending provider 16
of health care provided care to a pregnant or postpartum individual 17
or newborn infant in accordance with the provisions of this section; 18
(d) Provide incentives of any kind to an attending physician to 19
induce the attending physician to provide care to a pregnant or 20
postpartum individual or newborn infant in a manner that is 21
inconsistent with the provisions of this section; or 22
(e) Except as otherwise provided in subsection [4,] 5, restrict 23
benefits for any portion of a hospital stay required pursuant to the 24
provisions of this section in a manner that is less favorable than the 25
benefits provided for any preceding portion of that stay. 26
[4.] 5. Nothing in this section: 27
(a) Prohibits an individual health benefit plan from imposing a 28
deductible, coinsurance or other mechanism for sharing costs 29
relating to benefits for hospital stays in connection with childbirth 30
for a pregnant or postpartum individual or newborn child covered by 31
the plan, except that such coinsurance or other mechanism for 32
sharing costs for any portion of a hospital stay required by this 33
section may not be greater than the coinsurance or other mechanism 34
for any preceding portion of that stay. 35
(b) Prohibits an arrangement for payment between an individual 36
health benefit plan and a provider of health care that uses capitation 37
or other financial incentives, if the arrangement is designed to 38
provide services efficiently and consistently in the best interest of 39
the pregnant or postpartum individual and the newborn infant. 40
(c) Prevents an individual health benefit plan from negotiating 41
with a provider of health care concerning the level and type of 42
reimbursement to be provided in accordance with this section. 43
6. An individual health benefit plan subject to the provisions 44
of this chapter that is delivered, issued for delivery or renewed on 45
– 19 –
- *AB522_R1*
or after October 1, 2025, has the legal effect of including the 1
coverage required by this section, and any provision of the plan 2
that conflicts with the provisions of this section is void. 3
Sec. 16. Chapter 689B of NRS is hereby amended by adding 4
thereto the provisions set forth as sections 17 to 20, inclusive, of this 5
act. 6
Sec. 17. 1. An insurer that offers or issues a policy of 7
group health insurance which provides coverage for dependent 8
children shall continue to make such coverage available for an 9
adult child of an insured until such child reaches 26 years of age. 10
2. Nothing in this section shall be construed as requiring an 11
insurer to make coverage available for a dependent of an adult 12
child of an insured. 13
Sec. 18. 1. An insurer that offers or issues a policy of 14
group health insurance shall include in the policy coverage for: 15
(a) Screening for anxiety for insureds who are at least 8 but 16
not more than 18 years of age; 17
(b) Assessments relating to height, weight, body mass index 18
and medical history for insureds who are less than 18 years of 19
age; 20
(c) Comprehensive and intensive behavioral interventions for 21
insureds who are at least 12 but not more than 18 years of age and 22
have a body mass index in the 95th percentile or greater for 23
persons of the same age and sex; 24
(d) The application of fluoride varnish to the primary teeth for 25
insureds who are less than 5 years of age; 26
(e) Oral fluoride supplements for insureds who are at least 6 27
months of age but less than 5 years of age and whose supply of 28
water is deficient in fluoride; 29
(f) Counseling pertaining to the minimization of exposure to 30
ultraviolet radiation for insureds who are less than 24 years of age 31
and the parents or legal guardians of insureds who are less than 32
18 years of age for the purpose of minimizing the risk of skin 33
cancer in those persons; 34
(g) Brief behavioral counseling and interventions to prevent 35
tobacco use for insureds who are less than 18 years of age; and 36
(h) At least one screening for the detection of amblyopia or the 37
risk factors of amblyopia for insureds who are at least 3 but not 38
more than 5 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 41
of health care who participates in the network plan of the insurer. 42
3. Except as otherwise provided in subsection 5, an insurer 43
that offers or issues a policy of group health insurance shall not: 44
– 20 –
- *AB522_R1*
(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) 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
(e) Impose any other restrictions or delays on the access of an 16
insured to any such benefit. 17
4. A policy of group health insurance subject to the 18
provisions of this chapter that is delivered, issued for delivery or 19
renewed on or after October 1, 2025, has the legal effect of 20
including the coverage required by subsection 1, and any 21
provision of the policy or the renewal which is in conflict with this 22
section is void. 23
5. Except as otherwise provided in this section and federal 24
law, an insurer may use medical management techniques, 25
including, without limitation, any available clinical evidence, to 26
determine the frequency of or treatment relating to any benefit 27
required by this section or the type of provider of health care to 28
use for such treatment. 29
6. As used in this section: 30
(a) “Medical management technique” means a practice which 31
is used to control the cost or utilization of health care services or 32
prescription drug use. The term includes, without limitation, the 33
use 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 group health insurance 36
offered by an insurer under which the financing and delivery of 37
medical care, including items and services paid for as medical 38
care, are provided, in whole or in part, through a defined set of 39
providers of health care under contract with the insurer. 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
Sec. 19. 1. An insurer that offers or issues a policy of 44
group health insurance shall include in the policy coverage for: 45
– 21 –
- *AB522_R1*
(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) Counseling and behavioral interventions relating to the 9
promotion of healthy weight gain and the prevention of excessive 10
weight gain for insureds who are pregnant; 11
(e) Counseling for insureds who are pregnant or in the 12
postpartum stage of pregnancy and have an increased risk of 13
perinatal or postpartum depression; 14
(f) Screening for the presence of the rhesus D antigen and 15
antibodies in the blood of an insured who is pregnant during the 16
insured’s first visit for care relating to the pregnancy; 17
(g) Screening for rhesus D antibodies between 24 and 28 18
weeks of gestation for insureds who are negative for the rhesus D 19
antigen and have not been exposed to blood that is positive for the 20
rhesus D antigen; 21
(h) Behavioral counseling and intervention for tobacco 22
cessation for insureds who are pregnant; 23
(i) Screening for type 2 diabetes at such intervals as 24
recommended by the Health Resources and Services 25
Administration on January 1, 2025, for insureds who are in the 26
postpartum stage of pregnancy and who have a history of 27
gestational diabetes mellitus; 28
(j) Counseling relating to maintaining a healthy weight for 29
women who are at least 40 but not more than 60 years of age and 30
have a body mass index greater than 18.5; and 31
(k) Screening for osteoporosis for women who: 32
(1) Are 65 years of age or older; or 33
(2) Are less than 65 years of age and have a risk of 34
fracturing a bone equal to or greater than that of a woman who is 35
65 years of age without any additional risk factors. 36
2. An insurer must ensure that the benefits required by 37
subsection 1 are made available to an insured through a provider 38
of health care who participates in the network plan of the insurer. 39
3. Except as otherwise provided in subsection 5, an insurer 40
that offers or issues a policy of group health insurance 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 policy of 44
group health insurance pursuant to subsection 1; 45
– 22 –
- *AB522_R1*
(b) Refuse to issue a policy of group health insurance or 1
cancel a policy of group health insurance solely because the 2
person applying for or covered by the policy uses or may use any 3
such benefit; 4
(c) Offer or pay any type of material inducement or financial 5
incentive to an insured to discourage the insured from obtaining 6
any such benefit; 7
(d) Offer or pay any type of material inducement, bonus or 8
other financial incentive to a provider of health care to deny, 9
reduce, withhold, limit or delay access to any such benefit to an 10
insured; or 11
(e) Impose any other restrictions or delays on the access of an 12
insured to any such benefit. 13
4. A policy of group health insurance subject to the 14
provisions of this chapter that is delivered, issued for delivery or 15
renewed on or after October 1, 2025, has the legal effect of 16
including the coverage required by subsection 1, and any 17
provision of the policy or the renewal which is in conflict with this 18
section is void. 19
5. Except as otherwise provided in this section and federal 20
law, an insurer may use medical management techniques, 21
including, without limitation, any available clinical evidence, to 22
determine the frequency of or treatment relating to any benefit 23
required by this section or the type of provider of health care to 24
use for such treatment. 25
6. As used in this section: 26
(a) “Medical management technique” means a practice which 27
is used to control the cost or utilization of health care services or 28
prescription drug use. The term includes, without limitation, the 29
use of step therapy, prior authorization or categorizing drugs and 30
devices based on cost, type or method of administration. 31
(b) “Network plan” means a policy of group health insurance 32
offered by an insurer under which the financing and delivery of 33
medical care, including items and services paid for as medical 34
care, are provided, in whole or in part, through a defined set of 35
providers of health care under contract with the insurer. The term 36
does not include an arrangement for the financing of premiums. 37
(c) “Provider of health care” has the meaning ascribed to it in 38
NRS 629.031. 39
Sec. 20. 1. An insurer that offers or issues a policy of 40
group health insurance shall include in the policy coverage for: 41
(a) Behavioral counseling and interventions to promote 42
physical activity and a healthy diet for insureds with 43
cardiovascular risk factors; 44
– 23 –
- *AB522_R1*
(b) Statin preventive medication for insureds who are at least 1
40 but not more than 75 years of age and do not have a history of 2
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 insureds who 8
are 65 years of age or older and reside in a medical facility or 9
facility for the dependent; 10
(d) Screenings for latent tuberculosis infection in insureds 11
with an increased risk of contracting tuberculosis; 12
(e) Screening for hypertension; 13
(f) One abdominal aortic screening by ultrasound to detect 14
abdominal aortic aneurysms for men who are at least 65 but not 15
more than 75 years of age and have smoked during their lifetimes; 16
(g) Screening for drug and alcohol misuse for insureds who 17
are 18 years of age or older; 18
(h) If an insured engages in risky or hazardous consumption 19
of alcohol, as determined by the screening described in paragraph 20
(g), behavioral counseling to reduce such behavior; 21
(i) Screening for lung cancer using low-dose computed 22
tomography for insureds who are at least 50 but not more than 80 23
years of age in accordance with the most recent guidelines 24
published by the American Cancer Society or the 25
recommendations of the United States Preventive Services Task 26
Force in effect on January 1, 2025; 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. An insurer 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 insurer. 36
3. Except as otherwise provided in subsection 5, an insurer 37
that offers or issues a policy of group 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
group health insurance pursuant to subsection 1; 42
(b) Refuse to issue a policy of group health insurance or 43
cancel a policy of group health insurance solely because the 44
– 24 –
- *AB522_R1*
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) Offer or pay any type of material inducement, bonus or 6
other financial incentive to a provider of health care to deny, 7
reduce, withhold, limit or delay access to any such benefit to an 8
insured; or 9
(e) Impose any other restrictions or delays on the access of an 10
insured to any such benefit. 11
4. A policy of group health insurance subject to the 12
provisions of this chapter that is delivered, issued for delivery or 13
renewed on or after October 1, 2025, has the legal effect of 14
including the coverage required by subsection 1, and any 15
provision of the policy or the renewal which is in conflict with this 16
section is void. 17
5. 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
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 policy of group health insurance 37
offered by an insurer under which the financing and delivery of 38
medical care, including items and services paid for as medical 39
care, are provided, in whole or in part, through a defined set of 40
providers of health care under contract with the insurer. The term 41
does not include an arrangement for the financing of premiums. 42
(f) “Provider of health care” has the meaning ascribed to it in 43
NRS 629.031. 44
– 25 –
- *AB522_R1*
Sec. 21. NRS 689B.0314 is hereby amended to read as 1
follows: 2
689B.0314 1. An insurer that issues a policy of group health 3
insurance shall provide coverage for screening, genetic counseling 4
and testing for harmful mutations in the BRCA gene for women 5
under circumstances where such screening, genetic counseling or 6
testing, as applicable, is required by NRS 457.301. 7
2. An insurer shall ensure that the benefits required by 8
subsection 1 are made available to an insured through a provider of 9
health care who participates in the network plan of the insurer. 10
3. An insurer that issues a policy of group health insurance 11
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 policy of 15
group health insurance pursuant to subsection 1; 16
(b) Refuse to issue a policy of group health insurance or 17
cancel a policy of group health insurance solely because the 18
person applying for or covered by the policy uses or may use any 19
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) 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
(e) Impose any other restrictions or delays on the access of an 28
insured to any such benefit. 29
4. A policy of group health insurance subject to the provisions 30
of this chapter that is delivered, issued for delivery or renewed on or 31
after [January] October 1, [2022,] 2025, has the legal effect of 32
including the coverage required by subsection 1, and any provision 33
of the policy that conflicts with the provisions of this section is void. 34
[4.] 5. As used in this section: 35
(a) “Network plan” means a policy of group health insurance 36
offered by an insurer 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 insurer. The term does not include an 40
arrangement for the financing of premiums. 41
(b) “Provider of health care” has the meaning ascribed to it in 42
NRS 629.031. 43
– 26 –
- *AB522_R1*
Sec. 22. NRS 689B.0315 is hereby amended to read as 1
follows: 2
689B.0315 1. An insurer that issues a policy of group health 3
insurance shall provide coverage for the examination of a person 4
who is pregnant for the discovery of: 5
(a) Chlamydia trachomatis, gonorrhea, hepatitis B and hepatitis 6
C in accordance with NRS 442.013. 7
(b) Syphilis in accordance with NRS 442.010. 8
(c) Human immunodeficiency virus. 9
2. The coverage required by this section must be provided: 10
(a) Regardless of whether the benefits are provided to the 11
insured by a provider of health care, facility or medical laboratory 12
that participates in the network plan of the insurer; and 13
(b) Without prior authorization. 14
3. An insurer that issues a policy of group health insurance 15
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 policy of 19
group health insurance pursuant to subsection 1; 20
(b) Refuse to issue a policy of group health insurance or 21
cancel a policy of group health insurance solely because the 22
person applying for or covered by the policy uses or may use any 23
such benefit; 24
(c) Offer or pay any type of material inducement or financial 25
incentive to an insured to discourage the insured from obtaining 26
any such benefit; 27
(d) 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
(e) Impose any other restrictions or delays on the access of an 32
insured to any such benefit. 33
4. A policy of health insurance subject to the provisions of this 34
chapter that is delivered, issued for delivery or renewed on or after 35
[July] October 1, [2021,] 2025, has the legal effect of including the 36
coverage required by subsection 1, and any provision of the policy 37
that conflicts with the provisions of this section is void. 38
[4.] 5. As used in this section: 39
(a) “Medical laboratory” has the meaning ascribed to it in 40
NRS 652.060. 41
(b) “Network plan” means a policy of group health insurance 42
offered by an insurer under which the financing and delivery of 43
medical care, including items and services paid for as medical care, 44
are provided, in whole or in part, through a defined set of providers 45
– 27 –
- *AB522_R1*
under contract with the insurer. The term does not include an 1
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. 23. NRS 689B.0316 is hereby amended to read as 5
follows: 6
689B.0316 1. An insurer that offers or issues a policy of 7
group health insurance shall include in the policy: 8
(a) Coverage of testing for and the treatment of and prevention 9
of sexually transmitted diseases, including, without limitation, 10
Chlamydia trachomatis, gonorrhea, syphilis, human 11
immunodeficiency virus and hepatitis B and C, for all insureds, 12
regardless of age. Such coverage must include, without limitation, 13
the coverage required by NRS 689B.0312 and 689B.0315. 14
(b) Unrestricted coverage of condoms for insureds who are 13 15
years of age or older. 16
2. An insurer that offers or issues a policy of group health 17
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
group health insurance pursuant to subsection 1; 22
(b) Refuse to issue a policy of group health insurance or 23
cancel a policy of group health insurance solely because the 24
person applying for or covered by the policy uses or may use any 25
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) 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
(e) Impose any other restrictions or delays on the access of an 34
insured to any such benefit. 35
3. A policy of group health insurance subject to the provisions 36
of this chapter that is delivered, issued for delivery or renewed on or 37
after [January] October 1, [2024,] 2025, has the legal effect of 38
including the coverage required by subsection 1, and any provision 39
of the policy 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
– 28 –
- *AB522_R1*
Sec. 24. NRS 689B.0367 is hereby amended to read as 1
follows: 2
689B.0367 1. A policy of group health insurance [that 3
provides coverage for the treatment of colorectal cancer] must 4
provide coverage for colorectal cancer screening in accordance 5
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. An insurer must ensure that the benefits required by 13
subsection 1 are made available to an insured through a provider 14
of health care who participates in the network plan of the insurer. 15
3. An insurer that offers or issues a policy of group health 16
insurance shall not: 17
(a) Require an insured to pay a higher deductible, any 18
copayment or coinsurance or require a longer waiting period or 19
other condition to obtain any benefit provided in the policy of 20
group health insurance pursuant to subsection 1; 21
(b) Refuse to issue a policy of group health insurance or 22
cancel a policy of group health insurance solely because the 23
person applying for or covered by the policy uses or may use any 24
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) 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
(e) Impose any other restrictions or delays on the access of an 33
insured to any such benefit. 34
4. A policy of group health insurance subject to the provisions 35
of this chapter that is delivered, issued for delivery or renewed on or 36
after October 1, [2003,] 2025, has the legal effect of including the 37
coverage required by this section, and any provision of the policy 38
that conflicts with the provisions of this section is void. 39
5. As used in this section: 40
(a) “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
– 29 –
- *AB522_R1*
providers of health care under contract with the insurer. The term 1
does not include an arrangement for the financing of premiums. 2
(b) “Provider of health care” has the meaning ascribed to it in 3
NRS 629.031. 4
Sec. 25. (Deleted by amendment.) 5
Sec. 26. (Deleted by amendment.) 6
Sec. 27. NRS 689B.03785 is hereby amended to read as 7
follows: 8
689B.03785 1. An insurer that offers or issues a policy of 9
group health insurance shall include in the policy coverage for: 10
(a) Counseling, support and supplies for breastfeeding, 11
including breastfeeding equipment, counseling and education during 12
the antenatal, perinatal and postpartum period for not more than 1 13
year; 14
(b) Screening and counseling for interpersonal and domestic 15
violence for women at least annually with initial intervention 16
services consisting of education, strategies to reduce harm, 17
supportive services or a referral for any other appropriate services; 18
(c) Behavioral counseling concerning sexually transmitted 19
diseases from a provider of health care for sexually active [women] 20
insureds who are at increased risk for such diseases; 21
(d) Such prenatal screenings and tests as recommended by the 22
American College of Obstetricians and Gynecologists or its 23
successor organization; 24
(e) Screening for blood pressure abnormalities and diabetes, 25
including gestational diabetes, after at least 24 weeks of gestation or 26
as ordered by a provider of health care; 27
(f) Screening for cervical cancer at such intervals as are 28
recommended by the American College of Obstetricians and 29
Gynecologists or its successor organization; 30
(g) Screening for depression [;] for insureds who are 12 years 31
of age or older; 32
(h) Screening for anxiety disorders; 33
(i) Screening and counseling for the human immunodeficiency 34
virus consisting of a risk assessment, annual education relating to 35
prevention and at least one screening for the virus during the 36
lifetime of the insured or as ordered by a provider of health care; 37
[(i) Smoking] 38
(j) Tobacco cessation programs , including, without limitation, 39
pharmacotherapy approved by the United States Food and Drug 40
Administration, for an insured who is 18 years of age or older ; 41
[consisting of not more than two cessation attempts per year and 42
four counseling sessions per year; 43
(j)] (k) All vaccinations recommended by the Advisory 44
Committee on Immunization Practices of the Centers for Disease 45
– 30 –
- *AB522_R1*
Control and Prevention of the United States Department of Health 1
and Human Services or its successor organization; and 2
[(k)] (l) Such well-woman preventative visits as recommended 3
by the Health Resources and Services Administration [,] on 4
January 1, 2025, which must include at least one such visit per year 5
beginning at 14 years of age. 6
2. An insurer must ensure that the benefits required by 7
subsection 1 are made available to an insured through a provider of 8
health care who participates in the network plan of the insurer. 9
3. Except as otherwise provided in subsection 5, an insurer that 10
offers or issues a policy of group health insurance shall not: 11
(a) Require an insured to pay a higher deductible, any 12
copayment or coinsurance or require a longer waiting period or 13
other condition to obtain any benefit provided in the policy of group 14
health insurance pursuant to subsection 1; 15
(b) Refuse to issue a policy of group health insurance or cancel a 16
policy of group health insurance solely because the person applying 17
for or covered by the policy uses or may use any such benefit; 18
(c) Offer or pay any type of material inducement or financial 19
incentive to an insured to discourage the insured from obtaining any 20
such benefit; 21
(d) [Penalize a provider of health care who provides any such 22
benefit to an insured, including, without limitation, reducing the 23
reimbursement of the provider of health care; 24
(e)] Offer or pay any type of material inducement, bonus or 25
other financial incentive to a provider of health care to deny, reduce, 26
withhold, limit or delay access to any such benefit to an insured; or 27
[(f)] (e) Impose any other restrictions or delays on the access of 28
an insured to any such benefit. 29
4. A policy subject to the provisions of this chapter that is 30
delivered, issued for delivery or renewed on or after [January] 31
October 1, [2018,] 2025, has the legal effect of including the 32
coverage required by subsection 1, and any provision of the policy 33
or the renewal which is in conflict with this section is void. 34
5. Except as otherwise provided in this section and federal law, 35
an insurer may use medical management techniques, including, 36
without limitation, any available clinical evidence, to determine the 37
frequency of or treatment relating to any benefit required by this 38
section or the type of provider of health care to use for such 39
treatment. 40
6. As used in this section: 41
(a) “Medical management technique” means a practice which is 42
used to control the cost or utilization of health care services or 43
prescription drug use. The term includes, without limitation, the use 44
– 31 –
- *AB522_R1*
of step therapy, prior authorization or categorizing drugs and 1
devices based on cost, type or method of administration. 2
(b) “Network plan” means a policy of group health insurance 3
offered by an insurer under which the financing and delivery of 4
medical care, including items and services paid for as medical care, 5
are provided, in whole or in part, through a defined set of providers 6
under contract with the insurer. The term does not include an 7
arrangement for the financing of premiums. 8
(c) “Provider of health care” has the meaning ascribed to it in 9
NRS 629.031. 10
Sec. 28. NRS 689B.0675 is hereby amended to read as 11
follows: 12
689B.0675 1. An insurer that issues a policy of group health 13
insurance shall not discriminate against any person with respect to 14
participation or coverage under the policy on the basis of an actual 15
or perceived [gender identity or expression.] protected 16
characteristic. 17
2. Prohibited discrimination includes, without limitation: 18
[1.] (a) Denying, cancelling, limiting or refusing to issue or 19
renew a policy of group health insurance on the basis of [the] an 20
actual or perceived [gender identity or expression] protected 21
characteristic of a person or a family member of the person; 22
[2.] (b) Imposing a payment or premium that is based on [the] 23
an actual or perceived [gender identity or expression] protected 24
characteristic of an insured or a family member of the insured; 25
[3.] (c) Designating [the] an actual or perceived [gender 26
identity or expression] protected characteristic of a person or a 27
