1. A health care plan of a health maintenance organization must include coverage for services provided to an enrollee through telehealth to the same extent and, except for services provided through audio-only interaction, in the same amount as though provided in person or by other means.
2. A health maintenance organization shall not:
(a) Require an enrollee to establish a relationship in person with a provider of health care or provide any additional consent to or reason for obtaining services through telehealth as a condition to providing the coverage described in subsection 1;
(b) Require a provider of health care to demonstrate that it is necessary to provide services to an enrollee through telehealth or receive any additional type of certification or license to provide services through telehealth as a condition to providing the coverage described in subsection 1;
(c) Refuse to provide the coverage described in subsection 1 because of:
(1) The distant site from which a provider of health care provides services through telehealth or the originating site at which an enrollee receives services through telehealth; or
(2) The technology used to provide the services;
(d) Require covered services to be provided through telehealth as a condition to providing coverage for such services; or
(e) Categorize a service provided through telehealth differently for purposes relating to coverage or reimbursement than if the service had been provided in person or through other means.
3. A health care plan of a health maintenance organization must not require an enrollee to obtain prior authorization for any service provided through telehealth that is not required for the service when provided in person. Such a health care plan may require prior authorization for a service provided through telehealth if such prior authorization would be required if the service were provided in person or by other means.
4. The provisions of this section do not require a health maintenance organization to:
(a) Ensure that covered services are available to an enrollee through telehealth at a particular originating site;
(b) Provide coverage for a service that is not a covered service or that is not provided by a covered provider of health care; or
(c) Enter into a contract with any provider of health care or cover any service if the health maintenance organization is not otherwise required by law to do so.
5. Evidence of coverage 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 this section, and any provision of the plan or the renewal which is in conflict with this section is void.
6. As used in this section:
(a) "Distant site" has the meaning ascribed to it in NRS 629.515.
(b) "Originating site" has the meaning ascribed to it in NRS 629.515.
(c) "Provider of health care" has the meaning ascribed to it in NRS 439.820.
(d) "Telehealth" has the meaning ascribed to it in NRS 629.515.
(Added to NRS by 2015, 643; A 2021, 3036)
1. A health care plan of a health maintenance organization must include coverage for services provided to an enrollee through telehealth to the same extent and, for mental health services except when such services are provided through audio-only interaction, in the same amount as though provided in person or by other means.
2. A health maintenance organization shall not:
(a) Require an enrollee to establish a relationship in person with a provider of health care or provide any additional consent to or reason for obtaining services through telehealth as a condition to providing the coverage described in subsection 1;
(b) Require a provider of health care to demonstrate that it is necessary to provide services to an enrollee through telehealth or receive any additional type of certification or license to provide services through telehealth as a condition to providing the coverage described in subsection 1;
(c) Refuse to provide the coverage described in subsection 1 because of:
(1) The distant site from which a provider of health care provides services through telehealth or the originating site at which an enrollee receives services through telehealth; or
(2) The technology used to provide the services;
(d) Require covered services to be provided through telehealth as a condition to providing coverage for such services;
(e) Categorize a service provided through telehealth differently for purposes relating to coverage than if the service had been provided in person or through other means; or
(f) Categorize a mental health service provided through telehealth, other than through audio-only interaction, differently for purposes relating to reimbursement than if the service had been provided in person or by other means.
3. A health care plan of a health maintenance organization must not require an enrollee to obtain prior authorization for any service provided through telehealth that is not required for the service when provided in person. Such a health care plan may require prior authorization for a service provided through telehealth if such prior authorization would be required if the service were provided in person or by other means.
4. The provisions of this section do not require a health maintenance organization to:
(a) Ensure that covered services are available to an enrollee through telehealth at a particular originating site;
(b) Provide coverage for a service that is not a covered service or that is not provided by a covered provider of health care; or
(c) Enter into a contract with any provider of health care or cover any service if the health maintenance organization is not otherwise required by law to do so.
5. Evidence of coverage 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 this section, and any provision of the plan or the renewal which is in conflict with this section is void.
6. As used in this section:
(a) "Distant site" has the meaning ascribed to it in NRS 629.515.
(b) "Originating site" has the meaning ascribed to it in NRS 629.515.
(c) "Provider of health care" has the meaning ascribed to it in NRS 439.820.
(d) "Telehealth" has the meaning ascribed to it in NRS 629.515.
(Added to NRS by 2015, 643; A 2021, 3036, 3037, effective on the date 1 year after the date on which the Governor terminates the emergency described in the Declaration of Emergency for COVID-19 issued on March 12, 2020, only if the Governor terminates that emergency before July 1, 2022)
1. A health care plan of a health maintenance organization must include coverage for services provided to an enrollee through telehealth as though provided in person or by other means.
2. A health maintenance organization shall not:
(a) Require an enrollee to establish a relationship in person with a provider of health care or provide any additional consent to or reason for obtaining services through telehealth as a condition to providing the coverage described in subsection 1;
(b) Require a provider of health care to demonstrate that it is necessary to provide services to an enrollee through telehealth or receive any additional type of certification or license to provide services through telehealth as a condition to providing the coverage described in subsection 1;
(c) Refuse to provide the coverage described in subsection 1 because of:
(1) The distant site from which a provider of health care provides services through telehealth or the originating site at which an enrollee receives services through telehealth; or
(2) The technology used to provide the services;
(d) Require covered services to be provided through telehealth as a condition to providing coverage for such services; or
(e) Categorize a service provided through telehealth differently for purposes relating to coverage than if the service had been provided in person or through other means.
3. A health care plan of a health maintenance organization must not require an enrollee to obtain prior authorization for any service provided through telehealth that is not required for the service when provided in person. Such a health care plan may require prior authorization for a service provided through telehealth if such prior authorization would be required if the service were provided in person or by other means.
