EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted. Green numbers along left margin indicate location on the printed bill (e.g., 5-15 indicates page 5, line 15).

1-1 Section 1. NRS 679B.130 is hereby amended to read as follows:

1-2 679B.130 1. The commissioner may adopt reasonable regulations for

1-10 No penalty applies to any act done or omitted in good faith in conformity

2-1 with any such regulation, notwithstanding that the regulation may, after the

2-2 act or omission, be amended, rescinded or determined by a judicial or other

2-3 authority to be invalid for any reason.

2-4 Sec. 1.5. NRS 687B.225 is hereby amended to read as follows:

2-5 687B.225 1. Except as otherwise provided in NRS 689A.0405,

2-18 persons licensed to provide the covered care.

2-19 Sec. 2. Chapter 689A of NRS is hereby amended by adding thereto the

2-20 provisions set forth as sections 3, 4 and 4.5 of this act.

2-21 Sec. 3. An insurer shall, at the request of an insured or provider of

2-22 health care with whom it has a contract for the provision of health care

2-23 services, promptly provide the insured or provider of health care with an

2-24 estimate of the rate at which the provider of health care will be

2-25 reimbursed for providing a health care service to the insured and the

2-26 amount of money for which the insured will be responsible for the health

2-27 care service.

2-28 Sec. 4. 1. If an insured requires health care services that may be

2-29 provided only by a specialist and his insurer does not have a contract for

2-30 the provision of health care services with such a specialist who is located

2-31 within 75 miles from the residence of the insured, the insurer shall

2-32 reimburse a specialist who is located within 75 miles from the residence

2-33 of the insured for specialized health care services that are provided to the

2-34 insured by that specialist.

2-35 2. An insurer shall reimburse a specialist pursuant to the provisions

2-36 of this section in a reasonable amount that is not less than the amount

2-37 the insurer would reimburse a specialist with whom it has a contract for

2-38 the provision of health care services.

2-39 Sec. 4.5. 1. A policy of health insurance must include a provision

2-40 authorizing a woman covered by the policy to obtain covered health care

2-41 services for women without first receiving authorization or a referral

2-42 from her primary care physician.

3-1 2. The provisions of this section do not authorize a woman covered

3-2 by a policy of health insurance to designate an obstetrician or

3-3 gynecologist as her primary care physician.

3-4 3. A policy subject to the provisions of this chapter that is delivered,

3-5 issued for delivery or renewed on or after October 1, 1999, has the legal

3-6 effect of including the coverage required by this section, and any

3-7 provision of the policy or the renewal which is in conflict with this

3-8 section is void.

3-9 4. As used in this section:

3-10 (a) "Health care services for women" means gynecological or

3-11 obstetrical services, including, without limitation, perinatal care,

3-12 preventative gynecological care and reproductive health care services.

3-13 (b) "Primary care physician" has the meaning ascribed to it in NRS

3-14 695G.060.

3-15 Sec. 5. Chapter 689B of NRS is hereby amended by adding thereto the

3-16 provisions set forth as sections 6, 7 and 7.5 of this act.

3-17 Sec. 6. An insurer that issues a policy of group health insurance

3-18 shall, at the request of an insured or provider of health care with whom it

3-19 has a contract for the provision of health care services, promptly provide

3-20 the insured or provider of health care with an estimate of the rate at

3-21 which the provider of health care will be reimbursed for providing a

3-22 health care service to the insured and the amount of money for which the

3-23 insured will be responsible for the health care service.

3-24 Sec. 7. 1. If an insured requires health care services that may be

3-25 provided only by a specialist and his insurer that issues a policy of group

3-26 health insurance does not have a contract for the provision of health care

3-27 services with such a specialist who is located within 75 miles from the

3-28 residence of the insured, the insurer shall reimburse a specialist who is

3-29 located within 75 miles from the residence of the insured for specialized

3-30 health care services that are provided to the insured by that specialist.

3-31 2. An insurer that issues a policy of group health insurance shall

3-32 reimburse a specialist pursuant to the provisions of this section in a

3-33 reasonable amount that is not less than the amount the insurer would

3-34 reimburse a specialist with whom it has a contract for the provision of

3-35 health care services.

