AB 522 — Revises provisions relating to health care. (BDR 57-1135)

- *AB522_R1* – 7 – (d) Penalize a provider of health care who provides any such benefit to an insured, including, without limitation, reducing the reimbursement of the provider of health care;

- *AB522* – 7 – (e) Offer or pay any type of material inducement, bonus or other financial incentive to a provider of health care to deny, reduce, withhold, limit or delay access to any such benefit to an insured;

and - *AB522_R1* – 8 – (2) A calculated risk of at least 10 percent of acquiring cardiovascular disease within the next 10 years;

- *AB522* – 8 – (c) Interventions for exercise to prevent falls for insureds who are 65 years of age or older and reside in a medical facility or facility for the dependent;

(i) Screening for lung cancer using low-dose computed tomography for insureds who are at least 50 but not more than 80 years of age and:in accordance with the most recent guidelines published by the American Cancer Society or the recommendations of the United States Preventive Services Task Force in effect on January 1, 2025;

(1) Have a smoking history of 20 pack-years;

(2) Smoke or have stopped smoking within the immediately preceding 15 years;

and (3) Do not suffer from a health problem that substantially limits the life expectancy of the person or the willingness of the person to undergo curative surgery;

- *AB522**AB522_R1* – 9 – (c) Offer or pay any type of material inducement or financial incentive to an insured to discourage the insured from obtaining any such benefit;

(f) “Pack-year”“Provider means the product of thehealth numbercare” ofhas packs of cigarettes smoked per day and the numbermeaning ofascribed yearsto thatit thein personNRS has629.031. smoked.

- *AB522**AB522_R1* – 10 – (g)Sec. “Provider of health care” has the meaning ascribed to it in NRS 629.031.

Sec.

- *AB522**AB522_R1* – 11 – 2.

- *AB522**AB522_R1* – 12 – 2.

NRS(Deleted 689A.0405by isamendment.) herebySec. amended to read as follows:

689A.0405 1.

A policy of health insurance must provide coverage for benefits payable for expenses incurred for:

(a) A mammogram to screen for breast cancer annually for insureds who are 40 years of age or older.

(b) An imaging test to screen for breast cancer on an interval and at the age deemed most appropriate, when medically necessary, - *AB522* – 13 – as recommended by the insured’s provider of health care based on personal or family medical history or additional factors that may increase the risk of breast cancer for the insured.

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

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

or (2) Detected by other means of examination.

(d) Medication to prevent breast cancer for insureds who are at a high risk of developing breast cancer and have a low risk of adverse side effects from the medication.

2.

An insurer must ensure that the benefits required by subsection 1 are made available to an insured through a provider of health care who participates in the network plan of the insurer.

3.

Except as otherwise provided in subsection 5, an insurer that offers or issues a policy of health insurance shall not:

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

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

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

(d) Penalize a provider of health care who provides any such benefit to an insured, including, without limitation, reducing the reimbursement of the provider of health care;

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

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

4.

A policy subject to the provisions of this chapter which is delivered, issued for delivery or renewed on or after [January] October 1, [2024,] 2025, has the legal effect of including the coverage required by subsection 1, and any provision of the policy or the renewal which is in conflict with this section is void.

5.

Except as otherwise provided in this section and federal law, an insurer may use medical management techniques, including, without limitation, any available clinical evidence, to determine the - *AB522* – 14 – frequency of or treatment relating to any benefit required by this section or the type of provider of health care to use for such treatment.

6.

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

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

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

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

§ 223 has been satisfied.

7.

As used in this section:

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

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

(b) “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 an arrangement for the financing of premiums.

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

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

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

Sec.

- *AB522_R1* – 13 – (a) Chlamydia trachomatis, gonorrhea, hepatitis B and hepatitis C in accordance with NRS 442.013.

and - *AB522* – 15 – (b) Without prior authorization.

- *AB522_R1* – 14 – (c) “Provider of health care” has the meaning ascribed to it in NRS 629.031.

(a) Counseling, support and supplies for breastfeeding, including breastfeeding equipment, counseling and education during - *AB522* – 16 – the antenatal, perinatal and postpartum period for not more than 1 year;

[(i) Smoking] (j) Tobacco cessation programs , including, without limitation, pharmacotherapy approved by the United States Food and Drug Administration, for an insured who is 18 years of age or older consisting; of not more than two cessation attempts per year and four counseling sessions per year;

[(j)][consisting (k) All vaccinations recommended by the Advisory Committee on Immunization Practices of thenot Centersmore forthan Diseasetwo Controlcessation andattempts Preventionper ofyear the United States Department of Health and Humanfour Servicescounseling orsessions itsper successoryear; organization;

and(j)] [(k)](k) (l)All Suchvaccinations well-woman preventative visits as recommended by the HealthAdvisory ResourcesCommittee andon ServicesImmunization AdministrationPractices [,]of onthe JanuaryCenters 1,for 2025,Disease whichControl mustand includePrevention atof leastthe oneUnited suchStates visitDepartment perof yearHealth beginningand atHuman 14Services yearsor ofits age.successor organization;

and [(k)] (l) Such well-woman preventative visits as recommended by the Health Resources and Services Administration [,] on - *AB522_R1* – 15 – January 1, 2025, which must include at least one such visit per year beginning at 14 years of age.

- *AB522* – 17 – (a) Require an insured to pay a higher deductible, any copayment or coinsurance or require a longer waiting period or other condition to obtain any benefit provided in the policy of health insurance pursuant to subsection 1;

(b) “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 - *AB522_R1* – 16 – provided, in whole or in part, through a defined set of providers under contract with the insurer.

- *AB522* – 18 – Sec.

(e) Offer or pay any type of material inducement, bonus or other financial incentive to a provider of health care to deny, - *AB522_R1* – 17 – reduce, withhold, limit or delay access to any such benefit to an insured;

- *AB522* – 19 – 3.

- *AB522_R1* – 18 – [2.] 3.

or - *AB522* – 20 – (b) Stay in a hospital for a fixed period following the birth of the child.

An individual health benefit plan subject to the provisions of this chapter that is delivered, issued for delivery or renewed on - *AB522_R1* – 19 – or after October 1, 2025, has the legal effect of including the coverage required by this section, and any provision of the plan that conflicts with the provisions of this section is void.

- *AB522* – 21 – Sec.

