SB 280 — Revises provisions governing contraception. (BDR 40-40)

(a)- 82nd Session (2023) – 5 – the unique problems of operating such a facility in a rural area.tion (b) The licensure of ruralfacilities hospitalsfor refractive surgery which take into consideration the unique problemsfactors of operating such a facilityfacility. in a rural area.

(b) The licensure of facilities for refractive surgery which take into consideration the unique factors of operating such a facility.

In establishing the qualifications, the Board shall consider the related standards set by nationally recognized organizations which accreditacc6. such facilities.

6.

and (2) Includes a plan, which has been prepared under the supervisionemergency ofintervention aif registeredan nurseadverse orcondition licensedresults.t, pharmacist, for emergency(d) interventionExcept ifas anotherwise adverseauthorized conditionby results.the regulations adopted pursuant to NRS 449.0304, the prescribed medication is not administered by injection or intravenously.

(d) Except as otherwise authorized by the regulations adopted pursuant to NRS 449.0304, the prescribed medication is not administered by injection or intravenously.

The Board shall adopt separate regulations governing the licensing and operation of residential facilities for groups which provide- 82nd Session (2023) – 6 – licensing of a facility as a residential facility for groups which provides assisted living services.services and a residential facility for groups shall not claim that it provides “assisted living services” unless:

The Board shall not allow the - *SB280_R1* – 6 – licensing of a facility as a residential facility for groups which provides assisted living services and a residential facility for groups shall not claim that it provides “assisted living services” unless:

(c) The facility provides personalized care to the residents of the facilityincorporates andthese core principles:o operating the generalfacility approach(1) The facility is designed to operatingcreate thea facilityresidential incorporatesenvironment thesethat coreactively principles:supports and promotes each resident’s quality of life and right to privacy;

(1) The facility is designed to create a residential environment that actively supports and promotes each resident’s quality of life and right to privacy;

(5) The operation of the facility is designed to foster a social climate that allows the resident to develop and maintain personalpersonalsocial relationships with fellow residents and with persons in the general community;

and - 82nd Session (2023) – 7 – (7) The facility is operated in such a manner as to foster a culture that provides a high-quality environment for the residents, their families, the staff, any volunteers and the community at large.

The Division may grant an exception from the requirement of subparagraph (1) of paragraph (b) of subsection 7 to a facility - *SB280_R1* – 7 – which is licensed as a residential facility for groups on or before July 1, 2005, and which is authorized to have 10 or fewer beds and was originally constructed as a single-family dwelling if the Division finds that:

(b) The adoption of plans to provide for the evacuation of a residential facility for groups in an emergency, including, without limitation,evacuated;, plans to ensure that nonambulatory patients may be evacuated;(c) Educating the residents of residential facilities for groups concerning the plans adopted pursuant to paragraphs (a) and (b);

(c) Educating the residents of residential facilities for groups concerning the plans adopted pursuant to paragraphs (a) and (b);

(b) Facilities that provide or arrange for the provision of supportive services for residents of the facility to assist the residents with- reintegration82nd intoSession the(2023) community,– in8 addition– to providing a housing and living environment;

andandty, in addition to providing a (c) Facilities that provide or arrange for the provision of programs for alcohol and other substance use disorders, in addition to providing a housing and living environment and providing or arranging for the provision of other supportive services.

- *SB280_R1* – 8 –  The regulations must provide that if a facility was originally constructed as a single-family dwelling, the facility must not be authorized for more than eight beds.

(a) Except as otherwise provided in paragraph (b), require a natural person responsible for the operation of a provider of community-based living arrangement services and each employee of a provider of community-based living arrangement services who supervises or provides support to recipients of community-based living arrangement services to complete training concerning the provision of community-based living arrangement services to persons with mental illness and continuing education concerning the particular population served by the provider;

and (d) Require an applicant for a license to provide community- based living arrangement services to post a surety bond in an amount equal to the operating expenses of the applicant for 2 months, place that amount in escrow or take another action prescribed by the Division to ensure that, if the applicant becomes insolvent, recipients of community-based living arrangement becomes services from the applicant may continue to receive community- based living arrangement services for 2 months at the expense of the applicant.

(a) Align with the standards established by the American Association of Birth Centers, or its successor organization, the accrediting- body82nd ofSession the(2023) Commission– for9 the– Accreditation of Birth Centers, or its successor organization, or another nationallynationallyirth recognized organization for accrediting freestanding birthing centers;

- *SB280_R1* – 9 – Sec.