family member of the person as grounds to deny, cancel or limit 28
participation or coverage; and 29
[4.] (d) Denying, cancelling or limiting participation or 30
coverage on the basis of an actual or perceived [gender identity or 31
expression,] protected characteristic, including, without limitation, 32
by limiting or denying coverage for health care services that are: 33
[(a)] (1) Related to gender transition, provided that there is 34
coverage under the policy for the services when the services are not 35
related to gender transition; or 36
[(b)] (2) Ordinarily or exclusively available to persons of any 37
sex. 38
3. As used in this section, “protected characteristic” means: 39
(a) Race, color, national origin, age, physical or mental 40
disability, sexual orientation or gender identity or expression; or 41
(b) Sex, including, without limitation, sex characteristics, 42
intersex traits and pregnancy or related conditions. 43
– 32 –
- *AB522_R1*
Sec. 29. NRS 689B.520 is hereby amended to read as follows: 1
689B.520 1. An insurer that offers or issues a group health 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 group 6
health plan or coverage offered under group health insurance issued 7
pursuant to this chapter [that includes coverage for maternity care 8
and pediatric care for newborn infants] may not restrict benefits for 9
any length of stay in a hospital in connection with childbirth for a 10
pregnant or postpartum individual or newborn infant covered by the 11
plan or coverage to: 12
(a) Less than 48 hours after a normal vaginal delivery; and 13
(b) Less than 96 hours after a cesarean section. 14
If a different length of stay is provided in the guidelines 15
established by the American College of Obstetricians and 16
Gynecologists, or its successor organization, and the American 17
Academy of Pediatrics, or its successor organization, the group 18
health plan or health insurance coverage may follow such guidelines 19
in lieu of following the length of stay set forth above. The 20
provisions of this subsection do not apply to any group health plan 21
or health insurance coverage in any case in which the decision to 22
discharge the pregnant or postpartum individual or newborn infant 23
before the expiration of the minimum length of stay set forth in this 24
subsection is made by the attending physician of the pregnant or 25
postpartum individual or newborn infant. 26
[2.] 3. Nothing in this section requires a pregnant or 27
postpartum individual to: 28
(a) Deliver the baby in a hospital; or 29
(b) Stay in a hospital for a fixed period following the birth of the 30
child. 31
[3.] 4. A group health plan or coverage under group health 32
insurance [that offers coverage for maternity care and pediatric care 33
of newborn infants] may not: 34
(a) Deny a pregnant or postpartum individual or the newborn 35
infant coverage or continued coverage under the terms of the plan 36
[or coverage] if the sole purpose of the denial of coverage or 37
continued coverage is to avoid the requirements of this section; 38
(b) Provide monetary payments or rebates to a pregnant or 39
postpartum individual to encourage the individual to accept less than 40
the minimum protection available pursuant to this section; 41
(c) [Penalize, or otherwise reduce or limit, the reimbursement of 42
an attending provider of health care because the attending provider 43
of health care provided care to a pregnant or postpartum individual 44
or newborn infant in accordance with the provisions of this section; 45
– 33 –
- *AB522_R1*
(d)] Provide incentives of any kind to an attending physician to 1
induce the attending physician to provide care to a pregnant or 2
postpartum individual or newborn infant in a manner that is 3
inconsistent with the provisions of this section; or 4
[(e)] (d) Except as otherwise provided in subsection [4,] 5, 5
restrict benefits for any portion of a hospital stay required pursuant 6
to the provisions of this section in a manner that is less favorable 7
than the benefits provided for any preceding portion of that stay. 8
[4.] 5. Nothing in this section: 9
(a) Prohibits a group health plan or carrier from imposing a 10
deductible, coinsurance or other mechanism for sharing costs 11
relating to benefits for hospital stays in connection with childbirth 12
for a pregnant or postpartum individual or newborn child covered by 13
the plan, except that such coinsurance or other mechanism for 14
sharing costs for any portion of a hospital stay required by this 15
section may not be greater than the coinsurance or other mechanism 16
for any preceding portion of that stay. 17
(b) Prohibits an arrangement for payment between a group 18
health plan or carrier and a provider of health care that uses 19
capitation or other financial incentives, if the arrangement is 20
designed to provide services efficiently and consistently in the best 21
interest of the pregnant or postpartum individual and the newborn 22
infant. 23
(c) Prevents a group health plan or carrier from negotiating with 24
a provider of health care concerning the level and type of 25
reimbursement to be provided in accordance with this section. 26
6. A group health plan subject to the provisions of this 27
chapter that is delivered, issued for delivery or renewed on or after 28
October 1, 2025, has the legal effect of including the coverage 29
required by this section, and any provision of the plan that 30
conflicts with the provisions of this section is void. 31
Sec. 30. Chapter 689C of NRS is hereby amended by adding 32
thereto the provisions set forth as sections 31 to 35, inclusive, of this 33
act. 34
Sec. 31. 1. A carrier that offers or issues a health benefit 35
plan which provides coverage for dependent children shall 36
continue to make such coverage available for an adult child of an 37
insured until such child reaches 26 years of age. 38
2. Nothing in this section shall be construed as requiring a 39
carrier to make coverage available for a dependent of an adult 40
child of an insured. 41
Sec. 32. 1. A carrier that offers or issues a health benefit 42
plan shall include in the plan coverage for: 43
(a) Screening for anxiety for insureds who are at least 8 but 44
not more than 18 years of age; 45
– 34 –
- *AB522_R1*
(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 the parents or legal guardians of insureds who 15
are less than 18 years of age for the purpose of minimizing the 16
risk of skin cancer in those persons; 17
(g) Brief behavioral counseling and interventions to prevent 18
tobacco use for insureds who are less than 18 years of age; and 19
(h) At least one screening for the detection of amblyopia or the 20
risk factors of amblyopia for insureds who are at least 3 but not 21
more than 5 years of age. 22
2. A carrier must ensure that the benefits required by 23
subsection 1 are made available to an insured through a provider 24
of health care who participates in the network plan of the carrier. 25
3. Except as otherwise provided in subsection 5, a carrier that 26
offers or issues a health benefit plan shall not: 27
(a) Require an insured to pay a higher deductible, any 28
copayment or coinsurance or require a longer waiting period or 29
other condition to obtain any benefit provided in the health benefit 30
plan 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 36
any 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 41
other financial incentive to a provider of health care to deny, 42
reduce, withhold, limit or delay access to any such benefit to an 43
insured; or 44
– 35 –
- *AB522_R1*
(f) Impose any other restrictions or delays on the access of an 1
insured to any such benefit. 2
4. A health benefit plan subject to the provisions of this 3
chapter that is delivered, issued for delivery or renewed on or after 4
October 1, 2025, has the legal effect of including the coverage 5
required by subsection 1, and any provision of the plan or the 6
renewal which is in conflict with this section is void. 7
5. Except as otherwise provided in this section and federal 8
law, a carrier may use medical management techniques, 9
including, without limitation, any available clinical evidence, to 10
determine the frequency of or treatment relating to any benefit 11
required by this section or the type of provider of health care to 12
use for such treatment. 13
6. As used in this section: 14
(a) “Medical management technique” means a practice which 15
is used to control the cost or utilization of health care services or 16
prescription drug use. The term includes, without limitation, the 17
use of step therapy, prior authorization or categorizing drugs and 18
devices based on cost, type or method of administration. 19
(b) “Provider of health care” has the meaning ascribed to it in 20
NRS 629.031. 21
Sec. 33. 1. A carrier that offers or issues a health benefit 22
plan shall include in the plan coverage for: 23
(a) A daily dose of 0.4 to 0.8 milligrams of folic acid for 24
insureds who are pregnant or are planning on becoming 25
pregnant; 26
(b) A low dose of aspirin for the prevention of preeclampsia 27
for insureds who are determined to be at a high risk of that 28
condition after 12 weeks of gestation; 29
(c) Prophylactic ocular tubal medication for the prevention of 30
gonococcal ophthalmia in newborns; 31
(d) Screening for asymptomatic bacteriuria for insureds who 32
are pregnant; 33
(e) Counseling and behavioral interventions relating to the 34
promotion of healthy weight gain and the prevention of excessive 35
weight gain for insureds who are pregnant; 36
(f) Counseling for insureds who are pregnant or in the 37
postpartum stage of pregnancy and have an increased risk of 38
perinatal or postpartum depression; 39
(g) Screening for the presence of the rhesus D antigen and 40
antibodies in the blood of an insured who is pregnant during the 41
insured’s first visit for care relating to the pregnancy; 42
(h) Screening for rhesus D antibodies between 24 and 28 43
weeks of gestation for insureds who are negative for the rhesus D 44
– 36 –
- *AB522_R1*
antigen and have not been exposed to blood that is positive for the 1
rhesus D antigen; 2
(i) Behavioral counseling and intervention for tobacco 3
cessation for insureds who are pregnant; 4
(j) Screening for type 2 diabetes at such intervals as 5
recommended by the Health Resources and Services 6
Administration on January 1, 2025, for insureds who are in the 7
postpartum stage of pregnancy and who have a history of 8
gestational diabetes mellitus; 9
(k) Counseling relating to maintaining a healthy weight for 10
women who are at least 40 but not more than 60 years of age and 11
have a body mass index greater than 18.5; and 12
(l) Screening for osteoporosis for women who: 13
(1) Are 65 years of age or older; or 14
(2) Are less than 65 years of age and have a risk of 15
fracturing a bone equal to or greater than that of a woman who is 16
65 years of age without any additional risk factors. 17
2. A carrier must ensure that the benefits required by 18
subsection 1 are made available to an insured through a provider 19
of health care who participates in the network plan of the carrier. 20
3. Except as otherwise provided in subsection 5, a carrier that 21
offers or issues a health benefit plan shall not: 22
(a) Require an insured to pay a higher deductible, any 23
copayment or coinsurance or require a longer waiting period or 24
other condition to obtain any benefit provided in the health benefit 25
plan pursuant to subsection 1; 26
(b) Refuse to issue a health benefit plan or cancel a health 27
benefit plan solely because the person applying for or covered by 28
the plan uses or may use any such benefit; 29
(c) Offer or pay any type of material inducement or financial 30
incentive to an insured to discourage the insured from obtaining 31
any such benefit; 32
(d) Penalize a provider of health care who provides any such 33
benefit to an insured, including, without limitation, reducing the 34
reimbursement of the provider of health care; 35
(e) Offer or pay any type of material inducement, bonus or 36
other financial incentive to a provider of health care to deny, 37
reduce, withhold, limit or delay access to any such benefit to an 38
insured; or 39
(f) Impose any other restrictions or delays on the access of an 40
insured to any such benefit. 41
4. A health benefit plan subject to the provisions of this 42
chapter that is delivered, issued for delivery or renewed on or after 43
October 1, 2025, has the legal effect of including the coverage 44
– 37 –
- *AB522_R1*
required by subsection 1, and any provision of the plan or the 1
renewal which is in conflict with this section is void. 2
5. Except as otherwise provided in this section and federal 3
law, a carrier may use medical management techniques, 4
including, without limitation, any available clinical evidence, to 5
determine the frequency of or treatment relating to any benefit 6
required by this section or the type of provider of health care to 7
use for such treatment. 8
6. As used in this section: 9
(a) “Medical management technique” means a practice which 10
is used to control the cost or utilization of health care services or 11
prescription drug use. The term includes, without limitation, the 12
use of step therapy, prior authorization or categorizing drugs and 13
devices based on cost, type or method of administration. 14
(b) “Provider of health care” has the meaning ascribed to it in 15
NRS 629.031. 16
Sec. 34. 1. A carrier that offers or issues a health benefit 17
plan shall include in the plan coverage for: 18
(a) Behavioral counseling and interventions to promote 19
physical activity and a healthy diet for insureds with 20
cardiovascular risk factors; 21
(b) Statin preventive medication for insureds who are at least 22
40 but not more than 75 years of age and do not have a history of 23
cardiovascular disease, but who have: 24
(1) One or more risk factors for cardiovascular disease; 25
and 26
(2) A calculated risk of at least 10 percent of acquiring 27
cardiovascular disease within the next 10 years; 28
(c) Interventions for exercise to prevent falls for insureds who 29
are 65 years of age or older and reside in a medical facility or 30
facility for the dependent; 31
(d) Screenings for latent tuberculosis infection in insureds 32
with an increased risk of contracting tuberculosis; 33
(e) Screening for hypertension; 34
(f) One abdominal aortic screening by ultrasound to detect 35
abdominal aortic aneurysms for men who are at least 65 but not 36
more than 75 years of age and have smoked during their lifetimes; 37
(g) Screening for drug and alcohol misuse for insureds who 38
are 18 years of age or older; 39
(h) If an insured engages in risky or hazardous consumption 40
of alcohol, as determined by the screening described in paragraph 41
(g), behavioral counseling to reduce such behavior; 42
(i) Screening for lung cancer using low-dose computed 43
tomography for insureds who are at least 50 but not more than 80 44
years of age in accordance with the most recent guidelines 45
– 38 –
- *AB522_R1*
published by the American Cancer Society or the 1
recommendations of the United States Preventive Services Task 2
Force in effect on January 1, 2025; 3
(j) Screening for prediabetes and type 2 diabetes in insureds 4
who are at least 35 but not more than 70 years of age and have a 5
body mass index of 25 or greater; and 6
(k) Intensive behavioral interventions with multiple 7
components for insureds who are 18 years of age or older and 8
have a body mass index of 30 or greater. 9
2. The benefits provided pursuant to paragraph (h) of 10
subsection 1 are in addition to and separate from the benefits 11
provided pursuant to NRS 689C.167. 12
3. A carrier must ensure that the benefits required by 13
subsection 1 are made available to an insured through a provider 14
of health care who participates in the network plan of the carrier. 15
4. Except as otherwise provided in subsection 6, a carrier that 16
offers or issues a health benefit plan shall not: 17
(a) Require an insured to pay a higher deductible, any 18
copayment or coinsurance or require a longer waiting period or 19
other condition to obtain any benefit provided in the health benefit 20
plan pursuant to subsection 1; 21
(b) Refuse to issue a health benefit plan or cancel a health 22
benefit plan solely because the person applying for or covered by 23
the plan uses or may use any such benefit; 24
(c) Offer or pay any type of material inducement or financial 25
incentive to an insured to discourage the insured from obtaining 26
any such benefit; 27
(d) Penalize a provider of health care who provides any such 28
benefit to an insured, including, without limitation, reducing the 29
reimbursement of the provider of health care; 30
(e) Offer or pay any type of material inducement, bonus or 31
other financial incentive to a provider of health care to deny, 32
reduce, withhold, limit or delay access to any such benefit to an 33
insured; or 34
(f) Impose any other restrictions or delays on the access of an 35
insured to any such benefit. 36
5. A health benefit plan subject to the provisions of this 37
chapter that is delivered, issued for delivery or renewed on or after 38
October 1, 2025, has the legal effect of including the coverage 39
required by subsection 1, and any provision of the plan or the 40
renewal which is in conflict with this section is void. 41
6. Except as otherwise provided in this section and federal 42
law, a carrier may use medical management techniques, 43
including, without limitation, any available clinical evidence, to 44
determine the frequency of or treatment relating to any benefit 45
– 39 –
- *AB522_R1*
required by this section or the type of provider of health care to 1
use for such treatment. 2
7. As used in this section: 3
(a) “Computed tomography” means the process of producing 4
sectional and three-dimensional images using external ionizing 5
radiation. 6
(b) “Facility for the dependent” has the meaning ascribed to it 7
in NRS 449.0045. 8
(c) “Medical facility” has the meaning ascribed to it in 9
NRS 449.0151. 10
(d) “Medical management technique” means a practice which 11
is used to control the cost or utilization of health care services or 12
prescription drug use. The term includes, without limitation, the 13
use of step therapy, prior authorization or categorizing drugs and 14
devices based on cost, type or method of administration. 15
(e) “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
– 40 –
- *AB522_R1*
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
– 41 –
- *AB522_R1*
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
Sec. 38. (Deleted by amendment.) 45
– 42 –
- *AB522_R1*
Sec. 39. NRS 689C.1675 is hereby amended to read as 1
follows: 2
689C.1675 1. A carrier that issues a health benefit plan shall 3
provide coverage for the examination of a person who is pregnant 4
for the discovery of: 5
(a) Chlamydia trachomatis, gonorrhea, hepatitis B and hepatitis 6
C in accordance with NRS 442.013. 7
(b) Syphilis in accordance with NRS 442.010. 8
(c) Human immunodeficiency virus. 9
2. The coverage required by this section must be provided: 10
(a) Regardless of whether the benefits are provided to the 11
insured by a provider of health care, facility or medical laboratory 12
that participates in the network plan of the carrier; and 13
(b) Without prior authorization. 14
3. A carrier that 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 chapter 35
that is delivered, issued for delivery or renewed on or after [July] 36
October 1, [2021,] 2025, has the legal effect of including the 37
coverage required by subsection 1, and any provision of the plan 38
that conflicts with the provisions of this section is void. 39
[4.] 5. As used in this section: 40
(a) “Medical laboratory” has the meaning ascribed to it in 41
NRS 652.060. 42
(b) “Provider of health care” has the meaning ascribed to it in 43
NRS 629.031. 44
– 43 –
- *AB522_R1*
Sec. 40. NRS 689C.1678 is hereby amended to read as 1
follows: 2
689C.1678 1. A carrier that offers or issues a health benefit 3
plan shall include in the plan coverage for: 4
(a) Counseling, support and supplies for breastfeeding, 5
including breastfeeding equipment, counseling and education during 6
the antenatal, perinatal and postpartum period for not more than 1 7
year; 8
(b) Screening and counseling for interpersonal and domestic 9
violence for women at least annually, with initial intervention 10
services consisting of education, strategies to reduce harm, 11
supportive services or a referral for any other appropriate services; 12
(c) Behavioral counseling concerning sexually transmitted 13
diseases from a provider of health care for sexually active [women] 14
insureds who are at increased risk for such diseases; 15
(d) Hormone replacement therapy; 16
(e) Such prenatal screenings and tests as recommended by the 17
American College of Obstetricians and Gynecologists or its 18
successor organization; 19
(f) Screening for blood pressure abnormalities and diabetes, 20
including gestational diabetes, after at least 24 weeks of gestation or 21
as ordered by a provider of health care; 22
(g) Screening for cervical cancer at such intervals as are 23
recommended by the American College of Obstetricians and 24
Gynecologists or its successor organization; 25
(h) Screening for depression [;] for insureds who are 12 years 26
of age or older; 27
(i) Screening for anxiety disorders; 28
(j) Screening and counseling for the human immunodeficiency 29
virus consisting of a risk assessment, annual education relating to 30
prevention and at least one screening for the virus during the 31
lifetime of the insured or as ordered by a provider of health care; 32
[(j) Smoking] 33
(k) Tobacco cessation programs , including, without limitation, 34
pharmacotherapy approved by the United States Food and Drug 35
Administration, for an insured who is 18 years of age or older ; 36
[consisting of not more than two cessation attempts per year and 37
four counseling sessions per year; 38
(k)] (l) All vaccinations recommended by the Advisory 39
Committee on Immunization Practices of the Centers for Disease 40
Control and Prevention of the United States Department of Health 41
and Human Services or its successor organization; and 42
[(l)] (m) Such well-woman preventative visits as recommended 43
by the Health Resources and Services Administration [,] on 44
– 44 –
- *AB522_R1*
January 1, 2025, which must include at least one such visit per year 1
beginning at 14 years of age. 2
2. A carrier must ensure that the benefits required by 3
subsection 1 are made available to an insured through a provider of 4
health care who participates in the network plan of the carrier. 5
3. Except as otherwise provided in subsection 5, a carrier that 6
offers or issues a health benefit plan shall not: 7
(a) Require an insured to pay a higher deductible, any 8
copayment or coinsurance or require a longer waiting period or 9
other condition to obtain any benefit provided in the health benefit 10
plan pursuant to subsection 1; 11
(b) Refuse to issue a health benefit plan or cancel a health 12
benefit plan solely because the person applying for or covered by 13
the plan uses or may use any such benefit; 14
(c) Offer or pay any type of material inducement or financial 15
incentive to an insured to discourage the insured from obtaining any 16
such benefit; 17
(d) Penalize a provider of health care who provides any such 18
benefit to an insured, including, without limitation, reducing the 19
reimbursement of the provider of health care; 20
(e) Offer or pay any type of material inducement, bonus or other 21
financial incentive to a provider of health care to deny, reduce, 22
withhold, limit or delay access to any such benefit to an insured; or 23
(f) Impose any other restrictions or delays on the access of an 24
insured to any such benefit. 25
4. A plan subject to the provisions of this chapter that is 26
delivered, issued for delivery or renewed on or after [January] 27
October 1, [2018,] 2025, has the legal effect of including the 28
coverage required by subsection 1, and any provision of the plan or 29
the renewal which is in conflict with this section is void. 30
5. Except as otherwise provided in this section and federal law, 31
a carrier 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. 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 health benefit plan offered by a 43
carrier under which the financing and delivery of medical care, 44
including items and services paid for as medical care, are provided, 45
– 45 –
- *AB522_R1*
in whole or in part, through a defined set of providers under contract 1
with the carrier. The term does not include an arrangement for the 2
financing of premiums. 3
(c) “Provider of health care” has the meaning ascribed to it in 4
NRS 629.031. 5
Sec. 41. NRS 689C.194 is hereby amended to read as follows: 6
689C.194 1. A carrier that offers or issues a health benefit 7
plan subject to the provisions of this chapter shall include in the 8
plan coverage for maternity care and pediatric care for newborn 9
infants. 10
2. Except as otherwise provided in this subsection, a health 11
benefit plan issued pursuant to this chapter [that includes coverage 12
for maternity care and pediatric care for newborn infants] may not 13
restrict benefits for any length of stay in a hospital in connection 14
with childbirth for a pregnant or postpartum individual or newborn 15
infant covered by the plan to: 16
(a) Less than 48 hours after a normal vaginal delivery; and 17
(b) Less than 96 hours after a cesarean section. 18
If a different length of stay is provided in the guidelines 19
established by the American College of Obstetricians and 20
Gynecologists, or its successor organization, and the American 21
Academy of Pediatrics, or its successor organization, the health 22
benefit plan may follow such guidelines in lieu of following the 23
length of stay set forth above. The provisions of this subsection do 24
not apply to any health benefit plan in any case in which the 25
decision to discharge the pregnant or postpartum individual or 26
newborn infant before the expiration of the minimum length of stay 27
set forth in this subsection is made by the attending physician of the 28
pregnant or postpartum individual or newborn infant. 29
[2.] 3. Nothing in this section requires a pregnant or 30
postpartum individual to: 31
(a) Deliver the baby in a hospital; or 32
(b) Stay in a hospital for a fixed period following the birth of the 33
child. 34
[3.] 4. A health benefit plan [that offers coverage for maternity 35
care and pediatric care of newborn infants] may not: 36
(a) Deny a pregnant or postpartum individual or the newborn 37
infant coverage or continued coverage under the terms of the plan if 38
the sole purpose of the denial of coverage or continued coverage is 39
to avoid the requirements of this section; 40
(b) Provide monetary payments or rebates to a pregnant or 41
postpartum individual to encourage the individual to accept less than 42
the minimum protection available pursuant to this section; 43
(c) Penalize, or otherwise reduce or limit, the reimbursement of 44
an attending provider of health care because the attending provider 45
– 46 –
- *AB522_R1*
of health care provided care to a pregnant or postpartum individual 1
or newborn infant in accordance with the provisions of this section; 2
(d) Provide incentives of any kind to an attending physician to 3
induce the attending physician to provide care to a pregnant or 4
postpartum individual or newborn infant in a manner that is 5
inconsistent with the provisions of this section; or 6
(e) Except as otherwise provided in subsection [4,] 5, restrict 7
benefits for any portion of a hospital stay required pursuant to the 8
provisions of this section in a manner that is less favorable than the 9