(f) Counseling and education pertaining to the minimization of exposure to ultraviolet radiation for insureds who are less than 2524 years of age and have fair skin types and the parents or legal guardians of insureds who are less than 18 years of age and have fair skin types for the purpose of minimizing the risk of skin cancer in those persons;

and (h) At least one screening for the detection of amblyopia or the risk factors of amblyopia for insureds who are at least 3 but not more than 5 years of age;age.

and (i) Screening, tests and counseling for such other health conditions and diseases as recommended by the Health Resources and Services Administration on January 1, 2025, for insureds who are less than 18 years of age.

- *AB522* – 22 – 3.

- *AB522_R1* – 20 – (a) Require an insured to pay a higher deductible, any copayment or coinsurance or require a longer waiting period or other condition to obtain any benefit provided in the policy of group health insurance pursuant to subsection 1;

(d) PenalizeOffer aor providerpay any type of healthmaterial careinducement, whobonus providesor anyother suchfinancial benefitincentive to ana insured,provider including,of withouthealth limitation,care reducingto thedeny, reimbursementreduce, ofwithhold, thelimit provideror ofdelay healthaccess care;to any such benefit to an insured;

(e) Offer or pay(e) Impose any typeother ofrestrictions material inducement, bonus or otherdelays financialon incentivethe toaccess a provider of healthan careinsured to deny, reduce, withhold, limit or delay access to any such benefitbenefit. to an insured;

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

(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 - *AB522* – 23 – providers of health care under contract with the insurer.

- *AB522_R1* – 21 – (a) A daily dose of 0.4 to 0.8 milligrams of folic acid for insureds who are pregnant or are planning on becoming pregnant;

(d) ScreeningCounseling forand asymptomaticbehavioral bacteriuriainterventions relating to the promotion of healthy weight gain and the prevention of excessive weight gain for insureds who are pregnant;

(e) Counseling andfor behavioralinsureds interventionswho relatingare topregnant or in the promotionpostpartum stage of healthypregnancy weightand gainhave andan theincreased preventionrisk of excessiveperinatal weightor gainpostpartum fordepression; insureds who are pregnant;

(f) CounselingScreening for insuredsthe whopresence areof pregnantthe orrhesus D antigen and antibodies in the postpartumblood stage of pregnancyan andinsured havewho anis increasedpregnant riskduring ofthe perinatalinsured’s orfirst postpartumvisit depression;for care relating to the pregnancy;

(g) Screening for the presence of the rhesus D antigenantibodies andbetween antibodies24 inand the28 bloodweeks of angestation insuredfor insureds who isare pregnantnegative duringfor the insured’srhesus firstD visitantigen forand carehave relatingnot been exposed to blood that is positive for the pregnancy;rhesus D antigen;

(h) ScreeningBehavioral forcounseling rhesus D antibodies between 24 and 28intervention weeksfor oftobacco gestationcessation for insureds who are negativepregnant; for the rhesus D antigen and have not been exposed to blood that is positive for the rhesus D antigen;

(i) BehavioralScreening counselingfor type 2 diabetes at such intervals as recommended by the Health Resources and interventionServices forAdministration tobaccoon cessationJanuary 1, 2025, for insureds who are pregnant;in the postpartum stage of pregnancy and who have a history of gestational diabetes mellitus;

(j) AnCounseling annualrelating screeningto formaintaining urinarya incontinencehealthy weight for women;women who are at least 40 but not more than 60 years of age and have a body mass index greater than 18.5;

and (k) Screening for typeosteoporosis 2 diabetes at such intervals as recommended by the Health Resources and Services Administration on January 1, 2025, for insuredswomen whowho: are in the postpartum stage of pregnancy and who have a history of gestational diabetes mellitus;

(l) Counseling relating to maintaining a healthy weight for women who are at least 40 but not more than 60 years of age and have a body mass index greater than 18.5;

and (m) Screening for osteoporosis for women who:

- *AB522* – 24 – 2.

- *AB522_R1* – 22 – (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 any such benefit;

(d) PenalizeOffer aor providerpay any type of healthmaterial careinducement, whobonus providesor anyother suchfinancial benefitincentive to ana insured,provider including,of withouthealth limitation,care reducingto thedeny, reimbursementreduce, ofwithhold, thelimit provideror ofdelay healthaccess care;to any such benefit to an insured;

(e) Offer or pay(e) Impose any typeother ofrestrictions material inducement, bonus or otherdelays financialon incentivethe toaccess a provider of healthan careinsured to deny, reduce, withhold, limit or delay access to any such benefitbenefit. to an insured;

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

(b) “Network plan” means a policy of group health insurance offered by an insurer under which the financing and delivery of - *AB522* – 25 – medical care, including items and services paid for as medical care, are provided, in whole or in part, through a defined set of providers of health care under contract with the insurer.

- *AB522_R1* – 23 – (b) Statin preventive medication for insureds who are at least 40 but not more than 75 years of age and do not have a history of cardiovascular disease, but who have:

(i) Screening for lung cancer using low-dose computed tomography for insureds who are at least 50 but not more than 80 years of age and:in accordance with the most recent guidelines published by the American Cancer Society or the recommendations of the United States Preventive Services Task Force in effect on January 1, 2025;

(1) Have a smoking history of 20 pack-years;

(2) Smoke or have stopped smoking within the immediately preceding 15 years;

and (3) Do not suffer from a health problem that substantially limits the life expectancy of the person or the willingness of the person to undergo curative surgery;

and - *AB522* – 26 – (k) Intensive behavioral interventions with multiple components for insureds who are 18 years of age or older and have a body mass index of 30 or greater.

(b) Refuse to issue a policy of group health insurance or cancel a policy of group health insurance solely because the - *AB522_R1* – 24 – person applying for or covered by the policy uses or may use any such benefit;

(d) PenalizeOffer aor providerpay any type of healthmaterial careinducement, whobonus providesor anyother suchfinancial benefitincentive to ana insured,provider including,of withouthealth limitation,care reducingto thedeny, reimbursementreduce, ofwithhold, thelimit provideror ofdelay healthaccess care;to any such benefit to an insured;

(e) Offer or pay(e) Impose any typeother ofrestrictions material inducement, bonus or otherdelays financialon incentivethe toaccess a provider of healthan careinsured to deny, reduce, withhold, limit or delay access to any such benefitbenefit. to an insured;

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

- *AB522* – 27 – (b) “Facility for the dependent” has the meaning ascribed to it in NRS 449.0045.

