reglab/housing_qa huggingface dataset:
NV Rev Stat § 695B.1907 (2021)
2021 Nevada Revised Statutes|Chapter 695B - Nonprofit Corporations for Hospital, Medical and Dental Service|NRS 695B.1907 - Required provision concerning coverage for screening for colorectal cancer.

  1. A policy of health insurance issued by a hospital or medical service corporation that provides coverage for the treatment of colorectal cancer must provide coverage for colorectal cancer screening in accordance with:  (a) The guidelines concerning colorectal cancer screening which are published by the American Cancer Society; or  (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.  2. 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, 2003, has the legal effect of including the coverage required by this section, and any provision of the policy that conflicts with the provisions of this section is void.  (Added to NRS by 2003, 1335)
NV Rev Stat § 695B.1908 (2021)
2021 Nevada Revised Statutes|Chapter 695B - Nonprofit Corporations for Hospital, Medical and Dental Service|NRS 695B.1908 - Required provision concerning coverage for certain drugs for treatment of cancer.

Except as otherwise provided in NRS 695B.1903:  1. No contract for hospital or medical services that provides coverage for a drug approved by the Food and Drug Administration for use in the treatment of an illness, disease or other medical condition may be delivered or issued for delivery in this state unless the contract includes coverage for any other use of the drug for the treatment of cancer, if that use is:  (a) Specified in the most recent edition of or supplement to:  (1) The United States Pharmacopoeia Drug Information; or  (2) The American Hospital Formulary Service Drug Information; or  (b) Supported by at least two articles reporting the results of scientific studies that are published in scientific or medical journals, as defined in 21 C.F.R. § 99.3.  2. The coverage required pursuant to this section:  (a) Includes coverage for any medical services necessary to administer the drug to a person covered under the contract.  (b) Does not include coverage for any:  (1) Experimental drug used for the treatment of cancer if that drug has not been approved by the Food and Drug Administration; or  (2) Use of a drug that is contraindicated by the Food and Drug Administration.  3. A contract for hospital or medical services subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after October 1, 1999, has the legal effect of including the coverage required by this section, and any provision of the contract that conflicts with the provisions of this section is void.  (Added to NRS by 1999, 760; A 2003, 3528)
NV Rev Stat § 695B.1909 (2021)
2021 Nevada Revised Statutes|Chapter 695B - Nonprofit Corporations for Hospital, Medical and Dental Service|NRS 695B.1909 - Required provision concerning coverage for orally administered chemotherapy.

  1. An insurer that offers or issues a contract for hospital or medical service which provides coverage for the treatment of cancer through the use of chemotherapy shall not:  (a) Require a copayment, deductible or coinsurance amount for chemotherapy administered orally by means of a prescription drug in a combined amount that is more than $100 per prescription. The limitation on the amount of the deductible that may be required pursuant to this paragraph does not apply to a health benefit plan, as defined in NRS 687B.470, if the health benefit plan is a high deductible health plan, as defined in 26 U.S.C. § 223, and the amount of the annual deductible has not been satisfied.  (b) Make the coverage subject to monetary limits that are less favorable for chemotherapy administered orally by means of a prescription drug than the monetary limits applicable to chemotherapy which is administered by injection or intravenously.  (c) Decrease the monetary limits applicable to chemotherapy administered orally by means of a prescription drug or to chemotherapy which is administered by injection or intravenously to meet the requirements of this section.  2. A contract subject to the provisions of this chapter which provides coverage for the treatment of cancer through the use of chemotherapy and that is delivered, issued for delivery or renewed on or after January 1, 2015, has the legal effect of providing that coverage subject to the requirements of this section, and any provision of the contract or renewal which is in conflict with this section is void.  3. Nothing in this section shall be construed as requiring an insurer to provide coverage for the treatment of cancer through the use of chemotherapy administered by injection or intravenously or administered orally by means of a prescription drug.  (Added to NRS by 2013, 1998; A 2013, 3659)
NV Rev Stat § 695B.191 (2021)
2021 Nevada Revised Statutes|Chapter 695B - Nonprofit Corporations for Hospital, Medical and Dental Service|NRS 695B.191 - Required provision concerning coverage relating to mastectomy.

