and (2) evaluating policies to make such -access 81stmore Sessionequitable. (2021) – 2 – established, to be accessible through Internet websites maintained by thehboard, if Department and the Patient Protection Commission, respectively.

Sections 1 and 2 of this bill require the data dashboard , if established, to be accessible through Internet websites maintained by the Department and the Patient Protection Commission, respectively.

(1) include a requirement that an insurer or other third-party payer must cover services provided through telehealth to the same extent as if provided in person or by other means, regardless of the site at which the providerplans orfor patientstate isand located;local government employees, and workers’ compensation coverage.

and(NRS (2) apply to health coverage,287.010, including Medicaid and health plans for state and local 287.04335, 422.2721, 616C.730, 689A.0463, 689B.0369, 689C.195, 695A.265, 695B.1904, 695C.1708, 695D.216, 695G.162) Because section 8 includes services provided [using a standard telephone] through audio-only interaction within the definition of “telehealth” for the purposes of those requirements, section 8 makes those requirements applicable to services provided [by telephone.] through audio-only interaction.

Sections 4,4 9,[, 10,7] 11, 12, 13, 14, 15 and 169-16 additionally prohibit a servicesthird-party providedpayer throughwho telehealthis becausenot ofan theindustrial technologyinsurer usedfrom: to provide the services;

or(1) (2)refusing categorizingto apay servicefor services provided through provided through telehealth differently for purposes relating to coverage or reimbursementreimbursementervice than if the service had been provided in person or through other means.

Sections 4,4 9,[, 10,7] 11, 12, 13, 14, 15 and 9- 16 also require a third-party payer who is not an industrial insurer to cover services provided through telehealth, except for services provided through[using audio-a onlystandard telephone,] through audio-only interaction, in the same amount as services provided in person or by other means.

Sections 4.3-4.9, 9.3-9.9, 10.3-10.9, 11.3-11.9, 12.3-12.9, 13.3-13.9, 14.3- 14.9, 15.5, 16.1-16.3 and 17 of this bill:

(1) expire that requirement, as it applies to of the emergency declared for COVID-19 or on June 30, 2023, whichever is earlier;ation and (2) expire that requirement, as it applies to mental health services, by limitation on June 30, 2023.

EXPLANATION – Matter in bolded italics is new;

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

[The] To the extent that money is available for this purpose, the Department shall:

The data dashboard must,must [:] , to the extent authorized by federal law:

- 81st Session (2021) – 3 – (1) Include, without limitation, data concerning health care services, behavioral health services and dental services provided through telehealth;

and (2) Allow for the user to sort data based on the race, ethnicity, ancestry, national origin, color, sex, sexual orientation, gender identity or expression, mental or physical disability, income,income level or location of residence of the patient, type of telehealth service and any other category determined useful by the Department;

(a)Senate “DataAmendment dashboard”No. means a computerized tool that:

174 to Senate Bill No.

5 Page 5 (a) “Data dashboard” means a computerized tool that:

(a) Comprehensively examining the system for regulating health care in this State, including, without limitation, the licensing and regulation of health care facilities and providers of health care and the role of professional licensing boards, commissions and other bodies established to regulate or evaluate policies related to health care.

- 81st Session (2021) – 4 – (f) Reviewing the availability of health benefit plans, as defined in NRS 687B.470, in this State.

(g) Reviewing the effect of any changes to Medicaid, including, without limitation, the expansion of Medicaid pursuant to the Patient Protection and Affordable Care Act, Public Law 111-148, on the cost and availability of health care and health insurance in this State.

(h) [Using the] If a data dashboard is established pursuant to section 1 of this act,act , using the data dashboard to review access by different groups and populations in this State to services provided through telehealth and evaluating policies to make such access more equitable.

medical(5) services;ingResolving problems relating to the billing of patients for (6)medical Leveragingservices; the expenditure of money by the Medicaid program and reimbursement rates under Medicaid to increase the quality and accessibility of health care for low-income persons;

and(6) (7)Leveraging Increasingthe accessexpenditure toof healthmoney careby forthe uninsuredMedicaid populationsprogram inand thisreimbursement State,rates including,under withoutMedicaid limitation,to retireesincrease the quality and children.accessibility of health care for low-income persons;

and Senate Amendment No.

174 to Senate Bill No.

5 Page 6 (7) Increasing access to health care for uninsured populations in this State, including, without limitation, retirees and children.

- 81st Session (2021) – 5 – [(l)] (m) Making recommendations to the Governor, the Legislature, the Department of Health and Human Services, local health authorities and any other person or governmental entity to increase the quality, accessibility and affordability of health care in this State, including, without limitation, recommendations concerning the items described in this subsection.recommendationssubsection. 2.

If2. a data dashboard is established pursuant to section 1 of this act, the Commission shall make available on an Internet website maintained by the Commission a hyperlink to the data dashboard.

3.[The] If a data dashboard is established pursuant to section 1 of this act, the Commission shall make available on an Internet website maintained by the Commission a hyperlink to the data dashboard .

[concerning telehealth established pursuant to section 1 of this act.] 3.

Examine the business of providing insurance, including the development of cooperation with health maintenance organizations and organizations which restrict the performance of medicaltionsmedical services to certain physicians and hospitals, and procedures to contain the costs of these services.

- 81st Session (2021) – 6 – 8.

Examine the problem of providing and paying for medical care for indigent and medically indigent persons, including medical car10.care provided by physicians.

10.

11.Senate Amendment No.

174 to Senate Bill No.

