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Nevada Revised Statutes Title 57. Insurance § 695C.1694. Required provision concerning coverage of hormone replacement therapy in certain circumstances;  prohibited actions by health maintenance organization;  exception

Current as of January 01, 2021 | Updated by FindLaw Staff

1. A health maintenance organization which offers or issues a health care plan that provides coverage for prescription drugs or devices shall include in the plan 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. A health maintenance organization that offers or issues a health care plan that provides coverage for prescription drugs shall not:

(a) Require an enrollee to pay a higher deductible, any copayment or coinsurance or require a longer waiting period or other condition for coverage for hormone replacement therapy;

(b) Refuse to issue a health care plan or cancel a health care plan solely because the person applying for or covered by the plan uses or may use in the future hormone replacement therapy;

(c) Offer or pay any type of material inducement or financial incentive to an enrollee to discourage the enrollee from accessing hormone replacement therapy;

(d) Penalize a provider of health care who provides hormone replacement therapy to an enrollee, including, without limitation, reducing the reimbursement of the provider of health care;  or

(e) Offer or pay any type of material inducement, bonus or other financial incentive to a provider of health care to deny, reduce, withhold, limit or delay hormone replacement therapy to an enrollee.

3. Evidence of coverage subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after October 1, 1999, has the legal effect of including the coverage required by subsection 1, and any provision of the evidence of coverage or the renewal which is in conflict with this section is void.

4. The provisions of this section do not require a health maintenance organization to provide coverage for fertility drugs.

5. As used in this section, “provider of health care” has the meaning ascribed to it in NRS 629.031.

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Cite this article: FindLaw.com - Nevada Revised Statutes Title 57. Insurance § 695C.1694. Required provision concerning coverage of hormone replacement therapy in certain circumstances;  prohibited actions by health maintenance organization;  exception - last updated January 01, 2021 | https://codes.findlaw.com/nv/title-57-insurance/nv-rev-st-695c-1694/

Read this complete Nevada Revised Statutes Title 57. Insurance § 695C.1694. Required provision concerning coverage of hormone replacement therapy in certain circumstances;  prohibited actions by health maintenance organization;  exception on Westlaw

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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