  1. A policy of health insurance, issued by a medical service corporation, which provides coverage for the surgical procedure known as a mastectomy must also provide commensurate coverage for:  (a) Reconstruction of the breast on which the mastectomy has been performed;  (b) Surgery and reconstruction of the other breast to produce a symmetrical structure; and  (c) Prostheses and physical complications for all stages of mastectomy, including lymphedemas.  2. The provision of services must be determined by the attending physician and the patient.  3. The plan or issuer may require deductibles and coinsurance payments if they are consistent with those established for other benefits.  4. Written notice of the availability of the coverage must be given upon enrollment and annually thereafter. The notice must be sent to all participants:  (a) In the next mailing made by the plan or issuer to the participant or beneficiary; or  (b) As part of any annual information packet sent to the participant or beneficiary,  whichever is earlier.  5. A plan or issuer may not:  (a) Deny eligibility, or continued eligibility, to enroll or renew coverage, in order to avoid the requirements of subsections 1 to 4, inclusive; or  (b) Penalize, or limit reimbursement to, a provider of care, or provide incentives to a provider of care, in order to induce the provider not to provide the care listed in subsections 1 to 4, inclusive.  6. A plan or issuer may negotiate rates of reimbursement with providers of care.  7. If reconstructive surgery is begun within 3 years after a mastectomy, the amount of the benefits for that surgery must equal those amounts provided for in the policy at the time of the mastectomy. If the surgery is begun more than 3 years after the mastectomy, the benefits provided are subject to all of the terms, conditions and exclusions contained in the policy at the time of the reconstructive surgery.  8. A policy subject to the provisions of this chapter which is delivered, issued for delivery or renewed on or after October 1, 2001, has the legal effect of including the coverage required by this section, and any provision of the policy or the renewal which is in conflict with this section is void.  9. For the purposes of this section, "reconstructive surgery" means a surgical procedure performed following a mastectomy on one breast or both breasts to re-establish symmetry between the two breasts. The term includes augmentation mammoplasty, reduction mammoplasty and mastopexy.  (Added to NRS by 1983, 615; A 1989, 1890; 2001, 2249)
NV Rev Stat § 695B.1914 (2021)
2021 Nevada Revised Statutes|Chapter 695B - Nonprofit Corporations for Hospital, Medical and Dental Service|NRS 695B.1914 - Required provision concerning coverage of certain gynecological and obstetrical services without authorization or referral from primary care physician.

  1. A contract for hospital or medical service must include a provision authorizing a woman covered by the contract to obtain covered gynecological or obstetrical services without first receiving authorization or a referral from her primary care physician.  2. The provisions of this section do not authorize a woman covered by a contract for hospital or medical service to designate an obstetrician or gynecologist as her primary care physician.  3. A contract subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after October 1, 1999, has the legal effect of including the coverage required by this section, and any provision of the contract or the renewal which is in conflict with this section is void.  4. As used in this section, "primary care physician" has the meaning ascribed to it in NRS 695G.060.  (Added to NRS by 1999, 1944)
NV Rev Stat § 695B.1916 (2021)
2021 Nevada Revised Statutes|Chapter 695B - Nonprofit Corporations for Hospital, Medical and Dental Service|NRS 695B.1916 - Required provision concerning coverage of hormone replacement therapy in certain circumstances; prohibited actions by insurer; exception.

  1. An insurer that offers or issues a contract for hospital or medical service which provides coverage for prescription drugs or devices shall include in the contract coverage for any type of hormone replacement therapy which is lawfully prescribed or ordered and which has been approved by the Food and Drug Administration.  2. An insurer that offers or issues a contract for hospital or medical service that provides coverage for prescription drugs shall not:  (a) Require an insured to pay a higher deductible, any copayment or coinsurance or require a longer waiting period or other condition for coverage for a prescription for hormone replacement therapy;  (b) Refuse to issue a contract for hospital or medical service or cancel a contract for hospital or medical service solely because the person applying for or covered by the contract uses or may use in the future hormone replacement therapy;  (c) Offer or pay any type of material inducement or financial incentive to an insured to discourage the insured from accessing hormone replacement therapy;  (d) Penalize a provider of health care who provides hormone replacement therapy to an insured, including, without limitation, reducing the reimbursement of the provider of health care; or  (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 hormone replacement therapy to an insured.  3. 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 October 1, 1999, 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.  4. The provisions of this section do not require an insurer to provide coverage for fertility drugs.  5. As used in this section, "provider of health care" has the meaning ascribed to it in NRS 629.031.  (Added to NRS by 1999, 1999; A 2017, 1839, 3949)
NV Rev Stat § 695B.1918 (2021)
2021 Nevada Revised Statutes|Chapter 695B - Nonprofit Corporations for Hospital, Medical and Dental Service|NRS 695B.1918 - Required provision concerning coverage of health care services related to hormone replacement therapy in certain circumstances; prohibited actions by insurer.

