SB 330 — Revises provisions related to health care. (BDR 57-161)

(1) Seen or suspected from a mammogram described in paragraph (a) or an imaging test described in paragraph (b);

- *SB330_R1* – 4 – 2.

(a) Require[Require] Except as otherwise provided in subsection 6, require an insured to pay a [higher] deductible, [any] copayment , [or] coinsurance or any other form of cost-sharing or require a longer waiting period or other condition to obtain any benefit provided in the policy of group health insurance pursuant to subsection 1;

(e) Offer or pay any type of material inducement, bonus or other financial incentive to a provider of health care to deny, reduce,reduce,er withhold, limit or delay access to any such benefit to an insured;

- 82nd Session (2023) – 5 – 6.

If the application of paragraph (a) of subsection 3 would result in the ineligibility of a health savings account of an insured pursuant to 26 U.S.C.

§ 223, the prohibitions of paragraph (a) of subsection 3 shall apply only for a qualified policy of group health health insurance after the insured has satisfied the minimum group deductible pursuant to 26 U.S.C.

§ 223, except with respect to items or services that constitute preventive care pursuant to 26 U.S.C.

§ 223(c)(2)(C), in which case the prohibitions of paragraph (a) of subsection 3 shall apply regardless of whether the minimum deductible under 26 U.S.C.

§ 223 has been satisfied.

7.

(b) “Network plan” means a policy of group 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 - *SB330_R1* – 5 – under contract with the insurer.

Sec.(d) “Qualified policy of group health insurance” means a policy of group health insurance that has a high deductible and is establishing a health savings account.

the purposes of Sec.

(c) A diagnostic imaging test for breast cancer at the age deemed most appropriate, when medically necessary, as - 82nd Session (2023) – 6 – recommended by the insured’s provider of health care to evaluate an abnormality which is:

or (2)2. Detected by other means of examination.

2.(A carrier 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 carrier.

A carrier 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 carrier.

(a) Require[Require] Except as otherwise provided in subsection 6, require an insured to pay a [higher] deductible, [any] copayment , [or] coinsurance or any other form of cost-sharing or require a longer waiting period or other condition to obtain any benefit provided in the health benefit plan pursuant to subsection 1;

or (f)insured Imposeto any othersuch restrictionsbenefit.rictions or delays on the access of an insured4. to any such benefit.

- *SB330_R1* – 6 – 4.

If the application of paragraph (a) of subsection 3 would result in the ineligibility of a health savings account of an insured pursuant to 26 U.S.C.

§ 223, the prohibitions of paragraph (a) of - 82nd Session (2023) – 7 – subsection 3 shall apply only for a qualified health benefit plan with respect to the deductible of such a health benefit plan after the insured has satisfied the minimum deductible pursuant to 26 U.S.C.

§ 223, except with respect to items or services that which case the prohibitions of paragraph (a) of subsection 3 shalln apply regardless of whether the minimum deductible under 26 U.S.C.

§ 223 has been satisfied.

7.

(d) “Qualified health benefit plan” means a health benefit plan that has a high deductible and is in compliance with 26 U.S.C.

§ 223 for the purposes of establishing a health savings account.

695A.1855benefits 1.payable for expenses incurred for [a] :vide coverage for (a) A mammogram [every 2 years, or] to screen for breast cancer annually [if ordered by a provider of health care,] for [women] insureds who are 40 years of age or older.

A benefit contract must provide coverage for benefits payable for expenses incurred for [a] :

(a) A mammogram [every 2 years, or] to screen for breast cancer annually [if ordered by a provider of health care,] for [women] insureds who are 40 years of age or older.

or - 82nd Session (2023) – 8 – (2) Detected by other means of examination.

- *SB330_R1* – 7 – 2.

3.offers or issues a benefit contract shall not:tion 5, a society that (a) [Require] Except as otherwise provided in subsection 6, require an insured to pay a [higher] deductible, [any] copayment , [or] coinsurance or any other form of cost-sharing or require a longer waiting period or other condition for coverage to obtain any benefit provided in a benefit contract pursuant to subsection 1;

Except as otherwise provided in subsection 5, a society that offers or issues a benefit contract shall not:

(a) Require an insured to pay a [higher] deductible, [any] copayment , [or] coinsurance or any other form of cost-sharing or require a longer waiting period or other condition for coverage to obtain any benefit provided in a benefit contract pursuant to subsection 1;

A benefit contract subject to the provisions of this chapter which is delivered, issued for delivery or renewed on or after January 1, [2018,] 2024, has the legal effect of including the coverage required by subsection 1, and any provision of the benefit contract or the renewal which is in conflict with this section is void.

