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. Notwithstanding any provisions of this Title to the contrary, a

1-4 policy of health insurance delivered or issued for delivery in this state

1-5 pursuant to this chapter must provide coverage for the treatment of

1-6 conditions relating to severe mental illness.

1-7 2. The coverage required by this section:

1-8 (a) Must provide:

1-9 (1) Benefits for at least 40 days of hospitalization as an inpatient

1-10 per policy year and 40 visits for treatment as an outpatient per policy

1-11 year, excluding visits for the management of medication; and

1-12 (2) That two visits for partial or respite care, or a combination

1-13 thereof, may be substituted for each 1 day of hospitalization not used by

1-14 the insured. In no event is the policy required to provide coverage for

1-15 more than 40 days of hospitalization as an inpatient per policy year.

1-16 (b) Is not required to provide benefits for psychosocial rehabilitation

1-17 or care received as a custodial inpatient.

2-1 3. Any deductibles and copayments required to be paid for the

2-2 coverage required by this section must not be greater than 150 percent of

2-3 the out-of-pocket expenses required to be paid for medical and surgical

2-4 benefits provided pursuant to the policy of health insurance.

2-5 4. The provisions of this section do not apply to a policy of health

2-6 insurance if, at the end of the policy year, the premiums charged for that

2-7 policy, or a standard grouping of policies, increase by more than 2

2-8 percent as a result of providing the coverage required by this section and

2-9 the insurer obtains an exemption from the commissioner pursuant to

2-10 subsection 5.

2-11 5. To obtain the exemption required by subsection 4, an insurer must

2-12 submit to the commissioner a written request therefor that is signed by an

2-13 actuary and sets forth the reasons and actuarial assumptions upon which

2-14 the request is based. To determine whether an exemption may be

2-15 granted, the commissioner shall subtract from the amount of premiums

2-16 charged during the policy year the amount of premiums charged during

2-17 the period immediately preceding the policy year and the amount of any

2-18 increase in the premiums charged that is attributable to factors that are

2-19 unrelated to providing the coverage required by this section. The

2-20 commissioner shall verify the information within 30 days after receiving

2-21 the request. The request shall be deemed approved if the commissioner

2-22 does not deny the request within that time.

2-23 6. The provisions of this section do not:

2-24 (a) Limit the provision of specialized services covered by Medicaid for

2-25 persons with conditions relating to mental health or substance abuse.

2-26 (b) Supersede any provision of federal law, any federal or state policy

2-27 relating to Medicaid, or the terms and conditions imposed on any

2-28 Medicaid waiver granted to this state with respect to the provisions of

2-29 services to persons with conditions relating to mental health or substance

2-30 abuse.

2-31 7. A policy of health insurance subject to the provisions of this

2-32 chapter which is delivered, issued for delivery or renewed on or after

2-33 January 1, 2000, has the legal effect of including the coverage required

2-34 by this section, and any provision of the policy or the renewal which is in

2-35 conflict with this section is void, unless the policy is otherwise exempt

2-36 from the provisions of this section pursuant to subsection 4.

2-37 8. As used in this section, "severe mental illness" means any of the

2-38 following mental illnesses that are biologically based and for which

2-39 diagnostic criteria are prescribed in the "Diagnostic and Statistical

2-40 Manual of Mental Disorders," Fourth Edition, published by the

2-41 American Psychiatric Association:

2-42 (a) Schizophrenia.

2-43 (b) Schizoaffective disorder.

3-1 (c) Bipolar disorder.

3-2 (d) Major depressive disorders.

3-3 (e) Panic disorder.

3-4 (f) Obsessive-compulsive disorder.

3-5 Sec. 2. Chapter 689B of NRS is hereby amended by adding thereto a

3-43 attributable to factors that are unrelated to providing the coverage

4-1 required by this section. The commissioner shall verify the information

4-2 within 30 days after receiving the request. The request shall be deemed

4-3 approved if the commissioner does not deny the request within that time.

