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. Chapter 689A of NRS is hereby amended by adding thereto

1-2 a new section to read as follows:

1-3 1. Except as otherwise provided in subsection 2, any policy of health

1-4 insurance that provides coverage for a pregnancy, including, without

1-5 limitation, coverage relating to complications of pregnancy as defined in

1-6 NRS 689A.042, must also provide commensurate coverage for the

1-7 diagnosis and treatment of infertility, including, without limitation,

1-8 coverage for nonexperimental procedures using assisted reproductive

1-9 technology. Such coverage must be subject to the same terms and

1-10 conditions that apply to the coverage for the pregnancy.

1-11 2. Coverage for in vitro fertilization, gamete intrafallopian transfer

1-12 or zygote intrafallopian transfer must be provided only if:

1-13 (a) The insured person has been unable to bring a pregnancy to live

1-14 birth through less costly treatments for infertility that are medically

1-15 appropriate and are otherwise covered under the policy;

1-16 (b) The insured person has not undergone four complete oocyte

1-17 retrievals, except that, if the insured person has brought a pregnancy to

1-18 live birth after a complete oocyte retrieval, coverage for at least two

2-1 additional retrievals must be provided, with a lifetime limit of six

2-2 retrievals; and

2-3 (c) The procedure is performed at a facility that is accredited by the

2-4 Reproductive Laboratory Accreditation Program of the College of

2-5 American Pathologists, or a similar program of its successor

2-6 organization, and complies with the standards of the American Society

2-7 for Reproductive Medicine or the American College of Obstetricians and

2-8 Gynecologists, or their successor organizations.

2-9 3. A policy subject to the provisions of this chapter that is delivered,

2-10 issued for delivery or renewed on or after October 1, 1999, has the legal

2-11 effect of including the coverage required by this section, and any

2-12 provision of the policy that conflicts with the provisions of this section is

2-13 void.

2-14 4. As used in this section:

2-15 (a) "Gamete intrafallopian transfer" means the direct transfer of a

2-16 mixture of an egg and sperm into the fallopian tube of a woman, with

2-17 fertilization occurring inside the fallopian tube.

2-18 (b) "In vitro fertilization" means a procedure whereby eggs and sperm

2-19 are combined and any fertilized and dividing eggs resulting therefrom

2-20 are transferred into the uterus of a woman or preserved cryogenically for

2-21 future use.

2-22 (c) "Infertility" means a disease or condition that causes a

2-23 reproductive system to function abnormally and results in the inability of

2-24 a woman to conceive a child after 1 year of unprotected sexual

2-25 intercourse or to carry a pregnancy to live birth.

2-26 (d) "Nonexperimental procedure" means a clinical treatment or

2-27 procedure for infertility whose safety and efficacy is recognized by the

2-28 American Society for Reproductive Medicine or the American College of

2-29 Obstetricians and Gynecologists, or their successor organizations.

2-30 (e) "Zygote intrafallopian transfer" means a procedure whereby an

2-31 egg is fertilized and transferred into the fallopian tube of a woman before

2-32 the cells begin to divide.

2-33 Sec. 2. NRS 689A.330 is hereby amended to read as follows:

2-34 689A.330 If any policy is issued by a domestic insurer for delivery to a

2-40 section 1 of this act.

3-1 Sec. 3. Chapter 689B of NRS is hereby amended by adding thereto a

3-2 new section to read as follows:

3-3 1. Except as otherwise provided in subsection 2, any policy of group

3-4 health or blanket health insurance that provides coverage for a

3-5 pregnancy, including, without limitation, coverage relating to

3-6 complications of pregnancy as defined in NRS 689B.260, must also

3-7 provide commensurate coverage for the diagnosis and treatment of

3-8 infertility, including, without limitation, coverage for nonexperimental

3-9 procedures using assisted reproductive technology. Such coverage must

3-10 be subject to the same terms and conditions that apply to the coverage for

3-11 the pregnancy.

3-12 2. Coverage for in vitro fertilization, gamete intrafallopian transfer

3-13 or zygote intrafallopian transfer must be provided only if:

3-14 (a) The insured person has been unable to bring a pregnancy to live

3-15 birth through less costly treatments for infertility that are medically

3-16 appropriate and are otherwise covered under the policy;

3-17 (b) The insured person has not undergone four complete oocyte

3-18 retrievals, except that, if the insured person has brought a pregnancy to

3-19 live birth after a complete oocyte retrieval, coverage for at least two

3-20 additional retrievals must be provided, with a lifetime limit of six

3-21 retrievals; and

3-22 (c) The procedure is performed at a facility that is accredited by the

3-23 Reproductive Laboratory Accreditation Program of the College of

3-24 American Pathologists, or a similar program of its successor

3-25 organization, and complies with the standards of the American Society

3-26 for Reproductive Medicine or the American College of Obstetricians and

3-27 Gynecologists, or their successor organizations.

3-28 3. A policy subject to the provisions of this chapter that is delivered,

3-29 issued for delivery or renewed on or after October 1, 1999, has the legal

3-30 effect of including the coverage required by this section, and any

3-31 provision of the policy that conflicts with the provisions of with this

3-32 section is void.

