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Current as of January 01, 2021 | Updated by FindLaw Staff
1. A carrier that issues a health benefit plan shall include in the plan coverage for:
(a) Necessary case management services for an insured who has been diagnosed with sickle cell disease and its variants; and
(b) Medically necessary care for an insured who has been diagnosed with sickle cell disease and its variants.
2. A carrier that issues a health benefit plan which provides coverage for prescription drugs shall include in the plan coverage for medically necessary prescription drugs to treat sickle cell disease and its variants.
3. A carrier may use medical management techniques, including, without limitation, any available clinical evidence, to determine the frequency of or treatment relating to any benefit required by this section or the type of provider of health care to use for such treatment.
4. As used in this section:
(a) “Case management services” means medical or other health care management services to assist patients and providers of health care, including, without limitation, identifying and facilitating additional resources and treatments, providing information about treatment options and facilitating communication between providers of services to a patient.
(b) “Medical management technique” means a practice which is used to control the cost or utilization of health care services. The term includes, without limitation, the use of step therapy, prior authorization or categorizing drugs and devices based on cost, type or method of administration.
(c) “Medically necessary” has the meaning ascribed to it in NRS 695G.055.
(d) “Sickle cell disease and its variants” has the meaning ascribed to it in NRS 439.4927.
Cite this article: FindLaw.com - Nevada Revised Statutes Title 57. Insurance § 689C.1687. Coverage for management and treatment of sickle cell disease - last updated January 01, 2021 | https://codes.findlaw.com/nv/title-57-insurance/nv-rev-st-689c-1687/
FindLaw Codes may not reflect the most recent version of the law in your jurisdiction. Please verify the status of the code you are researching with the state legislature or via Westlaw before relying on it for your legal needs.
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