S.B. 217
- *SB217*
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, to provide a special enrollment period 48
to a person determined by a qualified provider of health care to be pregnant, during 49
which the pregnant person must be allowed to enroll in a health care plan outside of 50
the period of open enrollment. Section 17 of this bill provides for the enforcement 51
of section 15, which governs private employers who provide health benefits to 52
employees through a self-insured plan. Section 18 of this bill establishes civil and 53
criminal penalties for a violation of section 15, which are the same as the penalties 54
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for violations of other laws governing benefits provided by private employers. 55
Sections 21, 26, 34 and 39 of this bill make conforming changes to indicate the 56
applicability of certain definitions to sections 20, 24, 32 and 36, respectively. 57
Existing law requires public and private policies of health insurance regulated 58
under Nevada law to include certain coverage. (NRS 287.010, 287.04335, 59
422.2717-422.272428, 689A.04033-689A.0465, 689B.0303-689B.0379, 60
689C.1652-689C.169, 689C.194, 689C.1945, 689C.195, 689C.425, 695A.184-61
695A.1875, 695A.265, 695B.1901-695B.1948, 695C.050, 695C.1691-695C.176, 62
695G.162-695G.177) Existing law also requires employers to provide certain 63
benefits for health care to employees, including the coverage required of health 64
insurers, if the employer provides health benefits for its employees through a self-65
insured plan. (NRS 608.1555) Sections 12-14, 23, 31, 37, 38 and 44 of this bill 66
require Medicaid and public and private health care plans for groups of more than 67
100 insureds to include certain coverage for: (1) the treatment of infertility; and (2) 68
the preservation of fertility where the insured has a medical condition or requires 69
medical treatment that may cause infertility under certain circumstances. Section 70
16 of this bill exempts employers who provide benefits for health care for their 71
employees through a self-insured plan from those requirements. Sections 12-14, 19, 72
23, 31, 37, 38 and 44 of this bill prohibit an insurer from imposing conditions, 73
including cost-sharing, prior authorizations and waiting periods, on infertility 74
treatment or fertility preservation if such conditions are not required for similar 75
benefits that are not related to fertility. Section 11 of this bill makes a conforming 76
change to require the Director of the Department of Health and Human Services to 77
administer the provisions of section 14 in the same manner as other provisions 78
relating to Medicaid. Sections 25, 33 and 40 of this bill make conforming changes 79
to clarify the applicability of provisions indicating that certain insurers are not 80
required to cover fertility drugs. 81
Section 41 of this bill authorizes the Commissioner of Insurance to suspend or 82
revoke the certificate of a health maintenance organization that fails to provide the 83
coverage required by section 37. The Commissioner is also authorized to take such 84
action against other health insurers who fail to provide the coverage required by 85
sections 23 and 44. (NRS 680A.200) 86
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
Sec. 4. “Gamete” has the meaning ascribed to it in 10
NRS 126.560. 11
Sec. 5. “Governmental entity” means the State of Nevada or 12
any of its agencies or political subdivisions. 13
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Sec. 6. “Third party” means any insurer, governmental 1
entity or other organization providing health coverage or benefits 2
in accordance with state or federal law. 3
Sec. 7. 1. Except as otherwise provided in this section, the 4
provisions of sections 2 to 9, inclusive, of this act apply to all state 5
and local laws and ordinances and the implementation of those 6
laws and ordinances, whether statutory or otherwise, and whether 7
enacted before, on or after July 1, 2025. 8
2. State laws that are enacted on or after July 1, 2025, are 9
subject to the provisions of sections 2 to 9, inclusive, of this act 10
unless the law explicitly excludes such application by reference to 11
this section. 12
3. The provisions of sections 2 to 9, inclusive, of this act do 13
not authorize a governmental entity to burden: 14
(a) The access of any person to assisted reproduction, any 15
drug or device related to assisted reproduction or information 16
related to assisted reproduction; 17
(b) The ability of a provider of health care to provide assisted 18
reproduction or information related to assisted reproduction or to 19
provide, administer, dispense or prescribe any drug or device 20
related to assisted reproduction within the scope of practice, 21
training and experience of the provider of health care; 22
(c) The ability of a third party to provide coverage of assisted 23
reproduction or drugs or devices related to assisted reproduction; 24
or 25
(d) The ability of a person to control the use or disposition of 26
his or her gametes or other reproductive genetic material. 27
Sec. 8. 1. Except as otherwise provided in this section, a 28
governmental entity shall not enact or implement any limitation or 29
requirement that: 30
(a) Expressly, effectively, implicitly or, as implemented, singles 31
out assisted reproduction or any drug or device related to assisted 32
reproduction and substantially burdens: 33
(1) The access of a person to assisted reproduction, any 34
drug or device related to assisted reproduction or information 35
related to assisted reproduction; 36
(2) The ability of a provider of health care to: 37
(I) Provide assisted reproduction or information related 38
to assisted reproduction within the scope of practice, training and 39
experience of the provider of health care; or 40
(II) Provide, administer, dispense or prescribe any drug 41
or device related to assisted reproduction within the scope of 42
practice, training and experience of the provider of health care; or 43
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(3) The ability of a third party to provide coverage of 1
assisted reproduction or drugs or devices related to assisted 2
reproduction. 3
(b) Expressly, effectively, implicitly or, as implemented, 4
substantially burdens the ability of a person to control the use or 5
disposition of his or her gametes or other reproductive genetic 6
material. 7
2. A governmental entity may enact a requirement or 8
limitation described in subsection 1 if the governmental entity 9
demonstrates by clear and convincing evidence that the burden 10
imposed by the requirement or limitation described in subsection 11
1, as applied to the person, provider of health care or third party 12
who is subject to the burden: 13
(a) Furthers a compelling interest; and 14
(b) Is the least restrictive means of furthering that interest. 15
3. Notwithstanding any provision of NRS 41.0305 to 41.039, 16
inclusive, but subject to the limitation on an award for damages 17
set forth in NRS 41.035 when applicable, a person, provider of 18
health care or third party who has been substantially burdened in 19
violation of this section may assert that violation as a claim or 20
defense in a judicial proceeding and obtain appropriate relief. A 21
court shall award costs and attorney’s fees to a person, provider of 22
health care or third party who prevails on such a claim or defense 23
pursuant to this section. 24
4. The Attorney General may bring an action in any court of 25
competent jurisdiction in the name of the State of Nevada on his 26
or her own complaint or on the complaint of any person or entity 27
to enjoin any violation or proposed violation of the provisions of 28
this section. 29
5. A court may find that a person, provider of health care or 30
third party is a vexatious litigant if the person, provider of health 31
care or third party makes a claim within the scope of sections 2 to 32
9, inclusive, of this act which is without merit, fraudulent or 33
otherwise intended to harass or annoy a person or entity. If a 34
court finds that a person, provider of health care or third party is a 35
vexatious litigant pursuant to this subsection, the court may deny 36
standing to that person, provider of health care or third party to 37
bring further claims which allege a violation of this section. 38
Sec. 9. 1. Except as otherwise provided in this section, a 39
person or entity is not subject to civil or criminal liability, or 40
discipline or other administrative sanctions imposed by a 41
professional licensing board or other governmental entity, solely 42
because the person or entity provides or receives goods or services 43
related to assisted reproduction. 44
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2. Except as otherwise provided in this section, a person or 1
entity that stores or transports embryos for the purpose of assisted 2
reproduction or the manufacturer of goods used to facilitate the 3
process of assisted reproduction or the transportation of embryos 4
stored for the purpose of assisted reproduction is not subject to 5
civil or criminal liability, or discipline or other administrative 6
sanctions imposed by a professional licensing board or other 7
governmental entity, solely because of the death of or damage to 8
an embryo. 9
3. The provisions of this section do not preclude: 10
(a) Civil liability for any act or omission that independently 11
gives rise to such liability, including, without limitation, acts or 12
omissions that are the result of negligence; 13
(b) Criminal liability for any act or omission that would 14
otherwise constitute a crime; or 15
(c) The imposition of discipline or other administrative 16
sanctions for any act or omission that would otherwise constitute 17
grounds for discipline or other administrative sanctions, 18
including, without limitation, providing services that are outside 19
the scope of practice, training and experience of a person or 20
entity. 21
Sec. 10. The preliminary chapter of NRS is hereby amended 22
by adding thereto a new section to read as follows: 23
Any fertilized human egg or human embryo that exists in any 24
form before implantation in the uterus of a human body is not an 25
