1. An insurer that offers or issues a policy of group health insurance shall include in the policy coverage for:
(a) Drugs approved by the United States Food and Drug Administration for preventing the acquisition of human immunodeficiency virus;
(b) Laboratory testing that is necessary for therapy that uses such a drug; and
(c) The services described in NRS 639.28085, when provided by a pharmacist who participates in the network plan of the insurer.
2. An insurer that offers or issues a policy of group health insurance shall reimburse a pharmacist who participates in the network plan of the insurer for the services described in NRS 639.28085 at a rate equal to the rate of reimbursement provided to a physician, physician assistant or advanced practice registered nurse for similar services.
3. An insurer may subject the benefits required by subsection 1 to reasonable medical management techniques.
4. An insurer shall ensure that the benefits required by subsection 1 are made available to an insured through a provider of health care who participates in the network plan of the insurer.
5. A policy of group health insurance subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after October 1, 2021, has the legal effect of including the coverage required by subsection 1, and any provision of the policy that conflicts with the provisions of this section is void.
6. As used in this section:
(a) "Medical management technique" means a practice which is used to control the cost or use of health care services or prescription drugs. The term includes, without limitation, the use of step therapy, prior authorization and categorizing drugs and devices based on cost, type or method of administration.
(b) "Network plan" means a policy of group health insurance offered by an insurer under which the financing and delivery of medical care, including items and services paid for as medical care, are provided, in whole or in part, through a defined set of providers under contract with the insurer. The term does not include an arrangement for the financing of premiums.
(c) "Provider of health care" has the meaning ascribed to it in NRS 629.031.
(Added to NRS by 2021, 3207)
Structure Nevada Revised Statutes
Chapter 689B - Group and Blanket Health Insurance
NRS 689B.010 - Short title; scope.
NRS 689B.0265 - Policy to guaranteed association.
NRS 689B.030 - Required provisions.
NRS 689B.038 - Reimbursement for treatments by licensed psychologist.
NRS 689B.0393 - Reimbursement for treatments by podiatrist.
NRS 689B.0397 - Reimbursement for treatment by licensed clinical alcohol and drug counselor.
NRS 689B.045 - Reimbursement for services provided by certain nurses.
NRS 689B.047 - Reimbursement to provider of medical transportation.
NRS 689B.049 - Reimbursement for acupuncture.
NRS 689B.050 - Extended disability benefit.
NRS 689B.060 - Readjustment of premiums; dividends.
NRS 689B.063 - Primary and secondary policies: Determination of benefits.
NRS 689B.064 - Primary and secondary policies: Order of benefits.
NRS 689B.070 - "Blanket accident and health insurance" defined.
NRS 689B.080 - Authority to issue; required provisions.
NRS 689B.090 - Application and certificates.
NRS 689B.100 - Payment of benefits.
NRS 689B.110 - Legal liability of policyholders for death of or injury to insured member unaffected.
NRS 689B.250 - Acceptance of uniform forms for billing and claims.
NRS 689B.280 - Disclosure of information concerning medication of insured prohibited.
NRS 689B.350 - "Affiliation period" defined.
NRS 689B.355 - "Blanket accident and health insurance" defined.
NRS 689B.360 - "Carrier" defined.
NRS 689B.370 - "Contribution" defined.
NRS 689B.380 - "Creditable coverage" defined.
NRS 689B.390 - "Group health plan" defined.
NRS 689B.400 - "Group participation" defined.
NRS 689B.430 - "Open enrollment" defined.
NRS 689B.440 - "Plan sponsor" defined.
NRS 689B.450 - "Preexisting condition" defined.