Nevada Senate Bill SB217 Amended / Bill

                     	EXEMPT 
 (Reprinted with amendments adopted on April 18, 2025) 
 	FIRST REPRINT S.B. 217 
 
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SENATE BILL NO. 217–SENATORS CANNIZZARO, NGUYEN, 
SCHEIBLE, PAZINA, DONDERO LOOP; CRUZ-CRAWFORD, 
DALY, DOÑATE, FLORES, LANGE, NEAL, OHRENSCHALL 
AND TAYLOR 
 
FEBRUARY 19, 2025 
____________ 
 
Referred to Committee on Health and Human Services 
 
SUMMARY—Makes revisions relating to reproductive health care. 
(BDR 40-24) 
 
FISCAL NOTE: Effect on Local Government: May have Fiscal Impact. 
 Effect on the State: Yes. 
 
CONTAINS UNFUNDED MANDATE (§ 12) 
(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; prohibiting a governmental entity 
from substantially burdening certain activity relating to 
assisted reproduction under certain circumstances; 
authorizing a person whose engagement in such activity 
has been so burdened to assert the violation as a claim or 
defense in a judicial proceeding; authorizing a court to 
award damages against a governmental entity that 
substantially burdens such activity in certain 
circumstances; providing certain immunity from civil and 
criminal liability and administrative sanctions for certain 
persons and entities involved in the provision of assisted 
reproduction; providing that a fertilized egg or human 
embryo that exists before implantation in a human uterus 
is not a person for legal purposes; requiring certain health 
insurers to authorize a pregnant person to enroll in a 
health plan during a specified period; requiring certain 
public and private health insurers to provide certain 
coverage for the treatment of infertility and fertility 
preservation; providing a penalty; and providing other 
matters properly relating thereto.   
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Legislative Counsel’s Digest: 
 Existing law prescribes certain rights for a patient of a medical facility or a 1 
facility for the dependent. (NRS 449A.100-449A.124) Sections 2-9 of this bill 2 
establish certain rights related to assisted reproduction. Sections 3-6 define certain 3 
terms relating to assisted reproduction. Section 7 applies the provisions of sections 4 
2-9 to certain state laws and all local laws and ordinances and the implementation 5 
of those laws and ordinances, regardless of when those laws or ordinances were 6 
enacted. Section 8 generally prohibits a governmental entity from enacting or 7 
implementing any limitation or requirement that singles out assisted reproduction 8 
and substantially burdens: (1) the access of a person to assisted reproduction, any 9 
drug or device related to assisted reproduction or information related to assisted 10 
reproduction; (2) the ability of a provider of health care to provide assisted 11 
reproduction, any drug or device related to assisted reproduction or information 12 
related to assisted reproduction within his or her scope of practice, training and 13 
experience; (3) the ability of a third party to provide insurance coverage of assisted 14 
reproduction or drugs or devices related to assisted reproduction; or (4) the ability 15 
of a person to control the use or disposition of his or her reproductive genetic 16 
material. Section 8 creates an exception to such prohibitions if the governmental 17 
entity demonstrates by clear and convincing evidence that the burden, as applied to 18 
the person, provider of health care or third party who is subject to the burden: (1) 19 
furthers a compelling interest; and (2) is the least restrictive means of furthering 20 
that interest.  21 
 Section 8 authorizes a person, provider of health care or third party whose 22 
ability to access, provide or cover assisted reproduction, drugs or devices related to 23 
assisted reproduction or information related to assisted reproduction, or a person 24 
whose ability to control the use or disposition of his or her reproductive genetic 25 
material, is burdened to bring or defend an action in court and obtain appropriate 26 
relief. Section 8 requires a court to award costs and attorney’s fees to a person or 27 
entity who prevails on such a claim. Section 8 additionally authorizes the Attorney 28 
General to bring an action to enjoin any limitation or requirement that violates 29 
section 8. 30 
 Section 9 provides that a person or entity is not subject to civil or criminal 31 
liability or administrative sanctions solely because the person or entity provides or 32 
receives goods or services related to assisted reproduction. Section 9 also provides 33 
that the manufacturer of certain goods used to facilitate assisted reproduction is not 34 
subject to civil or criminal liability or administrative sanctions solely because of the 35 
death of or damage to an embryo. Under section 9, a person or entity is not immune 36 
from civil or criminal liability or administrative sanctions for acts or omissions that 37 
independently create liability or grounds for administrative sanctions, including, 38 
without limitation, negligence or providing services outside the scope of practice, 39 
training or experience of the person or entity. Section 10 of this bill provides that a 40 
fertilized egg or human embryo that exists before implantation in the uterus of a 41 
human body is not a human being for any purpose under Nevada law. 42 
 Existing law prescribes certain requirements governing the availability of 43 
health insurance plans in this State. (NRS 687B.480, 689A.430-689A.460, 44 
689B.300-689B.330, 695A.151-695A.157, 695B.340-695B.370, 695C.163-45 
695C.169, 695F.440-695F.470) Sections 12, 13, 15, 20, 24, 27-29, 32, 36, 38, 42 46 
and 45 of this bill require a health insurer, including public and private employers 47 
who provide insurance for their employees but excluding certain group plans, to 48 
provide a special enrollment period to a person determined by a qualified provider 49 
of health care to be pregnant, during which the pregnant person must be allowed to 50 
enroll in a health care plan outside of the period of open enrollment. Sections 45.2 51 
and 45.6 of this bill provide that until January 1, 2027, the requirements of section 52 
45 to provide such a special enrollment period do not apply to Medicaid managed 53 
care plans. Section 17 of this bill provides for the enforcement of section 15, which 54   
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governs private employers who provide health benefits to employees through a self-55 
insured plan. Section 18 of this bill establishes civil and criminal penalties for a 56 
violation of section 15, which are the same as the penalties for violations of other 57 
laws governing benefits provided by private employers. Sections 21, 26, 34 and 39 58 
of this bill make conforming changes to indicate the applicability of certain 59 
definitions to sections 20, 24, 32 and 36, respectively.  60 
 Existing law requires public and private policies of health insurance regulated 61 
under Nevada law to include certain coverage. (NRS 287.010, 287.04335, 62 
422.2717-422.272428, 689A.04033-689A.0465, 689B.0303-689B.0379, 63 
689C.1652-689C.169, 689C.194, 689C.1945, 689C.195, 689C.425, 695A.184-64 
695A.1875, 695A.265, 695B.1901-695B.1948, 695C.050, 695C.1691-695C.176, 65 
695G.162-695G.177) Existing law also requires employers to provide certain 66 
benefits for health care to employees, including the coverage required of health 67 
insurers, if the employer provides health benefits for its employees through a self-68 
insured plan. (NRS 608.1555) Sections 12, 13, 23, 31, 37 and 44 of this bill require 69 
public and private health care plans for groups of more than 50 employees or 70 
members to include certain coverage for: (1) the treatment of infertility; and (2) the 71 
preservation of fertility where the insured has a medical condition or requires 72 
medical treatment that may cause infertility under certain circumstances. Sections 73 
14, 38.5, 45.6 and 47 of this bill impose similar requirements on Medicaid, 74 
beginning on January 1, 2027. Section 16 of this bill exempts employers who 75 
provide benefits for health care for their employees through a self-insured plan 76 
from the requirements to cover services for the treatment or preservation of fertility. 77 
Sections 12-14, 19, 23, 31, 37, 38.5 and 44 of this bill prohibit an insurer, 78 
including Medicaid, from imposing conditions, including cost-sharing, prior 79 
authorizations and waiting periods, on infertility treatment or fertility preservation 80 
if such conditions are not required for similar benefits that are not related to 81 
fertility. Section 11 of this bill makes a conforming change to require the Director 82 
of the Department of Health and Human Services to administer the provisions of 83 
section 14 in the same manner as other provisions relating to Medicaid. Sections 84 
25, 33 and 40 of this bill make conforming changes to clarify the applicability of 85 
provisions indicating that certain insurers are not required to cover fertility drugs. 86 
 Section 41 of this bill authorizes the Commissioner of Insurance to suspend or 87 
revoke the certificate of a health maintenance organization that fails to provide the 88 
coverage required by section 37. The Commissioner is also authorized to take such 89 
action against other health insurers who fail to provide the coverage required by 90 
sections 23 and 44. (NRS 680A.200)  91 
 
 
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN 
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS: 
 