unborn child, a minor child, a person, a natural person or any 26
other term that connotes a human being for any purpose under 27
the law or regulations of this State or any political subdivision 28
thereof. 29
Sec. 11. NRS 232.320 is hereby amended to read as follows: 30
232.320 1. The Director: 31
(a) Shall appoint, with the consent of the Governor, 32
administrators of the divisions of the Department, who are 33
respectively designated as follows: 34
(1) The Administrator of the Aging and Disability Services 35
Division; 36
(2) The Administrator of the Division of Welfare and 37
Supportive Services; 38
(3) The Administrator of the Division of Child and Family 39
Services; 40
(4) The Administrator of the Division of Health Care 41
Financing and Policy; and 42
(5) The Administrator of the Division of Public and 43
Behavioral Health. 44
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(b) Shall administer, through the divisions of the Department, 1
the provisions of chapters 63, 424, 425, 427A, 432A to 442, 2
inclusive, 446 to 450, inclusive, 458A and 656A of NRS, NRS 3
127.220 to 127.310, inclusive, 422.001 to 422.410, inclusive, and 4
section 14 of this act, 422.580, 432.010 to 432.133, inclusive, 5
432B.6201 to 432B.626, inclusive, 444.002 to 444.430, inclusive, 6
and 445A.010 to 445A.055, inclusive, and all other provisions of 7
law relating to the functions of the divisions of the Department, but 8
is not responsible for the clinical activities of the Division of Public 9
and Behavioral Health or the professional line activities of the other 10
divisions. 11
(c) Shall administer any state program for persons with 12
developmental disabilities established pursuant to the 13
Developmental Disabilities Assistance and Bill of Rights Act of 14
2000, 42 U.S.C. §§ 15001 et seq. 15
(d) Shall, after considering advice from agencies of local 16
governments and nonprofit organizations which provide social 17
services, adopt a master plan for the provision of human services in 18
this State. The Director shall revise the plan biennially and deliver a 19
copy of the plan to the Governor and the Legislature at the 20
beginning of each regular session. The plan must: 21
(1) Identify and assess the plans and programs of the 22
Department for the provision of human services, and any 23
duplication of those services by federal, state and local agencies; 24
(2) Set forth priorities for the provision of those services; 25
(3) Provide for communication and the coordination of those 26
services among nonprofit organizations, agencies of local 27
government, the State and the Federal Government; 28
(4) Identify the sources of funding for services provided by 29
the Department and the allocation of that funding; 30
(5) Set forth sufficient information to assist the Department 31
in providing those services and in the planning and budgeting for the 32
future provision of those services; and 33
(6) Contain any other information necessary for the 34
Department to communicate effectively with the Federal 35
Government concerning demographic trends, formulas for the 36
distribution of federal money and any need for the modification of 37
programs administered by the Department. 38
(e) May, by regulation, require nonprofit organizations and state 39
and local governmental agencies to provide information regarding 40
the programs of those organizations and agencies, excluding 41
detailed information relating to their budgets and payrolls, which the 42
Director deems necessary for the performance of the duties imposed 43
upon him or her pursuant to this section. 44
(f) Has such other powers and duties as are provided by law. 45
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2. Notwithstanding any other provision of law, the Director, or 1
the Director’s designee, is responsible for appointing and removing 2
subordinate officers and employees of the Department. 3
Sec. 12. NRS 287.010 is hereby amended to read as follows: 4
287.010 1. The governing body of any county, school 5
district, municipal corporation, political subdivision, public 6
corporation or other local governmental agency of the State of 7
Nevada may: 8
(a) Adopt and carry into effect a system of group life, accident 9
or health insurance, or any combination thereof, for the benefit of its 10
officers and employees, and the dependents of officers and 11
employees who elect to accept the insurance and who, where 12
necessary, have authorized the governing body to make deductions 13
from their compensation for the payment of premiums on the 14
insurance. 15
(b) Purchase group policies of life, accident or health insurance, 16
or any combination thereof, for the benefit of such officers and 17
employees, and the dependents of such officers and employees, as 18
have authorized the purchase, from insurance companies authorized 19
to transact the business of such insurance in the State of Nevada, 20
and, where necessary, deduct from the compensation of officers and 21
employees the premiums upon insurance and pay the deductions 22
upon the premiums. 23
(c) Provide group life, accident or health coverage through a 24
self-insurance reserve fund and, where necessary, deduct 25
contributions to the maintenance of the fund from the compensation 26
of officers and employees and pay the deductions into the fund. The 27
money accumulated for this purpose through deductions from the 28
compensation of officers and employees and contributions of the 29
governing body must be maintained as an internal service fund as 30
defined by NRS 354.543. The money must be deposited in a state or 31
national bank or credit union authorized to transact business in the 32
State of Nevada. Any independent administrator of a fund created 33
under this section is subject to the licensing requirements of chapter 34
683A of NRS, and must be a resident of this State. Any contract 35
with an independent administrator must be approved by the 36
Commissioner of Insurance as to the reasonableness of 37
administrative charges in relation to contributions collected and 38
benefits provided. The provisions of NRS 439.581 to 439.597, 39
inclusive, 686A.135, 687B.352, 687B.408, 687B.692, 687B.723, 40
687B.725, 687B.805, 689B.030 to 689B.0317, inclusive, and 41
section 23 of this act, paragraphs (b) and (c) of subsection 1 of NRS 42
689B.0319, subsections 2, 4, 6 and 7 of NRS 689B.0319, 689B.033 43
to 689B.0369, inclusive, 689B.0375 to 689B.050, inclusive, 44
689B.0675, 689B.265, 689B.287 and 689B.500 and section 24 of 45
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this act apply to coverage provided pursuant to this paragraph, 1
except that the provisions of NRS 689B.0378, 689B.03785 and 2
689B.500 only apply to coverage for active officers and employees 3
of the governing body, or the dependents of such officers and 4
employees. 5
(d) Defray part or all of the cost of maintenance of a self-6
insurance fund or of the premiums upon insurance. The money for 7
contributions must be budgeted for in accordance with the laws 8
governing the county, school district, municipal corporation, 9
political subdivision, public corporation or other local governmental 10
agency of the State of Nevada. 11
2. If a school district offers group insurance to its officers and 12
employees pursuant to this section, members of the board of trustees 13
of the school district must not be excluded from participating in the 14
group insurance. If the amount of the deductions from compensation 15
required to pay for the group insurance exceeds the compensation to 16
which a trustee is entitled, the difference must be paid by the trustee. 17
3. In any county in which a legal services organization exists, 18
the governing body of the county, or of any school district, 19
municipal corporation, political subdivision, public corporation or 20
other local governmental agency of the State of Nevada in the 21
county, may enter into a contract with the legal services 22
organization pursuant to which the officers and employees of the 23
legal services organization, and the dependents of those officers and 24
employees, are eligible for any life, accident or health insurance 25
provided pursuant to this section to the officers and employees, and 26
the dependents of the officers and employees, of the county, school 27
district, municipal corporation, political subdivision, public 28
corporation or other local governmental agency. 29
4. If a contract is entered into pursuant to subsection 3, the 30
officers and employees of the legal services organization: 31
(a) Shall be deemed, solely for the purposes of this section, to be 32
officers and employees of the county, school district, municipal 33
corporation, political subdivision, public corporation or other local 34
governmental agency with which the legal services organization has 35
contracted; and 36
(b) Must be required by the contract to pay the premiums or 37
contributions for all insurance which they elect to accept or of which 38
they authorize the purchase. 39
5. A contract that is entered into pursuant to subsection 3: 40
(a) Must be submitted to the Commissioner of Insurance for 41
approval not less than 30 days before the date on which the contract 42
is to become effective. 43
(b) Does not become effective unless approved by the 44
Commissioner. 45
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(c) Shall be deemed to be approved if not disapproved by the 1
Commissioner within 30 days after its submission. 2
6. As used in this section, “legal services organization” means 3
an organization that operates a program for legal aid and receives 4
money pursuant to NRS 19.031. 5
Sec. 13. NRS 287.04335 is hereby amended to read as 6
follows: 7
287.04335 If the Board provides health insurance through a 8
plan of self-insurance, it shall comply with the provisions of NRS 9
439.581 to 439.597, inclusive, 686A.135, 687B.352, 687B.409, 10
687B.692, 687B.723, 687B.725, 687B.805, 689B.0353, 689B.255, 11
695C.1723, 695G.150, 695G.155, 695G.160, 695G.162, 12
695G.1635, 695G.164, 695G.1645, 695G.1665, 695G.167, 13
695G.1675, 695G.170 to 695G.1712, inclusive, and section 44 of 14
this act, 695G.1714 to 695G.174, inclusive, 695G.176, 695G.177, 15