(f) “Pack-year”“Provider means the product of thehealth numbercare” ofhas packs of cigarettes smoked per day and the numbermeaning ofascribed yearsto thatit thein personNRS has629.031. smoked.

(g)- “Provider*AB522_R1* of– health25 care”– hasSec. the meaning ascribed to it in NRS 629.031.

Sec.

-(d) *AB522*Offer –or 28pay –any (d)type Penalizeof amaterial providerinducement, ofbonus healthor careother whofinancial providesincentive anyto sucha benefitprovider of health care to andeny, insured,reduce, including,withhold, withoutlimit limitation,or reducingdelay theaccess reimbursementto ofany thesuch providerbenefit ofto healthan care;insured;

(e) Offer or pay(e) Impose any typeother ofrestrictions material inducement, bonus or otherdelays financialon incentivethe toaccess a provider of healthan careinsured to deny, reduce, withhold, limit or delay access to any such benefitbenefit. to an insured;

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

- *AB522_R1* – 26 – Sec.

(b) Refuse to issue a policy of group health insurance or cancel a policy of group health insurance solely because the - *AB522* – 29 – person applying for or covered by the policy uses or may use any such benefit;

(d) PenalizeOffer aor providerpay any type of healthmaterial careinducement, whobonus providesor anyother suchfinancial benefitincentive to ana insured,provider including,of withouthealth limitation,care reducingto thedeny, reimbursementreduce, ofwithhold, thelimit provideror ofdelay healthaccess care;to any such benefit to an insured;

(e) Offer or pay(e) Impose any typeother ofrestrictions material inducement, bonus or otherdelays financialon incentivethe toaccess a provider of healthan careinsured to deny, reduce, withhold, limit or delay access to any such benefitbenefit. to an insured;

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

(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 - *AB522_R1* – 27 – under contract with the insurer.

- *AB522* – 30 – (a) Require an insured to pay a higher deductible, any copayment or coinsurance or require a longer waiting period or other condition to obtain any benefit provided in the policy of group health insurance pursuant to subsection 1;

(d) PenalizeOffer aor providerpay any type of healthmaterial careinducement, whobonus providesor anyother suchfinancial benefitincentive to ana insured,provider including,of withouthealth limitation,care reducingto thedeny, reimbursementreduce, ofwithhold, thelimit provideror ofdelay healthaccess care;to any such benefit to an insured;

(e) Offer or pay(e) Impose any typeother ofrestrictions material inducement, bonus or otherdelays financialon incentivethe toaccess a provider of healthan careinsured to deny, reduce, withhold, limit or delay access to any such benefitbenefit. to an insured;

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

- *AB522_R1* – 28 – Sec.

- *AB522* – 31 – (a) Require an insured to pay a higher deductible, any copayment or coinsurance or require a longer waiting period or other condition to obtain any benefit provided in the policy of group health insurance pursuant to subsection 1;

(d) PenalizeOffer aor providerpay any type of healthmaterial careinducement, whobonus providesor anyother suchfinancial benefitincentive to ana insured,provider including,of withouthealth limitation,care reducingto thedeny, reimbursementreduce, ofwithhold, thelimit provideror ofdelay healthaccess care;to any such benefit to an insured;

(e) Offer or pay(e) Impose any typeother ofrestrictions material inducement, bonus or otherdelays financialon incentivethe toaccess a provider of healthan careinsured to deny, reduce, withhold, limit or delay access to any such benefitbenefit. to an insured;

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

(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 - *AB522_R1* – 29 – providers of health care under contract with the insurer.

NRS(Deleted 689B.0374by isamendment.) herebySec. amended to read as follows:

689B.0374 1.

A policy of group health insurance must provide coverage for benefits payable for expenses incurred for:

(a) A mammogram to screen for breast cancer annually for insureds who are 40 years of age or older.

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

- *AB522* – 32 – (c) A diagnostic imaging test for breast cancer at the age deemed most appropriate, when medically necessary, as recommended by the insured’s provider of health care to evaluate an abnormality which is:

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

or (2) Detected by other means of examination.

(d) Medication to prevent breast cancer for insureds who are at a high risk of developing breast cancer and have a low risk of adverse side effects from the medication.

2.

An insurer must ensure that the benefits required by subsection 1 are made available to an insured through a provider of health care who participates in the network plan of the insurer.

3.

Except as otherwise provided in subsection 5, an insurer that offers or issues a policy of group health insurance shall not:

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

(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 any such benefit;

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

(d) Penalize a provider of health care who provides any such benefit to an insured, including, without limitation, reducing the reimbursement of the provider of health care;

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

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

4.

A policy subject to the provisions of this chapter which is delivered, issued for delivery or renewed on or after [January] October 1, [2024,] 2025, has the legal effect of including the coverage required by subsection 1, and any provision of the policy or the renewal which is in conflict with this section is void.

5.

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

- *AB522* – 33 – 6.

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

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

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

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

§ 223 has been satisfied.

7.

As used in this section:

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

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

(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 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) “Qualified policy of group health insurance” means a policy of group health insurance that has a high deductible and is in compliance with 26 U.S.C.

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

Sec.

NRS(Deleted 689B.03766by isamendment.) herebySec. amended to read as follows:

689B.03766 1.

An insurer that offers or issues a policy of group health insurance [that includes coverage for maternity care] shall not deny, limit or seek reimbursement for maternity care because the insured is acting as a gestational carrier.

2.

If an insured acts as a gestational carrier, the child shall be deemed to be a child of the intended parent, as defined in NRS 126.590, for purposes related to the policy of group health insurance.

3.

As used in this section, “gestational carrier” has the meaning ascribed to it in NRS 126.580.

Sec.

- *AB522* – 34 – (a) Counseling, support and supplies for breastfeeding, including breastfeeding equipment, counseling and education during the antenatal, perinatal and postpartum period for not more than 1 year;

[(i) Smoking] (j) Tobacco cessation programs , including, without limitation, pharmacotherapy approved by the United States Food and Drug Administration, for an insured who is 18 years of age or older consisting; of not more than two cessation attempts per year and four counseling sessions per year;

[(j)][consisting (k) All vaccinations recommended by the Advisory Committee on Immunization Practices of thenot Centersmore forthan Diseasetwo Controlcessation andattempts Preventionper ofyear the United States Department of Health and Humanfour Servicescounseling orsessions itsper successoryear; organization;

(j)] (k) All vaccinations recommended by the Advisory Committee on Immunization Practices of the Centers for Disease - *AB522_R1* – 30 – Control and Prevention of the United States Department of Health and Human Services or its successor organization;

- *AB522* – 35 – 3.