5 Page 7 11.

Identify and evaluate, with the assistance of an advisory care,group, including, without limitation:onalization for providing long-term (a) An analysis of the costs of the alternatives to institutionalization and the costs of institutionalization for personsproviding receiving long-term carecare, inincluding, thiswithout State;limitation:

(b)(a) AAn determinationanalysis of the effectscosts of the variousalternatives methodsto ofinstitutionalization providingand long-term care services on the qualitycosts of lifeinstitutionalization offor persons receiving thoselong-term servicescare in this State;

(b) A determination of the effects of the various methods of providing long- term care services on the quality of life of persons receiving those services in this State;

Evaluate, with the assistance of an advisory group, the feasibility of obtaining a waiver from the Federal Government to integrate and coordinate acute care services provided through - 81st Session (2021) – 7 – Medicare and long-term care services provided through Medicaid in this State.

Evaluate, with the assistance of an advisory group, the feasibility of obtaining a waiver from the Federal Government to eliminate the requirement that elderly persons in this State impoverish themselves as a condition of receiving assistance for long-term care.

[Use the] If a data dashboard is established pursuant to section 1 of this act,act , use the data dashboard to review access by different groups and populations in this State to services provided through telehealth, as defined in NRS 629.515, and evaluate policies to make such access more equitable.

(a) A requirement that the State, and, to the extent applicable, any of its political subdivisions, shall pay for the nonfederal share of sameexpenses extent and, except for services provided throughto audio-onlya theperson interaction,through intelehealth to the same amountextent asand, thoughexcept providedfor inservices personSenate orAmendment byNo. other means;

174 to Senate Bill No.

5 Page 8 provided [using a standard telephone,] through audio-only interaction, in the same amount as though provided in person or by other means;

(2) Requiring a provider of health care to demonstrate that it is necessary to provide services to a person through telehealth or -receive 81stany Sessionadditional (2021)type –of 8certification –or license to provide services through telehealth as a condition to paying for services as described in paragraph (a).

(a) Require the Director to include in the State Plan for Medicaid coverage of any service that the Director is not otherwise required by law to include;

422.2721 1.

The Director shall include in the State Plan for Medicaid:

(a) A requirement that the State, and, to the extent applicable, any of its political subdivisions, shall pay for the nonfederal share of expenses for services provided to a person through telehealth to the same extent and, for mental health services except [for] when such services are provided through audio-only interaction, in the same amount as though provided in person or by other means;

and (b) A provision prohibiting the State from:

- 81st Session (2021) – 9 – would not be required if a service were provided in person orhat through other means, establish a relationship with a provider of health care or provide any additional consent to or reason for obtaining services through telehealth as a condition to paying for services as described in paragraph (a).

The State Plan for Medicaid may require prior authorization for a service provided through telehealth if such prior authorization would be required if the service were provided in person or through other means.

(2) Requiring a provider of health care to demonstrate that it is necessary to provide services to a person through telehealth or receive any additional type of certification or license to provide services through telehealth as a condition to paying for services as described in paragraph (a).

(3) Refusing to pay for services as described in paragraph (a) because of:

(I) The distant site from which a provider of health care a person who is covered by the State Plan for Medicaid receives which services through telehealth;

or (II) The technology used to provide the services.

(4) Requiring services to be provided through telehealth as a condition to paying for such services.

(5) Categorizing a service provided through telehealth differently for purposes relating to coverage [or reimbursement] than if the service had been provided in person or through other means.

(6) Categorizing a mental health service provided through telehealth, other than through audio-only interaction, differently for purposes relating to reimbursement than if the service had been provided in person or by other means.

2.

The provisions of this section do not:

(a) Require the Director to include in the State Plan for required by law to include;

orce that the Director is not otherwise (b) Require the State or any political subdivision thereof to:

(1) Ensure that covered services are available to a recipient of Medicaid through telehealth at a particular originating site;

or (2) Provide coverage for a service that is not included in the State Plan for Medicaid or provided by a provider of health care that does not participate in Medicaid.

3.

As used in this section:

(a) “Distant site” has the meaning ascribed to it in NRS 629.515.

- 81st Session (2021) – 10 – NRS 629.515.inating site” has the meaning ascribed to it in (c) “Provider of health care” has the meaning ascribed to it in NRS 439.820.

(d) “Telehealth” has the meaning ascribed to it in NRS 629.515.

4.6.

NRS 422.2721 is hereby amended to read as follows:

422.2721 1.

The Director shall include in the State Plan for Medicaid:

(a) A requirement that the State, and, to the extent applicable, any of its political subdivisions, shall pay for the nonfederal share of expenses for services provided to a person through telehealth to the same extent [and, for mental health services except where such services are provided through audio-only interaction, in the same amount] as though provided in person or by other means;

and (b) A provision prohibiting the State from:

(1) Requiring a person to obtain prior authorization that would not be required if a service were provided in person or health care or provide any additional consent to or reason forof obtaining services through telehealth as a condition to paying for services as described in paragraph (a).

The State Plan for Medicaid may require prior authorization for a service provided through telehealth if such prior authorization would be required if the service were provided in person or through other means.

(2) Requiring a provider of health care to demonstrate that it is necessary to provide services to a person through telehealth or receive any additional type of certification or license to provide services through telehealth as a condition to paying for services as described in paragraph (a).

(3) Refusing to pay for services as described in paragraph (a) because of:

(I) The distant site from which a provider of health care provides services through telehealth or the originating site at which services through telehealth;

orState Plan for Medicaid receives (II) The technology used to provide the services.

(4) Requiring services to be provided through telehealth as a condition to paying for such services.

(5) Categorizing a service provided through telehealth differently for purposes relating to coverage than if the service had been provided in person or through other means.

[(6) Categorizing a mental health service provided through telehealth, other than through audio-only interaction, differently for - 81st Session (2021) – 11 – provided in person or by other means.]n if the service had been 2.