(b)act.b) Aiding, abetting or permitting the commission of any illegal act.(c) Conduct inimical to the public health, morals, welfare and safety of the people of the State of Nevada in the maintenance and operation of the premises for which a license is issued.

(c) Conduct inimical to the public health, morals, welfare and safety of the people of the State of Nevada in the maintenance and operation of the premises for which a license is issued.

2.may revoke a license to operate a facility for the dependent if, with respect to that facility, the licensee that operates the facility, or an agent or employee of the licensee:

In addition to the provisions of subsection 1, the Division may revoke a license to operate a facility for the dependent if, with respect to that facility, the licensee that operates the facility, or an agent or employee of the licensee:

or (c)- Is82nd orderedSession by(2023) the– appropriate10 governmental– agency to correct a violation of a building, safety or health code or regulation but fails to correct the violation.

- *SB280_R1* – 10 – (b) A report of any investigation conducted with respect to the complaint;

On or before February 1 of each odd-numbered year, the Division shall submit to the Director of the Legislative Counsel Bureau a written report setting forth, for the previous biennium:

(a)determines Prohibitthat the facility fromhas admittingcorrected anythe patientviolation;ntil it (b) Limit the occupancy of the facility to the number of beds occupied when the violation occurred, until it determines that the facility has corrected the violation;

(b) Limit the occupancy of the facility to the number of beds occupied when the violation occurred, until it determines that the facility has corrected the violation;

- 82nd Session (2023) – 11 – (d) Impose an administrative penalty of not more than $5,000 per day for each violation, together with interest thereon at a rate not to exceed 10 percent per annum;

and (e) Appoint temporary management to oversee the operation of the facility and to ensure the health and safety of the patients of the facility, until:

to ensure the health and safety of the patients of the (1) It determines that the facility has corrected the violation and has management which is capable of ensuring continued compliance with the applicable statutes, conditions, standards and regulations;

- *SB280_R1* – 11 – (a) Suspend the license of the facility until the administrative penalty is paid;

Any money collected as administrative penalties pursuant to paragraph (d) of subsection 1 must be accounted for separately and used to administer and carry out the provisions of NRS 449.001 to 449.430, inclusive, and section 1 of this act, 449.435 to 449.531, inclusive, and chapter 449A of NRS to protect the health, safety, well-being and property of the patients and residents of facilities in accordance with applicable state and federal standards or for anyanyes in other purpose authorized by the Legislature.

and (3)- Dispensed82nd inSession accordance(2023) with– NRS12 639.28075;– (b) Any type of device for contraception which is lawfully prescribed or ordered and which has been approved by the Food and Drug Administration;

(b) Any type of device for contraception which is lawfully prescribed or ordered and which has been approved by the Food and Drug Administration;

(e) EducationA andcontraceptive counselinginjection, relatingincluding, towithout thelimitation, initiationsuch ofan theinjection useimmediately of contraceptives and any necessary follow-up after initiatinga suchperson use;gives birth;

(f) ManagementEducation ofand sidecounseling effects relating to contraception;the initiation of the use of contraceptives and any necessary follow-up after initiating such use;

and[(f)] (g) VoluntaryManagement sterilizationof forside women.effects relating to contraception;

-and *SB280_R1*[(g)] –(h) 12Voluntary –sterilization 2.for women.

Except as otherwise provided in subsections 4 and 5, to obtain any benefit provided in the Plan pursuant to subsection 1, a person enrolled in Medicaid must not be required to:

For each method of contraception which is approved by the Food and Drug Administration, the Plan must include at least one contraceptive drug or device for which no deductible, copayment or coinsurance may be charged to the person enrolled in Medicaid, but the Plan may charge a deductible, copayment or coinsurance for any other contraceptive drug or device that provides the same method of contraception.

(1)- Contains82nd anSession identical(2023) amount– of13 the– same active ingredients in the same dosage and method of administration as another drug;

(a) Is convicted of a felony relating to the practice of administeringoffense ainvolving nursingmoral facilityturpitude.r or residential facility or of any offense(b) involvingHas moralobtained turpitude.his or her license by the use of fraud or deceit.

(b)(c) HasViolates obtainedany hisof or her license by the useprovisions of fraudthis orchapter. deceit.

- *SB280_R1* – 13 – (c) Violates any of the provisions of this chapter.

If a licensee requests a hearing pursuant to subsection 1, the Board shall give the licensee written notice of a hearing pursuant to NRSor 233B.121her andright 241.034.to attend the hearing.e may waive, in writing, his 3.