(d) Penalize[Penalize a provider of health care who provides any such benefit to an insured, including, without limitation, reducing the reimbursement of the provider of health care;

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

or (f)[(f)] (e) Impose any other restrictions or delays on the access of an insured to any such benefit.

The term includes, without limitation, the use - *AB522_R1* – 31 – of step therapy, prior authorization or categorizing drugs and devices based on cost, type or method of administration.

- *AB522* – 36 – Sec.

- *AB522_R1* – 32 – Sec.

- *AB522* – 37 – (a) Less than 48 hours after a normal vaginal delivery;

(c) Penalize,[Penalize, or otherwise reduce or limit, the reimbursement of an attending provider of health care because the attending provider of health care provided care to a pregnant or postpartum individual or newborn infant in accordance with the provisions of this section;

(d)- *AB522_R1* – 33 – (d)] Provide incentives of any kind to an attending physician to induce the attending physician to provide care to a pregnant or postpartum individual or newborn infant in a manner that is inconsistent with the provisions of this section;

or (e)[(e)] (d) Except as otherwise provided in subsection [4,] 5, restrict benefits for any portion of a hospital stay required pursuant to the provisions of this section in a manner that is less favorable than the benefits provided for any preceding portion of that stay.

(a) Prohibits a group health plan or carrier from imposing a deductible, coinsurance or other mechanism for sharing costs relating to benefits for hospital stays in connection with childbirth - *AB522* – 38 – for a pregnant or postpartum individual or newborn child covered by the plan, except that such coinsurance or other mechanism for sharing costs for any portion of a hospital stay required by this section may not be greater than the coinsurance or other mechanism for any preceding portion of that stay.

- *AB522_R1* – 34 – (b) Assessments relating to height, weight, body mass index and medical history for insureds who are less than 18 years of age;

- *AB522* – 39 – (f) Counseling and education pertaining to the minimization of exposure to ultraviolet radiation for insureds who are less than 25 years of age and have fair skin types and the parents or legal guardians of insureds who are less than 18 years of age and have fair skin types for the purpose of minimizing the risk of skin cancer in those persons;

and (h) At least one screening for the detection of amblyopia or the risk factors of amblyopia for insureds who are at least 3 but not more than 5 years of age;age.

and (i) Screening, tests and counseling for such other health conditions and diseases as recommended by the Health Resources and Services Administration on January 1, 2025, for insureds who are less than 18 years of age.

or - *AB522_R1* – 35 – (f) Impose any other restrictions or delays on the access of an insured to any such benefit.

- *AB522* – 40 – 5.

(h) Screening for rhesus D antibodies between 24 and 28 weeks of gestation for insureds who are negative for the rhesus D - *AB522_R1* – 36 – antigen and have not been exposed to blood that is positive for the rhesus D antigen;

(j) AnScreening annualfor screeningtype for2 urinarydiabetes incontinenceat such intervals as recommended by the Health Resources and Services Administration on January 1, 2025, for women;insureds who are in the postpartum stage of pregnancy and who have a history of gestational diabetes mellitus;

(k) ScreeningCounseling forrelating typeto 2maintaining diabetesa athealthy suchweight intervals as recommended by the Health Resources and Services Administration on January 1, 2025, for insuredswomen who are inat theleast -40 *AB522*but –not 41more –than postpartum60 stageyears of pregnancyage and who have a historybody ofmass gestationalindex diabetesgreater mellitus;than 18.5;

and (l) CounselingScreening relatingfor toosteoporosis maintaining a healthy weight for women whowho: are at least 40 but not more than 60 years of age and have a body mass index greater than 18.5;

and (m) Screening for osteoporosis for women who:

A health benefit plan subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after October 1, 2025, has the legal effect of including the coverage - *AB522_R1* – 37 – required by subsection 1, and any provision of the plan or the renewal which is in conflict with this section is void.

- *AB522* – 42 – 6.

(i) Screening for lung cancer using low-dose computed tomography for insureds who are at least 50 but not more than 80 years of age and:in accordance with the most recent guidelines - *AB522_R1* – 38 – published by the American Cancer Society or the recommendations of the United States Preventive Services Task Force in effect on January 1, 2025;

(1)(j) HaveScreening for prediabetes and type 2 diabetes in insureds who are at least 35 but not more than 70 years of age and have a smokingbody historymass index of 2025 pack-years;or greater;

(2) Smoke or have stopped smoking within the immediately preceding 15 years;

and (3) Do not suffer from a health problem that substantially limits the life expectancy of the person or the willingness of the person to undergo curative surgery;

- *AB522* – 43 – (j) Screening for prediabetes and type 2 diabetes in insureds who are at least 35 but not more than 70 years of age and have a body mass index of 25 or greater;

Except as otherwise provided in this section and federal law, a carrier may use medical management techniques, including, without limitation, any available clinical evidence, to determine the frequency of or treatment relating to any benefit - *AB522_R1* – 39 – required by this section or the type of provider of health care to use for such treatment.

- *AB522* – 44 – (a) “Computed tomography” means the process of producing sectional and three-dimensional images using external ionizing radiation.

(e) “Pack-year”“Provider means the product of thehealth numbercare” ofhas packs of cigarettes smoked per day and the numbermeaning ofascribed yearsto thatit thein personNRS has629.031. smoked.

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

(e) Offer or pay any type of material inducement, bonus or other financial incentive to a provider of health care to deny, - *AB522**AB522_R1* – 4540 – reduce, withhold, limit or delay access to any such benefit to an insured;

- *AB522**AB522_R1* – 4641 – 3.

- *AB522* – 47 – Sec.

38.

NRS 689C.1674 is hereby amended to read as follows:

689C.1674 1.

A health benefit plan must provide coverage for benefits payable for expenses incurred for:

(a) A mammogram to screen for breast cancer annually for insureds who are 40 years of age or older.

