Nevada Revised Statutes
Chapter 695C - Health Maintenance Organizations
NRS 695C.1743 - Required provision concerning coverage for drugs, laboratory testing and certain services related to human immunodeficiency virus; reimbursement of pharmacist for certain services.

1. A health maintenance organization that offers or issues a health care plan shall include in the plan coverage for:
(a) Drugs approved by the United States Food and Drug Administration for preventing the acquisition of human immunodeficiency virus;
(b) Laboratory testing that is necessary for therapy that uses such a drug; and
(c) The services described in NRS 639.28085, when provided by a pharmacist who participates in the network plan of the health maintenance organization.
2. A health maintenance organization that offers or issues a health care plan shall reimburse a pharmacist who participates in the network plan of the health maintenance organization for the services described in NRS 639.28085 at a rate equal to the rate of reimbursement provided to a physician, physician assistant or advanced practice registered nurse for similar services.
3. A health maintenance organization may subject the benefits required by subsection 1 to reasonable medical management techniques.
4. A health maintenance organization shall ensure that the benefits required by subsection 1 are made available to an enrollee through a provider of health care who participates in the network plan of the health maintenance organization.
5. A health care plan 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 subsection 1, and any provision of the plan that conflicts with the provisions of this section is void.
6. As used in this section:
(a) "Medical management technique" means a practice which is used to control the cost or use of health care services or prescription drugs. The term includes, without limitation, the use of step therapy, prior authorization and categorizing drugs and devices based on cost, type or method of administration.
(b) "Network plan" means a health care plan offered by a health maintenance organization under which the financing and delivery of medical care, including items and services paid for as medical care, are provided, in whole or in part, through a defined set of providers under contract with the health maintenance organization. The term does not include an arrangement for the financing of premiums.
(c) "Provider of health care" has the meaning ascribed to it in NRS 629.031.
(Added to NRS by 2021, 3211)

Structure Nevada Revised Statutes