SB 217 — Makes revisions relating to reproductive health care. (BDR 40-24)

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

- *SB217_R1* – 4 – Sec.

Except as otherwise provided in this section, the provisions of sections 2 to 9, inclusive, of this act apply to all state and local laws and ordinances and the implementation of those laws- and83rd ordinances,Session whether(2025) statutory– or4 otherwise,– and whether enacted before, on or after July 1, 2025.

otherwise, and whether 2.

(c) The ability of a third party to provide coverage of assisted reproductionorproduction or drugs or devices related to assisted reproduction;

or (d) The ability of a person to control the use or disposition of his or her gametes or other reproductive genetic material.

(I) Provide assisted reproduction or information related to assisted reproduction within the scope of practice, training and experience(II) Provide, administer, dispense or prescribe any drug or device related to assisted reproduction within the scope of practice, training and experience of the provider of health care;

or - *SB217_R1* – 5 – (II) Provide, administer, dispense or prescribe any drug or device related to assisted reproduction within the scope of practice, training and experience of the provider of health care;

(b) Expressly, effectively, implicitly or, as implemented, substantially burdens the ability of a person to control the use or - 83rd Session (2025) – 5 – disposition of his or her gametes or other reproductive genetic material.

A governmental entity may enact a requirement or limitation described in subsection 1 if the governmental entity demonstrates by clear and convincing evidence that the burden imposed by the requirement or limitation described in subsection 1, as applied to the person, provider of health care or third party who is subject to the burden:

A court may find that a person, provider of health care or third party is a vexatious litigant if the person, provider of health care or third party makes a claim within the scope of sections 2 to 9, inclusive, of this act which is without merit, fraudulent or otherwise intended to harass or annoy a person or entity.

If aar court finds that a person, provider of health care or third party is a vexatious litigant pursuant to this subsection, the court may deny standing to that person, provider of health care or third party to bring further claims which allege a violation of this section.

Except as otherwise provided in this section, a person or entity is not subject to civil or criminal liability, or discipline or other administrative sanctions imposed by a professional licensing board or other governmental entity, solely - *SB217_R1* – 6 – because the person or entity provides or receives goods or services related to assisted reproduction.

Except as otherwise provided in this section, a person or entity that stores or transports embryos for the purpose of assisted reproduction or the manufacturer of goods used to facilitate the process of assisted reproduction or the transportation of embryos - 83rd Session (2025) – 6 – stored for the purpose of assisted reproduction is not subject to civil or criminal liability, or discipline or other administrative sanctions imposed by a professional licensing board or other governmental entity, solely because of the death of or damage to an embryo.3.bryThe provisions of this section do not preclude:

3.

The provisions of this section do not preclude:

(a) Shall appoint, with the consent of the Governor, administrators of the divisions of the Department, who areareGovernor, respectively designated as follows:

and - *SB217_R1* – 7 – (5) The Administrator of the Division of Public and Behavioral Health.

(b) Shall administer, through the divisions of the Department, the provisions of chapters 63, 424, 425, 427A, 432A to 442, inclusive, 446 to 450, inclusive, 458A and 656A of NRS, - 83rd Session (2025) – 7 – NRS 127.220 to 127.310, inclusive, 422.001 to 422.410, inclusive, and section 14 of this act, 422.580, 432.010 to 432.133, inclusive, 432B.6201 to 432B.626, inclusive, 444.002 to 444.430, inclusive, and 445A.010 to 445A.055, inclusive, and all other provisions of law relating to the functions of the divisions of the Department, but is not responsible for the clinical activities of the Division of Public and Behavioral Health or the professional line activities of the other divisions.

(5) Set forth sufficient information to assist the Department in providing those services and in the planning and budgeting for the future provision of those services;

(e) May, by regulation, require nonprofit organizations and state and local governmental agencies to provide information regarding the programs of those organizations and agencies, excluding detailed information relating to their budgets and payrolls, which the - *SB217_R1* – 8 – Director deems necessary for the performance of the duties imposed upon him or her pursuant to this section.

- 83rd Session (2025) – 8 – 2.

287.010district, 1.municipal corporation, political subdivision, public corporation or other local governmental agency of the State of Nevada may:

The governing body of any county, school district, municipal corporation, political subdivision, public corporation or other local governmental agency of the State of Nevada may:

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 defined by NRS 354.543.

The provisions of NRS 439.581 to 439.597, inclusive, 686A.135, 687B.352, 687B.408, 687B.692, 687B.723, 687B.725, 687B.805, 689B.030 to 689B.0317, inclusive, and section 23 of this act, paragraphs (b) and (c) of subsection 1 of NRS - *SB217_R1* – 9 – 689B.0319, subsections 2, 4, 6 and 7 of NRS 689B.0319, 689B.033 to- 689B.0369,83rd inclusive,Session 689B.0375(2025) to– 689B.050,9 inclusive,– 689B.0675, 689B.265, 689B.287 and 689B.500 and section 24 of this act apply to coverage provided pursuant to this paragraph, except that the provisions of NRS 689B.0378, 689B.03785 and 689B.500 only apply to coverage for active officers and employees of the governing body, or the dependents of such officers and employees.

If the amount of the deductions from compensation required to pay for the group insurance exceeds the compensation to which a trustee is entitled, the difference must be paid by the trustee.

(a) Shall be deemed, solely for the purposes of this section, to be officers and employees of the county, school district, municipal to be corporation, political subdivision, public corporation or other local governmental agency with which the legal services organization has contracted;

- *SB217_R1*83rd Session (2025) – 10 – (a) Must be submitted to the Commissioner of Insurance for approval not less than 30 days before the date on which the contract is to become effective.

(b) Does not become effective unless approved by the Commissioner.Com(c) Shall be deemed to be approved if not disapproved by the Commissioner within 30 days after its submission.

(c) Shall be deemed to be approved if not disapproved by the Commissioner within 30 days after its submission.

287.04335 If the Board provides health insurance through a plan of self-insurance, it shall comply with the provisions of NRS 439.581 to 439.597, inclusive, 686A.135, 687B.352, 687B.409, 687B.692, 687B.723, 687B.725, 687B.805, 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, and section 44 of this act, 695G.1714 to 695G.174, inclusive, 695G.176, 695G.177, 695G.200 to 695G.230, inclusive, 695G.241 to 695G.310, inclusive, 695G.405 and 695G.415, and section 45 of this act in the same manner as an insurer that is licensed pursuant to title 57 of NRS is required to comply with those provisions.

13.5.

NRS 287.04335 is hereby amended to read as follows:

287.04335 If the Board provides health insurance through a 439.581 to 439.597, inclusive, 686A.135, 687B.352, 687B.409,of NRS 687B.692, 687B.723, 687B.725, 687B.805, 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 695G.174, inclusive, 695G.176, 695G.177, 695G.200 to 695G.230, inclusive, 695G.241 to 695G.310, inclusive, 695G.405 and 695G.415, and [section] sections 44 and 45 of this act in the same manner as an insurer that is licensed pursuant to title 57 of NRS is required to comply with those provisions.

