Existing law prescribes certain rights for a patient of a medical facility or a facility for the dependent. (NRS 449A.100-449A.124) Sections 2-9 of this bill establish certain rights related to assisted reproduction. Sections 3-6 define certain terms relating to assisted reproduction. Section 7 applies the provisions of sections 2-9 to certain state laws and all local laws and ordinances and the implementation of those laws and ordinances, regardless of when those laws or ordinances were enacted. Section 8 generally prohibits a governmental entity from enacting or implementing any limitation or requirement that singles out assisted reproduction and substantially burdens: (1) the access of a person to assisted reproduction, any drug or device related to assisted reproduction or information related to assisted reproduction; (2) the ability of a provider of health care to provide assisted reproduction, any drug or device related to assisted reproduction or information related to assisted reproduction within his or her scope of practice, training and experience; (3) the ability of a third party to provide insurance coverage of assisted reproduction or drugs or devices related to assisted reproduction; or (4) the ability of a person to control the use or disposition of his or her reproductive genetic material. Section 8 creates an exception to such prohibitions if the governmental entity demonstrates by clear and convincing evidence that the burden, as applied to the person, provider of health care or third party who is subject to the burden: (1) furthers a compelling interest; and (2) is the least restrictive means of furthering that interest. Section 8 authorizes a person, provider of health care or third party whose ability to access, provide or cover assisted reproduction, drugs or devices related to assisted reproduction or information related to assisted reproduction, or a person whose ability to control the use or disposition of his or her reproductive genetic material, is burdened to bring or defend an action in court and obtain appropriate relief. Section 8 requires a court to award costs and attorney's fees to a person or entity who prevails on such a claim. Section 8 additionally authorizes the Attorney General to bring an action to enjoin any limitation or requirement that violates section 8. Section 9 provides that a person or entity is not subject to civil or criminal liability or administrative sanctions solely because the person or entity provides or receives goods or services related to assisted reproduction. Section 9 also provides that the manufacturer of certain goods used to facilitate assisted reproduction is not subject to civil or criminal liability or administrative sanctions solely because of the death of or damage to an embryo. Under section 9, a person or entity is not immune from civil or criminal liability or administrative sanctions for acts or omissions that independently create liability or grounds for administrative sanctions, including, without limitation, negligence or providing services outside the scope of practice, training or experience of the person or entity. Section 10 of this bill provides that a fertilized egg or human embryo that exists before implantation in the uterus of a human body is not a human being for any purpose under Nevada law. Existing law prescribes certain requirements governing the availability of health insurance plans in this State. (NRS 687B.480, 689A.430-689A.460, 689B.300-689B.330, 695A.151-695A.157, 695B.340-695B.370, 695C.163-695C.169, 695F.440-695F.470) Sections 12, 13, 15, 20, 24, 27-29, 32, 36, 38, 42 and 45 of this bill require a health insurer, including public and private employers who provide insurance for their employees, to provide a special enrollment period to a person determined by a qualified provider of health care to be pregnant, during which the pregnant person must be allowed to enroll in a health care plan outside of the period of open enrollment. Section 17 of this bill provides for the enforcement of section 15, which governs private employers who provide health benefits to employees through a self-insured plan. Section 18 of this bill establishes civil and criminal penalties for a violation of section 15, which are the same as the penalties for violations of other laws governing benefits provided by private employers. Sections 21, 26, 34 and 39 of this bill make conforming changes to indicate the applicability of certain definitions to sections 20, 24, 32 and 36, respectively. Existing law requires public and private policies of health insurance regulated under Nevada law to include certain coverage. (NRS 287.010, 287.04335, 422.2717-422.272428, 689A.04033-689A.0465, 689B.0303-689B.0379, 689C.1652-689C.169, 689C.194, 689C.1945, 689C.195, 689C.425, 695A.184-695A.1875, 695A.265, 695B.1901-695B.1948, 695C.050, 695C.1691-695C.176, 695G.162-695G.177) Existing law also requires employers to provide certain benefits for health care to employees, including the coverage required of health insurers, if the employer provides health benefits for its employees through a self-insured plan. (NRS 608.1555) Sections 12-14, 23, 31, 37, 38 and 44 of this bill require Medicaid and public and private health care plans for groups of more than 100 insureds to include certain coverage for: (1) the treatment of infertility; and (2) the preservation of fertility where the insured has a medical condition or requires medical treatment that may cause infertility under certain circumstances. Section 16 of this bill exempts employers who provide benefits for health care for their employees through a self-insured plan from those requirements. Sections 12-14, 19, 23, 31, 37, 38 and 44 of this bill prohibit an insurer from imposing conditions, including cost-sharing, prior authorizations and waiting periods, on infertility treatment or fertility preservation if such conditions are not required for similar benefits that are not related to fertility. Section 11 of this bill makes a conforming change to require the Director of the Department of Health and Human Services to administer the provisions of section 14 in the same manner as other provisions relating to Medicaid. Sections 25, 33 and 40 of this bill make conforming changes to clarify the applicability of provisions indicating that certain insurers are not required to cover fertility drugs. Section 41 of this bill authorizes the Commissioner of Insurance to suspend or revoke the certificate of a health maintenance organization that fails to provide the coverage required by section 37. The Commissioner is also authorized to take such action against other health insurers who fail to provide the coverage required by sections 23 and 44. (NRS 680A.200)

Statutes affected:
As Introduced: 232.320, 287.010, 287.04335, 608.1555, 608.180, 608.195, 687B.225, 689A.420, 689B.0376, 689B.290, 689C.425, 695B.1916, 695B.330, 695C.050, 695C.161, 695C.1694, 695C.330
BDR: 232.320, 287.010, 287.04335, 608.1555, 608.180, 608.195, 687B.225, 689A.420, 689B.0376, 689B.290, 689C.425, 695B.1916, 695B.330, 695C.050, 695C.161, 695C.1694, 695C.330