1. Except as otherwise provided in this subsection, a health benefit plan issued pursuant to this chapter that includes coverage for maternity care and pediatric care for newborn infants may not restrict benefits for any length of stay in a hospital in connection with childbirth for a pregnant or postpartum individual or newborn infant covered by the plan to:
(a) Less than 48 hours after a normal vaginal delivery; and
(b) Less than 96 hours after a cesarean section.
If a different length of stay is provided in the guidelines established by the American College of Obstetricians and Gynecologists, or its successor organization, and the American Academy of Pediatrics, or its successor organization, the health benefit plan may follow such guidelines in lieu of following the length of stay set forth above. The provisions of this subsection do not apply to any health benefit plan in any case in which the decision to discharge the pregnant or postpartum individual or newborn infant before the expiration of the minimum length of stay set forth in this subsection is made by the attending physician of the pregnant or postpartum individual or newborn infant.
2. Nothing in this section requires a pregnant or postpartum individual to:
(a) Deliver the baby in a hospital; or
(b) Stay in a hospital for a fixed period following the birth of the child.
3. A health benefit plan that offers coverage for maternity care and pediatric care of newborn infants may not:
(a) Deny a pregnant or postpartum individual or the newborn infant coverage or continued coverage under the terms of the plan if the sole purpose of the denial of coverage or continued coverage is to avoid the requirements of this section;
(b) Provide monetary payments or rebates to a pregnant or postpartum individual to encourage the individual to accept less than the minimum protection available pursuant to this section;
(c) Penalize, or otherwise reduce or limit, the reimbursement of an attending provider of health care because the attending provider of health care provided care to a pregnant or postpartum individual or newborn infant in accordance with the provisions of this section;
(d) Provide incentives of any kind to an attending physician to induce the attending physician to provide care to a pregnant or postpartum individual or newborn infant in a manner that is inconsistent with the provisions of this section; or
(e) Except as otherwise provided in subsection 4, restrict benefits for any portion of a hospital stay required pursuant to the provisions of this section in a manner that is less favorable than the benefits provided for any preceding portion of that stay.
4. Nothing in this section:
(a) Prohibits a health benefit plan or carrier from imposing a deductible, coinsurance or other mechanism for sharing costs relating to benefits for hospital stays in connection with childbirth for a pregnant or postpartum individual or newborn child covered by the plan, except that such coinsurance or other mechanism for sharing costs for any portion of a hospital stay required by this section may not be greater than the coinsurance or other mechanism for any preceding portion of that stay.
(b) Prohibits an arrangement for payment between a health benefit plan or carrier and a provider of health care that uses capitation or other financial incentives, if the arrangement is designed to provide services efficiently and consistently in the best interest of the pregnant or postpartum individual and the newborn infant.
(c) Prevents a health benefit plan or carrier from negotiating with a provider of health care concerning the level and type of reimbursement to be provided in accordance with this section.
(Added to NRS by 1997, 2924; A 2021, 2977)
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.