Nevada Public Welfare

Sec. § 422.27172
State Plan for Medicaid: Inclusion of requirement for payment of certain costs related to family planning.


1.

The Director shall include in the State Plan for Medicaid a requirement that the State pay the nonfederal share of expenditures incurred for:

(a)

Up to a 12-month supply, per prescription, of any type of drug for contraception or its therapeutic equivalent which is:

(1)

Lawfully prescribed or ordered;

(2)

Approved by the Food and Drug Administration; and

(3)

Dispensed in accordance with NRS 639.28075;

(b)

Any type of device for contraception which is lawfully prescribed or ordered and which has been approved by the Food and Drug Administration;

(c)

Insertion or removal of a device for contraception;

(d)

Education and counseling relating to the initiation of the use of contraceptives and any necessary follow-up after initiating such use;

(e)

Management of side effects relating to contraception; and

(f)

Voluntary sterilization for women.

2.

Except as otherwise provided in subsections 4 and 5, to obtain any benefit provided in the Plan pursuant to subsection 1, a person enrolled in Medicaid must not be required to:

(a)

Pay a higher deductible, any copayment or coinsurance; or

(b)

Be subject to a longer waiting period or any other condition.

3.

The Director shall ensure that the provisions of this section are carried out in a manner which complies with the requirements established by the Drug Use Review Board and set forth in the list of preferred prescription drugs established by the Department pursuant to NRS 422.4025.

4.

The Plan may require a person enrolled in Medicaid to pay a higher deductible, copayment or coinsurance for a drug for contraception if the person refuses to accept a therapeutic equivalent of the contraceptive drug.

5.

For each method of contraception which is approved by the Food and Drug Administration, the Plan must include at least one contraceptive drug or device for which no deductible, copayment or coinsurance may be charged to the person enrolled in Medicaid, but the Plan may charge a deductible, copayment or coinsurance for any other contraceptive drug or device that provides the same method of contraception.

6.

As used in this section:

(a)

“Drug Use Review Board” has the meaning ascribed to it in NRS 422.402.

(b)

“Therapeutic equivalent” means a drug which:

(1)

Contains an identical amount of the same active ingredients in the same dosage and method of administration as another drug;

(2)

Is expected to have the same clinical effect when administered to a patient pursuant to a prescription or order as another drug; and

(3)

Meets any other criteria required by the Food and Drug Administration for classification as a therapeutic equivalent.
Source

Last accessed
Feb. 5, 2021