The provisions of this section do not:

(a) Require the Director to include in the State Plan for Medicaid coverage of any service that the Director is not otherwise required by law to include;

or (b) Require the State or any political subdivision thereof to:

(1) Ensure that covered services are available to a recipient of Medicaid through telehealth at a particular originating site;

or (2) Provide coverage for a service that is not included in the State Plan for Medicaid or provided by a provider of health care that does not participate in Medicaid.

3.

As used in this section:

(a) “Distant site” has the meaning ascribed to it in NRS 629.515.

(b) “Originating site” has the meaning ascribed to it in NRS 629.515.

(c) “Provider of health care” has the meaning ascribed to it in NRS(d) “Telehealth” has the meaning ascribed to it in NRS 629.515.

Sec.

4.9.

NRS 422.2721 is hereby amended to read as follows:

422.2721 1.

The Director shall include in the State Plan for Medicaid:

(a) A requirement that the State, and, to the extent applicable, any of its political subdivisions, shall pay for the nonfederal share of expenses for services provided to a person through telehealth to the same extent [and, except for services provided through audio-only interaction, in the same amount] as though provided in person or by other means;

and (b) A provision prohibiting the State from:

(1) Requiring a person to obtain prior authorization that would not be required if a service were provided in person or through other means, establish a relationship with a provider of health care or provide any additional consent to or reason for services as described in paragraph (a).

The State Plan for Medicaid may require prior authorization for a service provided through telehealth if such prior authorization would be required if the service were provided in person or through other means.

(2) Requiring a provider of health care to demonstrate that it is necessary to provide services to a person through telehealth or receive any additional type of certification or license to provide services through telehealth as a condition to paying for services as described in paragraph (a).

- 81st Session (2021) – 12 – (3) Refusing to pay for services as described in paragraph (a) because of:

(I) The distant site from which a provider of health care provides services through telehealth or the originating site at which services through telehealth;

orState Plan for Medicaid receives (II) The technology used to provide the services.

(4) Requiring services to be provided through telehealth as a condition to paying for such services.

(5) Categorizing a service provided through telehealth differently for purposes relating to coverage [or reimbursement] than if the service had been provided in person or through other means.

2.

The provisions of this section do not:

(a) Require the Director to include in the State Plan for Medicaid coverage of any service that the Director is not otherwise required by law to include;

or (b) Require the State or any political subdivision thereof to:

(1) Ensure that covered services are available to a recipient of Medicaid through telehealth at a particular originating site;

or (2) Provide coverage for a service that is not included in the State Plan for Medicaid or provided by a provider of health care that does not participate in Medicaid.

3.

As used in this section:

(a) “Distant site” has the meaning ascribed to it in NRS 629.515.

(b) “Originating site” has the meaning ascribed to it in NRS 629.515.

NRS 439.820.ider of health care” has the meaning ascribed to it in (d) “Telehealth” has the meaning ascribed to it in NRS 629.515.

Sec.

(a) Establish policies to ensure adequate development and administration of services for persons with mental illness, persons with intellectual disabilities, persons with developmental disabilities, persons with substance use disorders or persons with co-co-occurring occurring disorders, including services to prevent mental illness, intellectual disabilities, developmental disabilities, substance use disorders and co-occurringco- occurring disorders, and services provided without admission to a facility or institution;

(b) Set policies for the care and treatment of persons with mental illness, persons with intellectual disabilities, persons with - 81st Session (2021) – 13 – developmental disabilities, persons with substance use disorders or persons with co-occurring disorders provided by all state agencies;

(c)Senate IfAmendment aNo. data dashboard is established pursuant to section 1 of this act, use the data dashboard to review access by different provided through telehealth, as defined in NRS 629.515, andervices evaluate policies to make such access more equitable;

174 to Senate Bill No.

5 Page 9 (c) [Use the] If a data dashboard is established pursuant to section 1 of this act , use the data dashboard to review access by different groups and populations in this State to behavioral health services provided through telehealth, as defined in NRS 629.515, and evaluate policies to make such access more equitable;

(1) Information concerning the quality of the care and treatment provided for persons with mental illness, persons with intellectual disabilities, persons with developmental disabilities, persons with substance use disorders or persons with co-occurringco- occurring disorders in this State and on any progress made toward improving the quality of that care and treatment;

and [(e)] (f) Review and make recommendations concerning NRSregulations 641.100,submitted 641A.160,to 641B.160the andCommission 641C.200.eviewfor review pursuant to 2.NRS 641.100, 641A.160, 641B.160 and 641C.200.

2.

- 81st Session (2021) – 14 – (3) Identified gaps in the behavioral health services which are available in the behavioral health region and any recommendations or service enhancements to address those gaps;

(4) Any federal, state or local law or regulation that relates to behavioral health which it determines is redundant, conflicts with other laws or is obsolete and any recommendation to address anyithany such redundant, conflicting or obsolete law or regulation;

(e) To the extent feasible, establish an organized, sustainable and accurate electronic repository of data and information concerning behavioral health and behavioral health services in the behavioral health region that is accessible to membersSenate ofAmendment theNo. public on an Internet website maintained by the policy board.

174 to Senate Bill No.

5 Page 10 members of the public on an Internet website maintained by the policy board.

(f) To the extent feasible, track and compile data concerning persons admitted to mental health facilities and hospitals pursuant to NRS 433A.145 to 433A.197, inclusive, and to mental health facilities and programs of community-based or outpatient services pursuant to NRS 433A.200 to 433A.330, inclusive, in the behavioral health region, including, without limitation:

(g) [Use the] If a data dashboard is established pursuant to section 1 of this act,act , use the data dashboard to review access by different groups and populations in this State to behavioral health services provided through telehealth, as defined in NRS 629.515, and evaluate policies to make such access more equitable.