A licensee may waive, in writing, his or her right to attend the hearing.

3.

- 82nd Session (2023) – 14 – 4.

The expiration of a license by operation of law or by order or decision of the Board or a court, or the voluntary surrender of a license, does not deprive the Board of jurisdiction to proceed with any investigation of, or action or disciplinary proceeding against, the licensee or to render a decision suspending or revoking the license.

- *SB280_R1* – 14 – (c) Self-administered hormonal contraceptives dispensed by a pharmacist pursuant to NRS 639.28078;

(e) Education and counseling relating to the initiation of the use of contraception and any necessary follow-up after initiating suchsuchuse use;

- 82nd Session (2023) – 15 – (a) Require an insured to pay a higher deductible, any copayment or coinsurance or require a longer waiting period or other condition for coverage to obtain any benefit included in the policy pursuant to subsection 1;

(b) Refuse to issue a policy of health insurance or cancel a policy of health insurance solely because the person applying for or covered by the policy uses or may use any such benefit;

Except as otherwise provided in subsection 7, a policy subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after January 1, [2022,] 2024, has the legal effect of including the coverage required by subsection 1, and - *SB280_R1* – 15 – any provision of the policy or the renewal which is in conflict with this section is void.

An insurer that offers or issues a policy of health insurance and which is affiliated with a religious organization is not required to provide the coverage required by subsection 1 if the insurerinsurerquired objects on religious grounds.

For each of the 18 methods of contraception listed in subsection 10 that have been approved by the Food and Drug Administration, a policy of health insurance must include at least one drug or device for contraception within each method for which no deductible, copayment or coinsurance may be charged to the insured, but the insurer may charge a deductible, copayment or - 82nd Session (2023) – 16 – coinsurance for any other drug or device that provides the same method of contraception.

(a) Voluntary sterilization for women;

Except as otherwise provided in this section and federal law, an insurer may use medical management techniques, including, - *SB280_R1* – 16 – without limitation, any available clinical evidence, to determine the frequency of or treatment relating to any benefit required by this section or the type of provider of health care to use for suchsuchthis treatment.

or (b) Refuse to cover a contraceptive injection or the insertion of a device described in paragraph (c), (d) or (e) of subsection 10 at a hospital immediately after an insured gives birth.

14.- 82nd Session (2023) – 17 – (a) “Medical management technique” means a practice which is used to control the cost or utilization of health care services or prescription drug use.

As used in this section:

(a) “Medical management technique” means a practice which is used to control the cost or utilization of health care services or prescription drug use.

(1) Contains an identical amount of the same active ingredients in the same dosage and method of administration as anothe(2) Is expected to have the same clinical effect when administered to a patient pursuant to a prescription or order as another drug;

(2) Is expected to have the same clinical effect when administered to a patient pursuant to a prescription or order as another drug;

- *SB280_R1* – 17 – (a) Up to a 12-month supply, per prescription, of any type of drug for contraception or its therapeutic equivalent which is:

and (4)(b) DispensedAny intype accordanceof withdevice NRSfor 639.28075;contraception which is:

(b) Any type of device for contraception which is:

- 82nd Session (2023) – 18 – (e) Education and counseling relating to the initiation of the use of contraception and any necessary follow-up after initiating such use;

and (g)2.) VoluntaryVAn sterilizationinsurer formust women.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 insurer.

2.

An insurer 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 insurer.

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

- *SB280_R1* – 18 – (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;

- 82nd Session (2023) – 19 – 7.

Such an insurer shall, before the issuance of a policy of group health insurance and before the renewal of such a policy, provide to the group policyholder ororthe prospective insured, as applicable, written notice of the coverage that the insurer refuses to provide pursuant to this subsection.

(d) Copper-based intrauterine devices;

- *SB280_R1* – 19 – (i) Extended- or continuous-regimen drugs;

and (r)- Ulipristal82nd acetateSession for(2023) emergency– contraception.20 – 12.

12.

or (b) Refuse to cover a contraceptive injection or the insertion of a device described in paragraph (c), (d) or (e) of subsection 11 at a hospital immediately after an insured gives birth.

An insurer must provide an accessible, transparent and expedited process which is not unduly burdensome by which an insured, or the authorized representative of the insured, may request an exception relating to any medical management technique used by the insurer to obtain any benefit required by this section without a higher deductible, copayment or coinsurance.

