AB 428 — Requires certain health plans to include coverage for fertility preservation services. (BDR 57-915)

(a) “Network plan” means a health benefit plan offered by a carrier 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 carrier.

Except as otherwise provided in subsection 4, a society that issues a benefit contract shall include in the contract coverage for any procedure or service for the preservation of fertility consistent with established medical practice or any guidelines published by the American Society for Reproductive Medicine or the American Society of Clinical Oncology, or their successor organizations, that isbeen medicallydiagnosed necessarywith tobreast preserveor fertilityovarian becausecancer and:use the insured has been(a) diagnosedThe withcancer breastmay, in the judgment of a provider of health care, directly or ovarianindirectly cancercause and:infertility;

(a) The cancer may, in the judgment of a provider of health care, directly or indirectly cause infertility;

For the purposes of subsection 1, a medical treatment may directly or indirectly cause infertility if the treatment has a potential side effect of impaired fertility, as established by the - *AB428_R1* – 6 – American Society of Clinical Oncology or the American Society for Reproductive Medicine, or their successor organizations.

- 83rd Session (2025) – 6 – 4.

Such a society shall, before the issuance of a benefit contract that is subject to the requirements of subsection 1 and before the renewal of such a contract, provide to the insured or prospective insured, as a applicable, written notice of the coverage that the society refuses to provide pursuant to this subsection.

Except as otherwise provided in subsection 4, a hospital or medical services corporation that issues a policy of health insurance shall include in the policy coverage for any procedure or service for the preservation of fertility consistent with established medical practice or any guidelines published by the American Society for Reproductive Medicine or the American Society of Clinical Oncology, or their successor organizations, that is medically necessary to preserve fertility because the insured has been diagnosed with breast or ovarian cancer and:

For the purposes of subsection 1, a medical treatment may directly or indirectly cause infertility if the treatment has a - *AB428_R1* – 7 – 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.

- 83rd Session (2025) – 7 – 3.

4.with a religious organization is not required to provide thefiliated coverage required by subsection 1 if the hospital or medical services corporation objects on religious grounds.

A hospital or medical services corporation that is affiliated with a religious organization is not required to provide the coverage required by subsection 1 if the hospital or medical services corporation objects on religious grounds.

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

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

- *AB428_R1* – 8 – (a) The cancer may, in the judgment of a provider of health care, directly or indirectly cause infertility;

or - 83rd Session (2025) – 8 – (b) The enrollee is expected to receive medical treatment for the cancer and such treatment may directly or indirectly cause infertility.

For the purposes of subsection 1, 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.

6.

As used in this section:

This provision does not apply to an insurer licensed and regulated pursuant to this title - *AB428_R1*83rd Session (2025) – 9 – except with respect to its activities as a health maintenance organization authorized and regulated pursuant to this chapter.

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.

to 3.

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 8 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.

care to recipients of Medicaid under the 6.

- 83rd Session (2025) – 10 –  This subsection does not exempt a health maintenance organization from any provision of this chapter for services provided pursuant to any other contract.

- *AB428_R1* – 10 – Sec.

695C.330certificate 1.of authority issued to a health maintenance organization pursuant to the provisions of this chapter if the Commissioner finds that any of the following conditions exist:

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

or (2) Is unable to fulfill its obligations to furnish health care servicesser(e) asThe requiredhealth undermaintenance organization is no longer financially responsible and may reasonably be expected to be unable to meet its healthobligations careto plan;enrollees or prospective enrollees;

(e) The health maintenance organization is no longer financially responsible and may reasonably be expected to be unable to meet its obligations to enrollees or prospective enrollees;

(h)- The83rd healthSession maintenance(2025) organization– or11 any– person on its behalf has advertised or merchandised its services in an untrue, misrepresentative, misleading, deceptive or unfair manner;

- *AB428_R1* – 11 – (j) The health maintenance organization fails to provide the coverage required by NRS 695C.1691;

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

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

Except as otherwise provided in subsection 4, a managed care organization that issues a health care plan shall include in the plan coverage for any procedure or service for the preservation of fertility consistent with established medical practice or any guidelines published by the American Society for ReproductiveReproductiveany Medicine or the American Society of Clinical Oncology, or their successor organizations, that is medically necessary to preserve fertility because the insured has been diagnosed with breast or ovarian cancer and:

or - 83rd Session (2025) – 12 – (b) The insured is expected to receive medical treatment for the cancer and such treatment may directly or indirectly cause infertility.

For the purposes of subsection 1, 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 managed care organization shall ensure that the benefits required by subsection 1 are made available to an insured through - *AB428_R1* – 12 – a provider of health care who participates in the network plan of the managed care organization.

(a) “Network plan” means a health care plan offered by a managed care organization under which the financing andandby a 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.

- 83rd Session (2025) – 13 – (2) The Administrator of the Division of Welfare and Supportive Services;

(4) The Administrator of the Division of Health Care Financing and Policy;

andandtor of the Division of Health Care (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, NRS 127.220 to 127.310, inclusive, 422.001 to 422.410, inclusive, and - *AB428_R1* – 13 – section 15 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.