(h) Identify and coordinate with other entities in the behavioral health region and this State that address issues relating to behavioral - 81st Session (2021) – 15 – health to increase awareness of such issues and avoid duplication of efforts.

[(h)] (i) In coordination with existing entities in this State that address issues relating to behavioral health services, submit an annual (1)report Theto specificthe behavioralCommission healthwhich needsincludes, ofwithout thelimitation: behavioraln:

(1) The specific behavioral health needs of the behavioral health region;

Every policy of insurance issued pursuant to chapters 616A to 617, inclusive, of NRS must include coverage for services provided to an employee through telehealth to the same extent [and, except for services provided using a standard telephone, in the same amount] as though provided in person or by other means.

2.

An insurer shall not:

(c) Refuse to provide the coverage described in subsection 1 because of the distant[: site from which a provider of health care provides services through telehealth or the originating site at which an employee receives services through telehealth;

orSenate (d)Amendment RequireNo. covered services to be provided through telehealth as a condition to providing coverage for such services.

-174 81stto SessionSenate (2021)Bill –No. 16 – 3.

5 Page 11 (1) The] distant site from which a provider of health care provides services through telehealth or the originating site at which an employee receives services through telehealth;

or [ (2) The technology used to provide the services;] (d) Require covered services to be provided through telehealth as a condition to providing coverage for such services .

[;

or (e) Categorize a service provided through telehealth differently for purposes relating to coverage or reimbursement than if the service had been provided in person or through other means.] 3.

Such a policy of insurance may require prior authorization for a service provided through telehealth if such prior authorization would be required if the service were provided in person or by other means.

A policy of insurance subject to the provisions of chapters 616A to 617, inclusive, of NRS that is delivered, issued for delivery or renewed on or after July 1, 2015, [October 1, 2021,] has the legal effect of including the coverage required by this section, and any provision of the policy or the renewal which is in conflict with this section is void.

(d) “Telehealth” [has the meaning ascribed to it in NRS 629.515.] means the delivery of services from a provider of health care to a patient at a different location through athe synchronouslthuse interactionof using information and audio-visual communication technology, not including audio-onlystandard technology,telephone, facsimile or electronic mail.

The term includes, without limitation, the delivery of services from a provider of health care to a patient at a different location through the use of synchronous interaction or an asynchronous system of storing and forwarding information.

The requirements of this subsection do not apply to a provider of health care who is providing services within the scope of his or her employment by or -pursuant 81stto Sessiona (2021)contract –entered 17into –with an urban Indian organization, as defined in 25 U.S.C.

§ 1603.rban1603. Indian 2.

2.

or (b)Senate AuthorizeAmendment aNo. provider of health care to provide services in a setting that is not authorized by law or in a manner that violates the standard of care required of the provider of health care.

174 to Senate Bill No.

5 Page 12 (b) Authorize a provider of health care to provide services in a setting that is not authorized by law or in a manner that violates the standard of care required of the provider of health care.

(a) Is subject to the laws and jurisdiction of the State of Nevada, including, without limitation, any regulations adopted by an occupational licensing board in this State, regardless of the location from which the provider of health care provides services through tel(b)telehealth. Shall comply with all federal and state laws that would apply if the provider were located at a distant site in this State.

(b) Shall comply with all federal and state laws that would apply if the provider were located at a distant site in this State.

(c) “Telehealth” means the delivery of services from a provider of health care to a patient at a different location through the use of information and audio-visual communication technology, not including [standard telephone,] facsimile or electronic mail.

The term includes, without limitation, the delivery of services from a provider of health care to a patient at a different location through the use of:of [a standard telephone.] :

and - 81st Session (2021) – 18 – (2) Audio-only interaction, whether synchronous or asynchronous.

A policy of health insurance must include coverage for services provided to an insured through telehealth to the same extent and, except for services provided through[using audio-toa onlystandard telephone,] through audio-only interaction, in the same amount as though provided in person or by other means.

or (e)Senate CategorizeAmendment aNo. service provided through telehealth differently service had been provided in person or through other means.the 3.

174 to Senate Bill No.

5 Page 13 (e) Categorize a service provided through telehealth differently for purposes relating to coverage or reimbursement than if the service had been provided in person or through other means.

3.

or - 81st Session (2021) – 19 – (c) Enter into a contract with any provider of health care or cover any service if the insurer is not otherwise required by law to do so.

5.

A policy of health insurance subject to the provisions of this [July 1, 2015,] October 1, 2021, has the legal effect of including the coverage required by this section, and any provision of the policy or the renewal which is in conflict with this section is void.

6.

As used in this section:

(a) “Distant site” has the meaning ascribed to it in NRS 629.515.

(b) “Originating site” has the meaning ascribed to it in NRS 629.515.

(c) “Provider of health care” has the meaning ascribed to it in NRS 439.820.

(d) “Telehealth” has the meaning ascribed to it in NRS 629.515.

Sec.

9.3.

NRS 689A.0463 is hereby amended to read as follows:

689A.0463 1.

A policy of health insurance must include coverage for services provided to an insured through telehealth to the same extent and, for mental health services except [for] when such services are provided through audio-only interaction, in the same amount as though provided in person or by other means.

2.