 Section 1.  Chapter 449A of NRS is hereby amended by 1 
adding thereto the provisions set forth as sections 2 to 9, inclusive, 2 
of this act. 3 
 Sec. 2.  As used in sections 2 to 9, inclusive, of this act, unless 4 
the context otherwise requires, the words and terms defined in 5 
sections 3 to 6, inclusive, of this act have the meanings ascribed to 6 
them in those sections. 7 
 Sec. 3.  “Assisted reproduction” has the meaning ascribed to 8 
it in NRS 126.510. 9   
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 Sec. 4.  “Gamete” has the meaning ascribed to it in  1 
NRS 126.560. 2 
 Sec. 5.  “Governmental entity” means the State of Nevada or 3 
any of its agencies or political subdivisions. 4 
 Sec. 6.  “Third party” means any insurer, governmental 5 
entity or other organization providing health coverage or benefits 6 
in accordance with state or federal law. 7 
 Sec. 7.  1.  Except as otherwise provided in this section, the 8 
provisions of sections 2 to 9, inclusive, of this act apply to all state 9 
and local laws and ordinances and the implementation of those 10 
laws and ordinances, whether statutory or otherwise, and whether 11 
enacted before, on or after July 1, 2025.  12 
 2.  State laws that are enacted on or after July 1, 2025, are 13 
subject to the provisions of sections 2 to 9, inclusive, of this act 14 
unless the law explicitly excludes such application by reference to 15 
this section. 16 
 3.  The provisions of sections 2 to 9, inclusive, of this act do 17 
not authorize a governmental entity to burden: 18 
 (a) The access of any person to assisted reproduction, any 19 
drug or device related to assisted reproduction or information 20 
related to assisted reproduction; 21 
 (b) The ability of a provider of health care to provide assisted 22 
reproduction or information related to assisted reproduction or to 23 
provide, administer, dispense or prescribe any drug or device 24 
related to assisted reproduction within the scope of practice, 25 
training and experience of the provider of health care;  26 
 (c) The ability of a third party to provide coverage of assisted 27 
reproduction or drugs or devices related to assisted reproduction; 28 
or 29 
 (d) The ability of a person to control the use or disposition of 30 
his or her gametes or other reproductive genetic material. 31 
 Sec. 8.  1. Except as otherwise provided in this section, a 32 
governmental entity shall not enact or implement any limitation or 33 
requirement that: 34 
 (a) Expressly, effectively, implicitly or, as implemented, singles 35 
out assisted reproduction or any drug or device related to assisted 36 
reproduction and substantially burdens: 37 
  (1) The access of a person to assisted reproduction, any 38 
drug or device related to assisted reproduction or information 39 
related to assisted reproduction;  40 
  (2) The ability of a provider of health care to: 41 
   (I) Provide assisted reproduction or information related 42 
to assisted reproduction within the scope of practice, training and 43 
experience of the provider of health care; or 44   
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   (II) Provide, administer, dispense or prescribe any drug 1 
or device related to assisted reproduction within the scope of 2 
practice, training and experience of the provider of health care; or 3 
  (3) The ability of a third party to provide coverage of 4 
assisted reproduction or drugs or devices related to assisted 5 
reproduction. 6 
 (b) Expressly, effectively, implicitly or, as implemented, 7 
substantially burdens the ability of a person to control the use or 8 
disposition of his or her gametes or other reproductive genetic 9 
material. 10 
 2. A governmental entity may enact a requirement or 11 
limitation described in subsection 1 if the governmental entity 12 
demonstrates by clear and convincing evidence that the burden 13 
imposed by the requirement or limitation described in subsection 14 
1, as applied to the person, provider of health care or third party 15 
who is subject to the burden: 16 
 (a) Furthers a compelling interest; and  17 
 (b) Is the least restrictive means of furthering that interest. 18 
 3. Notwithstanding any provision of NRS 41.0305 to 41.039, 19 
inclusive, but subject to the limitation on an award for damages 20 
set forth in NRS 41.035 when applicable, a person, provider of 21 
health care or third party who has been substantially burdened in 22 
violation of this section may assert that violation as a claim or 23 
defense in a judicial proceeding and obtain appropriate relief. A 24 
court shall award costs and attorney’s fees to a person, provider of 25 
health care or third party who prevails on such a claim or defense 26 
pursuant to this section. 27 
 4. The Attorney General may bring an action in any court of 28 
competent jurisdiction in the name of the State of Nevada on his 29 
or her own complaint or on the complaint of any person or entity 30 
to enjoin any violation or proposed violation of the provisions of 31 
this section. 32 
 5. A court may find that a person, provider of health care or 33 
third party is a vexatious litigant if the person, provider of health 34 
care or third party makes a claim within the scope of sections 2 to 35 
9, inclusive, of this act which is without merit, fraudulent or 36 
otherwise intended to harass or annoy a person or entity. If a 37 
court finds that a person, provider of health care or third party is a 38 
vexatious litigant pursuant to this subsection, the court may deny 39 
standing to that person, provider of health care or third party to 40 
bring further claims which allege a violation of this section.  41 
 Sec. 9.  1. Except as otherwise provided in this section, a 42 
person or entity is not subject to civil or criminal liability, or 43 
discipline or other administrative sanctions imposed by a 44 
professional licensing board or other governmental entity, solely 45   
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because the person or entity provides or receives goods or services 1 
related to assisted reproduction. 2 
 2. Except as otherwise provided in this section, a person or 3 
entity that stores or transports embryos for the purpose of assisted 4 
reproduction or the manufacturer of goods used to facilitate the 5 
process of assisted reproduction or the transportation of embryos 6 
stored for the purpose of assisted reproduction is not subject to 7 
civil or criminal liability, or discipline or other administrative 8 
sanctions imposed by a professional licensing board or other 9 
governmental entity, solely because of the death of or damage to 10 
an embryo. 11 
 3. The provisions of this section do not preclude: 12 
 (a) Civil liability for any act or omission that independently 13 
gives rise to such liability, including, without limitation, acts or 14 
omissions that are the result of negligence; 15 
 (b) Criminal liability for any act or omission that would 16 
otherwise constitute a crime; or 17 
 (c) The imposition of discipline or other administrative 18 
sanctions for any act or omission that would otherwise constitute 19 
grounds for discipline or other administrative sanctions, 20 
including, without limitation, providing services that are outside 21 
the scope of practice, training and experience of a person or 22 
entity. 23 
 Sec. 10.  The preliminary chapter of NRS is hereby amended 24 
by adding thereto a new section to read as follows: 25 
 Any fertilized human egg or human embryo that exists in any 26 
form before implantation in the uterus of a human body is not an 27 
unborn child, a minor child, a person, a natural person or any 28 
other term that connotes a human being for any purpose under 29 
the law or regulations of this State or any political subdivision 30 
thereof. 31 
 Sec. 11.  NRS 232.320 is hereby amended to read as follows: 32 
 232.320 1.  The Director: 33 
 (a) Shall appoint, with the consent of the Governor, 34 
administrators of the divisions of the Department, who are 35 
respectively designated as follows: 36 
  (1) The Administrator of the Aging and Disability Services 37 
Division; 38 
  (2) The Administrator of the Division of Welfare and 39 
Supportive Services; 40 
  (3) The Administrator of the Division of Child and Family 41 
Services; 42 
  (4) The Administrator of the Division of Health Care 43 
Financing and Policy; and 44   
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  (5) The Administrator of the Division of Public and 1 
Behavioral Health. 2 
 (b) Shall administer, through the divisions of the Department, 3 
the provisions of chapters 63, 424, 425, 427A, 432A to 442, 4 
inclusive, 446 to 450, inclusive, 458A and 656A of NRS, NRS 5 
127.220 to 127.310, inclusive, 422.001 to 422.410, inclusive, and 6 
section 14 of this act, 422.580, 432.010 to 432.133, inclusive, 7 
432B.6201 to 432B.626, inclusive, 444.002 to 444.430, inclusive, 8 
and 445A.010 to 445A.055, inclusive, and all other provisions of 9 
law relating to the functions of the divisions of the Department, but 10 
is not responsible for the clinical activities of the Division of Public 11 
and Behavioral Health or the professional line activities of the other 12 
divisions. 13 
 (c) Shall administer any state program for persons with 14 
developmental disabilities established pursuant to the 15 
Developmental Disabilities Assistance and Bill of Rights Act of 16 
2000, 42 U.S.C. §§ 15001 et seq. 17 
 (d) Shall, after considering advice from agencies of local 18 
governments and nonprofit organizations which provide social 19 
services, adopt a master plan for the provision of human services in 20 
this State. The Director shall revise the plan biennially and deliver a 21 
copy of the plan to the Governor and the Legislature at the 22 
beginning of each regular session. The plan must: 23 
  (1) Identify and assess the plans and programs of the 24 
Department for the provision of human services, and any 25 
duplication of those services by federal, state and local agencies; 26 
  (2) Set forth priorities for the provision of those services; 27 
  (3) Provide for communication and the coordination of those 28 
services among nonprofit organizations, agencies of local 29 
government, the State and the Federal Government; 30 
  (4) Identify the sources of funding for services provided by 31 
the Department and the allocation of that funding; 32 
  (5) Set forth sufficient information to assist the Department 33 
in providing those services and in the planning and budgeting for the 34 
future provision of those services; and 35 
  (6) Contain any other information necessary for the 36 
Department to communicate effectively with the Federal 37 
Government concerning demographic trends, formulas for the 38 
distribution of federal money and any need for the modification of 39 
programs administered by the Department. 40 
 (e) May, by regulation, require nonprofit organizations and state 41 
and local governmental agencies to provide information regarding 42 
the programs of those organizations and agencies, excluding 43 
detailed information relating to their budgets and payrolls, which the 44   
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Director deems necessary for the performance of the duties imposed 1 
upon him or her pursuant to this section. 2 
 (f) Has such other powers and duties as are provided by law. 3 
 2.  Notwithstanding any other provision of law, the Director, or 4 
the Director’s designee, is responsible for appointing and removing 5 
subordinate officers and employees of the Department. 6 
 Sec. 12.  NRS 287.010 is hereby amended to read as follows: 7 
 287.010 1.  The governing body of any county, school 8 
district, municipal corporation, political subdivision, public 9 
corporation or other local governmental agency of the State of 10 
Nevada may: 11 
 (a) Adopt and carry into effect a system of group life, accident 12 
or health insurance, or any combination thereof, for the benefit of its 13 
officers and employees, and the dependents of officers and 14 
employees who elect to accept the insurance and who, where 15 
necessary, have authorized the governing body to make deductions 16 
from their compensation for the payment of premiums on the 17 
insurance. 18 
 (b) Purchase group policies of life, accident or health insurance, 19 
or any combination thereof, for the benefit of such officers and 20 
employees, and the dependents of such officers and employees, as 21 
have authorized the purchase, from insurance companies authorized 22 
to transact the business of such insurance in the State of Nevada, 23 
and, where necessary, deduct from the compensation of officers and 24 
employees the premiums upon insurance and pay the deductions 25 
upon the premiums. 26 
 (c) Provide group life, accident or health coverage through a 27 
self-insurance reserve fund and, where necessary, deduct 28 
contributions to the maintenance of the fund from the compensation 29 
of officers and employees and pay the deductions into the fund. The 30 
money accumulated for this purpose through deductions from the 31 
compensation of officers and employees and contributions of the 32 
governing body must be maintained as an internal service fund as 33 
defined by NRS 354.543. The money must be deposited in a state or 34 
national bank or credit union authorized to transact business in the 35 
State of Nevada. Any independent administrator of a fund created 36 
under this section is subject to the licensing requirements of chapter 37 
683A of NRS, and must be a resident of this State. Any contract 38 
with an independent administrator must be approved by the 39 
Commissioner of Insurance as to the reasonableness of 40 
administrative charges in relation to contributions collected and 41 
benefits provided. The provisions of NRS 439.581 to 439.597, 42 
inclusive, 686A.135, 687B.352, 687B.408, 687B.692, 687B.723, 43 
687B.725, 687B.805, 689B.030 to 689B.0317, inclusive, and 44 
section 23 of this act, paragraphs (b) and (c) of subsection 1 of NRS 45   
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689B.0319, subsections 2, 4, 6 and 7 of NRS 689B.0319, 689B.033 1 
to 689B.0369, inclusive, 689B.0375 to 689B.050, inclusive, 2 
689B.0675, 689B.265, 689B.287 and 689B.500 and section 24 of 3 
this act apply to coverage provided pursuant to this paragraph, 4 
except that the provisions of NRS 689B.0378, 689B.03785 and 5 
689B.500 only apply to coverage for active officers and employees 6 
of the governing body, or the dependents of such officers and 7 
employees. 8 
 (d) Defray part or all of the cost of maintenance of a self-9 
insurance fund or of the premiums upon insurance. The money for 10 
contributions must be budgeted for in accordance with the laws 11 
governing the county, school district, municipal corporation, 12 
political subdivision, public corporation or other local governmental 13 
agency of the State of Nevada. 14 
 2.  If a school district offers group insurance to its officers and 15 
employees pursuant to this section, members of the board of trustees 16 
of the school district must not be excluded from participating in the 17 
group insurance. If the amount of the deductions from compensation 18 
required to pay for the group insurance exceeds the compensation to 19 
which a trustee is entitled, the difference must be paid by the trustee. 20 
 3.  In any county in which a legal services organization exists, 21 
the governing body of the county, or of any school district, 22 
municipal corporation, political subdivision, public corporation or 23 
other local governmental agency of the State of Nevada in the 24 
county, may enter into a contract with the legal services 25 
organization pursuant to which the officers and employees of the 26 
legal services organization, and the dependents of those officers and 27 
employees, are eligible for any life, accident or health insurance 28 
provided pursuant to this section to the officers and employees, and 29 
the dependents of the officers and employees, of the county, school 30 
district, municipal corporation, political subdivision, public 31 
corporation or other local governmental agency. 32 
 4.  If a contract is entered into pursuant to subsection 3, the 33 
officers and employees of the legal services organization: 34 
 (a) Shall be deemed, solely for the purposes of this section, to be 35 
officers and employees of the county, school district, municipal 36 
corporation, political subdivision, public corporation or other local 37 
governmental agency with which the legal services organization has 38 
contracted; and 39 
 (b) Must be required by the contract to pay the premiums or 40 
contributions for all insurance which they elect to accept or of which 41 
they authorize the purchase. 42 
 5.  A contract that is entered into pursuant to subsection 3: 43   
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 (a) Must be submitted to the Commissioner of Insurance for 1 
approval not less than 30 days before the date on which the contract 2 
is to become effective. 3 
 (b) Does not become effective unless approved by the 4 
Commissioner. 5 
 (c) Shall be deemed to be approved if not disapproved by the 6 
Commissioner within 30 days after its submission. 7 
 6.  As used in this section, “legal services organization” means 8 
an organization that operates a program for legal aid and receives 9 
money pursuant to NRS 19.031. 10 
 Sec. 13.  NRS 287.04335 is hereby amended to read as 11 
follows: 12 
 287.04335 If the Board provides health insurance through a 13 
plan of self-insurance, it shall comply with the provisions of NRS 14 
439.581 to 439.597, inclusive, 686A.135, 687B.352, 687B.409, 15 
687B.692, 687B.723, 687B.725, 687B.805, 689B.0353, 689B.255, 16 
695C.1723, 695G.150, 695G.155, 695G.160, 695G.162, 17 
695G.1635, 695G.164, 695G.1645, 695G.1665, 695G.167, 18 
695G.1675, 695G.170 to 695G.1712, inclusive, and section 44 of 19 
this act, 695G.1714 to 695G.174, inclusive, 695G.176, 695G.177, 20 
695G.200 to 695G.230, inclusive, 695G.241 to 695G.310, inclusive, 21 
695G.405 and 695G.415, and section 45 of this act in the same 22 
manner as an insurer that is licensed pursuant to title 57 of NRS is 23 
required to comply with those provisions. 24 
 Sec. 14.  Chapter 422 of NRS is hereby amended by adding 25 
thereto a new section to read as follows: 26 
 1. To the extent that federal financial participation is 27 
available, the Director shall, except as otherwise provided in 28 
subsection 4, include under Medicaid coverage for: 29 
 (a) Any procedure or medication determined by a qualified 30 
provider of health care to be necessary for the diagnosis and 31 
treatment of infertility in accordance with established medical 32 
practice or any guidelines published by the American College of 33 
Obstetricians and Gynecologists or the American Society for 34 
Reproductive Medicine, or their successor organizations. Such 35 
coverage must include, without limitation, coverage for: 36 
  (1) At least three but not more than five completed 37 
retrievals of oocytes; and  38 
  (2) At least three but not more than five transfers of 39 
embryos, including, without limitation, single-embryo transfer 40 
where appropriate, in accordance with the guidelines of the 41 
American Society for Reproductive Medicine, or its successor 42 
organization. 43   
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 (b) At least 5 years of standard fertility preservation services 1 
that are necessary to preserve fertility because the recipient of 2 
Medicaid: 3 
  (1) Has been diagnosed with a medical or genetic condition 4 
that may directly or indirectly cause infertility, as determined 5 
pursuant to paragraph (a) of subsection 2; or  6 
  (2) Is expected to receive a medical treatment that may 7 
directly or indirectly cause infertility, as determined pursuant to 8 
paragraph (b) of subsection 2.  9 
 2. For the purposes of subsection 1:  10 
 (a) A medical or genetic condition may directly or indirectly 11 
cause infertility if the condition or treatment for the condition is 12 
likely to cause infertility, as established by the American Society of 13 
Clinical Oncology, the American Society for Reproductive 14 
Medicine or the American College of Obstetricians and 15 
Gynecologists, or their successor organizations.  16 
 (b) A medical treatment may directly or indirectly cause 17 
infertility if the treatment has a potential side effect of impaired 18 
fertility, as established by the American Society of Clinical 19 
Oncology or the American Society for Reproductive Medicine, or 20 
their successor organizations.  21 
 3. Medicaid must not: 22 
 (a) Require a recipient of Medicaid to pay a higher deductible, 23 
copayment, coinsurance or other form of cost-sharing for the 24 
benefits described in subsection 1 than is required for similar 25 
benefits that are not related to fertility; 26 
 (b) Require a recipient of Medicaid to obtain prior 27 
authorization for the benefits described in subsection 1 that is not 28 
required for similar benefits that are not related to fertility; 29 
 (c) Require a longer waiting period for the coverage required 30 
by subsection 1 than is required for similar benefits that are not 31 
related to fertility; or 32 
 (d) Impose any other exclusions, limitations, restrictions or 33 
delays on the access of a recipient of Medicaid to the goods and 34 
services described in subsection 1 that is not imposed on similar 35 
benefits that are not related to fertility. 36 
 4. Medicaid is not required to provide coverage pursuant to 37 
subsection 1 for a recipient whose infertility is solely caused by a 38 
voluntary sterilization procedure that has not been successfully 39 
reversed. 40 
 5. The Department shall: 41 
 (a) Apply to the Secretary of Health and Human Services for 42 
any waiver of federal law or apply for any amendment of the State 43 
Plan for Medicaid that is necessary for the Department to receive 44 
federal funding to provide the coverage described in subsection 1. 45   
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 (b) Fully cooperate in good faith with the Federal Government 1 
during the application process to satisfy the requirements of the 2 
Federal Government for obtaining a waiver or amendment 3 
pursuant to paragraph (a). 4 
 6.  As used in this section:  5 
 (a) “Infertility” means a condition characterized by: 6 
  (1) The inability of a person to achieve pregnancy, not 7 
including conception resulting in a miscarriage, where the person 8 
and the partner of the person or a donor have the necessary 9 
gametes to achieve pregnancy and after: 10 
   (I) At least 12 months of regular, unprotected sexual 11 
intercourse or therapeutic donor insemination for a person who is 12 
less than 35 years of age; or 13 
   (II) At least 6 months of regular, unprotected sexual 14 
intercourse or therapeutic donor insemination for a person who is 15 
35 years of age or older; 16 
  (2) The inability of a person or the partner of the person to 17 
reproduce or the inability of a person to reproduce with a 18 
particular partner; or 19 
  (3) A finding by a qualified provider of health care that a 20 
person is infertile based on: 21 
   (I) The medical, sexual and reproductive history or age 22 
of the person; 23 
   (II) Physical findings; or 24 
   (III) Diagnostic testing. 25 
 (b) “Provider of health care” has the meaning ascribed to it in 26 
NRS 629.031.  27 
 (c) “Standard fertility preservation services”:  28 
  (1) Means a procedure or services for the preservation of 29 
fertility that: 30 
   (I) Is not considered experimental or investigational by 31 
the American Society for Reproductive Medicine, or its successor 32 
organization, or the American Society of Clinical Oncology, or its 33 
successor organization; and 34 
   (II) Is consistent with established medical practices or 35 
professional guidelines published by the American Society for 36 
Reproductive Medicine, or its successor organization, or the 37 
American Society of Clinical Oncology, or its successor 38 
organization. 39 
  (2) Includes, without limitation, sperm banking, oocyte 40 
banking, embryo banking, banking of reproductive tissues and the 41 
storage of reproductive cells and tissues. 42   
 	– 13 – 
 