benefits provided for any preceding portion of that stay. 10
[4.] 5. Nothing in this section: 11
(a) Prohibits a health benefit plan or carrier from imposing a 12
deductible, coinsurance or other mechanism for sharing costs 13
relating to benefits for hospital stays in connection with childbirth 14
for a pregnant or postpartum individual or newborn child covered by 15
the plan, except that such coinsurance or other mechanism for 16
sharing costs for any portion of a hospital stay required by this 17
section may not be greater than the coinsurance or other mechanism 18
for any preceding portion of that stay. 19
(b) Prohibits an arrangement for payment between a health 20
benefit plan or carrier and a provider of health care that uses 21
capitation or other financial incentives, if the arrangement is 22
designed to provide services efficiently and consistently in the best 23
interest of the pregnant or postpartum individual and the newborn 24
infant. 25
(c) Prevents a health benefit plan or carrier from negotiating 26
with a provider of health care concerning the level and type of 27
reimbursement to be provided in accordance with this section. 28
6. A health benefit plan subject to the provisions of this 29
chapter that is delivered, issued for delivery or renewed on or after 30
October 1, 2025, has the legal effect of including the coverage 31
required by this section, and any provision of the plan that 32
conflicts with the provisions of this section is void. 33
Sec. 42. NRS 689C.1945 is hereby amended to read as 34
follows: 35
689C.1945 1. A carrier that offers or issues a health benefit 36
plan [that includes coverage for maternity care] shall not deny, limit 37
or seek reimbursement for maternity care because the insured is 38
acting as a gestational carrier. 39
2. If an insured acts as a gestational carrier, the child shall be 40
deemed to be a child of the intended parent, as defined in NRS 41
126.590, for purposes related to the health benefit plan. 42
3. As used in this section, “gestational carrier” has the meaning 43
ascribed to it in NRS 126.580. 44
– 47 –
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Sec. 43. NRS 689C.1975 is hereby amended to read as 1
follows: 2
689C.1975 1. A carrier that issues a health benefit plan shall 3
not discriminate against any person with respect to participation or 4
coverage under the plan on the basis of an actual or perceived 5
[gender identity or expression.] protected characteristic. 6
2. Prohibited discrimination includes, without limitation: 7
[1.] (a) Denying, cancelling, limiting or refusing to issue or 8
renew a health benefit plan on the basis of [the] an actual or 9
perceived [gender identity or expression] protected characteristic of 10
a person or a family member of the person; 11
[2.] (b) Imposing a payment or premium that is based on [the] 12
an actual or perceived [gender identity or expression] protected 13
characteristic of an insured or a family member of the insured; 14
[3.] (c) Designating [the] an actual or perceived [gender 15
identity or expression] protected characteristic of a person or a 16
family member of the person as grounds to deny, cancel or limit 17
participation or coverage; and 18
[4.] (d) Denying, cancelling or limiting participation or 19
coverage on the basis of an actual or perceived [gender identity or 20
expression,] protected characteristic, including, without limitation, 21
by limiting or denying coverage for health care services that are: 22
[(a)] (1) Related to gender transition, provided that there is 23
coverage under the plan for the services when the services are not 24
related to gender transition; or 25
[(b)] (2) Ordinarily or exclusively available to persons of any 26
sex. 27
3. As used in this section, “protected characteristic” means: 28
(a) Race, color, national origin, age, physical or mental 29
disability, sexual orientation or gender identity or expression; or 30
(b) Sex, including, without limitation, sex characteristics, 31
intersex traits and pregnancy or related conditions. 32
Sec. 44. NRS 689C.425 is hereby amended to read as follows: 33
689C.425 A voluntary purchasing group and any contract 34
issued to such a group pursuant to NRS 689C.360 to 689C.600, 35
inclusive, are subject to the provisions of NRS 689C.015 to 36
689C.355, inclusive, and sections 31 to 35, inclusive, of this act to 37
the extent applicable and not in conflict with the express provisions 38
of NRS 687B.408 and 689C.360 to 689C.600, inclusive. 39
Sec. 45. Chapter 695A of NRS is hereby amended by adding 40
thereto the provisions set forth as sections 46 to 51, inclusive, of this 41
act. 42
Sec. 46. 1. A society that offers or issues a benefit contract 43
which provides coverage for dependent children shall continue to 44
– 48 –
- *AB522_R1*
make such coverage available for an adult child of an insured 1
until such child reaches 26 years of age. 2
2. Nothing in this section shall be construed as requiring a 3
society to make coverage available for a dependent of an adult 4
child of an insured. 5
Sec. 47. 1. A society that offers or issues a benefit contract 6
shall include in the benefit contract 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 the parents or legal guardians of insureds who 24
are less than 18 years of age for the purpose of minimizing the 25
risk of skin cancer in those persons; 26
(g) Brief behavioral counseling and interventions to prevent 27
tobacco use for insureds who are less than 18 years of age; and 28
(h) At least one screening for the detection of amblyopia or the 29
risk factors of amblyopia for insureds who are at least 3 but not 30
more than 5 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
– 49 –
- *AB522_R1*
(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_R1*
(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) Screening for type 2 diabetes at such intervals as 20
recommended by the Health Resources and Services 21
Administration on January 1, 2025, for insureds who are in the 22
postpartum stage of pregnancy and who have a history of 23
gestational diabetes mellitus; 24
(k) Counseling relating to maintaining a healthy weight for 25
women who are at least 40 but not more than 60 years of age and 26
have a body mass index greater than 18.5; and 27
(l) Screening for osteoporosis for women who: 28
(1) Are 65 years of age or older; or 29
(2) Are less than 65 years of age and have a risk of 30
fracturing a bone equal to or greater than that of a woman who is 31
65 years of age without any additional risk factors. 32
2. A society 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 society. 35
3. Except as otherwise provided in subsection 5, a society that 36
offers or issues a benefit contract 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 benefit 40
contract pursuant to subsection 1; 41
(b) Refuse to issue a benefit contract or cancel a benefit 42
contract solely because the person applying for or covered by the 43
benefit contract uses or may use any such benefit; 44
– 51 –
- *AB522_R1*
(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_R1*
(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 in accordance with the most recent guidelines 21
published by the American Cancer Society or the 22
recommendations of the United States Preventive Services Task 23
Force in effect on January 1, 2025; 24
(j) Screening for prediabetes and type 2 diabetes in insureds 25
who are at least 35 but not more than 70 years of age and have a 26
body mass index of 25 or greater; and 27
(k) Intensive behavioral interventions with multiple 28
components for insureds who are 18 years of age or older and 29
have a body mass index of 30 or greater. 30
2. A society must ensure that the benefits required by 31
subsection 1 are made available to an insured through a provider 32
of health care who participates in the network plan of the society. 33
3. Except as otherwise provided in subsection 5, a society that 34
offers or issues a benefit contract shall not: 35
(a) Require an insured to pay a higher deductible, any 36
copayment or coinsurance or require a longer waiting period or 37
other condition to obtain any benefit provided in the benefit 38
contract pursuant to subsection 1; 39
(b) Refuse to issue a benefit contract or cancel a benefit 40
contract solely because the person applying for or covered by the 41
benefit contract uses or may use any such benefit; 42
(c) Offer or pay any type of material inducement or financial 43
incentive to an insured to discourage the insured from obtaining 44
any such benefit; 45
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- *AB522_R1*
(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 11
October 1, 2025, has the legal effect of including the coverage 12
required by subsection 1, and any provision of the contract 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 society may use medical management techniques, 16
including, without limitation, any available clinical evidence, to 17
determine the frequency of or treatment relating to any benefit 18
required by this section or the type of provider of health care to 19
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 benefit contract offered by a 34
society under which the financing and delivery of medical care, 35
including items and services paid for as medical care, are 36
provided, in whole or in part, through a defined set of providers of 37
health care under contract with the society. The term does not 38
include an arrangement for the financing of premiums. 39
(f) “Provider of health care” has the meaning ascribed to it in 40
NRS 629.031. 41
Sec. 50. 1. A benefit contract must provide coverage for 42
colorectal cancer screening in accordance with: 43
(a) The guidelines concerning colorectal cancer screening 44
which are published by the American Cancer Society; or 45
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- *AB522_R1*
(b) Other guidelines or reports concerning colorectal cancer 1
screening which are published by nationally recognized 2
professional organizations and which include current or 3
prevailing supporting scientific data. 4
2. A society must ensure that the benefits required by 5
subsection 1 are made available to an insured through a provider 6
of health care who participates in the network plan of the society. 7
3. A society that offers or issues a benefit contract 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 benefit 11
contract pursuant to subsection 1; 12
(b) Refuse to issue a benefit contract or cancel a benefit 13
contract solely because the person applying for or covered by the 14
benefit contract uses or may use any such benefit; 15
(c) Offer or pay any type of material inducement or financial 16
incentive to an insured to discourage the insured from obtaining 17
any such benefit; 18
(d) Penalize a provider of health care who provides any such 19
benefit to an insured, including, without limitation, reducing the 20
reimbursement of the provider of health care; 21
(e) Offer or pay any type of material inducement, bonus or 22
other financial incentive to a provider of health care to deny, 23
reduce, withhold, limit or delay access to any such benefit to an 24
insured; or 25
(f) Impose any other restrictions or delays on the access of an 26
insured to any such benefit. 27
4. A benefit contract subject to the provisions of this chapter 28
that is delivered, issued for delivery or renewed on or after 29
October 1, 2025, has the legal effect of including the coverage 30
required by this section, and any provision of the benefit contract 31
that conflicts with the provisions of this section is void. 32
5. As used in this section: 33
(a) “Network plan” means a benefit contract offered by a 34
society under which the financing and delivery of medical care, 35
including items and services paid for as medical care, are 36
provided, in whole or in part, through a defined set of providers of 37
health care under contract with the society. The term does not 38
include an arrangement for the financing of premiums. 39
(b) “Provider of health care” has the meaning ascribed to it in 40
NRS 629.031. 41
Sec. 51. 1. A society that offers or issues a benefit contract 42
subject to the provisions of this chapter shall include in the benefit 43
contract coverage for maternity care and pediatric care for 44
newborn infants. 45
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- *AB522_R1*
2. Except as otherwise provided in this subsection, a benefit 1
contract issued pursuant to this chapter may not restrict benefits 2
for any length of stay in a hospital in connection with childbirth 3
for a pregnant or postpartum individual or newborn infant 4
covered by the benefit contract to: 5
(a) Less than 48 hours after a normal vaginal delivery; and 6
(b) Less than 96 hours after a cesarean section. 7
If a different length of stay is provided in the guidelines 8
established by the American College of Obstetricians and 9
Gynecologists, or its successor organization, and the American 10
Academy of Pediatrics, or its successor organization, the benefit 11
contract may follow such guidelines in lieu of following the length 12
of stay set forth above. The provisions of this subsection do not 13
apply to any benefit contract in any case in which the decision to 14
discharge the pregnant or postpartum individual or newborn 15
infant before the expiration of the minimum length of stay set 16
forth in this subsection is made by the attending physician of the 17
pregnant or postpartum individual or newborn infant. 18
3. Nothing in this section requires a pregnant or postpartum 19
individual to: 20
(a) Deliver the baby in a hospital; or 21
(b) Stay in a hospital for a fixed period following the birth of 22
the child. 23
4. A benefit contract may not: 24
(a) Deny a pregnant or postpartum individual or the newborn 25
infant coverage or continued coverage under the terms of the 26
contract if the sole purpose of the denial of coverage or continued 27
coverage is to avoid the requirements of this section; 28
(b) Provide monetary payments or rebates to a pregnant or 29
postpartum individual to encourage the individual to accept less 30
than the minimum protection available pursuant to this section; 31
(c) Penalize, or otherwise reduce or limit, the reimbursement 32
of an attending provider of health care because the attending 33
provider of health care provided care to a pregnant or postpartum 34
individual or newborn infant in accordance with the provisions of 35
this section; 36
(d) Provide incentives of any kind to an attending physician to 37
induce the attending physician to provide care to a pregnant or 38
postpartum individual or newborn infant in a manner that is 39
inconsistent with the provisions of this section; or 40
(e) Except as otherwise provided in subsection 5, restrict 41
benefits for any portion of a hospital stay required pursuant to the 42
provisions of this section in a manner that is less favorable than 43
the benefits provided for any preceding portion of that stay. 44
5. Nothing in this section: 45
– 56 –
- *AB522_R1*
(a) Prohibits a society from imposing a deductible, 1
coinsurance or other mechanism for sharing costs relating to 2
benefits for hospital stays in connection with childbirth for a 3
pregnant or postpartum individual or newborn child covered by 4
the benefit contract, except that such coinsurance or other 5
mechanism for sharing costs for any portion of a hospital stay 6
required by this section may not be greater than the coinsurance 7
or other mechanism for any preceding portion of that stay. 8
(b) Prohibits an arrangement for payment between a society 9
and a provider of health care that uses capitation or other 10
financial incentives, if the arrangement is designed to provide 11
services efficiently and consistently in the best interest of the 12
pregnant or postpartum individual and the newborn infant. 13
(c) Prevents a society from negotiating with a provider of 14
health care concerning the level and type of reimbursement to be 15
provided in accordance with this section. 16
6. A benefit contract subject to the provisions of this chapter 17
that is delivered, issued for delivery or renewed on or after 18
October 1, 2025, has the legal effect of including the coverage 19
required by this section, and any provision of the contract that 20
conflicts with the provisions of this section is void. 21
Sec. 52. NRS 695A.1844 is hereby amended to read as 22
follows: 23
695A.1844 1. A society that offers or issues a benefit 24
contract shall include in the contract: 25
(a) Coverage of testing for and the treatment and prevention of 26
sexually transmitted diseases, including, without limitation, 27
Chlamydia trachomatis, gonorrhea, syphilis, human 28
immunodeficiency virus and hepatitis B and C, for all insureds, 29
regardless of age. Such coverage must include, without limitation, 30
the coverage required by NRS 695A.1843 and 695A.1856. 31
(b) Unrestricted coverage of condoms for insureds who are 13 32
years of age or older. 33
2. A society that offers or 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
– 57 –
- *AB522_R1*
(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
3. 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, [2024,] 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. As used in this section, “provider of health care” has the 15
meaning ascribed to it in NRS 629.031. 16
Sec. 53. NRS 695A.1853 is hereby amended to read as 17
follows: 18
695A.1853 1. A society that issues a benefit contract shall 19
provide coverage for screening, genetic counseling and testing for 20
harmful mutations in the BRCA gene for women under 21
circumstances where such screening, genetic counseling or testing, 22
as applicable, is required by NRS 457.301. 23
2. A society shall ensure that the benefits required by 24
subsection 1 are made available to an insured through a provider of 25
health care who participates in the network plan of the society. 26
3. A society that issues a benefit contract shall not: 27
(a) Require an insured to pay a higher deductible, any 28
copayment or coinsurance or require a longer waiting period or 29
other condition to obtain any benefit provided in the benefit 30
contract pursuant to subsection 1; 31
(b) Refuse to issue a benefit contract or cancel a benefit 32
contract solely because the person applying for or covered by the 33
benefit contract 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 36
any 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 41
other financial incentive to a provider of health care to deny, 42
reduce, withhold, limit or delay access to any such benefit to an 43
insured; or 44
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(f) Impose any other restrictions or delays on the access of an 1
insured to any such benefit. 2
4. A benefit contract subject to the provisions of this chapter 3
that is delivered, issued for delivery or renewed on or after [January] 4
October 1, [2022,] 2025, has the legal effect of including the 5
coverage required by subsection 1, and any provision of the plan 6
that conflicts with the provisions of this section is void. 7
[4.] 5. As used in this section: 8
(a) “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
(b) “Provider of health care” has the meaning ascribed to it in 15
NRS 629.031. 16
Sec. 54. (Deleted by amendment.) 17
Sec. 55. NRS 695A.1856 is hereby amended to read as 18
follows: 19
695A.1856 1. A society that issues a benefit contract shall 20
provide coverage for the examination of a person who is pregnant 21
for the discovery of: 22
(a) Chlamydia trachomatis, gonorrhea, hepatitis B and hepatitis 23
C in accordance with NRS 442.013. 24
(b) Syphilis in accordance with NRS 442.010. 25
(c) Human immunodeficiency virus. 26
2. The coverage required by this section must be provided: 27
(a) Regardless of whether the benefits are provided to the 28
insured by a provider of health care, facility or medical laboratory 29
that participates in the network plan of the society; and 30
(b) Without prior authorization. 31
3. A society that issues a benefit contract 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 benefit 35
contract pursuant to subsection 1; 36
(b) Refuse to issue a benefit contract or cancel a benefit 37
contract solely because the person applying for or covered by the 38
benefit contract uses 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 41
any 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 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 benefit contract subject to the provisions of this chapter 7
that is delivered, issued for delivery or renewed on or after [July] 8
October 1, [2021,] 2025, has the legal effect of including the 9
coverage required by subsection 1, and any provision of the contract 10
that conflicts with the provisions of this section is void. 11
[4.] 5. As used in this section: 12
(a) “Medical laboratory” has the meaning ascribed to it in 13
NRS 652.060. 14
(b) “Network plan” means a benefit contract offered by a society 15
under which the financing and delivery of medical care, including 16
items and services paid for as medical care, are provided, in whole 17
or in part, through a defined set of providers under contract with the 18
society. The term does not include an arrangement for the financing 19
of premiums. 20
(c) “Provider of health care” has the meaning ascribed to it in 21
NRS 629.031. 22
Sec. 56. NRS 695A.1857 is hereby amended to read as 23
follows: 24
695A.1857 1. A society that offers or issues a benefit 25
contract [that includes coverage for maternity care] shall not deny, 26
limit or seek reimbursement for maternity care because the insured 27
is acting as a gestational carrier. 28
2. If an insured acts as a gestational carrier, the child shall be 29
deemed to be a child of the intended parent, as defined in NRS 30
126.590, for purposes related to the benefit contract. 31
3. As used in this section, “gestational carrier” has the meaning 32
ascribed to it in NRS 126.580. 33
Sec. 57. NRS 695A.1875 is hereby amended to read as 34
follows: 35
695A.1875 1. A society that offers or issues a benefit 36
contract shall include in the contract coverage for: 37
(a) Counseling, support and supplies for breastfeeding, 38
including breastfeeding equipment, counseling and education during 39
the antenatal, perinatal and postpartum period for not more than 1 40
year; 41
(b) Screening and counseling for interpersonal and domestic 42
violence for women at least annually with initial intervention 43
services consisting of education, strategies to reduce harm, 44
supportive services or a referral for any other appropriate services; 45
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(c) Behavioral counseling concerning sexually transmitted 1
diseases from a provider of health care for sexually active [women] 2
insureds who are at increased risk for such diseases; 3
(d) Hormone replacement therapy; 4
(e) Such prenatal screenings and tests as recommended by the 5
American College of Obstetricians and Gynecologists or its 6
successor organization; 7
(f) Screening for blood pressure abnormalities and diabetes, 8
including gestational diabetes, after at least 24 weeks of gestation or 9
as ordered by a provider of health care; 10
(g) Screening for cervical cancer at such intervals as are 11
recommended by the American College of Obstetricians and 12
Gynecologists or its successor organization; 13
(h) Screening for depression [;] for insureds who are 12 years 14
of age or older; 15
(i) Screening for anxiety disorders; 16
(j) Screening and counseling for the human immunodeficiency 17
virus consisting of a risk assessment, annual education relating to 18
prevention and at least one screening for the virus during the 19
lifetime of the insured or as ordered by a provider of health care; 20
[(j) Smoking] 21
(k) Tobacco cessation programs , including, without limitation, 22
pharmacotherapy approved by the United States Food and Drug 23
Administration, for an insured who is 18 years of age or older ; 24
[consisting of not more than two cessation attempts per year and 25
four counseling sessions per year; 26
(k)] (l) All vaccinations recommended by the Advisory 27
Committee on Immunization Practices of the Centers for Disease 28
Control and Prevention of the United States Department of Health 29
and Human Services or its successor organization; and 30
[(l)] (m) Such well-woman preventative visits as recommended 31
by the Health Resources and Services Administration [,] on 32
January 1, 2025, which must include at least one such visit per year 33
beginning at 14 years of age. 34
2. A society must ensure that the benefits required by 35
subsection 1 are made available to an insured through a provider of 36
health care who participates in the network plan of the society. 37
3. Except as otherwise provided in subsection 5, a society that 38
offers or issues a benefit contract 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 benefit contract 42
pursuant to subsection 1; 43
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(b) Refuse to issue a benefit contract or cancel a benefit contract 1
solely because the person applying for or covered by the contract 2
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 any 5
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 other 10
financial incentive to a provider of health care to deny, reduce, 11
withhold, limit or delay access to any such benefit to an insured; or 12
(f) Impose any other restrictions or delays on the access of an 13
insured to any such benefit. 14
4. A benefit contract subject to the provisions of this chapter 15
that is delivered, issued for delivery or renewed on or after [January] 16
October 1, [2018,] 2025, has the legal effect of including the 17
coverage required by subsection 1, and any provision of the benefit 18
contract or the renewal which is in conflict with this section is void. 19
5. Except as otherwise provided in this section and federal law, 20
a society 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. As used in this section: 26
(a) “Medical management technique” means a practice which is 27
used to control the cost or utilization of health care services or 28
prescription drug use. The term includes, without limitation, the use 29
of step therapy, prior authorization or categorizing drugs and 30
devices based on cost, type or method of administration. 31
(b) “Network plan” means a benefit contract offered by a society 32
under which the financing and delivery of medical care, including 33
items and services paid for as medical care, are provided, in whole 34
or in part, through a defined set of providers under contract with the 35
society. The term does not include an arrangement for the financing 36
of premiums. 37
(c) “Provider of health care” has the meaning ascribed to it in 38
NRS 629.031. 39
Sec. 58. NRS 695A.198 is hereby amended to read as follows: 40
695A.198 1. A society that issues a benefit contract shall not 41
discriminate against any person with respect to participation or 42
coverage under the contract on the basis of an actual or perceived 43
[gender identity or expression.] protected characteristic. 44
2. Prohibited discrimination includes, without limitation: 45
– 62 –
- *AB522_R1*
[1.] (a) Denying, cancelling, limiting or refusing to issue or 1
renew a benefit contract on the basis of [the] an actual or perceived 2
[gender identity or expression] protected characteristic of a person 3
or a family member of the person; 4
[2.] (b) Imposing a payment or premium that is based on [the] 5
an actual or perceived [gender identity or expression] protected 6
characteristic of an insured or a family member of the insured; 7
[3.] (c) Designating [the] an actual or perceived [gender 8
identity or expression] protected characteristic of a person or a 9