695G.200 to 695G.230, inclusive, 695G.241 to 695G.310, inclusive, 16
695G.405 and 695G.415, and section 45 of this act in the same 17
manner as an insurer that is licensed pursuant to title 57 of NRS is 18
required to comply with those provisions. 19
Sec. 14. Chapter 422 of NRS is hereby amended by adding 20
thereto a new section to read as follows: 21
1. To the extent that federal financial participation is 22
available, the Director shall include under Medicaid 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 completed retrievals of oocytes; and 31
(2) Unlimited transfers of embryos, including, without 32
limitation, single-embryo transfer where appropriate, in 33
accordance with the guidelines of the American Society for 34
Reproductive Medicine, or its successor organization. 35
(b) Any procedure or service for the preservation of fertility 36
consistent with established medical practice or any guidelines 37
published by the American Society for Reproductive Medicine or 38
the American Society of Clinical Oncology, or their successor 39
organizations, that are determined by a qualified provider of 40
health care to be medically necessary to preserve fertility because 41
the recipient of Medicaid: 42
(1) Has been diagnosed with a medical or genetic condition 43
that may directly or indirectly cause infertility, as determined 44
pursuant to paragraph (a) of subsection 2; or 45
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(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. Medicaid must not: 16
(a) Require a recipient of Medicaid to pay a higher deductible, 17
copayment, coinsurance or other form of cost-sharing for the 18
benefits described in subsection 1 than is required for similar 19
benefits that are not related to fertility; 20
(b) Require a recipient of Medicaid to obtain prior 21
authorization for the benefits described in subsection 1 that is not 22
required for similar benefits that are not related to fertility; 23
(c) Require a longer waiting period for the coverage required 24
by subsection 1 than is required for similar benefits that are not 25
related to fertility; or 26
(d) Impose any other exclusions, limitations, restrictions or 27
delays on the access of a recipient of Medicaid to the goods and 28
services described in subsection 1 that is not imposed on similar 29
benefits that are not related to fertility. 30
4. The Department shall: 31
(a) Apply to the Secretary of Health and Human Services for 32
any waiver of federal law or apply for any amendment of the State 33
Plan for Medicaid that is necessary for the Department to receive 34
federal funding to provide the coverage described in subsection 1. 35
(b) Fully cooperate in good faith with the Federal Government 36
during the application process to satisfy the requirements of the 37
Federal Government for obtaining a waiver or amendment 38
pursuant to paragraph (a). 39
5. As used in this section: 40
(a) “Infertility” means a condition characterized by: 41
(1) The inability of a person to achieve pregnancy, not 42
including conception resulting in a miscarriage, where the person 43
and the partner of the person or a donor have the necessary 44
gametes to achieve pregnancy and after: 45
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(I) At least 12 months of regular, unprotected sexual 1
intercourse or therapeutic donor insemination for a person who is 2
less than 35 years of age; or 3
(II) At least 6 months of regular, unprotected sexual 4
intercourse or therapeutic donor insemination for a person who is 5
35 years of age or older; 6
(2) The inability of a person or the partner of the person to 7
reproduce or the inability of a person to reproduce with a 8
particular partner; or 9
(3) A finding by a qualified provider of health care that a 10
person is infertile based on: 11
(I) The medical, sexual and reproductive history or age 12
of the person; 13
(II) Physical findings; or 14
(III) Diagnostic testing. 15
(b) “Provider of health care” has the meaning ascribed to it in 16
NRS 629.031. 17
Sec. 15. Chapter 608 of NRS is hereby amended by adding 18
thereto a new section to read as follows: 19
1. Regardless of whether an employee who is pregnant 20
already has health coverage, an employer who provides benefits 21
for health care to his or her employees shall ensure that the 22
employee is allowed to enroll in any plan to provide such benefits 23
without any additional fee or penalty within at least 30 days after 24
the employee has been confirmed to be pregnant by a qualified 25
provider of health care. 26
2. Coverage for an employee who enrolls in a plan to provide 27
benefits for health care pursuant to subsection 1 must be effective: 28
(a) Except as otherwise provided in paragraph (b), on the first 29
day of the month in which a qualified provider of health care 30
confirms that the employee is pregnant; or 31
(b) Upon the election of the employee, on the first day of the 32
month after the employee elects to enroll in the plan. 33
3. As used in this section, “provider of health care” has the 34
meaning ascribed to it in NRS 629.031. 35
Sec. 16. NRS 608.1555 is hereby amended to read as follows: 36
608.1555 [Any] 1. Except as otherwise provided in this 37
section, any employer who provides benefits for health care to his 38
or her employees shall provide the same benefits and pay providers 39
of health care in the same manner as a policy of insurance pursuant 40
to chapters 689A and 689B of NRS, including, without limitation, 41
as required by NRS 687B.409, 687B.723 and 687B.725. 42
2. An employer who employs less than 100 employees and 43
provides benefits for health care to his or her employees through a 44
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plan of self-insurance is exempt from the requirements of section 1
23 of this act. 2
Sec. 17. NRS 608.180 is hereby amended to read as follows: 3
608.180 The Labor Commissioner or the representative of the 4
Labor Commissioner shall cause the provisions of NRS 608.005 to 5
608.195, inclusive, and section 15 of this act and 608.215 to be 6
enforced, and upon notice from the Labor Commissioner or the 7
representative: 8
1. The district attorney of any county in which a violation of 9
those sections has occurred; 10
2. The Deputy Labor Commissioner, as provided in 11
NRS 607.050; 12
3. The Attorney General, as provided in NRS 607.160 or 13
607.220; or 14
4. The special counsel, as provided in NRS 607.065, 15
shall prosecute the action for enforcement according to law. 16
Sec. 18. NRS 608.195 is hereby amended to read as follows: 17
608.195 1. Except as otherwise provided in NRS 608.0165, 18
any person who violates any provision of NRS 608.005 to 608.195, 19
inclusive, and section 15 of this act or 608.215, or any regulation 20
adopted pursuant thereto, is guilty of a misdemeanor. 21
2. In addition to any other remedy or penalty, the Labor 22
Commissioner may impose against the person an administrative 23
penalty of not more than $5,000 for each such violation. 24
Sec. 19. NRS 687B.225 is hereby amended to read as follows: 25
687B.225 1. Except as otherwise provided in NRS 26
689A.0405, 689A.0412, 689A.0413, 689A.0418, 689A.0437, 27
689A.044, 689A.0445, 689A.0459, 689B.031, 689B.0312, 28
689B.0313, 689B.0315, 689B.0317, 689B.0319, 689B.0374, 29
689B.0378, 689C.1665, 689C.1671, 689C.1675, 689C.1676, 30
695A.1843, 695A.1856, 695A.1865, 695A.1874, 695B.1912, 31
695B.1913, 695B.1914, 695B.1919, 695B.19197, 695B.1924, 32
695B.1925, 695B.1942, 695C.1696, 695C.1699, 695C.1713, 33
695C.1735, 695C.1737, 695C.1743, 695C.1745, 695C.1751, 34
695G.170, 695G.1705, 695G.171, 695G.1714, 695G.1715, 35
695G.1719 and 695G.177, and sections 23, 31, 37 and 44 of this 36
act, any contract for group, blanket or individual health insurance or 37
any contract by a nonprofit hospital, medical or dental service 38
corporation or organization for dental care which provides for 39
payment of a certain part of medical or dental care may require the 40
insured or member to obtain prior authorization for that care from 41
the insurer or organization. The insurer or organization shall: 42
(a) File its procedure for obtaining approval of care pursuant to 43
this section for approval by the Commissioner; and 44
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(b) Unless a shorter time period is prescribed by a specific 1
statute, including, without limitation, NRS 689A.0446, 689B.0361, 2
689C.1688, 695A.1859, 695B.19087, 695C.16932 and 695G.1703, 3
respond to any request for approval by the insured or member 4
pursuant to this section within 20 days after it receives the request. 5
2. The procedure for prior authorization may not discriminate 6
among persons licensed to provide the covered care. 7
Sec. 20. Chapter 689A of NRS is hereby amended by adding 8
thereto a new section to read as follows: 9
1. Regardless of whether a person who is pregnant already 10
has health coverage, an insurer shall allow the person to enroll in 11
a policy of health insurance without any additional fee or penalty 12
within at least 60 days after the person has been confirmed to be 13
pregnant by a qualified provider of health care. 14
2. Coverage for a person who enrolls in a policy of health 15
insurance pursuant to subsection 1 must be effective: 16
(a) Except as otherwise provided in paragraph (b), on the first 17
day of the month in which a qualified provider of health care 18
confirms that the person is pregnant; or 19
(b) Upon the election of the person, on the first day of the 20
month after the person elects to enroll in the policy. 21
3. As used in this section, “provider of health care” has the 22
meaning ascribed to it in NRS 629.031. 23
Sec. 21. NRS 689A.420 is hereby amended to read as follows: 24
689A.420 As used in NRS 689A.420 to 689A.460, inclusive, 25
and section 20 of this act, unless the context otherwise requires: 26
1. “Medicaid” means a program established in any state 27
pursuant to Title XIX of the Social Security Act (42 U.S.C. §§ 1396 28
et seq.) to provide assistance for part or all of the cost of medical 29
care rendered on behalf of indigent persons. 30
2. “Order for medical coverage” means an order of a court or 31
