reglab/housing_qa huggingface dataset:
NV Rev Stat § 695C.173 (2021)
2021 Nevada Revised Statutes|Chapter 695C - Health Maintenance Organizations|NRS 695C.173 - 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 health care plans which provide coverage for a family member of the enrollee must as to such coverage provide that the health care services applicable for children are payable with respect to:  (a) A newly born child of the enrollee 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 enrollee 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 plans must provide the coverage specified in subsection 3, and must not exclude premature births.  2. The evidence of coverage 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 charge, if any, must be furnished to the health maintenance organization 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 preventive health care services as well as 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 health maintenance organization 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 plan. Any provision relating to an exclusion for a preexisting condition must comply with NRS 689B.500 or 689C.190, as appropriate.  5. For covered services provided to the child, the health maintenance organization 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, 2436; 1997, 2959)
NV Rev Stat § 695C.173 (2021)
2021 Nevada Revised Statutes|Chapter 695C - Health Maintenance Organizations|NRS 695C.173 - Required provision concerning coverage for newly born and adopted children and children placed for adoption. [Effective January 1, 2020.]

  1. All individual and group health care plans which provide coverage for a family member of the enrollee must as to such coverage provide that the health care services applicable for children are payable with respect to:  (a) A newly born child of the enrollee 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 enrollee 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 plans must provide the coverage specified in subsection 3, and must not exclude premature births.  2. The evidence of coverage 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 charge, if any, must be furnished to the health maintenance organization 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 preventive health care services as well as 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. For covered services provided to the child, the health maintenance organization 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, 2436; 1997, 2959; 2019, 309, effective January 1, 2020)
NV Rev Stat § 695C.1731 (2021)
2021 Nevada Revised Statutes|Chapter 695C - Health Maintenance Organizations|NRS 695C.1731 - Required provision concerning coverage for screening for colorectal cancer.

  1. A health care plan issued by a health maintenance organization 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. An evidence of coverage for a health care plan 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 evidence of coverage that conflicts with the provisions of this section is void.  (Added to NRS by 2003, 1335)
NV Rev Stat § 695C.1733 (2021)
2021 Nevada Revised Statutes|Chapter 695C - Health Maintenance Organizations|NRS 695C.1733 - Required provision concerning coverage for certain drugs for treatment of cancer.

Except as otherwise provided in NRS 695C.1693:  1. No evidence of coverage 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 evidence of coverage 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 enrollee.  (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. Any evidence of coverage 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 evidence of coverage that conflicts with the provisions of this section is void.  (Added to NRS by 1999, 761; A 2003, 3531)
NV Rev Stat § 695C.17335 (2021)
2021 Nevada Revised Statutes|Chapter 695C - Health Maintenance Organizations|NRS 695C.17335 - Required provision concerning coverage for orally administered chemotherapy.

  1. A health maintenance organization that offers or issues a health care plan 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 such 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. Evidence of coverage 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 evidence of coverage or the renewal which is in conflict with this section is void.  3. Nothing in this section shall be construed as requiring a health maintenance organization 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, 1999; A 2013, 3659)
NV Rev Stat § 695C.1734 (2021)
2021 Nevada Revised Statutes|Chapter 695C - Health Maintenance Organizations|NRS 695C.1734 - Required provision concerning coverage for prescription drug previously approved for medical condition of enrollee.

  1. Except as otherwise provided in this section, evidence of coverage 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 health maintenance organization or insurer for a medical condition of an enrollee and the enrollee’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 enrollee; and  (b) Is appropriately prescribed and considered safe and effective for treating the medical condition of the enrollee.  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 health maintenance organization or insurer from charging a deductible, copayment or coinsurance for the provision of benefits for prescription drugs to the enrollee 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 evidence of coverage that is medically appropriate for the enrollee; 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 evidence of coverage.  3. Any provision of an evidence of coverage 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, 863; A 2003, 2300; 2017, 639)
NV Rev Stat § 695C.17345 (2021)
2021 Nevada Revised Statutes|Chapter 695C - Health Maintenance Organizations|NRS 695C.17345 - Required provision concerning coverage for prescription drugs irregularly dispensed for purpose of synchronization of chronic medications.

