1. A hospital or medical service corporation that issues a policy of health insurance shall include in the policy coverage for:
(a) Necessary case management services for an insured who has been diagnosed with sickle cell disease and its variants; and
(b) Medically necessary care for an insured who has been diagnosed with sickle cell disease and its variants.
2. A hospital or medical service corporation that issues a policy of health insurance which provides coverage for prescription drugs shall include in the policy coverage for medically necessary prescription drugs to treat sickle cell disease and its variants.
3. A hospital or medical service corporation may use medical management techniques, including, without limitation, any available clinical evidence, to determine the frequency of or treatment relating to any benefit required by this section or the type of provider of health care to use for such treatment.
4. As used in this section:
(a) "Case management services" means medical or other health care management services to assist patients and providers of health care, including, without limitation, identifying and facilitating additional resources and treatments, providing information about treatment options and facilitating communication between providers of services to a patient.
(b) "Medical management technique" means a practice which is used to control the cost or utilization of health care services. The term includes, without limitation, the use of step therapy, prior authorization or categorizing drugs and devices based on cost, type or method of administration.
(c) "Medically necessary" has the meaning ascribed to it in NRS 695G.055.
(d) "Sickle cell disease and its variants" has the meaning ascribed to it in NRS 439.4927.
(Added to NRS by 2019, 2172)
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.