Nevada § 287.04337 - Coverage for mammograms for certain women required to be provided if Board provides health insurance through a plan of self-insurance

§ 287.04337. Coverage for mammograms for certain women required to be provided if Board provides health insurance through a plan of self-insurance

1. If the Board provides health insurance through a plan of self-insurance, it shall

provide coverage for benefits payable for expenses incurred for a mammogram every

2 years, or annually if ordered by a provider of health care, for women 40 years of

age or older. 2. If the Board provides health insurance through a plan of self-insurance, it 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 Board. 3. Except as otherwise provided in subsection 5, if the Board provides health insurance

through a plan of self-insurance, it shall not: (a) Except as otherwise provided in subsection 6, 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 plan of self-insurance pursuant to

subsection 1; (b) Refuse to issue a plan of self-insurance or cancel a plan of self-insurance 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. 4. A plan of self-insurance described in subsection 1 which is delivered, issued for

delivery or renewed on or after January 1, 2024, 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, if the Board provides

health insurance through a plan of self-insurance, the Board 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

plan of self-insurance with respect to the deductible of such a plan of self-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 plan of self-insurance provided by the Board 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 Board. 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 plan of self-insurance ” means a plan of self-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.