Sec.

- 83rd Session (2025) – 11 – (a) Any procedure or medication determined by a qualified provider of health care to be necessary for the diagnosis and treatment of infertility in accordance with established medical practice or any guidelines published by the American College of Obstetricians and Gynecologists or the American Society for Reproductive Medicine, or their successor organizations.

- *SB217_R1* – 11 – (b) At least 5 years of standard fertility preservation services that are necessary to preserve fertility because the recipient of Medicaid:

(a) A medical or genetic condition may directly or indirectly cause infertility if the condition or treatment for the condition is likely to cause infertility, as established by the American Society of Clinical Oncology, the American Society for Reproductive Medicine or the American College of Obstetricians andandive Gynecologists, or their successor organizations.

(c)- Require83rd aSession longer(2025) waiting– period12 for– the coverage required by subsection 1 than is required for similar benefits that are not related to fertility;

- *SB217_R1* – 12 – (b) Fully cooperate in good faith with the Federal Government during the application process to satisfy the requirements of the Federal Government for obtaining a waiver or amendmentamendmentents of the pursuant to paragraph (a).

or (II) At least 6 months of regular, unprotected sexual intercourse or therapeutic donor insemination for a person who is 35 years of age or older;

(2) The inability of a person or the partner of the person to reproduce or the inability of a person to reproduce with a particular partner;

ororlity of a person to reproduce with a (3) A finding by a qualified provider of health care that a person is infertile based on:

(c)- “Standard83rd fertilitySession (2025) – 13 – (c)(1) Means a procedure or services for the preservation services”:of fertility that:

(1) Means a procedure or services for the preservation of fertility that:

- *SB217_R1* – 13 – Sec.

1.already has health coverage, an employer who provides benefits for health care to his or her employees shall, except as otherwise provided in subsection 3, ensure that the employee is allowed to enroll in any plan to provide such benefits without any additional fee or penalty within at least 30 days after the employee has been confirmed to be pregnant by a qualified provider of health care.

Regardless of whether an employee who is pregnant already has health coverage, an employer who provides benefits for health care to his or her employees shall, except as otherwise provided in subsection 3, ensure that the employee is allowed to enroll in any plan to provide such benefits without any additional fee or penalty within at least 30 days after the employee has been confirmed to be pregnant by a qualified provider of health care.

4.meaning ascribed to it in NRS 629.031.ider of health care” has the Sec.

As used in this section, “provider of health care” has the meaning ascribed to it in NRS 629.031.

Sec.

- 83rd Session (2025) – 14 – 2.

An employer who employs less than 10051 employees and provides benefits for health care to his or her employees through a plan of self-insurance is exemptnot fromrequired to provide the requirementscoverage ofdescribed in section 23 of this act.

Sec.

17.

NRS 608.180 is hereby amended to read as follows:

- *SB217_R1* – 14 – Sec.

687B.225689A.0405, 1.689A.0412, 689A.0413, 689A.0418, 689A.0437,n NRS 689A.044, 689A.0445, 689A.0459, 689B.031, 689B.0312, 689B.0313, 689B.0315, 689B.0317, 689B.0319, 689B.0374, 689B.0378, 689C.1665, 689C.1671, 689C.1675, 689C.1676, 695A.1843, 695A.1856, 695A.1865, 695A.1874, 695B.1912, 695B.1913, 695B.1914, 695B.1919, 695B.19197, 695B.1924, 695B.1925, 695B.1942, 695C.1696, 695C.1699, 695C.1713, 695C.1735, 695C.1737, 695C.1743, 695C.1745, 695C.1751, 695G.170, 695G.1705, 695G.171, 695G.1714, 695G.1715, 695G.1719 and 695G.177, and sections 23, 31, 37 and 44 of this act, any contract for group, blanket or individual health insurance or any contract by a nonprofit hospital, medical or dental service corporation or organization for dental care which provides for payment of a certain part of medical or dental care may require the - 83rd Session (2025) – 15 – insured or member to obtain prior authorization for that care from the insurer or organization.

Except as otherwise provided in NRS 689A.0405, 689A.0412, 689A.0413, 689A.0418, 689A.0437, 689A.044, 689A.0445, 689A.0459, 689B.031, 689B.0312, 689B.0313, 689B.0315, 689B.0317, 689B.0319, 689B.0374, 689B.0378, 689C.1665, 689C.1671, 689C.1675, 689C.1676, 695A.1843, 695A.1856, 695A.1865, 695A.1874, 695B.1912, 695B.1913, 695B.1914, 695B.1919, 695B.19197, 695B.1924, 695B.1925, 695B.1942, 695C.1696, 695C.1699, 695C.1713, 695C.1735, 695C.1737, 695C.1743, 695C.1745, 695C.1751, 695G.170, 695G.1705, 695G.171, 695G.1714, 695G.1715, 695G.1719 and 695G.177, and sections 23, 31, 37 and 44 of this act, any contract for group, blanket or individual health insurance or any contract by a nonprofit hospital, medical or dental service corporation or organization for dental care which provides for payment of a certain part of medical or dental care may require the insured or member to obtain prior authorization for that care from the insurer or organization.

and (b) Unless a shorter time period is prescribed by a specific statute, including, without limitation, NRS 689A.0446, 689B.0361, 689C.1688, 695A.1859, 695B.19087, 695C.16932 and 695G.1703, respond to any request for approval by the insured or member pursuant to this section within 20 days after it receives the request.

- *SB217_R1* – 15 – (a) Except as otherwise provided in paragraph (b), on the first day of the month in which a qualified provider of health care confirms that the person is pregnant;

Sec.689A.420 NRS As used in NRS 689A.420 to 689A.460, inclusive, and section 20 of this act, unless the context otherwise requires:

21.

NRS 689A.420 is hereby amended to read as follows:

689A.420 As used in NRS 689A.420 to 689A.460, inclusive, and section 20 of this act, unless the context otherwise requires:

Except as otherwise provided in subsections 55, 6 and 6,7, an insurer that issues a policy of group health insurance withto more- 83rd Session (2025) – 16 – coverage for:her than 50a employeessmall employer shall include in the policy (a) Any procedure or membersmedication determined by a qualified provider of health care to be necessary for the insureddiagnosis groupand shalltreatment includeof infertility in accordance with established medical practice or any guidelines published by the policyAmerican coverageCollege for:of Obstetricians and Gynecologists or the American Society for Reproductive Medicine, or their successor organizations.