family member of the person as grounds to deny, cancel or limit 10
participation or coverage; and 11
[4.] (d) Denying, cancelling or limiting participation or 12
coverage on the basis of an actual or perceived [gender identity or 13
expression,] protected characteristic, including, without limitation, 14
by limiting or denying coverage for health care services that are: 15
[(a)] (1) Related to gender transition, provided that there is 16
coverage under the contract for the services when the services are 17
not related to gender transition; or 18
[(b)] (2) Ordinarily or exclusively available to persons of any 19
sex. 20
3. As used in this section, “protected characteristic” means: 21
(a) Race, color, national origin, age, physical or mental 22
disability, sexual orientation or gender identity or expression; or 23
(b) Sex, including, without limitation, sex characteristics, 24
intersex traits and pregnancy or related conditions. 25
Sec. 59. Chapter 695B of NRS is hereby amended by adding 26
thereto the provisions set forth as sections 60 to 64, inclusive, of this 27
act. 28
Sec. 60. 1. A hospital or medical services corporation that 29
offers or issues a policy of health insurance which provides 30
coverage for dependent children shall continue to make such 31
coverage available for an adult child of an insured until such 32
child reaches 26 years of age. 33
2. Nothing in this section shall be construed as requiring a 34
hospital or medical services corporation to make coverage 35
available for a dependent of an adult child of an insured. 36
Sec. 61. 1. A hospital or medical services corporation that 37
offers or issues a policy of health insurance shall include in the 38
policy coverage for: 39
(a) Screening for anxiety for insureds who are at least 8 but 40
not more than 18 years of age; 41
(b) Assessments relating to height, weight, body mass index 42
and medical history for insureds who are less than 18 years of 43
age; 44
– 63 –
- *AB522_R1*
(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 the parents or legal guardians of insureds who 12
are less than 18 years of age for the purpose of minimizing the 13
risk of skin cancer in those persons; 14
(g) Brief behavioral counseling and interventions to prevent 15
tobacco use for insureds who are less than 18 years of age; and 16
(h) At least one screening for the detection of amblyopia or the 17
risk factors of amblyopia for insureds who are at least 3 but not 18
more than 5 years of age. 19
2. A hospital or medical services corporation must ensure 20
that the benefits required by subsection 1 are made available to an 21
insured through a provider of health care who participates in the 22
network plan of the hospital or medical services corporation. 23
3. Except as otherwise provided in subsection 5, a hospital or 24
medical services corporation that offers or issues a policy of health 25
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
– 64 –
- *AB522_R1*
4. A policy of health insurance subject to the provisions of 1
this chapter that is delivered, issued for delivery or renewed on or 2
after October 1, 2025, has the legal effect of including the 3
coverage required by subsection 1, and any provision of the policy 4
or the renewal which is in conflict with this section is void. 5
5. Except as otherwise provided in this section and federal 6
law, a hospital or medical services corporation 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 policy of health insurance offered 18
by a hospital or medical services corporation under which the 19
financing and delivery of medical care, including items and 20
services paid for as medical care, are provided, in whole or in part, 21
through a defined set of providers of health care under contract 22
with the hospital or medical services corporation. The term does 23
not include an 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. 62. 1. A hospital or medical services corporation that 27
offers or issues a policy of health insurance shall include in the 28
policy coverage for: 29
(a) A daily dose of 0.4 to 0.8 milligrams of folic acid for 30
insureds who are pregnant or are planning on becoming 31
pregnant; 32
(b) A low dose of aspirin for the prevention of preeclampsia 33
for insureds who are determined to be at a high risk of that 34
condition after 12 weeks of gestation; 35
(c) Prophylactic ocular tubal medication for the prevention of 36
gonococcal ophthalmia in newborns; 37
(d) Screening for asymptomatic bacteriuria for insureds who 38
are pregnant; 39
(e) Counseling and behavioral interventions relating to the 40
promotion of healthy weight gain and the prevention of excessive 41
weight gain for insureds who are pregnant; 42
(f) Counseling for insureds who are pregnant or in the 43
postpartum stage of pregnancy and have an increased risk of 44
perinatal or postpartum depression; 45
– 65 –
- *AB522_R1*
(g) Screening for the presence of the rhesus D antigen and 1
antibodies in the blood of an insured who is pregnant during the 2
insured’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 insureds 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 insureds who are pregnant; 9
(j) Screening for type 2 diabetes at such intervals as 10
recommended by the Health Resources and Services 11
Administration on January 1, 2025, for insureds who are in the 12
postpartum stage of pregnancy and who have a history of 13
gestational diabetes mellitus; 14
(k) Counseling relating to maintaining a healthy weight for 15
women who are 40 but not more than 60 years of age and have a 16
body mass index greater than 18.5; and 17
(l) Screening for osteoporosis for women who: 18
(1) Are 65 years of age or older; or 19
(2) Are less than 65 years of age and have a risk of 20
fracturing a bone equal to or greater than that of a woman who is 21
65 years of age without any additional risk factors. 22
2. A hospital or medical services corporation must ensure 23
that the benefits required by subsection 1 are made available to an 24
insured through a provider of health care who participates in the 25
network plan of the hospital or medical services corporation. 26
3. Except as otherwise provided in subsection 5, hospital or 27
medical services corporation that offers or issues a policy of health 28
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
– 66 –
- *AB522_R1*
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, a hospital or medical services corporation 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 policy of health insurance offered 22
by a hospital or medical services corporation under which the 23
financing and delivery of medical care, including items and 24
services paid for as medical care, are provided, in whole or in part, 25
through a defined set of providers of health care under contract 26
with the hospital or medical services corporation. The term does 27
not include an 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. 63. 1. A hospital or medical services corporation that 31
offers or issues a policy of health insurance shall include in the 32
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
– 67 –
- *AB522_R1*
(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 in accordance with the most recent guidelines 17
published by the American Cancer Society or the 18
recommendations of the United States Preventive Services Task 19
Force in effect on January 1, 2025; 20
(j) Screening for prediabetes and type 2 diabetes in insureds 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 insureds who are 18 years of age or older and 25
have a body mass index of 30 or greater. 26
2. A hospital or medical services corporation must ensure 27
that the benefits required by subsection 1 are made available to an 28
insured through a provider of health care who participates in the 29
network plan of the hospital or medical services corporation. 30
3. Except as otherwise provided in subsection 5, a hospital or 31
medical services corporation that offers or issues a policy of health 32
insurance 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 policy of 36
health insurance pursuant to subsection 1; 37
(b) Refuse to issue a policy of health insurance or cancel a 38
policy of health insurance solely because the person applying for 39
or covered by 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 42
any such benefit; 43
– 68 –
- *AB522_R1*
(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) “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 policy of health insurance offered 34
by a hospital or medical services corporation under which the 35
financing and delivery of medical care, including items and 36
services paid for as medical care, are provided, in whole or in part, 37
through a defined set of providers of health care under contract 38
with the hospital or medical services corporation. The term does 39
not include an arrangement for the financing of premiums. 40
(f) “Provider of health care” has the meaning ascribed to it in 41
NRS 629.031. 42
Sec. 64. 1. A hospital or medical services corporation that 43
offers or issues a policy of health insurance subject to the 44
– 69 –
- *AB522_R1*
provisions of this chapter shall include in the policy coverage for 1
maternity care and pediatric care for newborn infants. 2
2. Except as otherwise provided in this subsection, a policy of 3
health insurance issued pursuant to this chapter may not restrict 4
benefits for any length of stay in a hospital in connection with 5
childbirth for a pregnant or postpartum individual or newborn 6
infant covered by the policy to: 7
(a) Less than 48 hours after a normal vaginal delivery; and 8
(b) Less than 96 hours after a cesarean section. 9
If a different length of stay is provided in the guidelines 10
established by the American College of Obstetricians and 11
Gynecologists, or its successor organization, and the American 12
Academy of Pediatrics, or its successor organization, the policy of 13
health insurance may follow such guidelines in lieu of following 14
the length of stay set forth above. The provisions of this subsection 15
do not apply to any policy of health insurance in any case in 16
which the decision to discharge the pregnant or postpartum 17
individual or newborn infant before the expiration of the 18
minimum length of stay set forth in this subsection is made by the 19
attending physician of the pregnant or postpartum individual or 20
newborn infant. 21
3. Nothing in this section requires a pregnant or postpartum 22
individual to: 23
(a) Deliver the baby in a hospital; or 24
(b) Stay in a hospital for a fixed period following the birth of 25
the child. 26
4. A policy of health insurance may not: 27
(a) Deny a pregnant or postpartum individual or the newborn 28
infant coverage or continued coverage under the terms of the 29
policy if the sole purpose of the denial of coverage or continued 30
coverage is to avoid the requirements of this section; 31
(b) Provide monetary payments or rebates to a pregnant or 32
postpartum individual to encourage the individual to accept less 33
than the minimum protection available pursuant to this section; 34
(c) Penalize, or otherwise reduce or limit, the reimbursement 35
of an attending provider of health care because the attending 36
provider of health care provided care to a pregnant or postpartum 37
individual or newborn infant in accordance with the provisions of 38
this section; 39
(d) Provide incentives of any kind to an attending physician to 40
induce the attending physician to provide care to a pregnant or 41
postpartum individual or newborn infant in a manner that is 42
inconsistent with the provisions of this section; or 43
(e) Except as otherwise provided in subsection 5, restrict 44
benefits for any portion of a hospital stay required pursuant to the 45
– 70 –
- *AB522_R1*
provisions of this section in a manner that is less favorable than 1
the benefits provided for any preceding portion of that stay. 2
5. Nothing in this section: 3
(a) Prohibits a hospital or medical services corporation from 4
imposing a deductible, coinsurance or other mechanism for 5
sharing costs relating to benefits for hospital stays in connection 6
with childbirth for a pregnant or postpartum individual or 7
newborn child covered by the policy, except that such coinsurance 8
or other mechanism for sharing costs for any portion of a hospital 9
stay required by this section may not be greater than the 10
coinsurance or other mechanism for any preceding portion of that 11
stay. 12
(b) Prohibits an arrangement for payment between a hospital 13
or medical services corporation and a provider of health care that 14
uses capitation or other financial incentives, if the arrangement is 15
designed to provide services efficiently and consistently in the best 16
interest of the pregnant or postpartum individual and the newborn 17
infant. 18
(c) Prevents a hospital or medical services corporation from 19
negotiating with a provider of health care concerning the level and 20
type of reimbursement to be provided in accordance with this 21
section. 22
6. 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 this section, and any provision of the policy 26
that conflicts with the provisions of this section is void. 27
Sec. 65. NRS 695B.1907 is hereby amended to read as 28
follows: 29
695B.1907 1. A policy of health insurance issued by a 30
hospital or medical service corporation [that provides coverage for 31
the treatment of colorectal cancer] must provide coverage for 32
colorectal cancer screening in accordance 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. 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
3. A hospital or medical services corporation that offers or 44
issues a policy of health insurance shall not: 45
– 71 –
- *AB522_R1*
(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
health 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 6
or 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 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 policy of health insurance subject to the provisions of this 20
chapter that is delivered, issued for delivery or renewed on or after 21
October 1, [2003,] 2025, has the legal effect of including the 22
coverage required by this section, and any provision of the policy 23
that conflicts with the provisions of this section is void. 24
5. As used in this section: 25
(a) “Network plan” means a policy of health insurance offered 26
by a hospital or medical services corporation under which the 27
financing and delivery of medical care, including items and 28
services paid for as medical care, are provided, in whole or in part, 29
through a defined set of providers of health care under contract 30
with the hospital or medical services corporation. The term does 31
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. 66. NRS 695B.1911 is hereby amended to read as 35
follows: 36
695B.1911 1. A hospital or medical services corporation that 37
issues a policy of health insurance shall provide coverage for 38
screening, genetic counseling and testing for harmful mutations in 39
the BRCA gene for women under circumstances where such 40
screening, genetic counseling or testing, as applicable, is required by 41
NRS 457.301. 42
2. A hospital or medical services corporation shall ensure that 43
the benefits required by subsection 1 are made available to an 44
– 72 –
- *AB522_R1*
insured through a provider of health care who participates in the 1
network plan of the hospital or medical services corporation. 2
3. A hospital or medical services corporation that issues a 3
policy of health insurance shall not: 4
(a) Require an insured to pay a higher deductible, any 5
copayment or coinsurance or require a longer waiting period or 6
other condition to obtain any benefit provided in the policy of 7
health insurance pursuant to subsection 1; 8
(b) Refuse to issue a policy of health insurance or cancel a 9
policy of health insurance solely because the person applying for 10
or covered by the policy 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 13
any 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 18
other financial incentive to a provider of health care to deny, 19
reduce, withhold, limit or delay access to any such benefit to an 20
insured; or 21
(f) Impose any other restrictions or delays on the access of an 22
insured to any such benefit. 23
4. A policy of health insurance subject to the provisions of this 24
chapter that is delivered, issued for delivery or renewed on or after 25
[January] October 1, [2022,] 2025, has the legal effect of including 26
the coverage required by subsection 1, and any provision of the 27
policy that conflicts with the provisions of this section is void. 28
[4.] 5. As used in this section: 29
(a) “Network plan” means a policy of health insurance offered 30
by a hospital or medical services corporation under which the 31
financing and delivery of medical care, including items and services 32
paid for as medical care, are provided, in whole or in part, through a 33
defined set of providers under contract with the hospital or medical 34
services corporation. The term does not include an arrangement for 35
the financing of premiums. 36
(b) “Provider of health care” has the meaning ascribed to it in 37
NRS 629.031. 38
Sec. 67. (Deleted by amendment.) 39
Sec. 68. NRS 695B.1913 is hereby amended to read as 40
follows: 41
695B.1913 1. A hospital or medical services corporation that 42
issues a policy of health insurance shall provide coverage for the 43
examination of a person who is pregnant for the discovery of: 44
– 73 –
- *AB522_R1*
(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 hospital or medical 8
services corporation; and 9
(b) Without prior authorization. 10
3. A hospital or medical services corporation that issues a 11
policy of health insurance 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 policy of 15
health insurance pursuant to subsection 1; 16
(b) Refuse to issue a policy of health insurance or cancel a 17
policy of health insurance solely because the person applying for 18
or covered by the policy 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. A policy of health insurance subject to the provisions of this 32
chapter that is delivered, issued for delivery or renewed on or after 33
[July] October 1, [2021,] 2025, has the legal effect of including the 34
coverage required by subsection 1, and any provision of the policy 35
that conflicts with the provisions of this section is void. 36
[4.] 5. As used in this section: 37
(a) “Medical laboratory” has the meaning ascribed to it in 38
NRS 652.060. 39
(b) “Network plan” means a policy of health insurance offered 40
by a hospital or medical services corporation 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 hospital or medical 44
– 74 –
- *AB522_R1*
services corporation. The term does not include an arrangement for 1
the financing of premiums. 2
(c) “Provider of health care” has the meaning ascribed to it in 3
NRS 629.031. 4
Sec. 69. NRS 695B.19195 is hereby amended to read as 5
follows: 6
695B.19195 1. An insurer that offers or issues a contract for 7
hospital or medical service shall include in the contract coverage 8
for: 9
(a) Counseling, support and supplies for breastfeeding, 10
including breastfeeding equipment, counseling and education during 11
the antenatal, perinatal and postpartum period for not more than 1 12
year; 13
(b) Screening and counseling for interpersonal and domestic 14
violence for women at least annually with initial intervention 15
services consisting of education, strategies to reduce harm, 16
supportive services or a referral for any other appropriate services; 17
(c) Behavioral counseling concerning sexually transmitted 18
diseases from a provider of health care for sexually active [women] 19
insureds who are at increased risk for such diseases; 20
(d) Such prenatal screenings and tests as recommended by the 21
American College of Obstetricians and Gynecologists or its 22
successor organization; 23
(e) Screening for blood pressure abnormalities and diabetes, 24
including gestational diabetes, after at least 24 weeks of gestation or 25
as ordered by a provider of health care; 26
(f) Screening for cervical cancer at such intervals as are 27
recommended by the American College of Obstetricians and 28
Gynecologists or its successor organization; 29
(g) Screening for depression [;] for insureds who are 12 years 30
of age or older; 31
(h) Screening for anxiety disorders; 32
(i) Screening and counseling for the human immunodeficiency 33
virus consisting of a risk assessment, annual education relating to 34
prevention and at least one screening for the virus during the 35
lifetime of the insured or as ordered by a provider of health care; 36
[(i) Smoking] 37
(j) Tobacco cessation programs , including, without limitation, 38
pharmacotherapy approved by the United States Food and Drug 39
Administration, for an insured who is 18 years of age or older ; 40
[consisting of not more than two cessation attempts per year and 41
four counseling sessions per year; 42
(j)] (k) All vaccinations recommended by the Advisory 43
Committee on Immunization Practices of the Centers for Disease 44
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- *AB522_R1*
Control and Prevention of the United States Department of Health 1
and Human Services or its successor organization; and 2
[(k)] (l) Such well-woman preventative visits as recommended 3
by the Health Resources and Services Administration [,] on 4
January 1, 2025, which must include at least one such visit per year 5
beginning at 14 years of age. 6
2. An insurer must ensure that the benefits required by 7
subsection 1 are made available to an insured through a provider of 8
health care who participates in the network plan of the insurer. 9
3. Except as otherwise provided in subsection 5, an insurer that 10
offers or issues a contract for hospital or medical service shall not: 11
(a) Require an insured to pay a higher deductible, any 12
copayment or coinsurance or require a longer waiting period or 13
other condition to obtain any benefit provided in the contract for 14
hospital or medical service pursuant to subsection 1; 15
(b) Refuse to issue a contract for hospital or medical service or 16
cancel a contract for hospital or medical service solely because the 17
person applying for or covered by the contract uses or may use any 18
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 any 21
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 other 26
financial incentive to a provider of health care to deny, reduce, 27
withhold, limit or delay access to any such benefit to an insured; or 28
(f) Impose any other restrictions or delays on the access of an 29
insured to any such benefit. 30
4. A contract for hospital or medical service subject to the 31
provisions of this chapter that is delivered, issued for delivery or 32
renewed on or after [January] October 1, [2018,] 2025, has the legal 33
effect of including the coverage required by subsection 1, and any 34
provision of the contract or the renewal which is in conflict with this 35
section is void. 36
5. Except as otherwise provided in this section and federal law, 37
an insurer may use medical management techniques, including, 38
without limitation, any available clinical evidence, to determine the 39
frequency of or treatment relating to any benefit required by this 40
section or the type of provider of health care to use for such 41
treatment. 42
6. As used in this section: 43
(a) “Medical management technique” means a practice which is 44
used to control the cost or utilization of health care services or 45
– 76 –
- *AB522_R1*
prescription drug use. The term includes, without limitation, the use 1
of step therapy, prior authorization or categorizing drugs and 2
devices based on cost, type or method of administration. 3
(b) “Network plan” means a contract for hospital or medical 4
service offered by an insurer under which the financing and delivery 5
of medical care, including items and services paid for as medical 6
care, are provided, in whole or in part, through a defined set of 7
providers under contract with the insurer. The term does not include 8
an arrangement for the financing of premiums. 9
(c) “Provider of health care” has the meaning ascribed to it in 10
NRS 629.031. 11
Sec. 70. NRS 695B.1926 is hereby amended to read as 12
follows: 13
695B.1926 1. A hospital or medical services corporation that 14
offers or issues a policy of health insurance shall include in the 15
policy: 16
(a) Coverage of testing for and the treatment and prevention of 17
sexually transmitted diseases, including, without limitation, 18
Chlamydia trachomatis, gonorrhea, syphilis, human 19
immunodeficiency virus and hepatitis B and C, for all insureds, 20
regardless of age. Such coverage must include, without limitation, 21
the coverage required by NRS 695B.1913 and 695B.1924. 22
(b) Unrestricted coverage of condoms for insureds who are 13 23
years of age or older. 24
2. A hospital or medical services corporation that offers or 25
issues a 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
– 77 –
- *AB522_R1*
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. 71. NRS 695B.1948 is hereby amended to read as 8
follows: 9
695B.1948 1. An insurer that offers or issues a contract for 10
hospital or medical services [that includes coverage for maternity 11
care] shall not deny, limit or seek reimbursement for maternity care 12
because the insured is acting as a gestational carrier. 13
2. If an insured acts as a gestational carrier, the child shall be 14
deemed to be a child of the intended parent, as defined in NRS 15
126.590, for purposes related to the contract for hospital or medical 16
services. 17
3. As used in this section, “gestational carrier” has the meaning 18
ascribed to it in NRS 126.580. 19
Sec. 72. NRS 695B.3167 is hereby amended to read as 20
follows: 21
695B.3167 1. A hospital or medical services corporation that 22
issues a policy of health insurance shall not discriminate against any 23
person with respect to participation or coverage under the policy on 24
the basis of an actual or perceived [gender identity or expression.] 25
protected characteristic. 26
2. Prohibited discrimination includes, without limitation: 27
[1.] (a) Denying, cancelling, limiting or refusing to issue or 28
renew a policy of health insurance on the basis of [the] an actual or 29
perceived [gender identity or expression] protected characteristic of 30
a person or a family member of the person; 31
[2.] (b) Imposing a payment or premium that is based on [the] 32
an actual or perceived [gender identity or expression] protected 33
characteristic of an insured or a family member of the insured; 34
[3.] (c) Designating [the] an actual or perceived [gender 35
identity or expression] protected characteristic of a person or a 36
family member of the person as grounds to deny, cancel or limit 37
participation or coverage; and 38
[4.] (d) Denying, cancelling or limiting participation or 39
coverage on the basis of an actual or perceived [gender identity or 40
expression,] protected characteristic including, without limitation, 41
by limiting or denying coverage for health care services that are: 42
[(a)] (1) Related to gender transition, provided that there is 43
coverage under the policy for the services when the services are not 44
related to gender transition; or 45
– 78 –
- *AB522_R1*
[(b)] (2) Ordinarily or exclusively available to persons of any 1
sex. 2
3. As used in this section, “protected characteristic” means: 3
(a) Race, color, national origin, age, physical or mental 4
disability, sexual orientation or gender identity or expression; or 5
(b) Sex, including, without limitation, sex characteristics, 6
intersex traits and pregnancy or related conditions. 7
Sec. 73. Chapter 695C of NRS is hereby amended by adding 8
