NRS 689A.0405
Coverage for mammograms for certain women

  • prohibited acts.


A policy of 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.


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.


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


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 health insurance pursuant to subsection 1;


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


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


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;


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


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


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.


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.


As used in this section:


“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.


“Network plan” means a policy of 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.


“Provider of health care” has the meaning ascribed to it in NRS 629.031.

Source: Section 689A.0405 — Coverage for mammograms for certain women; prohibited acts., https://www.­leg.­state.­nv.­us/NRS/NRS-689A.­html#NRS689ASec0405.

Contents of policy
Coverage relating to mastectomy.
Coverage relating to complications of pregnancy.
Coverage of newly born and adopted children and children placed for adoption.
Required coverage for certain tests and vaccines relating to human papillomavirus
Benefits for treatment of alcohol or substance use disorder.
Procedure for arbitration of disputes concerning independent medical, dental or chiropractic evaluations.
Coverage for use of certain drugs for treatment of cancer.
Coverage for mammograms for certain women
Coverage for certain gynecological or obstetrical services without authorization or referral from primary care physician.
Coverage for hormone replacement therapy in certain circumstances
Coverage for health care services related to hormone replacement therapy in certain circumstances
Coverage for drug or device for contraception and related health services
Coverage for certain services, screenings and tests relating to wellness
Coverage for treatment of certain inherited metabolic diseases.
Policy that includes coverage for maternity care must not deny coverage for gestational carrier
Individual health benefit plan that includes coverage for maternity care and pediatric care: Requirement to allow minimum stay in hospital in connection with childbirth
Coverage for management and treatment of diabetes.
Coverage for management and treatment of sickle cell disease.
Coverage for autism spectrum disorders.
Coverage for prostate cancer screening.
Coverage for orally administered chemotherapy.
Coverage for treatment of conditions relating to severe mental illness.
Coverage for services provided through telehealth
Coverage of treatment of temporomandibular joint.
Coverage for treatment received as part of clinical trial or study.
Coverage for continued medical treatment.
Coverage for screening for colorectal cancer.
Coverage for prescription drug previously approved for medical condition of insured.
Coverage for prescription drugs irregularly dispensed for purpose of synchronization of chronic medications.
Coverage for early refills of topical ophthalmic products.
Last Updated

Jun. 24, 2021

§ 689A.0405’s source at nv​.us