 
- *SB217_R1* 
 Sec. 15.  Chapter 608 of NRS is hereby amended by adding 1 
thereto a new section to read as follows: 2 
 1. Regardless of whether an employee who is pregnant 3 
already has health coverage, an employer who provides benefits 4 
for health care to his or her employees shall, except as otherwise 5 
provided in subsection 3, ensure that the employee is allowed to 6 
enroll in any plan to provide such benefits without any additional 7 
fee or penalty within at least 30 days after the employee has been 8 
confirmed to be pregnant by a qualified provider of health care. 9 
 2. Coverage for an employee who enrolls in a plan to provide 10 
benefits for health care pursuant to subsection 1 must be effective: 11 
 (a) Except as otherwise provided in paragraph (b), on the first 12 
day of the month in which a qualified provider of health care 13 
confirms that the employee is pregnant; or 14 
 (b) Upon the election of the employee, on the first day of the 15 
month after the employee elects to enroll in the plan. 16 
 3. The provisions of this section do not apply to a cafeteria 17 
plan, as defined in 26 U.S.C. § 125(d). 18 
 4. As used in this section, “provider of health care” has the 19 
meaning ascribed to it in NRS 629.031. 20 
 Sec. 16.  NRS 608.1555 is hereby amended to read as follows: 21 
 608.1555 [Any] 1. Except as otherwise provided in this 22 
section, any employer who provides benefits for health care to his 23 
or her employees shall provide the same benefits and pay providers 24 
of health care in the same manner as a policy of insurance pursuant 25 
to chapters 689A and 689B of NRS, including, without limitation, 26 
as required by NRS 687B.409, 687B.723 and 687B.725. 27 
 2. An employer who employs less than 100 employees and 28 
provides benefits for health care to his or her employees through a 29 
plan of self-insurance is exempt from the requirements of section 30 
23 of this act. 31 
 Sec. 17.  NRS 608.180 is hereby amended to read as follows: 32 
 608.180 The Labor Commissioner or the representative of the 33 
Labor Commissioner shall cause the provisions of NRS 608.005 to 34 
608.195, inclusive, and section 15 of this act and 608.215 to be 35 
enforced, and upon notice from the Labor Commissioner or the 36 
representative: 37 
 1.  The district attorney of any county in which a violation of 38 
those sections has occurred; 39 
 2.  The Deputy Labor Commissioner, as provided in  40 
NRS 607.050; 41 
 3.  The Attorney General, as provided in NRS 607.160 or 42 
607.220; or 43 
 4.  The special counsel, as provided in NRS 607.065, 44 
 shall prosecute the action for enforcement according to law. 45   
 	– 14 – 
 
 
- *SB217_R1* 
 Sec. 18.  NRS 608.195 is hereby amended to read as follows: 1 
 608.195 1.  Except as otherwise provided in NRS 608.0165, 2 
any person who violates any provision of NRS 608.005 to 608.195, 3 
inclusive, and section 15 of this act or 608.215, or any regulation 4 
adopted pursuant thereto, is guilty of a misdemeanor. 5 
 2.  In addition to any other remedy or penalty, the Labor 6 
Commissioner may impose against the person an administrative 7 
penalty of not more than $5,000 for each such violation. 8 
 Sec. 19.  NRS 687B.225 is hereby amended to read as follows: 9 
 687B.225 1.  Except as otherwise provided in NRS 10 
689A.0405, 689A.0412, 689A.0413, 689A.0418, 689A.0437, 11 
689A.044, 689A.0445, 689A.0459, 689B.031, 689B.0312, 12 
689B.0313, 689B.0315, 689B.0317, 689B.0319, 689B.0374, 13 
689B.0378, 689C.1665, 689C.1671, 689C.1675, 689C.1676, 14 
695A.1843, 695A.1856, 695A.1865, 695A.1874, 695B.1912, 15 
695B.1913, 695B.1914, 695B.1919, 695B.19197, 695B.1924, 16 
695B.1925, 695B.1942, 695C.1696, 695C.1699, 695C.1713, 17 
695C.1735, 695C.1737, 695C.1743, 695C.1745, 695C.1751, 18 
695G.170, 695G.1705, 695G.171, 695G.1714, 695G.1715, 19 
695G.1719 and 695G.177, and sections 23, 31, 37 and 44 of this 20 
act, any contract for group, blanket or individual health insurance or 21 
any contract by a nonprofit hospital, medical or dental service 22 
corporation or organization for dental care which provides for 23 
payment of a certain part of medical or dental care may require the 24 
insured or member to obtain prior authorization for that care from 25 
the insurer or organization. The insurer or organization shall: 26 
 (a) File its procedure for obtaining approval of care pursuant to 27 
this section for approval by the Commissioner; and 28 
 (b) Unless a shorter time period is prescribed by a specific 29 
statute, including, without limitation, NRS 689A.0446, 689B.0361, 30 
689C.1688, 695A.1859, 695B.19087, 695C.16932 and 695G.1703, 31 
respond to any request for approval by the insured or member 32 
pursuant to this section within 20 days after it receives the request. 33 
 2.  The procedure for prior authorization may not discriminate 34 
among persons licensed to provide the covered care. 35 
 Sec. 20.  Chapter 689A of NRS is hereby amended by adding 36 
thereto a new section to read as follows: 37 
 1. Regardless of whether a person who is pregnant already 38 
has health coverage, an insurer shall allow the person to enroll in 39 
a policy of health insurance without any additional fee or penalty 40 
within at least 60 days after the person has been confirmed to be 41 
pregnant by a qualified provider of health care. 42 
 2. Coverage for a person who enrolls in a policy of health 43 
insurance pursuant to subsection 1 must be effective: 44   
 	– 15 – 
 