thereto the provisions set forth as sections 74 to 78, inclusive, of this 9
act. 10
Sec. 74. 1. A health maintenance organization that offers 11
or issues a health care plan which provides coverage for 12
dependent children shall continue to make such coverage 13
available for an adult child of an enrollee until such child reaches 14
26 years of age. 15
2. Nothing in this section shall be construed as requiring a 16
health maintenance organization to make coverage available for a 17
dependent of an adult child of an enrollee. 18
Sec. 75. 1. A health maintenance organization that offers 19
or issues a health care plan shall include in the plan coverage for: 20
(a) Screening for anxiety for enrollees who are at least 8 but 21
not more than 18 years of age; 22
(b) Assessments relating to height, weight, body mass index 23
and medical history for enrollees who are less than 18 years of 24
age; 25
(c) Comprehensive and intensive behavioral interventions for 26
enrollees who are at least 12 but not more than 18 years of age 27
and have a body mass index in the 95th percentile or greater for 28
persons of the same age and sex; 29
(d) The application of fluoride varnish to the primary teeth for 30
enrollees who are less than 5 years of age; 31
(e) Oral fluoride supplements for enrollees who are at least 6 32
months of age but less than 5 years of age and whose supply of 33
water is deficient in fluoride; 34
(f) Counseling and education pertaining to the minimization of 35
exposure to ultraviolet radiation for enrollees who are less than 25 36
years of age and the parents or legal guardians of enrollees who 37
are less than 18 years of age for the purpose of minimizing the 38
risk of skin cancer in those persons; 39
(g) Brief behavioral counseling and interventions to prevent 40
tobacco use for enrollees who are less than 18 years of age; and 41
(h) At least one screening for the detection of amblyopia or the 42
risk factors of amblyopia for enrollees who are at least 3 but not 43
more than 5 years of age. 44
– 79 –
- *AB522_R1*
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) Require an enrollee to pay a higher deductible, any 8
copayment or coinsurance or require a longer waiting period or 9
other condition to obtain any benefit provided in the health care 10
plan pursuant to subsection 1; 11
(b) Refuse to issue a health care plan or cancel a health care 12
plan solely because the person applying for or covered by the plan 13
uses or may use any such benefit; 14
(c) Offer or pay any type of material inducement or financial 15
incentive to an enrollee to discourage the enrollee from obtaining 16
any such benefit; 17
(d) Penalize a provider of health care who provides any such 18
benefit to an enrollee, including, without limitation, reducing the 19
reimbursement of the provider of health care; 20
(e) Offer or pay any type of material inducement, bonus or 21
other financial incentive to a provider of health care to deny, 22
reduce, withhold, limit or delay access to any such benefit to an 23
enrollee; or 24
(f) Impose any other restrictions or delays on the access of an 25
enrollee to any such benefit. 26
4. A health care plan subject to the provisions of this chapter 27
that is delivered, issued for delivery or renewed on or after 28
October 1, 2025, has the legal effect of including the coverage 29
required by subsection 1, and any provision of the plan or the 30
renewal which is in conflict with this section is void. 31
5. Except as otherwise provided in this section and federal 32
law, a health maintenance organization may use medical 33
management techniques, including, without limitation, any 34
available clinical evidence, to determine the frequency of or 35
treatment relating to any benefit required by this section or the 36
type of provider of health care to 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 health care plan offered by a 44
health maintenance organization under which the financing and 45
– 80 –
- *AB522_R1*
delivery of medical care, including items and services paid for as 1
medical care, are provided, in whole or in part, through a defined 2
set of providers of health care under contract with the health 3
maintenance organization. The term does not include an 4
arrangement for the financing of premiums. 5
(c) “Provider of health care” has the meaning ascribed to it in 6
NRS 629.031. 7
Sec. 76. 1. A health maintenance organization that offers 8
or issues a health care plan shall include in the plan coverage for: 9
(a) A daily dose of 0.4 to 0.8 milligrams of folic acid for 10
enrollees who are pregnant or are planning on becoming 11
pregnant; 12
(b) A low dose of aspirin for the prevention of preeclampsia 13
for enrollees who are determined to be at a high risk of that 14
condition after 12 weeks of gestation; 15
(c) Prophylactic ocular tubal medication for the prevention of 16
gonococcal ophthalmia in newborns; 17
(d) Screening for asymptomatic bacteriuria for enrollees who 18
are pregnant; 19
(e) Counseling and behavioral interventions relating to the 20
promotion of healthy weight gain and the prevention of excessive 21
weight gain for enrollees who are pregnant; 22
(f) Counseling for enrollees who are pregnant or in the 23
postpartum stage of pregnancy and have an increased risk of 24
perinatal or postpartum depression; 25
(g) Screening for the presence of the rhesus D antigen and 26
antibodies in the blood of an enrollee who is pregnant during the 27
enrollee’s first visit for care relating to the pregnancy; 28
(h) Screening for rhesus D antibodies between 24 and 28 29
weeks of gestation for enrollees who are negative for the rhesus D 30
antigen and have not been exposed to blood that is positive for the 31
rhesus D antigen; 32
(i) Behavioral counseling and intervention for tobacco 33
cessation for enrollees who are pregnant; 34
(j) Screening for type 2 diabetes at such intervals as 35
recommended by the Health Resources and Services 36
Administration on January 1, 2025, for enrollees who are in the 37
postpartum stage of pregnancy and who have a history of 38
gestational diabetes mellitus; 39
(k) Counseling relating to maintaining a healthy weight for 40
women who are at least 40 but not more than 60 years of age and 41
have a body mass index greater than 18.5; and 42
(l) Screening for osteoporosis for women who: 43
(1) Are 65 years of age or older; or 44
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- *AB522_R1*
(2) Are less than 65 years of age and have a risk of 1
fracturing a bone equal to or greater than that of a woman who is 2
65 years of age without any additional risk factors. 3
2. A health maintenance organization must ensure that the 4
benefits required by subsection 1 are made available to an enrollee 5
through a provider of health care who participates in the network 6
plan of the health maintenance organization. 7
3. Except as otherwise provided in subsection 5, a health 8
maintenance organization that offers or issues a health care plan 9
shall not: 10
(a) Require an enrollee 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 care 13
plan pursuant to subsection 1; 14
(b) Refuse to issue a health care plan or cancel a health care 15
plan solely because the person applying for or covered by the plan 16
uses or may use any such benefit; 17
(c) Offer or pay any type of material inducement or financial 18
incentive to an enrollee to discourage the enrollee from obtaining 19
any such benefit; 20
(d) Penalize a provider of health care who provides any such 21
benefit to an enrollee, 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
enrollee; or 27
(f) Impose any other restrictions or delays on the access of an 28
enrollee to any such benefit. 29
4. A health care plan subject to the provisions of this chapter 30
that is delivered, issued for delivery or renewed on or after 31
October 1, 2025, has the legal effect of including the coverage 32
required by subsection 1, and any provision of the plan or the 33
renewal which is in conflict with this section is void. 34
5. Except as otherwise provided in this section and federal 35
law, a health maintenance organization may use medical 36
management techniques, including, without limitation, any 37
available clinical evidence, to determine the frequency of or 38
treatment relating to any benefit required by this section or the 39
type of provider of health care to use for such treatment. 40
6. As used in this section: 41
(a) “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
– 82 –
- *AB522_R1*
use of step therapy, prior authorization or categorizing drugs and 1
devices based on cost, type or method of administration. 2
(b) “Network plan” means a health care plan offered by a 3
health maintenance organization under which the financing and 4
delivery of medical care, including items and services paid for as 5
medical care, are provided, in whole or in part, through a defined 6
set of providers of health care under contract with the health 7
maintenance organization. The term does not include an 8
arrangement for the financing of premiums. 9
(c) “Provider of health care” has the meaning ascribed to it in 10
NRS 629.031. 11
Sec. 77. 1. A health maintenance organization that offers 12
or issues a health care plan shall include in the plan coverage for: 13
(a) Behavioral counseling and interventions to promote 14
physical activity and a healthy diet for enrollees with 15
cardiovascular risk factors; 16
(b) Statin preventive medication for enrollees who are at least 17
40 but not more than 75 years of age and do not have a history of 18
cardiovascular disease, but who have: 19
(1) One or more risk factors for cardiovascular disease; 20
and 21
(2) A calculated risk of at least 10 percent of acquiring 22
cardiovascular disease within the next 10 years; 23
(c) Interventions for exercise to prevent falls for enrollees who 24
are 65 years of age or older and reside in a medical facility or 25
facility for the dependent; 26
(d) Screenings for latent tuberculosis infection in enrollees 27
with an increased risk of contracting tuberculosis; 28
(e) Screening for hypertension; 29
(f) One abdominal aortic screening by ultrasound to detect 30
abdominal aortic aneurysms for men who are at least 65 but not 31
more than 75 years of age and have smoked during their lifetimes; 32
(g) Screening for drug and alcohol misuse for enrollees who 33
are 18 years of age or older; 34
(h) If an enrollee engages in risky or hazardous consumption 35
of alcohol, as determined by the screening described in paragraph 36
(g), behavioral counseling to reduce such behavior; 37
(i) Screening for lung cancer using low-dose computed 38
tomography for enrollees who are at least 50 but not more than 80 39
years of age in accordance with the most recent guidelines 40
published by the American Cancer Society or the 41
recommendations of the United States Preventive Services Task 42
Force in effect on January 1, 2025; 43
– 83 –
- *AB522_R1*
(j) Screening for prediabetes and type 2 diabetes in enrollees 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 enrollees who are 18 years of age or older and 5
have a body mass index of 30 or greater. 6
2. A health maintenance organization must ensure that the 7
benefits required by subsection 1 are made available to an enrollee 8
through a provider of health care who participates in the network 9
plan of the health maintenance organization. 10
3. Except as otherwise provided in subsection 5, a health 11
maintenance organization that offers or issues a health care plan 12
shall not: 13
(a) Require an enrollee 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 enrollee to discourage the enrollee from obtaining 22
any such benefit; 23
(d) Penalize a provider of health care who provides any such 24
benefit to an enrollee, 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
enrollee; or 30
(f) Impose any other restrictions or delays on the access of an 31
enrollee 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 34
October 1, 2025, has the legal effect of including the coverage 35
required by subsection 1, and any provision of the plan or the 36
renewal which is in conflict with this section is void. 37
5. Except as otherwise provided in this section and federal 38
law, a health maintenance organization may use medical 39
management techniques, including, without limitation, any 40
available clinical evidence, to determine the frequency of or 41
treatment relating to any benefit required by this section or the 42
type of provider of health care to use for such treatment. 43
6. As used in this section: 44
– 84 –
- *AB522_R1*
(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) “Network plan” means a health care plan offered by a 13
health maintenance organization under which the financing and 14
delivery of medical care, including items and services paid for as 15
medical care, are provided, in whole or in part, through a defined 16
set of providers of health care under contract with the health 17
maintenance organization. The term does not include an 18
arrangement for the financing of premiums. 19
(f) “Provider of health care” has the meaning ascribed to it in 20
NRS 629.031. 21
Sec. 78. 1. A health maintenance organization that offers 22
or issues a health care plan subject to the provisions of this 23
chapter shall include in the health care plan coverage for 24
maternity care and pediatric care for newborn infants. 25
2. Except as otherwise provided in this subsection, a health 26
care plan issued pursuant to this chapter may not restrict benefits 27
for any length of stay in a hospital in connection with childbirth 28
for a pregnant or postpartum individual or newborn infant 29
covered by the plan to: 30
(a) Less than 48 hours after a normal vaginal delivery; and 31
(b) Less than 96 hours after a cesarean section. 32
If a different length of stay is provided in the guidelines 33
established by the American College of Obstetricians and 34
Gynecologists, or its successor organization, and the American 35
Academy of Pediatrics, or its successor organization, the health 36
care plan may follow such guidelines in lieu of following the 37
length of stay set forth above. The provisions of this subsection do 38
not apply to any health care plan in any case in which the decision 39
to discharge the pregnant or postpartum individual or newborn 40
infant before the expiration of the minimum length of stay set 41
forth in this subsection is made by the attending physician of the 42
pregnant or postpartum individual or newborn infant. 43
3. Nothing in this section requires a pregnant or postpartum 44
individual to: 45
– 85 –
- *AB522_R1*
(a) Deliver the baby in a hospital; or 1
(b) Stay in a hospital for a fixed period following the birth of 2
the child. 3
4. A health care plan 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
if the sole purpose of the denial of coverage or continued coverage 7
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 10
than the minimum protection available pursuant to this section; 11
(c) Penalize, or otherwise reduce or limit, the reimbursement 12
of an attending provider of health care because the attending 13
provider of health care provided care to a pregnant or postpartum 14
individual or newborn infant in accordance with the provisions of 15
this section; 16
(d) Provide incentives of any kind to an attending physician to 17
induce the attending physician to provide care to a pregnant or 18
postpartum individual or newborn infant in a manner that is 19
inconsistent with the provisions of this section; or 20
(e) Except as otherwise provided in subsection 5, restrict 21
benefits for any portion of a hospital stay required pursuant to the 22
provisions of this section in a manner that is less favorable than 23
the benefits provided for any preceding portion of that stay. 24
5. Nothing in this section: 25
(a) Prohibits a health maintenance organization from 26
imposing a deductible, coinsurance or other mechanism for 27
sharing costs relating to benefits for hospital stays in connection 28
with childbirth for a pregnant or postpartum individual or 29
newborn child covered by the plan, except that such coinsurance 30
or other mechanism for sharing costs for any portion of a hospital 31
stay required by this section may not be greater than the 32
coinsurance or other mechanism for any preceding portion of that 33
stay. 34
(b) Prohibits an arrangement for payment between a health 35
maintenance organization and a provider of health care that uses 36
capitation or other financial incentives, if the arrangement is 37
designed to provide services efficiently and consistently in the best 38
interest of the pregnant or postpartum individual and the newborn 39
infant. 40
(c) Prevents a health maintenance organization from 41
negotiating with a provider of health care concerning the level and 42
type of reimbursement to be provided in accordance with this 43
section. 44
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6. 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 this section, and any provision of the plan that 4
conflicts with the provisions of this section is void. 5
Sec. 79. NRS 695C.050 is hereby amended to read as follows: 6
695C.050 1. Except as otherwise provided in this chapter or 7
in specific provisions of this title, the provisions of this title are not 8
applicable to any health maintenance organization granted a 9
certificate of authority under this chapter. This provision does not 10
apply to an insurer licensed and regulated pursuant to this title 11
except with respect to its activities as a health maintenance 12
organization authorized and regulated pursuant to this chapter. 13
2. Solicitation of enrollees by a health maintenance 14
organization granted a certificate of authority, or its representatives, 15
must not be construed to violate any provision of law relating to 16
solicitation or advertising by practitioners of a healing art. 17
3. Any health maintenance organization authorized under this 18
chapter shall not be deemed to be practicing medicine and is exempt 19
from the provisions of chapter 630 of NRS. 20
4. The provisions of NRS 695C.110, 695C.125, 695C.1691, 21
695C.1693, 695C.170, 695C.1703, 695C.1705, 695C.1709 to 22
695C.173, inclusive, 695C.1733, 695C.17335, 695C.1734, 23
695C.1751, 695C.1755, 695C.1759, 695C.176 to 695C.200, 24
inclusive, and 695C.265 do not apply to a health maintenance 25
organization that provides health care services through managed 26
care to recipients of Medicaid under the State Plan for Medicaid or 27
insurance pursuant to the Children’s Health Insurance Program 28
pursuant to a contract with the Division of Health Care Financing 29
and Policy of the Department of Health and Human Services. This 30
subsection does not exempt a health maintenance organization from 31
any provision of this chapter for services provided pursuant to any 32
other contract. 33
5. The provisions of NRS 695C.16932 to 695C.1699, 34
inclusive, 695C.1701, 695C.1708, 695C.1728, 695C.1731, 35
695C.17333, 695C.17345, 695C.17347, 695C.1736 to 695C.1745, 36
inclusive, 695C.1757 and 695C.204 and sections 74 to 78, 37
inclusive, of this act apply to a health maintenance organization that 38
provides health care services through managed care to recipients of 39
Medicaid under the State Plan for Medicaid. 40
6. The provisions of NRS 695C.17095 do not apply to a health 41
maintenance organization that provides health care services to 42
members of the Public Employees’ Benefits Program. This 43
subsection does not exempt a health maintenance organization from 44
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any provision of this chapter for services provided pursuant to any 1
other contract. 2
7. The provisions of NRS 695C.1735 do not apply to a health 3
maintenance organization that provides health care services to: 4
(a) The officers and employees, and the dependents of officers 5
and employees, of the governing body of any county, school district, 6
municipal corporation, political subdivision, public corporation or 7
other local governmental agency of this State; or 8
(b) Members of the Public Employees’ Benefits Program. 9
This subsection does not exempt a health maintenance 10
organization from any provision of this chapter for services 11
provided pursuant to any other contract. 12
Sec. 80. NRS 695C.1698 is hereby amended to read as 13
follows: 14
695C.1698 1. A health maintenance organization that offers 15
or issues a health care plan shall include in the plan coverage for: 16
(a) Counseling, support and supplies for breastfeeding, 17
including breastfeeding equipment, counseling and education during 18
the antenatal, perinatal and postpartum period for not more than 1 19
year; 20
(b) Screening and counseling for interpersonal and domestic 21
violence for women at least annually with initial intervention 22
services consisting of education, strategies to reduce harm, 23
supportive services or a referral for any other appropriate services; 24
(c) Behavioral counseling concerning sexually transmitted 25
diseases from a provider of health care for sexually active [women] 26
enrollees who are at increased risk for such diseases; 27
(d) Such prenatal screenings and tests as recommended by the 28
American College of Obstetricians and Gynecologists or its 29
successor organization; 30
(e) Screening for blood pressure abnormalities and diabetes, 31
including gestational diabetes, after at least 24 weeks of gestation or 32
as ordered by a provider of health care; 33
(f) Screening for cervical cancer at such intervals as are 34
recommended by the American College of Obstetricians and 35
Gynecologists or its successor organization; 36
(g) Screening for depression [;] for enrollees who are 12 years 37
of age or older; 38
(h) Screening for anxiety disorders; 39
(i) Screening and counseling for the human immunodeficiency 40
virus consisting of a risk assessment, annual education relating to 41
prevention and at least one screening for the virus during the 42
lifetime of the enrollee or as ordered by a provider of health care; 43
[(i) Smoking] 44
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(j) Tobacco cessation programs , including, without limitation, 1
pharmacotherapy approved by the United States Food and Drug 2
Administration, for an enrollee who is 18 years of age or older ; 3
[not more than two cessation attempts per year and four counseling 4
sessions per year; 5
(j)] (k) All vaccinations recommended by the Advisory 6
Committee on Immunization Practices of the Centers for Disease 7
Control and Prevention of the United States Department of Health 8
and Human Services or its successor organization; and 9
[(k)] (l) Such well-woman preventative visits as recommended 10
by the Health Resources and Services Administration [,] on 11
January 1, 2025, which must include at least one such visit per year 12
beginning at 14 years of age. 13
2. A health maintenance organization must ensure that the 14
benefits required by subsection 1 are made available to an enrollee 15
through a provider of health care who participates in the network 16
plan of the health maintenance organization. 17
3. Except as otherwise provided in subsection 5, a health 18
maintenance organization that offers or issues a health care plan 19
shall not: 20
(a) Require an enrollee 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 care plan 23
pursuant to subsection 1; 24
(b) Refuse to issue a health care plan or cancel a health care plan 25
solely because the person applying for or covered by the plan uses 26
or may use any such benefit; 27
(c) Offer or pay any type of material inducement or financial 28
incentive to an enrollee to discourage the enrollee from obtaining 29
any such benefit; 30
(d) Penalize a provider of health care who provides any such 31
benefit to an enrollee, 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 other 34
financial incentive to a provider of health care to deny, reduce, 35
withhold, limit or delay access to any such benefit to an enrollee; or 36
(f) Impose any other restrictions or delays on the access of an 37
enrollee 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 [January] 40
October 1, [2018,] 2025, has the legal effect of including the 41
coverage required by subsection 1, and any provision of the plan or 42
the renewal which is in conflict with this section is void. 43
5. Except as otherwise provided in this section and federal law, 44
a health maintenance organization may use medical management 45
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techniques, including, without limitation, any available clinical 1
evidence, to determine the frequency of or treatment relating to any 2
benefit required by this section or the type of provider of health care 3
to use for such treatment. 4
6. 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
Sec. 81. NRS 695C.1712 is hereby amended to read as 19
follows: 20
695C.1712 1. A health maintenance organization that offers 21
or issues a health care plan [that includes coverage for maternity 22
care] shall not deny, limit or seek reimbursement for maternity care 23
because the enrollee is acting as a gestational carrier. 24
2. If an enrollee acts as a gestational carrier, the child shall be 25
deemed to be a child of the intended parent, as defined in NRS 26
126.590, for purposes related to the health care plan. 27
3. As used in this section, “gestational carrier” has the meaning 28
ascribed to it in NRS 126.580. 29
Sec. 82. NRS 695C.1731 is hereby amended to read as 30
follows: 31
695C.1731 1. A health care plan issued by a health 32
maintenance organization [that provides coverage for the treatment 33
of colorectal cancer] must provide coverage for colorectal cancer 34
screening in accordance with: 35
(a) The guidelines concerning colorectal cancer screening which 36
are published by the American Cancer Society; or 37
(b) Other guidelines or reports concerning colorectal cancer 38
screening which are published by nationally recognized professional 39
organizations and which include current or prevailing supporting 40
scientific data. 41
2. A health maintenance organization must ensure that the 42
benefits required by subsection 1 are made available to an enrollee 43
through a provider of health care who participates in the network 44
plan of the health maintenance organization. 45
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3. A health maintenance organization that offers or issues a 1
health care plan shall not: 2
(a) Require an enrollee 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 enrollee to discourage the enrollee from obtaining 11
any such benefit; 12
(d) Penalize a provider of health care who provides any such 13
benefit to an enrollee, 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
enrollee; or 19
(f) Impose any other restrictions or delays on the access of an 20
enrollee to any such benefit. 21
4. An evidence of coverage for a health care plan subject to the 22
provisions of this chapter that is delivered, issued for delivery or 23
renewed on or after October 1, [2003,] 2025, has the legal effect of 24
including the coverage required by this section, and any provision of 25
the evidence of coverage that conflicts with the provisions of this 26
section is void. 27
5. As used in this section: 28
(a) “Network plan” means a health care plan offered by a 29
health maintenance organization under which the financing and 30
delivery of medical care, including items and services paid for as 31
medical care, are provided, in whole or in part, through a defined 32
set of providers of health care under contract with the health 33
maintenance organization. The term does not include an 34
arrangement for the financing of premiums. 35
(b) “Provider of health care” has the meaning ascribed to it in 36
NRS 629.031. 37