(c) “Provider of health care” has the meaning ascribed to it in NRSNRS(d) 629.031.“Therapeutic equivalent” means a drug which:

- *SB280_R1* – 20 – (d) “Therapeutic equivalent” means a drug which:

Sec.- 82nd Session (2023) – 21 – follows:12.

12.NRS 689C.1676 is hereby amended to read as 689C.1676 1.

NRS 689C.1676 is hereby amended to read as follows:

689C.1676 1.

(d) Insertion of a device for contraception or removal of such a device if the device was inserted while the insured was covered bybya the same health benefit plan;

4.carrier that offers or issues a health benefit plan shall not:1, a (a) 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 included in the health benefit plan pursuant to subsection 1;

Except as otherwise provided in subsections 8, 9 and 11, a carrier that offers or issues a health benefit plan shall not:

- *SB280_R1* – 21 – (a) 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 included in the health benefit plan pursuant to subsection 1;

- 82nd Session (2023) – 22 – (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 to anthe insured,provider including,of withouthealth limitation,care;itation, reducing the reimbursement(e) Offer or pay any type of material inducement, bonus or other financial incentive to thea 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;

A carrier may require an insured to pay a higher deductible, copayment or coinsurance for a drug for contraception if the insured refuses to accept a therapeutic equivalent of the drug.drug.f the insured 9.

9.

- *SB280_R1* – 22 – 10.

- 82nd Session (2023) – 23 – (e) Progesterone-based intrauterine devices;

(i) Extended- or continuous-regimen drugs;

or (b) Refuse to cover the insertion of a devicecontraceptive describedinjection in paragraph (c), (d) or (e)the ofinsertion subsectionof 10 at a hospital immediately after an insured gives birth.

subsection 10 at a 13.

The term includes, without limitation, the use - *SB280_R1* – 23 – of step therapy, prior authorization or categorizing drugs and devices based on cost, type or method of administration.

(b) “Network plan” means a health benefit plan offered by a carrier under which the financing and delivery of medical care, including- items82nd andSession services(2023) paid– for24 as– medical care, are provided, in whole or in part, through a defined set of providers under contract with the carrier.

695A.1865a 1.society that offers or issues a benefit contract which provides, coverage for prescription drugs or devices shall include in the contract coverage for:

Except as otherwise provided in subsection 7, a society that offers or issues a benefit contract which provides coverage for prescription drugs or devices shall include in the contract coverage for:

(d) Insertion of a device for contraception or removal of such a device if the device was inserted while the insured was covered bybya the same benefit contract;

- *SB280_R1*82nd Session (2023) – 2425 – 2.

If a covered therapeutic equivalent listed in subsection 1 is not available or a provider of health care deems a covered therapeutic equivalent to be medically inappropriate, an alternate therapeutic equivalent prescribed by a provider of health care must be covered by the society.

or (f) Impose any other restrictions or delays on the access of an insuredins5.ed Coverage pursuant to anythis suchsection benefit.for the covered dependent of an insured must be the same as for the insured.

5.

Coverage pursuant to this section for the covered dependent of an insured must be the same as for the insured.

- *SB280_R1*82nd Session (2023) – 2526 – 8.

For each of the 18 methods of contraception listed in subsection 10 that have been approved by the Food and Drug Administration, a benefit contract must include at least one drug or device for contraception within each method for which no deductible, copayment or coinsurance may be charged to the insured, but the society may charge a deductible, copayment or coinsurance for any other drug or device that provides the same method of contraception.

(o)(p) FemaleSpermicide;oms; condoms;

(p) Spermicide;

or - *SB280_R1*82nd –Session 26(2023) – (b)27 Refuse– to cover the insertion of a device described in paragraph (c), (d) or (e) of subsection 10 at a hospital immediately after an insured gives birth.

(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 society.

NRS 695B.1919 is hereby amended to read as follows:fol695B.1919 1.

695B.1919 1.

(b)- Any82nd typeSession of(2023) device– for28 contraception– (b) (1) Lawfully prescribed or ordered;n which is:

(1)(2) LawfullyApproved prescribedby orthe ordered;Food and Drug Administration;

- *SB280_R1* – 27 – (2) Approved by the Food and Drug Administration;

An insurer that offers or issues a contract for hospital or medical services must ensure that the benefits required by subsection 1 are made available to an insured through a provider of hea3.h cIf a covered therapeutic equivalent listed in subsection 1 is not available or a provider of health care whodeems participatesa incovered thetherapeutic networkequivalent planto be medically inappropriate, an alternate therapeutic equivalent prescribed by a provider of health care must be covered by the insurer.

