1. A carrier who offers or issues a health benefit plan which provides coverage for prescription drugs:
(a) Must authorize coverage for and may apply a copayment and deductible to a prescription that is dispensed by a pharmacy for less than a 30-day supply if, for the purpose of synchronizing the insured’s chronic medications:
(1) The prescriber or pharmacist determines that filling or refilling the prescription in that manner is in the best interest of the insured; and
(2) The insured requests less than a 30-day supply.
(b) May not deny coverage for a prescription described in paragraph (a) which is otherwise approved for coverage by the carrier.
(c) Unless otherwise provided by a contract or other agreement, may not prorate any pharmacy dispensing fees for a prescription described in paragraph (a).
2. A health benefit plan subject to the provisions of this chapter which provides coverage for prescription drugs and that is delivered, issued for delivery or renewed on or after January 1, 2017, has the legal effect of providing that coverage subject to the requirements of this section, and any provision of the health benefit plan or renewal which is in conflict with this section is void.
3. The provisions of this section do not apply to unit-of-use packaging for which synchronization is not practicable or to a controlled substance.
4. As used in this section:
(a) "Chronic medication" means any drug that is prescribed to treat any disease or other condition which is determined to be permanent, persistent or lasting indefinitely.
(b) "Synchronization" means the alignment of the dispensing of multiple medications by a single contracted pharmacy for the purpose of improving a patient’s adherence to a prescribed course of medication.
(c) "Unit-of-use packaging" means medication that is prepackaged by the manufacturer in blister packs, compliance packs, course-of-therapy packs or any other packaging which is designed and intended to be dispensed directly to the patient without modification by the dispensing pharmacy, except for the addition of a prescription label.
(Added to NRS by 2015, 2125)
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.