(a) Any procedure or medication determined by a qualified provider of health care to be necessary for the diagnosis and treatment of infertility in accordance with established medical practice or any guidelines published by the American College of Obstetricians and Gynecologists or the American Society for Reproductive Medicine, or their successor organizations.

(b) At least 5 years of standard fertility preservation services that area(1) necessaryHas been diagnosed with a medical or genetic condition that may directly or indirectly cause infertility, as determined pursuant to preserveparagraph fertility(a) becauseof thesubsection insured:2;

(1)or Has(2) beenIs diagnosedexpected withto receive a medical ortreatment genetic condition that may directly or indirectly cause infertility, as determined pursuant to paragraph (a)(b) of subsection 2;2.

or - *SB217_R1* – 16 – (2) Is expected to receive a medical treatment that may directly or indirectly cause infertility, as determined pursuant to paragraph (b) of subsection 2.

(b) A medical treatment may directly or indirectly cause infertility if the treatment has a potential side effect of impaired fertility, as established by the American Society of Clinical Oncology or the American Society for Reproductive Medicine, or their successor organizations.

(a) Require an insured to pay a higher deductible, copayment, coinsurance or other form of cost-sharing for the benefits required- by83rd subsectionSession 1(2025) than– is17 required– for similar benefits that are not related to fertility;

is required for similar benefits that (b) Require an insured to obtain prior authorization for the benefits described in subsection 1 that is not required for similar benefits that are not related to fertility;

(f) Offer or pay any type of material inducement or financial incentiveany tobenefit andescribed insuredin tosubsection discourage1;the the insured from accessing (g) Penalize a provider of health care who provides any benefit described in subsection 1;1 to an insured, including, without limitation, reducing the reimbursement of the provider of health care;

(g)or Penalize(h) aOffer provideror pay any type of healthmaterial careinducement, whobonus providesor anyother benefitfinancial describedincentive into subsectiona 1provider of health care to andeny, insured,reduce, including,withhold, withoutlimit limitation,or reducingdelay theany reimbursementbenefit ofdescribed thein providersubsection ofto healthan care;insured.

or - *SB217_R1* – 17 – (h) 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 any benefit described in subsection 1 to an insured.

An insurer that is affiliated with a religious organization is not required to provide the coverage required by subsection 1 if before the issuance of a policy of group health insurance that is subject to the requirements of subsection 1 and before the renewal of such a policy, provide to the group policyholder or prospective insured, as applicable, written notice of the coverage that the insurer objectsrefuses onto religiousprovide grounds.pursuant to this subsection.

Such an insurer shall, before the issuance of a policy of group health insurance that is subject to the requirements of subsection 1 and before the renewal of such a policy, provide to the group policyholder or prospective insured, as applicable, written notice of the coverage that the insurer refuses to provide pursuant to this subsection.

AThe policy of group health insurance with more than 50 employees or members of the insured group that is subject to the provisions of this chaptersection anddo isnot delivered,apply issuedto foran deliveryemployee orbenefit renewedplan, onas ordefined afterin January29 1,U.S.C. 2026, has the legal effect of including the coverage required by subsection 1, and any provision of the policy or the renewal that conflicts with the provisions of this section is void.

§ 1002(3), that:

(a) Meets the requirements of 29 C.F.R.

§ 2510.3-3;

and - 83rd Session (2025) – 18 – acting indirectly in the interest of an employer pursuant to 29 U.S.C.

§ 1002(5).

A policy of group health insurance that is subject to the provisions of this section and is delivered, issued for delivery or renewed on or after January 1, 2026, has the legal effect of including the coverage required by subsection 1, and any provision of the policy or the renewal that conflicts with the provisions of this section is void.

9.

(I) At least 12 months of regular, unprotected sexual intercourse or therapeutic donor insemination for a person who is less than 35(II) At least 6 months of regular, unprotected sexual intercourse or therapeutic donor insemination for a person who is years of age;age or older;

or (II) At least 6 months of regular, unprotected sexual intercourse or therapeutic donor insemination for a person who is 35 years of age or older;

- *SB217_R1* – 18 – (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 under contract with the insurer.

The term does notnotet of include an arrangement for the financing of premiums.

(d) “Standard“Small fertilityemployer” preservationhas services”:the meaning ascribed to it in NRS 689C.095.

(e) “Standard fertility preservation services”:

- 83rd Session (2025) – 19 – (I) Is not considered experimental or investigational by the American Society for Reproductive Medicine, or its successor organization, or the American Society of Clinical Oncology, or its successor organization;

and (II) Is consistent with established medical practices or professional guidelines published by the American Society forfores or Reproductive Medicine, or its successor organization, or the American Society of Clinical Oncology, or its successor organization.

4.meaning ascribed to it in NRS 629.031.ider of health care” has the Sec.

As used in this section, “provider of health care” has the meaning ascribed to it in NRS 629.031.

Sec.

An insurer that offers or issues a policy of group health insurance which provides coverage for prescription drugs or devices shall include in the policy coverage for any type of - *SB217_R1* – 19 – hormone replacement therapy which is lawfully prescribed or ordered and which has been approved by the Food and Drug Administration.

- 83rd Session (2025) – 20 – (b) Refuse to issue a policy of group health insurance or cancel a policy of group health insurance solely because the person applying for or covered by the policy uses or may use in the future hormone replacement therapy;

(c) Offer or pay any type of material inducement or financial incentive to an insured to discourage the insured from accessing hormone replacement therapy;

“Medicaid” means a program established in any state pursuantet seq.) to Titleprovide XIXassistance for part or all of the Socialcost Securityof Actmedical (42care U.S.C.rendered on behalf of indigent persons.

§§ 1396 et seq.) to provide assistance for part or all of the cost of medical care rendered on behalf of indigent persons.

- *SB217_R1* – 20 – Sec.

- 83rd Session (2025) – 21 – (a) Except as otherwise provided in paragraph (b), on the first day of the month in which a qualified provider of health care confirms that the person is pregnant;

or (b) Upon the election of the person, on the first day of the monthmon3. after the person elects to enroll in the health benefit plan.

3.aThe provisions of this section do not apply to a cafeterian.

The provisions of this section do not apply to a cafeteria plan, as defined in 26 U.S.C.

(a) Except as otherwise provided in paragraph (b), on the first day of the month in which a qualified provider of health care confirmscon(b) thatUpon the election of the person, on the first day of the month after the person iselects pregnant;to enroll in the benefit contract.

or (b) Upon the election of the person, on the first day of the month after the person elects to enroll in the benefit contract.

- *SB217_R1* – 21 – Sec.