An insurer shall not:

(a) Require an insured to establish a relationship in person with a provider of health care or provide any additional consent to or reason for obtaining services through telehealth as a condition to providing the coverage described in subsection 1;

necessary to provide services to an insured through telehealth ors receive any additional type of certification or license to provide services through telehealth as a condition to providing the coverage described in subsection 1;

(c) Refuse to provide the coverage described in subsection 1 because of:

(1) The distant site from which a provider of health care provides services through telehealth or the originating site at which an insured receives services through telehealth;

or (2) The technology used to provide the services;

(d) Require covered services to be provided through telehealth as a condition to providing coverage for such services;

[or] (e) Categorize a service provided through telehealth differently for purposes relating to coverage [or reimbursement] than if the service had been provided in person or through other means [.] ;

or - 81st Session (2021) – 20 – (f) Categorize a mental health service provided through telehealth, other than through audio-only interaction, differently for purposes relating to reimbursement than if the service had been provided in person or by other means.

obtain prior authorization for any service provided throughsured to telehealth that is not required for the service when provided in person.

A policy of health insurance may require prior authorization for a service provided through telehealth if such prior authorization would be required if the service were provided in person or by other means.

4.

The provisions of this section do not require an insurer to:

(a) Ensure that covered services are available to an insured through telehealth at a particular originating site;

(b) Provide coverage for a service that is not a covered service or that is not provided by a covered provider of health care;

A policy of health insurance subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after [July 1, 2015,] October 1, 2021, has the legal effect of including the coverage required by this section, and any provision of the policy or the renewal which is in conflict with this section is void.

(b) “Originating site” has the meaning ascribed to it in NRS(c) “Provider of health care” has the meaning ascribed to it in NRS 439.820.

(d) “Telehealth” has the meaning ascribed to it in NRS 629.515.

Sec.

9.6.

NRS 689A.0463 is hereby amended to read as follows:

689A.0463 1.

A policy of health insurance must include coverage for services provided to an insured through telehealth to the same extent [and, for mental health services except where such services are provided through audio-only interaction, in the same amount] as though provided in person or by other means.

2.

An insurer shall not:

(a) Require an insured to establish a relationship in person with a provider of health care or provide any additional consent to or reason for obtaining services through telehealth as a condition to providing the coverage described in subsection 1;

- 81st Session (2021) – 21 – necessary to provide services to an insured through telehealth ors receive any additional type of certification or license to provide services through telehealth as a condition to providing the coverage described in subsection 1;

(c) Refuse to provide the coverage described in subsection 1 because of:

(1) The distant site from which a provider of health care provides services through telehealth or the originating site at which an insured receives services through telehealth;

or (2) The technology used to provide the services;

(d) Require covered services to be provided through telehealth as a condition to providing coverage for such services;

or (e) Categorize a service provided through telehealth differently for purposes relating to coverage than if the service had been provided in person or through other means .

[;

or (f) Categorize a mental health service provided through purposes relating to reimbursement than if the service had beently for provided in person or by other means.] 3.

A policy of health insurance must not require an insured to obtain prior authorization for any service provided through telehealth that is not required for the service when provided in person.

A policy of health insurance may require prior authorization for a service provided through telehealth if such prior authorization would be required if the service were provided in person or by other means.

4.

The provisions of this section do not require an insurer to:

(a) Ensure that covered services are available to an insured through telehealth at a particular originating site;

(b) Provide coverage for a service that is not a covered service or that is not provided by a covered provider of health care;

or (c) Enter into a contract with any provider of health care or do so.any service if the insurer is not otherwise required by law to 5.

A policy of health insurance subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after October 1, 2021, has the legal effect of including the coverage required by this section, and any provision of the policy or the renewal which is in conflict with this section is void.

6.

As used in this section:

(a) “Distant site” has the meaning ascribed to it in NRS 629.515.

- 81st Session (2021) – 22 – NRS 629.515.inating site” has the meaning ascribed to it in (c) “Provider of health care” has the meaning ascribed to it in NRS 439.820.

(d) “Telehealth” has the meaning ascribed to it in NRS 629.515.

Sec.

9.9.

NRS 689A.0463 is hereby amended to read as follows:

689A.0463 1.

A policy of health insurance must include coverage for services provided to an insured through telehealth to the same extent [and, except for services provided through audio- only interaction, in the same amount] as though provided in person or by other means.

2.

An insurer shall not:

(a) Require an insured to establish a relationship in person with a provider of health care or provide any additional consent to or reason for obtaining services through telehealth as a condition to providing the coverage described in subsection 1;

necessary to provide services to an insured through telehealth ors receive any additional type of certification or license to provide services through telehealth as a condition to providing the coverage described in subsection 1;

(c) Refuse to provide the coverage described in subsection 1 because of:

(1) The distant site from which a provider of health care provides services through telehealth or the originating site at which an insured receives services through telehealth;

or (2) The technology used to provide the services;

(d) Require covered services to be provided through telehealth as a condition to providing coverage for such services;

or (e) Categorize a service provided through telehealth differently for purposes relating to coverage [or reimbursement] than if the service had been provided in person or through other means.

obtain prior authorization for any service provided throughsured to telehealth that is not required for the service when provided in person.

A policy of health insurance may require prior authorization for a service provided through telehealth if such prior authorization would be required if the service were provided in person or by other means.

4.

The provisions of this section do not require an insurer to:

(a) Ensure that covered services are available to an insured through telehealth at a particular originating site;

- 81st Session (2021) – 23 – or that is not provided by a covered provider of health care;

orice (c) Enter into a contract with any provider of health care or cover any service if the insurer is not otherwise required by law to do so.

5.

A policy of health insurance subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after October 1, 2021, has the legal effect of including the coverage required by this section, and any provision of the policy or the renewal which is in conflict with this section is void.

6.

As used in this section:

(a) “Distant site” has the meaning ascribed to it in NRS 629.515.

follows:10.

NRS 689B.0369 is hereby amended to read as 689B.0369 1.

A policy of group or blanket health insurance must include coverage for services provided to an insured through telehealth to the same extent and, except for services provided through audio-only interaction, in the same amount as though provided in person or by other means.