  1. A health maintenance organization that offers or issues a health care plan which provides coverage for prescription drugs:  (a) Must authorize coverage for and may apply a copayment and deductible to a prescription that is dispensed by a pharmacy for less than a 30-day supply if, for the purpose of synchronizing the enrollee’s chronic medications:  (1) The prescriber or pharmacist determines that filling or refilling the prescription in that manner is in the best interest of the enrollee; and  (2) The enrollee requests less than a 30-day supply.  (b) May not deny coverage for a prescription described in paragraph (a) which is otherwise approved for coverage by the health maintenance organization.  (c) Unless otherwise provided by a contract or other agreement, may not prorate any pharmacy dispensing fees for a prescription described in paragraph (a).  2. An evidence of coverage subject to the provisions of this chapter which provides coverage for prescription drugs and that is delivered, issued for delivery or renewed on or after January 1, 2017, has the legal effect of providing that coverage subject to the requirements of this section, and any provision of the evidence of coverage or renewal which is in conflict with this section is void.  3. The provisions of this section do not apply to unit-of-use packaging for which synchronization is not practicable or to a controlled substance.  4. As used in this section:  (a) "Chronic medication" means any drug that is prescribed to treat any disease or other condition which is determined to be permanent, persistent or lasting indefinitely.  (b) "Synchronization" means the alignment of the dispensing of multiple medications by a single contracted pharmacy for the purpose of improving a patient’s adherence to a prescribed course of medication.  (c) "Unit-of-use packaging" means medication that is prepackaged by the manufacturer in blister packs, compliance packs, course-of-therapy packs or any other packaging which is designed and intended to be dispensed directly to the patient without modification by the dispensing pharmacy, except for the addition of a prescription label.  (Added to NRS by 2015, 2126)
NV Rev Stat § 695C.1751 (2021)
2021 Nevada Revised Statutes|Chapter 695C - Health Maintenance Organizations|NRS 695C.1751 - Required provision concerning coverage for prostate cancer screening.

  1. A health care plan of a health maintenance organization that provides coverage for the treatment of prostate cancer must provide coverage for prostate cancer screening in accordance with:  (a) The guidelines concerning prostate cancer screening which are published by the American Cancer Society; or  (b) Other guidelines or reports concerning prostate cancer screening which are published by nationally recognized professional organizations and which include current or prevailing supporting scientific data.  2. A health care plan of a health maintenance organization that provides coverage for the treatment of prostate cancer must not require an insured to obtain prior authorization for any service provided pursuant to subsection 1.  3. Any evidence of coverage for a health care plan of a health maintenance organization that provides coverage for the treatment of prostate cancer which is delivered, issued for delivery or renewed on or after July 1, 2007, has the legal effect of including the coverage required by subsection 1, and any provision of the evidence of coverage or the renewal which is in conflict with subsection 1 is void.  (Added to NRS by 2007, 3239)
NV Rev Stat § 695C.1755 (2021)
2021 Nevada Revised Statutes|Chapter 695C - Health Maintenance Organizations|NRS 695C.1755 - Required provision concerning coverage for treatment of temporomandibular joint.

  1. Except as otherwise provided in this section, no evidence of coverage may be delivered or issued for delivery in this state if it contains an exclusion of coverage of the treatment of the temporomandibular joint whether by specific language in the evidence of coverage or by a claims settlement practice. An evidence of coverage may exclude coverage of those methods of treatment which are recognized as dental procedures, including, but not limited to, the extraction of teeth and the application of orthodontic devices and splints.  2. The health maintenance organization may limit its liability on the treatment of the temporomandibular joint to:  (a) No more than 50 percent of the usual and customary charges for such treatment actually received by an enrollee, but in no case more than 50 percent of the maximum benefits provided by the evidence of coverage for such treatment; and  (b) Treatment which is medically necessary.  3. Any provision of an evidence of coverage subject to the provisions of this chapter and issued or delivered on or after January 1, 1990, which is in conflict with this section is void.  (Added to NRS by 1989, 2139)
NV Rev Stat § 695C.1757 (2021)
2021 Nevada Revised Statutes|Chapter 695C - Health Maintenance Organizations|NRS 695C.1757 - Required provision concerning coverage for early refills of topical ophthalmic products.

  1. A health maintenance organization which offers or issues a health care plan that provides coverage for prescription drugs shall not deny coverage for a topical ophthalmic product which is otherwise approved for coverage by the health maintenance organization when the enrollee, pursuant to NRS 639.2395, receives a refill of the product:  (a) After 21 days or more but before 30 days after receiving any 30-day supply of the product;  (b) After 42 days or more but before 60 days after receiving any 60-day supply of the product; or  (c) After 63 days or more but before 90 days after receiving any 90-day supply of the product.  2. The provisions of this section do not affect any deductibles, copayments or coinsurance established by the health care plan.  3. An evidence of coverage subject to the provisions of this chapter which provides coverage for prescription drugs and that is delivered, issued for delivery or renewed on or after January 1, 2016, has the legal effect of including the coverage required by this section, and any provision of the evidence of coverage or renewal which is in conflict with this section is void.  4. As used in this section, "topical ophthalmic product" means a liquid prescription drug which is applied directly to the eye from a bottle or by means of a dropper.  (Added to NRS by 2015, 208)
NV Rev Stat § 695C.176 (2021)
2021 Nevada Revised Statutes|Chapter 695C - Health Maintenance Organizations|NRS 695C.176 - Required provision concerning coverage for hospice care.