The Director shall revise the plan biennially and deliver a copy of the plan to the Governor and the Legislature at the beginning of each regular session.

The plan must:must:ure at the (1) Identify and assess the plans and programs of the Department for the provision of human services, and any duplication of those services by federal, state and local agencies;

(1) Identify and assess the plans and programs of the Department for the provision of human services, and any duplication of those services by federal, state and local agencies;

and (6) Contain any other information necessary for the Department to communicate effectively with the Federal - 83rd Session (2025) – 14 – Government concerning demographic trends, formulas for the distribution of federal money and any need for the modification of programs administered by the Department.

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

- *AB428_R1* – 14 – Sec.

(b) Purchase group policies of life, accident or health insurance, or any combination thereof, for the benefit of such officers and employees, and the dependents of such officers and employees, as have authorized the purchase, from insurance companies authorized to transact the business of such insurance in the State of Nevada, and, where necessary, deduct from the compensation of officers and employees the premiums upon insurance and pay the deductions upon the premiums.

Any independent administrator of a fund created - 83rd Session (2025) – 15 – under this section is subject to the licensing requirements of chapter 683A of NRS, and must be a resident of this State.

Any contract with an independent administrator must be approved by the Commissioner of Insurance as to the reasonableness of administrative charges in relation to contributions collected and benefits provided.

The provisions of NRS 439.581 to 439.597,439.597,d and inclusive, 686A.135, 687B.352, 687B.408, 687B.692, 687B.723, 687B.725, 687B.805, 689B.030 to 689B.0317, inclusive, and section 3 of this act, paragraphs (b) and (c) of subsection 1 of NRS 689B.0319, subsections 2, 4, 6 and 7 of NRS 689B.0319, 689B.033 to 689B.0369, inclusive, 689B.0375 to 689B.050, inclusive, 689B.0675, 689B.265, 689B.287 and 689B.500 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 - *AB428_R1* – 15 – 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 whichwhi3. a trustee is entitled, the difference must be paid by the trustee.

3.a In any county in which a legal services organization exists,tee.

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

- 83rd Session (2025) – 16 – (a) Shall be deemed, solely for the purposes of this section, to be officers and employees of the county, school district, municipal corporation, political subdivision, public corporation or other local governmental agency with which the legal services organization has contracted;con(b) Must be required by the contract to pay the premiums or contributions for all insurance which they elect to accept or of which they authorize the purchase.

and (b) Must be required by the contract to pay the premiums or contributions for all insurance which they elect to accept or of which they authorize the purchase.

- *AB428_R1* – 16 – 6.

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, 695G.1714 to 695G.174, inclusive, and section 11 of this act, 695G.176, 695G.177, 695G.200 to 695G.230, inclusive, 695G.241 to 695G.310, inclusive, 695G.405 and 695G.415, in the same manner as an insurer that is licensed pursuant to title 57 of NRS is required to comply with those provisions.

- 83rd Session (2025) – 17 – (a) The cancer may, in the judgment of a provider of health care, directly or indirectly cause infertility;

or (b) The recipient is expected to receive medical treatment for the cancer and such treatment may directly or indirectly cause infertility.inf2.tilFor the purposes of subsection 1, 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.

2.

For the purposes of subsection 1, 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.

(b) Fully cooperate in good faith with the Federal Government during the application process to satisfy the requirements of the -Federal *AB428_R1*Government –for 17obtaining – pursuant to paragraph (a).aining a waiver or amendment 4.pursuant to paragraph (a).

4.

15.5.

1.

There is hereby appropriated from the State General Fund to the Division of Health Care Financing and Policy of the Department of Health and Human Services for the costs of providing Medicaid coverage for procedures and services for the preservation of fertility pursuant to sections 9 and 15 of this act and computer system upgrades and vendor costs associated with providFor the Fiscal Year 2025-2026..................................$158,600 For the Fiscal Year 2026-2027....................................$69,434 2.

Expenditure of the following sums not appropriated from the State General Fund or the State Highway Fund is hereby authorized by the Division of Health Care Financing and Policy of the Department of Health and Human Services for the same purposes as set forth in subsection 1:

For the Fiscal Year 2025-2026..................................$225,800 For the Fiscal Year 2026-2027..................................$193,008 3.

Any balance of the sums appropriated by subsection 1 remaining at the end of the respective fiscal years must not be committed for expenditure after June 30 of the respective fiscal years by the entity to which the appropriation is made or any entity to which money from the appropriation is granted or otherwise transferred in any manner, and any portion of the appropriated - 83rd Session (2025) – 18 – money remaining must not be spent for any purpose after September 18, 2026, and September 17, 2027, respectively, by either the entity to which the money was appropriated or the entity to which the money was subsequently granted or transferred, and September 18, 2026, and September 17, 2027, respectively.

Sec.

SectionsSection 115.5 to 16, inclusive, of this act becomebecomes effective:effective on July 1, 2025.

3.

Sections 1 to 15, inclusive, and 16 of this act become effective:

and (b) On January 1, 2026,2027, for all other purposes.

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