reglab/housing_qa huggingface dataset:
NV Rev Stat § 689B.033 (2021)
2021 Nevada Revised Statutes|Chapter 689B - Group and Blanket Health Insurance|NRS 689B.033 - Required provision concerning coverage for newly born and adopted children and children placed for adoption.

  1. All group health insurance policies providing coverage on an expense-incurred basis and all employee welfare plans providing medical, surgical or hospital care or benefits established or maintained for employees or their families or dependents, or for both, must as to the family members’ coverage provide that the health benefits applicable for children are payable with respect to:  (a) A newly born child of the insured 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 insured 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 policies must provide the coverage specified in subsection 3 and must not exclude premature births.  2. The policy or 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 premium or fees, if any, must be furnished to the insurer or welfare plan 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.  (Added to NRS by 1975, 1109; A 1989, 740; 1995, 2430; 1997, 2914; 2013, 3618)
NV Rev Stat § 689B.034 (2021)
2021 Nevada Revised Statutes|Chapter 689B - Group and Blanket Health Insurance|NRS 689B.034 - Required provision concerning effect of benefits under other valid group coverage; subrogation.

  1. Every policy of group health insurance must contain a provision which reduces the insurer’s liability because of benefits under other valid group coverage. To the extent authorized by the Commissioner, such a provision may include subrogation.  2. A provision for subrogation may include a lien upon any recovery by an insured from a third person for the cost of medical benefits paid by the insurer for injuries incurred as a result of the actions of the third person. The lien may not exceed the amount paid by the insurer.  3. An insurer may not deny payment for services because of the inclusion of a provision required by this section.  (Added to NRS by 1985, 1060; A 1995, 1628)
NV Rev Stat § 689B.0345 (2021)
2021 Nevada Revised Statutes|Chapter 689B - Group and Blanket Health Insurance|NRS 689B.0345 - Required provision concerning coverage for employee or member on leave without pay as result of total disability.

  1. As used in this section, "total disability" and "totally disabled" mean the continuing inability of the employee or member, because of an injury or illness, to perform substantially the duties related to his or her employment for which the employee or member is otherwise qualified.  2. No group policy of health insurance may be delivered or issued for delivery in this state unless it provides continuing coverage for an employee or member of the insured group, and the dependents of the employee or member who are otherwise covered by the policy, while the employee or member is on leave without pay as a result of a total disability. The coverage must be for any injury or illness suffered by the employee or member which is not related to the total disability or for any injury or illness suffered by the dependent of the employee or member. The coverage for such injury or illness must be equal to or greater than the coverage otherwise provided by the policy.  3. The coverage required pursuant to subsection 2 must continue until:  (a) The date on which the employment of the employee or member is terminated;  (b) The date on which the employee or member obtains another policy of health insurance;  (c) The date on which the group policy of health insurance is terminated; or  (d) After a period of 12 months in which benefits under such coverage are provided to the employee or member,  whichever occurs first.  (Added to NRS by 1989, 1249)
NV Rev Stat § 689B.035 (2021)
2021 Nevada Revised Statutes|Chapter 689B - Group and Blanket Health Insurance|NRS 689B.035 - Required provision concerning termination of coverage on dependent child.

  1. A group health insurance policy delivered or issued for delivery after November 1, 1973, which provides for the termination of coverage on a dependent child of a member of the insured group, when such child attains a contractually specified limiting age, shall also provide that such coverage shall not terminate when the dependent child reaches such age if such child is and continues to be:  (a) Incapable of self-sustaining employment due to a physical handicap or an intellectual disability; and  (b) Dependent on the member of the insured group for support and maintenance.  2. Proof of such child’s incapacity and dependency shall be furnished to the insurer by the member of the insured group within 31 days after such child attains the specified limiting age and as often as the insurer may thereafter require, but no more than once a year beginning 2 years after such child attains the specified limiting age.  (Added to NRS by 1973, 548; A 2013, 699)
NV Rev Stat § 689B.0353 (2021)
2021 Nevada Revised Statutes|Chapter 689B - Group and Blanket Health Insurance|NRS 689B.0353 - Required provision concerning coverage for treatment of certain inherited metabolic diseases.

  1. A policy of group health insurance 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 policy was purchased.  3. A policy 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 policy 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, 1526)
NV Rev Stat § 689B.0357 (2021)
2021 Nevada Revised Statutes|Chapter 689B - Group and Blanket Health Insurance|NRS 689B.0357 - Required provision concerning coverage for management and treatment of diabetes.

  1. No group policy of health insurance that provides coverage for hospital, medical or surgical expenses may be delivered or issued for delivery in this state unless the policy 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 policy specified in subsection 1:  (a) Shall include in any disclosure of the coverage provided by the policy notice to each policyholder and subscriber under the policy 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 policy.  3. A policy 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 policy 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 the employee or member of the insured group after the employee or member 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 employee or member of the insured group and which requires modification of his or her 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, 743; A 2017, 2369)
NV Rev Stat § 689B.0358 (2021)
2021 Nevada Revised Statutes|Chapter 689B - Group and Blanket Health Insurance|NRS 689B.0358 - Required provision concerning coverage for management and treatment of sickle cell disease.