Each health care plan must provide benefits for hospice care.  (Added to NRS by 1983, 1936; A 1985, 1779; 1989, 1033)
NV Rev Stat § 695C.1765 (2021)
2021 Nevada Revised Statutes|Chapter 695C - Health Maintenance Organizations|NRS 695C.1765 - Reimbursement for acupuncture.

If any evidence of coverage provides coverage for acupuncture performed by a physician, the insured is entitled to reimbursement for acupuncture performed by a person who is licensed pursuant to chapter 634A of NRS.  (Added to NRS by 1991, 1134)
NV Rev Stat § 695C.177 (2021)
2021 Nevada Revised Statutes|Chapter 695C - Health Maintenance Organizations|NRS 695C.177 - Reimbursement for treatments by licensed psychologist.

If any evidence of coverage provides coverage for treatment of an illness which is within the authorized scope of the practice of a qualified psychologist, the insured is entitled to reimbursement for treatments by a licensed psychologist.  (Added to NRS by 1981, 576; A 1989, 1553; 2017, 935)
NV Rev Stat § 695C.1773 (2021)
2021 Nevada Revised Statutes|Chapter 695C - Health Maintenance Organizations|NRS 695C.1773 - Reimbursement for treatment by licensed marriage and family therapist or licensed clinical professional counselor.

If any evidence of coverage provides coverage for treatment of an illness which is within the authorized scope of practice of a licensed marriage and family therapist or licensed clinical professional counselor, the insured is entitled to reimbursement for treatment by a marriage and family therapist or clinical professional counselor who is licensed pursuant to chapter 641A of NRS.  (Added to NRS by 1987, 2134; A 2007, 3094)
NV Rev Stat § 695C.1775 (2021)
2021 Nevada Revised Statutes|Chapter 695C - Health Maintenance Organizations|NRS 695C.1775 - Reimbursement for treatment by licensed associate in social work, social worker, independent social worker or clinical social worker.

If any evidence of coverage provides coverage for treatment of an illness which is within the authorized scope of the practice of a licensed associate in social work, social worker, independent social worker or clinical social worker, the insured is entitled to reimbursement for treatment by an associate in social work, social worker, independent social worker or clinical social worker who is licensed pursuant to chapter 641B of NRS.  (Added to NRS by 1987, 1123)
NV Rev Stat § 695C.178 (2021)
2021 Nevada Revised Statutes|Chapter 695C - Health Maintenance Organizations|NRS 695C.178 - Reimbursement for treatment by chiropractor.

  1. If any evidence of coverage provides coverage for treatment of an illness which is within the authorized scope of practice of a qualified chiropractor, the insured is entitled to reimbursement for treatments by a chiropractor who is licensed pursuant to chapter 634 of NRS.  2. The terms of the policy must not limit:  (a) Coverage for treatments by a chiropractor to a number less than for treatments by other physicians.  (b) Reimbursement for treatments by a chiropractor to an amount less than that charged for similar treatments by other physicians.  (Added to NRS by 1981, 930; A 1983, 328)
NV Rev Stat § 695C.1783 (2021)
2021 Nevada Revised Statutes|Chapter 695C - Health Maintenance Organizations|NRS 695C.1783 - Reimbursement for treatment by podiatrist.

  1. If any evidence of coverage provides coverage for treatment of an illness which is within the authorized scope of practice of a qualified podiatrist, the insured is entitled to reimbursement for treatments by a podiatrist who is licensed pursuant to chapter 635 of NRS.  2. The terms of the policy must not limit:  (a) Coverage for treatments by a podiatrist to a number less than for treatments by other physicians.  (b) Reimbursement for treatments by a podiatrist to an amount less than that reimbursed for similar treatments by other physicians.  (Added to NRS by 2007, 1046)
NV Rev Stat § 695C.1789 (2021)
2021 Nevada Revised Statutes|Chapter 695C - Health Maintenance Organizations|NRS 695C.1789 - Reimbursement for treatment by licensed clinical alcohol and drug abuse counselor.

If any evidence of coverage provides coverage for treatment of an illness which is within the authorized scope of practice of a licensed clinical alcohol and drug abuse counselor, the insured is entitled to reimbursement for treatment by a clinical alcohol and drug abuse counselor who is licensed pursuant to chapter 641C of NRS unless the clinical alcohol and drug abuse counselor must be directly reimbursed pursuant to:  1. An assignment of benefits described in NRS 687B.409; or  2. Any other applicable assignment of benefits.  (Added to NRS by 2007, 3094; A 2017, 2211)