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

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

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

or (2) Detected by other means of examination.

(d) Medication to prevent breast cancer for insureds who are at a high risk of developing breast cancer and have a low risk of adverse side effects from the medication.

2.

A carrier must ensure that the benefits required by subsection 1 are made available to an insured through a provider of health care who participates in the network plan of the carrier.

3.

Except as otherwise provided in subsection 5, a carrier that offers or issues a health benefit plan shall not:

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

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

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

(d) Penalize a provider of health care who provides any such benefit to an insured, including, without limitation, reducing the reimbursement of the provider of health care;

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

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

- *AB522* – 48 – 4.

A plan subject to the provisions of this chapter which is delivered, issued for delivery or renewed on or after [January] October 1, [2024,] 2025, has the legal effect of including the coverage required by subsection 1, and any provision of the plan or the renewal which is in conflict with this section is void.

5.

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

6.

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

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

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

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

§ 223 has been satisfied.

7.

As used in this section:

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

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

(b) “Network plan” means a health benefit plan offered by a carrier under which the financing and delivery of medical care, including 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.

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

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

38.

(Deleted by amendment.) - *AB522_R1* – 42 – Sec.

- *AB522* – 49 – (a) Chlamydia trachomatis, gonorrhea, hepatitis B and hepatitis C in accordance with NRS 442.013.

- *AB522_R1* – 43 – Sec.

(a) Counseling, support and supplies for breastfeeding, including breastfeeding equipment, counseling and education during - *AB522* – 50 – the antenatal, perinatal and postpartum period for not more than 1 year;

[(j) Smoking] (k) Tobacco cessation programs , including, without limitation, pharmacotherapy approved by the United States Food and Drug Administration, for an insured who is 18 years of age or older consisting; of not more than two cessation attempts per year and four counseling sessions per year;

[(k)][consisting (l) All vaccinations recommended by the Advisory Committee on Immunization Practices of thenot Centersmore forthan Diseasetwo Controlcessation andattempts Preventionper ofyear the United States Department of Health and Humanfour Servicescounseling orsessions itsper successoryear; organization;

and(k)] [(l)](l) (m)All Suchvaccinations well-woman preventative visits as recommended by the HealthAdvisory ResourcesCommittee andon ServicesImmunization AdministrationPractices [,]of onthe JanuaryCenters 1,for 2025,Disease whichControl mustand includePrevention atof leastthe oneUnited suchStates visitDepartment perof yearHealth beginningand atHuman 14Services yearsor ofits age.successor organization;

and [(l)] (m) Such well-woman preventative visits as recommended by the Health Resources and Services Administration [,] on - *AB522_R1* – 44 – January 1, 2025, which must include at least one such visit per year beginning at 14 years of age.

- *AB522* – 51 – (a) Require an insured to pay a higher deductible, any copayment or coinsurance or require a longer waiting period or other condition to obtain any benefit provided in the health benefit plan pursuant to subsection 1;

(b) “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, - *AB522_R1* – 45 – in whole or in part, through a defined set of providers under contract with the carrier.

- *AB522* – 52 – Sec.

(c) Penalize, or otherwise reduce or limit, the reimbursement of an attending provider of health care because the attending provider - *AB522_R1* – 46 – of health care provided care to a pregnant or postpartum individual or newborn infant in accordance with the provisions of this section;

(d) Provide incentives of any kind to an attending physician to induce the attending physician to provide care to a pregnant or - *AB522* – 53 – postpartum individual or newborn infant in a manner that is inconsistent with the provisions of this section;

- *AB522_R1* – 47 – Sec.

A carrier that issues a health benefit plan shall not discriminate against any person with respect to participation or - *AB522* – 54 – coverage under the plan on the basis of an actual or perceived [gender identity or expression.] protected characteristic.

A society that offers or issues a benefit contract which provides coverage for dependent children shall continue to - *AB522_R1* – 48 – make such coverage available for an adult child of an insured until such child reaches 26 years of age.

- *AB522* – 55 – Sec.

(f) Counseling and education pertaining to the minimization of exposure to ultraviolet radiation for insureds who are less than 25 years of age and have fair skin types and the parents or legal guardians of insureds who are less than 18 years of age and have fair skin types for the purpose of minimizing the risk of skin cancer in those persons;

and (h) At least one screening for the detection of amblyopia or the risk factors of amblyopia for insureds who are at least 3 but not more than 5 years of age;age.

and (i) Screening, tests and counseling for such other health conditions and diseases as recommended by the Health Resources and Services Administration on January 1, 2025, for insureds who are less than 18 years of age.

- *AB522**AB522_R1* – 5649 – (c) Offer or pay any type of material inducement or financial incentive to an insured to discourage the insured from obtaining any such benefit;

- *AB522**AB522_R1* – 5750 – (c) Prophylactic ocular tubal medication for the prevention of gonococcal ophthalmia in newborns;

(j) AnScreening annualfor screeningtype for2 urinarydiabetes incontinenceat such intervals as recommended by the Health Resources and Services Administration on January 1, 2025, for women;insureds who are in the postpartum stage of pregnancy and who have a history of gestational diabetes mellitus;

(k) ScreeningCounseling forrelating typeto 2maintaining diabetesa athealthy suchweight intervalsfor aswomen recommendedwho byare theat Healthleast Resources40 andbut Servicesnot Administrationmore onthan January60 1,years 2025, for insureds who are in the postpartum stage of pregnancyage and who have a historybody ofmass gestationalindex diabetesgreater mellitus;than 18.5;

and (l) CounselingScreening relatingfor toosteoporosis maintaining a healthy weight for women whowho: are at least 40 but not more than 60 years of age and have a body mass index greater than 18.5;

and (m) Screening for osteoporosis for women who:

- *AB522**AB522_R1* – 5851 – (c) Offer or pay any type of material inducement or financial incentive to an insured to discourage the insured from obtaining any such benefit;

- *AB522**AB522_R1* – 5952 – (1) One or more risk factors for cardiovascular disease;

(i) Screening for lung cancer using low-dose computed tomography for insureds who are at least 50 but not more than 80 years of age and:in accordance with the most recent guidelines published by the American Cancer Society or the recommendations of the United States Preventive Services Task Force in effect on January 1, 2025;

(1) Have a smoking history of 20 pack-years;

(2) Smoke or have stopped smoking within the immediately preceding 15 years;

and (3) Do not suffer from a health problem that substantially limits the life expectancy of the person or the willingness of the person to undergo curative surgery;

- *AB522* – 60 – (c) Offer or pay any type of material inducement or financial incentive to an insured to discourage the insured from obtaining any such benefit;

- *AB522_R1* – 53 – (d) Penalize a provider of health care who provides any such benefit to an insured, including, without limitation, reducing the reimbursement of the provider of health care;

(f) “Pack-year”“Provider means the product of thehealth numbercare” ofhas packs of cigarettes smoked per day and the numbermeaning ofascribed yearsto thatit thein personNRS has629.031. smoked.

