Required provision concerning coverage of health care services related to contraceptives and hormone replacement therapy in certain circumstances; prohibited actions by health maintenance organization; exceptions.
1. Except as otherwise provided in subsection 5, a health maintenance organization that offers or issues a health care plan which provides coverage for outpatient care shall include in the plan coverage for any health care service related to contraceptives or hormone replacement therapy.
2. A health maintenance organization that offers or issues a health care plan that provides coverage for outpatient care shall not:
(a) Require an enrollee to pay a higher deductible, copayment or coinsurance or require a longer waiting period or other condition for coverage for outpatient care related to contraceptives or hormone replacement therapy than is required for other outpatient care covered by the plan;
(b) Refuse to issue a health care plan or cancel a health care plan solely because the person applying for or covered by the plan uses or may use in the future any of the services listed in subsection 1;
(c) Offer or pay any type of material inducement or financial incentive to an enrollee to discourage the enrollee from accessing any of the services listed in subsection 1;
(d) Penalize a provider of health care who provides any of the services listed in subsection 1 to an enrollee, including, without limitation, reducing the reimbursement of the provider of health care; or
(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 any of the services listed in subsection 1 to an enrollee.
3. Except as otherwise provided in subsection 5, evidence of coverage subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after October 1, 1999, has the legal effect of including the coverage required by subsection 1, and any provision of the evidence of coverage or the renewal which is in conflict with this section is void.
4. The provisions of this section do not prohibit a health maintenance organization from requiring an enrollee to pay a deductible, copayment or coinsurance for the coverage required by subsection 1 that is the same as the enrollee is required to pay for other outpatient care covered by the plan.
5. A health maintenance organization which offers or issues a health care plan and which is affiliated with a religious organization is not required to provide the coverage for health care service related to contraceptives required by this section if the health maintenance organization objects on religious grounds. The health maintenance organization shall, before the issuance of a health care plan and before renewal of enrollment in such a plan, provide to the group policyholder or prospective enrollee, as applicable, written notice of the coverage that the health maintenance organization refuses to provide pursuant to this subsection. The health maintenance organization shall provide notice to each enrollee, at the time the enrollee receives his evidence of coverage, that the health maintenance organization refused to provide coverage pursuant to this subsection.
6. If a health maintenance organization refuses, pursuant to subsection 5, to provide the coverage required by paragraph (a) of subsection 1, an employer may otherwise provide for the coverage for his employees.
7. As used in this section, “provider of health care” has the meaning ascribed to it in NRS 629.031.
Last modified: February 27, 2006