AsIf usedthe application of paragraph (a) of subsection 3 would result in thisthe section:ineligibility of a health savings account of an insured pursuant to 26 U.S.C.

§ 223, the prohibitions of paragraph (a) of subsection 3 shall apply only for a qualified benefit contract with respect to the deductible of such a benefit contract after the insured has satisfied the minimum deductible pursuant to 26 U.S.C.

§ 223, except with respect to items or services that - 82nd Session (2023) – 9 – constitute preventive care pursuant to 26 U.S.C.

§ 223(c)(2)(C), in which case the prohibitions of paragraph (a) of subsection 3 shall apply regardless of whether the minimum deductible under 26 U.S.C.

§ 223 has been satisfied.

(b) “Network plan” means a benefit contract offered by a society 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 - *SB330_R1* – 8 – society.

(d) “Qualified benefit contract” means a benefit contract that has a high deductible and is in compliance with 26 U.S.C.

§ 223 for the purposes of establishing a health savings account.

(a) A mammogram [every 2 years, or] to screen for breast cancer annually [if ordered by a provider of health care,] for [women][wo(b) insuredsAn whoimaging aretest 40to yearsscreen offor breast cancer on an interval and at the age deemed most appropriate, when medically necessary, as recommended by the insured’s provider of health care based on personal or older.family medical history or additional factors that may increase the risk of breast cancer for the insured.

(b) An imaging test to screen for breast cancer on an interval and at the age deemed most appropriate, when medically necessary, as recommended by the insured’s provider of health care based on personal or family medical history or additional factors that may increase the risk of breast cancer for the insured.

- 82nd Session (2023) – 10 – 3.

(a) Require[Require] Except as otherwise provided in subsection 6, require an insured to pay a [higher] deductible, [any] copayment , [or] coinsurance or any other form of cost-sharing or require a longer waiting period or other condition to obtain any benefitbenefita provided in a contract for hospital or medical service pursuant to subsection 1;

- *SB330_R1* – 9 – (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 access to any such benefit to an insured;

A contract for hospital or medical service subject to the provisions of this chapter which is delivered, issued for delivery or renewed on or after January 1, [2018,] 2024, has the legal effect of including the coverage required by subsection 1, and any provision ofvoid.e the contract or the renewal which is in conflict with this section is void.5.

5.

AsIf usedthe application of paragraph (a) of subsection 3 would result in thisthe section:ineligibility of a health savings account of an insured pursuant to 26 U.S.C.

§ 223, the prohibitions of paragraph (a) of subsection 3 shall apply only for a qualified contract for hospital or medical service with respect to the deductible of such a contract for hospital or medical service after the insured has satisfied the minimum deductible pursuant to 26 U.S.C.

§ 223, except with respect to items or services that constitute preventive care - 82nd Session (2023) – 11 – pursuant to 26 U.S.C.

§ 223(c)(2)(C), in which case the prohibitions of paragraph (a) of subsection 3 shall apply regardless of whether the minimum deductible under 26 U.S.C.

§ has been satisfied.

(d) “Qualified contract for hospital or medical service” means a contract for hospital or medical service that has a high deductible and is in compliance with 26 U.S.C.

§ 223 for the purposes of establishing a health savings account.

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

- *SB330_R1* – 10 – 3.

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, 695C.1751, 695C.1755, 695C.1759, 695C.176 to 695C.200, inclusive, and 695C.265 do not apply to a health maintenance organization that provides health care services through managed - 82nd Session (2023) – 12 – 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.

This subsection does not exempt a health maintenance organization from any provision of this chapter for services provided pursuant to any other contract.

The provisions of NRS 695C.1735 do not apply to a health maintenance organization that provides health care services toto: members of the Public Employees’ Benefits Program.

This(a) subsectionThe doesofficers notand exemptemployees, aand healththe maintenancedependents organizationof fromofficers anyand provisionemployees, of thisthe chaptergoverning forbody servicesof providedany pursuantcounty, toschool anydistrict, municipal corporation, political subdivision, public corporation or other contract.local governmental agency of this State;

or (b) Members of the Public Employees’ Benefits Program.

 This subsection does not exempt a health maintenance organization from any provision of this chapter for services provided pursuant to any other contract.

(a) A mammogram [every 2 years, or] to screen for breast cancer annually [if ordered by a provider of health care,] for [women] enrollees who are 40 years of age or older.