 
- *SB217_R1* 
 (a) Except as otherwise provided in paragraph (b), on the first 1 
day of the month in which a qualified provider of health care 2 
confirms that the person is pregnant; or 3 
 (b) Upon the election of the person, on the first day of the 4 
month after the person elects to enroll in the policy. 5 
 3. As used in this section, “provider of health care” has the 6 
meaning ascribed to it in NRS 629.031. 7 
 Sec. 21.  NRS 689A.420 is hereby amended to read as follows: 8 
 689A.420 As used in NRS 689A.420 to 689A.460, inclusive, 9 
and section 20 of this act, unless the context otherwise requires: 10 
 1.  “Medicaid” means a program established in any state 11 
pursuant to Title XIX of the Social Security Act (42 U.S.C. §§ 1396 12 
et seq.) to provide assistance for part or all of the cost of medical 13 
care rendered on behalf of indigent persons. 14 
 2.  “Order for medical coverage” means an order of a court or 15 
administrative tribunal to provide coverage under a policy of health 16 
insurance to a child pursuant to the provisions of 42 U.S.C. § 17 
1396g-1. 18 
 Sec. 22.  Chapter 689B of NRS is hereby amended by adding 19 
thereto the provisions set forth as sections 23 and 24 of this act. 20 
 Sec. 23.  1. Except as otherwise provided in subsections 5 21 
and 6, an insurer that issues a policy of group health insurance 22 
with more than 50 employees or members of the insured group 23 
shall include in the policy coverage for: 24 
 (a) Any procedure or medication determined by a qualified 25 
provider of health care to be necessary for the diagnosis and 26 
treatment of infertility in accordance with established medical 27 
practice or any guidelines published by the American College of 28 
Obstetricians and Gynecologists or the American Society for 29 
Reproductive Medicine, or their successor organizations. Such 30 
coverage must include, without limitation, coverage for: 31 
  (1) At least three but not more than five completed 32 
retrievals of oocytes; and  33 
  (2) At least three but not more than five transfers of 34 
embryos, including, without limitation, single-embryo transfer 35 
where appropriate, in accordance with the guidelines of the 36 
American Society for Reproductive Medicine, or its successor 37 
organization. 38 
 (b) At least 5 years of standard fertility preservation services 39 
that are necessary to preserve fertility because the insured: 40 
  (1) Has been diagnosed with a medical or genetic condition 41 
that may directly or indirectly cause infertility, as determined 42 
pursuant to paragraph (a) of subsection 2; or  43   
 	– 16 – 
 
 
- *SB217_R1* 
  (2) Is expected to receive a medical treatment that may 1 
directly or indirectly cause infertility, as determined pursuant to 2 
paragraph (b) of subsection 2.  3 
 2. For the purposes of subsection 1:  4 
 (a) A medical or genetic condition may directly or indirectly 5 
cause infertility if the condition or treatment for the condition is 6 
likely to cause infertility, as established by the American Society of 7 
Clinical Oncology, the American Society for Reproductive 8 
Medicine or the American College of Obstetricians and 9 
Gynecologists, or their successor organizations.  10 
 (b) A medical treatment may directly or indirectly cause 11 
infertility if the treatment has a potential side effect of impaired 12 
fertility, as established by the American Society of Clinical 13 
Oncology or the American Society for Reproductive Medicine, or 14 
their successor organizations.  15 
 3. An insurer shall ensure that the benefits required by 16 
subsection 1 are made available to an insured through a provider 17 
of health care who participates in the network plan of the insurer.  18 
 4. An insurer shall not: 19 
 (a) Require an insured to pay a higher deductible, copayment, 20 
coinsurance or other form of cost-sharing for the benefits 21 
required by subsection 1 than is required for similar benefits that 22 
are not related to fertility; 23 
 (b) Require an insured to obtain prior authorization for the 24 
benefits described in subsection 1 that is not required for similar 25 
benefits that are not related to fertility; 26 
 (c) Require a longer waiting period for the coverage required 27 
by subsection 1 than is required for similar benefits that are not 28 
related to fertility; 29 
 (d) Impose any other exclusions, limitations, restrictions or 30 
delays on the access of an insured to any benefit described in 31 
subsection 1 that is not imposed on similar benefits that are not 32 
related to fertility; 33 
 (e) Refuse to issue a policy of group health insurance or 34 
cancel a policy of group health insurance solely because the 35 
person applying for or covered by the policy uses or may use in the 36 
future any benefit described in subsection 1; 37 
 (f) Offer or pay any type of material inducement or financial 38 
incentive to an insured to discourage the insured from accessing 39 
any benefit described in subsection 1; 40 
 (g) Penalize a provider of health care who provides any benefit 41 
described in subsection 1 to an insured, including, without 42 
limitation, reducing the reimbursement of the provider of health 43 
care; or 44   
 	– 17 – 
 
 
- *SB217_R1* 
 (h) 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 any benefit described in subsection 3 
1 to an insured. 4 
 5. An insurer is not required to provide the coverage required 5 
by subsection 1 for an insured whose infertility is solely caused by 6 
a voluntary sterilization procedure that has not been successfully 7 
reversed. 8 
 6. An insurer that is affiliated with a religious organization is 9 
not required to provide the coverage required by subsection 1 if 10 
the insurer objects on religious grounds. Such an insurer shall, 11 
before the issuance of a policy of group health insurance that is 12 
subject to the requirements of subsection 1 and before the renewal 13 
of such a policy, provide to the group policyholder or prospective 14 
insured, as applicable, written notice of the coverage that the 15 
insurer refuses to provide pursuant to this subsection. 16 
 7.  A policy of group health insurance with more than 50 17 
employees or members of the insured group that is subject to the 18 
provisions of this chapter and is delivered, issued for delivery or 19 
renewed on or after January 1, 2026, has the legal effect of 20 
including the coverage required by subsection 1, and any 21 
provision of the policy or the renewal that conflicts with the 22 
provisions of this section is void.  23 
 8.  As used in this section:  24 
 (a) “Infertility” means a condition characterized by: 25 
  (1) The inability of a person to achieve pregnancy, not 26 
including conception resulting in a miscarriage, where the person 27 
and the partner of the person or a donor have the necessary 28 
gametes to achieve pregnancy and after: 29 
   (I) At least 12 months of regular, unprotected sexual 30 
intercourse or therapeutic donor insemination for a person who is 31 
less than 35 years of age; or 32 
   (II) At least 6 months of regular, unprotected sexual 33 
intercourse or therapeutic donor insemination for a person who is 34 
35 years of age or older; 35 
  (2) The inability of a person or the partner of the person to 36 
reproduce or the inability of a person to reproduce with a 37 
particular partner; or 38 
  (3) A finding by a qualified provider of health care that a 39 
person is infertile based on: 40 
   (I) The medical, sexual and reproductive history or age 41 
of the person; 42 
   (II) Physical findings; or 43 
   (III) Diagnostic testing. 44   
 	– 18 – 
 
 
- *SB217_R1* 
 (b) “Network plan” means a policy of group health insurance 1 
offered by an insurer under which the financing and delivery of 2 
medical care, including items and services paid for as medical 3 
care, are provided, in whole or in part, through a defined set of 4 
providers under contract with the insurer. The term does not 5 
include an arrangement for the financing of premiums.  6 
 (c) “Provider of health care” has the meaning ascribed to it in 7 
NRS 629.031.  8 
 (d) “Standard fertility preservation services”:  9 
  (1) Means a procedure or services for the preservation of 10 
fertility that: 11 
   (I) Is not considered experimental or investigational by 12 
the American Society for Reproductive Medicine, or its successor 13 
organization, or the American Society of Clinical Oncology, or its 14 
successor organization; and 15 
   (II) Is consistent with established medical practices or 16 
professional guidelines published by the American Society for 17 
Reproductive Medicine, or its successor organization, or the 18 
American Society of Clinical Oncology, or its successor 19 
organization. 20 
  (2) Includes, without limitation, sperm banking, oocyte 21 
banking, embryo banking, banking of reproductive tissues and the 22 
storage of reproductive cells and tissues. 23 
 Sec. 24.  1. Regardless of whether a person who is pregnant 24 
already has health coverage, an insurer shall, except as otherwise 25 
provided in subsection 3, allow the person to enroll in a policy of 26 
group health insurance without any additional fee or penalty 27 
within at least 30 days after the person has been confirmed to be 28 
pregnant by a qualified provider of health care. 29 
 2. Coverage for a person who enrolls in a policy of group 30 
health insurance pursuant to subsection 1 must be effective: 31 
 (a) Except as otherwise provided in paragraph (b), on the first 32 
day of the month in which a qualified provider of health care 33 
confirms that the person is pregnant; or 34 
 (b) Upon the election of the person, on the first day of the 35 
month after the person elects to enroll in the policy. 36 
 3. The provisions of this section do not apply to a cafeteria 37 
plan, as defined in 26 U.S.C. § 125(d). 38 
 4. As used in this section, “provider of health care” has the 39 
meaning ascribed to it in NRS 629.031. 40 
 Sec. 25.  NRS 689B.0376 is hereby amended to read as 41 
follows: 42 
 689B.0376 1.  An insurer that offers or issues a policy of 43 
group health insurance which provides coverage for prescription 44 
drugs or devices shall include in the policy coverage for any type of 45   
 	– 19 – 
 
 
- *SB217_R1* 
hormone replacement therapy which is lawfully prescribed or 1 
ordered and which has been approved by the Food and Drug 2 
Administration. 3 
 2.  An insurer that offers or issues a policy of group health 4 
insurance that provides coverage for prescription drugs 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 for coverage for a prescription for hormone 8 
replacement therapy; 9 
 (b) Refuse to issue a policy of group health insurance or cancel a 10 
policy of group health insurance solely because the person applying 11 
for or covered by the policy uses or may use in the future hormone 12 
replacement therapy; 13 
 (c) Offer or pay any type of material inducement or financial 14 
incentive to an insured to discourage the insured from accessing 15 
hormone replacement therapy; 16 
 (d) Penalize a provider of health care who provides hormone 17 
replacement therapy to an insured, including, without limitation, 18 
reducing the reimbursement of the provider of health care; or 19 
 (e) Offer or pay any type of material inducement, bonus or other 20 
financial incentive to a provider of health care to deny, reduce, 21 
withhold, limit or delay hormone replacement therapy to an insured. 22 
 3.  A policy subject to the provisions of this chapter that is 23 
delivered, issued for delivery or renewed on or after October 1, 24 
1999, has the legal effect of including the coverage required by 25 
subsection 1, and any provision of the policy or the renewal which is 26 
in conflict with this section is void. 27 
 4.  The provisions of this section do not require an insurer to 28 
provide coverage for fertility drugs [.] , except as required by 29 
section 23 of this act. 30 
 5.  As used in this section, “provider of health care” has the 31 
meaning ascribed to it in NRS 629.031. 32 
 Sec. 26.  NRS 689B.290 is hereby amended to read as follows: 33 
 689B.290 As used in NRS 689B.290 to 689B.330, inclusive, 34 
and section 24 of this act, unless the context otherwise requires: 35 
 1.  “Medicaid” means a program established in any state 36 
pursuant to Title XIX of the Social Security Act (42 U.S.C. §§ 1396 37 
et seq.) to provide assistance for part or all of the cost of medical 38 
care rendered on behalf of indigent persons. 39 
 2.  “Order for medical coverage” means an order of a court or 40 
administrative tribunal to provide coverage under a group health 41 
policy to a child pursuant to the provisions of 42 U.S.C. § 1396g-1. 42   
 	– 20 – 
 