2.

An insurer shall not:

(a) Require an insured to establish a relationship in person with a provider of health care or provide any additional consent to or reason for obtaining services through telehealth as a condition to providing the coverage described in subsection 1;

(b) Require a provider of health care to demonstrate that it is necessary to provide services to an insured through telehealth or receive any additional type of certification or license to provide services through telehealth as a condition to providing the coverage des(c) Refuse to provide the coverage described in subsection 1 because of [the] :

(1) The distant site from which a provider of health care provides services through telehealth or the originating site at which an insured receives services through telehealth;

or (2) The technology used to provide the services;

(d) Require covered services to be provided through telehealth as a condition to providing coverage for such services [.] ;

or - 81st Session (2021) – 24 – (e) Categorize a service provided through telehealth differently for purposes relating to coverage or reimbursement than if the service had been provided in person or through other means.

3.

A policy of group or blanket health insurance must not provided through telehealth that is not required for that service when provided in person.

A policy of group or blanket health insurance may require prior authorization for a service provided through telehealth if such prior authorization would be required if the service were provided in person or by other means.

4.

The provisions of this section do not require an insurer to:

(a) Ensure that covered services are available to an insured through telehealth at a particular originating site;

(b) Provide coverage for a service that is not a covered service or that is not provided by a covered provider of health care;

or (c) Enter into a contract with any provider of health care or cover any service if the insurer is not otherwise required by law to do so.

5.

A policy of group or blanket health insurance subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after [July 1, 2015,] October 1, 2021, has the legal effect of including the coverage required by this section, and any provision of the policy or the renewal which is in conflict with this section is void.

6.

As used in this section:

(a) “Distant site” has the meaning ascribed to it in NRS 629.515.

(b) “Originating site” has the meaning ascribed to it in NRS(c) “Provider of health care” has the meaning ascribed to it in NRS 439.820.

(d) “Telehealth” has the meaning ascribed to it in NRS 629.515.

10.3.10.

A policy of group or blanket health insurance must include coverage for services provided to an insured through telehealth to the same extent and, except for mental health services exceptprovided [for][using whena suchstandard servicestelephone,] are provided through audio-onlyaudio- only interaction, in the same amount as though provided in person or by other means.

(a) Require an insured to establish a relationship in person with a provider of health care or provide any additional consent to or - 81st Session (2021) – 25 – providing the coverage described in subsection 1;as a condition to (b) Require a provider of health care to demonstrate that it is necessary to provide services to an insured through telehealth or receive any additional type of certification or license to provide services through telehealth as a condition to providing the coverage described in subsection 1;

(c) Refuse to provide the coverage described in subsection 1 because of:

(1) The distant site from which a provider of health care provides services through telehealth or the originating site at which an insured receives services through telehealth;

or (2) The technology used to provide the services;

(d) Require covered services to be provided through telehealth as a condition to providing coverage for such services;

[or] (e) Categorize a service provided through telehealth differently for purposes relating to coverage [or reimbursement] than if the ser(f) Categorize a mental health service provided through [.] ;

or telehealth, other than through audio-only interaction, differently for purposes relating to reimbursement than if the service had been provided in person or by other means.

3.

A policy of group or blanket health insurance must not require an insured to obtain prior authorization for any service provided through telehealth that is not required for that service when provided in person.

A policy of group or blanket health insurance may require prior authorization for a service provided through telehealth if such prior authorization would be required if the service were provided in person or by other means.

4.

The provisions of this section do not require an insurer to:

(a) Ensure that covered services are available to an insured through telehealth at a particular originating site;

(b) Provide coverage for a service that is not a covered service or (c) Enter into a contract with any provider of health care or cover any service if the insurer is not otherwise required by law to do so.

5.

A policy of group or blanket health insurance subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after October 1, 2021, has the legal effect of including the coverage required by this section, and any provision of the policy or the renewal which is in conflict with this section is void.

- 81st Session (2021) – 26 – 6.

As used in this section:

(a) “Distant site” has the meaning ascribed to it in NRS 629.515.

(b) “Originating site” has the meaning ascribed to it in NRS 629.515.

NRS 439.820.ider of health care” has the meaning ascribed to it in (d) “Telehealth” has the meaning ascribed to it in NRS 629.515.

Sec.

10.6.

NRS 689B.0369 is hereby amended to read as follows:

689B.0369 1.

A policy of group or blanket health insurance must include coverage for services provided to an insured through telehealth to the same extent [and, for mental health services except where such services are provided through audio-only interaction, in the same amount] as though provided in person or by other means.

2.

An insurer shall not:

(c) Refuse to provide the coverage described in subsection 1 because of:of [the] :

(1) The distant site from which a provider of health care provides services through telehealth or the originating site at which an insured receives services through telehealth;

orting site at which (2) The technology used to provide the services;

(d) Require covered services to be provided through telehealth as a condition to providing coverage for such services;

or (e) Categorize a service provided through telehealth differently for purposes relating to coverage than if the service had been provided in person or through other means .

[;

or (f) Categorize a mental health service provided through telehealth, other than through audio-only interaction, differently for purposes relating to reimbursement than if the service had been provided in person or by other means.] 3.

A policy of group or blanket health insurance must not require an insured to obtain prior authorization for any service provided through telehealth that is not required for that service when provided in person.

A policy of group or blanket health insurance - 81st Session (2021) – 27 – may require prior authorization for a service provided through telehealth if such prior authorization would be required if the service were provided in person or by other means.

4.

The provisions of this section do not require an insurer to:

through telehealth at a particular originating site;

an insured (b) Provide coverage for a service that is not a covered service or that is not provided by a covered provider of health care;

or (c) Enter into a contract with any provider of health care or cover any service if the insurer is not otherwise required by law to do so.