3-33 4. As used in this section:

3-34 (a) "Gamete intrafallopian transfer" means the direct transfer of a

3-35 mixture of an egg and sperm into the fallopian tube of a woman, with

3-36 fertilization occurring inside the fallopian tube.

3-37 (b) "In vitro fertilization" means a procedure whereby eggs and sperm

3-38 are combined and any fertilized and dividing eggs resulting therefrom

3-39 are transferred into the uterus of a woman or preserved cryogenically for

3-40 future use.

3-41 (c) "Infertility" means a disease or condition that causes a

3-42 reproductive system to function abnormally and results in the inability of

4-1 a woman to conceive a child after 1 year of unprotected sexual

4-2 intercourse or to carry a pregnancy to live birth.

4-3 (d) "Nonexperimental procedure" means a clinical treatment or

4-4 procedure for infertility whose safety and efficacy is recognized by the

4-5 American Society for Reproductive Medicine or the American College of

4-6 Obstetricians and Gynecologists, or their successor organizations.

4-7 (e) "Zygote intrafallopian transfer" means a procedure whereby an

4-8 egg is fertilized and transferred into the fallopian tube of a woman before

4-9 the cells begin to divide.

4-10 Sec. 4. Chapter 695B of NRS is hereby amended by adding thereto a

4-11 new section to read as follows:

4-12 1. Except as otherwise provided in subsection 2, any contract for

4-13 hospital or medical services that provides coverage for a pregnancy,

4-14 including, without limitation, coverage relating to complications of

4-15 pregnancy as defined in NRS 695B.192, must also provide

4-16 commensurate coverage for the diagnosis and treatment of infertility,

4-17 including, without limitation, coverage for nonexperimental procedures

4-18 using assisted reproductive technology. Such coverage must be subject to

4-19 the same terms and conditions that apply to the coverage for the

4-20 pregnancy.

4-21 2. Coverage for in vitro fertilization, gamete intrafallopian transfer

4-22 or zygote intrafallopian transfer must be provided only if:

4-23 (a) The insured person has been unable to bring a pregnancy to live

4-24 birth through less costly treatments for infertility that are medically

4-25 appropriate and are otherwise covered under the policy;

4-26 (b) The insured person has not undergone four complete oocyte

4-27 retrievals, except that, if the insured person has brought a pregnancy to

4-28 live birth after a complete oocyte retrieval, coverage for at least two

4-29 additional retrievals must be provided, with a lifetime limit of six

4-30 retrievals; and

4-31 (c) The procedure is performed at a facility that is accredited by the

4-32 Reproductive Laboratory Accreditation Program of the College of

4-33 American Pathologists, or a similar program of its successor

4-34 organization, and complies with the standards of the American Society

4-35 for Reproductive Medicine or the American College of Obstetricians and

4-36 Gynecologists, or their successor organizations.

4-37 3. A contract for hospital or medical services subject to the

4-38 provisions of this chapter that is delivered, issued for delivery or renewed

4-39 on or after October 1, 1999, has the legal effect of including the coverage

4-40 required by this section, and any provision of the contract that conflicts

4-41 with the provisions of this section is void.

4-42 4. As used in this section:

5-1 (a) "Gamete intrafallopian transfer" means the direct transfer of a

5-2 mixture of an egg and sperm into the fallopian tube of a woman, with

5-3 fertilization occurring inside the fallopian tube.

5-4 (b) "In vitro fertilization" means a procedure whereby eggs and sperm

5-5 are combined and any fertilized and dividing eggs resulting therefrom

5-6 are transferred into the uterus of a woman or preserved cryogenically for

5-7 future use.

5-8 (c) "Infertility" means a disease or condition that causes a

5-9 reproductive system to function abnormally and results in the inability of

5-10 a woman to conceive a child after 1 year of unprotected sexual

5-11 intercourse or to carry a pregnancy to live birth.

5-12 (d) "Nonexperimental procedure" means a clinical treatment or

5-13 procedure for infertility whose safety and efficacy is recognized by the

5-14 American Society for Reproductive Medicine or the American College of

5-15 Obstetricians and Gynecologists, or their successor organizations.

5-16 (e) "Zygote intrafallopian transfer" means a procedure whereby an

5-17 egg is fertilized and transferred into the fallopian tube of a woman before

5-18 the cells begin to divide.

5-19 Sec. 5. Chapter 695C of NRS is hereby amended by adding thereto a

5-20 new section to read as follows:

5-21 1. Except as otherwise provided in subsection 2, any health

5-22 maintenance plan that provides coverage for a pregnancy, including,

5-23 without limitation, coverage relating to complications of pregnancy, as

5-24 defined in NRS 695C.172, must also provide commensurate coverage for

5-25 the diagnosis and treatment of infertility, including, without limitation,

5-26 coverage for nonexperimental procedures using assisted reproductive

5-27 technology. Such coverage must be subject to the same terms and

5-28 conditions that apply to the coverage for the pregnancy.