 
- *SB217_R1* 
 Sec. 27.  Chapter 689C of NRS is hereby amended by adding 1 
thereto a new section to read as follows: 2 
 1. Regardless of whether a person who is pregnant already 3 
has health coverage, a carrier shall, except as otherwise provided 4 
in subsection 3, allow the person to enroll in a health benefit plan 5 
without any additional fee or penalty within at least 30 days after 6 
the person has been confirmed to be pregnant by a qualified 7 
provider of health care. 8 
 2. Coverage for a person who enrolls in a health benefit plan 9 
pursuant to subsection 1 must be effective: 10 
 (a) Except as otherwise provided in paragraph (b), on the first 11 
day of the month in which a qualified provider of health care 12 
confirms that the person is pregnant; or 13 
 (b) Upon the election of the person, on the first day of the 14 
month after the person elects to enroll in the health benefit plan. 15 
 3. The provisions of this section do not apply to a cafeteria 16 
plan, as defined in 26 U.S.C. § 125(d). 17 
 4. As used in this section, “provider of health care” has the 18 
meaning ascribed to it in NRS 629.031. 19 
 Sec. 28.  NRS 689C.425 is hereby amended to read as follows: 20 
 689C.425 A voluntary purchasing group and any contract 21 
issued to such a group pursuant to NRS 689C.360 to 689C.600, 22 
inclusive, are subject to the provisions of NRS 689C.015 to 23 
689C.355, inclusive, and section 27 of this act to the extent 24 
applicable and not in conflict with the express provisions of NRS 25 
687B.408 and 689C.360 to 689C.600, inclusive. 26 
 Sec. 29.  Chapter 695A of NRS is hereby amended by adding 27 
thereto a new section to read as follows: 28 
 1. Regardless of whether a person who is pregnant already 29 
has health coverage, a society shall allow the person to enroll in a 30 
benefit contract without any additional fee or penalty within at 31 
least 60 days after the person has been confirmed to be pregnant 32 
by a qualified provider of health care. 33 
 2. Coverage for a person who enrolls in a benefit contract 34 
pursuant to subsection 1 must be effective: 35 
 (a) Except as otherwise provided in paragraph (b), on the first 36 
day of the month in which a qualified provider of health care 37 
confirms that the person is pregnant; or 38 
 (b) Upon the election of the person, on the first day of the 39 
month after the person elects to enroll in the benefit contract. 40 
 3. As used in this section, “provider of health care” has the 41 
meaning ascribed to it in NRS 629.031. 42   
 	– 21 – 
 
 
- *SB217_R1* 
 Sec. 30.  Chapter 695B of NRS is hereby amended by adding 1 
thereto the provisions set forth as sections 31 and 32 of this act. 2 
 Sec. 31.  1. Except as otherwise provided in subsections 5 3 
and 6, a hospital or medical services corporation that issues a 4 
policy of group health insurance with more than 50 employees or 5 
members of the insured group shall include in the policy coverage 6 
for: 7 
 (a) Any procedure or medication determined by a qualified 8 
provider of health care to be necessary for the diagnosis and 9 
treatment of infertility in accordance with established medical 10 
practice or any guidelines published by the American College of 11 
Obstetricians and Gynecologists or the American Society for 12 
Reproductive Medicine, or their successor organizations. Such 13 
coverage must include, without limitation, coverage for: 14 
  (1) At least three but not more than five completed 15 
retrievals of oocytes; and  16 
  (2) At least three but not more than five transfers of 17 
embryos, including, without limitation, single-embryo transfer 18 
where appropriate, in accordance with the guidelines of the 19 
American Society for Reproductive Medicine, or its successor 20 
organization. 21 
 (b) At least 5 years of standard fertility preservation services 22 
that are necessary to preserve fertility because the insured: 23 
  (1) Has been diagnosed with a medical or genetic condition 24 
that may directly or indirectly cause infertility, as determined 25 
pursuant to paragraph (a) of subsection 2; or  26 
  (2) Is expected to receive a medical treatment that may 27 
directly or indirectly cause infertility, as determined pursuant to 28 
paragraph (b) of subsection 2.  29 
 2. For the purposes of subsection 1:  30 
 (a) A medical or genetic condition may directly or indirectly 31 
cause infertility if the condition or treatment for the condition is 32 
likely to cause infertility, as established by the American Society of 33 
Clinical Oncology, the American Society for Reproductive 34 
Medicine or the American College of Obstetricians and 35 
Gynecologists, or their successor organizations.  36 
 (b) A medical treatment may directly or indirectly cause 37 
infertility if the treatment has a potential side effect of impaired 38 
fertility, as established by the American Society of Clinical 39 
Oncology or the American Society for Reproductive Medicine, or 40 
their successor organizations.  41 
 3. A hospital or medical services corporation shall ensure 42 
that the benefits required by subsection 1 are made available to an 43 
insured through a provider of health care who participates in the 44 
network plan of the hospital or medical services corporation.  45   
 	– 22 – 
 
 
- *SB217_R1* 
 4. A hospital or medical services corporation shall not: 1 
 (a) Require an insured to pay a higher deductible, copayment, 2 
coinsurance or other form of cost-sharing for the benefits 3 
required by subsection 1 than is required for similar benefits that 4 
are not related to fertility; 5 
 (b) Require an insured to obtain prior authorization for the 6 
benefits described in subsection 1 that is not required for similar 7 
benefits that are not related to fertility; 8 
 (c) Require a longer waiting period for the coverage required 9 
by subsection 1 than is required for similar benefits that are not 10 
related to fertility; 11 
 (d) Impose any other exclusions, limitations, restrictions or 12 
delays on the access of an insured to any benefit described in 13 
subsection 1 that is not imposed on similar benefits that are not 14 
related to fertility; 15 
 (e) Refuse to issue a policy of group health insurance or 16 
cancel a policy of group health insurance solely because the 17 
person applying for or covered by the policy uses or may use in the 18 
future any benefit described in subsection 1; 19 
 (f) Offer or pay any type of material inducement or financial 20 
incentive to an insured to discourage the insured from accessing 21 
any benefit described in subsection 1; 22 
 (g) Penalize a provider of health care who provides any benefit 23 
described in subsection 1 to an insured, including, without 24 
limitation, reducing the reimbursement of the provider of health 25 
care; or 26 
 (h) 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 any benefit described in subsection 29 
1 to an insured. 30 
 5. A hospital or medical services corporation is not required 31 
to provide the coverage required by subsection 1 for an insured 32 
whose infertility is solely caused by a voluntary sterilization 33 
procedure that has not been successfully reversed. 34 
 6. A hospital or medical services corporation that is affiliated 35 
with a religious organization is not required to provide the 36 
coverage required by subsection 1 if the hospital or medical 37 
services corporation objects on religious grounds. Such a hospital 38 
or medical services corporation shall, before the issuance of a 39 
policy of group health insurance that is subject to the 40 
requirements of subsection 1 and before the renewal of such a 41 
policy, provide to the group policyholder or prospective insured, as 42 
applicable, written notice of the coverage that the hospital or 43 
medical services corporation refuses to provide pursuant to this 44 
subsection. 45   
 	– 23 – 
 
 
- *SB217_R1* 
 7.  A policy of group health insurance with more than 50 1 
employees or members of the insured group that is subject to the 2 
provisions of this chapter and is delivered, issued for delivery or 3 
renewed on or after January 1, 2026, has the legal effect of 4 
including the coverage required by subsection 1, and any 5 
provision of the policy or the renewal that conflicts with the 6 
provisions of this section is void.  7 
 8.  As used in this section:  8 
 (a) “Infertility” means a condition characterized by: 9 
  (1) The inability of a person to achieve pregnancy, not 10 
including conception resulting in a miscarriage, where the person 11 
and the partner of the person or a donor have the necessary 12 
gametes to achieve pregnancy and after: 13 
   (I) At least 12 months of regular, unprotected sexual 14 
intercourse or therapeutic donor insemination for a person who is 15 
less than 35 years of age; or 16 
   (II) At least 6 months of regular, unprotected sexual 17 
intercourse or therapeutic donor insemination for a person who is 18 
35 years of age or older; 19 
  (2) The inability of a person or the partner of the person to 20 
reproduce or the inability of a person to reproduce with a 21 
particular partner; or 22 
  (3) A finding by a qualified provider of health care that a 23 
person is infertile based on: 24 
   (I) The medical, sexual and reproductive history or age 25 
of the person; 26 
   (II) Physical findings; or 27 
   (III) Diagnostic testing. 28 
 (b) “Network plan” means a policy of health insurance offered 29 
by a hospital or medical services corporation under which the 30 
financing and delivery of medical care, including items and 31 
services paid for as medical care, are provided, in whole or in part, 32 
through a defined set of providers under contract with the hospital 33 
or medical services corporation. The term does not include an 34 
arrangement for the financing of premiums.  35 
 (c) “Provider of health care” has the meaning ascribed to it in 36 
NRS 629.031. 37 
 (d) “Standard fertility preservation services”:  38 
  (1) Means a procedure or services for the preservation of 39 
fertility that: 40 
   (I) Is not considered experimental or investigational by 41 
the American Society for Reproductive Medicine, or its successor 42 
organization, or the American Society of Clinical Oncology, or its 43 
successor organization; and 44   
 	– 24 – 
 
 
- *SB217_R1* 
   (II) Is consistent with established medical practices or 1 
professional guidelines published by the American Society for 2 
Reproductive Medicine, or its successor organization, or the 3 
American Society of Clinical Oncology, or its successor 4 
organization. 5 
  (2) Includes, without limitation, sperm banking, oocyte 6 
banking, embryo banking, banking of reproductive tissues and the 7 
storage of reproductive cells and tissues.  8 
 Sec. 32.  1. Regardless of whether a person who is pregnant 9 
already has health coverage, a corporation shall, except as 10 
otherwise provided in subsection 3, allow the person to enroll in a 11 
policy of health insurance without any additional fee or penalty 12 
within at least: 13 
 (a) Sixty days after the person has been confirmed to be 14 
pregnant by a qualified provider of health care, if the policy is 15 
offered on the individual market; or 16 
 (b) Thirty days after the person has been confirmed to be 17 
pregnant by a qualified provider of health care, if the policy is 18 
offered on the group market. 19 
 2. Coverage for a person who enrolls in a policy of health 20 
insurance pursuant to subsection 1 must be effective: 21 
 (a) Except as otherwise provided in paragraph (b), on the first 22 
day of the month in which a qualified provider of health care 23 
confirms that the person is pregnant; or 24 
 (b) Upon the election of the person, on the first day of the 25 
month after the person elects to enroll in the policy. 26 
 3. The provisions of this section do not apply to a cafeteria 27 
plan, as defined in 26 U.S.C. § 125(d). 28 
 4. As used in this section, “provider of health care” has the 29 
meaning ascribed to it in NRS 629.031. 30 
 Sec. 33.  NRS 695B.1916 is hereby amended to read as 31 
follows: 32 
 695B.1916 1.  An insurer that offers or issues a contract for 33 
hospital or medical service which provides coverage for prescription 34 
drugs or devices shall include in the contract coverage for any type 35 
of hormone replacement therapy which is lawfully prescribed or 36 
ordered and which has been approved by the Food and Drug 37 
Administration. 38 
 2.  An insurer that offers or issues a contract for hospital or 39 
medical service that provides coverage for prescription drugs shall 40 
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 for coverage for a prescription for hormone 44 
replacement therapy; 45   
 	– 25 – 
 
