GroundRules
Browse Nevada
Read the original sections, or search by topic.
- NRS 695G.1702 · Plan covering prescription drugs: Submission to step therapy protocol for drug to treat psychiatric condition prohibited in certain circumstances.
- NRS 695G.1703 · Required provision concerning coverage for biomarker testing for diagnosis, treatment, management and monitoring of cancer in certain circumstances; establishment of process to request exception or appeal denial of coverage; time for responding to request for prior authorization.
- NRS 695G.1705 · Required provision concerning coverage for drugs, laboratory testing and certain services related to human immunodeficiency virus and hepatitis C; reimbursement of certain providers of health care for certain services; prohibited acts.
- NRS 695G.1707 · Required provision concerning coverage for testing, treatment and prevention of sexually transmitted diseases; required provision concerning coverage for condoms for certain insureds.
- NRS 695G.1709 · Required provisions concerning coverage of certain gynecological and obstetrical services without prior authorization or referral from primary care physician; designation of obstetrician or gynecologist as primary care physician.
- NRS 695G.171 · Required provision concerning coverage for certain tests and vaccines relating to human papillomavirus; prohibited acts.
- NRS 695G.1712 · Required provision concerning coverage for screening, genetic counseling and testing related to BRCA gene in certain circumstances.
- NRS 695G.1713 · Required provision concerning coverage for certain screenings and tests for breast cancer; prohibited acts.
- NRS 695G.1714 · Required provision concerning coverage for examination of person who is pregnant for certain diseases.
- NRS 695G.17145 · Required provision concerning coverage for noninvasive prenatal screening in certain plans.
- NRS 695G.1715 · Required provision concerning coverage for drug or device for contraception and related health services; prohibited acts; exceptions.
- NRS 695G.1716 · Health care plan covering maternity care: Prohibited acts by managed care organization if insured is acting as gestational carrier; child deemed child of intended parent for purposes of plan.
- NRS 695G.17165 · Required provision concerning coverage for procedure or service for preservation of fertility in certain circumstances; exemption. [Effective January 1, 2027.]
- NRS 695G.1717 · Required provision concerning coverage for certain services, screenings and tests relating to wellness; prohibited acts.
- NRS 695G.1718 · Required provision concerning coverage for medically necessary treatment of conditions relating to gender dysphoria and gender incongruence; restriction on refusal to cover certain treatments; authority of managed care organization to prescribe requirements for covering surgical treatments for minors; determination of medical necessity.
- NRS 695G.1719 · Required provision concerning coverage for certain drugs and services related to substance use disorder and opioid use disorder; reimbursement of pharmacists and pharmacies for certain services; prohibited acts.
- NRS 695G.172 · Plan covering prescription drugs: Denial of coverage prohibited for early refills of otherwise covered topical ophthalmic products.
- NRS 695G.173 · Required provision concerning coverage for certain treatment received as part of clinical trial or study for treatment of cancer or chronic fatigue syndrome; authority of managed care organization to require certain information; immunity from liability.
- NRS 695G.174 · Required provision concerning coverage for management and treatment of sickle cell disease and its variants; plan covering prescription drugs required to provide coverage for medically necessary prescription drugs to treat sickle cell disease and its variants.
- NRS 695G.175 · Contracts for provision of emergency medical services, outpatient services or inpatient services with hospital or other facility that provides acute care in smaller city or county: Prohibited acts.
- NRS 695G.176 · Plan covering anatomical gifts, organ transplants or treatments or services related to organ transplants: Prohibited acts by managed care organization if insured is person with disability.
- NRS 695G.1765 · Required provision concerning coverage for dental service provided by qualified dental hygienist in certain circumstances.
- NRS 695G.177 · Required provision in plans covering treatment of prostate cancer concerning coverage for prostate cancer screening; prohibited acts.
- NRS 695G.180 · Quality assurance program: Requirements; written description; informing providers; necessary staff; review; responsibility for activities.
- NRS 695G.190 · Quality improvement committee: Administration; duties.
- NRS 695G.200 · Establishment; approval; requirements; assistance for persons filing complaints; examination.
- NRS 695G.210 · Review board; appeal; right to expedited review of complaint; notice to insured.
- NRS 695G.220 · Annual report; managed care organization required to maintain records of and report complaints concerning something other than health care services.
- NRS 695G.230 · Written notice required by carrier to insured explaining rights of insureds regarding decision to deny coverage; written notice to insured when health carrier denies coverage of health care service.
- NRS 695G.241 · Circumstances under which adverse determination may be subject to external review; exceptions.
- NRS 695G.243 · Applicability.
- NRS 695G.245 · Written notice of right to request external review; form; contents.
- NRS 695G.247 · Requests for external review to be in writing; exception; form and content.
- NRS 695G.251 · Request for review; assignment of independent review organization; provision of documents relating to adverse determination to independent review organization.
- NRS 695G.261 · Review of documents by independent review organization; decision of independent review organization.
- NRS 695G.271 · Expedited approval or denial of request.
- NRS 695G.275 · Experimental or investigational health care service or treatment: Request for external review; request for expedited external review.
- NRS 695G.280 · Basis for decision of independent review organization.
- NRS 695G.290 · Decision in favor of covered person binding on health carrier; limitation of liability; cost for independent review organization.
- NRS 695G.300 · Submission of complaint of covered person to independent review organization.