Sec. 83. NRS 695C.17347 is hereby amended to read as 38
follows: 39
695C.17347 1. A health maintenance organization that issues 40
a health care plan shall provide coverage for screening, genetic 41
counseling and testing for harmful mutations in the BRCA gene for 42
women under circumstances where such screening, genetic 43
counseling or testing, as applicable, is required by NRS 457.301. 44
– 91 –
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2. A health maintenance organization shall 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. A health maintenance organization that issues a health 5
care plan shall not: 6
(a) Require an enrollee to pay a higher deductible, any 7
copayment or coinsurance or require a longer waiting period or 8
other condition to obtain any benefit provided in the health care 9
plan pursuant to subsection 1; 10
(b) Refuse to issue a health care plan or cancel a health care 11
plan solely because the person applying for or covered by the plan 12
uses or may use any such benefit; 13
(c) Offer or pay any type of material inducement or financial 14
incentive to an enrollee to discourage the enrollee from obtaining 15
any such benefit; 16
(d) Penalize a provider of health care who provides any such 17
benefit to an enrollee, 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
enrollee; or 23
(f) Impose any other restrictions or delays on the access of an 24
enrollee to any such benefit. 25
4. A health care plan subject to the provisions of this chapter 26
that is delivered, issued for delivery or renewed on or after [January] 27
October 1, [2022,] 2025, has the legal effect of including the 28
coverage required by subsection 1, and any provision of the plan 29
that conflicts with the provisions of this section is void. 30
[4.] 5. As used in this section: 31
(a) “Network plan” means a health care plan offered by a health 32
maintenance organization under which the financing and delivery of 33
medical care, including items and services paid for as medical care, 34
are provided, in whole or in part, through a defined set of providers 35
under contract with the health maintenance organization. The term 36
does not include an arrangement for the financing of premiums. 37
(b) “Provider of health care” has the meaning ascribed to it in 38
NRS 629.031. 39
Sec. 84. (Deleted by amendment.) 40
Sec. 85. NRS 695C.1736 is hereby amended to read as 41
follows: 42
695C.1736 1. A health maintenance organization that offers 43
or issues a health care plan shall include in the plan: 44
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(a) Coverage of testing for and the treatment and prevention of 1
sexually transmitted diseases, including, without limitation, 2
Chlamydia trachomatis, gonorrhea, syphilis, human 3
immunodeficiency virus and hepatitis B and C, for all enrollees, 4
regardless of age. Such coverage must include, without limitation, 5
the coverage required by NRS 695C.1737 and 695C.1743. 6
(b) Unrestricted coverage of condoms for enrollees who are 13 7
years of age or older. 8
2. A health maintenance organization that offers or issues a 9
health care plan shall not: 10
(a) Require an enrollee 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 care 13
plan pursuant to subsection 1; 14
(b) Refuse to issue a health care plan or cancel a health care 15
plan solely because the person applying for or covered by the plan 16
uses or may use any such benefit; 17
(c) Offer or pay any type of material inducement or financial 18
incentive to an enrollee to discourage the enrollee from obtaining 19
any such benefit; 20
(d) Penalize a provider of health care who provides any such 21
benefit to an enrollee, 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
enrollee; or 27
(f) Impose any other restrictions or delays on the access of an 28
enrollee to any such benefit. 29
3. A health care plan subject to the provisions of this chapter 30
that is delivered, issued for delivery or renewed on or after [January] 31
October 1, [2024,] 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. As used in this section, “provider of health care” has the 35
meaning ascribed to it in NRS 629.031. 36
Sec. 86. NRS 695C.1737 is hereby amended to read as 37
follows: 38
695C.1737 1. A health maintenance organization that issues 39
a health care plan shall provide coverage for the examination of a 40
person who is pregnant for the discovery of: 41
(a) Chlamydia trachomatis, gonorrhea, hepatitis B and hepatitis 42
C in accordance with NRS 442.013. 43
(b) Syphilis in accordance with NRS 442.010. 44
(c) Human immunodeficiency virus. 45
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2. The coverage required by this section must be provided: 1
(a) Regardless of whether the benefits are provided to the 2
enrollee by a provider of health care, facility or medical laboratory 3
that participates in the network plan of the health maintenance 4
organization; and 5
(b) Without prior authorization. 6
3. A health maintenance organization that issues a health 7
care plan shall not: 8
(a) Require an enrollee 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 health care 11
plan pursuant to subsection 1; 12
(b) Refuse to issue a health care plan or cancel a health care 13
plan solely because the person applying for or covered by the plan 14
uses 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 such benefit; 18
(d) Penalize a provider of health care who provides any such 19
benefit to an enrollee, including, without limitation, reducing the 20
reimbursement of the provider of health care; 21
(e) Offer or pay any type of material inducement, bonus or 22
other financial incentive to a provider of health care to deny, 23
reduce, withhold, limit or delay access to any such benefit to an 24
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
that is delivered, issued for delivery or renewed on or after [July] 29
October 1, [2021,] 2025, has the legal effect of including the 30
coverage required by subsection 1, and any provision of the plan 31
that conflicts with the provisions of this section is void. 32
[4.] 5. As used in this section: 33
(a) “Medical laboratory” has the meaning ascribed to it in 34
NRS 652.060. 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. 87. NRS 695C.204 is hereby amended to read as follows: 1
695C.204 1. A health maintenance organization that issues a 2
health care plan shall not discriminate against any person with 3
respect to participation or coverage under the plan on the basis of an 4
actual or perceived [gender identity or expression.] protected 5
characteristic. 6
2. Prohibited discrimination includes, without limitation: 7
[1.] (a) Denying, cancelling, limiting or refusing to issue or 8
renew a health care plan on the basis of [the] an actual or perceived 9
[gender identity or expression] protected characteristic of a person 10
or a family member of the person; 11
[2.] (b) Imposing a payment or premium that is based on [the] 12
an actual or perceived [gender identity or expression] protected 13
characteristic of an enrollee or a family member of the enrollee; 14
[3.] (c) Designating [the] an actual or perceived [gender 15
identity or expression] protected characteristic of a person or a 16
family member of the person as grounds to deny, cancel or limit 17
participation or coverage; and 18
[4.] (d) Denying, cancelling or limiting participation or 19
coverage on the basis of an actual or perceived [gender identity or 20
expression,] protected characteristic, including, without limitation, 21
by limiting or denying coverage for health care services that are: 22
[(a)] (1) Related to gender transition, provided that there is 23
coverage under the plan for the services when the services are not 24
related to gender transition; or 25
[(b)] (2) Ordinarily or exclusively available to persons of any 26
sex. 27
3. As used in this section, “protected characteristic” means: 28
(a) Race, color, national origin, age, physical or mental 29
disability, sexual orientation or gender identity or expression; or 30
(b) Sex, including, without limitation, sex characteristics, 31
intersex traits and pregnancy or related conditions. 32
Sec. 88. NRS 695C.330 is hereby amended to read as follows: 33
695C.330 1. The Commissioner may suspend or revoke any 34
certificate of authority issued to a health maintenance organization 35
pursuant to the provisions of this chapter if the Commissioner finds 36
that any of the following conditions exist: 37
(a) The health maintenance organization is operating 38
significantly in contravention of its basic organizational document, 39
its health care plan or in a manner contrary to that described in and 40
reasonably inferred from any other information submitted pursuant 41
to NRS 695C.060, 695C.070 and 695C.140, unless any amendments 42
to those submissions have been filed with and approved by the 43
Commissioner; 44
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(b) The health maintenance organization issues evidence of 1
coverage or uses a schedule of charges for health care services 2
which do not comply with the requirements of NRS 695C.1691 to 3
695C.200, inclusive, and sections 74 to 78, inclusive, of this act, 4
695C.204 or 695C.207; 5
(c) The health care plan does not furnish comprehensive health 6
care services as provided for in NRS 695C.060; 7
(d) The Commissioner certifies that the health maintenance 8
organization: 9
(1) Does not meet the requirements of subsection 1 of NRS 10
695C.080; or 11
(2) Is unable to fulfill its obligations to furnish health care 12
services as required under its health care plan; 13
(e) The health maintenance organization is no longer financially 14
responsible and may reasonably be expected to be unable to meet its 15
obligations to enrollees or prospective enrollees; 16
(f) The health maintenance organization has failed to put into 17
effect a mechanism affording the enrollees an opportunity to 18
participate in matters relating to the content of programs pursuant to 19
NRS 695C.110; 20
(g) The health maintenance organization has failed to put into 21
effect the system required by NRS 695C.260 for: 22
(1) Resolving complaints in a manner reasonably to dispose 23
of valid complaints; and 24
(2) Conducting external reviews of adverse determinations 25
that comply with the provisions of NRS 695G.241 to 695G.310, 26
inclusive; 27
(h) The health maintenance organization or any person on its 28
behalf has advertised or merchandised its services in an untrue, 29
misrepresentative, misleading, deceptive or unfair manner; 30
(i) The continued operation of the health maintenance 31
organization would be hazardous to its enrollees or creditors or to 32
the general public; 33
(j) The health maintenance organization fails to provide the 34
coverage required by NRS 695C.1691; or 35
(k) The health maintenance organization has otherwise failed to 36
comply substantially with the provisions of this chapter. 37
2. A certificate of authority must be suspended or revoked only 38
after compliance with the requirements of NRS 695C.340. 39
3. If the certificate of authority of a health maintenance 40
organization is suspended, the health maintenance organization shall 41
not, during the period of that suspension, enroll any additional 42
groups or new individual contracts, unless those groups or persons 43
were contracted for before the date of suspension. 44
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4. If the certificate of authority of a health maintenance 1
organization is revoked, the organization shall proceed, immediately 2
following the effective date of the order of revocation, to wind up its 3
affairs and shall conduct no further business except as may be 4
essential to the orderly conclusion of the affairs of the organization. 5
It shall engage in no further advertising or solicitation of any kind. 6
The Commissioner may, by written order, permit such further 7
operation of the organization as the Commissioner may find to be in 8
the best interest of enrollees to the end that enrollees are afforded 9
the greatest practical opportunity to obtain continuing coverage for 10
health care. 11
Sec. 89. Chapter 695G of NRS is hereby amended by adding 12
thereto the provisions set forth as sections 90 to 94, inclusive, of this 13
act. 14
Sec. 90. 1. A managed care organization that offers or 15
issues a health care plan which provides coverage for dependent 16
children shall continue to make such coverage available for an 17
adult child of an insured until such child reaches 26 years of age. 18
2. Nothing in this section shall be construed as requiring a 19
managed care organization to make coverage available for a 20
dependent of an adult child of an insured. 21
Sec. 91. 1. A managed care organization that offers or 22
issues a health care plan shall include in the plan coverage for: 23
(a) Screening for anxiety for insureds who are at least 8 but 24
not more than 18 years of age; 25
(b) Assessments relating to height, weight, body mass index 26
and medical history for insureds who are less than 18 years of 27
age; 28
(c) Comprehensive and intensive behavioral interventions for 29
insureds who are at least 12 but not more than 18 years of age and 30
have a body mass index in the 95th percentile or greater for 31
persons of the same age and sex; 32
(d) The application of fluoride varnish to the primary teeth for 33
insureds who are less than 5 years of age; 34
(e) Oral fluoride supplements for insureds who are at least 6 35
months of age but less than 5 years of age and whose supply of 36
water is deficient in fluoride; 37
(f) Counseling and education pertaining to the minimization of 38
exposure to ultraviolet radiation for insureds who are less than 25 39
years of age and the parents or legal guardians of insureds who 40
are less than 18 years of age for the purpose of minimizing the 41
risk of skin cancer in those persons; 42
(g) Brief behavioral counseling and interventions to prevent 43
tobacco use for insureds who are less than 18 years of age; and 44
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(h) At least one screening for the detection of amblyopia or the 1
risk factors of amblyopia for insureds who are at least 3 but not 2
more than 5 years of age. 3
2. A managed care organization must ensure that the benefits 4
required by subsection 1 are made available to an insured through 5
a provider of health care who participates in the network plan of 6
the managed care organization. 7
3. Except as otherwise provided in subsection 5, a managed 8
care organization that offers or issues a health care plan shall not: 9
(a) Require an insured to pay a higher deductible, any 10
copayment or coinsurance or require a longer waiting period or 11
other condition to obtain any benefit provided in the health care 12
plan pursuant to subsection 1; 13
(b) Refuse to issue a health care plan or cancel a health care 14
plan solely because the person applying for or covered by the plan 15
uses or may use any 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 health care plan subject to the provisions of this chapter 29
that is delivered, issued for delivery or renewed on or after 30
October 1, 2025, has the legal effect of including the coverage 31
required by subsection 1, and any provision of the plan or the 32
renewal which is in conflict with this section is void. 33
5. Except as otherwise provided in this section and federal 34
law, a managed care organization may use medical management 35
techniques, including, without limitation, any available clinical 36
evidence, to determine the frequency of or treatment relating to 37
any benefit required by this section or the type of provider of 38
health care to use for such treatment. 39
6. As used in this section: 40
(a) “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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(b) “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
(c) “Provider of health care” has the meaning ascribed to it in 8
NRS 629.031. 9
Sec. 92. 1. A managed care organization that offers or 10
issues a health care plan shall include in the plan coverage for: 11
(a) A daily dose of 0.4 to 0.8 milligrams of folic acid for 12
insureds who are pregnant or are planning on becoming 13
pregnant; 14
(b) A low dose of aspirin for the prevention of preeclampsia 15
for insureds who are determined to be at a high risk of that 16
condition after 12 weeks of gestation; 17
(c) Prophylactic ocular tubal medication for the prevention of 18
gonococcal ophthalmia in newborns; 19
(d) Screening for asymptomatic bacteriuria for insureds who 20
are pregnant; 21
(e) Counseling and behavioral interventions relating to the 22
promotion of healthy weight gain and the prevention of excessive 23
weight gain for insureds who are pregnant; 24
(f) Counseling for insureds who are pregnant or in the 25
postpartum stage of pregnancy and have an increased risk of 26
perinatal or postpartum depression; 27
(g) Screening for the presence of the rhesus D antigen and 28
antibodies in the blood of an insured who is pregnant during the 29
insured’s first visit for care relating to the pregnancy; 30
(h) Screening for rhesus D antibodies between 24 and 28 31
weeks of gestation for insureds who are negative for the rhesus D 32
antigen and have not been exposed to blood that is positive for the 33
rhesus D antigen; 34
(i) Behavioral counseling and intervention for tobacco 35
cessation for insureds who are pregnant; 36
(j) Screening for type 2 diabetes at such intervals as 37
recommended by the Health Resources a nd Services 38
Administration on January 1, 2025, for insureds who are in the 39
postpartum stage of pregnancy and who have a history of 40
gestational diabetes mellitus; 41
(k) Counseling relating to maintaining a healthy weight for 42
women who are at least 40 but not more than 60 years of age and 43
have a body mass index greater than 18.5; and 44
(l) Screening for osteoporosis for women who: 45
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(1) Are 65 years of age or older; or 1
(2) Are less than 65 years of age and have a risk of 2
fracturing a bone equal to or greater than that of a woman who is 3
65 years of age without any additional risk factors. 4
2. A managed care organization must ensure that the benefits 5
required by subsection 1 are made available to an insured through 6
a provider of health care who participates in the network plan of 7
the managed care organization. 8
3. Except as otherwise provided in subsection 5, a managed 9
care organization that offers or issues a health care 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 care 13
plan pursuant to subsection 1; 14
(b) Refuse to issue a health care plan or cancel a health care 15
plan solely because the person applying for or covered by the plan 16
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 care plan subject to the provisions of this chapter 30
that is delivered, issued for delivery or renewed on or after 31
October 1, 2025, has the legal effect of including the coverage 32
required by subsection 1, and any provision of the plan or the 33
renewal which is in conflict with this section is void. 34
5. Except as otherwise provided in this section and federal 35
law, a managed care organization may use medical management 36
techniques, including, without limitation, any available clinical 37
evidence, to determine the frequency of or treatment relating to 38
any benefit required by this section or the type of provider of 39
health care to use for such treatment. 40
6. As used in this section: 41
(a) “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
(b) “Network plan” means a health care plan offered by a 3
managed care organization under which the financing and 4
delivery of medical care, including items and services paid for as 5
medical care, are provided, in whole or in part, through a defined 6
set of providers of health care under contract with the managed 7
care organization. The term does not include an arrangement for 8
the financing of premiums. 9
(c) “Provider of health care” has the meaning ascribed to it in 10
NRS 629.031. 11
Sec. 93. 1. A managed care organization that offers or 12
issues a health care plan shall include in the plan coverage for: 13
(a) Behavioral counseling and interventions to promote 14
physical activity and a healthy diet for insureds with 15
cardiovascular risk factors; 16
(b) Statin preventive medication for insureds who are at least 17
40 but not more than 75 years of age and do not have a history of 18
cardiovascular disease, but who have: 19
(1) One or more risk factors for cardiovascular disease; 20
and 21
(2) A calculated risk of at least 10 percent of acquiring 22
cardiovascular disease within the next 10 years; 23
(c) Interventions for exercise to prevent falls for insureds who 24
are 65 years of age or older and reside in a medical facility or 25
facility for the dependent; 26
(d) Screenings for latent tuberculosis infection in insureds 27
with an increased risk of contracting tuberculosis; 28
(e) Screening for hypertension; 29
(f) One abdominal aortic screening by ultrasound to detect 30
abdominal aortic aneurysms for men who are at least 65 but not 31
more than 75 years of age and have smoked during their lifetimes; 32
(g) Screening for drug and alcohol misuse for insureds who 33
are 18 years of age or older; 34
(h) If an insured engages in risky or hazardous consumption 35
of alcohol, as determined by the screening described in paragraph 36
(g), behavioral counseling to reduce such behavior; 37
(i) Screening for lung cancer using low-dose computed 38
tomography for insureds who are at least 50 but not more than 80 39
years of age in accordance with the most recent guidelines 40
published by the American Cancer Society or the 41
recommendations of the United States Preventive Services Task 42
Force in effect on January 1, 2025; 43
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(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. 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. Except as otherwise provided in subsection 5, a managed 11
care organization that offers or issues a health 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. A health care plan subject to the provisions of this chapter 32
that is delivered, issued for delivery or renewed on or after 33
October 1, 2025, has the legal effect of including the coverage 34
required by subsection 1, and any provision of the plan or the 35
renewal which is in conflict with this section is void. 36
5. Except as otherwise provided in this section and federal 37
law, a managed care organization may use medical management 38
techniques, including, without limitation, any available clinical 39
evidence, to determine the frequency of or treatment relating to 40
any benefit required by this section or the type of provider of 41
health care to use for such treatment. 42
6. As used in this section: 43
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(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) “Network plan” means a health care plan offered by a 13
managed care organization under which the financing and 14
delivery of medical care, including items and services paid for as 15
medical care, are provided, in whole or in part, through a defined 16
set of providers of health care under contract with the managed 17
care organization. The term does not include an arrangement for 18
the financing of premiums. 19
(f) “Provider of health care” has the meaning ascribed to it in 20
NRS 629.031. 21
Sec. 94. 1. A managed care organization that offers or 22
issues a health care plan subject to the provisions of this chapter 23
shall include in the health care plan coverage for maternity care 24
and pediatric care for newborn infants. 25
2. Except as otherwise provided in this subsection, a health 26
care plan issued pursuant to this chapter may not restrict benefits 27
for any length of stay in a hospital in connection with childbirth 28
for a pregnant or postpartum individual or newborn infant 29
covered by the plan to: 30
(a) Less than 48 hours after a normal vaginal delivery; and 31
(b) Less than 96 hours after a cesarean section. 32
If a different length of stay is provided in the guidelines 33
established by the American College of Obstetricians and 34
Gynecologists, or its successor organization, and the American 35
Academy of Pediatrics, or its successor organization, the health 36
care plan may follow such guidelines in lieu of following the 37
length of stay set forth above. The provisions of this subsection do 38
not apply to any health care plan in any case in which the decision 39
to discharge the pregnant or postpartum individual or newborn 40
infant before the expiration of the minimum length of stay set 41
forth in this subsection is made by the attending physician of the 42
pregnant or postpartum individual or newborn infant. 43
3. Nothing in this section requires a pregnant or postpartum 44
individual to: 45
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(a) Deliver the baby in a hospital; or 1
(b) Stay in a hospital for a fixed period following the birth of 2
the child. 3
4. A health care plan 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
if the sole purpose of the denial of coverage or continued coverage 7
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 10
than the minimum protection available pursuant to this section; 11
(c) Penalize, or otherwise reduce or limit, the reimbursement 12
of an attending provider of health care because the attending 13
provider of health care provided care to a pregnant or postpartum 14
individual or newborn infant in accordance with the provisions of 15
this section; 16
(d) Provide incentives of any kind to an attending physician to 17
induce the attending physician to provide care to a pregnant or 18
postpartum individual or newborn infant in a manner that is 19
inconsistent with the provisions of this section; or 20
(e) Except as otherwise provided in subsection 5, restrict 21
benefits for any portion of a hospital stay required pursuant to the 22
provisions of this section in a manner that is less favorable than 23
the benefits provided for any preceding portion of that stay. 24
5. Nothing in this section: 25
(a) Prohibits a managed care organization from imposing a 26
deductible, coinsurance or other mechanism for sharing costs 27
relating to benefits for hospital stays in connection with childbirth 28
for a pregnant or postpartum individual or newborn child covered 29
by the plan, except that such coinsurance or other mechanism for 30
sharing costs for any portion of a hospital stay required by this 31
section may not be greater than the coinsurance or other 32
mechanism for any preceding portion of that stay. 33
(b) Prohibits an arrangement for payment between a managed 34
care organization and a provider of health care that uses 35
capitation or other financial incentives, if the arrangement is 36
designed to provide services efficiently and consistently in the best 37
interest of the pregnant or postpartum individual and the newborn 38
infant. 39
(c) Prevents a managed care organization from negotiating 40
with a provider of health care concerning the level and type of 41
reimbursement to be provided in accordance with this section. 42
6. A health care plan subject to the provisions of this chapter 43
that is delivered, issued for delivery or renewed on or after 44
October 1, 2025, has the legal effect of including the coverage 45
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required by this section, and any provision of the plan that 1
conflicts with the provisions of this section is void. 2
Sec. 95. NRS 695G.168 is hereby amended to read as follows: 3
695G.168 1. A health care plan issued by a managed care 4
organization [that provides coverage for the treatment of colorectal 5