5.

A policy of group or blanket health insurance subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after October 1, 2021, has the legal effect of including the coverage required by this section, and any provision of the policy or the renewal which is in conflict with this section is void.

6.

As used in this section:

(a) “Distant site” has the meaning ascribed to it in NRS 629.515.

(b) “Originating site” has the meaning ascribed to it in NRS 629.515.

(c) “Provider of health care” has the meaning ascribed to it in NRS 439.820.

(d) “Telehealth” has the meaning ascribed to it in NRS 629.515.

Sec.

10.9.

NRS 689B.0369 is hereby amended to read as follows:

689B.0369 1.

A policy of group or blanket health insurance telehealth to the same extent [and, except for services providedh through audio-only interaction, in the same amount] as though provided in person or by other means.

2.

An insurer shall not:

(a) Require an insured to establish a relationship in person with a provider of health care or provide any additional consent to or reason for obtaining services through telehealth as a condition to providing the coverage described in subsection 1;

(b) Require a provider of health care to demonstrate that it is necessary to provide services to an insured through telehealth or receive any additional type of certification or license to provide services through telehealth as a condition to providing the coverage described in subsection 1;

(c) Refuse to provide the coverage described in subsection 1 because of:

- 81st Session (2021) – 28 – (1) The distant site from which a provider of health care provides services through telehealth or the originating site at which an insured receives services through telehealth;

(d) Require covered services to be provided through telehealth as a condition to providing coverage for such services;services [.] ;

orehealthor (e) Categorize a service provided through telehealth differently for purposes relating to coverage [oror reimbursement]reimbursement than if the service had been provided in person or through other means.

A policy of group or blanket healthSenate insuranceAmendment mayNo. require prior authorization for a service provided through telehealth if such prior authorization would be required if the service were provided in person or by other means.

174 to Senate Bill No.

5 Page 14 health insurance may require prior authorization for a service provided through telehealth if such prior authorization would be required if the service were provided in person or by other means.

A policy of group or blanket health insurance subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after [July 1, 2015,] October 1, 2021, has the legal effect of including the coverage required by this section, and any provision of the policy or the renewal which is in conflict with this section isofis void.

A health benefit plan must include coverage for services provided to an insured through telehealth to the same extent and, except for services provided [using a standard telephone,] through audio-only interaction, in the same amount as though provided in person or by other means.

-2. 81st Session (2021) – 29 – (a) Require an insured to establish a relationship in person with a provider of health care or provide any additional consent to or reason for obtaining services through telehealth as a condition to providing the coverage described in subsection 1;

A carrier shall not:

(a) Require an insured to establish a relationship in person with a provider of health care or provide any additional consent to or reason for obtaining services through telehealth as a condition to providing the coverage described in subsection 1;

(d) Require covered services to be provided through telehealth as (e) Categorize a servicecondition providedto throughproviding telehealthcoverage differently for purposessuch relatingservices to[.] coverage; or reimbursement than if the service had been provided in person or through other means.

or (e) Categorize a service provided through telehealth differently for purposes relating to coverage or reimbursement than if the service had been provided in person or through other means.

(b)Senate ProvideAmendment coverageNo. for a service that is not a covered service or that is not provided by a covered provider of health care;

or174 (c)to EnterSenate intoBill aNo. contract with any provider of health care or do so.any service if the carrier is not otherwise required by law to 5.

5 Page 15 (b) Provide coverage for a service that is not a covered service or that is not provided by a covered provider of health care;

or (c) Enter into a contract with any provider of health care or cover any service if the carrier is not otherwise required by law to do so.

5.

- 81st Session (2021) – 30 – (b) “Originating site” has the meaning ascribed to it in NRS 629.515.

(c) “Provider of health care” has the meaning ascribed to it in NRS 439.820.

Sec.

11.3.ealNRS 689C.195 is hereby amended to read as 629.515.

follows:

689C.195 1.

A health benefit plan must include coverage for services provided to an insured through telehealth to the same extent and, for mental health services except [for] when such services are provided through audio-only interaction, in the same amount as though provided in person or by other means.

2.

A carrier shall not:

(a) Require an insured to establish a relationship in person with a provider of health care or provide any additional consent to or reason for obtaining services through telehealth as a condition to providing the coverage described in subsection 1;

(b) Require a provider of health care to demonstrate that it is necessary to provide services to an insured through telehealth or receive any additional type of certification or license to provide services through telehealth as a condition to providing the coverage described in subsection 1;

(c) Refuse to provide the coverage described in subsection 1 because of:

(1) The distant site from which a provider of health care provides services through telehealth or the originating site at which an insured receives services through telehealth;

or (d) Require covered services to be provided through telehealth as a condition to providing coverage for such services;

[or] (e) Categorize a service provided through telehealth differently for purposes relating to coverage [or reimbursement] than if the service had been provided in person or through other means [.] ;

or (f) Categorize a mental health service provided through telehealth, other than through audio-only interaction, differently for purposes relating to reimbursement than if the service had been provided in person or by other means.

3.

A health benefit plan must not require an insured to obtain prior authorization for any service provided through telehealth that is not required for the service when provided in person.

A health benefit plan may require prior authorization for a service provided through telehealth if such prior authorization would be required if the service were provided in person or by other means.

- 81st Session (2021) – 31 – 4.

The provisions of this section do not require a carrier to:

(a) Ensure that covered services are available to an insured through telehealth at a particular originating site;

(b) Provide coverage for a service that is not a covered service or (c) Enter into a contract with any provider of health care or cover any service if the carrier is not otherwise required by law to do so.

5.

A plan subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after October 1, 2021, has the legal effect of including the coverage required by this section, and any provision of the plan or the renewal which is in conflict with this section is void.