Except as otherwise provided in subsections 55, 6 and 6,7, a hospital or medical services corporation that issues a policy of group health insurance withto moreany thanentity 50other employeesthan ora memberssmall ofemployer the insured group shall include in the policy coverage for:

(a) Any procedure or medication determined by a qualified provider of health care to be necessary for the diagnosis and treatment of infertility in accordance with established medical practice or any guidelines published by the American College of Obstetricians and Gynecologists or the American Society for Reproductive- Medicine,83rd orSession their(2025) successor– organizations.22 – coverage must include, without limitation, coverage for:

Such coverage(1) mustAt include,least withoutthree limitation,but coveragenot for:more than five completed retrievals of oocytes;

(1) At least three but not more than five completed retrievals of oocytes;

2.

For the purposes of subsection 1:

- *SB217_R1* – 22 – 4.

A hospital or medical services corporation shall not:

(c)- Require83rd aSession longer(2025) waiting– period23 for– the coverage required by subsection 1 than is required for similar benefits that are not related to fertility;

(g) Penalize a provider of health care who provides any benefit described in subsection 1 to an insured, including, without limitation, reducing the reimbursement of the provider of health care;car(h) 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 any benefit described in subsection to an insured.

or (h) 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 any benefit described in subsection 1 to an insured.

Such a hospital or medical services corporation shall, before the issuance of a policy of group health insurance that is subject to the requirements of subsection 1 and before the renewal of such a policy, provide to the group policyholder or prospective insured, as applicable, written notice of the coverage that the hospital orord, as medical services corporation refuses to provide pursuant to this subsection.

- *SB217_R1* – 23 – 7.

AThe policy of group health insurance with more than 50 employees or members of the insured group that is subject to the provisions of this chaptersection anddo isnot delivered,apply issuedto foran deliveryemployee orbenefit renewedplan, onas ordefined afterin January29 1,U.S.C. 2026, has the legal effect of including the coverage required by subsection 1, and any provision of the policy or the renewal that conflicts with the provisions of this section is void.

8.§ 1002(3), that:

(a) Meets the requirements of 29 C.F.R.

§ 2510.3-3;

and (b) Is established by a bona fide association of employers acting indirectly in the interest of an employer pursuant to 29 U.S.C.

§ 1002(5).

- 83rd Session (2025) – 24 – provisions of this section and is delivered, issued for delivery or renewed on or after January 1, 2026, has the legal effect of including the coverage required by subsection 1, and any provision of the policy or the renewal that conflicts with the provisions of this section is void.

9.

or (II) At least 6 months of regular, unprotected sexual intercourse or therapeutic donor insemination for a person who is 35yea(2) yearsThe inability of agea person or older;the partner of the person to reproduce or the inability of a person to reproduce with a particular partner;

(2) The inability of a person or the partner of the person to reproduce or the inability of a person to reproduce with a particular partner;

The term does not include an arrangementarr(c) for“Provider of health care” has the financingmeaning ofascribed premiums.to it in NRS 629.031.

(c)(d) “Provider“Small ofemployer” health care” has the meaning ascribed to it in NRS 629.031.689C.095.

(d)(e) “Standard fertility preservation services”:

(I) Is not considered experimental or investigational by the American Society for Reproductive Medicine, or its successor - 83rd Session (2025) – 25 – organization, or the American Society of Clinical Oncology, or its successor organization;

and - *SB217_R1* – 24 – (II) Is consistent with established medical practices or professional guidelines published by the American Society for Reproductive Medicine, or its successor organization, or the American Society of Clinical Oncology, or its successorsuccessorr the organization.

or (b) Upon the election of the person, on the first day of the monthmon3. after the person elects to enroll in the policy.

3.afThe provisions of this section do not apply to a cafeteria plan, as defined in 26 U.S.C.

The provisions of this section do not apply to a cafeteria plan, as defined in 26 U.S.C.

- 83rd Session (2025) – 26 – (a) Require an insured to pay a higher deductible, any copayment or coinsurance or require a longer waiting period or other condition for coverage for a prescription for hormone replacement therapy;

- *SB217_R1* – 25 – (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 in the future hormone replacement therapy;

As used in this section, “provider of health care” has the meaningmeaSec. ascribed to it in NRS 629.031.

Sec.

- 83rd Session (2025) – 27 – Sec.

Regardless of whether a person who is pregnant already has health coverage, a health maintenance organization shall, except as otherwise provided in subsection 3, allow the person to enroll in a health care plan without any additional fee or penalty within at least:

- *SB217_R1* – 26 – (a) Sixty days after the person has been confirmed to be pregnant by a qualified provider of health care, if the health care plan is offered on the individual market;

Except as otherwise provided in subsections 55, 6 and 6,7, a health maintenance organization that issues a group health care plan withto moreany thanentity 50other employeesthan ora memberssmall ofemployer theshall coveredinc(a) groupAny procedure or medication determined by a planqualified thatprovider providesof health care servicesto throughbe managednecessary carefor tothe recipientsdiagnosis and treatment of Medicaidinfertility underin accordance with established medical practice or any guidelines published by the StateAmerican PlanCollege forof MedicaidObstetricians shalland includeGynecologists inor the planAmerican coverageSociety for:for Reproductive Medicine, or their successor organizations.

(a) Any procedure or medication determined by a qualified provider of health care to be necessary for the diagnosis and treatment of infertility in accordance with established medical practice or any guidelines published by the American College of Obstetricians and Gynecologists or the American Society for Reproductive Medicine, or their successor organizations.

(b)- At83rd leastSession 5(2025) years– of28 standard– fertility preservation services that are necessary to preserve fertility because the enrollee:enrollee:vices (1) Has been diagnosed with a medical or genetic condition that may directly or indirectly cause infertility, as determined pursuant to paragraph (a) of subsection 2;

(1) Has been diagnosed with a medical or genetic condition that may directly or indirectly cause infertility, as determined pursuant to paragraph (a) of subsection 2;

- *SB217_R1* – 27 – 2.

(b) A medical treatment may directly or indirectly cause infertility if the treatment has a potential side effect of impaired fertility, as established by the American Society of Clinical Oncology or the American Society for Reproductive Medicine, or their successor organizations.

(c) Require a longer waiting period for the coverage required byrelated to fertility;is required for similar benefits that are not (d) Impose any other exclusions, limitations, restrictions or delays on the access of an enrollee to any benefit described in subsection 1 thanthat is requirednot forimposed on similar benefits that are not related to fertility;

(d) Impose any other exclusions, limitations, restrictions or delays on the access of an enrollee to any benefit described in subsection 1 that is not imposed on similar benefits that are not related to fertility;

- 83rd Session (2025) – 29 – (f) Offer or pay any type of material inducement or financial incentive to an enrollee to discourage the enrollee from accessing any benefit described in subsection 1;

(g) Penalize a provider of health care who provides any benefit described in subsection 1 to an enrollee, including, without limitation, reducing the reimbursement of the provider of health care;

or (h) Offer or pay any type of material inducement, bonus or other financial incentive to a provider of health care to deny, - *SB217_R1* – 28 – reduce, withhold, limit or delay any benefit described in subsection 1 to an enrollee.