  1. An insurer that offers or issues a contract for hospital or medical service which provides coverage for outpatient care shall include in the contract coverage for any health care service related to hormone replacement therapy.  2. An insurer that offers or issues a contract for hospital or medical service that provides coverage for outpatient care shall not:  (a) Require an insured to pay a higher deductible, any copayment or coinsurance or require a longer waiting period or other condition for coverage for outpatient care related to hormone replacement therapy;  (b) Refuse to issue a contract for hospital or medical service or cancel a contract for hospital or medical service solely because the person applying for or covered by the contract uses or may use in the future hormone replacement therapy;  (c) Offer or pay any type of material inducement or financial incentive to an insured to discourage the insured from accessing hormone replacement therapy;  (d) Penalize a provider of health care who provides hormone replacement therapy to an insured, including, without limitation, reducing the reimbursement of the provider of health care; or  (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 hormone replacement therapy to an insured.  3. 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 October 1, 1999, 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.  4. As used in this section, "provider of health care" has the meaning ascribed to it in NRS 629.031.  (Added to NRS by 1999, 2000; A 2017, 1840, 3950)
NV Rev Stat § 695B.192 (2021)
2021 Nevada Revised Statutes|Chapter 695B - Nonprofit Corporations for Hospital, Medical and Dental Service|NRS 695B.192 - Required provision concerning coverage relating to complications of pregnancy.

  1. No hospital, medical or dental service contract issued by a corporation pursuant to the provisions of this chapter may contain any exclusion, reduction or other limitation of coverage relating to complications of pregnancy, unless the provision applies generally to all benefits payable under the contract and complies with the provisions of NRS 689B.340 to 689B.580, inclusive, and chapter 689C of NRS relating to the portability and availability of health insurance.  2. As used in this section, the term "complications of pregnancy" includes any condition which requires hospital confinement for medical treatment and:  (a) If the pregnancy is not terminated, is caused by an injury or sickness not directly related to the pregnancy or by acute nephritis, nephrosis, cardiac decompensation, missed abortion or similar medically diagnosed conditions; or  (b) If the pregnancy is terminated, results in nonelective cesarean section, ectopic pregnancy or spontaneous termination.  3. A contract subject to the provisions of this chapter which is issued or delivered on or after July 1, 1977, has the legal effect of including the coverage required by this section, and any provision of the contract which is in conflict with this section is void.  (Added to NRS by 1977, 416; A 1997, 2955; 2013, 3637)
NV Rev Stat § 695B.1923 (2021)
2021 Nevada Revised Statutes|Chapter 695B - Nonprofit Corporations for Hospital, Medical and Dental Service|NRS 695B.1923 - Required provision concerning coverage for treatment of certain inherited metabolic diseases.

  1. A contract for hospital or medical service must provide coverage for:  (a) Enteral formulas for use at home that are prescribed or ordered by a physician as medically necessary for the treatment of inherited metabolic diseases characterized by deficient metabolism, or malabsorption originating from congenital defects or defects arising shortly after birth, of amino acid, organic acid, carbohydrate or fat; and  (b) At least $2,500 per year for special food products which are prescribed or ordered by a physician as medically necessary for the treatment of a person described in paragraph (a).  2. The coverage required by subsection 1 must be provided whether or not the condition existed when the contract was purchased.  3. A contract subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after January 1, 1998, has the legal effect of including the coverage required by this section, and any provision of the contract or the renewal which is in conflict with this section is void.  4. As used in this section:  (a) "Inherited metabolic disease" means a disease caused by an inherited abnormality of the body chemistry of a person.  (b) "Special food product" means a food product that is specially formulated to have less than one gram of protein per serving and is intended to be consumed under the direction of a physician for the dietary treatment of an inherited metabolic disease. The term does not include a food that is naturally low in protein.  (Added to NRS by 1997, 1527)
NV Rev Stat § 695B.1927 (2021)
2021 Nevada Revised Statutes|Chapter 695B - Nonprofit Corporations for Hospital, Medical and Dental Service|NRS 695B.1927 - Required provision concerning coverage for management and treatment of diabetes.

