NRS 689A.040 – Contents of policy; substitution of provisions; captions; omission or modification of provisions.

1. Except as otherwise provided in subsection 2, each such policy delivered or issued for delivery to any person in this State must contain the provisions specified in NRS 689A.050 to 689A.170, inclusive, in the words in which the provisions appear, except that the insurer may, at its option, substitute for one or more of […]

NRS 689A.0403 – Procedure for arbitration of disputes concerning independent medical, dental or chiropractic evaluations. [Effective through December 31, 2021.] Procedure for arbitration of disputes concerning independent medical, dental or chiropractic evaluations. [Effective January 1, 2022.]

1. Each policy of health insurance must include a procedure for binding arbitration to resolve disputes concerning independent medical evaluations pursuant to the rules of the American Arbitration Association. 2. If an insurer, for any final determination of benefits or care, requires an independent evaluation of the medical, dental or chiropractic care of any person […]

NRS 689A.04033 – Coverage for certain treatment received as part of clinical trial or study for treatment of cancer or chronic fatigue syndrome required; authority of insurer to require certain information; immunity from liability.

1. A policy of health insurance must provide coverage for medical treatment which a policyholder or subscriber receives as part of a clinical trial or study if: (a) The medical treatment is provided in a Phase I, Phase II, Phase III or Phase IV study or clinical trial for the treatment of cancer or in […]

NRS 689A.04036 – Coverage for continued medical treatment required in certain policies; exceptions; regulations.

1. The provisions of this section apply to a policy of health insurance offered or issued by an insurer if an insured covered by the policy receives health care through a defined set of providers of health care who are under contract with the insurer. 2. Except as otherwise provided in this section, if an […]

NRS 689A.0404 – Coverage for use of certain drugs and related services for treatment of cancer required in certain policies.

Except as otherwise provided in NRS 689A.04033: 1. No policy of health insurance that provides coverage for a drug approved by the Food and Drug Administration for use in the treatment of an illness, disease or other medical condition may be delivered or issued for delivery in this state unless the policy includes coverage for […]

NRS 689A.04041 – Policy covering prescription drug for treatment of cancer or cancer symptom that is part of step therapy protocol: Insurer required to allow insured or attending practitioner to apply for exemption from step therapy protocol in certain circumstances; procedure for applying for and granting exemption. [Effective January 1, 2022.]

1. An insurer that offers or issues a policy of health insurance which provides coverage of a prescription drug for the treatment of cancer or any symptom of cancer that is part of a step therapy protocol shall allow an insured who has been diagnosed with stage 3 or 4 cancer or the attending practitioner […]

NRS 689A.04042 – Coverage for colorectal cancer screening required in policy covering treatment of colorectal cancer.

1. A policy of health insurance that provides coverage for the treatment of colorectal cancer must provide coverage for colorectal cancer screening in accordance with: (a) The guidelines concerning colorectal cancer screening which are published by the American Cancer Society; or (b) Other guidelines or reports concerning colorectal cancer screening which are published by nationally […]

NRS 689A.04044 – Policy covering prescription drugs: Required actions by insurer related to acquisition of prescription drugs for certain insureds residing in area for which emergency or disaster has been declared.

1. If the Governor or the Legislature proclaims the existence of a state of emergency or issues a declaration of disaster pursuant to NRS 414.070, an insurer who has issued a policy of health insurance which provides coverage for prescription drugs shall, notwithstanding any provision of the policy to the contrary: (a) Waive any provision […]

NRS 689A.04045 – Policy covering prescription drugs prohibited from limiting or excluding coverage for prescription drug previously approved for medical condition of insured; exception.

1. Except as otherwise provided in this section, a policy of health insurance which provides coverage for prescription drugs must not limit or exclude coverage for a drug if the drug: (a) Had previously been approved for coverage by the insurer for a medical condition of an insured and the insured’s provider of health care […]

NRS 689A.04046 – Coverage for prescription drugs irregularly dispensed for purpose of synchronization of chronic medications required in policy covering prescription drugs; prohibited acts; exception.