 
- *SB217_R1* 
 (b) Refuse to issue a contract for hospital or medical service or 1 
cancel a contract for hospital or medical service solely because the 2 
person applying for or covered by the contract uses or may use in 3 
the future hormone replacement therapy; 4 
 (c) Offer or pay any type of material inducement or financial 5 
incentive to an insured to discourage the insured from accessing 6 
hormone replacement therapy; 7 
 (d) Penalize a provider of health care who provides hormone 8 
replacement therapy to an insured, including, without limitation, 9 
reducing the reimbursement of the provider of health care; or 10 
 (e) Offer or pay any type of material inducement, bonus or other 11 
financial incentive to a provider of health care to deny, reduce, 12 
withhold, limit or delay hormone replacement therapy to an insured. 13 
 3.  A contract for hospital or medical service subject to the 14 
provisions of this chapter that is delivered, issued for delivery or 15 
renewed on or after October 1, 1999, has the legal effect of 16 
including the coverage required by subsection 1, and any provision 17 
of the contract or the renewal which is in conflict with this section is 18 
void. 19 
 4. The provisions of this section do not require an insurer to 20 
provide coverage for fertility drugs [.] , except as required by 21 
section 31 of this act. 22 
 5.  As used in this section, “provider of health care” has the 23 
meaning ascribed to it in NRS 629.031. 24 
 Sec. 34.  NRS 695B.330 is hereby amended to read as follows: 25 
 695B.330 As used in NRS 695B.330 to 695B.370, inclusive, 26 
and section 32 of this act, unless the context otherwise requires: 27 
 1.  “Contract” means a contract for hospital, medical or dental 28 
services issued pursuant to this chapter. 29 
 2.  “Corporation” means a corporation organized pursuant to 30 
this chapter. 31 
 3.  “Medicaid” means a program established in any state 32 
pursuant to Title XIX of the Social Security Act (42 U.S.C. §§ 1396 33 
et seq.) to provide assistance for part or all of the cost of medical 34 
care rendered on behalf of indigent persons. 35 
 4.  “Order for medical coverage” means an order of a court or 36 
administrative tribunal to provide coverage under a contract to a 37 
child pursuant to the provisions of 42 U.S.C. § 1396g-1. 38 
 Sec. 35.  Chapter 695C of NRS is hereby amended by adding 39 
thereto the provisions set forth as sections 36 and 37 of this act. 40 
 Sec. 36.  1. Regardless of whether a person who is pregnant 41 
already has health coverage, a health maintenance organization 42 
shall, except as otherwise provided in subsection 3, allow the 43 
person to enroll in a health care plan without any additional fee or 44 
penalty within at least: 45   
 	– 26 – 
 
 
- *SB217_R1* 
 (a) Sixty days after the person has been confirmed to be 1 
pregnant by a qualified provider of health care, if the health care 2 
plan is offered on the individual market; or 3 
 (b) Thirty days after the person has been confirmed to be 4 
pregnant by a qualified provider of health care, if the health care 5 
plan is offered on the group market. 6 
 2. Coverage for a person who enrolls in a health care plan 7 
pursuant to subsection 1 must be effective: 8 
 (a) Except as otherwise provided in paragraph (b), on the first 9 
day of the month in which a qualified provider of health care 10 
confirms that the person is pregnant; or 11 
 (b) Upon the election of the person, on the first day of the 12 
month after the person elects to enroll in the plan. 13 
 3. The provisions of this section do not apply to a cafeteria 14 
plan, as defined in 26 U.S.C. § 125(d). 15 
 4. As used in this section, “provider of health care” has the 16 
meaning ascribed to it in NRS 629.031. 17 
 Sec. 37.  1. Except as otherwise provided in subsections 5 18 
and 6, a health maintenance organization that issues a group 19 
health care plan with more than 50 employees or members of the 20 
covered group or a plan that provides health care services through 21 
managed care to recipients of Medicaid under the State Plan for 22 
Medicaid shall include in the plan coverage for: 23 
 (a) Any procedure or medication determined by a qualified 24 
provider of health care to be necessary for the diagnosis and 25 
treatment of infertility in accordance with established medical 26 
practice or any guidelines published by the American College of 27 
Obstetricians and Gynecologists or the American Society for 28 
Reproductive Medicine, or their successor organizations. Such 29 
coverage must include, without limitation, coverage for: 30 
  (1) At least three but not more than five completed 31 
retrievals of oocytes; and  32 
  (2) At least three but not more than five transfers of 33 
embryos, including, without limitation, single-embryo transfer 34 
where appropriate, in accordance with the guidelines of the 35 
American Society for Reproductive Medicine, or its successor 36 
organization. 37 
 (b) At least 5 years of standard fertility preservation services 38 
that are necessary to preserve fertility because the enrollee: 39 
  (1) Has been diagnosed with a medical or genetic condition 40 
that may directly or indirectly cause infertility, as determined 41 
pursuant to paragraph (a) of subsection 2; or  42 
  (2) Is expected to receive a medical treatment that may 43 
directly or indirectly cause infertility, as determined pursuant to 44 
paragraph (b) of subsection 2.  45   
 	– 27 – 
 
 
- *SB217_R1* 
 2. For the purposes of subsection 1:  1 
 (a) A medical or genetic condition may directly or indirectly 2 
cause infertility if the condition or treatment for the condition is 3 
likely to cause infertility, as established by the American Society of 4 
Clinical Oncology, the American Society for Reproductive 5 
Medicine or the American College of Obstetricians and 6 
Gynecologists, or their successor organizations.  7 
 (b) A medical treatment may directly or indirectly cause 8 
infertility if the treatment has a potential side effect of impaired 9 
fertility, as established by the American Society of Clinical 10 
Oncology or the American Society for Reproductive Medicine, or 11 
their successor organizations.  12 
 3. A health maintenance organization shall ensure that the 13 
benefits required by subsection 1 are made available to an enrollee 14 
through a provider of health care who participates in the network 15 
plan of the health maintenance organization. 16 
 4. A health maintenance organization shall not: 17 
 (a) Require an enrollee to pay a higher deductible, copayment, 18 
coinsurance or other form of cost-sharing for the benefits 19 
required by subsection 1 than is required for similar benefits that 20 
are not related to fertility; 21 
 (b) Require an enrollee to obtain prior authorization for the 22 
benefits described in subsection 1 that is not required for similar 23 
benefits that are not related to fertility; 24 
 (c) Require a longer waiting period for the coverage required 25 
by subsection 1 than is required for similar benefits that are not 26 
related to fertility; 27 
 (d) Impose any other exclusions, limitations, restrictions or 28 
delays on the access of an enrollee to any benefit described in 29 
subsection 1 that is not imposed on similar benefits that are not 30 
related to fertility; 31 
 (e) Refuse to issue a health care plan or cancel a health care 32 
plan solely because the person applying for or covered by the plan 33 
uses or may use in the future any benefit described in  34 
subsection 1; 35 
 (f) Offer or pay any type of material inducement or financial 36 
incentive to an enrollee to discourage the enrollee from accessing 37 
any benefit described in subsection 1; 38 
 (g) Penalize a provider of health care who provides any benefit 39 
described in subsection 1 to an enrollee, including, without 40 
limitation, reducing the reimbursement of the provider of health 41 
care; or 42 
 (h) Offer or pay any type of material inducement, bonus or 43 
other financial incentive to a provider of health care to deny, 44   
 	– 28 – 
 
 
- *SB217_R1* 
reduce, withhold, limit or delay any benefit described in subsection 1 
1 to an enrollee. 2 
 5. A health maintenance organization is not required to 3 
provide the coverage required by subsection 1 for an enrollee 4 
whose infertility is solely caused by a voluntary sterilization 5 
procedure that has not been successfully reversed. 6 
 6. A health maintenance organization which is affiliated with 7 
a religious organization is not required to provide the coverage 8 
required by subsection 1 if the health maintenance organization 9 
objects on religious grounds. Such a health maintenance 10 
organization shall, before the issuance of a group health care plan 11 
that is subject to the requirements of subsection 1 and before the 12 
renewal of such a plan, provide to the group policyholder or 13 
prospective enrollee, as applicable, written notice of the coverage 14 
that the health maintenance organization refuses to provide 15 
pursuant to this subsection. 16 
 7.  A group health care plan with more than 50 employees or 17 
members of the covered group that is subject to the provisions of 18 
this chapter and is delivered, issued for delivery or renewed on or 19 
after January 1, 2026, has the legal effect of including the 20 
coverage required by subsection 1, and any provision of the plan 21 
or the renewal that conflicts with the provisions of this section is 22 
void.  23 
 8.  As used in this section:  24 
 (a) “Infertility” means a condition characterized by: 25 
  (1) The inability of a person to achieve pregnancy, not 26 
including conception resulting in a miscarriage, where the person 27 
and the partner of the person or a donor have the necessary 28 
gametes to achieve pregnancy and after: 29 
   (I) At least 12 months of regular, unprotected sexual 30 
intercourse or therapeutic donor insemination for a person who is 31 
less than 35 years of age; or 32 
   (II) At least 6 months of regular, unprotected sexual 33 
intercourse or therapeutic donor insemination for a person who is 34 
35 years of age or older; 35 
  (2) The inability of a person or the partner of the person to 36 
reproduce or the inability of a person to reproduce with a 37 
particular partner; or 38 
  (3) A finding by a qualified provider of health care that a 39 
person is infertile based on: 40 
   (I) The medical, sexual and reproductive history or age 41 
of the person; 42 
   (II) Physical findings; or 43 
   (III) Diagnostic testing. 44   
 	– 29 – 
 
 
- *SB217_R1* 
 (b) “Network plan” means a health care plan offered by a 1 
health maintenance 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 under contract with the health maintenance 5 
organization. The term does not include an arrangement for the 6 
financing of premiums.  7 
 (c) “Provider of health care” has the meaning ascribed to it in 8 
NRS 629.031. 9 
 (d) “Standard fertility preservation services”:  10 
  (1) Means a procedure or services for the preservation of 11 
fertility that: 12 
   (I) Is not considered experimental or investigational by 13 
the American Society for Reproductive Medicine, or its successor 14 
organization, or the American Society of Clinical Oncology, or its 15 
successor organization; and 16 
   (II) Is consistent with established medical practices or 17 
professional guidelines published by the American Society for 18 
Reproductive Medicine, or its successor organization, or the 19 
American Society of Clinical Oncology, or its successor 20 
organization. 21 
  (2) Includes, without limitation, sperm banking, oocyte 22 
banking, embryo banking, banking of reproductive tissues and the 23 
storage of reproductive cells and tissues.  24 
 Sec. 38.  NRS 695C.050 is hereby amended to read as follows: 25 
 695C.050 1.  Except as otherwise provided in this chapter or 26 
in specific provisions of this title, the provisions of this title are not 27 
applicable to any health maintenance organization granted a 28 
certificate of authority under this chapter. This provision does not 29 
apply to an insurer licensed and regulated pursuant to this title 30 
except with respect to its activities as a health maintenance 31 
organization authorized and regulated pursuant to this chapter. 32 
 2.  Solicitation of enrollees by a health maintenance 33 
organization granted a certificate of authority, or its representatives, 34 
must not be construed to violate any provision of law relating to 35 
solicitation or advertising by practitioners of a healing art. 36 
 3.  Any health maintenance organization authorized under this 37 
chapter shall not be deemed to be practicing medicine and is exempt 38 
from the provisions of chapter 630 of NRS. 39 
 4.  The provisions of NRS 695C.110, 695C.125, 695C.1691, 40 
695C.1693, 695C.170, 695C.1703, 695C.1705, 695C.1709 to 41 
695C.173, inclusive, 695C.1733, 695C.17335, 695C.1734, 42 
695C.1751, 695C.1755, 695C.1759, 695C.176 to 695C.200, 43 
inclusive, and 695C.265 and section 37 of this act do not apply to a 44 
health maintenance organization that provides health care services 45   
 	– 30 – 
 
