AB 472 — Revises provisions relating to insurance coverage of maternity care. (BDR 57-812)

(ReprintedAssembly withBill amendmentsNo. adopted on April 22, 2019) FIRST REPRINT A.B.

472472–Committee ASSEMBLYon BILLNHealth O.and Human Services CHAPTER..........

472–C OMMITTEE ON H EALTH AND H UMAN SERVICES M ARCH 25, 2019 ____________ Referred to Committee on Commerce and Labor SUMMARY—Revises provisions relating to insurance coverage of maternity care.

(BDR 57-812) FISCAL NOTE:

EffEffect on the State:

Yes.May have Fiscal Impact.

~ EXPLANATION – Matter in bolded italics is new;

matter between brackets [omitted material] is material to be omitted.

Existing law prohibits an individual or group insurance plan from denying coverage or restricting benefits for any length of stay in a hospital in connection with childbirth to less than 48 hours after a vaginal delivery or 96 hours after a cesarean section, unless otherwise recommended by the American College ofsof after a Obstetricians and Gynecologists or the American Academy of Pediatrics.

(1) prohibit any insurer, excluding Medicaid and insurance provided by local governments for their employees, from denying, limiting or seeking reimbursement child carried by a gestational carrier to be deemed, for purposesmaternity relatingcare tobecause a policya of health insurance, to be the childinsured ofacts the person or persons who manifest the intent to be legally bound as thea parentgestational ofcarrier; the child.

and (2) require a child carried by a gestational carrier to be deemed, for purposes relating to a policy of health insurance, to be the child of the person or persons who manifest the intent to be legally bound as the parent of the child.

-EXPLANATION *AB472_R1* – 2Matter –in THEbolded PEOPLEitalics OFis THEnew; STATE OF NEVADA, REPRESENTED IN SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:

matter between brackets [omitted material] is material to be omitted.

THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:

689A.330 If any policy is issued by a domestic insurer for delivery to a person residing in another state, and if the insurance commissioner or corresponding public officer of that other state has - 80th Session (2019) – 2 – informed the Commissioner that the policy is not subject to approval or disapproval by that officer, the Commissioner may by ruling require that the policy meet the standards set forth in NRS 689A.030 to 689A.320, inclusive [.] , and section 1 of this act.

An insurer that offers or issues a policy of group health insurance that includes coverage for maternity care shall not deny, limit or seek reimbursement for maternity care because the insuredins2.ed isIf actingan insured acts as a gestational carrier.carrier, the child shall be deemed to be a child of the intended parent, as defined in NRS 126.590, for purposes related to the policy of group health insurance.

2.

If an insured acts as a gestational carrier, the child shall be deemed to be a child of the intended parent, as defined in NRS 126.590, for purposes related to the policy of group health insurance.

- *AB472_R1* – 3 – Sec.

689C.425 A voluntary purchasing group and any contract issued to such a group pursuant to NRS 689C.360 to 689C.600, inclusive, are subject to the provisions of NRS 689C.015 toto, 689C.355, inclusive, and section 4 of this act to the extent applicable and not in conflict with the express provisions of NRS 687B.408 and 689C.360 to 689C.600, inclusive.

- 80th Session (2019) – 3 – 3.

An insurer that offers or issues a contract for hospital or medical services that includes coverage for maternity care shall not deny, limit or seek reimbursement for maternity care because the2.nsuIfthe an insured actsis acting as a gestational carrier,carrier. the child shall be deemed to be a child of the intended parent, as defined in NRS medical services.oses related to the contract for hospital or 3.

2.

If an insured acts as a gestational carrier, the child shall 126.590, for purposes related to the contract for hospital or NRS medical services.

3.

Except as otherwise provided in this chapter or in specific provisions of this title, the provisions of this title are not applicable to any health maintenance organization granted a -apply *AB472_R1*to –an 4insurer –licensed certificateand ofregulated authoritypursuant underto this titlenot except with respect to its activities as a health maintenance organization authorized and regulated pursuant to this chapter.

This provision does not apply to an insurer licensed and regulated pursuant to this title except with respect to its activities as a health maintenance organization authorized and regulated pursuant to this chapter.

The provisions of NRS 695C.110, 695C.125, 695C.1691, 695C.1693, 695C.170, 695C.1703, 695C.1705, 695C.1709 to 695C.173, inclusive, 695C.1733, 695C.17335, 695C.1734, - 80th Session (2019) – 4 – 695C.1751, 695C.1755, 695C.176 to 695C.200, inclusive, and section 8 of this act and 695C.265 do not apply to a health maintenance organization that provides health care services through managed care to recipients of Medicaid under the State Plan for Medicaid or insurance pursuant to the Children’s Health Insurance Program pursuant to a contract with the Division of Health Care Financing and Policy of the Department of Health and Human Services.

The provisions of NRS 695C.1694 to 695C.1698, inclusive, 695C.1708, 695C.1731, 695C.17345, 695C.1735, 695C.1745 and 695C.1757 apply to a health maintenance organization that provides health care services through managed care to recipients of Medicaid under the State Plan for Medicaid.

(b) The health maintenance organization issues evidence of coverage or uses a schedule of charges for health care services which695C.200, doinclusive, notand complysection with8 theof requirementsthis ofact NRSor 695C.1691695C.207;to to(c) 695C.200,The inclusive,health andcare sectionplan 8does ofnot thisfurnish actcomprehensive orhealth 695C.207;care services as provided for in NRS 695C.060;

- *AB472_R1* – 5 – (c) The health care plan does not furnish comprehensive health care services as provided for in NRS 695C.060;

- 80th Session (2019) – 5 – (f) The health maintenance organization has failed to put into effect a mechanism affording the enrollees an opportunity to participate in matters relating to the content of programs pursuant to NRS 695C.110;

and (2) Conducting external reviews of adverse determinations thatinclusive;y comply with the provisions of NRS 695G.241 to 695G.310, inclusive;(h) The health maintenance organization or any person on its behalf has advertised or merchandised its services in an untrue, misrepresentative, misleading, deceptive or unfair manner;

(h) The health maintenance organization or any person on its misrepresentative, misleading, deceptive or unfair manner;ntrue, (i) The continued operation of the health maintenance theorganization generalwould public;bebe hazardous to its enrollees or creditors or to (j) The health maintenance organization fails to provide the coveragegeneral requiredpublic; by NRS 695C.1691;

(j) The health maintenance organization fails to provide the coverage required by NRS 695C.1691;

If the certificate of authority of a health maintenance organization is revoked, the organization shall proceed, immediately following the effective date of the order of revocation, to wind up its affairs and shall conduct no further business except as may be essential to the orderly conclusion of the affairs of the organization.

- *AB472_R1* – 6 – The Commissioner may, by written order, permit such further operation of the organization as the Commissioner may find to be in the best interest of enrollees to the end that enrollees are afforded the greatest practical opportunity to obtain continuing coverage for health care.

A managed care organization that offers or issues a health care plan that includes coverage for maternity care shall not deny, - 80th Session (2019) – 6 – limit or seek reimbursement for maternity care because the insured is acting as a gestational carrier.

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