AThe group health care plan with more than 50 employees or members of the covered group that is subject to the provisions of this chaptersection anddo isnot delivered,apply issuedto foran deliveryemployee orbenefit renewedplan, onas ordefined afterin January29 1,U.S.C. 2026, has the legal effect of including the coverage required by subsection 1, and any provision of the plan or the renewal that conflicts with the provisions of this section is void.

§ 1002(3), that:

(b) Is established by a bona fide association of employers acting indirectly in the interest of an employer pursuant to 29 U.S.C.

§ 1002(5).

A group health care plan that is subject to the provisions of this section and is delivered, issued for delivery or renewed on or after January 1, 2026, has the legal effect of including the coverage required by subsection 1, and any provision of the plan or the renewal that conflicts with the provisions of this section is void.

9.

(I)- At83rd leastSession 12(2025) months– of30 regular,– unprotected sexual intercourse or therapeutic donor insemination for a person who is less than 35 years of age;

or (II) At least 6 months of regular, unprotected sexual intercourse or therapeutic donor insemination for a person who is 35 years of age or older;

- *SB217_R1* – 29 – (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.

(d) “Standard“Small fertilityemployer” preservationhas services”:the meaning ascribed to it in NRS 689C.095.

(e) “Standard fertility preservation services”:

and (II) Is consistent with established medical practices or professional guidelines published by the American Society forfores or Reproductive Medicine, or its successor organization, or the American Society of Clinical Oncology, or its successor organization.

- 83rd Session (2025) – 31 – Sec.

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

2.

Solicitation of enrollees by a health maintenance organization granted a certificate of authority, or its representatives, must not be construed to violate any provision of law relating to solicitation or advertising by practitioners of a healing art.

3.

Any health maintenance organization authorized under this chapter shall not be deemed to be practicing medicine and is exempt from the provisions of chapter 630 of NRS.

4.

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 and sections 36 and 37 of this act do not apply to a health maintenance organization that provides health care services through managed care to recipients of Medicaid under the State Plan for Medicaid or insurance pursuant to the Children’s Health Insurance Program pursuant to a contract with the Division of Health Care Financing and Policy of the Department of Health and Human Services.

This subsection does not exempt a health maintenance organization from any provision of this chapter for ser5.

The provisions of NRS 695C.16932 to 695C.1699, inclusive, 695C.1701, 695C.1708, 695C.1728, 695C.1731, 695C.17333, 695C.17345, 695C.17347, 695C.1736 to 695C.1745, inclusive, 695C.1757 and 695C.204 apply to a health maintenance organization that provides health care services through managed care to recipients of Medicaid under the State Plan for Medicaid.

6.

The provisions of NRS 695C.17095 do not apply to a health maintenance organization that provides health care services to 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.

7.

The provisions of NRS 695C.1735 do not apply to a health maintenance organization that provides health care services to:

- 83rd Session (2025) – 32 – (a) The officers and employees, and the dependents of officers and employees, of the governing body of any county, school district, municipal corporation, political subdivision, public corporation or other local governmental agency of this State;

or  This subsection does not exempt a health maintenanceam.

organization from any provision of this chapter for services provided pursuant to any other contract.

Sec.

38.5.

NRS 695C.050 is hereby amended to read as follows:

695C.050 1.

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 and [sections 36 and] section 37 of this act do not apply to a health maintenance organization that provides health care services - *SB217_R1* – 30 – through managed care to recipients of Medicaid under the State Plan for Medicaid or insurance pursuant to the Children’s Health Insurance Program pursuant to a contract with the Division of Health Care Financing and Policy of the Department of Health and Human Services.

The provisions of NRS 695C.16932 to 695C.1699, inclusive, 695C.1701, 695C.1708, 695C.1728, 695C.1731, 695C.17333, 695C.17345, 695C.17347, 695C.1736 to 695C.1745, inclusive, 695C.1757 and 695C.204 and section 36 of this act apply to a health maintenance organization that provides health care - 83rd Session (2025) – 33 – services through managed care to recipients of Medicaid under the State Plan for Medicaid.

The provisions of NRS 695C.17095 do not apply to a health maintenance organization that provides health care services to memberssubsection does not exempt a health maintenance organization from any provision of thethis Publicchapter Employees’for Benefitsservices Program.provided pursuant to any other contract.

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

38.5.38.7.

2.organization granted a certificate of authority, or its representatives, must not be construed to violate any provision of law relating to solicitation or advertising by practitioners of a healing art.

Solicitation3. of enrollees by a health maintenance organization granted a certificate of authority, or its representatives, must not be construed to violate any provision of law relating to solicitation or advertising by practitioners of a healing art.

- *SB217_R1* – 31 – 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 [and section 37 of this act] do not apply to a health maintenance organization that provides health care services through managed care to recipients of Medicaid under the State Plan for Medicaid or insurance pursuant to the Children’s Health Insurance Program pursuant to a contract with the Division of - 83rd Session (2025) – 34 – Health Care Financing and Policy of the Department of Health and Human Services.

5.inclusive,pr695C.1701,f NRS695C.1708,2 to695C.1728,, 695C.1731, 695C.17333, 695C.17345, 695C.17347, 695C.1736 to 695C.1745, inclusive, 695C.1757 and 695C.204 and [section] sections 36 and of this act apply to a health maintenance organization that provides health care services through managed care to recipients of Medicaid under the State Plan for Medicaid.

The provisions of NRS 695C.16932 to 695C.1699, inclusive, 695C.1701, 695C.1708, 695C.1728, 695C.1731, 695C.17333, 695C.17345, 695C.17347, 695C.1736 to 695C.1745, inclusive, 695C.1757 and 695C.204 and [section] sections 36 and 37 of this act apply to a health maintenance organization that provides health care services through managed care to recipients of Medicaid under the State Plan for Medicaid.

Sec.695C.161 NRSAs used in NRS 695C.161 to 695C.169, inclusive, and section 36 of this act, unless the context otherwise requires:

39.

NRS 695C.161 is hereby amended to read as follows:

695C.161 As used in NRS 695C.161 to 695C.169, inclusive, and section 36 of this act, unless the context otherwise requires:

§§ 1396 - *SB217_R1* – 32 – et seq.) to provide assistance for part or all of the cost of medical care rendered on behalf of indigent persons.

A health maintenance organization which offers or issues a health care plan that provides coverage for prescription drugs or devices shall include in the plan coverage for any type of hormone replacement therapy which is lawfully - 83rd Session (2025) – 35 – prescribed or ordered and which has been approved by the Food and Drug Administration.