 
- *SB217_R1* 
through managed care to recipients of Medicaid under the State Plan 1 
for Medicaid or insurance pursuant to the Children’s Health 2 
Insurance Program pursuant to a contract with the Division of 3 
Health Care Financing and Policy of the Department of Health and 4 
Human Services. This subsection does not exempt a health 5 
maintenance organization from any provision of this chapter for 6 
services provided pursuant to any other contract. 7 
 5.  The provisions of NRS 695C.16932 to 695C.1699, 8 
inclusive, 695C.1701, 695C.1708, 695C.1728, 695C.1731, 9 
695C.17333, 695C.17345, 695C.17347, 695C.1736 to 695C.1745, 10 
inclusive, 695C.1757 and 695C.204 and section 36 of this act apply 11 
to a health maintenance organization that provides health care 12 
services through managed care to recipients of Medicaid under the 13 
State Plan for Medicaid. 14 
 6.  The provisions of NRS 695C.17095 do not apply to a health 15 
maintenance organization that provides health care services to 16 
members of the Public Employees’ Benefits Program. This 17 
subsection does not exempt a health maintenance organization from 18 
any provision of this chapter for services provided pursuant to any 19 
other contract. 20 
 7.  The provisions of NRS 695C.1735 do not apply to a health 21 
maintenance organization that provides health care services to: 22 
 (a) The officers and employees, and the dependents of officers 23 
and employees, of the governing body of any county, school district, 24 
municipal corporation, political subdivision, public corporation or 25 
other local governmental agency of this State; or 26 
 (b) Members of the Public Employees’ Benefits Program.  27 
 This subsection does not exempt a health maintenance 28 
organization from any provision of this chapter for services 29 
provided pursuant to any other contract. 30 
 Sec. 38.5.  NRS 695C.050 is hereby amended to read as 31 
follows: 32 
 695C.050 1.  Except as otherwise provided in this chapter or 33 
in specific provisions of this title, the provisions of this title are not 34 
applicable to any health maintenance organization granted a 35 
certificate of authority under this chapter. This provision does not 36 
apply to an insurer licensed and regulated pursuant to this title 37 
except with respect to its activities as a health maintenance 38 
organization authorized and regulated pursuant to this chapter. 39 
 2.  Solicitation of enrollees by a health maintenance 40 
organization granted a certificate of authority, or its representatives, 41 
must not be construed to violate any provision of law relating to 42 
solicitation or advertising by practitioners of a healing art. 43   
 	– 31 – 
 
 
- *SB217_R1* 
 3.  Any health maintenance organization authorized under this 1 
chapter shall not be deemed to be practicing medicine and is exempt 2 
from the provisions of chapter 630 of NRS. 3 
 4.  The provisions of NRS 695C.110, 695C.125, 695C.1691, 4 
695C.1693, 695C.170, 695C.1703, 695C.1705, 695C.1709 to 5 
695C.173, inclusive, 695C.1733, 695C.17335, 695C.1734, 6 
695C.1751, 695C.1755, 695C.1759, 695C.176 to 695C.200, 7 
inclusive, and 695C.265 [and section 37 of this act] do not apply to 8 
a health maintenance organization that provides health care services 9 
through managed care to recipients of Medicaid under the State Plan 10 
for Medicaid or insurance pursuant to the Children’s Health 11 
Insurance Program pursuant to a contract with the Division of 12 
Health Care Financing and Policy of the Department of Health and 13 
Human Services. This subsection does not exempt a health 14 
maintenance organization from any provision of this chapter for 15 
services provided pursuant to any other contract. 16 
 5.  The provisions of NRS 695C.16932 to 695C.1699, 17 
inclusive, 695C.1701, 695C.1708, 695C.1728, 695C.1731, 18 
695C.17333, 695C.17345, 695C.17347, 695C.1736 to 695C.1745, 19 
inclusive, 695C.1757 and 695C.204 and [section] sections 36 and 20 
37 of this act apply to a health maintenance organization that 21 
provides health care services through managed care to recipients of 22 
Medicaid under the State Plan for Medicaid. 23 
 6.  The provisions of NRS 695C.17095 do not apply to a health 24 
maintenance organization that provides health care services to 25 
members of the Public Employees’ Benefits Program. This 26 
subsection does not exempt a health maintenance organization from 27 
any provision of this chapter for services provided pursuant to any 28 
other contract. 29 
 7.  The provisions of NRS 695C.1735 do not apply to a health 30 
maintenance organization that provides health care services to: 31 
 (a) The officers and employees, and the dependents of officers 32 
and employees, of the governing body of any county, school district, 33 
municipal corporation, political subdivision, public corporation or 34 
other local governmental agency of this State; or 35 
 (b) Members of the Public Employees’ Benefits Program.  36 
 This subsection does not exempt a health maintenance 37 
organization from any provision of this chapter for services 38 
provided pursuant to any other contract. 39 
 Sec. 39.  NRS 695C.161 is hereby amended to read as follows: 40 
 695C.161 As used in NRS 695C.161 to 695C.169, inclusive, 41 
and section 36 of this act, unless the context otherwise requires: 42 
 1.  “Medicaid” means a program established in any state 43 
pursuant to Title XIX of the Social Security Act (42 U.S.C. §§ 1396 44   
 	– 32 – 
 
 
- *SB217_R1* 
et seq.) to provide assistance for part or all of the cost of medical 1 
care rendered on behalf of indigent persons. 2 
 2.  “Order for medical coverage” means an order of a court or 3 
administrative tribunal to provide coverage under a health care plan 4 
to a child pursuant to the provisions of 42 U.S.C. § 1396g-1. 5 
 Sec. 40.  NRS 695C.1694 is hereby amended to read as 6 
follows: 7 
 695C.1694 1.  A health maintenance organization which 8 
offers or issues a health care plan that provides coverage for 9 
prescription drugs or devices shall include in the plan coverage for 10 
any type of hormone replacement therapy which is lawfully 11 
prescribed or ordered and which has been approved by the Food and 12 
Drug Administration. 13 
 2.  A health maintenance organization that offers or issues a 14 
health care plan that provides coverage for prescription drugs shall 15 
not: 16 
 (a) Require an enrollee to pay a higher deductible, any 17 
copayment or coinsurance or require a longer waiting period or 18 
other condition for coverage for hormone replacement therapy; 19 
 (b) Refuse to issue a health care plan or cancel a health care plan 20 
solely because the person applying for or covered by the plan uses 21 
or may use in the future hormone replacement therapy; 22 
 (c) Offer or pay any type of material inducement or financial 23 
incentive to an enrollee to discourage the enrollee from accessing 24 
hormone replacement therapy; 25 
 (d) Penalize a provider of health care who provides hormone 26 
replacement therapy to an enrollee, including, without limitation, 27 
reducing the reimbursement of the provider of health care; or 28 
 (e) Offer or pay any type of material inducement, bonus or other 29 
financial incentive to a provider of health care to deny, reduce, 30 
withhold, limit or delay hormone replacement therapy to an 31 
enrollee. 32 
 3.  Evidence of coverage subject to the provisions of this 33 
chapter that is delivered, issued for delivery or renewed on or after 34 
October 1, 1999, has the legal effect of including the coverage 35 
required by subsection 1, and any provision of the evidence of 36 
coverage or the renewal which is in conflict with this section is void. 37 
 4.  The provisions of this section do not require a health 38 
maintenance organization to provide coverage for fertility drugs [.] , 39 
except as required by section 37 of this act. 40 
 5.  As used in this section, “provider of health care” has the 41 
meaning ascribed to it in NRS 629.031. 42 
 Sec. 41.  NRS 695C.330 is hereby amended to read as follows: 43 
 695C.330 1.  The Commissioner may suspend or revoke any 44 
certificate of authority issued to a health maintenance organization 45   
 	– 33 – 
 
 
- *SB217_R1* 
pursuant to the provisions of this chapter if the Commissioner finds 1 
that any of the following conditions exist: 2 
 (a) The health maintenance organization is operating 3 
significantly in contravention of its basic organizational document, 4 
its health care plan or in a manner contrary to that described in and 5 
reasonably inferred from any other information submitted pursuant 6 
to NRS 695C.060, 695C.070 and 695C.140, unless any amendments 7 
to those submissions have been filed with and approved by the 8 
Commissioner; 9 
 (b) The health maintenance organization issues evidence of 10 
coverage or uses a schedule of charges for health care services 11 
which do not comply with the requirements of NRS 695C.1691 to 12 
695C.200, inclusive, and section 37 of this act, 695C.204 or 13 
695C.207; 14 
 (c) The health care plan does not furnish comprehensive health 15 
care services as provided for in NRS 695C.060; 16 
 (d) The Commissioner certifies that the health maintenance 17 
organization: 18 
  (1) Does not meet the requirements of subsection 1 of NRS 19 
695C.080; or 20 
  (2) Is unable to fulfill its obligations to furnish health care 21 
services as required under its health care plan; 22 
 (e) The health maintenance organization is no longer financially 23 
responsible and may reasonably be expected to be unable to meet its 24 
obligations to enrollees or prospective enrollees; 25 
 (f) The health maintenance organization has failed to put into 26 
effect a mechanism affording the enrollees an opportunity to 27 
participate in matters relating to the content of programs pursuant to 28 
NRS 695C.110; 29 
 (g) The health maintenance organization has failed to put into 30 
effect the system required by NRS 695C.260 for: 31 
  (1) Resolving complaints in a manner reasonably to dispose 32 
of valid complaints; and 33 
  (2) Conducting external reviews of adverse determinations 34 
that comply with the provisions of NRS 695G.241 to 695G.310, 35 
inclusive; 36 
 (h) The health maintenance organization or any person on its 37 
behalf has advertised or merchandised its services in an untrue, 38 
misrepresentative, misleading, deceptive or unfair manner; 39 
 (i) The continued operation of the health maintenance 40 
organization would be hazardous to its enrollees or creditors or to 41 
the general public; 42 
 (j) The health maintenance organization fails to provide the 43 
coverage required by NRS 695C.1691; or 44   
 	– 34 – 
 
 
- *SB217_R1* 
 (k) The health maintenance organization has otherwise failed to 1 
comply substantially with the provisions of this chapter. 2 
 2.  A certificate of authority must be suspended or revoked only 3 
after compliance with the requirements of NRS 695C.340. 4 
 3.  If the certificate of authority of a health maintenance 5 
organization is suspended, the health maintenance organization shall 6 
not, during the period of that suspension, enroll any additional 7 
groups or new individual contracts, unless those groups or persons 8 
were contracted for before the date of suspension. 9 
 4.  If the certificate of authority of a health maintenance 10 
organization is revoked, the organization shall proceed, immediately 11 
following the effective date of the order of revocation, to wind up its 12 
affairs and shall conduct no further business except as may be 13 
essential to the orderly conclusion of the affairs of the organization. 14 
It shall engage in no further advertising or solicitation of any kind. 15 
The Commissioner may, by written order, permit such further 16 
operation of the organization as the Commissioner may find to be in 17 
the best interest of enrollees to the end that enrollees are afforded 18 
the greatest practical opportunity to obtain continuing coverage for 19 
health care. 20 
 Sec. 42.  Chapter 695F of NRS is hereby amended by adding 21 
thereto a new section to read as follows: 22 
 1. Regardless of whether a person who is pregnant already 23 
has health coverage, a prepaid limited health service organization 24 
that offers coverage for pregnancy and childbirth shall allow the 25 
person to enroll in such coverage without any additional fee or 26 
penalty within at least 60 days after the person has been confirmed 27 
to be pregnant by a qualified provider of health care. 28 
 2. Coverage for a person who enrolls in coverage pursuant to 29 
subsection 1 must be effective: 30 
 (a) Except as otherwise provided in paragraph (b), on the first 31 
day of the month in which a qualified provider of health care 32 
confirms that the person is pregnant; or 33 
 (b) Upon the election of the person, on the first day of the 34 
month after the person elects to enroll in the coverage. 35 
 3. As used in this section, “provider of health care” has the 36 
meaning ascribed to it in NRS 629.031. 37 
 Sec. 43.  Chapter 695G of NRS is hereby amended by adding 38 
thereto the provisions set forth as sections 44 and 45 of this act. 39 
 Sec. 44.  1. Except as otherwise provided in subsections 5 40 
and 6, a managed care organization that issues a group health 41 
care plan with more than 50 employees or members of the insured 42 
group or a plan that provides health care services through 43 
managed care to recipients of Medicaid under the State Plan for 44 
Medicaid shall include in the plan coverage for: 45   
 	– 35 – 
 
