1. A carrier that offers or issues a health benefit plan shall include in the plan 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 health benefit plan of the carrier.
2. A carrier that offers or issues a health benefit plan shall reimburse a pharmacist who participates in the health benefit plan of the carrier 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. A carrier may subject the benefits required by subsection 1 to reasonable medical management techniques.
4. A carrier 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 carrier.
5. A health benefit plan 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 plan 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 health benefit plan offered by a carrier 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 carrier. 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, 3208)
Structure Nevada Revised Statutes
Chapter 689C - Health Insurance for Small Employers
NRS 689C.017 - "Affiliated" defined.
NRS 689C.019 - "Affiliation period" defined.
NRS 689C.023 - "Bona fide association" defined.
NRS 689C.025 - "Carrier" defined.
NRS 689C.045 - "Class of business" defined.
NRS 689C.047 - "Control" defined.
NRS 689C.053 - "Creditable coverage" defined.
NRS 689C.055 - "Dependent" defined.
NRS 689C.065 - "Eligible employee" defined.
NRS 689C.066 - "Employee leasing company" defined.
NRS 689C.071 - "Geographic rating area" defined.
NRS 689C.072 - "Geographic service area" defined.
NRS 689C.073 - "Group health plan" defined.
NRS 689C.075 - "Health benefit plan" defined.
NRS 689C.077 - "Network plan" defined.
NRS 689C.078 - "Open enrollment" defined.
NRS 689C.079 - "Plan for coverage of a bona fide association" defined.
NRS 689C.081 - "Plan sponsor" defined.
NRS 689C.082 - "Preexisting condition" defined.
NRS 689C.083 - "Producer" defined.
NRS 689C.0835 - "Professional employer organization" defined.
NRS 689C.085 - "Rating period" defined.
NRS 689C.095 - "Small employer" defined.
NRS 689C.104 - "Voluntary purchasing group" defined.
NRS 689C.106 - "Waiting period" defined.
NRS 689C.1065 - Applicability.
NRS 689C.111 - Professional employer organization deemed large employer in certain circumstances.
NRS 689C.115 - Mandatory and optional coverage.
NRS 689C.125 - Rating factors for determining premiums; rating periods.
NRS 689C.160 - Carrier must uniformly apply requirements to determine whether to provide coverage.
NRS 689C.1674 - Coverage for mammograms for certain women required; prohibited acts.
NRS 689C.1675 - Coverage for examination of person who is pregnant for certain diseases required.
NRS 689C.169 - Coverage for severe mental illness required under group health insurance policy.
NRS 689C.200 - Circumstances in which carrier is not required to offer coverage.
NRS 689C.207 - Regulations concerning reissuance of health benefit plan.
NRS 689C.220 - Adjustment in rates required to be applied uniformly.
NRS 689C.380 - "Contract" defined.
NRS 689C.390 - "Dependent" defined.
NRS 689C.420 - "Voluntary purchasing group" defined.
NRS 689C.425 - Applicability of other provisions.
NRS 689C.500 - Registration: Requirements; application.
NRS 689C.510 - Registration: Fee for application; response to application; regulations.
NRS 689C.520 - Registration: Additional requirements.
NRS 689C.530 - Filing reports; annual renewal fee; regulations.
NRS 689C.550 - Collection of premiums; trust account for deposit of premiums.
NRS 689C.580 - Prohibited acts.
NRS 689C.590 - Disciplinary or other action for violation of provisions.
NRS 689C.630 - "Church plan" defined.
NRS 689C.660 - "Individual carrier" defined.
NRS 689C.670 - "Individual health benefit plan" defined.
NRS 689C.940 - Regulations concerning determination of status of stop-loss policy.