A health maintenance organization that offers or issues a health care plan that provides coverage for prescription drugs shall not:not(a) Require an enrollee to pay a higher deductible, any copayment or coinsurance or require a longer waiting period or other condition for coverage for hormone replacement therapy;

(a) Require an enrollee to pay a higher deductible, any copayment or coinsurance or require a longer waiting period or other condition for coverage for hormone replacement therapy;

The provisions of this section do not require a health maintenance organization to provide coverage for fertility drugs [.] , except as required by section 37 of this act.act.for fertility drugs [.] , 5.

5.

The Commissioner may suspend or revoke any certificate of authority issued to a health maintenance organization - *SB217_R1* – 33 – pursuant to the provisions of this chapter if the Commissioner finds that any of the following conditions exist:

(b)- The83rd healthSession maintenance(2025) organization– issues36 evidence– of coverage or uses a schedule of charges for health care services which do not comply with the requirements of NRS 695C.1691 to 695C.200, inclusive, and section 37 of this act, 695C.204 or 695C.207;

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

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

orortion -fails *SB217_R1*to –provide 34the – (k) The health maintenance organization has otherwise failed to comply substantially with the provisions of this chapter.

If the certificate of authority of a health maintenance organization is suspended, the health maintenance organization shall not, during the period of that suspension, enroll any additional - 83rd Session (2025) – 37 – groups or new individual contracts, unless those groups or persons were contracted for before the date of suspension.

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

or (b) Upon the election of the person, on the first day of the monthmon3. after the person elects to enroll in the coverage.

3.afAs used in this section, “provider of health care” has the meaning ascribed to it in NRS 629.031.

As used in this section, “provider of health care” has the meaning ascribed to it in NRS 629.031.

Chapter 695G of NRS is hereby amended by adding thereto the provisions set forth as sections 43.5, 44 and 45 of this act.

43.5.

“Small employer” has the meaning ascribed to it in NRS 689C.095.

Sec.

Except as otherwise provided in subsections 55, 6 and 6,7, a managed care organization that issues a group health care plan withto moreany thanentity 50other employeesthan or members of the insured group or a plansmall thatemployer provides health care services through managed care to recipients of Medicaid under the State Plan for Medicaid shall include in the plan coverage for:

- *SB217_R1* – 35 – (a) Any procedure or medication determined by a qualified provider of health care to be necessary for the diagnosis and treatment of infertility in accordance with established medical practice or any guidelines published by the American College of Obstetricians- and83rd GynecologistsSession or(2025) the– American38 Society– for Reproductive Medicine, or their successor organizations.

or (2) Is expected to receive a medical treatment that may directly or indirectly cause infertility, as determined pursuant to paragraphpar2.rapFor (b)the purposes of subsection 2.1:

2.

For the purposes of subsection 1:

A managed care organization shall 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 thethe4.anaA managed care organization.organization shall not:

4.

A managed care organization shall not:

- *SB217_R1* – 36 – (b) Require an insured to obtain prior authorization for the benefits described in subsection 1 that is not required for similar benefits that are not related to fertility;

- 83rd Session (2025) – 39 – (c) Require a longer waiting period for the coverage required by subsection 1 than is required for similar benefits that are not related to fertility;

(d) Impose any other exclusions, limitations, restrictions or delays on the access of an insured to any benefit described in subsection 1 that is not imposed on similar benefits that are not related to fertility;

or (h) 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 any benefit described in subsection 1 to an insured.

A managed care organization that is affiliated with a religious organization is not required to provide the coverage required by subsection 1 if the managed care organization objects on religious grounds.

AThe group health care plan with more than 50 employees or members of the insured group that is subject to the provisions of this chaptersection anddo isnot delivered,apply issuedto foran deliveryemployee orbenefit renewedplan, onas ordefined afterin January29 1,U.S.C. 2026, has the legal effect of including the coverage required by subsection 1, and any provision of the plan or the renewal that conflicts with the provisions of this section is void.

-§ *SB217_R1*1002(3), –that: 37 – 8.

(a) Meets the requirements of 29 C.F.R.

§ 2510.3-3;

and (b) Is established by a bona fide association of employers acting indirectly in the interest of an employer pursuant to 29 U.S.C.

§ 1002(5).

8.

A group health care plan that is subject to the provisions of this section and is delivered, issued for delivery or renewed on or - 83rd Session (2025) – 40 – coverage required by subsection 1, and any provision of the plan or the renewal that conflicts with the provisions of this section is void.

9.

or (II) At least 6 months of regular, unprotected sexual intercourse or therapeutic donor insemination for a person who is 35 years of age or older;

(2) The inability of a person or the partner of the person to reproduce or the inability of a person to reproduce with a particular partner;

ororlity of a person to reproduce with a (3) A finding by a qualified provider of health care that a person is infertile based on:

(c) “Provider of health care” has the meaning ascribed to it in NRSNRS(d) 629.031.“Standard fertility preservation services”:

(d) “Standard fertility preservation services”:

and (II) Is consistent with established medical practices or professional guidelines published by the American Society for - 83rd Session (2025) – 41 – Reproductive Medicine, or its successor organization, or the American Society of Clinical Oncology, or its successor organization.

(2) Includes, without limitation, sperm banking, oocyte banking,storage embryo banking, banking of reproductive tissuescells and thetissues.uctive storagetissues of reproductive cells and tissues.the Sec.

- *SB217_R1* – 38 – Sec.

As used in this section, “provider of health care” has the meaningmeaSec. ascribed to it in NRS 629.031.

45.1.bedNRS 695G.010 is hereby amended to read as follows:

695G.010 As used in this chapter, unless the context otherwise requires, the words and terms defined in NRS 695G.012 to 695G.085, inclusive, and section 43.5 of this act have the meanings ascribed to them in those sections.

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 - 83rd Session (2025) – 42 – benefit society, a hospital or medical service corporation and a health maintenance organization.

(a) The provisions of chapter 686A of NRS, including all obligations and remedies set forth therein;

andandncluding all (b) Any other applicable provision of this title.

The provisions of NRS 695G.127, 695G.1639, 695G.164, 695G.1645, 695G.167 and 695G.200 to 695G.230, inclusive, and sectionsections 44 and 45 of this act do not apply to a managed care organization that provides health care services 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.

- *SB217_R1* – 39 – 4.

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 health insurance, a carrier serving small employers, a fraternalp benefit society, a hospital or medical service corporation and a health maintenance organization.

2.

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

(a) The provisions of chapter 686A of NRS, including all obligations and remedies set forth therein;

and (b) Any other applicable provision of this title.

3.

The provisions of NRS 695G.127, 695G.1639, 695G.164, 695G.1645, 695G.167 and 695G.200 to 695G.230, inclusive, and [sections] section 44 [and 45] of this act do not apply to a managed care organization that provides health care services 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 - 83rd Session (2025) – 43 – the Division of Health Care Financing and Policy of the Department of Health and Human Services.