administrative tribunal to provide coverage under a policy of health 32
insurance to a child pursuant to the provisions of 42 U.S.C. § 33
1396g-1. 34
Sec. 22. Chapter 689B of NRS is hereby amended by adding 35
thereto the provisions set forth as sections 23 and 24 of this act. 36
Sec. 23. 1. Except as otherwise provided in subsection 5, an 37
insurer that issues a policy of group health insurance with more 38
than 100 insureds shall include in the policy coverage for: 39
(a) Any procedure or medication determined by a qualified 40
provider of health care to be necessary for the diagnosis and 41
treatment of infertility in accordance with established medical 42
practice or any guidelines published by the American College of 43
Obstetricians and Gynecologists or the American Society for 44
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Reproductive Medicine, or their successor organizations. Such 1
coverage must include, without limitation, coverage for: 2
(1) At least three completed retrievals of oocytes; and 3
(2) Unlimited transfers of embryos, including, without 4
limitation, single-embryo transfer where appropriate, in 5
accordance with the guidelines of the American Society for 6
Reproductive Medicine, or its successor organization. 7
(b) Any procedure or service for the preservation of fertility 8
consistent with established medical practice or any guidelines 9
published by the American Society for Reproductive Medicine or 10
the American Society of Clinical Oncology, or their successor 11
organizations, that are determined by a qualified provider of 12
health care to be medically necessary to preserve fertility because 13
the insured: 14
(1) Has been diagnosed with a medical or genetic condition 15
that may directly or indirectly cause infertility, as determined 16
pursuant to paragraph (a) of subsection 2; or 17
(2) Is expected to receive a medical treatment that may 18
directly or indirectly cause infertility, as determined pursuant to 19
paragraph (b) of subsection 2. 20
2. For the purposes of subsection 1: 21
(a) A medical or genetic condition may directly or indirectly 22
cause infertility if the condition or treatment for the condition is 23
likely to cause infertility, as established by the American Society of 24
Clinical Oncology, the American Society for Reproductive 25
Medicine or the American College of Obstetricians and 26
Gynecologists, or their successor organizations. 27
(b) A medical treatment may directly or indirectly cause 28
infertility if the treatment has a potential side effect of impaired 29
fertility, as established by the American Society of Clinical 30
Oncology or the American Society for Reproductive Medicine, or 31
their successor organizations. 32
3. An insurer shall ensure that the benefits required by 33
subsection 1 are made available to an insured through a provider 34
of health care who participates in the network plan of the insurer. 35
4. An insurer shall not: 36
(a) Require an insured to pay a higher deductible, copayment, 37
coinsurance or other form of cost-sharing for the benefits 38
required by subsection 1 than is required for similar benefits that 39
are not related to fertility; 40
(b) Require an insured to obtain prior authorization for the 41
benefits described in subsection 1 that is not required for similar 42
benefits that are not related to fertility; 43
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(c) Require a longer waiting period for the coverage required 1
by subsection 1 than is required for similar benefits that are not 2
related to fertility; 3
(d) Impose any other exclusions, limitations, restrictions or 4
delays on the access of an insured to any benefit described in 5
subsection 1 that is not imposed on similar benefits that are not 6
related to fertility; 7
(e) Refuse to issue a policy of group health insurance or 8
cancel a policy of group health insurance solely because the 9
person applying for or covered by the policy uses or may use in the 10
future any benefit described in subsection 1; 11
(f) Offer or pay any type of material inducement or financial 12
incentive to an insured to discourage the insured from accessing 13
any benefit described in subsection 1; 14
(g) Penalize a provider of health care who provides any benefit 15
described in subsection 1 to an insured, including, without 16
limitation, reducing the reimbursement of the provider of health 17
care; or 18
(h) Offer or pay any type of material inducement, bonus or 19
other financial incentive to a provider of health care to deny, 20
reduce, withhold, limit or delay any benefit described in subsection 21
1 to an insured. 22
5. An insurer that is affiliated with a religious organization is 23
not required to provide the coverage required by subsection 1 if 24
the insurer objects on religious grounds. Such an insurer shall, 25
before the issuance of a policy of group health insurance that is 26
subject to the requirements of subsection 1 and before the renewal 27
of such a policy, provide to the group policyholder or prospective 28
insured, as applicable, written notice of the coverage that the 29
insurer refuses to provide pursuant to this subsection. 30
6. A policy of group health insurance with more than 100 31
insureds that is subject to the provisions of this chapter and is 32
delivered, issued for delivery or renewed on or after January 1, 33
2026, has the legal effect of including the coverage required by 34
subsection 1, and any provision of the policy or the renewal that 35
conflicts with the provisions of this section is void. 36
7. As used in this section: 37
(a) “Infertility” means a condition characterized by: 38
(1) The inability of a person to achieve pregnancy, not 39
including conception resulting in a miscarriage, where the person 40
and the partner of the person or a donor have the necessary 41
gametes to achieve pregnancy and after: 42
(I) At least 12 months of regular, unprotected sexual 43
intercourse or therapeutic donor insemination for a person who is 44
less than 35 years of age; or 45
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(II) At least 6 months of regular, unprotected sexual 1
intercourse or therapeutic donor insemination for a person who is 2
35 years of age or older; 3
(2) The inability of a person or the partner of the person to 4
reproduce or the inability of a person to reproduce with a 5
particular partner; or 6
(3) A finding by a qualified provider of health care that a 7
person is infertile based on: 8
(I) The medical, sexual and reproductive history or age 9
of the person; 10
(II) Physical findings; or 11
(III) Diagnostic testing. 12
(b) “Network plan” means a policy of group health insurance 13
offered by an insurer under which the financing and delivery of 14
medical care, including items and services paid for as medical 15
care, are provided, in whole or in part, through a defined set of 16
providers under contract with the insurer. The term does not 17
include an arrangement for the financing of premiums. 18
(c) “Provider of health care” has the meaning ascribed to it in 19
NRS 629.031. 20
Sec. 24. 1. Regardless of whether a person who is pregnant 21
already has health coverage, an insurer shall allow the person to 22
enroll in a policy of group health insurance without any additional 23
fee or penalty within at least 30 days after the person has been 24
confirmed to be pregnant by a qualified provider of health care. 25
2. Coverage for a person who enrolls in a policy of group 26
health insurance pursuant to subsection 1 must be effective: 27
(a) Except as otherwise provided in paragraph (b), on the first 28
day of the month in which a qualified provider of health care 29
confirms that the person is pregnant; or 30
(b) Upon the election of the person, on the first day of the 31
month after the person elects to enroll in the policy. 32
3. As used in this section, “provider of health care” has the 33
meaning ascribed to it in NRS 629.031. 34
Sec. 25. NRS 689B.0376 is hereby amended to read as 35
follows: 36
689B.0376 1. An insurer that offers or issues a policy of 37
group health insurance which provides coverage for prescription 38
drugs or devices shall include in the policy coverage for any type of 39
hormone replacement therapy which is lawfully prescribed or 40
ordered and which has been approved by the Food and Drug 41
Administration. 42
2. An insurer that offers or issues a policy of group health 43
insurance that provides coverage for prescription drugs shall not: 44
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(a) Require an insured to pay a higher deductible, any 1
copayment or coinsurance or require a longer waiting period or 2
other condition for coverage for a prescription for hormone 3
replacement therapy; 4
(b) Refuse to issue a policy of group health insurance or cancel a 5
policy of group health insurance solely because the person applying 6
for or covered by the policy uses or may use in the future hormone 7
replacement therapy; 8
(c) Offer or pay any type of material inducement or financial 9
incentive to an insured to discourage the insured from accessing 10
hormone replacement therapy; 11
(d) Penalize a provider of health care who provides hormone 12
replacement therapy to an insured, including, without limitation, 13
reducing the reimbursement of the provider of health care; or 14
(e) Offer or pay any type of material inducement, bonus or other 15
financial incentive to a provider of health care to deny, reduce, 16
withhold, limit or delay hormone replacement therapy to an insured. 17
3. A policy subject to the provisions of this chapter that is 18
delivered, issued for delivery or renewed on or after October 1, 19
1999, has the legal effect of including the coverage required by 20
subsection 1, and any provision of the policy or the renewal which is 21
in conflict with this section is void. 22
4. The provisions of this section do not require an insurer to 23
provide coverage for fertility drugs [.] , except as required by 24
section 23 of this act. 25
5. As used in this section, “provider of health care” has the 26
meaning ascribed to it in NRS 629.031. 27
Sec. 26. NRS 689B.290 is hereby amended to read as follows: 28
689B.290 As used in NRS 689B.290 to 689B.330, inclusive, 29