  1. An insurer that issues a policy of group 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. An insurer that issues a policy of group 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. 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.  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, 2170)
NV Rev Stat § 689B.0362 (2021)
2021 Nevada Revised Statutes|Chapter 689B - Group and Blanket Health Insurance|NRS 689B.0362 - Required provision concerning coverage for orally administered chemotherapy.

  1. An insurer that offers or issues a policy of group health insurance 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 policy 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 policy 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, 3658)
NV Rev Stat § 689B.0365 (2021)
2021 Nevada Revised Statutes|Chapter 689B - Group and Blanket Health Insurance|NRS 689B.0365 - Required provision concerning coverage for use of certain drugs for treatment of cancer.

Except as otherwise provided in NRS 689B.0306:  1. No group policy of health insurance 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 policy 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 the employee or member of the insured group.  (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 policy 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 policy that conflicts with the provisions of this section is void.  (Added to NRS by 1999, 760; A 2003, 3525)
NV Rev Stat § 689B.0367 (2021)
2021 Nevada Revised Statutes|Chapter 689B - Group and Blanket Health Insurance|NRS 689B.0367 - Required provision concerning coverage for screening for colorectal cancer.

  1. A policy of group health insurance 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 group 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 § 689B.0368 (2021)
2021 Nevada Revised Statutes|Chapter 689B - Group and Blanket Health Insurance|NRS 689B.0368 - Required provision concerning coverage for prescription drug previously approved for medical condition of insured.

  1. Except as otherwise provided in this section, a policy of group health insurance which provides coverage for prescription drugs must not limit or exclude coverage for a drug if the drug:  (a) Had previously been approved for coverage by the insurer for a medical condition of an insured and the insured’s provider of health care determines, after conducting a reasonable investigation, that none of the drugs which are otherwise currently approved for coverage are medically appropriate for the insured; and  (b) Is appropriately prescribed and considered safe and effective for treating the medical condition of the insured.  2. The provisions of subsection 1 do not:  (a) Apply to coverage for any drug that is prescribed for a use that is different from the use for which that drug has been approved for marketing by the Food and Drug Administration;  (b) Prohibit:  (1) The insurer from charging a deductible, copayment or coinsurance for the provision of benefits for prescription drugs to the insured or from establishing, by contract, limitations on the maximum coverage for prescription drugs;  (2) A provider of health care from prescribing another drug covered by the policy that is medically appropriate for the insured; or  (3) The substitution of another drug pursuant to NRS 639.23286 or 639.2583 to 639.2597, inclusive; or  (c) Require any coverage for a drug after the term of the policy.  3. Any provision of a policy subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after October 1, 2001, which is in conflict with this section is void.  (Added to NRS by 2001, 858; A 2003, 2298; 2017, 637)
NV Rev Stat § 689B.0369 (2021)
2021 Nevada Revised Statutes|Chapter 689B - Group and Blanket Health Insurance|NRS 689B.0369 - Required provision concerning coverage for services provided through telehealth.

  1. A policy of group or blanket health insurance must include coverage for services provided to an insured through telehealth to the same extent as though provided in person or by other means.  2. An insurer shall not:  (a) Require an insured to establish a relationship in person with a provider of health care or provide any additional consent to or reason for obtaining services through telehealth as a condition to providing the coverage described in subsection 1;   (b) Require a provider of health care to demonstrate that it is necessary to provide services to an insured through telehealth or receive any additional type of certification or license to provide services through telehealth as a condition to providing the coverage described in subsection 1;  (c) Refuse to provide the coverage described in subsection 1 because of the distant site from which a provider of health care provides services through telehealth or the originating site at which an insured receives services through telehealth; or  (d) Require covered services to be provided through telehealth as a condition to providing coverage for such services.  3. A policy of group or blanket health insurance must not require an insured to obtain prior authorization for any service provided through telehealth that is not required for that service when provided in person. A policy of group or blanket health insurance may require prior authorization for a service provided through telehealth if such prior authorization would be required if the service were provided in person or by other means.  4. The provisions of this section do not require an insurer to:  (a) Ensure that covered services are available to an insured through telehealth at a particular originating site;  (b) Provide coverage for a service that is not a covered service or that is not provided by a covered provider of health care; or  (c) Enter into a contract with any provider of health care or cover any service if the insurer is not otherwise required by law to do so.  5. A policy of group or blanket health insurance subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after July 1, 2015, 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.  6. As used in this section:  (a) "Distant site" has the meaning ascribed to it in NRS 629.515.  (b) "Originating site" has the meaning ascribed to it in NRS 629.515.  (c) "Provider of health care" has the meaning ascribed to it in NRS 439.820.  (d) "Telehealth" has the meaning ascribed to it in NRS 629.515.  (Added to NRS by 2015, 638)