4.

The provisions of NRS 695C.1735 and 695G.1639 do not apply to a managed care organization that provides health care ser5.cesSubsections 3 and 4 do not exempt a managed careogram.

organization from any provision of this chapter for services provided pursuant to any other contract.

Sec.

45.65.

NRS 695G.090 is hereby amended to read as follows:

695G.090 1.

The provisions of NRS 695G.127, 695G.1639, 695G.164, 695G.1645, 695G.167 and 695G.200 to 695G.230, inclusive, [and section 4544 of this act] do not apply to a managed care organization that provides health care services 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 DivisionDivision’s of Health Care Financing and Policy of the Department of Health and Human Services.

45.7.

NRS 695G.130 is hereby amended to read as follows:

695G.130 1.

In addition to any other report which is required to be filed with the Commissioner, each managed care organization shall file with the Commissioner, with its annual filing made pursuant to NRS 686B.070 of forms and rates relating to policies of - 83rd Session (2025) – 44 – insurance for individuals and small employer groups, a report regarding its methods for reviewing the quality of health care services provided to its insureds.

The report must be submitted on a form prescribed by the Commissioner.

available for public inspection within a reasonable time after it is received by the Commissioner.

[3.

As used in this section, “small employer” has the meaning ascribed to it in NRS 689C.095.] Sec.

45.8.

Section 37 of this act is hereby amended to read as follows:

Sec.

37.

1.

Except as otherwise provided in subsections 5, 6 and 7, a health maintenance organization that issues a group health care plan to any entity other than a small employer or a plan that provides health care services through managed care to recipients of Medicaid under the State Plan for Medicaid shall include in the plan coverage for:

(a) Any procedure or medication determined by a qualified provider of health care to be necessary for the diagnosis and treatment of infertility in accordance with established medical practice or any guidelines published by the American College of Obstetricians and Gynecologists or the American Society for Reproductive Medicine, or their successor organizations.

Such coverage must include, without limitation, coverage for:

(1) At least three but not more than five completed retrie(2) At least three but not more than five transfers of embryos, including, without limitation, single-embryo transfer where appropriate, in accordance with the guidelines of the American Society for Reproductive Medicine, or its successor organization.

(b) At least 5 years of standard fertility preservation services that are necessary to preserve fertility because the enrollee:

(1) Has been diagnosed with a medical or genetic condition that may directly or indirectly cause infertility, as determined pursuant to paragraph (a) of subsection 2;

or (2) Is expected to receive a medical treatment that may directly or indirectly cause infertility, as determined pursuant to paragraph (b) of subsection 2.

2.

For the purposes of subsection 1:

- 83rd Session (2025) – 45 – indirectly cause infertility if the condition or treatment for the condition is likely to cause infertility, as established by the American Society of Clinical Oncology, the American Society for Reproductive Medicine or the American College of Obstetricians and Gynecologists, or their successor organizations.

(b) A medical treatment may directly or indirectly cause infertility if the treatment has a potential side effect of impaired fertility, as established by the American Society of Clinical Oncology or the American Society for Reproductive Medicine, or their successor organizations.

3.

A health maintenance organization shall ensure that the benefits required by subsection 1 are made available to an enrollee through a provider of health care who participates in the network plan of the health maintenance organization.

4.

A health maintenance organization shall not:

copayment, coinsurance or other form of cost-sharing for the benefits required by subsection 1 than is required for similar benefits that are not related to fertility;

(b) Require an enrollee to obtain prior authorization for the benefits described in subsection 1 that is not required for similar benefits that are not related to fertility;

(c) Require a longer waiting period for the coverage required by subsection 1 than is required for similar benefits that are not related to fertility;

(d) Impose any other exclusions, limitations, restrictions or delays on the access of an enrollee to any benefit described in subsection 1 that is not imposed on similar benefits that are not related to fertility;

(e) Refuse to issue a health care plan or cancel a health care plan solely because the person applying for or covered described in subsection 1;e in the future any benefit (f) Offer or pay any type of material inducement or financial incentive to an enrollee to discourage the enrollee from accessing any benefit described in subsection 1;

(g) Penalize a provider of health care who provides any benefit described in subsection 1 to an enrollee, including, without limitation, reducing the reimbursement of the provider of health care;

or - 83rd Session (2025) – 46 – (h) 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 any benefit described in subsection 1 to an enrollee.

provide the coverage required by subsection 1 for an enrollee whose infertility is solely caused by a voluntary sterilization procedure that has not been successfully reversed.

6.

A health maintenance organization which is affiliated with a religious organization is not required to provide the coverage required by subsection 1 if the health maintenance organization objects on religious grounds.

Such a health maintenance organization shall, before the issuance of a group health care plan that is subject to the requirements of subsection 1 and before the renewal of such a plan, provide to the group policyholder or prospective enrollee, as applicable, written notice of the coverage that the health maintenance organization refuses to provide pursuant to this subsection.

7.

The provisions of this section do not apply to an employee benefit plan, as defined in 29 U.S.C.

§ 1002(3), that:

(a) Meets the requirements of 29 C.F.R.

§ 2510.3-3;

and (b) Is established by a bona fide association of employers acting indirectly in the interest of an employer pursuant to 29 U.S.C.

§ 1002(5).

8.

A group health care plan that is subject to the provisions of this section and is delivered, issued for delivery legal effect of including the coverage required by subsectione 1, and any provision of the plan or the renewal that conflicts with the provisions of this section is void.

9.

As used in this section:

(a) “Infertility” means a condition characterized by:

(1) The inability of a person to achieve pregnancy, not including conception resulting in a miscarriage, where the person and the partner of the person or a donor have the necessary gametes to achieve pregnancy and after:

(I) At least 12 months of regular, unprotected sexual intercourse or therapeutic donor insemination for a person who is less than 35 years of age;

or (II) At least 6 months of regular, unprotected sexual intercourse or therapeutic donor insemination for a person who is 35 years of age or older;

- 83rd Session (2025) – 47 – (2) The inability of a person or the partner of the person to reproduce or the inability of a person to reproduce with a particular partner;

or (3) A finding by a qualified provider of health care that a pe(I) The medical, sexual and reproductive history or age of the person;

(II) Physical findings;

or (III) Diagnostic testing.

(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.

The term does not include an arrangement for the financing of premiums.

(c) “Provider of health care” has the meaning ascribed to it in NRS 629.031.

(d) “Small employer” has the meaning ascribed to it in NRS 689C.095.

(e) “Standard fertility preservation services”:

(1) Means a procedure or services for the preservation of fertility that:

(I) Is not considered experimental or investigational by the American Society for Reproductive Medicine, or its successor organization, or the American Society of Clinical Oncology, or its successor organization;

and (II) Is consistent with established medical practices or professional guidelines published by the American Society for Reproductive Medicine, or its successor organization, or the American Society of Clinical Oncology, or its successor organization.