4. The provisions of this section do not require a health maintenance organization to:
(a) Ensure that covered services are available to an enrollee through telehealth at a particular originating site;
(b) Provide coverage for a service that is not a covered service or that is not provided by a covered provider of health care; or
(c) Enter into a contract with any provider of health care or cover any service if the health maintenance organization is not otherwise required by law to do so.
5. Evidence of coverage 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 this section, and any provision of the plan or the renewal which is in conflict with this section is void.
6. As used in this section:
(a) "Distant site" has the meaning ascribed to it in NRS 629.515.
(b) "Originating site" has the meaning ascribed to it in NRS 629.515.
(c) "Provider of health care" has the meaning ascribed to it in NRS 439.820.
(d) "Telehealth" has the meaning ascribed to it in NRS 629.515.
(Added to NRS by 2015, 643; A 2021, 3036, 3037, 3038, 3039, effective July 1, 2023, only if the Governor terminates the emergency described in the Declaration of Emergency for COVID-19 issued on March 12, 2020, before July 1, 2022)
1. A health care plan of a health maintenance organization must include coverage for services provided to an enrollee through telehealth to the same extent as though provided in person or by other means.
2. A health maintenance organization shall not:
(a) Require an enrollee to establish a relationship in person with a provider of health care or provide any additional consent to or reason for obtaining services through telehealth as a condition to providing the coverage described in subsection 1;
(b) Require a provider of health care to demonstrate that it is necessary to provide services to an enrollee through telehealth or receive any additional type of certification or license to provide services through telehealth as a condition to providing the coverage described in subsection 1;
(c) Refuse to provide the coverage described in subsection 1 because of:
(1) The distant site from which a provider of health care provides services through telehealth or the originating site at which an enrollee receives services through telehealth; or
(2) The technology used to provide the services;
(d) Require covered services to be provided through telehealth as a condition to providing coverage for such services; or
(e) Categorize a service provided through telehealth differently for purposes relating to coverage than if the service had been provided in person or through other means.
3. A health care plan of a health maintenance organization must not require an enrollee to obtain prior authorization for any service provided through telehealth that is not required for the service when provided in person. Such a health care plan may require prior authorization for a service provided through telehealth if such prior authorization would be required if the service were provided in person or by other means.
4. The provisions of this section do not require a health maintenance organization to:
(a) Ensure that covered services are available to an enrollee through telehealth at a particular originating site;
(b) Provide coverage for a service that is not a covered service or that is not provided by a covered provider of health care; or
(c) Enter into a contract with any provider of health care or cover any service if the health maintenance organization is not otherwise required by law to do so.
5. Evidence of coverage 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 this section, and any provision of the plan or the renewal which is in conflict with this section is void.
6. As used in this section:
(a) "Distant site" has the meaning ascribed to it in NRS 629.515.
(b) "Originating site" has the meaning ascribed to it in NRS 629.515.
(c) "Provider of health care" has the meaning ascribed to it in NRS 439.820.
(d) "Telehealth" has the meaning ascribed to it in NRS 629.515.
(Added to NRS by 2015, 643; A 2021, 3036, 3037, 3038, 3039, effective June 30, 2023, only if the Governor terminates the emergency described in the Declaration of Emergency for COVID-19 issued on March 12, 2020, on or after July 1, 2022)
Structure Nevada Revised Statutes
Chapter 695C - Health Maintenance Organizations
NRS 695C.020 - Legislative declaration.
NRS 695C.050 - Applicability of certain provisions.
NRS 695C.055 - Applicability of certain other provisions.
NRS 695C.060 - Establishment of health maintenance organization.
NRS 695C.070 - Certificate of authority: Application.
NRS 695C.080 - Certificate of authority: Evaluation of application.
NRS 695C.090 - Certificate of authority: Issuance.
NRS 695C.100 - Certificate of authority: Denial.
NRS 695C.110 - Governing body: Composition; participation by enrollees.
NRS 695C.120 - Powers of health maintenance organization.
NRS 695C.123 - Contracts with certain federally qualified health centers.
NRS 695C.130 - Notice and approval required for exercise of powers; rules or regulations.
NRS 695C.140 - Notice and approval required for modification of operations; regulations.
NRS 695C.150 - Fiduciary responsibilities.
NRS 695C.170 - Evidence of coverage: Issuance; form and contents.
NRS 695C.176 - Required provision concerning coverage for hospice care.
NRS 695C.1765 - Reimbursement for acupuncture.
NRS 695C.177 - Reimbursement for treatments by licensed psychologist.
NRS 695C.1783 - Reimbursement for treatment by podiatrist.
NRS 695C.1789 - Reimbursement for treatment by licensed clinical alcohol and drug counselor.
NRS 695C.179 - Reimbursement for services provided by certain nurses.
NRS 695C.1795 - Reimbursement to provider of medical transportation.
NRS 695C.200 - Approval of forms and schedules.
NRS 695C.215 - Financial statement required to include report of net worth.
NRS 695C.220 - Applications, filings and reports open to public inspection; exception.
NRS 695C.230 - Fees; forwarding of premium tax.
NRS 695C.240 - Information required to be available for inspection.
NRS 695C.270 - Surety bond or deposit required; waiver.
NRS 695C.280 - Commissioner authorized to adopt regulations for licensing of agents or brokers.
NRS 695C.300 - Prohibited practices.
NRS 695C.315 - Financial examination: Payment of expense.
NRS 695C.317 - Procedures required for examination and hearing.
NRS 695C.320 - Rehabilitation, liquidation or conservation: Conduct.
NRS 695C.330 - Disciplinary proceedings: Grounds; effect of suspension or revocation.
NRS 695C.340 - Disciplinary proceedings: Notice; hearing; judicial review.