and section 24 of this act, unless the context otherwise requires: 30
1. “Medicaid” means a program established in any state 31
pursuant to Title XIX of the Social Security Act (42 U.S.C. §§ 1396 32
et seq.) to provide assistance for part or all of the cost of medical 33
care rendered on behalf of indigent persons. 34
2. “Order for medical coverage” means an order of a court or 35
administrative tribunal to provide coverage under a group health 36
policy to a child pursuant to the provisions of 42 U.S.C. § 1396g-1. 37
Sec. 27. Chapter 689C of NRS is hereby amended by adding 38
thereto a new section to read as follows: 39
1. Regardless of whether a person who is pregnant already 40
has health coverage, a carrier shall allow the person to enroll in a 41
health benefit plan without any additional fee or penalty within at 42
least 30 days after the person has been confirmed to be pregnant 43
by a qualified provider of health care. 44
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2. Coverage for a person who enrolls in a health benefit plan 1
pursuant to subsection 1 must be effective: 2
(a) Except as otherwise provided in paragraph (b), on the first 3
day of the month in which a qualified provider of health care 4
confirms that the person is pregnant; or 5
(b) Upon the election of the person, on the first day of the 6
month after the person elects to enroll in the health benefit plan. 7
3. As used in this section, “provider of health care” has the 8
meaning ascribed to it in NRS 629.031. 9
Sec. 28. NRS 689C.425 is hereby amended to read as follows: 10
689C.425 A voluntary purchasing group and any contract 11
issued to such a group pursuant to NRS 689C.360 to 689C.600, 12
inclusive, are subject to the provisions of NRS 689C.015 to 13
689C.355, inclusive, and section 27 of this act to the extent 14
applicable and not in conflict with the express provisions of NRS 15
687B.408 and 689C.360 to 689C.600, inclusive. 16
Sec. 29. Chapter 695A of NRS is hereby amended by adding 17
thereto a new section to read as follows: 18
1. Regardless of whether a person who is pregnant already 19
has health coverage, a society shall allow the person to enroll in a 20
benefit contract without any additional fee or penalty within at 21
least 60 days after the person has been confirmed to be pregnant 22
by a qualified provider of health care. 23
2. Coverage for a person who enrolls in a benefit contract 24
pursuant to subsection 1 must be effective: 25
(a) Except as otherwise provided in paragraph (b), on the first 26
day of the month in which a qualified provider of health care 27
confirms that the person is pregnant; or 28
(b) Upon the election of the person, on the first day of the 29
month after the person elects to enroll in the benefit contract. 30
3. As used in this section, “provider of health care” has the 31
meaning ascribed to it in NRS 629.031. 32
Sec. 30. Chapter 695B of NRS is hereby amended by adding 33
thereto the provisions set forth as sections 31 and 32 of this act. 34
Sec. 31. 1. Except as otherwise provided in subsection 5, a 35
hospital or medical services corporation that issues a policy of 36
group health insurance with more than 100 insureds shall include 37
in the policy coverage for: 38
(a) Any procedure or medication determined by a qualified 39
provider of health care to be necessary for the diagnosis and 40
treatment of infertility in accordance with established medical 41
practice or any guidelines published by the American College of 42
Obstetricians and Gynecologists or the American Society for 43
Reproductive Medicine, or their successor organizations. Such 44
coverage must include, without limitation, coverage for: 45
– 20 –
- *SB217*
(1) At least three completed retrievals of oocytes; and 1
(2) Unlimited transfers of embryos, including, without 2
limitation, single-embryo transfer where appropriate, in 3
accordance with the guidelines of the American Society for 4
Reproductive Medicine, or its successor organization. 5
(b) Any procedure or service for the preservation of fertility 6
consistent with established medical practice or any guidelines 7
published by the American Society for Reproductive Medicine or 8
the American Society of Clinical Oncology, or their successor 9
organizations, that are determined by a qualified provider of 10
health care to be medically necessary to preserve fertility because 11
the insured: 12
(1) Has been diagnosed with a medical or genetic condition 13
that may directly or indirectly cause infertility, as determined 14
pursuant to paragraph (a) of subsection 2; or 15
(2) Is expected to receive a medical treatment that may 16
directly or indirectly cause infertility, as determined pursuant to 17
paragraph (b) of subsection 2. 18
2. For the purposes of subsection 1: 19
(a) A medical or genetic condition may directly or indirectly 20
cause infertility if the condition or treatment for the condition is 21
likely to cause infertility, as established by the American Society of 22
Clinical Oncology, the American Society for Reproductive 23
Medicine or the American College of Obstetricians and 24
Gynecologists, or their successor organizations. 25
(b) A medical treatment may directly or indirectly cause 26
infertility if the treatment has a potential side effect of impaired 27
fertility, as established by the American Society of Clinical 28
Oncology or the American Society for Reproductive Medicine, or 29
their successor organizations. 30
3. A hospital or medical services corporation shall ensure 31
that the benefits required by subsection 1 are made available to an 32
insured through a provider of health care who participates in the 33
network plan of the hospital or medical services corporation. 34
4. A hospital or medical services corporation shall not: 35
(a) Require an insured to pay a higher deductible, copayment, 36
coinsurance or other form of cost-sharing for the benefits 37
required by subsection 1 than is required for similar benefits that 38
are not related to fertility; 39
(b) Require an insured to obtain prior authorization for the 40
benefits described in subsection 1 that is not required for similar 41
benefits that are not related to fertility; 42
(c) Require a longer waiting period for the coverage required 43
by subsection 1 than is required for similar benefits that are not 44
related to fertility; 45
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- *SB217*
(d) Impose any other exclusions, limitations, restrictions or 1
delays on the access of an insured to any benefit described in 2
subsection 1 that is not imposed on similar benefits that are not 3
related to fertility; 4
(e) Refuse to issue a policy of group health insurance or 5
cancel a policy of group health insurance solely because the 6
person applying for or covered by the policy uses or may use in the 7
future any benefit described in subsection 1; 8
(f) Offer or pay any type of material inducement or financial 9
incentive to an insured to discourage the insured from accessing 10
any benefit described in subsection 1; 11
(g) Penalize a provider of health care who provides any benefit 12
described in subsection 1 to an insured, including, without 13
limitation, reducing the reimbursement of the provider of health 14
care; or 15
(h) Offer or pay any type of material inducement, bonus or 16
other financial incentive to a provider of health care to deny, 17
reduce, withhold, limit or delay any benefit described in subsection 18
1 to an insured. 19
5. A hospital or medical services corporation that is affiliated 20
with a religious organization is not required to provide the 21
coverage required by subsection 1 if the hospital or medical 22
services corporation objects on religious grounds. Such a hospital 23
or medical services corporation shall, before the issuance of a 24
policy of group health insurance that is subject to the 25
requirements of subsection 1 and before the renewal of such a 26
policy, provide to the group policyholder or prospective insured, as 27
applicable, written notice of the coverage that the hospital or 28
medical services corporation refuses to provide pursuant to this 29
subsection. 30
6. A policy of group health insurance with more than 100 31
insureds that is subject to the provisions of this chapter and is 32
delivered, issued for delivery or renewed on or after January 1, 33
2026, has the legal effect of including the coverage required by 34
subsection 1, and any provision of the policy or the renewal that 35
conflicts with the provisions of this section is void. 36
7. As used in this section: 37
(a) “Infertility” means a condition characterized by: 38
(1) The inability of a person to achieve pregnancy, not 39
including conception resulting in a miscarriage, where the person 40
and the partner of the person or a donor have the necessary 41
gametes to achieve pregnancy and after: 42
(I) At least 12 months of regular, unprotected sexual 43
intercourse or therapeutic donor insemination for a person who is 44
less than 35 years of age; or 45
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(II) At least 6 months of regular, unprotected sexual 1
intercourse or therapeutic donor insemination for a person who is 2
35 years of age or older; 3
(2) The inability of a person or the partner of the person to 4
reproduce or the inability of a person to reproduce with a 5
particular partner; or 6
(3) A finding by a qualified provider of health care that a 7
person is infertile based on: 8
(I) The medical, sexual and reproductive history or age 9
of the person; 10
(II) Physical findings; or 11
(III) Diagnostic testing. 12
(b) “Network plan” means a policy of health insurance offered 13
by a hospital or medical services corporation under which the 14
financing and delivery of medical care, including items and 15
services paid for as medical care, are provided, in whole or in part, 16
through a defined set of providers under contract with the hospital 17
or medical services corporation. The term does not include an 18
arrangement for the financing of premiums. 19
(c) “Provider of health care” has the meaning ascribed to it in 20
NRS 629.031. 21
Sec. 32. 1. Regardless of whether a person who is pregnant 22