4-4 6. The provisions of this section do not:

4-5 (a) Limit the provision of specialized services covered by Medicaid for

4-6 persons with conditions relating to mental health or substance abuse.

4-7 (b) Supersede any provision of federal law, any federal or state policy

4-8 relating to Medicaid, or the terms and conditions imposed on any

4-9 Medicaid waiver granted to this state with respect to the provisions of

4-10 services to persons with conditions relating to mental health or substance

4-11 abuse.

4-12 7. A policy of group health insurance subject to the provisions of this

4-13 chapter which is delivered, issued for delivery or renewed on or after

4-14 January 1, 2000, has the legal effect of including the coverage required

4-15 by this section, and any provision of the policy or the renewal which is in

4-16 conflict with this section is void, unless the policy is otherwise exempt

4-17 from the provisions of this section pursuant to subsection 4.

4-18 8. As used in this section, "severe mental illness" means any of the

4-19 following mental illnesses that are biologically based and for which

4-20 diagnostic criteria are prescribed in the "Diagnostic and Statistical

4-21 Manual of Mental Disorders," Fourth Edition, published by the

4-22 American Psychiatric Association:

4-23 (a) Schizophrenia.

4-24 (b) Schizoaffective disorder.

4-25 (c) Bipolar disorder.

4-26 (d) Major depressive disorders.

4-27 (e) Panic disorder.

4-28 (f) Obsessive-compulsive disorder.

4-29 Sec. 3. Chapter 695B of NRS is hereby amended by adding thereto a

4-43 more than 40 days of hospitalization as an inpatient per contract year.

5-1 (b) Is not required to provide benefits for psychosocial rehabilitation

5-2 or care received as a custodial inpatient.

5-3 3. Any deductibles and copayments required to be paid for the

5-4 coverage required by this section must not be greater than 150 percent of

5-5 the out-of-pocket expenses required to be paid for medical and surgical

5-6 benefits provided pursuant to the contract for hospital or medical

5-7 services.

5-8 4. The provisions of this section do not apply to a contract for

5-9 hospital or medical service:

5-10 (a) Delivered or issued for delivery to an employer to provide coverage

5-11 for his employees if the employer has no more than 25 employees.

5-12 (b) If, at the end of the contract year, the premiums charged for that

5-13 contract, or a standard grouping of contracts, increase by more than 2

5-14 percent as a result of providing the coverage required by this section and

5-15 the insurer obtains an exemption from the commissioner pursuant to

5-16 subsection 5.

5-17 5. To obtain the exemption required by paragraph (b) of subsection

5-18 4, an insurer must submit to the commissioner a written request therefor

5-19 that is signed by an actuary and sets forth the reasons and actuarial

5-20 assumptions upon which the request is based. To determine whether an

5-21 exemption may be granted, the commissioner shall subtract from the

5-22 amount of premiums charged during the contract year the amount of

5-23 premiums charged during the period immediately preceding the contract

5-24 year and the amount of any increase in the premiums charged that is

5-25 attributable to factors that are unrelated to providing the coverage

5-26 required by this section. The commissioner shall verify the information

5-27 within 30 days after receiving the request. The request shall be deemed

5-28 approved if the commissioner does not deny the request within that time.

5-29 6. The provisions of this section do not:

5-30 (a) Limit the provision of specialized services covered by Medicaid for

5-31 persons with conditions relating to mental health or substance abuse.

5-32 (b) Supersede any provision of federal law, any federal or state policy

5-33 relating to Medicaid, or the terms and conditions imposed on any

5-34 Medicaid waiver granted to this state with respect to the provisions of

5-35 services to persons with conditions relating to mental health or substance

5-36 abuse.

5-37 7. A contract for hospital or medical service subject to the provisions

5-38 of this chapter which is delivered, issued for delivery or renewed on or

5-39 after January 1, 2000, has the legal effect of including the coverage

5-40 required by this section, and any provision of the contract or the renewal

5-41 which is in conflict with this section is void, unless the contract is

5-42 otherwise exempt from the provisions of this section pursuant to

5-43 subsection 4.