- *SB330_R1* – 11 – (1) Seen or suspected from a mammogram described in paragraph (a) or an imaging test described in paragraph (b);

- 82nd Session (2023) – 13 – 2.

3.maintenance organization that offers or issues a health care plan shall not:

(a) [Require] Except as otherwise provided in subsection 5,6, require an enrollee to pay a health[higher] maintenancedeductible, organization[any] thatcopayment offers, [or] coinsurance or issuesany other form of cost-sharing or require a longer waiting period or other condition to obtain any benefit provided in the health care plan shallpursuant not:to subsection 1;

(a) Require an enrollee to pay a [higher] deductible, [any] copayment , [or] coinsurance or any other form of cost-sharing or require a longer waiting period or other condition to obtain any benefit provided in the health care plan pursuant to subsection 1;

4.which is delivered, issued for delivery or renewed on or afterhapter January 1, [2018,] 2024, has the legal effect of including the coverage required by subsection 1, and any provision of the plan or the renewal which is in conflict with this section is void.

A health care plan subject to the provisions of this chapter which is delivered, issued for delivery or renewed on or after January 1, [2018,] 2024, has the legal effect of including the coverage required by subsection 1, and any provision of the plan or the renewal which is in conflict with this section is void.

If the application of paragraph (a) of subsection 3 would result in the ineligibility of a health savings account of an enrollee pursuant to 26 U.S.C.

§ 223, the prohibitions of paragraph (a) of subsection 3 shall apply only for a qualified health care plan with respect to the deductible of such a health care plan after the - 82nd Session (2023) – 14 – U.S.C.

§ 223, except with respect to items or services that6 constitute preventive care pursuant to 26 U.S.C.

§ 223(c)(2)(C), in which case the prohibitions of paragraph (a) of subsection 3 shall apply regardless of whether the minimum deductible under 26 U.S.C.

§ 223 has been satisfied.

7.

The term includes, without limitation, the use - *SB330_R1* – 12 – of step therapy, prior authorization or categorizing drugs and devices based on cost, type or method of administration.

The term doesdoe(c) not“Provider includeof anhealth arrangementcare” forhas the financingmeaning ofascribed premiums.to it in NRS 629.031.

(c)(d) “Provider“Qualified health care plan” means a health care plan of a health care”maintenance organization that has thea meaninghigh ascribeddeductible toand itis in NRScompliance 629.031.with 26 U.S.C.

§ 223 for the purposes of establishing a health savings account.

Except as otherwise provided in subsection 3, the provisions of this chapter apply to each organization and insurer that operates as a managed care organization and may include, without limitation, an insurer that issues a policy of health insurance, an insurer that issues a policy of individual or group health insurance, a carrier serving small employers, a fraternal benefit society, a hospital or medical service corporation and a healthhea2.h maintenancemIn organization.addition to the provisions of this chapter, each managed care organization shall comply with:

2.

In addition to the provisions of this chapter, each managed care organization shall comply with:

The provisions of NRS 695G.127, 695G.164, 695G.1645, 695G.167 and 695G.200 to 695G.230, inclusive, do not apply to a managed care organization that provides health care services to recipients of Medicaid under the State Plan for Medicaid or - 82nd Session (2023) – 15 – 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.

[This subsection does] 4.managed care organization that provides health care services to members of the Public Employees’ Benefits Program.

The provisions of NRS 695C.1735 do not apply to a managed care organization that provides health care services to members of the Public Employees’ Benefits Program.

- *SB330_R1* – 13 – (a) A mammogram [every 2 years, or] to screen for breast cancer annually [if ordered by a provider of health care,] for [women] insureds who are 40 years of age or older.

(1) Seen or suspected from a mammogram described in paragraphparagr(2) (a)Detected orby another imagingmeans testof describedexamination.agraph in paragraph (b);

or (2)2. Detected by other means of examination.

2.

(a) Require[Require] Except as otherwise provided in subsection 6, require an insured to pay a [higher] deductible, [any] copayment , [or] coinsurance or any other form of cost-sharing or require a longer waiting period or other condition to obtain any benefit provided in the health care plan pursuant to subsection 1;

(b)- Refuse82nd toSession issue(2023) a– health16 care– plan or cancel a health care plan solely because the person applying for or covered by the plan usesusesplan or may use any such benefit;

A health care plan subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after January 1, [2018,] 2024, has the legal effect of including the coverage required by subsection 1, and any provision of the plan or the renewal which is in conflict with this section is void.