3-36 Sec. 7.5. 1. A policy of group health insurance must include a

3-37 provision authorizing a woman covered by the policy to obtain covered

3-38 health care services for women without first receiving authorization or a

3-39 referral from her primary care physician.

3-40 2. The provisions of this section do not authorize a woman covered

3-41 by a policy of group health insurance to designate an obstetrician or

3-42 gynecologist as her primary care physician.

4-1 3. A policy subject to the provisions of this chapter that is delivered,

4-2 issued for delivery or renewed on or after October 1, 1999, has the legal

4-3 effect of including the coverage required by this section, and any

4-4 provision of the policy or the renewal which is in conflict with this

4-5 section is void.

4-6 4. As used in this section:

4-7 (a) "Health care services for women" means gynecological or

4-8 obstetrical services, including, without limitation, perinatal care,

4-9 preventative gynecological care and reproductive health care services.

4-10 (b) "Primary care physician" has the meaning ascribed to it in NRS

4-11 695G.060.

4-12 Sec. 8. Chapter 695A of NRS is hereby amended by adding thereto the

4-13 provisions set forth as sections 9 and 10 of this act.

4-14 Sec. 9. A society shall, at the request of an insured or provider of

4-15 health care with whom it has a contract for the provision of health care

4-16 services, promptly provide the insured or provider of health care with an

4-17 estimate of the rate at which the provider of health care will be

4-18 reimbursed for providing a health care service to the insured and the

4-19 amount of money for which the insured will be responsible for the health

4-20 care service.

4-21 Sec. 10. 1. If an insured requires health care services that may be

4-22 provided only by a specialist and his society does not have a contract for

4-23 the provision of health care services with such a specialist who is located

4-24 within 75 miles from the residence of the insured, the society shall

4-25 reimburse a specialist who is located within 75 miles from the residence

4-26 of the insured for specialized health care services that are provided to the

4-27 insured by that specialist.

4-28 2. A society shall reimburse a specialist pursuant to the provisions of

4-29 this section in a reasonable amount that is not less than the amount the

4-30 society would reimburse a specialist with whom it has a contract for the

4-31 provision of health care services.

4-32 Sec. 11. Chapter 695B of NRS is hereby amended by adding thereto

4-33 the provisions set forth as sections 12, 13 and 13.5 of this act.

4-34 Sec. 12. A corporation subject to the provisions of this chapter shall,

4-35 at the request of an insured or provider of health care with whom it has a

4-36 contract for the provision of health care services, promptly provide the

4-37 insured or provider of health care with an estimate of the rate at which

4-38 the provider of health care will be reimbursed for providing a health care

4-39 service to the insured and the amount of money for which the insured

4-40 will be responsible for the health care service.

4-41 Sec. 13. 1. If an insured requires health care services that may be

4-42 provided only by a specialist and his corporation, subject to the

4-43 provisions of this chapter, does not have a contract for the provision of

5-1 health care services with such a specialist who is located within 75 miles

5-2 from the residence of the insured, the corporation shall reimburse a

5-3 specialist who is located within 75 miles from the residence of the insured

5-4 for specialized health care services that are provided to the insured by

5-5 that specialist.

5-6 2. A corporation subject to the provisions of this chapter shall

5-7 reimburse a specialist pursuant to the provisions of this section in a

5-8 reasonable amount that is not less than the amount the corporation

5-9 would reimburse a specialist with whom it has a contract for the

5-10 provision of health care services.

5-11 Sec. 13.5. 1. A contract for hospital or medical service must

5-12 include a provision authorizing a woman covered by the contract to

5-13 obtain covered health care services for women without first receiving

5-14 authorization or a referral from her primary care physician.

5-15 2. The provisions of this section do not authorize a woman covered

5-16 by a contract for hospital or medical service to designate an obstetrician

5-17 or gynecologist as her primary care physician.

5-18 3. A contract subject to the provisions of this chapter that is

5-19 delivered, issued for delivery or renewed on or after October 1, 1999, has

5-20 the legal effect of including the coverage required by this section, and

5-21 any provision of the contract or the renewal which is in conflict with this

5-22 section is void.

5-23 4. As used in this section:

5-24 (a) "Health care services for women" means gynecological or

5-25 obstetrical services, including, without limitation, perinatal care,

5-26 preventative gynecological care and reproductive health care services.