6-1 8. As used in this section, "severe mental illness" means any of the

6-2 following mental illnesses that are biologically based and for which

6-3 diagnostic criteria are prescribed in the "Diagnostic and Statistical

6-4 Manual of Mental Disorders," Fourth Edition, published by the

6-5 American Psychiatric Association:

6-6 (a) Schizophrenia.

6-7 (b) Schizoaffective disorder.

6-8 (c) Bipolar disorder.

6-9 (d) Major depressive disorders.

6-10 (e) Panic disorder.

6-11 (f) Obsessive-compulsive disorder.

6-12 Sec. 4. Chapter 695C of NRS is hereby amended by adding thereto a

6-43 pursuant to subsection 5.

7-1 5. To obtain the exemption required by paragraph (b) of subsection

7-2 4, a health maintenance organization must submit to the commissioner a

7-3 written request therefor that is signed by an actuary and sets forth the

7-4 reasons and actuarial assumptions upon which the request is based. To

7-5 determine whether an exemption may be granted, the commissioner shall

7-6 subtract from the amount of premiums charged during the year for

7-7 which coverage was provided the amount of premiums charged during

7-8 the period immediately preceding that year and the amount of any

7-9 increase in the premiums charged that is attributable to factors that are

7-10 unrelated to providing the coverage required by this section. The

7-11 commissioner shall verify the information within 30 days after receiving

7-12 the request. The request shall be deemed approved if the commissioner

7-13 does not deny the request within that time.

7-14 6. The provisions of this section do not:

7-15 (a) Limit the provision of specialized services covered by Medicaid for

7-16 persons with conditions relating to mental health or substance abuse.

7-17 (b) Supersede any provision of federal law, any federal or state policy

7-18 relating to Medicaid, or the terms and conditions imposed on any

7-19 Medicaid waiver granted to this state with respect to the provisions of

7-20 services to persons with conditions relating to mental health or substance

7-21 abuse.

7-22 7. Any evidence of coverage subject to the provisions of this chapter

7-23 which is delivered, issued for delivery or renewed on or after January 1,

7-24 2000, has the legal effect of including the coverage required by this

7-25 section, and any provision of the evidence of coverage or the renewal

7-26 which is in conflict with this section is void, unless the evidence of

7-27 coverage is otherwise exempt from the provisions of this section pursuant

7-28 to subsection 4.

7-29 8. As used in this section, "severe mental illness" means any of the

7-30 following mental illnesses that are biologically based and for which

7-31 diagnostic criteria are prescribed in the "Diagnostic and Statistical

7-32 Manual of Mental Disorders," Fourth Edition, published by the

7-33 American Psychiatric Association:

7-34 (a) Schizophrenia.

7-35 (b) Schizoaffective disorder.

7-36 (c) Bipolar disorder.

7-37 (d) Major depressive disorders.

7-38 (e) Panic disorder.

7-39 (f) Obsessive-compulsive disorder.

7-40 Sec. 5. NRS 287.010 is hereby amended to read as follows:

7-41 287.010 1. The governing body of any county, school district,

7-43 public agency of the State of Nevada may:

8-1 (a) Adopt and carry into effect a system of group life, accident or health

8-2 insurance, or any combination thereof, for the benefit of its officers and

8-3 employees, and the dependents of officers and employees who elect to

8-4 accept the insurance and who, where necessary, have authorized the

8-5 governing body to make deductions from their compensation for the

8-6 payment of premiums on the insurance.

8-7 (b) Purchase group policies of life, accident or health insurance, or any

8-8 combination thereof, for the benefit of such officers and employees, and the

8-9 dependents of such officers and employees, as have authorized the

8-10 purchase, from insurance companies authorized to transact the business of

8-11 such insurance in the State of Nevada, and, where necessary, deduct from

8-12 the compensation of officers and employees the premiums upon insurance

8-13 and pay the deductions upon the premiums.