1. An insurer who offers or issues a policy of health insurance which provides coverage for prescription drugs: (a) Must authorize coverage for and may apply a copayment and deductible to a prescription that is dispensed by a pharmacy for less than a 30-day supply if, for the purpose of synchronizing the insured’s chronic medications: […]

NRS 689A.04047 – Policy covering prescription drugs: Denial of coverage prohibited for early refills of otherwise covered topical ophthalmic products.

1. An insurer who offers or issues a policy of health insurance which provides coverage for prescription drugs shall not deny coverage for a topical ophthalmic product which is otherwise approved for coverage by the insurer when the insured, pursuant to NRS 639.2395, receives a refill of the product: (a) After 21 days or more […]

NRS 689A.04049 – Coverage for screening, genetic counseling and testing related to BRCA gene required in certain circumstances. [Effective January 1, 2022.]

1. An insurer that issues a policy of health insurance shall provide coverage for screening, genetic counseling and testing for harmful mutations in the BRCA gene for women under circumstances where such screening, genetic counseling or testing, as applicable, is required by NRS 457.301. 2. An insurer shall ensure that the benefits required by subsection […]

NRS 689A.0405 – Coverage for mammograms for certain women required; prohibited acts.

1. A policy of health insurance must provide coverage for benefits payable for expenses incurred for a mammogram every 2 years, or annually if ordered by a provider of health care, for women 40 years of age or older. 2. An insurer must ensure that the benefits required by subsection 1 are made available to […]

NRS 689A.041 – Coverage relating to mastectomy required in policy covering mastectomies; prohibited acts.

1. A policy of health insurance which provides coverage for the surgical procedure known as a mastectomy must also provide commensurate coverage for: (a) Reconstruction of the breast on which the mastectomy has been performed; (b) Surgery and reconstruction of the other breast to produce a symmetrical structure; and (c) Prostheses and physical complications for […]

NRS 689A.0412 – Coverage for examination of person who is pregnant for certain diseases required.

1. An insurer that issues a policy of health insurance shall provide coverage for the examination of a person who is pregnant for the discovery of: (a) Chlamydia trachomatis, gonorrhea, hepatitis B and hepatitis C in accordance with NRS 442.013. (b) Syphilis in accordance with NRS 442.010. 2. The coverage required by this section must […]

NRS 689A.0413 – Coverage for certain gynecological or obstetrical services without authorization or referral from primary care physician required.

1. A policy of health insurance must include a provision authorizing a woman covered by the policy to obtain covered gynecological or obstetrical services without first receiving authorization or a referral from her primary care physician. 2. The provisions of this section do not authorize a woman covered by a policy of health insurance to […]

NRS 689A.0415 – Coverage for hormone replacement therapy in certain circumstances required in policy covering prescription drugs or devices; prohibited acts; exception.

1. An insurer that offers or issues a policy of health insurance which provides coverage for prescription drugs or devices shall include in the policy coverage for any type of hormone replacement therapy which is lawfully prescribed or ordered and which has been approved by the Food and Drug Administration. 2. An insurer that offers […]

NRS 689A.0417 – Coverage for health care services related to hormone replacement therapy required in policy covering outpatient care; prohibited acts.

1. An insurer that offers or issues a policy of health insurance which provides coverage for outpatient care shall include in the policy coverage for any health care service related to hormone replacement therapy. 2. An insurer that offers or issues a policy of health insurance that provides coverage for outpatient care shall not: (a) […]

NRS 689A.0418 – Coverage for drug or device for contraception and related health services required; prohibited acts; exceptions. [Effective through December 31, 2021.] Coverage for drug or device for contraception and related health services required; prohibited acts; exceptions. [Effective January 1, 2022.]

1. Except as otherwise provided in subsection 7, an insurer that offers or issues a policy of health insurance shall include in the policy coverage for: (a) Up to a 12-month supply, per prescription, of any type of drug for contraception or its therapeutic equivalent which is: (1) Lawfully prescribed or ordered; (2) Approved by […]

NRS 689A.0419 – Coverage for certain services, screenings and tests relating to wellness required; prohibited acts.

1. An insurer that offers or issues a policy of health insurance shall include in the policy coverage for: (a) Counseling, support and supplies for breastfeeding, including breastfeeding equipment, counseling and education during the antenatal, perinatal and postpartum period for not more than 1 year; (b) Screening and counseling for interpersonal and domestic violence for […]