3.

If a covered therapeutic equivalent listed in subsection 1 is not available or a provider of health care deems a covered therapeutic equivalent to be medically inappropriate, an alternate therapeutic equivalent prescribed by a provider of health care must be covered by the insurer.

(b) Refuse to issue a contract for hospital or medical service or cancel a contract for hospital or medical service solely because the person applying for or covered by the contract uses or may use any suc(c) Offer or pay any type of material inducement or financial incentive to an insured to discourage the insured from obtaining any such benefit;

(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) – 29 – (f) Impose any other restrictions or delays on the access of an insured to any such benefit.

-hospital *SB280_R1*or –medical 28service –subject 6.to the provisions of this chapter that is delivered, issued for delivery or renewed on or after January 1, [2022,] 2024, has the legal effect of including the coverage required by subsection 1, and any provision of the contract or the renewal which is in conflict with this section is void.

Except as otherwise provided in subsection 7, a contract for hospital or medical service subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after January 1, [2022,] 2024, has the legal effect of including the coverage required by subsection 1, and any provision of the contract or the renewal which is in conflict with this section is void.

For each of the 18 methods of contraception listed in subsection 11 that have been approved by the Food and Drug Administration, a contract for hospital or medical service must include at least one drug or device for contraception within each method for which no deductible, copayment or coinsurance may bebech charged to the insured, but the insurer may charge a deductible, copayment or coinsurance for any other drug or device that provides the same method of contraception.

- 82nd Session (2023) – 30 – (j) Estrogen- and progestin-based patches;

(n)(o) CervicalFemale capscondoms;ith with spermicide;

(o)(p) FemaleSpermicide; condoms;

- *SB280_R1* – 29 – (p) Spermicide;

or (b) Refuse to cover a contraceptive injection or the insertion of a device described in paragraph (c), (d) or (e) of subsection 11 at a hospital immediately after an insured gives birth.

An insurer must provide an accessible, transparent and expedited process which is not unduly burdensome by which an insured, or the authorized representative of the insured, may request an exception relating to any medical management technique used bybyuest the insurer to obtain any benefit required by this section without a higher deductible, copayment or coinsurance.

(c)- “Provider82nd Session (2023) – 31 – NRS 629.031.ider of health care” has the meaning ascribed to it in NRS(d) 629.031.“Therapeutic equivalent” means a drug which:

(d) “Therapeutic equivalent” means a drug which:

- *SB280_R1* – 30 – (2) Is expected to have the same clinical effect when administered to a patient pursuant to a prescription or order as another drug;

(a) Up to a 12-month supply, per prescription, of any type of drug forfo(1) contraceptionLawfully prescribed or itsordered;equivalent therapeutic equivalent which is:

(1) Lawfully prescribed or ordered;

(e) Education and counseling relating to the initiation of the use of contraception and any necessary follow-up after initiating such use;use(f) Management of side effects relating to contraception;

(f) Management of side effects relating to contraception;

If a covered therapeutic equivalent listed in subsection 1 is not available or a provider of health care deems a covered therapeutic equivalent to be medically inappropriate, an alternate - 82nd Session (2023) – 32 – therapeutic equivalent prescribed by a provider of health care must be covered by the health maintenance organization.

Except as otherwise provided in subsections 9, 10 and 12, a health maintenance organization that offers or issues a health care pla(a) Require an enrollee to pay a higher deductible, any copayment or coinsurance or require a longer waiting period or other condition to obtain any benefit included in the health care plan shallpursuant not:to subsection 1;

(a) Require an enrollee to pay a higher deductible, any copayment or coinsurance or require a longer waiting period or - *SB280_R1* – 31 – other condition to obtain any benefit included in the health care plan pursuant to subsection 1;

Except as otherwise provided in subsection 7, a health care plan subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after January 1, [2022,] 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.

- 82nd Session (2023) – 33 – 9.

10.subsection 11 that have been approved by the Food and Drugin Administration, a health care plan must include at least one drug or device for contraception within each method for which no deductible, copayment or coinsurance may be charged to the enrollee, but the health maintenance organization may charge a deductible, copayment or coinsurance for any other drug or device that provides the same method of contraception.

For each of the 18 methods of contraception listed in subsection 11 that have been approved by the Food and Drug Administration, a health care plan must include at least one drug or device for contraception within each method for which no deductible, copayment or coinsurance may be charged to the - *SB280_R1* – 32 – enrollee, but the health maintenance organization may charge a deductible, copayment or coinsurance for any other drug or device that provides the same method of contraception.