cancer] must provide coverage for colorectal cancer screening in 6
accordance with: 7
(a) The guidelines concerning colorectal cancer screening which 8
are published by the American Cancer Society; or 9
(b) Other guidelines or reports concerning colorectal cancer 10
screening which are published by nationally recognized professional 11
organizations and which include current or prevailing supporting 12
scientific data. 13
2. A managed care organization must ensure that the benefits 14
required by subsection 1 are made available to an insured through 15
a provider of health care who participates in the network plan of 16
the managed care organization. 17
3. A managed care organization that offers or issues a health 18
care 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. An evidence of coverage for a health care plan subject to the 39
provisions of this chapter that is delivered, issued for delivery or 40
renewed on or after October 1, [2003,] 2025, has the legal effect of 41
including the coverage required by this section, and any provision of 42
the evidence of coverage that conflicts with the provisions of this 43
section is void. 44
5. As used in this section: 45
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(a) “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
(b) “Provider of health care” has the meaning ascribed to it in 8
NRS 629.031. 9
Sec. 96. NRS 695G.1707 is hereby amended to read as 10
follows: 11
695G.1707 1. A managed care organization that offers or 12
issues a health care plan shall include in the plan: 13
(a) Coverage of testing for, treatment of and prevention of 14
sexually transmitted diseases, including, without limitation, 15
Chlamydia trachomatis, gonorrhea, syphilis, human 16
immunodeficiency virus and hepatitis B and C, for all insureds, 17
regardless of age. Such coverage must include, without limitation, 18
the coverage required by NRS 695G.1705 and 695G.1714. 19
(b) Unrestricted coverage of condoms for insureds who are 13 20
years of age or older. 21
2. A managed care organization that offers or issues a health 22
care plan 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 health care 26
plan pursuant to subsection 1; 27
(b) Refuse to issue a health care plan or cancel a health care 28
plan solely because the person applying for or covered by the plan 29
uses or may use any such benefit; 30
(c) Offer or pay any type of material inducement or financial 31
incentive to an insured to discourage the insured from obtaining 32
any such benefit; 33
(d) Penalize a provider of health care who provides any such 34
benefit to an insured, including, without limitation, reducing the 35
reimbursement of the provider of health care; 36
(e) Offer or pay any type of material inducement, bonus or 37
other financial incentive to a provider of health care to deny, 38
reduce, withhold, limit or delay access to any such benefit to an 39
insured; or 40
(f) Impose any other restrictions or delays on the access of an 41
insured to any such benefit. 42
3. A health care plan subject to the provisions of this chapter 43
that is delivered, issued for delivery or renewed on or after [January] 44
October 1, [2024,] 2025, has the legal effect of including the 45
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coverage required by subsection 1, and any provision of the plan 1
that conflicts with the provisions of this section is void. 2
4. As used in this section, “provider of health care” has the 3
meaning ascribed to it in NRS 629.031. 4
Sec. 97. NRS 695G.1712 is hereby amended to read as 5
follows: 6
695G.1712 1. A managed care organization that issues a 7
health care plan shall provide coverage for screening, genetic 8
counseling and testing for harmful mutations in the BRCA gene for 9
women under circumstances where such screening, genetic 10
counseling or testing, as applicable, is required by NRS 457.301. 11
2. A managed care organization shall ensure that the benefits 12
required by subsection 1 are made available to an insured through a 13
provider of health care who participates in the network plan of the 14
managed care organization. 15
3. A managed care organization that issues a health care 16
plan shall not: 17
(a) Require an insured to pay a higher deductible, any 18
copayment or coinsurance or require a longer waiting period or 19
other condition to obtain any benefit provided in the health care 20
plan pursuant to subsection 1; 21
(b) Refuse to issue a health care plan or cancel a health care 22
plan solely because the person applying for or covered by the plan 23
uses or may use any such benefit; 24
(c) Offer or pay any type of material inducement or financial 25
incentive to an insured to discourage the insured from obtaining 26
any such benefit; 27
(d) Penalize a provider of health care who provides any such 28
benefit to an insured, including, without limitation, reducing the 29
reimbursement of the provider of health care; 30
(e) Offer or pay any type of material inducement, bonus or 31
other financial incentive to a provider of health care to deny, 32
reduce, withhold, limit or delay access to any such benefit to an 33
insured; or 34
(f) Impose any other restrictions or delays on the access of an 35
insured to any such benefit. 36
4. A health care plan subject to the provisions of this chapter 37
that is delivered, issued for delivery or renewed on or after [January] 38
October 1, [2022,] 2025, has the legal effect of including the 39
coverage required by subsection 1, and any provision of the plan 40
that conflicts with the provisions of this section is void. 41
[4.] 5. As used in this section: 42
(a) “Network plan” means a health care plan offered by a 43
managed care organization 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 managed care organization. The 2
term does not include an arrangement for the financing of 3
premiums. 4
(b) “Provider of health care” has the meaning ascribed to it in 5
NRS 629.031. 6
Sec. 98. (Deleted by amendment.) 7
Sec. 99. NRS 695G.1714 is hereby amended to read as 8
follows: 9
695G.1714 1. A managed care organization that issues a 10
health care plan shall provide coverage for the examination of a 11
person who is pregnant for the discovery of: 12
(a) Chlamydia trachomatis, gonorrhea, hepatitis B and hepatitis 13
C in accordance with NRS 442.013. 14
(b) Syphilis in accordance with NRS 442.010. 15
(c) Human immunodeficiency virus. 16
2. The coverage required by this section must be provided: 17
(a) Regardless of whether the benefits are provided to the 18
insured by a provider of health care, facility or medical laboratory 19
that participates in the network plan of the managed care 20
organization; and 21
(b) Without prior authorization. 22
3. A managed care organization that issues a health care 23
plan shall not: 24
(a) Require an insured to pay a higher deductible, any 25
copayment or coinsurance or require a longer waiting period or 26
other condition to obtain any benefit provided in the health care 27
plan pursuant to subsection 1; 28
(b) Refuse to issue a health care plan or cancel a health care 29
plan solely because the person applying for or covered by the plan 30
uses or may use any 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 33
any 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 38
other financial incentive to a provider of health care to deny, 39
reduce, withhold, limit or delay access to any such benefit to an 40
insured; or 41
(f) Impose any other restrictions or delays on the access of an 42
insured to any such benefit. 43
4. A health care plan subject to the provisions of this chapter 44
that is delivered, issued for delivery or renewed on or after 45
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- *AB522_R1*
[July] October 1, [2021,] 2025, has the legal effect of including the 1
coverage required by subsection 1, and any provision of the plan 2
that conflicts with the provisions of this section is void. 3
[4.] 5. As used in this section: 4
(a) “Medical laboratory” has the meaning ascribed to it in 5
NRS 652.060. 6
(b) “Network plan” means a health care plan offered by a 7
managed care organization under which the financing and delivery 8
of medical care, including items and services paid for as medical 9
care, are provided, in whole or in part, through a defined set of 10
providers under contract with the managed care organization. The 11
term does not include an arrangement for the financing of 12
premiums. 13
(c) “Provider of health care” has the meaning ascribed to it in 14
NRS 629.031. 15
Sec. 100. NRS 695G.1716 is hereby amended to read as 16
follows: 17
695G.1716 1. A managed care organization that offers or 18
issues a health care plan [that includes coverage for maternity care] 19
shall not deny, limit or seek reimbursement for maternity care 20
because the insured is acting as a gestational carrier. 21
2. If an insured acts as a gestational carrier, the child shall be 22
deemed to be a child of the intended parent, as defined in NRS 23
126.590, for purposes related to the health care plan. 24
3. As used in this section, “gestational carrier” has the meaning 25
ascribed to it in NRS 126.580. 26
Sec. 101. NRS 695G.1717 is hereby amended to read as 27
follows: 28
695G.1717 1. A managed care organization that offers or 29
issues a health care plan shall include in the plan coverage for: 30
(a) Counseling, support and supplies for breastfeeding, 31
including breastfeeding equipment, counseling and education during 32
the antenatal, perinatal and postpartum period for not more than 1 33
year; 34
(b) Screening and counseling for interpersonal and domestic 35
violence for women at least annually with initial intervention 36
services consisting of education, strategies to reduce harm, 37
supportive services or a referral for any other appropriate services; 38
(c) Behavioral counseling concerning sexually transmitted 39
diseases from a provider of health care for sexually active [women] 40
insureds who are at increased risk for such diseases; 41
(d) Hormone replacement therapy; 42
(e) Such prenatal screenings and tests as recommended by the 43
American College of Obstetricians and Gynecologists or its 44
successor organization; 45
– 109 –
- *AB522_R1*
(f) Screening for blood pressure abnormalities and diabetes, 1
including gestational diabetes, after at least 24 weeks of gestation or 2
as ordered by a provider of health care; 3
(g) Screening for cervical cancer at such intervals as are 4
recommended by the American College of Obstetricians and 5
Gynecologists or its successor organization; 6
(h) Screening for depression [;] for insureds who are 12 years 7
of age or older; 8
(i) Screening for anxiety disorders; 9
(j) Screening and counseling for the human immunodeficiency 10
virus consisting of a risk assessment, annual education relating to 11
prevention and at least one screening for the virus during the 12
lifetime of the insured or as ordered by a provider of health care; 13
[(j) Smoking] 14
(k) Tobacco cessation programs , including, without limitation, 15
pharmacotherapy approved by the United States Food and Drug 16
Administration, for an insured who is 18 years of age or older ; 17
[consisting of not more than two cessation attempts per year and 18
four counseling sessions per year; 19
(k)] (l) All vaccinations recommended by the Advisory 20
Committee on Immunization Practices of the Centers for Disease 21
Control and Prevention of the United States Department of Health 22
and Human Services or its successor organization; and 23
[(l)] (m) Such well-woman preventative visits as recommended 24
by the Health Resources and Services Administration [,] on 25
January 1, 2025, which must include at least one such visit per year 26
beginning at 14 years of age. 27
2. A managed care organization must ensure that the benefits 28
required by subsection 1 are made available to an insured through a 29
provider of health care who participates in the network plan of the 30
managed care organization. 31
3. Except as otherwise provided in subsection 5, a managed 32
care organization that offers or issues a health care plan 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 health care plan 36
pursuant to subsection 1; 37
(b) Refuse to issue a health care plan or cancel a health care plan 38
solely because the person applying for or covered by the plan uses 39
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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- *AB522_R1*
(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 health care plan subject to the provisions of this chapter 9
that is delivered, issued for delivery or renewed on or after [January] 10
October 1, [2018,] 2025, has the legal effect of including the 11
coverage required by subsection 1, and any provision of the plan or 12
the renewal which is in conflict with this section is void. 13
5. Except as otherwise provided in this section and federal law, 14
a managed care organization may use medical management 15
techniques, including, without limitation, any available clinical 16
evidence, to determine the frequency of or treatment relating to any 17
benefit required by this section or the type of provider of health care 18
to use for such treatment. 19
6. As used in this section: 20
(a) “Medical management technique” means a practice which is 21
used to control the cost or utilization of health care services or 22
prescription drug use. The term includes, without limitation, the use 23
of step therapy, prior authorization or categorizing drugs and 24
devices based on cost, type or method of administration. 25
(b) “Network plan” means a health care plan offered by a 26
managed care organization under which the financing and delivery 27
of medical care, including items and services paid for as medical 28
care, are provided, in whole or in part, through a defined set of 29
providers under contract with the managed care organization. The 30
term does not include an arrangement for the financing of 31
premiums. 32
(c) “Provider of health care” has the meaning ascribed to it in 33
NRS 629.031. 34
Sec. 102. NRS 695G.415 is hereby amended to read as 35
follows: 36
695G.415 1. A managed care organization that issues a 37
health care plan shall not discriminate against any person with 38
respect to participation or coverage under the plan on the basis of an 39
actual or perceived [gender identity or expression.] protected 40
characteristic. 41
2. Prohibited discrimination includes, without limitation: 42
[1.] (a) Denying, cancelling, limiting or refusing to issue or 43
renew a health care plan on the basis of [the] an actual or perceived 44
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[gender identity or expression] protected characteristic of a person 1
or a family member of the person; 2
[2.] (b) Imposing a payment or premium that is based on [the] 3
an actual or perceived [gender identity or expression] protected 4
characteristic of an insured or a family member of the insured; 5
[3.] (c) Designating [the] an actual or perceived [gender 6
identity or expression] protected characteristic of a person or a 7
family member of the person as grounds to deny, cancel or limit 8
participation or coverage; and 9
[4.] (d) Denying, cancelling or limiting participation or 10
coverage on the basis of an actual or perceived [gender identity or 11
expression,] protected characteristic, including, without limitation, 12
by limiting or denying coverage for health care services that are: 13
[(a)] (1) Related to gender transition, provided that there is 14
coverage under the plan for the services when the services are not 15
related to gender transition; or 16
[(b)] (2) Ordinarily or exclusively available to persons of any 17
sex. 18
3. As used in this section, “protected characteristic” means: 19
(a) Race, color, national origin, age, physical or mental 20
disability, sexual orientation or gender identity or expression; or 21
(b) Sex, including, without limitation, sex characteristics, 22
intersex traits and pregnancy or related conditions. 23
Sec. 103. NRS 232.320 is hereby amended to read as follows: 24
232.320 1. The Director: 25
(a) Shall appoint, with the consent of the Governor, 26
administrators of the divisions of the Department, who are 27
respectively designated as follows: 28
(1) The Administrator of the Aging and Disability Services 29
Division; 30
(2) The Administrator of the Division of Welfare and 31
Supportive Services; 32
(3) The Administrator of the Division of Child and Family 33
Services; 34
(4) The Administrator of the Division of Health Care 35
Financing and Policy; and 36
(5) The Administrator of the Division of Public and 37
Behavioral Health. 38
(b) Shall administer, through the divisions of the Department, 39
the provisions of chapters 63, 424, 425, 427A, 432A to 442, 40
inclusive, 446 to 450, inclusive, 458A and 656A of NRS, NRS 41
127.220 to 127.310, inclusive, 422.001 to 422.410, inclusive, and 42
sections 109 to 112, inclusive, of this act, 422.580, 432.010 to 43
432.133, inclusive, 432B.6201 to 432B.626, inclusive, 444.002 to 44
444.430, inclusive, and 445A.010 to 445A.055, inclusive, and all 45
– 112 –
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other provisions of law relating to the functions of the divisions of 1
the Department, but is not responsible for the clinical activities of 2
the Division of Public and Behavioral Health or the professional line 3
activities of the other divisions. 4
(c) Shall administer any state program for persons with 5
developmental disabilities established pursuant to the 6
Developmental Disabilities Assistance and Bill of Rights Act of 7
2000, 42 U.S.C. §§ 15001 et seq. 8
(d) Shall, after considering advice from agencies of local 9
governments and nonprofit organizations which provide social 10
services, adopt a master plan for the provision of human services in 11
this State. The Director shall revise the plan biennially and deliver a 12
copy of the plan to the Governor and the Legislature at the 13
beginning of each regular session. The plan must: 14
(1) Identify and assess the plans and programs of the 15
Department for the provision of human services, and any 16
duplication of those services by federal, state and local agencies; 17
(2) Set forth priorities for the provision of those services; 18
(3) Provide for communication and the coordination of those 19
services among nonprofit organizations, agencies of local 20
government, the State and the Federal Government; 21
(4) Identify the sources of funding for services provided by 22
the Department and the allocation of that funding; 23
(5) Set forth sufficient information to assist the Department 24
in providing those services and in the planning and budgeting for the 25
future provision of those services; and 26
(6) Contain any other information necessary for the 27
Department to communicate effectively with the Federal 28
Government concerning demographic trends, formulas for the 29
distribution of federal money and any need for the modification of 30
programs administered by the Department. 31
(e) May, by regulation, require nonprofit organizations and state 32
and local governmental agencies to provide information regarding 33
the programs of those organizations and agencies, excluding 34
detailed information relating to their budgets and payrolls, which the 35
Director deems necessary for the performance of the duties imposed 36
upon him or her pursuant to this section. 37
(f) Has such other powers and duties as are provided by law. 38
2. Notwithstanding any other provision of law, the Director, or 39
the Director’s designee, is responsible for appointing and removing 40
subordinate officers and employees of the Department. 41
Sec. 104. NRS 287.010 is hereby amended to read as follows: 42
287.010 1. The governing body of any county, school 43
district, municipal corporation, political subdivision, public 44
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corporation or other local governmental agency of the State of 1
Nevada may: 2
(a) Adopt and carry into effect a system of group life, accident 3
or health insurance, or any combination thereof, for the benefit of its 4
officers and employees, and the dependents of officers and 5
employees who elect to accept the insurance and who, where 6
necessary, have authorized the governing body to make deductions 7
from their compensation for the payment of premiums on the 8
insurance. 9
(b) Purchase group policies of life, accident or health insurance, 10
or any combination thereof, for the benefit of such officers and 11
employees, and the dependents of such officers and employees, as 12
have authorized the purchase, from insurance companies authorized 13
to transact the business of such insurance in the State of Nevada, 14
and, where necessary, deduct from the compensation of officers and 15
employees the premiums upon insurance and pay the deductions 16
upon the premiums. 17
(c) Provide group life, accident or health coverage through a 18
self-insurance reserve fund and, where necessary, deduct 19
contributions to the maintenance of the fund from the compensation 20
of officers and employees and pay the deductions into the fund. The 21
money accumulated for this purpose through deductions from the 22
compensation of officers and employees and contributions of the 23
governing body must be maintained as an internal service fund as 24
defined by NRS 354.543. The money must be deposited in a state or 25
national bank or credit union authorized to transact business in the 26
State of Nevada. Any independent administrator of a fund created 27
under this section is subject to the licensing requirements of chapter 28
683A of NRS, and must be a resident of this State. Any contract 29
with an independent administrator must be approved by the 30
Commissioner of Insurance as to the reasonableness of 31
administrative charges in relation to contributions collected and 32
benefits provided. The provisions of NRS 439.581 to 439.597, 33
inclusive, 686A.135, 687B.352, 687B.408, 687B.692, 687B.723, 34
687B.725, 687B.805, 689B.030 to 689B.0317, inclusive, paragraphs 35
(b) and (c) of subsection 1 of NRS 689B.0319, subsections 2, 4, 6 36
and 7 of NRS 689B.0319, 689B.033 to 689B.0369, inclusive, 37
689B.0375 to 689B.050, inclusive, 689B.0675, 689B.265, 689B.287 38
, [and] 689B.500 and 689B.520 and sections 17 to 20, inclusive, of 39
this act apply to coverage provided pursuant to this paragraph, 40
except that the provisions of NRS 689B.0314, 689B.0315, 41
689B.0316, 689B.0367, 689B.0378, 689B.03785 [and] , 689B.0675, 42
689B.500 and 689B.520 and sections 17 to 20, inclusive, of this act 43
only apply to coverage for active officers and employees of the 44
governing body, or the dependents of such officers and employees. 45
– 114 –
- *AB522_R1*
(d) Defray part or all of the cost of maintenance of a self-1
insurance fund or of the premiums upon insurance. The money for 2
contributions must be budgeted for in accordance with the laws 3
governing the county, school district, municipal corporation, 4
political subdivision, public corporation or other local governmental 5
agency of the State of Nevada. 6
2. If a school district offers group insurance to its officers and 7
employees pursuant to this section, members of the board of trustees 8
of the school district must not be excluded from participating in the 9
group insurance. If the amount of the deductions from compensation 10
required to pay for the group insurance exceeds the compensation to 11
which a trustee is entitled, the difference must be paid by the trustee. 12
3. In any county in which a legal services organization exists, 13
the governing body of the county, or of any school district, 14
municipal corporation, political subdivision, public corporation or 15
other local governmental agency of the State of Nevada in the 16
county, may enter into a contract with the legal services 17
organization pursuant to which the officers and employees of the 18
legal services organization, and the dependents of those officers and 19
employees, are eligible for any life, accident or health insurance 20
provided pursuant to this section to the officers and employees, and 21
the dependents of the officers and employees, of the county, school 22
district, municipal corporation, political subdivision, public 23
corporation or other local governmental agency. 24
4. If a contract is entered into pursuant to subsection 3, the 25
officers and employees of the legal services organization: 26
(a) Shall be deemed, solely for the purposes of this section, to be 27
officers and employees of the county, school district, municipal 28
corporation, political subdivision, public corporation or other local 29
governmental agency with which the legal services organization has 30
contracted; and 31
(b) Must be required by the contract to pay the premiums or 32
contributions for all insurance which they elect to accept or of which 33
they authorize the purchase. 34
5. A contract that is entered into pursuant to subsection 3: 35
(a) Must be submitted to the Commissioner of Insurance for 36
approval not less than 30 days before the date on which the contract 37
is to become effective. 38
(b) Does not become effective unless approved by the 39
Commissioner. 40
(c) Shall be deemed to be approved if not disapproved by the 41
Commissioner within 30 days after its submission. 42
6. As used in this section, “legal services organization” means 43
an organization that operates a program for legal aid and receives 44
money pursuant to NRS 19.031. 45
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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 [.] ; and 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 this paragraph; or 16
(2) Detected by other means of examination. 17
2. The governing body of any county, school district, 18
municipal corporation, political subdivision, public corporation or 19
other local governmental agency of the State of Nevada that 20
provides health insurance through a plan of self-insurance must 21
ensure that the benefits required by subsection 1 are made available 22
to an insured through a provider of health care who participates in 23
the network plan of the governing body. 24
3. Except as otherwise provided in subsection 5, the governing 25
body of any county, school district, municipal corporation, political 26
subdivision, public corporation or other local governmental agency 27
of the State of Nevada that provides health insurance through a plan 28
of self-insurance shall not: 29
(a) Except as otherwise provided in subsection 6, require an 30
insured to pay a higher deductible, any copayment or coinsurance or 31
require a longer waiting period or other condition to obtain any 32
benefit provided in the plan of self-insurance pursuant to 33
subsection 1; 34
(b) Refuse to issue a plan of self-insurance or cancel a plan of 35
self-insurance solely because the person applying for or covered by 36
the policy 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 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 plan of self-insurance subject to the provisions of this 6
chapter which is delivered, issued for delivery or renewed on or 7
after January 1, 2024, has the legal effect of including the coverage 8
required by subsection 1, and any provision of the policy or the 9
renewal which is in conflict with this section is void. 10
5. Except as otherwise provided in this section and federal law, 11
the governing body of any county, school district, municipal 12
corporation, political subdivision, public corporation or other local 13
governmental agency of the State of Nevada that provides health 14
insurance through a plan of self-insurance may use medical 15
management techniques, including, without limitation, any available 16
clinical evidence, to determine the frequency of or treatment relating 17