5-29 2. Coverage for in vitro fertilization, gamete intrafallopian transfer

5-30 or zygote intrafallopian transfer must be provided only if:

5-31 (a) The insured person has been unable to bring a pregnancy to live

5-32 birth through less costly treatments for infertility that are medically

5-33 appropriate and are otherwise covered under the health maintenance

5-34 plan;

5-35 (b) The insured person has not undergone four complete oocyte

5-36 retrievals, except that, if the insured person has brought a pregnancy to

5-37 live birth after a complete oocyte retrieval, coverage for at least two

5-38 additional retrievals must be provided, with a lifetime limit of six

5-39 retrievals; and

5-40 (c) The procedure is performed at a facility that is accredited by the

5-41 Reproductive Laboratory Accreditation Program of the College of

5-42 American Pathologists, or a similar program of its successor

5-43 organization, and complies with the standards of the American Society

6-1 for Reproductive Medicine or the American College of Obstetricians and

6-2 Gynecologists, or their successor organizations.

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

6-4 that is delivered, issued for delivery or renewed on or after October 1,

6-5 1999, has the legal effect of including the coverage required by this

6-6 section, and any provision of the evidence of coverage that conflicts with

6-7 the provisions of this section is void.

6-8 4. As used in this section:

6-9 (a) "Gamete intrafallopian transfer" means the direct transfer of a

6-10 mixture of an egg and sperm into the fallopian tube of a woman, with

6-11 fertilization occurring inside the fallopian tube.

6-12 (b) "In vitro fertilization" means a procedure whereby eggs and sperm

6-13 are combined and any fertilized and dividing eggs resulting therefrom

6-14 are transferred into the uterus of a woman or preserved cryogenically for

6-15 future use.

6-16 (c) "Infertility" means a disease or condition that causes a

6-17 reproductive system to function abnormally and results in the inability of

6-18 a woman to conceive a child after 1 year of unprotected sexual

6-19 intercourse or to carry a pregnancy to live birth.

6-20 (d) "Nonexperimental procedure" means a clinical treatment or

6-21 procedure for infertility whose safety and efficacy is recognized by the

6-22 American Society for Reproductive Medicine or the American College of

6-23 Obstetricians and Gynecologists, or their successor organizations.

6-24 (e) "Zygote intrafallopian transfer" means a procedure whereby an

6-25 egg is fertilized and transferred into the fallopian tube of a woman before

6-26 the cells begin to divide.

6-27 Sec. 6. NRS 695C.330 is hereby amended to read as follows:

6-28 695C.330 1. The commissioner may suspend or revoke any

6-43 services as provided for in NRS 695C.060;

7-1 (d) The state board of health certifies to the commissioner that [:

7-2 (1) The] the health maintenance organization [does] :

7-3 (1) Does not meet the requirements of subsection 2 of NRS

7-4 695C.080; or

7-5 (2) [The health maintenance organization is] Is unable to fulfill its

7-6 obligations to furnish health care services as required under its health care

7-7 plan;

7-8 (e) The health maintenance organization is no longer financially

7-9 responsible and may reasonably be expected to be unable to meet its

7-10 obligations to enrollees or prospective enrollees;

7-11 (f) The health maintenance organization has failed to put into effect a

7-12 mechanism affording the enrollees an opportunity to participate in matters

7-13 relating to the content of programs pursuant to NRS 695C.110;

7-14 (g) The health maintenance organization has failed to put into effect the

7-15 system for complaints required by NRS 695C.260 in a manner reasonably

7-16 to dispose of valid complaints;

7-17 (h) The health maintenance organization or any person on its behalf has

7-18 advertised or merchandised its services in an untrue, misrepresentative,

7-19 misleading, deceptive or unfair manner;

7-20 (i) The continued operation of the health maintenance organization

7-21 would be hazardous to its enrollees; or

7-22 (j) The health maintenance organization has otherwise failed to comply

7-23 substantially with the provisions of this chapter.

7-24 2. A certificate of authority must be suspended or revoked only after

7-25 compliance with the requirements of NRS 695C.340.

7-26 3. If the certificate of authority of a health maintenance organization is

7-27 suspended, the health maintenance organization shall not, during the period

7-28 of that suspension, enroll any additional groups or new individual contracts,

7-29 unless those groups or persons were contracted for before the date of

7-30 suspension.

7-31 4. If the certificate of authority of a health maintenance organization is

7-32 revoked, the organization shall proceed, immediately following the

7-33 effective date of the order of revocation, to wind up its affairs and shall

7-34 conduct no further business except as may be essential to the orderly

7-35 conclusion of the affairs of the organization. It shall engage in no further

7-36 advertising or solicitation of any kind. The commissioner may by written

7-37 order permit such further operation of the organization as he may find to be

7-38 in the best interest of enrollees to the end that enrollees are afforded the

7-39 greatest practical opportunity to obtain continuing coverage for health care.

8-1 Sec. 7. The amendatory provisions of this act do not apply to offenses

8-2 that were committed before October 1, 1999.