Existing law requires certain public and private insurers, including Medicaid and health plans for public and private employees, to provide coverage for medically necessary biomarker testing for the diagnosis, treatment, appropriate management and ongoing monitoring of cancer when such biomarker testing is supported by medical and scientific evidence. (NRS 287.010, 287.04335, 422.272364, 608.1555, 689A.0446, 689B.0361, 689C.1688, 689C.425, 695A.1859, 695B.19087, 695C.050, 695C.16932, 695G.1703) Existing law also requires such health insurance to cover the examination of a pregnant woman for the discovery of certain sexually transmitted diseases. (NRS 287.010, 287.04335, 422.27173, 608.1555, 689A.0412, 689B.0315, 689C.1675, 689C.925, 695A.1856, 695B.1913, 695C.050, 695C.1737, 695G.1714) Sections 2, 4-10, 12 and 14-16 of this bill require such insurers to cover certain screenings of the blood of a person who is pregnant to detect chromosomal abnormalities in the fetus. Sections 1, 2, 4-10, 12 and 14-16 prohibit such insurers from requiring prior authorization for such screenings. Section 3 of this bill authorizes the Commissioner of Insurance to require that certain policies of health insurance issued by a domestic insurer to a person who resides in another state include the coverage required by section 2. Section 11 of this bill authorizes the Commissioner to suspend or revoke the certificate of a health maintenance organization that fails to comply with the requirements of section 9. The Commissioner would also be authorized to take such action against other private health insurers who fail to comply with the requirements of sections 2, 4-8, 10 or 12. (NRS 680A.200) Section 16 additionally requires Medicaid to cover certain screenings of the parents of a fetus to determine if they are carriers of certain genetic disorders without requiring prior authorization for such screenings. Section 13 of this bill requires the Director of the Department of Health and Human Services to administer the provisions of section 16 in the same manner as the provisions of existing law governing Medicaid.

Statutes affected:
As Introduced: 687B.225, 689A.330, 689C.425, 695C.050, 695C.330, 232.320, 287.010, 287.04335
BDR: 687B.225, 689A.330, 689C.425, 695C.050, 695C.330, 232.320, 287.010, 287.04335