already has health coverage, a corporation shall allow the person 23
to enroll in a policy of health insurance without any additional fee 24
or penalty within at least: 25
(a) Sixty days after the person has been confirmed to be 26
pregnant by a qualified provider of health care, if the policy is 27
offered on the individual market; or 28
(b) Thirty days after the person has been confirmed to be 29
pregnant by a qualified provider of health care, if the policy is 30
offered on the group market. 31
2. Coverage for a person who enrolls in a policy of health 32
insurance pursuant to subsection 1 must be effective: 33
(a) Except as otherwise provided in paragraph (b), on the first 34
day of the month in which a qualified provider of health care 35
confirms that the person is pregnant; or 36
(b) Upon the election of the person, on the first day of the 37
month after the person elects to enroll in the policy. 38
3. As used in this section, “provider of health care” has the 39
meaning ascribed to it in NRS 629.031. 40
Sec. 33. NRS 695B.1916 is hereby amended to read as 41
follows: 42
695B.1916 1. An insurer that offers or issues a contract for 43
hospital or medical service which provides coverage for prescription 44
drugs or devices shall include in the contract coverage for any type 45
– 23 –
- *SB217*
of 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 contract for hospital or 4
medical service that provides coverage for prescription drugs shall 5
not: 6
(a) Require an insured to pay a higher deductible, any 7
copayment or coinsurance or require a longer waiting period or 8
other condition for coverage for a prescription for hormone 9
replacement therapy; 10
(b) Refuse to issue a contract for hospital or medical service or 11
cancel a contract for hospital or medical service solely because the 12
person applying for or covered by the contract uses or may use in 13
the future hormone replacement therapy; 14
(c) Offer or pay any type of material inducement or financial 15
incentive to an insured to discourage the insured from accessing 16
hormone replacement therapy; 17
(d) Penalize a provider of health care who provides hormone 18
replacement therapy to an insured, including, without limitation, 19
reducing the reimbursement of the provider of health care; or 20
(e) Offer or pay any type of material inducement, bonus or other 21
financial incentive to a provider of health care to deny, reduce, 22
withhold, limit or delay hormone replacement therapy to an insured. 23
3. A contract for hospital or medical service subject to the 24
provisions of this chapter that is delivered, issued for delivery or 25
renewed on or after October 1, 1999, has the legal effect of 26
including the coverage required by subsection 1, and any provision 27
of the contract or the renewal which is in conflict with this section is 28
void. 29
4. The provisions of this section do not require an insurer to 30
provide coverage for fertility drugs [.] , except as required by 31
section 31 of this act. 32
5. As used in this section, “provider of health care” has the 33
meaning ascribed to it in NRS 629.031. 34
Sec. 34. NRS 695B.330 is hereby amended to read as follows: 35
695B.330 As used in NRS 695B.330 to 695B.370, inclusive, 36
and section 32 of this act, unless the context otherwise requires: 37
1. “Contract” means a contract for hospital, medical or dental 38
services issued pursuant to this chapter. 39
2. “Corporation” means a corporation organized pursuant to 40
this chapter. 41
3. “Medicaid” means a program established in any state 42
pursuant to Title XIX of the Social Security Act (42 U.S.C. §§ 1396 43
et seq.) to provide assistance for part or all of the cost of medical 44
care rendered on behalf of indigent persons. 45
– 24 –
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4. “Order for medical coverage” means an order of a court or 1
administrative tribunal to provide coverage under a contract to a 2
child pursuant to the provisions of 42 U.S.C. § 1396g-1. 3
Sec. 35. Chapter 695C of NRS is hereby amended by adding 4
thereto the provisions set forth as sections 36 and 37 of this act. 5
Sec. 36. 1. Regardless of whether a person who is pregnant 6
already has health coverage, a health maintenance organization 7
shall allow the person to enroll in a health care plan without any 8
additional fee or penalty within at least: 9
(a) Sixty days after the person has been confirmed to be 10
pregnant by a qualified provider of health care, if the health care 11
plan is offered on the individual market; or 12
(b) Thirty days after the person has been confirmed to be 13
pregnant by a qualified provider of health care, if the health care 14
plan is offered on the group market. 15
2. Coverage for a person who enrolls in a health care plan 16
pursuant to subsection 1 must be effective: 17
(a) Except as otherwise provided in paragraph (b), on the first 18
day of the month in which a qualified provider of health care 19
confirms that the person is pregnant; or 20
(b) Upon the election of the person, on the first day of the 21
month after the person elects to enroll in the plan. 22
3. As used in this section, “provider of health care” has the 23
meaning ascribed to it in NRS 629.031. 24
Sec. 37. 1. Except as otherwise provided in subsection 5, a 25
health maintenance organization that issues a group health care 26
plan with more than 100 enrollees or a plan that provides health 27
care services through managed care to recipients of Medicaid 28
under the State Plan for Medicaid shall include in the plan 29
coverage for: 30
(a) Any procedure or medication determined by a qualified 31
provider of health care to be necessary for the diagnosis and 32
treatment of infertility in accordance with established medical 33
practice or any guidelines published by the American College of 34
Obstetricians and Gynecologists or the American Society for 35
Reproductive Medicine, or their successor organizations. Such 36
coverage must include, without limitation, coverage for: 37
(1) At least three completed retrievals of oocytes; and 38
(2) Unlimited transfers of embryos, including, without 39
limitation, single-embryo transfer where appropriate, in 40
accordance with the guidelines of the American Society for 41
Reproductive Medicine, or its successor organization. 42
(b) Any procedure or service for the preservation of fertility 43
consistent with established medical practice or any guidelines 44
published by the American Society for Reproductive Medicine or 45
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the American Society of Clinical Oncology, or their successor 1
organizations, that are determined by a qualified provider of 2
health care to be medically necessary to preserve fertility because 3
the enrollee: 4
(1) Has been diagnosed with a medical or genetic condition 5
that may directly or indirectly cause infertility, as determined 6
pursuant to paragraph (a) of subsection 2; or 7
(2) Is expected to receive a medical treatment that may 8
directly or indirectly cause infertility, as determined pursuant to 9
paragraph (b) of subsection 2. 10
2. For the purposes of subsection 1: 11
(a) A medical or genetic condition may directly or indirectly 12
cause infertility if the condition or treatment for the condition is 13
likely to cause infertility, as established by the American Society of 14
Clinical Oncology, the American Society for Reproductive 15
Medicine or the American College of Obstetricians and 16
Gynecologists, or their successor organizations. 17
(b) A medical treatment may directly or indirectly cause 18
infertility if the treatment has a potential side effect of impaired 19
fertility, as established by the American Society of Clinical 20
Oncology or the American Society for Reproductive Medicine, or 21
their successor organizations. 22
3. A health maintenance organization shall ensure that the 23
benefits required by subsection 1 are made available to an enrollee 24
through a provider of health care who participates in the network 25
plan of the health maintenance organization. 26
4. A health maintenance organization shall not: 27
(a) Require an enrollee to pay a higher deductible, copayment, 28
coinsurance or other form of cost-sharing for the benefits 29
required by subsection 1 than is required for similar benefits that 30
are not related to fertility; 31
(b) Require an enrollee to obtain prior authorization for the 32
benefits described in subsection 1 that is not required for similar 33
benefits that are not related to fertility; 34
(c) Require a longer waiting period for the coverage required 35
by subsection 1 than is required for similar benefits that are not 36
related to fertility; 37
(d) Impose any other exclusions, limitations, restrictions or 38
delays on the access of an enrollee to any benefit described in 39
subsection 1 that is not imposed on similar benefits that are not 40
related to fertility; 41
(e) Refuse to issue a health care plan or cancel a health care 42
plan solely because the person applying for or covered by the plan 43
uses or may use in the future any benefit described in 44
subsection 1; 45
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(f) Offer or pay any type of material inducement or financial 1
incentive to an enrollee to discourage the enrollee from accessing 2
any benefit described in subsection 1; 3
(g) Penalize a provider of health care who provides any benefit 4
described in subsection 1 to an enrollee, including, without 5
limitation, reducing the reimbursement of the provider of health 6
care; or 7
(h) Offer or pay any type of material inducement, bonus or 8
other financial incentive to a provider of health care to deny, 9
reduce, withhold, limit or delay any benefit described in subsection 10
1 to an enrollee. 11
5. A health maintenance organization which is affiliated with 12
a religious organization is not required to provide the coverage 13
required by subsection 1 if the health maintenance organization 14
objects on religious grounds. Such a health maintenance 15
organization shall, before the issuance of a group health care plan 16
that is subject to the requirements of subsection 1 and before the 17
renewal of such a plan, provide to the group policyholder or 18