- NRS 695G.303 · Independent review organization and health carrier required to maintain written records; submission of report upon request.
- NRS 695G.307 · Health carrier required to provide description of external review procedures; format; contents.
- NRS 695G.310 · Annual report; requirements.
- NRS 695G.320 · Provision of health care services to recipients of Medicaid or enrollees in Children’s Health Insurance Program: Requirement to contract with hospital with certain endorsement for inclusion in network of providers.
- NRS 695G.325 · Provision of health care services to recipients of Medicaid: Notice to recipients if Nevada Health Authority obtains waiver to provide dental care to persons with diabetes; coordination to ensure receipt of such care.
- NRS 695G.330 · Provision of health care services to recipients of Medicaid: Coverage for antipsychotic or anticonvulsant medication that is not on list of preferred prescription drugs required upon failure of drug on list to treat condition.
- NRS 695G.340 · Approval or denial; payment of claim and interest; request for additional information; award of costs and attorney’s fees; compliance with requirements; imposition of administrative fine or suspension or revocation of certificate of authority for failure to comply; report of compliance by organization.
- NRS 695G.400 · Managed care organization prohibited from restricting or interfering with certain communications between provider of health care and patient.
- NRS 695G.405 · Managed care organization prohibited from denying coverage solely because applicant or insured was intoxicated or under the influence of controlled substance; exceptions.
- NRS 695G.410 · Managed care organization prohibited from taking certain actions against provider solely because provider advocates on behalf of patient, assists patient or reports violation of law.
- NRS 695G.415 · Managed care organization prohibited from discriminating against person with respect to participation or coverage on basis of gender identity or expression.
- NRS 695G.420 · Managed care organization prohibited from offering or paying financial incentive to provider to deny, reduce, withhold, limit or delay medically necessary services.
- NRS 695H.010 · Definitions.
- NRS 695H.020 · “Administrator” defined.
- NRS 695H.030 · “Affiliate of an insurer” defined.
- NRS 695H.040 · “Insurer” defined.
- NRS 695H.050 · “Medical discount plan” defined.
- NRS 695H.060 · “Provider of health care” defined.
- NRS 695H.070 · Medical discount plans under exclusive jurisdiction of Commissioner.
- NRS 695H.080 · Offering, marketing, selling or engaging in business as medical discount plan without registration unlawful; exceptions.
- NRS 695H.090 · Application for registration; renewal of registration; fees; regulations.
- NRS 695H.100 · Person responsible for conducting business activities of medical discount plan prohibited from engaging in certain acts.
- NRS 695H.105 · Contracts with dentists: Assignments; toll-free telephone number.
- NRS 695H.110 · Required disclosures.
- NRS 695H.120 · Type size for disclosures.
- NRS 695H.130 · Net worth.
- NRS 695H.140 · Examinations and inspection of accounts, books and records by Commissioner.
- NRS 695H.150 · Records: Maintenance, retention and storage.
- NRS 695H.160 · Regulations.
- NRS 695H.170 · Administrative penalty for commission of certain acts; availability of list of participating providers of health care required.
- NRS 695H.180 · Penalties.
- NRS 695I.010 · Definitions.
- NRS 695I.015 · “Authority” defined.
- NRS 695I.020 · “Board” defined.
- NRS 695I.025 · “Division” defined.
- NRS 695I.030 · “Exchange” defined.
- NRS 695I.040 · “Executive Director” defined.
- NRS 695I.060 · “Medical facility” defined.
- NRS 695I.070 · “Provider of health care” defined.
- NRS 695I.080 · “Qualified health plan” defined.
- NRS 695I.090 · “Qualified individual” defined.
- NRS 695I.100 · “Qualified small employer” defined.
- NRS 695I.110 · “Small employer” defined.
- NRS 695I.200 · Establishment within Consumer Health Division of Nevada Health Authority; purpose.
- NRS 695I.210 · Powers and duties of Consumer Health Division of Nevada Health Authority through Exchange; applicability of state purchasing provisions.
- NRS 695I.300 · Membership of Board.
- NRS 695I.310 · Terms of office; reappointment; removal; vacancy.
- NRS 695I.320 · Chair and Vice Chair: Election; term and limit on number of terms; vacancy.
- NRS 695I.330 · Compensation of members; per diem and travel expenses.
- NRS 695I.340 · Meetings; quorum; voting.
- NRS 695I.350 · Subcommittees and advisory committees.
- NRS 695I.360 · Compliance with Open Meeting Law.
- NRS 695I.370 · Powers and duties of Board: Advise Executive Director; adopt bylaws; reports; audits; regulations; recommendations concerning contracts for services.
- NRS 695I.380 · Appointment, classification, qualifications and duties of Executive Director; appointment, classification and removal of other employees; contracting for services.
- NRS 695I.390 · Coordination with Medicaid, Children’s Health Insurance Program and other public programs.
- NRS 695I.500 · State agencies to provide support to Nevada Health Authority and Exchange; intergovernmental agreements.
- NRS 695I.505 · Policies to meet unique needs of tradespersons: Application for federal waiver by Executive Director; requirements for offering policy on Exchange; criteria for eligibility for policy.
- NRS 695I.510 · Temporary advance from State General Fund for authorized expenses of Exchange.
- NRS 695I.520 · Construction of chapter.
- NRS 695J.010 · Definitions.