to any benefit required by this section or the type of provider of 18
health care to use for such treatment. 19
6. If the application of paragraph (a) of subsection 3 would 20
result in the ineligibility of a health savings account of an insured 21
pursuant to 26 U.S.C. § 223, the prohibitions of paragraph (a) of 22
subsection 3 shall apply only for a qualified plan of self-insurance 23
with respect to the deductible of such a plan of self-insurance after 24
the insured has satisfied the minimum deductible pursuant to 26 25
U.S.C. § 223, except with respect to items or services that constitute 26
preventive care pursuant to 26 U.S.C. § 223(c)(2)(C), in which case 27
the prohibitions of paragraph (a) of subsection 3 shall apply 28
regardless of whether the minimum deductible under 26 U.S.C. § 29
223 has been satisfied. 30
7. As used in this section: 31
(a) “Medical management technique” means a practice which is 32
used to control the cost or utilization of health care services or 33
prescription drug use. The term includes, without limitation, the use 34
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 plan of self-insurance provided by 37
the governing body of a local governmental agency under which the 38
financing and delivery of medical care, including items and services 39
paid for as medical care, are provided, in whole or in part, through a 40
defined set of providers under contract with the governing body. 41
The term does not include an arrangement for the financing of 42
premiums. 43
(c) “Provider of health care” has the meaning ascribed to it in 44
NRS 629.031. 45
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(d) “Qualified plan of self-insurance” means a plan of self-1
insurance that has a high deductible and is in compliance with 26 2
U.S.C. § 223 for the purposes of establishing a health savings 3
account. 4
Sec. 106. NRS 287.04335 is hereby amended to read as 5
follows: 6
287.04335 If the Board provides health insurance through a 7
plan of self-insurance, it shall comply with the provisions of NRS 8
439.581 to 439.597, inclusive, 686A.135, 687B.352, 687B.409, 9
687B.692, 687B.723, 687B.725, 687B.805, 689B.0353, 689B.255, 10
695C.1723, 695G.150, 695G.155, 695G.160, 695G.162, 11
695G.1635, 695G.164, 695G.1645, 695G.1665 [, 695G.167, 12
695G.1675, 695G.170] to 695G.1712, inclusive, 695G.1714 to 13
695G.174, inclusive, 695G.176, 695G.177, 695G.200 to 695G.230, 14
inclusive, 695G.241 to 695G.310, inclusive, 695G.405 and 15
695G.415, and sections 90 to 94, inclusive, of this act in the same 16
manner as an insurer that is licensed pursuant to title 57 of NRS is 17
required to comply with those provisions. 18
Sec. 107. NRS 287.04337 is hereby amended to read as 19
follows: 20
287.04337 1. If the Board provides health insurance through 21
a plan of self-insurance, it shall provide coverage for benefits 22
payable for expenses incurred for [a] : 23
(a) A mammogram every 2 years, or annually if ordered by a 24
provider of health care, for women 40 years of age or older [.] ; and 25
(b) A diagnostic imaging test for breast cancer at the age 26
deemed most appropriate, when medically necessary, as 27
recommended by the insured’s provider of health care to evaluate 28
an abnormality which is: 29
(1) Seen or suspected from the mammogram described in 30
paragraph (a) or the imaging test described in this paragraph or 31
(2) Detected by other means of examination. 32
2. If the Board provides health insurance through a plan of self-33
insurance, it must ensure that the benefits required by subsection 1 34
are made available to an insured through a provider of health care 35
who participates in the network plan of the Board. 36
3. Except as otherwise provided in subsection 5, if the Board 37
provides health insurance through a plan of self-insurance, it shall 38
not: 39
(a) Except as otherwise provided in subsection 6, require an 40
insured to pay a higher deductible, any copayment or coinsurance or 41
require a longer waiting period or other condition to obtain any 42
benefit provided in the plan of self-insurance pursuant to 43
subsection 1; 44
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(b) Refuse to issue a plan of self-insurance or cancel a plan of 1
self-insurance solely because the person applying for or covered by 2
the plan 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 any 5
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 other 10
financial incentive to a provider of health care to deny, reduce, 11
withhold, limit or delay access to any such benefit to an insured; or 12
(f) Impose any other restrictions or delays on the access of an 13
insured to any such benefit. 14
4. A plan of self-insurance described in subsection 1 which is 15
delivered, issued for delivery or renewed on or after January 1, 16
2024, has the legal effect of including the coverage required by 17
subsection 1, and any provision of the policy or the renewal which is 18
in conflict with this section is void. 19
5. Except as otherwise provided in this section and federal law, 20
if the Board provides health insurance through a plan of self-21
insurance, the Board may use medical management techniques, 22
including, without limitation, any available clinical evidence, to 23
determine the frequency of or treatment relating to any benefit 24
required by this section or the type of provider of health care to use 25
for such treatment. 26
6. If the application of paragraph (a) of subsection 3 would 27
result in the ineligibility of a health savings account of an insured 28
pursuant to 26 U.S.C. § 223, the prohibitions of paragraph (a) of 29
subsection 3 shall apply only for a qualified plan of self-insurance 30
with respect to the deductible of such a plan of self-insurance after 31
the insured has satisfied the minimum deductible pursuant to 26 32
U.S.C. § 223, except with respect to items or services that constitute 33
preventive care pursuant to 26 U.S.C. § 223(c)(2)(C), in which case 34
the prohibitions of paragraph (a) of subsection 3 shall apply 35
regardless of whether the minimum deductible under 26 U.S.C. § 36
223 has been satisfied. 37
7. As used in this section: 38
(a) “Medical management technique” means a practice which is 39
used to control the cost or utilization of health care services or 40
prescription drug use. The term includes, without limitation, the use 41
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 plan of self-insurance provided by 44
the Board under which the financing and delivery of medical care, 45
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including items and services paid for as medical care, are provided, 1
in whole or in part, through a defined set of providers under contract 2
with the Board. The term does not include an arrangement for the 3
financing of premiums. 4
(c) “Provider of health care” has the meaning ascribed to it in 5
NRS 629.031. 6
(d) “Qualified plan of self-insurance” means a plan of self-7
insurance that has a high deductible and is in compliance with 26 8
U.S.C. § 223 for the purposes of establishing a health savings 9
account. 10
Sec. 108. Chapter 422 of NRS is hereby amended by adding 11
thereto the provisions set forth as sections 109 to 112, inclusive, of 12
this act. 13
Sec. 109. 1. The Director shall include under Medicaid a 14
requirement that the State pay the nonfederal share of 15
expenditures incurred for: 16
(a) Screening for major depressive disorder for recipients of 17
Medicaid who are at least 12 but less than 18 years of age; 18
(b) Screening for anxiety for recipients of Medicaid who are at 19
least 8 but less than 18 years of age; 20
(c) Assessments relating to height, weight, body mass index 21
and medical history for recipients of Medicaid who are less than 22
18 years of age; 23
(d) Comprehensive and intensive behavioral interventions for 24
recipients of Medicaid who are at least 6 but less than 18 years of 25
age and have a body mass index in the 95th percentile or greater 26
for persons of the same age and sex; 27
(e) The application of fluoride varnish to the primary teeth for 28
recipients of Medicaid who are less than 5 years of age; 29
(f) Oral fluoride supplements for recipients of Medicaid who 30
are at least 6 months of age but less than 5 years of age whose 31
supply of water is deficient in fluoride; 32
(g) Counseling and education pertaining to the minimization 33
of exposure to ultraviolet radiation for recipients of Medicaid who 34
are less than 25 years of age and the parents or legal guardians of 35
recipients of Medicaid who are less than 18 years of age for the 36
purpose of minimizing the risk of skin cancer in those persons; 37
(h) Brief behavioral counseling and interventions prevent 38
tobacco use for recipients of Medicaid who are less than 18 years 39
of age; and 40
(i) At least one screening for the detection of amblyopia or the 41
risk factors of amblyopia for recipients of Medicaid who are at 42
least 3 but not more than 5 years of age. 43
2. To obtain any benefit provided under Medicaid pursuant to 44
subsection 1, a recipient of Medicaid must not be required to: 45
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(a) Pay a higher deductible or any copayment or coinsurance; 1
or 2
(b) Be subject to a longer waiting period or any other 3
condition. 4
3. The Department shall: 5
(a) Apply to the Secretary of Health and Human Services for 6
any waiver of federal law or apply for any amendment of the State 7
Plan for Medicaid that is necessary for the Department to receive 8
federal funding to provide the coverage described in subsection 1. 9
(b) Fully cooperate with the Federal Government during the 10
application process to satisfy the requirements of the Federal 11
Government for obtaining a waiver or amendment pursuant to 12
paragraph (a). 13
Sec. 110. 1. The Director shall include under Medicaid a 14
requirement that the State pay the nonfederal share of 15
expenditures incurred for: 16
(a) A daily dose of 0.4 to 0.8 milligrams of folic acid for 17
recipients of Medicaid who are pregnant or are planning on 18
becoming pregnant; 19
(b) A low dose of aspirin for the prevention of preeclampsia 20
for recipients of Medicaid who are determined to be at a high risk 21
of that 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 recipients of 25
Medicaid who 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 recipients of Medicaid who are pregnant; 29
(f) Counseling for recipients of Medicaid who are pregnant or 30
in the postpartum stage of pregnancy and have an increased risk 31
of perinatal or postpartum depression; 32
(g) Screening for the presence of the rhesus D antigen and 33
antibodies in the blood of a recipient of Medicaid who is pregnant 34
during the recipient’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 recipients of Medicaid who are negative for 37
the rhesus D antigen and have not been exposed to blood that is 38
positive for the rhesus D antigen; 39
(i) Behavioral counseling and intervention for tobacco 40
cessation for recipients of Medicaid who are pregnant; 41
(j) Screening for diabetes after at least 24 weeks of gestation or 42
as ordered by a provider of health care; 43
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(k) Counseling relating to maintaining a healthy weight for 1
women who are at least 40 but not more than 60 years of age and 2
have a body mass index of 18.5 or greater; and 3
(l) Screening for osteoporosis for women who: 4
(1) Are 65 years of age or older; or 5
(2) Are less than 65 years of age and have a risk of 6
fracturing a bone equal to or greater than that of a woman who is 7
65 years of age without any additional risk factors. 8
2. To obtain any benefit provided under Medicaid 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 13
condition. 14
3. The Department shall: 15
(a) Apply to the Secretary of Health and Human Services for 16
any waiver of federal law or apply for any amendment of the State 17
Plan for Medicaid that is necessary for the Department to receive 18
federal funding to provide the coverage described in subsection 1. 19
(b) Fully cooperate with the Federal Government during the 20
application process to satisfy the requirements of the Federal 21
Government for obtaining a waiver or amendment pursuant to 22
paragraph (a). 23
Sec. 111. 1. The Director shall include under Medicaid a 24
requirement that the State pay the nonfederal share of 25
expenditures incurred for: 26
(a) Behavioral counseling and interventions to promote 27
physical activity and a heathy diet for recipients of Medicaid with 28
cardiovascular risk factors; 29
(b) Statin preventive medication for recipients of Medicaid 30
who are at least 40 but not more than 75 years of age and do not 31
have a history of cardiovascular disease, but who have: 32
(1) One or more risk factors for cardiovascular disease; 33
and 34
(2) A calculated risk of at least 10 percent of acquiring 35
cardiovascular disease within the next 10 years; 36
(c) Interventions for exercise to prevent falls for recipients of 37
Medicaid who are 65 years of age or older and reside in a medical 38
facility or facility for the dependent; 39
(d) Screenings for latent tuberculosis infection in recipients of 40
Medicaid with an increased risk of contracting tuberculosis; 41
(e) One abdominal aortic screening by ultrasound to detect 42
abdominal aortic aneurysms for men who are at least 65 but not 43
more than 75 years of age and have smoked during their lifetimes; 44
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(f) Screening for drug and alcohol misuse for persons who are 1
at least 18 years of age; 2
(g) If a recipient of Medicaid engages in risky or hazardous 3
consumption of alcohol, as determined by the screening described 4
in paragraph (f), behavioral counseling to reduce such behavior; 5
(h) Screening for lung cancer using low-dose computed 6
tomography for recipients of Medicaid who are at least 50 but not 7
more than 80 years of age in accordance with the most recent 8
guidelines published by the American Cancer Society or the 9
recommendations of the United States Preventive Services Task 10
Force in effect on January 1, 2025; 11
(i) Screening for colorectal cancer for persons who are at least 12
45 but not more than 85 years of age; and 13
(j) Intensive behavioral interventions with multiple 14
components for recipients of Medicaid who are 18 years of age or 15
older and have a body mass index of 30 or greater. 16
2. To obtain any benefit provided under Medicaid pursuant to 17
subsection 1, a recipient of Medicaid must not be required to: 18
(a) Pay a higher deductible or any copayment or coinsurance; 19
or 20
(b) Be subject to a longer waiting period or any other 21
condition. 22
3. The Department shall: 23
(a) Apply to the Secretary of Health and Human Services for 24
any waiver of federal law or apply for any amendment of the State 25
Plan for Medicaid that is necessary for the Department to receive 26
federal funding to provide the coverage described in subsection 1. 27
(b) Fully cooperate with the Federal Government during the 28
application process to satisfy the requirements of the Federal 29
Government for obtaining a waiver or amendment pursuant to 30
paragraph (a). 31
4. As used in this section: 32
(a) “Computed tomography” means the process of producing 33
sectional and three-dimensional images using external ionizing 34
radiation. 35
(b) “Facility for the dependent” has the meaning ascribed to it 36
in NRS 449.0045. 37
(c) “Medical facility” has the meaning ascribed to it in 38
NRS 449.0151. 39
Sec. 112. 1. To the extent that federal financial 40
participation is available, the Director shall include under 41
Medicaid coverage for maternity care and pediatric care for 42
newborn infants. 43
2. Except as otherwise provided in this subsection, Medicaid 44
may not restrict benefits for any length of stay in a hospital in 45
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connection with childbirth for a pregnant or postpartum 1
individual or newborn infant who is a recipient of Medicaid to: 2
(a) Less than 48 hours after a normal vaginal delivery; and 3
(b) Less than 96 hours after a cesarean section. 4
If a different length of stay is provided in the guidelines 5
established by the American College of Obstetricians and 6
Gynecologists, or its successor organization, and the American 7
Academy of Pediatrics, or its successor organization, Medicaid 8
may follow such guidelines in lieu of following the length of stay 9
set forth above. The provisions of this subsection do not apply in 10
any case in which the decision to discharge the pregnant or 11
postpartum individual or newborn infant before the expiration of 12
the minimum length of stay set forth in this subsection is made by 13
the attending physician of the pregnant or postpartum individual 14
or newborn infant. 15
3. Nothing in this section requires a pregnant or postpartum 16
individual to: 17
(a) Deliver the baby in a hospital; or 18
(b) Stay in a hospital for a fixed period following the birth of 19
the child. 20
4. Nothing in this section: 21
(a) Prohibits Medicaid from imposing a deductible, 22
coinsurance or other mechanism for sharing costs relating to 23
benefits for hospital stays in connection with childbirth for a 24
pregnant or postpartum individual or newborn child who is a 25
recipient of Medicaid, except that such coinsurance or other 26
mechanism for sharing costs for any portion of a hospital stay 27
required by this section may not be greater than the coinsurance 28
or other mechanism for any preceding portion of that stay. 29
(b) Prohibits an arrangement for payment between the 30
Department and a provider of health care that uses capitation or 31
other financial incentives, if the arrangement is designed to 32
provide services efficiently and consistently in the best interest of 33
the pregnant or postpartum individual and the newborn infant. 34
(c) Prevents the Department from negotiating with a provider 35
of health care concerning the level and type of reimbursement to 36
be provided in accordance with this section. 37
Sec. 113. NRS 422.2701 is hereby amended to read as 38
follows: 39
422.2701 1. The Department shall not discriminate against 40
any person with respect to participation or coverage under Medicaid 41
on the basis of an actual or perceived [gender identity or 42
expression.] protected characteristic. 43
2. Prohibited discrimination includes, without limitation: 44
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[1.] (a) Denying, cancelling, limiting or refusing to issue a 1
payment or coverage on the basis of [the] an actual or perceived 2
[gender identity or expression] protected characteristic of a person 3
or a family member of the person; 4
[2.] (b) Imposing a payment that is based on [the] an actual or 5
perceived [gender identity or expression] protected characteristic of 6
a recipient of Medicaid or a family member of the recipient; 7
[3.] (c) Designating [the] an actual or perceived [gender 8
identity or expression] protected characteristic of a person or a 9
family member of the person as grounds to deny, cancel or limit 10
participation or coverage; and 11
[4.] (d) Denying, cancelling or limiting participation or 12
coverage on the basis of an actual or perceived [gender identity or 13
expression,] protected characteristic, including, without limitation, 14
by limiting or denying payment or coverage for health care services 15
that are: 16
[(a)] (1) Related to gender transition, provided that there is 17
coverage under Medicaid for the services when the services are not 18
related to gender transition; or 19
[(b)] (2) Ordinarily or exclusively available to persons of any 20
sex. 21
3. As used in this section, “protected characteristic” means: 22
(a) Race, color, national origin, age, physical or mental 23
disability, sexual orientation or gender identity or expression; or 24
(b) Sex, including, without limitation, sex characteristics, 25
intersex traits and pregnancy or related conditions. 26
Sec. 114. NRS 422.27173 is hereby amended to read as 27
follows: 28
422.27173 1. The Director shall include in the State Plan for 29
Medicaid a requirement that the State must pay the nonfederal share 30
of expenditures incurred for: 31
[1.] (a) Testing for and the treatment and prevention of sexually 32
transmitted diseases, including, without limitation, Chlamydia 33
trachomatis, gonorrhea, syphilis, human immunodeficiency virus 34
and hepatitis B and C, for all recipients of Medicaid, regardless of 35
age. Services covered pursuant to this section must include, without 36
limitation, the examination of a pregnant woman for the discovery 37
of: 38
[(a)] (1) Chlamydia trachomatis, gonorrhea, hepatitis B and 39
hepatitis C in accordance with NRS 442.013. 40
[(b)] (2) Syphilis in accordance with NRS 442.010. 41
[2.] (3) Human immunodeficiency virus. 42
(b) Condoms for recipients of Medicaid. 43
2. To obtain any benefit provided pursuant to subsection 1, a 44
recipient of Medicaid must not be required to: 45
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(a) Pay a higher deductible or any copayment or coinsurance; 1
or 2
(b) Be subject to a longer waiting period or any other 3
condition. 4
Sec. 115. NRS 422.27174 is hereby amended to read as 5
follows: 6
422.27174 1. The Director shall include in the State Plan for 7
Medicaid a requirement that the State pay the nonfederal share of 8
expenditures incurred for: 9
(a) Counseling and support for breastfeeding; 10
(b) Screening and counseling for interpersonal and domestic 11
violence; 12
(c) Counseling for sexually transmitted diseases; 13
(d) Screening for blood pressure abnormalities and diabetes, 14
including gestational diabetes; 15
(e) Screening for prediabetes in recipients of Medicaid who 16
are at least 35 but not more than 70 years of age and have a body 17
mass index of 25 or greater; 18
(f) An annual screening for cervical cancer; 19
[(f)] (g) Screening for anxiety and depression; 20
[(g)] (h) Screening and counseling for the human 21
immunodeficiency virus; 22
[(h)] (i) Smoking cessation programs; 23
[(i)] (j) All vaccinations recommended by the Advisory 24
Committee on Immunization Practices of the Centers for Disease 25
Control and Prevention of the United States Department of Health 26
and Human Services or its successor organization; and 27
[(j)] (k) Such well-woman preventative visits as recommended 28
by the Health Resources and Services Administration [.] on 29
January 1, 2025, and any additional well-woman preventative 30
visits that may be so recommended thereafter. 31
2. To obtain any benefit provided in the Plan pursuant to 32
subsection 1, a recipient of Medicaid must not be required to: 33
(a) Pay a higher deductible [,] or any copayment or coinsurance; 34
or 35
(b) Be subject to a longer waiting period or any other condition. 36
Sec. 116. NRS 422.27175 is hereby amended to read as 37
follows: 38
422.27175 1. The Director shall include in the State Plan for 39
Medicaid a requirement that the State, to the extent authorized by 40
federal law, must pay the nonfederal share of expenditures incurred 41
for screening, genetic counseling and testing for harmful mutations 42
in the BRCA gene for women under circumstances where such 43
screening, genetic counseling or testing, as applicable, is required by 44
NRS 457.301. 45
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2. To obtain any benefit provided pursuant to subsection 1, a 1
recipient of Medicaid must not be required to: 2
(a) Pay a higher deductible or any copayment or coinsurance; 3
or 4
(b) Be subject to a longer waiting period or any other 5
condition. 6
Sec. 117. NRS 422.27176 is hereby amended to read as 7
follows: 8
422.27176 1. The Director shall include in the State Plan for 9
Medicaid a requirement that the State pay the nonfederal share of 10
expenditures incurred for a mammogram. 11
2. To obtain any benefit provided pursuant to subsection 1, a 12
recipient of Medicaid must not be required to: 13
(a) Pay a higher deductible or any copayment or coinsurance; 14
or 15
(b) Be subject to a longer waiting period or any other 16
condition. 17
Sec. 118. NRS 422.27179 is hereby amended to read as 18
follows: 19
422.27179 1. To the extent that money is available, the 20
Director shall include in the State Plan for Medicaid a requirement 21
that the State pay the nonfederal share of expenditures incurred for: 22
(a) Supplies for breastfeeding a child until the child’s first 23
birthday. Such supplies include, without limitation, electric or 24
hospital-grade breast pumps that: 25
(1) Have been prescribed or ordered by a qualified provider 26
of health care; and 27
(2) Are medically necessary for the mother or the child. 28
(b) Such prenatal screenings and tests as are recommended by 29
the American College of Obstetricians and Gynecologists, or its 30
successor organization. 31
2. The Director shall include in the State Plan for Medicaid a 32
requirement that, to the extent that money and federal financial 33
participation are available, the State must pay the nonfederal share 34
of expenditures incurred for lactation consultation and support. 35
3. To obtain any benefit provided pursuant to subsection 1, a 36
recipient of Medicaid must not be required to: 37
(a) Pay a higher deductible or any copayment or coinsurance; 38
or 39
(b) Be subject to a longer waiting period or any other 40
condition. 41
4. As used in this section: 42
(a) “Medically necessary” has the meaning ascribed to it in 43
NRS 695G.055. 44
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(b) “Provider of health care” has the meaning ascribed to it in 1
NRS 629.031. 2
Sec. 119. Chapter 629 of NRS is hereby amended by adding 3
thereto a new section to read as follows: 4
1. A provider of health care shall not discriminate in the 5
provision of services to a person seeking to receive or receiving 6
services from the provider of health care based wholly or partially 7
on the actual or perceived: 8
(a) Race, color, national origin, age, physical or mental 9
disability, sexual orientation or gender identity or expression of 10
the person or a person with whom the person associates; or 11
(b) Sex, including, without limitation, sex characteristics, 12
intersex traits and pregnancy or related conditions. 13
2. A health care licensing board may adopt regulations 14
prescribing the specific types of discrimination prohibited by 15
subsection 1. 16
3. A provider of health care who violates any provision of this 17
section or any regulation adopted pursuant thereto is guilty of 18
unprofessional conduct and is subject to disciplinary action by the 19
health care licensing board by which he or she is licensed, 20
certified or regulated. 21
4. The provisions of this section shall not be construed to: 22
(a) Require a provider of health care to take or refrain from 23
taking any action in violation of medical standards; or 24
(b) Prohibit a provider of health care from adopting a policy 25
that is applied uniformly and in a nondiscriminatory manner. 26
5. As used in this section, “health care licensing board” 27
means a board created pursuant to chapter 630, 630A, 631, 632, 28
633, 634, 634A, 634B, 636, 637, 637B, 639, 640, 640A, 640B, 29
640C, 640D, 640E, 641, 641A, 641B, 641C or 641D of NRS. 30
Sec. 120. The provisions of NRS 354.599 do not apply to any 31
additional expenses of a local government that are related to the 32
provisions of this act. 33
Sec. 121. 1. This section becomes effective upon passage 34
and approval. 35
2. Sections 1 to 120, inclusive, of this act become effective: 36
(a) Upon passage and approval for the purpose of adopting any 37
regulations and performing any other preparatory administrative 38
tasks that are necessary to carry out the provisions of this act; and 39
(b) On October 1, 2025, for all other purposes. 40
H