prospective enrollee, as applicable, written notice of the coverage 19
that the health maintenance organization refuses to provide 20
pursuant to this subsection. 21
6. A group health care plan with more than 100 enrollees that 22
is subject to the provisions of this chapter and is delivered, issued 23
for delivery or renewed on or after January 1, 2026, has the legal 24
effect of including the coverage required by subsection 1, and any 25
provision of the plan or the renewal that conflicts with the 26
provisions of this section is void. 27
7. As used in this section: 28
(a) “Infertility” means a condition characterized by: 29
(1) The inability of a person to achieve pregnancy, not 30
including conception resulting in a miscarriage, where the person 31
and the partner of the person or a donor have the necessary 32
gametes to achieve pregnancy and after: 33
(I) At least 12 months of regular, unprotected sexual 34
intercourse or therapeutic donor insemination for a person who is 35
less than 35 years of age; or 36
(II) At least 6 months of regular, unprotected sexual 37
intercourse or therapeutic donor insemination for a person who is 38
35 years of age or older; 39
(2) The inability of a person or the partner of the person to 40
reproduce or the inability of a person to reproduce with a 41
particular partner; or 42
(3) A finding by a qualified provider of health care that a 43
person is infertile based on: 44
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(I) The medical, sexual and reproductive history or age 1
of the person; 2
(II) Physical findings; or 3
(III) Diagnostic testing. 4
(b) “Network plan” means a health care plan offered by a 5
health maintenance organization under which the financing and 6
delivery of medical care, including items and services paid for as 7
medical care, are provided, in whole or in part, through a defined 8
set of providers under contract with the health maintenance 9
organization. The term does not include an arrangement for the 10
financing of premiums. 11
(c) “Provider of health care” has the meaning ascribed to it in 12
NRS 629.031. 13
Sec. 38. NRS 695C.050 is hereby amended to read as follows: 14
695C.050 1. Except as otherwise provided in this chapter or 15
in specific provisions of this title, the provisions of this title are not 16
applicable to any health maintenance organization granted a 17
certificate of authority under this chapter. This provision does not 18
apply to an insurer licensed and regulated pursuant to this title 19
except with respect to its activities as a health maintenance 20
organization authorized and regulated pursuant to this chapter. 21
2. Solicitation of enrollees by a health maintenance 22
organization granted a certificate of authority, or its representatives, 23
must not be construed to violate any provision of law relating to 24
solicitation or advertising by practitioners of a healing art. 25
3. Any health maintenance organization authorized under this 26
chapter shall not be deemed to be practicing medicine and is exempt 27
from the provisions of chapter 630 of NRS. 28
4. The provisions of NRS 695C.110, 695C.125, 695C.1691, 29
695C.1693, 695C.170, 695C.1703, 695C.1705, 695C.1709 to 30
695C.173, inclusive, 695C.1733, 695C.17335, 695C.1734, 31
695C.1751, 695C.1755, 695C.1759, 695C.176 to 695C.200, 32
inclusive, and 695C.265 do not apply to a health maintenance 33
organization that provides health care services through managed 34
care to recipients of Medicaid under the State Plan for Medicaid or 35
insurance pursuant to the Children’s Health Insurance Program 36
pursuant to a contract with the Division of Health Care Financing 37
and Policy of the Department of Health and Human Services. This 38
subsection does not exempt a health maintenance organization from 39
any provision of this chapter for services provided pursuant to any 40
other contract. 41
5. The provisions of NRS 695C.16932 to 695C.1699, 42
inclusive, 695C.1701, 695C.1708, 695C.1728, 695C.1731, 43
695C.17333, 695C.17345, 695C.17347, 695C.1736 to 695C.1745, 44
inclusive, 695C.1757 and 695C.204 and sections 36 and 37 of this 45
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act apply to a health maintenance organization that provides health 1
care services through managed care to recipients of Medicaid under 2
the State Plan for Medicaid. 3
6. The provisions of NRS 695C.17095 do not apply to a health 4
maintenance organization that provides health care services to 5
members of the Public Employees’ Benefits Program. This 6
subsection does not exempt a health maintenance organization from 7
any provision of this chapter for services provided pursuant to any 8
other contract. 9
7. The provisions of NRS 695C.1735 do not apply to a health 10
maintenance organization that provides health care services to: 11
(a) The officers and employees, and the dependents of officers 12
and employees, of the governing body of any county, school district, 13
municipal corporation, political subdivision, public corporation or 14
other local governmental agency of this State; or 15
(b) Members of the Public Employees’ Benefits Program. 16
This subsection does not exempt a health maintenance 17
organization from any provision of this chapter for services 18
provided pursuant to any other contract. 19
Sec. 39. NRS 695C.161 is hereby amended to read as follows: 20
695C.161 As used in NRS 695C.161 to 695C.169, inclusive, 21
and section 36 of this act, unless the context otherwise requires: 22
1. “Medicaid” means a program established in any state 23
pursuant to Title XIX of the Social Security Act (42 U.S.C. §§ 1396 24
et seq.) to provide assistance for part or all of the cost of medical 25
care rendered on behalf of indigent persons. 26
2. “Order for medical coverage” means an order of a court or 27
administrative tribunal to provide coverage under a health care plan 28
to a child pursuant to the provisions of 42 U.S.C. § 1396g-1. 29
Sec. 40. NRS 695C.1694 is hereby amended to read as 30
follows: 31
695C.1694 1. A health maintenance organization which 32
offers or issues a health care plan that provides coverage for 33
prescription drugs or devices shall include in the plan coverage for 34
any type of hormone replacement therapy which is lawfully 35
prescribed or ordered and which has been approved by the Food and 36
Drug Administration. 37
2. A health maintenance organization that offers or issues a 38
health care plan that provides coverage for prescription drugs shall 39
not: 40
(a) Require an enrollee to pay a higher deductible, any 41
copayment or coinsurance or require a longer waiting period or 42
other condition for coverage for hormone replacement therapy; 43
– 29 –
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(b) Refuse to issue a health care plan or cancel a health care plan 1
solely because the person applying for or covered by the plan uses 2
or may use in the future hormone replacement therapy; 3
(c) Offer or pay any type of material inducement or financial 4
incentive to an enrollee to discourage the enrollee from accessing 5
hormone replacement therapy; 6
(d) Penalize a provider of health care who provides hormone 7
replacement therapy to an enrollee, including, without limitation, 8
reducing the reimbursement of the provider of health care; or 9
(e) Offer or pay any type of material inducement, bonus or other 10
financial incentive to a provider of health care to deny, reduce, 11
withhold, limit or delay hormone replacement therapy to an 12
enrollee. 13
3. Evidence of coverage subject to the provisions of this 14
chapter that is delivered, issued for delivery or renewed on or after 15
October 1, 1999, has the legal effect of including the coverage 16
required by subsection 1, and any provision of the evidence of 17
coverage or the renewal which is in conflict with this section is void. 18
4. The provisions of this section do not require a health 19
maintenance organization to provide coverage for fertility drugs [.] , 20
except as required by section 37 of this act. 21
5. As used in this section, “provider of health care” has the 22
meaning ascribed to it in NRS 629.031. 23
Sec. 41. NRS 695C.330 is hereby amended to read as follows: 24
695C.330 1. The Commissioner may suspend or revoke any 25
certificate of authority issued to a health maintenance organization 26
pursuant to the provisions of this chapter if the Commissioner finds 27
that any of the following conditions exist: 28
(a) The health maintenance organization is operating 29
significantly in contravention of its basic organizational document, 30
its health care plan or in a manner contrary to that described in and 31
reasonably inferred from any other information submitted pursuant 32
to NRS 695C.060, 695C.070 and 695C.140, unless any amendments 33
to those submissions have been filed with and approved by the 34
Commissioner; 35
(b) The health maintenance organization issues evidence of 36
coverage or uses a schedule of charges for health care services 37
which do not comply with the requirements of NRS 695C.1691 to 38
695C.200, inclusive, and section 37 of this act, 695C.204 or 39
695C.207; 40
(c) The health care plan does not furnish comprehensive health 41
care services as provided for in NRS 695C.060; 42
(d) The Commissioner certifies that the health maintenance 43
organization: 44
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(1) Does not meet the requirements of subsection 1 of NRS 1
695C.080; or 2
(2) Is unable to fulfill its obligations to furnish health care 3
services as required under its health care plan; 4
(e) The health maintenance organization is no longer financially 5
responsible and may reasonably be expected to be unable to meet its 6
obligations to enrollees or prospective enrollees; 7
(f) The health maintenance organization has failed to put into 8
effect a mechanism affording the enrollees an opportunity to 9
participate in matters relating to the content of programs pursuant to 10
NRS 695C.110; 11
(g) The health maintenance organization has failed to put into 12
effect the system required by NRS 695C.260 for: 13
(1) Resolving complaints in a manner reasonably to dispose 14
of valid complaints; and 15
(2) Conducting external reviews of adverse determinations 16