- *AB522* – 61 – (g) “Provider of health care” has the meaning ascribed to it in NRS 629.031.

or - *AB522_R1* – 54 – (b) Other guidelines or reports concerning colorectal cancer screening which are published by nationally recognized professional organizations and which include current or prevailing supporting scientific data.

- *AB522* – 62 – (b) “Provider of health care” has the meaning ascribed to it in NRS 629.031.

- *AB522_R1* – 55 – 2.

(d) Provide incentives of any kind to an attending physician to induce the attending physician to provide care to a pregnant or - *AB522* – 63 – postpartum individual or newborn infant in a manner that is inconsistent with the provisions of this section;

- *AB522_R1* – 56 – (a) Prohibits a society from imposing a deductible, coinsurance or other mechanism for sharing costs relating to benefits for hospital stays in connection with childbirth for a pregnant or postpartum individual or newborn child covered by the benefit contract, except that such coinsurance or other mechanism for sharing costs for any portion of a hospital stay required by this section may not be greater than the coinsurance or other mechanism for any preceding portion of that stay.

- *AB522* – 64 – (b) Refuse to issue a benefit contract or cancel a benefit contract solely because the person applying for or covered by the benefit contract uses or may use any such benefit;

- *AB522_R1* – 57 – (d) Penalize a provider of health care who provides any such benefit to an insured, including, without limitation, reducing the reimbursement of the provider of health care;

- *AB522* – 65 – (d) Penalize a provider of health care who provides any such benefit to an insured, including, without limitation, reducing the reimbursement of the provider of health care;

or - *AB522_R1* – 58 – (f) Impose any other restrictions or delays on the access of an insured to any such benefit.

NRS(Deleted 695A.1855by isamendment.) herebySec. amended to read as follows:

695A.1855 1.

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

(a) A mammogram to screen for breast cancer annually for insureds who are 40 years of age or older.

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

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

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

or (2) Detected by other means of examination.

(d) Medication to prevent breast cancer for insureds who are at a high risk of developing breast cancer and have a low risk of adverse side effects from the medication.

- *AB522* – 66 – 2.

A society must ensure that the benefits required by subsection 1 are made available to an insured through a provider of health care who participates in the network plan of the society.

3.

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

(a) Except as otherwise provided in subsection 6, require an insured to pay a deductible, copayment, coinsurance or any other form of cost-sharing or require a longer waiting period or other condition for coverage to obtain any benefit provided in a benefit contract pursuant to subsection 1;

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

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

(d) Penalize a provider of health care who provides any such benefit to an insured, including, without limitation, reducing the reimbursement of the provider of health care;

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

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

4.

A benefit contract subject to the provisions of this chapter which is delivered, issued for delivery or renewed on or after [January] October 1, [2024,] 2025, has the legal effect of including the coverage required by subsection 1, and any provision of the benefit contract or the renewal which is in conflict with this section is void.

5.

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

6.

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

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

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

§ 223(c)(2)(C), in which case the prohibitions of paragraph (a) of subsection 3 shall apply regardless - *AB522* – 67 – of whether the minimum deductible under 26 U.S.C.

§ 223 has been satisfied.

7.

As used in this section:

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

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

(b) “Network plan” means a benefit contract offered by a society under which the financing and delivery of medical care, including items and services paid for as medical care, are provided, in whole or in part, through a defined set of providers under contract with the society.

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

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

Sec.

- *AB522* – 68 – (d) Penalize a provider of health care who provides any such benefit to an insured, including, without limitation, reducing the reimbursement of the provider of health care;

- *AB522_R1* – 59 – (e) Offer or pay any type of material inducement, bonus or other financial incentive to a provider of health care to deny, reduce, withhold, limit or delay access to any such benefit to an insured;

- *AB522* – 69 – (b) Screening and counseling for interpersonal and domestic violence for women at least annually with initial intervention services consisting of education, strategies to reduce harm, supportive services or a referral for any other appropriate services;

- *AB522_R1* – 60 – (c) Behavioral counseling concerning sexually transmitted diseases from a provider of health care for sexually active [women] insureds who are at increased risk for such diseases;

[(j) Smoking] (k) Tobacco cessation programs , including, without limitation, pharmacotherapy approved by the United States Food and Drug Administration, for an insured who is 18 years of age or older consisting; of not more than two cessation attempts per year and four counseling sessions per year;

[(k)][consisting (l) All vaccinations recommended by the Advisory Committee on Immunization Practices of thenot Centersmore forthan Diseasetwo Controlcessation andattempts Preventionper ofyear the United States Department of Health and Humanfour Servicescounseling orsessions itsper successoryear; organization;

(k)] (l) All vaccinations recommended by the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention of the United States Department of Health and Human Services or its successor organization;

(a) Require an insured to pay a higher deductible, any copayment or coinsurance or require a longer waiting period or - *AB522* – 70 – other condition to obtain any benefit provided in the benefit contract pursuant to subsection 1;

- *AB522_R1* – 61 – (b) Refuse to issue a benefit contract or cancel a benefit contract solely because the person applying for or covered by the contract uses or may use any such benefit;

A society that issues a benefit contract shall not discriminate against any person with respect to participation or - *AB522* – 71 – coverage under the contract on the basis of an actual or perceived [gender identity or expression.] protected characteristic.