8-14 (c) Provide group life, accident or health coverage through a self-

8-15 insurance reserve fund and, where necessary, deduct contributions to the

8-16 maintenance of the fund from the compensation of officers and employees

8-17 and pay the deductions into the fund. The money accumulated for this

8-18 purpose through deductions from the compensation of officers and

8-19 employees and contributions of the governing body must be maintained as

8-20 an internal service fund as defined by NRS 354.543. The money must be

8-21 deposited in a state or national bank or credit union authorized to transact

8-22 business in the State of Nevada. Any independent administrator of a fund

8-23 created under this section is subject to the licensing requirements of chapter

8-24 683A of NRS, and must be a resident of this state. Any contract with an

8-25 independent administrator must be approved by the commissioner of

8-26 insurance as to the reasonableness of administrative charges in relation to

8-27 contributions collected and benefits provided. The provisions of NRS

8-28 689B.030 to 689B.050, inclusive, and sections 6 and 7 of [this act]

8-29 Assembly Bill No. 60 of this session apply to coverage provided pursuant

8-30 to this paragraph [.] , except that the provisions of section 2 of this act do

8-31 not apply to such coverage.

8-32 (d) Defray part or all of the cost of maintenance of a self-insurance fund

8-33 or of the premiums upon insurance. The money for contributions must be

8-34 budgeted for in accordance with the laws governing the county, school

8-35 district, municipal corporation, political subdivision, public corporation or

8-36 other public agency of the State of Nevada.

8-37 2. If a school district offers group insurance to its officers and

8-38 employees pursuant to this section, members of the board of trustees of the

8-39 school district must not be excluded from participating in the group

8-40 insurance. If the amount of the deductions from compensation required to

8-41 pay for the group insurance exceeds the compensation to which a trustee is

8-42 entitled, the difference must be paid by the trustee.

9-1 Sec. 6. Section 35 of Assembly Bill No. 293 of this session is hereby

9-2 amended to read as follows:

9-3 Sec. 35. [1. This section and sections 1, 2, 4, 6 to 22,

9-4 inclusive, 24 to 29, inclusive, 32, 33 and 34 of this act become

9-5 effective on July 1, 1999.

9-6 2.] Sections 3, 5, 23, 30 and 31 of this act become effective on

9-7 October 1, 1999.

9-8 Sec. 7. Upon request, an insurer who delivers or issues for delivery a

9-9 policy of insurance, contract for hospital or medical service or evidence of

9-10 coverage pursuant to chapter 689A, 689B, 695B or 695C of NRS shall

9-11 provide to the commissioner of insurance such information as the

9-12 commissioner deems necessary to carry out the provisions of subsection 3

9-13 of section 9 of this act.

9-14 Sec. 8. Sections 1, 2, 4, 6 to 22, inclusive, 24 to 29, inclusive, 32, 33

9-15 and 34 of Assembly Bill No. 293 of this session are hereby repealed.

9-16 Sec. 9. 1. This section and sections 6 and 8 of this act become

9-17 effective upon passage and approval only if the governor has first signed

9-18 Assembly Bill No. 293 of this session.

9-19 2. Sections 1 to 5, inclusive, and 7 of this act become effective on

9-20 January 1, 2000, only if the governor has first signed Assembly Bill No.

9-21 293 of this session.

9-22 3. The provisions of sections 1 to 5, inclusive, and 7 of this act expire

9-23 by limitation on May 1, 2004, if, on January 1, 2003, the commissioner of

9-24 insurance issues a determination that the cumulative average increase in

9-25 premiums for policies of insurance, contracts for hospital or medical

9-26 service and evidence of coverage delivered or issued for delivery pursuant

9-27 to chapters 689A, 689B, 695B and 695C of NRS, respectively, that is

9-28 directly attributable to coverage for the treatment of conditions relating to

9-29 severe mental illness required to be provided by this act is greater than 6

9-30 percent.