5-27 (b) "Primary care physician" has the meaning ascribed to it in NRS

5-28 695G.060.

5-29 Sec. 14. Chapter 695C of NRS is hereby amended by adding thereto

5-30 the provisions set forth as sections 15, 16 and 16.5 of this act.

5-31 Sec. 15. A health maintenance organization shall, at the request of

5-32 an enrollee or provider of health care with whom it has a contract for the

5-33 provision of health care services, promptly provide the enrollee or

5-34 provider of health care with an estimate of the rate at which the provider

5-35 of health care will be reimbursed for providing a health care service to

5-36 the enrollee and the amount of money for which the enrollee will be

5-37 responsible for the health care service.

5-38 Sec. 16. 1. If an enrollee requires health care services that may be

5-39 provided only by a specialist and his health maintenance organization

5-40 does not have a contract for the provision of health care services with

5-41 such a specialist who is located within 75 miles from the residence of the

5-42 enrollee, the health maintenance organization shall reimburse a

6-1 specialist who is located within 75 miles from the residence of the

6-2 enrollee for specialized health care services that are provided to the

6-3 enrollee by that specialist.

6-4 2. A health maintenance organization shall reimburse a specialist

6-5 pursuant to the provisions of this section in a reasonable amount that is

6-6 not less than the amount the health maintenance organization would

6-7 reimburse a specialist with whom it has a contract for the provision of

6-8 health care services.

6-9 Sec. 16.5. 1. A health care plan must include a provision

6-10 authorizing a woman covered by the plan to obtain covered health care

6-11 services for women without first receiving authorization or a referral

6-12 from her primary care physician.

6-13 2. The provisions of this section do not authorize a woman covered

6-14 by a health care plan to designate an obstetrician or gynecologist as her

6-15 primary care physician.

6-16 3. An evidence of coverage subject to the provisions of this chapter

6-17 that is delivered, issued for delivery or renewed on or after October 1,

6-18 1999, has the legal effect of including the coverage required by this

6-19 section, and any provision of the evidence of coverage or the renewal

6-20 which is in conflict with this section is void.

6-21 4. As used in this section:

6-22 (a) "Health care services for women" means gynecological or

6-23 obstetrical services, including, without limitation, perinatal care,

6-24 preventative gynecological care and reproductive health care services.

6-25 (b) "Primary care physician" has the meaning ascribed to it in NRS

6-26 695G.060.

6-27 Sec. 17. NRS 695C.050 is hereby amended to read as follows:

6-28 695C.050 1. Except as otherwise provided in this chapter or in

7-1 4. The provisions of NRS 695C.110, 695C.170 to 695C.200, inclusive,

7-2 695C.250 and 695C.265 and sections 15, 16 and 16.5 of this act do not

7-3 apply to a health maintenance organization that provides health care

7-4 services through managed care to recipients of Medicaid pursuant to a

7-5 contract with the welfare division of the department of human resources.

7-6 This subsection does not exempt a health maintenance organization from

7-7 any provision of this chapter for services provided pursuant to any other

7-8 contract.

7-9 Sec. 18. NRS 695F.090 is hereby amended to read as follows:

7-10 695F.090 Prepaid limited health service organizations are subject to

7-33 11. Chapter 692C of NRS, concerning holding companies.

7-34 Sec. 19. Chapter 287 of NRS is hereby amended by adding thereto a

7-35 new section to read as follows:

7-36 Any health insurance provided by the committee on benefits through a

7-37 plan of self-insurance must comply with the provisions of NRS 689B.255,

7-38 695G.150, 695G.160, 695G.170, 695G.200 to 695G.230, inclusive, and

7-39 sections 6 and 7 of this act in the same manner as an insurer subject to

7-40 the provisions of Title 57 of NRS.

8-1 Sec. 20. NRS 287.043 is hereby amended to read as follows:

8-2 287.043 The committee on benefits shall:

9-1 For the purposes of this section, "employee benefits" includes any form of

9-2 compensation provided to a state employee pursuant to this Title except

9-3 federal benefits, wages earned, legal holidays, deferred compensation and

9-4 benefits available pursuant to chapter 286 of NRS.

9-5 Sec. 21. NRS 287.0432 is hereby amended to read as follows:

9-6 287.0432 The committee on benefits shall by regulation provide for