NRS 689B.0374
Required provision concerning coverage for mammograms for certain women

  • prohibited acts.

1.

A policy of group health insurance must provide coverage for benefits payable for expenses incurred for a mammogram every 2 years, or annually if ordered by a provider of health care, for women 40 years of age or older.

2.

An insurer must ensure that the benefits required by subsection 1 are made available to an insured through a provider of health care who participates in the network plan of the insurer.

3.

Except as otherwise provided in subsection 5, an insurer that offers or issues a policy of group health insurance shall not:

(a)

Require an insured to pay a higher deductible, any copayment or coinsurance or require a longer waiting period or other condition to obtain any benefit provided in the policy of group health insurance pursuant to subsection 1;

(b)

Refuse to issue a policy of group health insurance or cancel a policy of group health insurance solely because the person applying for or covered by the policy uses or may use any such benefit;

(c)

Offer or pay any type of material inducement or financial incentive to an insured to discourage the insured from obtaining any such benefit;

(d)

Penalize a provider of health care who provides any such benefit to an insured, including, without limitation, reducing the reimbursement of the provider of health care;

(e)

Offer or pay any type of material inducement, bonus or other financial incentive to a provider of health care to deny, reduce, withhold, limit or delay access to any such benefit to an insured; or

(f)

Impose any other restrictions or delays on the access of an insured to any such benefit.

4.

A policy subject to the provisions of this chapter which is delivered, issued for delivery or renewed on or after January 1, 2018, has the legal effect of including the coverage required by subsection 1, and any provision of the policy or the renewal which is in conflict with this section is void.

5.

Except as otherwise provided in this section and federal law, an insurer 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.

6.

As used in this section:

(a)

“Medical management technique” means a practice which is used to control the cost or utilization of health care services or prescription drug use. 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.

(b)

“Network plan” means a policy of group health insurance offered by an insurer 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 insurer. 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.

Source: Section 689B.0374 — Required provision concerning coverage for mammograms for certain women; prohibited acts., https://www.­leg.­state.­nv.­us/NRS/NRS-689B.­html#NRS689BSec0374.

689B.030
Required provisions.
689B.031
Required provision concerning coverage of certain gynecological or obstetrical services without authorization or referral from primary care physician.
689B.033
Required provision concerning coverage for newly born and adopted children and children placed for adoption.
689B.034
Required provision concerning effect of benefits under other valid group coverage
689B.035
Required provision concerning termination of coverage on dependent child.
689B.0303
Required provision concerning coverage for continued medical treatment.
689B.0306
Required provision concerning coverage for treatment received as part of clinical trial or study.
689B.0313
Required coverage for certain tests and vaccines relating to human papillomavirus
689B.0317
Required provision concerning coverage for prostate cancer screening.
689B.0335
Required provision concerning coverage for autism spectrum disorders.
689B.0345
Required provision concerning coverage for employee or member on leave without pay as result of total disability.
689B.0353
Required provision concerning coverage for treatment of certain inherited metabolic diseases.
689B.0357
Required provision concerning coverage for management and treatment of diabetes.
689B.0358
Required provision concerning coverage for management and treatment of sickle cell disease.
689B.0362
Required provision concerning coverage for orally administered chemotherapy.
689B.0365
Required provision concerning coverage for use of certain drugs for treatment of cancer.
689B.0367
Required provision concerning coverage for screening for colorectal cancer.
689B.0368
Required provision concerning coverage for prescription drug previously approved for medical condition of insured.
689B.0369
Required provision concerning coverage for services provided through telehealth.
689B.0374
Required provision concerning coverage for mammograms for certain women
689B.0375
Required provision concerning coverage relating to mastectomy.
689B.0376
Policy covering prescription drugs or devices to provide coverage of hormone replacement therapy in certain circumstances
689B.0377
Policy covering outpatient care to provide coverage for health care services related to hormone replacement therapy
689B.0378
Required provision concerning coverage for drug or device for contraception and related health services
689B.0379
Required provision concerning coverage for treatment of temporomandibular joint.
689B.03762
Policy covering prescription drugs to provide coverage for drugs irregularly dispensed for purpose of synchronization of chronic medications.
689B.03764
Policy covering prescription drugs to provide coverage for early refills of topical ophthalmic products.
689B.03766
Policy covering maternity care must not deny coverage for gestational carrier
689B.03785
Required provisions concerning coverage for certain services, screenings and tests relating to wellness
Last Updated

Jun. 24, 2021

§ 689B.0374’s source at nv​.us