1. A contract for hospital or medical service must provide coverage for:
(a) Enteral formulas for use at home that are prescribed or ordered by a physician as medically necessary for the treatment of inherited metabolic diseases characterized by deficient metabolism, or malabsorption originating from congenital defects or defects arising shortly after birth, of amino acid, organic acid, carbohydrate or fat; and
(b) At least $2,500 per year for special food products which are prescribed or ordered by a physician as medically necessary for the treatment of a person described in paragraph (a).
2. The coverage required by subsection 1 must be provided whether or not the condition existed when the contract was purchased.
3. A contract subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after July 1, 2021, has the legal effect of including the coverage required by this section, and any provision of the contract or the renewal which is in conflict with this section is void.
4. As used in this section:
(a) "Enteral formula" includes, without limitation, a formula that is ingested orally.
(b) "Inherited metabolic disease" means a disease caused by an inherited abnormality of the body chemistry of a person.
(c) "Special food product" means a food product that is specially formulated to have less than one gram of protein per serving and is intended to be consumed under the direction of a physician for the dietary treatment of an inherited metabolic disease. The term does not include a food that is naturally low in protein.
(Added to NRS by 1997, 1527; A 2021, 3624)
Structure Nevada Revised Statutes
Chapter 695B - Nonprofit Corporations for Hospital, Medical and Dental Service
NRS 695B.040 - Corporations authorized to undertake and operate plans.
NRS 695B.050 - Manner of incorporation.
NRS 695B.060 - Directors: Qualifications.
NRS 695B.070 - Merger and consolidation: Procedure.
NRS 695B.080 - Merger and consolidation: Continuance of contracts and contribution certificates.
NRS 695B.090 - Merger and consolidation: Withdrawal of prior deposit of securities.
NRS 695B.110 - Certificate of authority: Required; fees.
NRS 695B.120 - Certificate of authority: Qualifications.
NRS 695B.130 - Certificate of authority: Application; issuance.
NRS 695B.135 - Certificate of authority: Expiration; renewal.
NRS 695B.165 - Annual statement required to include report of net worth.
NRS 695B.170 - Acquisition costs and administrative expenses; effect of finding of excess costs.
NRS 695B.180 - Required provisions.
NRS 695B.189 - Group contract: Required provision permitting continuation of coverage.
NRS 695B.190 - Family contracts.
NRS 695B.1951 - Reimbursement for treatment by podiatrist.
NRS 695B.1955 - Reimbursement for treatment by licensed clinical alcohol and drug counselor.
NRS 695B.196 - Reimbursement for acupuncture.
NRS 695B.197 - Reimbursement for treatment by licensed psychologist.
NRS 695B.199 - Reimbursement for services provided by certain nurses.
NRS 695B.1995 - Reimbursement to provider of medical transportation.
NRS 695B.200 - Group contracts written under master contract: Conditions required for issuance.
NRS 695B.210 - Group master service contract: Required provisions.
NRS 695B.225 - Policies of group insurance: Order of benefits.
NRS 695B.230 - Filing and approval of forms and schedules of premium rates.
NRS 695B.240 - Provision of group service coverage before approval of forms.
NRS 695B.250 - Extensions of time; automatic approval.
NRS 695B.252 - Conversion privilege available to spouse and children; conditions.
NRS 695B.254 - Choice of types of contracts required to be offered.
NRS 695B.256 - Issuance and effective date of converted contract; premiums; persons covered.
NRS 695B.257 - Notice of conversion privilege.
NRS 695B.2575 - Converted contract delivered outside Nevada: Form.
NRS 695B.258 - Extension of coverage under existing group contract.
NRS 695B.2585 - Provision of group coverage in lieu of converted individual contract.
NRS 695B.259 - Continuation of identical coverage in lieu of converted contract.
NRS 695B.260 - Suspension or revocation of permission to provide coverage before approval of forms.
NRS 695B.270 - Disapproval of forms; issuance unlawful.
NRS 695B.280 - Regulations; limitations.
NRS 695B.285 - Use of Uniform Billing and Claims Forms authorized.
NRS 695B.290 - Agent’s license required.
NRS 695B.320 - Applicability of other provisions.
NRS 695B.380 - Establishment; approval; requirements; examination.