2022 Nevada Revised Statutes
Chapter 695B - Nonprofit Corporations for Hospital, Medical and Dental Service
NRS 695B.1924 - Required provision concerning coverage for drugs, laboratory testing and certain services related to human immunodeficiency virus; reimbursement of pharmacist for certain services.
1. A hospital or medical services corporation that offers or issues a policy of health insurance shall include in the policy coverage for:
(a) Drugs approved by the United States Food and Drug Administration for preventing the acquisition of human immunodeficiency virus;
(b) Laboratory testing that is necessary for therapy using such a drug; and
(c) The services described in NRS 639.28085, when provided by a pharmacist who participates in the network plan of the hospital or medical services corporation.
2. A hospital or medical services corporation that offers or issues a policy of health insurance shall reimburse a pharmacist who participates in the network plan of the hospital or medical services corporation for the services described in NRS 639.28085 at a rate equal to the rate of reimbursement provided to a physician, physician assistant or advanced practice registered nurse for similar services.
3. A hospital or medical services corporation may subject the benefits required by subsection 1 to reasonable medical management techniques.
4. A hospital or medical services corporation shall ensure that the benefits required by subsection 1 are made available to an insured through a provider of health care who participates in the network plan of the hospital or medical services corporation.
5. A policy of health insurance subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after October 1, 2021, has the legal effect of including the coverage required by subsection 1, and any provision of the policy that conflicts with the provisions of this section is void.
6. As used in this section:
(a) "Medical management technique" means a practice which is used to control the cost or use of health care services or prescription drugs. The term includes, without limitation, the use of step therapy, prior authorization and categorizing drugs and devices based on cost, type or method of administration.
(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 services corporation. 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.
(Added to NRS by 2021, 3210)