  1. No contract for hospital or medical service that provides coverage for hospital, medical or surgical expenses may be delivered or issued for delivery in this state unless the contract includes coverage for the management and treatment of diabetes, including, without limitation, coverage for the self-management of diabetes.  2. An insurer who delivers or issues for delivery a contract specified in subsection 1:  (a) Shall include in any disclosure of the coverage provided by the contract notice to each policyholder or subscriber covered under the contract of the availability of the benefits required by this section.  (b) Shall provide the coverage required by this section subject to the same deductible, copayment, coinsurance and other such conditions for coverage that are required under the contract.  3. 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 1, 1998, has the legal effect of including the coverage required by this section, and any provision of the contract that conflicts with this section is void.  4. As used in this section:  (a) "Coverage for the management and treatment of diabetes" includes coverage for medication, equipment, supplies and appliances that are medically necessary for the treatment of diabetes.  (b) "Coverage for the self-management of diabetes" includes:  (1) The training and education provided to a person covered under the contract after the person is initially diagnosed with diabetes which is medically necessary for the care and management of diabetes, including, without limitation, counseling in nutrition and the proper use of equipment and supplies for the treatment of diabetes;  (2) Training and education which is medically necessary as a result of a subsequent diagnosis that indicates a significant change in the symptoms or condition of the person covered under the contract and which requires modification of the person’s program of self-management of diabetes; and  (3) Training and education which is medically necessary because of the development of new techniques and treatment for diabetes.  (c) "Diabetes" includes type I, type II and gestational diabetes.  (Added to NRS by 1997, 744; A 2017, 2389)
NV Rev Stat § 695B.1929 (2021)
2021 Nevada Revised Statutes|Chapter 695B - Nonprofit Corporations for Hospital, Medical and Dental Service|NRS 695B.1929 - Required provision of coverage for management and treatment of sickle cell disease.

  1. A hospital or medical service corporation that issues a policy of health insurance shall include in the policy coverage for:  (a) Necessary case management services for an insured who has been diagnosed with sickle cell disease and its variants; and  (b) Medically necessary care for an insured who has been diagnosed with sickle cell disease and its variants.  2. A hospital or medical service corporation that issues a policy of health insurance which provides coverage for prescription drugs shall include in the policy coverage for medically necessary prescription drugs to treat sickle cell disease and its variants.  3. A hospital or medical service corporation 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.  4. As used in this section:  (a) "Case management services" means medical or other health care management services to assist patients and providers of health care, including, without limitation, identifying and facilitating additional resources and treatments, providing information about treatment options and facilitating communication between providers of services to a patient.  (b) "Medical management technique" means a practice which is used to control the cost or utilization of health care services. 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.  (c) "Medically necessary" has the meaning ascribed to it in NRS 695G.055.  (d) "Sickle cell disease and its variants" has the meaning ascribed to it in NRS 439.4927.  (Added to NRS by 2019, 2172)
NV Rev Stat § 695B.193 (2021)
2021 Nevada Revised Statutes|Chapter 695B - Nonprofit Corporations for Hospital, Medical and Dental Service|NRS 695B.193 - Required provision concerning coverage for newly born and adopted children and children placed for adoption. [Effective through December 31, 2019.]

  1. All individual and group service or indemnity-type contracts issued by a nonprofit corporation which provide coverage for a family member of the subscriber must as to such coverage provide that the health benefits applicable for children are payable with respect to:  (a) A newly born child of the subscriber from the moment of birth;  (b) An adopted child from the date the adoption becomes effective, if the child was not placed in the home before adoption; and  (c) A child placed with the subscriber for the purpose of adoption from the moment of placement as certified by the public or private agency making the placement. The coverage of such a child ceases if the adoption proceedings are terminated as certified by the public or private agency making the placement.  The contracts must provide the coverage specified in subsection 3, and must not exclude premature births.  2. The contract may require that notification of:  (a) The birth of a newly born child;  (b) The effective date of adoption of a child; or  (c) The date of placement of a child for adoption,  and payments of the required fees, if any, must be furnished to the nonprofit service corporation within 31 days after the date of birth, adoption or placement for adoption in order to have the coverage continue beyond the 31-day period.  3. The coverage for newly born and adopted children and children placed for adoption consists of coverage of injury or sickness, including the necessary care and treatment of medically diagnosed congenital defects and birth abnormalities and, within the limits of the policy, necessary transportation costs from place of birth to the nearest specialized treatment center under major medical policies, and with respect to basic policies to the extent such costs are charged by the treatment center.  4. A corporation shall not restrict the coverage of a dependent child adopted or placed for adoption solely because of a preexisting condition the child has at the time the child would otherwise become eligible for coverage pursuant to that contract. Any provision relating to an exclusion for a preexisting condition must comply with NRS 689C.190.  5. For covered services provided to the child, the corporation shall reimburse noncontracted providers of health care to an amount equal to the average amount of payment for which the organization has agreements, contracts or arrangements for those covered services.  (Added to NRS by 1975, 1110; A 1989, 741; 1995, 2434; 1997, 2956)