6.

As used in this section:

(a) “Distant site” has the meaning ascribed to it in NRS 629.515.

11.6.

NRS 689C.195 is hereby amended to read as follows:

689C.195 1.

A health benefit plan must include coverage for services provided to an insured through telehealth to the same extent [and, for mental health services except where such services are provided through audio-only interaction, in the same amount] as though provided in person or by other means.

(a) Require an insured to establish a relationship in person with a provider of health care or provide any additional consent to or reason for obtaining services through telehealth as a condition to providing the coverage described in subsection 1;

(b) Require a provider of health care to demonstrate that it is necessary to provide services to an insured through telehealth or receive any additional type of certification or license to provide services through telehealth as a condition to providing the coverage described in subsection 1;

(c) Refuse to provide the coverage described in subsection 1 because of:

(1) The distant site from which a provider of health care provides services through telehealth or the originating site at which an insured receives services through telehealth;

or (2) The technology used to provide the services;

- 81st Session (2021) – 32 – (d) Require covered services to be provided through telehealth as a condition to providing coverage for such services;

or (e) Categorize a service provided through telehealth differently for purposes relating to coverage than if the service had been pro(f) Categorize a mental health service provided through telehealth, other than through audio-only interaction, differently for purposes relating to reimbursement than if the service had been provided in person or by other means.] 3.

A health benefit plan must not require an insured to obtain prior authorization for any service provided through telehealth that is not required for the service when provided in person.

A health benefit plan may require prior authorization for a service provided through telehealth if such prior authorization would be required if the service were provided in person or by other means.

4.

The provisions of this section do not require a carrier to:

(a) Ensure that covered services are available to an insured through telehealth at a particular originating site;

(b) Provide coverage for a service that is not a covered service or that is not provided by a covered provider of health care;

or (c) Enter into a contract with any provider of health care or cover any service if the carrier is not otherwise required by law to do so.

5.

A plan subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after October 1, 2021, has the legal effect of including the coverage required by this section, and any provision of the plan or the renewal which is in con6.ictAs used in this section:id.

(a) “Distant site” has the meaning ascribed to it in NRS 629.515.

(b) “Originating site” has the meaning ascribed to it in NRS 629.515.

(c) “Provider of health care” has the meaning ascribed to it in NRS 439.820.

(d) “Telehealth” has the meaning ascribed to it in NRS 629.515.

Sec.

11.9.

NRS 689C.195 is hereby amended to read as follows:

689C.195 1.

A health benefit plan must include coverage for services provided to an insured through telehealth to the same extent [and, except for services provided through audio-only interaction, in the same amount] as though provided in person or by other means.

2.

A carrier shall not:

- 81st Session (2021) – 33 – a provider of health care or provide any additional consent to orith reason for obtaining services through telehealth as a condition to providing the coverage described in subsection 1;

(b) Require a provider of health care to demonstrate that it is necessary to provide services to an insured through telehealth or receive any additional type of certification or license to provide services through telehealth as a condition to providing the coverage described in subsection 1;

(c) Refuse to provide the coverage described in subsection 1 because of:

(1) The distant site from which a provider of health care provides services through telehealth or the originating site at which an insured receives services through telehealth;

or (2) The technology used to provide the services;

(d) Require covered services to be provided through telehealth as a condition to providing coverage for such services;

or for purposes relating to coverage [or reimbursement] than if thetly service had been provided in person or through other means.

3.

A health benefit plan must not require an insured to obtain prior authorization for any service provided through telehealth that is not required for the service when provided in person.

A health benefit plan may require prior authorization for a service provided through telehealth if such prior authorization would be required if the service were provided in person or by other means.

4.

The provisions of this section do not require a carrier to:

(a) Ensure that covered services are available to an insured through telehealth at a particular originating site;

(b) Provide coverage for a service that is not a covered service or that is not provided by a covered provider of health care;

or (c) Enter into a contract with any provider of health care or cover any service if the carrier is not otherwise required by law to do 5.

A plan subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after October 1, 2021, has the legal effect of including the coverage required by this section, and any provision of the plan or the renewal which is in conflict with this section is void.

6.

As used in this section:

(a) “Distant site” has the meaning ascribed to it in NRS 629.515.

(b) “Originating site” has the meaning ascribed to it in NRS 629.515.

- 81st Session (2021) – 34 – NRS 439.820.ider of health care” has the meaning ascribed to it in (d) “Telehealth” has the meaning ascribed to it in NRS 629.515.

Sec.

A benefit contract must include coverage for services provided to an insured through telehealth to the same extent and, except for services provided [using a standard telephone,] through audio-only interaction, in the same amount as though provided in person or by other means.

(b) Require a provider of health care to demonstrate that it is necessary to provide services to an insured through telehealth or receive any additional type of certification or license to provide describedservices inthrough subsectiontelehealth 1;h as a condition to providing the coverage (c) Refuse to provide the coverage described in subsection 11; because of [the] :

(c) Refuse to provide the coverage described in subsection 1 because of [the] :

A benefit contract telehealth if such prior authorization would be required if the service were provided in person or by other means.

4.

The provisions of this section do not require a society to:

(a) Ensure that covered services are available to an insured through telehealth at a particular originating site;

(b) Provide coverage for a service that is not a covered service or that is not provided by a covered provider of health care;

or - 81st Session (2021) – 35 – (c) Enter into a contract with any provider of health care or cover any service if the society is not otherwise required by law to do so.

5.

A benefit contract subject to the provisions of this chapter 2015,] October 1, 2021, has the legal effect of including the [July 1, coverage required by this section, and any provision of the contract or the renewal which is in conflict with this section is void.

6.