and (2) provides a written notice to insureds or prospective insureds disclosing that the insurer to the Division of Health Care Financing and Policy of the Department of Healthion and Human Services and authorizes certain expenditures for the costs associated with providing such coverage under Medicaid pursuant to sections 9 and 15.

Section 12 of this bill makes a conforming change to require the Director of the Department of Health and Human Services to administer the provisions of section 15 in the same mannSectionmanner 10as ofother thisprovisions billrelating authorizes the Commissioner to suspendMedicaid. or revoke the certificate of a health maintenance organization that fails to provide the coverage required by section 8.

TheAssembly CommissionerAmendment isNo. also authorized to take such action against other health insurers who fail to provide the coverage required by sections 1, 3-8 and 11.

(NRS439 680A.200)to -Assembly 83rdBill SessionNo. (2025) – 2 – EXPLANATION – Matter in bolded italics is new;

matter428 betweenPage brackets4 [omitteda material]health maintenance organization that fails to provide the coverage required by section 8.e of The Commissioner is materialalso authorized to betake omitted.such action against other health insurers who fail to provide the coverage required by sections 1, 3-8 and 11.

(NRS 680A.200) THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:

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

oreror of health (b) The insured is expected to receive medical treatment for the cancer and such treatment may directly or indirectly cause infertility.

A policy of health insurance that is subject to the provisions of this chapter 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 anytany of provision of the policy or the renewal that conflicts with the provisions of this section is void.

- 83rd Session (2025) – 3 – 6.

(a) “Network plan” means a policy of 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 not include andersan arrangement for the financing of premiums.

689A.330 If any policy is issued by a domestic insurer for delivery to a person residing in another state, and if the insurance commissioner or correspondingAssembly publicAmendment officerNo. of that other state has informed the Commissioner that the policy is not subject to approval or disapproval by that officer, the Commissioner may by ruling require that the policy meet the standards set forth in NRS 689A.030 to 689A.320, inclusive [.] , and section 1 of this act.

439 to Assembly Bill No.

428 Page 5 corresponding public officer of that other state has informed the Commissioner that the policy is not subject to approval or disapproval by that officer, the Commissioner may by ruling require that the policy meet the standards set forth in NRS 689A.030 to 689A.320, inclusive [.] , and section 1 of this act.

Except as otherwise provided in subsection [4,] 3, an insurer that issues a policy of group 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 ova(a)ovarian The cancer may,and: in the judgment of a provider of health care, directly or indirectly cause infertility;

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

An[An insurer shall ensure that isthe affiliatedbenefits withrequired aby religioussubsection organization1 isare notmade requiredavailable to providean theinsured coveragethrough requireda byprovider subsectionof 1health ifcare who participates in the insurernetwork objectsplan onof religiousthe grounds.insurer.

Such4.] anAn insurer shall,that beforeis theaffiliated issuancewith of a policyreligious oforganization group health insurance that is subjectnot required to the requirements of subsection 1 and before the renewal - 83rd Session (2025) – 4 – of such a policy, provide to the groupcoverage policyholderrequired orby prospectivesubsection insured,1 asif applicable, written notice of the coverage that the insurer refusesobjects toon providereligious pursuantgrounds. 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.

[5.] 4.

A policy of group health insurance that is subject to the provisions of this chapter 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.

[6.

As used in this section:

(a) “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 not include an arrangement for the financing of premiums.

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

A policy of group health insurance that is subject to the renewed on or after January 1, 2026, has the legal effect ofvery or 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.

Sec.

4.

(a)Assembly TheAmendment cancerNo. may, in the judgment of a provider of health care, directly or indirectly cause infertility;

439 to Assembly Bill No.

428 Page 6 (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 American Society of Clinical Oncology or the American Society for Reproductive Medicine, or their successor organizations.yorganizations. 3.

3.

A health benefit plan that is subject to the provisions of this chapter and is delivered, issued for delivery or renewed on or after January 1, 2026, has the legal effect of including the - 83rd Session (2025) – 5 – coverage required by subsection 1, and any provision of the plan or the renewal that conflicts with the provisions of this section is void.