 
- *SB217_R1* 
 (a) Any procedure or medication determined by a qualified 1 
provider of health care to be necessary for the diagnosis and 2 
treatment of infertility in accordance with established medical 3 
practice or any guidelines published by the American College of 4 
Obstetricians and Gynecologists or the American Society for 5 
Reproductive Medicine, or their successor organizations. Such 6 
coverage must include, without limitation, coverage for: 7 
  (1) At least three but not more than five completed 8 
retrievals of oocytes; and  9 
  (2) At least three but not more than five transfers of 10 
embryos, including, without limitation, single-embryo transfer 11 
where appropriate, in accordance with the guidelines of the 12 
American Society for Reproductive Medicine, or its successor 13 
organization. 14 
 (b) At least 5 years of standard fertility preservation services 15 
that are necessary to preserve fertility because the insured: 16 
  (1) Has been diagnosed with a medical or genetic condition 17 
that may directly or indirectly cause infertility, as determined 18 
pursuant to paragraph (a) of subsection 2; or  19 
  (2) Is expected to receive a medical treatment that may 20 
directly or indirectly cause infertility, as determined pursuant to 21 
paragraph (b) of subsection 2.  22 
 2. For the purposes of subsection 1:  23 
 (a) A medical or genetic condition may directly or indirectly 24 
cause infertility if the condition or treatment for the condition is 25 
likely to cause infertility, as established by the American Society of 26 
Clinical Oncology, the American Society for Reproductive 27 
Medicine or the American College of Obstetricians and 28 
Gynecologists, or their successor organizations.  29 
 (b) A medical treatment may directly or indirectly cause 30 
infertility if the treatment has a potential side effect of impaired 31 
fertility, as established by the American Society of Clinical 32 
Oncology or the American Society for Reproductive Medicine, or 33 
their successor organizations.  34 
 3. A managed care organization shall ensure that the benefits 35 
required by subsection 1 are made available to an insured through 36 
a provider of health care who participates in the network plan of 37 
the managed care organization. 38 
 4. A managed care organization shall not: 39 
 (a) Require an insured to pay a higher deductible, copayment, 40 
coinsurance or other form of cost-sharing for the benefits 41 
required by subsection 1 than is required for similar benefits that 42 
are not related to fertility; 43   
 	– 36 – 
 
 
- *SB217_R1* 
 (b) Require an insured to obtain prior authorization for the 1 
benefits described in subsection 1 that is not required for similar 2 
benefits that are not related to fertility; 3 
 (c) Require a longer waiting period for the coverage required 4 
by subsection 1 than is required for similar benefits that are not 5 
related to fertility; 6 
 (d) Impose any other exclusions, limitations, restrictions or 7 
delays on the access of an insured to any benefit described in 8 
subsection 1 that is not imposed on similar benefits that are not 9 
related to fertility; 10 
 (e) Refuse to issue a group health care plan or cancel a group 11 
health care plan solely because the person applying for or covered 12 
by the plan uses or may use in the future any benefit described in 13 
subsection 1; 14 
 (f) Offer or pay any type of material inducement or financial 15 
incentive to an insured to discourage the insured from accessing 16 
any benefit described in subsection 1; 17 
 (g) Penalize a provider of health care who provides any benefit 18 
described in subsection 1 to an insured, including, without 19 
limitation, reducing the reimbursement of the provider of health 20 
care; or 21 
 (h) 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 any benefit described in subsection 24 
1 to an insured. 25 
 5.  A managed care organization is not required to provide the 26 
coverage required by subsection 1 for an insured whose infertility 27 
is solely caused by a voluntary sterilization procedure that has not 28 
been successfully reversed. 29 
 6.  A managed care organization that is affiliated with a 30 
religious organization is not required to provide the coverage 31 
required by subsection 1 if the managed care organization objects 32 
on religious grounds. Such a managed care organization shall, 33 
before the issuance of a group health care plan that is subject to 34 
the requirements of subsection 1 and before the renewal of such a 35 
plan, provide to the group policyholder or prospective insured, as 36 
applicable, written notice of the coverage that the managed care 37 
organization refuses to provide pursuant to this subsection. 38 
 7.  A group health care plan with more than 50 employees or 39 
members of the insured group that is subject to the provisions of 40 
this chapter and is delivered, issued for delivery or renewed on or 41 
after January 1, 2026, has the legal effect of including the 42 
coverage required by subsection 1, and any provision of the plan 43 
or the renewal that conflicts with the provisions of this section is 44 
void.  45   
 	– 37 – 
 
 
- *SB217_R1* 
 8.  As used in this section:  1 
 (a) “Infertility” means a condition characterized by: 2 
  (1) The inability of a person to achieve pregnancy, not 3 
including conception resulting in a miscarriage, where the person 4 
and the partner of the person or a donor have the necessary 5 
gametes to achieve pregnancy and after: 6 
   (I) At least 12 months of regular, unprotected sexual 7 
intercourse or therapeutic donor insemination for a person who is 8 
less than 35 years of age; or 9 
   (II) At least 6 months of regular, unprotected sexual 10 
intercourse or therapeutic donor insemination for a person who is 11 
35 years of age or older; 12 
  (2) The inability of a person or the partner of the person to 13 
reproduce or the inability of a person to reproduce with a 14 
particular partner; or 15 
  (3) A finding by a qualified provider of health care that a 16 
person is infertile based on: 17 
   (I) The medical, sexual and reproductive history or age 18 
of the person; 19 
   (II) Physical findings; or 20 
   (III) Diagnostic testing. 21 
 (b) “Network plan” means a health care plan offered by a 22 
managed care organization under which the financing and 23 
delivery of medical care, including items and services paid for as 24 
medical care, are provided, in whole or in part, through a defined 25 
set of providers under contract with the managed care 26 
organization. The term does not include an arrangement for the 27 
financing of premiums.  28 
 (c) “Provider of health care” has the meaning ascribed to it in 29 
NRS 629.031. 30 
 (d) “Standard fertility preservation services”:  31 
  (1) Means a procedure or services for the preservation of 32 
fertility that: 33 
   (I) Is not considered experimental or investigational by 34 
the American Society for Reproductive Medicine, or its successor 35 
organization, or the American Society of Clinical Oncology, or its 36 
successor organization; and 37 
   (II) Is consistent with established medical practices or 38 
professional guidelines published by the American Society for 39 
Reproductive Medicine, or its successor organization, or the 40 
American Society of Clinical Oncology, or its successor 41 
organization. 42 
  (2) Includes, without limitation, sperm banking, oocyte 43 
banking, embryo banking, banking of reproductive tissues and the 44 
storage of reproductive cells and tissues.  45   
 	– 38 – 
 
 
- *SB217_R1* 
 Sec. 45.  1. Regardless of whether a person who is pregnant 1 
already has health coverage, a managed care organization shall, 2 
except as otherwise provided in subsection 3, allow the person to 3 
enroll in a health care plan without any additional fee or penalty 4 
within at least: 5 
 (a) Sixty days after the person has been confirmed to be 6 
pregnant by a qualified provider of health care, if the health care 7 
plan is offered on the individual market; or 8 
 (b) Thirty days after the person has been confirmed to be 9 
pregnant by a qualified provider of health care, if the health care 10 
plan is offered on the group market. 11 
 2. Coverage for a person who enrolls in a health care plan 12 
pursuant to subsection 1 must be effective: 13 
 (a) Except as otherwise provided in paragraph (b), on the first 14 
day of the month in which a qualified provider of health care 15 
confirms that the person is pregnant; or 16 
 (b) Upon the election of the person, on the first day of the 17 
month after the person elects to enroll in the plan. 18 
 3. The provisions of this section do not apply to a cafeteria 19 
plan, as defined in 26 U.S.C. § 125(d). 20 
 4. As used in this section, “provider of health care” has the 21 
meaning ascribed to it in NRS 629.031. 22 
 Sec. 45.2.  NRS 695G.090 is hereby amended to read as 23 
follows: 24 
 695G.090 1.  Except as otherwise provided in subsection 3, 25 
the provisions of this chapter apply to each organization and insurer 26 
that operates as a managed care organization and may include, 27 
without limitation, an insurer that issues a policy of health 28 
insurance, an insurer that issues a policy of individual or group 29 
health insurance, a carrier serving small employers, a fraternal 30 
benefit society, a hospital or medical service corporation and a 31 
health maintenance organization. 32 
 2.  In addition to the provisions of this chapter, each managed 33 
care organization shall comply with: 34 
 (a) The provisions of chapter 686A of NRS, including all 35 
obligations and remedies set forth therein; and 36 
 (b) Any other applicable provision of this title. 37 
 3.  The provisions of NRS 695G.127, 695G.1639, 695G.164, 38 
695G.1645, 695G.167 and 695G.200 to 695G.230, inclusive, and 39 
section 45 of this act do not apply to a managed care organization 40 
that provides health care services to recipients of Medicaid under 41 
the State Plan for Medicaid or insurance pursuant to the Children’s 42 
Health Insurance Program pursuant to a contract with the Division 43 
of Health Care Financing and Policy of the Department of Health 44 
and Human Services.  45   
 	– 39 – 
 
 
- *SB217_R1* 
 4. The provisions of NRS 695C.1735 and 695G.1639 do not 1 
apply to a managed care organization that provides health care 2 
services to members of the Public Employees’ Benefits Program. 3 
 5. Subsections 3 and 4 do not exempt a managed care 4 
organization from any provision of this chapter for services 5 
provided pursuant to any other contract. 6 
 Sec. 45.6.  NRS 695G.090 is hereby amended to read as 7 
follows: 8 
 695G.090 1.  Except as otherwise provided in subsection 3, 9 
the provisions of this chapter apply to each organization and insurer 10 
that operates as a managed care organization and may include, 11 
without limitation, an insurer that issues a policy of health 12 
insurance, an insurer that issues a policy of individual or group 13 
health insurance, a carrier serving small employers, a fraternal 14 
benefit society, a hospital or medical service corporation and a 15 
health maintenance organization. 16 
 2.  In addition to the provisions of this chapter, each managed 17 
care organization shall comply with: 18 
 (a) The provisions of chapter 686A of NRS, including all 19 
obligations and remedies set forth therein; and 20 
 (b) Any other applicable provision of this title. 21 
 3.  The provisions of NRS 695G.127, 695G.1639, 695G.164, 22 
695G.1645, 695G.167 and 695G.200 to 695G.230, inclusive, [and 23 
section 45 of this act] do not apply to a managed care organization 24 
that provides health care services to recipients of Medicaid under 25 
the State Plan for Medicaid or insurance pursuant to the Children’s 26 
Health Insurance Program pursuant to a contract with the Division 27 
of Health Care Financing and Policy of the Department of Health 28 
and Human Services.  29 
 4. The provisions of NRS 695C.1735 and 695G.1639 do not 30 
apply to a managed care organization that provides health care 31 
services to members of the Public Employees’ Benefits Program. 32 
 5. Subsections 3 and 4 do not exempt a managed care 33 
organization from any provision of this chapter for services 34 
provided pursuant to any other contract. 35 
 Sec. 46.  The provisions of subsection 1 of NRS 354.599 do 36 
not apply to any additional expenses of a local government which 37 
are related to the provisions of this act. 38 
 Sec. 47.  1. This section and section 10 of this act become 39 
effective upon passage and approval. 40 
 2. Sections 1 to 9, inclusive, of this act become effective on 41 
July 1, 2025. 42 
 3. Sections 12, 13, 15 to 38, inclusive, 39 to 45.2, inclusive, 43 
and 46 of this act become effective: 44   
 	– 40 – 
 
 
- *SB217_R1* 
 (a) Upon passage and approval for the purpose of adopting any 1 
regulations and performing any other preparatory administrative 2 
tasks that are necessary to carry out the provisions of this act; and 3 
 (b) On January 1, 2026, for all other purposes. 4 
 4. Sections 11, 14, 38.5 and 45.6 of this act become effective: 5 
 (a) Upon passage and approval for the purpose of adopting any 6 
regulations and performing any other preparatory administrative 7 
tasks that are necessary to carry out the provisions of this act; and 8 
 (b) On January 1, 2027, for all other purposes. 9 
 
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