- *AB522_R1* – 62 – [1.] (a) Denying, cancelling, limiting or refusing to issue or renew a benefit contract on the basis of [the] an actual or perceived [gender identity or expression] protected characteristic of a person or a family member of the person;

- *AB522* – 72 – (b) Assessments relating to height, weight, body mass index and medical history for insureds who are less than 18 years of age;

- *AB522_R1* – 63 – (c) Comprehensive and intensive behavioral interventions for insureds who are at least 12 but not more than 18 years of age and have a body mass index in the 95th percentile or greater for persons of the same age and sex;

(f) Counseling and education pertaining to the minimization of exposure to ultraviolet radiation for insureds who are less than 25 years of age and have fair skin types and the parents or legal guardians of insureds who are less than 18 years of age and have fair skin types for the purpose of minimizing the risk of skin cancer in those persons;

and (h) At least one screening for the detection of amblyopia or the risk factors of amblyopia for insureds who are at least 3 but not more than 5 years of age;age.

and (i) Screening, tests and counseling for such other health conditions and diseases as recommended by the Health Resources and Services Administration on January 1, 2025, for insureds who are less than 18 years of age.

- *AB522* – 73 – (d) Penalize a provider of health care who provides any such benefit to an insured, including, without limitation, reducing the reimbursement of the provider of health care;

- *AB522_R1* – 64 – 4.

- *AB522* – 74 – (c) Prophylactic ocular tubal medication for the prevention of gonococcal ophthalmia in newborns;

- *AB522_R1* – 65 – (g) Screening for the presence of the rhesus D antigen and antibodies in the blood of an insured who is pregnant during the insured’s first visit for care relating to the pregnancy;

(j) AnScreening annualfor screeningtype for2 urinarydiabetes incontinenceat such intervals as recommended by the Health Resources and Services Administration on January 1, 2025, for women;insureds who are in the postpartum stage of pregnancy and who have a history of gestational diabetes mellitus;

(k) ScreeningCounseling forrelating typeto 2maintaining diabetesa athealthy suchweight intervals as recommended by the Health Resources and Services Administration on January 1, 2025, for insuredswomen who are in40 thebut postpartumnot stagemore than 60 years of pregnancyage and who have a historybody ofmass gestationalindex diabetesgreater mellitus;than 18.5;

and (l) CounselingScreening relatingfor toosteoporosis maintaining a healthy weight for women whowho: are 40 but not more than 60 years of age and have a body mass index greater than 18.5;

and (m) Screening for osteoporosis for women who:

- *AB522* – 75 – (b) Refuse to issue a policy of health insurance or cancel a policy of health insurance solely because the person applying for or covered by the policy uses or may use any such benefit;

(e) Offer or pay any type of material inducement, bonus or other financial incentive to a provider of health care to deny, - *AB522_R1* – 66 – reduce, withhold, limit or delay access to any such benefit to an insured;

- *AB522* – 76 – (a) Behavioral counseling and interventions to promote physical activity and a healthy diet for insureds with cardiovascular risk factors;

- *AB522_R1* – 67 – (c) Interventions for exercise to prevent falls for insureds who are 65 years of age or older and reside in a medical facility or facility for the dependent;

(i) Screening for lung cancer using low-dose computed tomography for insureds who are at least 50 but not more than 80 years of age and:in accordance with the most recent guidelines published by the American Cancer Society or the recommendations of the United States Preventive Services Task Force in effect on January 1, 2025;

(1) Have a smoking history of 20 pack-years;

(2) Smoke or have stopped smoking within the immediately preceding 15 years;

and (3) Do not suffer from a health problem that substantially limits the life expectancy of the person or the willingness of the person to undergo curative surgery;

- *AB522* – 77 – 3.

- *AB522_R1* – 68 – (d) Penalize a provider of health care who provides any such benefit to an insured, including, without limitation, reducing the reimbursement of the provider of health care;

The term includes, without limitation, the - *AB522* – 78 – use of step therapy, prior authorization or categorizing drugs and devices based on cost, type or method of administration.

(f) “Pack-year”“Provider means the product of thehealth numbercare” ofhas packs of cigarettes smoked per day and the numbermeaning ofascribed yearsto thatit thein personNRS has629.031. smoked.

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

A hospital or medical services corporation that offers or issues a policy of health insurance subject to the - *AB522_R1* – 69 – provisions of this chapter shall include in the policy coverage for maternity care and pediatric care for newborn infants.

(a) Deny a pregnant or postpartum individual or the newborn infant coverage or continued coverage under the terms of the - *AB522* – 79 – policy if the sole purpose of the denial of coverage or continued coverage is to avoid the requirements of this section;

or (e) Except as otherwise provided in subsection 5, restrict benefits for any portion of a hospital stay required pursuant to the - *AB522_R1* – 70 – provisions of this section in a manner that is less favorable than the benefits provided for any preceding portion of that stay.

- *AB522* – 80 – Sec.

- *AB522_R1* – 71 – (a) Require an insured to pay a higher deductible, any copayment or coinsurance or require a longer waiting period or other condition to obtain any benefit provided in the policy of health insurance pursuant to subsection 1;

(a) “Network plan” means a policy of health insurance offered by a hospital or medical services corporation under which the - *AB522* – 81 – 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 of health care under contract with the hospital or medical services corporation.

A hospital or medical services corporation shall ensure that the benefits required by subsection 1 are made available to an - *AB522_R1* – 72 – insured through a provider of health care who participates in the network plan of the hospital or medical services corporation.

- *AB522* – 82 – [4.] 5.

NRS(Deleted 695B.1912by isamendment.) herebySec. amended to read as follows:

695B.1912 1.

An insurer that offers or issues a contract for hospital or medical service must provide coverage for benefits payable for expenses incurred for:

(a) A mammogram to screen for breast cancer annually for insureds who are 40 years of age or older.

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

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

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

or (2) Detected by other means of examination.

(d) Medication to prevent breast cancer for insureds who are at a high risk of developing breast cancer and have a low risk of adverse side effects from the medication.

2.

An insurer must ensure that the benefits required by subsection 1 are made available to an insured through a provider of health care who participates in the network plan of the insurer.

3.

Except as otherwise provided in subsection 5, an insurer that offers or issues a contract for hospital or medical service shall not:

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

(b) Refuse to issue a contract for hospital or medical service or cancel a contract for hospital or medical service solely because the - *AB522* – 83 – person applying for or covered by the contract uses or may use any such benefit;

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

(d) Penalize a provider of health care who provides any such benefit to an insured, including, without limitation, reducing the reimbursement of the provider of health care;

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

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

4.