(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 beenis diagnosedmedically withnecessary breastto orpreserve ovarianfertility cancerbecause and:use the insured has (a)been Thediagnosed cancerwith may,breast in the judgment of a provider of health care, directly or indirectlyovarian causecancer infertility;and:

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

3.Assembly Amendment No.

439 to Assembly Bill No.

428 Page 7 3.

- 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:

- 83rd Session (2025) – 7 – 3.

with4. 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.

5.Assembly Amendment No.

439 to Assembly Bill No.

428 Page 8 5.

The term does not include an arr(b)arrangement “Providerfor of health care” has the meaningfinancing ascribedof topremiums. it in NRS 629.031.

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

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:

(b)Assembly “ProviderAmendment ofNo. health care” has the meaning ascribed to it in NRS 629.031.

439 to Assembly Bill No.

428 Page 9 (b) “Provider of health care” has the meaning ascribed to it in NRS 629.031.

This provision does not apply to an insurer licensed and regulated pursuant to this title - 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.

certificate695C.330 of1. 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:

(a) The healthCommissioner maintenancemay organizationsuspend isor operatingrevoke significantlyany incertificate contravention of itsauthority basicissued organizationalto document,a its health caremaintenance planorganization orpursuant in a manner contrary to thatthe describedprovisions inof andthis reasonablychapter inferredif fromthe anyCommissioner otherfinds informationthat submitted pursuant to NRS 695C.060, 695C.070 and 695C.140, unless any amendmentsof tothe thosefollowing submissionsconditions haveexist: been filed with and approved by the Commissioner;

(a) The health maintenance organization is operating significantly in contravention of its basic organizational document, its health care plan or in a manner contrary to that described in and reasonably inferred from any other information submitted pursuant to NRS 695C.060, 695C.070 and 695C.140, unless Assembly Amendment No.

439 to Assembly Bill No.

428 Page 10 any amendments to those submissions have been filed with and approved by the Commissioner;

or (2) Is unable to fulfill its obligations to furnish health care ser(e)services Theas healthrequired maintenanceunder organization is no longer financially responsible and may reasonably be expected to be unable to meet its obligationshealth tocare enrolleesplan; 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) 83rdThe Sessionhealth (2025)maintenance –organization 11or –any person on its behalf has advertised or merchandised its services in an untrue, misrepresentative, misleading, deceptive or unfair manner;

organization4. 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 guidelines published by the American Society for Reproductiveany Medicine or the American Society of Clinical Oncology, or their successor organizations, that is medically necessary to preserve fertility becauseconsistent the insured has been diagnosed with breastAssembly orAmendment ovarianNo. cancer and:

439 to Assembly Bill No.

428 Page 11 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:

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) “Network plan” means a health care plan offered by a managed care organization under which the financing andbyand 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;

andtorand 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 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 DivisionAssembly ofAmendment PublicNo. and Behavioral Health or the professional line activities of the other divisions.

439 to Assembly Bill No.

428 Page 12 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:uremust: 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, excludingrdingexcluding 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.

(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.

(c) Provide group life, accident or health coverage through a self-insurance reserve fund and, where necessary, deduct contributions to the maintenance of the fundAssembly fromAmendment theNo. compensation of officers and employees and pay the deductions into the fund.

439 to Assembly Bill No.

428 Page 13 fund from the compensation of officers and employees and pay the deductions into the fund.

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,d439.597, 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 for active officers and employees of the governing body, or the dependents of such officers and employees.

(d) Defray part or all of the cost of maintenance of a self-self-insurance insurance fund or of the premiums upon insurance.

If the amount of the deductions from compensation required to pay for the group insurance exceeds the compensation to whi3.which a trustee is entitled, the difference must be paid by the trustee.

a3. 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 con(b)contracted; 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.

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

439 to Assembly Bill No.

428 Page 14 (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,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 inf2.tilForinfertility. 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.

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.

SectionSections 15.51 to 16, inclusive, of this act becomesbecome effectiveeffective: on July 1, 2025.

3.

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

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

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