-plan *SB330_R1*or – 14 – 5.

If the application of paragraph (a) of subsection 3 would result in the ineligibility of a health savings account of an insured pursuant to 26 U.S.C.

§ 223, the prohibitions of paragraph (a) of subsection 3 shall apply only for a qualified health care plan with respect to the deductible of such a health care plan after the insured has satisfied the minimum deductible pursuant to 26 U.S.C.

§ 223, except with respect to items or services that constitute preventive care pursuant to 26 U.S.C.

§ 223(c)(2)(C), in apply regardless of whether the minimum deductible under 263 shall U.S.C.

§ 223 has been satisfied.

7.

(b)- “Network82nd plan”Session means(2023) a– health17 care– plan offered by a managed care organization 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 managed care organization.

(d) “Qualified health care plan” means a health care plan issued by a managed care organization that has a high deductible and is in compliance with 26 U.S.C.

§ 223 for the purposes of establishing a health savings account.

The governing body of any county, school district, municipal corporation, political subdivision, public corporation or other local governmental agency of the State of Nevada that provides health insurance through a plan of self-self-f insurance shall 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.

Except as otherwise provided in subsection 5, the governing body of any county, school district, municipal corporation, political subdivision, public corporation or other local governmental agency of the State of Nevada that provides healthhea(a) insuranceExcept throughas otherwise provided in subsection 6, 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 plan of self-insurance shallpursuant not:to subsection 1;

(a) Require an insured to pay a higher deductible, any copayment or coinsurance or require a longer waiting period or - *SB330_R1* – 15 – other condition to obtain any benefit provided in the plan of self- insurance pursuant to subsection 1;

- 82nd Session (2023) – 18 – (c) Offer or pay any type of material inducement or financial incentive to an insured to discourage the insured from obtaining any such benefit;

(d) Penalize a provider of health care who provides any such benefitreimbursement toof anthe insured,provider including,of withouthealth limitation,care;itation, reducing the reimbursement(e) Offer or pay any type of thematerial inducement, bonus or other financial incentive to a provider of health care;care to deny, reduce, withhold, limit or delay access to any such benefit to an insured;

(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 access to any such benefit to an insured;

If the application of paragraph (a) of subsection 3 would pursuant to 26 U.S.C.

§ 223, the prohibitions of paragraph (a) ofured subsection 3 shall apply only for a qualified plan of self-insurance with respect to the deductible of such a plan of self-insurance after the insured has satisfied the minimum deductible pursuant to 26 U.S.C.

§ 223, except with respect to items or services that constitute preventive care pursuant to 26 U.S.C.

§ 223(c)(2)(C), in which case the prohibitions of paragraph (a) of subsection 3 shall apply regardless of whether the minimum deductible under 26 U.S.C.

§ 223 has been satisfied.

7.

(b)- “Network82nd plan”Session means(2023) a– plan19 of– self-insurance provided by the governing body of a local governmental agency underunderded 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 governing body.

- *SB330_R1* – 16 – (c) “Provider of health care” has the meaning ascribed to it in NRS 629.031.

(d) “Qualified plan of self-insurance” means a plan of self- insurance that has a high deductible and is in compliance with 26 U.S.C.

§ 223 for the purposes of establishing a health savings account.

If the Board provides health insurance through a plan of self-insurance, it shall 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 yearsyea2. of age or older.

2.oIf the Board provides health insurance through a plan of self-insurance, it 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 Board.

If the Board provides health insurance through a plan of self-insurance, it 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 Board.

(a) RequireExcept as otherwise provided in subsection 6, 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 plan of self-self-insurance insurance pursuant to subsection 1;

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

or - 82nd Session (2023) – 20 – (f) Impose any other restrictions or delays on the access of an insured to any such benefit.

A plan of self-insurance described in subsection 1 which is delivered, issued for delivery or renewed on or after January 1, 2024, 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.

- *SB330_R1* – 17 – 6.

If the application of paragraph (a) of subsection 3 would result in the ineligibility of a health savings account of an insured pursuant to 26 U.S.C.

§ 223, the prohibitions of paragraph (a) of subsection 3 shall apply only for a qualified plan of self-insurance with respect to the deductible of such a plan of self-insurance after the insured has satisfied the minimum deductible pursuant to 26 U.S.C.

§ 223, except with respect to items or services that constitute preventive care pursuant to 26 U.S.C.

§ 223(c)(2)(C), in which case the prohibitions of paragraph (a) of subsection 3 shall apply regardless of whether the minimum deductible under 26 U.S.C.

