Nevada Revised Statutes 689A.0437 – Coverage for drugs, laboratory testing and certain services related to human immunodeficiency virus required; reimbursement of pharmacist for certain services
1. An insurer that offers or issues a policy of health insurance shall include in the policy coverage for:
Terms Used In Nevada Revised Statutes 689A.0437
- Contract: A legal written agreement that becomes binding when signed.
- insured: as used in this chapter , shall not be construed as preventing a person other than the insured with a proper insurable interest from making application for and owning a policy covering the insured or from being entitled under such a policy to any indemnities, benefits and rights provided therein. See Nevada Revised Statutes 689A.310
- physician: means a person who engages in the practice of medicine, including osteopathy and homeopathy. See Nevada Revised Statutes 0.040
(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 that uses 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 insurer.
2. An insurer that offers or issues a policy of health insurance shall reimburse a pharmacist who participates in the network plan of the insurer 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. An insurer may subject the benefits required by subsection 1 to reasonable medical management techniques.
4. An insurer 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 insurer.
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 an insurer 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 insurer. 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.