that comply with the provisions of NRS 695G.241 to 695G.310, 17
inclusive; 18
(h) The health maintenance organization or any person on its 19
behalf has advertised or merchandised its services in an untrue, 20
misrepresentative, misleading, deceptive or unfair manner; 21
(i) The continued operation of the health maintenance 22
organization would be hazardous to its enrollees or creditors or to 23
the general public; 24
(j) The health maintenance organization fails to provide the 25
coverage required by NRS 695C.1691; or 26
(k) The health maintenance organization has otherwise failed to 27
comply substantially with the provisions of this chapter. 28
2. A certificate of authority must be suspended or revoked only 29
after compliance with the requirements of NRS 695C.340. 30
3. If the certificate of authority of a health maintenance 31
organization is suspended, the health maintenance organization shall 32
not, during the period of that suspension, enroll any additional 33
groups or new individual contracts, unless those groups or persons 34
were contracted for before the date of suspension. 35
4. If the certificate of authority of a health maintenance 36
organization is revoked, the organization shall proceed, immediately 37
following the effective date of the order of revocation, to wind up its 38
affairs and shall conduct no further business except as may be 39
essential to the orderly conclusion of the affairs of the organization. 40
It shall engage in no further advertising or solicitation of any kind. 41
The Commissioner may, by written order, permit such further 42
operation of the organization as the Commissioner may find to be in 43
the best interest of enrollees to the end that enrollees are afforded 44
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the greatest practical opportunity to obtain continuing coverage for 1
health care. 2
Sec. 42. Chapter 695F of NRS is hereby amended by adding 3
thereto a new section to read as follows: 4
1. Regardless of whether a person who is pregnant already 5
has health coverage, a prepaid limited health service organization 6
that offers coverage for pregnancy and childbirth shall allow the 7
person to enroll in such coverage without any additional fee or 8
penalty within at least 60 days after the person has been confirmed 9
to be pregnant by a qualified provider of health care. 10
2. Coverage for a person who enrolls in coverage pursuant to 11
subsection 1 must be effective: 12
(a) Except as otherwise provided in paragraph (b), on the first 13
day of the month in which a qualified provider of health care 14
confirms that the person is pregnant; or 15
(b) Upon the election of the person, on the first day of the 16
month after the person elects to enroll in the coverage. 17
3. As used in this section, “provider of health care” has the 18
meaning ascribed to it in NRS 629.031. 19
Sec. 43. Chapter 695G of NRS is hereby amended by adding 20
thereto the provisions set forth as sections 44 and 45 of this act. 21
Sec. 44. 1. Except as otherwise provided in subsection 5, a 22
managed care organization that issues a group health care plan 23
with more than 100 insureds or a plan that provides health care 24
services through managed care to recipients of Medicaid under 25
the State Plan for Medicaid shall include in the plan coverage for: 26
(a) Any procedure or medication determined by a qualified 27
provider of health care to be necessary for the diagnosis and 28
treatment of infertility in accordance with established medical 29
practice or any guidelines published by the American College of 30
Obstetricians and Gynecologists or the American Society for 31
Reproductive Medicine, or their successor organizations. Such 32
coverage must include, without limitation, coverage for: 33
(1) At least three completed retrievals of oocytes; and 34
(2) Unlimited transfers of embryos, including, without 35
limitation, single-embryo transfer where appropriate, in 36
accordance with the guidelines of the American Society for 37
Reproductive Medicine, or its successor organization. 38
(b) Any procedure or service for the preservation of fertility 39
consistent with established medical practice or any guidelines 40
published by the American Society for Reproductive Medicine or 41
the American Society of Clinical Oncology, or their successor 42
organizations, that are determined by a qualified provider of 43
health care to be medically necessary to preserve fertility because 44
the insured: 45
– 32 –
- *SB217*
(1) Has been diagnosed with a medical or genetic condition 1
that may directly or indirectly cause infertility, as determined 2
pursuant to paragraph (a) of subsection 2; or 3
(2) Is expected to receive a medical treatment that may 4
directly or indirectly cause infertility, as determined pursuant to 5
paragraph (b) of subsection 2. 6
2. For the purposes of subsection 1: 7
(a) A medical or genetic condition may directly or indirectly 8
cause infertility if the condition or treatment for the condition is 9
likely to cause infertility, as established by the American Society of 10
Clinical Oncology, the American Society for Reproductive 11
Medicine or the American College of Obstetricians and 12
Gynecologists, or their successor organizations. 13
(b) A medical treatment may directly or indirectly cause 14
infertility if the treatment has a potential side effect of impaired 15
fertility, as established by the American Society of Clinical 16
Oncology or the American Society for Reproductive Medicine, or 17
their successor organizations. 18
3. A managed care organization shall ensure that the benefits 19
required by subsection 1 are made available to an insured through 20
a provider of health care who participates in the network plan of 21
the managed care organization. 22
4. A managed care organization shall not: 23
(a) Require an insured to pay a higher deductible, copayment, 24
coinsurance or other form of cost-sharing for the benefits 25
required by subsection 1 than is required for similar benefits that 26
are not related to fertility; 27
(b) Require an insured to obtain prior authorization for the 28
benefits described in subsection 1 that is not required for similar 29
benefits that are not related to fertility; 30
(c) Require a longer waiting period for the coverage required 31
by subsection 1 than is required for similar benefits that are not 32
related to fertility; 33
(d) Impose any other exclusions, limitations, restrictions or 34
delays on the access of an insured to any benefit described in 35
subsection 1 that is not imposed on similar benefits that are not 36
related to fertility; 37
(e) Refuse to issue a group health care plan or cancel a group 38
health care plan solely because the person applying for or covered 39
by the plan uses or may use in the future any benefit described in 40
subsection 1; 41
(f) Offer or pay any type of material inducement or financial 42
incentive to an insured to discourage the insured from accessing 43
any benefit described in subsection 1; 44
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(g) Penalize a provider of health care who provides any benefit 1
described in subsection 1 to an insured, including, without 2
limitation, reducing the reimbursement of the provider of health 3
care; or 4
(h) Offer or pay any type of material inducement, bonus or 5
other financial incentive to a provider of health care to deny, 6
reduce, withhold, limit or delay any benefit described in subsection 7
1 to an insured. 8
5. A managed care organization that is affiliated with a 9
religious organization is not required to provide the coverage 10
required by subsection 1 if the managed care organization objects 11
on religious grounds. Such a managed care organization shall, 12
before the issuance of a group health care plan that is subject to 13
the requirements of subsection 1 and before the renewal of such a 14
plan, provide to the group policyholder or prospective insured, as 15
applicable, written notice of the coverage that the managed care 16
organization refuses to provide pursuant to this subsection. 17
6. A group health care plan with more than 100 insureds that 18
is subject to the provisions of this chapter and is delivered, issued 19
for delivery or renewed on or after January 1, 2026, has the legal 20
effect of including the coverage required by subsection 1, and any 21
provision of the plan or the renewal that conflicts with the 22
provisions of this section is void. 23
7. 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
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(b) “Network plan” means a health care plan offered by a 1
managed care organization under which the financing and 2
delivery of medical care, including items and services paid for as 3
medical care, are provided, in whole or in part, through a defined 4
set of providers under contract with the managed care 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
Sec. 45. 1. Regardless of whether a person who is pregnant 10
already has health coverage, a managed care organization shall 11
allow the person to enroll in a health care plan without any 12
additional fee or penalty 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 health care 15
plan is 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 health care 18
plan is offered on the group market. 19
2. Coverage for a person who enrolls in a health care plan 20
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 plan. 26
3. As used in this section, “provider of health care” has the 27
meaning ascribed to it in NRS 629.031. 28
Sec. 46. The provisions of subsection 1 of NRS 354.599 do 29
not apply to any additional expenses of a local government which 30
are related to the provisions of this act. 31
Sec. 47. 1. This section and section 10 of this act become 32
effective upon passage and approval. 33
2. Sections 1 to 9, inclusive, of this act become effective on 34
July 1, 2025. 35
3. Sections 11 to 46, inclusive, of this act become effective: 36
(a) Upon passage and approval for the purpose of adopting any 37
regulations and performing any other preparatory administrative 38
tasks that are necessary to carry out the provisions of this act; and 39
(b) On January 1, 2026, for all other purposes. 40
H