(n)(o) CervicalFemale capscondoms;ith with spermicide;

(o) Female condoms;

(a)- Use82nd medicalSession management(2023) techniques– to34 require– an enrollee to use a method of contraception other than the method prescribed or ordered by a provider of health care [.] ;

or (b) Refuse to cover a contraceptive injection or the insertion of a device described in paragraph (c), (d) or (e) of subsection 11 at a hospital immediately after an enrollee gives birth.

- *SB280_R1* – 33 – 15.

The term includes, without limitation, the use ofdevices stepbased therapy,on priorcost, authorizationtype or categorizingmethod drugsof administration.gs and devices(b) based“Network onplan” cost,means typea health care plan offered by a health maintenance organization under which the financing and delivery of medical care, including items and services paid for as medical care, are provided, in whole or methodin part, through a defined set of administration.providers under contract with the health maintenance organization.

(b) “Network plan” means a health care plan offered by a health maintenance 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 health maintenance organization.

(2) Is expected to have the same clinical effect when administered to a patient pursuant to a prescription or order as anotheranother(3) drug;Meets any other criteria required by the Food and Drug Administration for classification as a therapeutic equivalent.

and (3) Meets any other criteria required by the Food and Drug Administration for classification as a therapeutic equivalent.

(1)- Lawfully82nd prescribedSession or(2023) ordered;– 35 – (2) Approved by the Food and Drug Administration;

(2) Approved by the Food and Drug Administration;

- *SB280_R1* – 34 – (e) Education and counseling relating to the initiation of the use of contraception and any necessary follow-up after initiating such use;

and (g)2.) VoluntaryVA sterilizationmanaged forcare women.organization 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 managed care organization.

2.

A managed care organization 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 managed care organization.

(a) 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 included in the health care plan pursuantpur(b) Refuse to subsectionissue 1;a health care plan or cancel a health care plan solely because the person applying for or covered by the plan uses or may use any such benefits;

(b) Refuse to issue a health care plan or cancel a health care plan solely because the person applying for or covered by the plan uses or may use any such benefits;

- 82nd Session (2023) – 36 – (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 benefits to an insured;

or (f) Impose any other restrictions or delays on the access of an insuredins5.ed Coverage pursuant to anythis suchsection benefits.for the covered dependent of an insured must be the same as for the insured.

5.

Coverage pursuant to this section for the covered dependent of an insured must be the same as for the insured.

A managed care organization that offers or issues a health care plan and which is affiliated with a religious organization is not - *SB280_R1* – 35 – required to provide the coverage required by subsection 1 if the managed care organization objects on religious grounds.

For each of the 18 methods of contraception listed in subsection 10 that have been approved by the Food and Drug Administration, a health care plan must include at least one drug or device for contraception within each method for which no one drug or deductible, copayment or coinsurance may be charged to the insured, but the managed care organization may charge a deductible, copayment or coinsurance for any other drug or device that provides the same method of contraception.

- 82nd Session (2023) – 37 – (i) Extended- or continuous-regimen drugs;

(m) Sponges with spermicide;

Except as otherwise provided in this section and federal law, a managed care organization may use medical management techniques, including, without limitation, any available clinical evidence, to determine the frequency of or treatment relating to any - *SB280_R1* – 36 – benefit required by this section or the type of provider of health care to use for such treatment.

or (b) Refuse to cover a contraceptive injection or the insertion of a device described in paragraph (c), (d) or (e) of subsection 10 at a hospital immediately after an insured gives birth.

A managed care organization must provide an accessible, transparent and expedited process which is not unduly burdensome by which an insured, or the authorized representative of the insured, may request an exception relating to any medical managementmanagemente insured, technique used by the managed care organization to obtain any benefit required by this section without a higher deductible, copayment or coinsurance.

The - 82nd Session (2023) – 38 – term does not include an arrangement for the financing of premiums.

(d) “Therapeutic(1) equivalent”Contains meansan aidentical drugamount which:of the same active ingredients in the same dosage and method of administration as another drug;

(1) Contains an identical amount of the same active ingredients in the same dosage and method of administration as another drug;

- *SB280_R1* – 37 – 2.

(a) Upon passage and approval for the purpose of adopting any regulations or performing any other preparatory administrative tasks that are necessary to carry out the provisions of this act;

andtasksand (b) On January 1, 2024, for all other purposes.

H~~~~~ 23 - *SB280_R1*82nd Session (2023)