(2) Includes, without limitation, sperm banking, oocyte banking, embryo banking, banking of reproductive tissues and the storage of reproductive cells and tissues.

Sec.

45.9.

Section 44 of this act is hereby amended to read as follows:

Sec.

44.

1.

Except as otherwise provided in subsections 5, 6 and 7, a managed care organization that issues a group health care plan to any entity other than a small employer or a plan that provides health care services through managed care to recipients of Medicaid under the - 83rd Session (2025) – 48 – State Plan for Medicaid shall include in the plan coverage for:

(a) Any procedure or medication determined by a qualified provider of health care to be necessary for the established medical practice or any guidelines published by the American College of Obstetricians and Gynecologists or the American Society for Reproductive Medicine, or their successor organizations.

Such coverage must include, without limitation, coverage for:

(1) At least three but not more than five completed retrievals of oocytes;

and (2) At least three but not more than five transfers of embryos, including, without limitation, single-embryo transfer where appropriate, in accordance with the guidelines of the American Society for Reproductive Medicine, or its successor organization.

(b) At least 5 years of standard fertility preservation services that are necessary to preserve fertility because the insured:

(1) Has been diagnosed with a medical or genetic condition that may directly or indirectly cause infertility, as determined pursuant to paragraph (a) of subsection 2;

or (2) Is expected to receive a medical treatment that may directly or indirectly cause infertility, as determined pursuant to paragraph (b) of subsection 2.

2.

For the purposes of subsection 1:

indirectly cause infertility if the condition or treatment for the condition is likely to cause infertility, as established by the American Society of Clinical Oncology, the American Society for Reproductive Medicine or the American College of Obstetricians and Gynecologists, or their successor organizations.

(b) A medical treatment may directly or indirectly cause infertility if the treatment has a potential side effect of impaired fertility, as established by the American Society of Clinical Oncology or the American Society for Reproductive Medicine, or their successor organizations.

3.

A managed care organization shall 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.

- 83rd Session (2025) – 49 – (a) Require an insured to pay a higher deductible, copayment, coinsurance or other form of cost-sharing for the benefits required by subsection 1 than is required for similar benefits that are not related to fertility;

(b) Require an insured to obtain prior authorization for the benefits described in subsection 1 that is not required for similar benefits that are not related to fertility;

(c) Require a longer waiting period for the coverage required by subsection 1 than is required for similar benefits that are not related to fertility;

(d) Impose any other exclusions, limitations, restrictions or delays on the access of an insured to any benefit described in subsection 1 that is not imposed on similar benefits that are not related to fertility;

(e) Refuse to issue a group health care plan or cancel a group health care plan solely because the person applying for benefit described in subsection 1;

use in the future any (f) Offer or pay any type of material inducement or financial incentive to an insured to discourage the insured from accessing any benefit described in subsection 1;

(g) Penalize a provider of health care who provides any benefit described in subsection 1 to an insured, including, without limitation, reducing the reimbursement of the provider of health care;

or (h) 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 any benefit described in subsection 1 to an insured.

5.

A managed care organization is not required to provide the coverage required by subsection 1 for an insured whose infertility is solely caused by a voluntary sterilization pro6.duA managed care organization that is affiliated with a religious organization is not required to provide the coverage required by subsection 1 if the managed care organization objects on religious grounds.

Such a managed care organization shall, before the issuance of a group health care plan that is subject to the requirements of subsection 1 and before the renewal of such a plan, provide to the group policyholder or prospective insured, as applicable, written - 83rd Session (2025) – 50 – refuses to provide pursuant to this subsection.ganization 7.

The provisions of this section do not apply to an employee benefit plan, as defined in 29 U.S.C.

§ 1002(3), that:

(a) Meets the requirements of 29 C.F.R.

§ 2510.3-3;

and (b) Is established by a bona fide association of employers acting indirectly in the interest of an employer pursuant to 29 U.S.C.

§ 1002(5).

8.

A group health care plan that is subject to the provisions of this section and is delivered, issued for delivery or renewed on or after [January] July 1, [2026,] 2027, has the legal effect of including the coverage required by subsection 1, and any provision of the plan or the renewal that conflicts with the provisions of this section is void.

9.

As used in this section:

(a) “Infertility” means a condition characterized by:

including conception resulting in a miscarriage, where thenot person and the partner of the person or a donor have the necessary gametes to achieve pregnancy and after:

(I) At least 12 months of regular, unprotected sexual intercourse or therapeutic donor insemination for a person who is less than 35 years of age;

or (II) At least 6 months of regular, unprotected sexual intercourse or therapeutic donor insemination for a person who is 35 years of age or older;

(2) The inability of a person or the partner of the person to reproduce or the inability of a person to reproduce with a particular partner;

or (3) A finding by a qualified provider of health care that a person is infertile based on:

(I) The medical, sexual and reproductive history or age of the(II) Physical findings;

or (III) Diagnostic testing.

(b) “Network plan” means a health 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.

The term does not include an arrangement for the financing of premiums.

- 83rd Session (2025) – 51 – (c) “Provider of health care” has the meaning ascribed to it in NRS 629.031.

(d) “Standard fertility preservation services”:

(1) Means a procedure or services for the preservation of fertili(I) Ist:

not considered experimental or investigational by the American Society for Reproductive Medicine, or its successor organization, or the American Society of Clinical Oncology, or its successor organization;

and (II) Is consistent with established medical practices or professional guidelines published by the American Society for Reproductive Medicine, or its successor organization, or the American Society of Clinical Oncology, or its successor organization.

(2) Includes, without limitation, sperm banking, oocyte banking, embryo banking, banking of reproductive tissues and the storage of reproductive cells and tissues.

Sec.

Sections 12, 13, 15 to 38, inclusive, 39 to 45.2, inclusive, 45.7 and 46 of this act become effective:

- *SB217_R1* – 40 – (a) Upon passage and approval for the purpose of adopting any regulations and performing any other preparatory administrativeadministrativey tasks that are necessary to carry out the provisions of this act;

Sections 11, 14, 38.5 and 45.6 of this act become effective:

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

H5. - *SB217_R1*

Sections 11, 13.5, 14, 38.7, 45.65, 45.8 and 45.9 of this act become effective:

(a) Upon passage and approval for the purpose of adopting any regulations, applying for and obtaining any waiver of federal law or any amendment of the State Plan for Medicaid that is necessary for the Department of Health and Human Services to receive federal funding to provide the coverage under Medicaid described in section - 83rd Session (2025) – 52 – of this act and performing any other preparatory administrative tasks that are necessary to carry out the provisions of this act;

and (b) On July 1, 2027, for all other purposes.

~~~~~ 25 - 83rd Session (2025)