§ 223 has been satisfied.

7.

(a) “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, thethes or use of step therapy, prior authorization or categorizing drugs and devices based on cost, type or method of administration.

Sec.(d) “Qualified plan of self-insurance” means a plan of self- insurance that has a high deductible and is in compliance with 26 U.S.C.

§ 223 for the purposes of establishing a health savings account.

- 82nd Session (2023) – 21 – Sec.

The governing body of any county, school district, municipal corporation, political subdivision, public corporation or other local governmental agency of the State of NevadaNev(a) may:Adopt and carry into effect a system of group life, accident or health insurance, or any combination thereof, for the benefit of its officers and employees, and the dependents of officers and employees who elect to accept the insurance and who, where necessary, have authorized the governing body to make deductions from their compensation for the payment of premiums on the insurance.

(a) Adopt and carry into effect a system of group life, accident or health insurance, or any combination thereof, for the benefit of its officers and employees, and the dependents of officers and employees who elect to accept the insurance and who, where necessary, have authorized the governing body to make deductions from their compensation for the payment of premiums on the insurance.

The money accumulated for this purpose through deductions from the compensation of officers and employees and contributions of the governing body must be maintained as an internal service fund as definednational bybank NRSor 354.543.credit union authorized to transact business in the State of Nevada.

TheAny moneyindependent mustadministrator beof depositeda infund acreated stateunder orthis nationalsection bankis orsubject creditto unionthe authorizedlicensing torequirements transactof businesschapter in683A theof StateNRS, and must be a resident of Nevada.this State.

Any independent administrator of a fund created under this section is subject to the licensing requirements of - *SB330_R1* – 18 – chapter 683A of NRS, and must be a resident of this State.

(d)- Defray82nd partSession or(2023) all– of22 the– cost of maintenance of a self- insurance fund or of the premiums upon insurance.

In any county in which a legal services organization exists, the governing body of the county, or of any school district, municipal corporation, political subdivision, public corporation or other local governmental agency of the State of Nevada in the county, may enter into a contract with the legal services organization pursuant to which the officers and employees of the legal services organization, and the dependents of those officers and employees, are eligible for any life, accident or health insurance provided pursuant to this section to the officers and employees, and the dependents of the officers and employees, of the county, school district, municipal corporation, political subdivision, public corporation or other local governmental agency.

and - *SB330_R1* – 19 – (b) Must be required by the contract to pay the premiums or contributions for all insurance which they elect to accept or of which theythe5.autA authorizecontract thethat purchase.is entered into pursuant to subsection 3:

5.

A contract that is entered into pursuant to subsection 3:

- 82nd Session (2023) – 23 – 6.

287.040 The provisions of NRS 287.010 to 287.040, inclusive, and section 7.2 of this act do not make it compulsory upon any governing body of any county, school district, municipal corporation, political subdivision, public corporation or other local governmental agency of the State of Nevada, except as otherwise provided in NRS 287.021 or subsection 4 of NRS 287.023 or in an agreement entered into pursuant to subsection 3 of NRS 287.015, to pay any premiums, contributions or other costs for group insurance, a plan of benefits or medical or hospital services establishedestablishedance, pursuant to NRS 287.010, 287.015, 287.020 or paragraph (b), (c) or (d) of subsection 1 of NRS 287.025, for coverage under the Public Employees’ Benefits Program, or to make any contributions to a trust fund established pursuant to NRS 287.017, or upon any officer or employee of any county, school district, municipal corporation, political subdivision, public corporation or other local governmental agency of this State to accept any such coverage or to assign his or her wages or salary in payment of premiums or contributions therefor.

287.04335 If the Board provides health insurance through a plan of self-insurance, it shall comply with the provisions of NRS 686A.135, 687B.352, 687B.409, 687B.723, 687B.725, 689B.0353, 689B.255, 695C.1723, 695G.150, 695G.155, 695G.160, 695G.162, 695G.1635, 695G.164, 695G.1645, 695G.1665, 695G.167, 695G.1675, 695G.170 to 695G.1712, inclusive, 695G.1714 to - *SB330_R1* – 20 – 695G.174, inclusive, 695G.176, 695G.177, 695G.200 to 695G.230, inclusive, 695G.241 to 695G.310, inclusive, and 695G.405, in the same manner as an insurer that is licensed pursuant to title 57 of NRS is required to comply with those provisions.

H~~~~~ 23 - *SB330_R1*82nd Session (2023)