A contract for hospital or medical service subject to the provisions of this chapter which is delivered, issued for delivery or renewed on or after [January] October 1, [2024,] 2025, has the legal effect of including the coverage required by subsection 1, and any provision of the contract or the renewal which is in conflict with this section is void.

5.

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

6.

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

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

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

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

§ 223 has been satisfied.

7.

As used in this section:

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

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

(b) “Network plan” means a contract for hospital or medical service offered by an insurer under which the financing and delivery of medical care, including items and services paid for as medical - *AB522* – 84 – 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.

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

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

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

Sec.

- *AB522_R1* – 73 – (a) Chlamydia trachomatis, gonorrhea, hepatitis B and hepatitis C in accordance with NRS 442.013.

- *AB522* – 85 – 4.

(b) “Network plan” means a policy of health insurance offered by a hospital or medical services corporation 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 hospital or medical - *AB522_R1* – 74 – services corporation.

- *AB522* – 86 – (i) Screening and counseling for the human immunodeficiency virus consisting of a risk assessment, annual education relating to prevention and at least one screening for the virus during the lifetime of the insured or as ordered by a provider of health care;

[(i) Smoking] (j) Tobacco cessation programs , including, without limitation, pharmacotherapy approved by the United States Food and Drug Administration, for an insured who is 18 years of age or older consisting; of not more than two cessation attempts per year and four counseling sessions per year;

[(j)][consisting (k) All vaccinations recommended by the Advisory Committee on Immunization Practices of thenot Centersmore forthan Diseasetwo Controlcessation andattempts Preventionper ofyear the United States Department of Health and Humanfour Servicescounseling orsessions itsper successoryear; organization;

(j)] (k) All vaccinations recommended by the Advisory Committee on Immunization Practices of the Centers for Disease - *AB522_R1* – 75 – Control and Prevention of the United States Department of Health and Human Services or its successor organization;

A contract for hospital or medical service subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after [January] October 1, [2018,] 2025, has the legal - *AB522* – 87 – effect of including the coverage required by subsection 1, and any provision of the contract or the renewal which is in conflict with this section is void.

(a) “Medical management technique” means a practice which is used to control the cost or utilization of health care services or - *AB522_R1* – 76 – prescription drug use.

- *AB522* – 88 – (c) Offer or pay any type of material inducement or financial incentive to an insured to discourage the insured from obtaining any such benefit;

- *AB522_R1* – 77 – 3.

- *AB522* – 89 – [2.] (b) Imposing a payment or premium that is based on [the] an actual or perceived [gender identity or expression] protected characteristic of an insured or a family member of the insured;

or - *AB522_R1* – 78 – [(b)] (2) Ordinarily or exclusively available to persons of any sex.

- *AB522* – 90 – (e) Oral fluoride supplements for enrollees who are at least 6 months of age but less than 5 years of age and whose supply of water is deficient in fluoride;

(f) Counseling and education pertaining to the minimization of exposure to ultraviolet radiation for enrollees who are less than 25 years of age and have fair skin types and the parents or legal guardians of enrollees who are less than 18 years of age and have fair skin types for the purpose of minimizing the risk of skin cancer in those persons;

and (h) At least one screening for the detection of amblyopia or the risk factors of amblyopia for enrollees who are at least 3 but not more than 5 years of age;age.

and- (i)*AB522_R1* Screening,– tests79 and– counseling2. for such other health conditions and diseases as recommended by the Health Resources and Services Administration on January 1, 2025, for enrollees who are less than 18 years of age.

2.

- *AB522* – 91 – 4.

(b) “Network plan” means a health care plan offered by a health maintenance organization under which the financing and - *AB522_R1* – 80 – 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 of health care under contract with the health maintenance organization.

- *AB522* – 92 – (g) Screening for the presence of the rhesus D antigen and antibodies in the blood of an enrollee who is pregnant during the enrollee’s first visit for care relating to the pregnancy;

(j) AnScreening annualfor screeningtype for2 urinarydiabetes incontinenceat such intervals as recommended by the Health Resources and Services Administration on January 1, 2025, for women;enrollees who are in the postpartum stage of pregnancy and who have a history of gestational diabetes mellitus;

(k) ScreeningCounseling forrelating typeto 2maintaining diabetesa athealthy suchweight intervalsfor aswomen recommendedwho byare theat Healthleast Resources40 andbut Servicesnot Administrationmore onthan January60 1,years 2025, for enrollees who are in the postpartum stage of pregnancyage and who have a historybody ofmass gestationalindex diabetesgreater mellitus;than 18.5;

and (l) CounselingScreening relatingfor toosteoporosis maintaining a healthy weight for women whowho: are at least 40 but not more than 60 years of age and have a body mass index greater than 18.5;

and (m) Screening for osteoporosis for women who:

or - *AB522_R1* – 81 – (2) Are less than 65 years of age and have a risk of fracturing a bone equal to or greater than that of a woman who is 65 years of age without any additional risk factors.

(e) Offer or pay any type of material inducement, bonus or other financial incentive to a provider of health care to deny, - *AB522* – 93 – reduce, withhold, limit or delay access to any such benefit to an enrollee;

The term includes, without limitation, the - *AB522_R1* – 82 – use of step therapy, prior authorization or categorizing drugs and devices based on cost, type or method of administration.

- *AB522* – 94 – (d) Screenings for latent tuberculosis infection in enrollees with an increased risk of contracting tuberculosis;

(i) Screening for lung cancer using low-dose computed tomography for enrollees who are at least 50 but not more than 80 years of age and:in accordance with the most recent guidelines published by the American Cancer Society or the recommendations of the United States Preventive Services Task Force in effect on January 1, 2025;

(1)- Have*AB522_R1* – 83 – (j) Screening for prediabetes and type 2 diabetes in enrollees who are at least 35 but not more than 70 years of age and have a smokingbody historymass index of 2025 pack-years;or greater;

(2) Smoke or have stopped smoking within the immediately preceding 15 years;

and (3) Do not suffer from a health problem that substantially limits the life expectancy of the person or the willingness of the person to undergo curative surgery;

(j) Screening for prediabetes and type 2 diabetes in enrollees who are at least 35 but not more than 70 years of age and have a body mass index of 25 or greater;

- *AB522* – 95 – (d) Penalize a provider of health care who provides any such benefit to an enrollee, including, without limitation, reducing the reimbursement of the provider of health care;