NRS695B.1916. Required provision concerning coverage of drug or device for contraception and of hormone replacement therapy in certain circumstances; prohibited actions by insurer; exceptions.  


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  •       1.  Except as otherwise provided in subsection 5, an insurer that offers or issues a contract for hospital or medical service which provides coverage for prescription drugs or devices shall include in the contract coverage for:

          (a) Any type of drug or device for contraception; and

          (b) Any type of hormone replacement therapy,

    Ê which is lawfully prescribed or ordered and which has been approved by the Food and Drug Administration.

          2.  An insurer that offers or issues a contract for hospital or medical service that provides coverage for prescription drugs shall not:

          (a) Require an insured to pay a higher deductible, copayment or coinsurance or require a longer waiting period or other condition for coverage for a prescription for a contraceptive or hormone replacement therapy than is required for other prescription drugs covered by the contract;

          (b) Refuse to issue a contract for hospital or medical service or cancel a contract for hospital or medical service solely because the person applying for or covered by the contract uses or may use in the future any of the services listed in subsection 1;

          (c) Offer or pay any type of material inducement or financial incentive to an insured to discourage the insured from accessing any of the services listed in subsection 1;

          (d) Penalize a provider of health care who provides any of the services listed in subsection 1 to an insured, 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 any of the services listed in subsection 1 to an insured.

          3.  Except as otherwise provided in subsection 5, a contract 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 contract or the renewal which is in conflict with this section is void.

          4.  The provisions of this section do not:

          (a) Require an insurer to provide coverage for fertility drugs.

          (b) Prohibit an insurer from requiring an insured to pay a deductible, copayment or coinsurance for the coverage required by paragraphs (a) and (b) of subsection 1 that is the same as the insured is required to pay for other prescription drugs covered by the contract.

          5.  An insurer which offers or issues a contract for hospital or medical service and which is affiliated with a religious organization is not required to provide the coverage required by paragraph (a) of subsection 1 if the insurer objects on religious grounds. Such an insurer shall, before the issuance of a contract for hospital or medical service and before the renewal of such a contract, provide to the group policyholder or prospective insured, as applicable, written notice of the coverage that the insurer refuses to provide pursuant to this subsection. The insurer shall provide notice to each insured, at the time the insured receives his or her certificate of coverage or evidence of coverage, that the insurer refused to provide coverage pursuant to this subsection.

          6.  If an insurer refuses, pursuant to subsection 5, to provide the coverage required by paragraph (a) of subsection 1, an employer may otherwise provide for the coverage for the employees of the employer.

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

      (Added to NRS by 1999, 1999)