AB428 - Requires certain health plans to include coverage for fertility preservation services. (BDR 57-915)

- 83rd Session (2025) Assembly Bill No. 428–Assemblymembers Flanagan, Monroe- Moreno, Roth, Anderson, Moore; Brown-May, Carter, Considine, D’Silva, González, Hunt, Jauregui, Karris, La Rue Hatch, Marzola, Miller, Nadeem, Torres-Fossett and Yeager CHAPTER.......... AN ACT relating to insurance; requiring certain health plans to include coverage for certain procedures or services for the preservation of fertility of insureds who have been diagnosed with breast or ovarian cancer; providing certain exceptions for insurers affiliated with religious organizations; authorizing certain expenditures; making an appropriation; and providing other matters properly relating thereto. Legislative Counsel’s Digest: Existing law requires public and private policies of insurance to include certain coverage. (NRS 287.010, 287.04335, 422.2717-422.272428, 689A.04033- 689A.0465, 689B.030-689B.0379, 689C.1652-689C.169, 689C.425, 695A.184- 695A.1875, 695A.255-695A.265, 695B.1901-695B.1949, 695C.050, 695C.1691- 695C.176, 695G.162-695G.177) Existing law also requires employers to provide certain benefits to employees, including the coverage required of health insurers, if the employer provides health benefits for its employees. (NRS 608.1555) Sections 1, 3-9, 11 and 13-15 of this bill require public and private health plans, including Medicaid and insurance for state and local government employees, to provide coverage for certain procedures or services that are medically necessary to preserve fertility for an insured who has been diagnosed with breast or ovarian cancer if: (1) the cancer may directly or indirectly cause infertility; or (2) the insured is expected to receive medical treatment for the cancer and the treatment could directly or indirectly cause infertility. An insurer that is affiliated with a religious organization is not required to provide the coverage required by sections 1, 3-8 and 11 if the insurer: (1) objects to providing the coverage on religious grounds; and (2) provides a written notice to insureds or prospective insureds disclosing that the insurer refuses to provide such coverage. Section 15.5 of this bill makes an appropriation to the Division of Health Care Financing and Policy of the Department of Health and Human Services and authorizes certain expenditures for the costs associated with providing such coverage under Medicaid pursuant to sections 9 and 15. Section 2 of this bill authorizes the Commissioner of Insurance to require a policy of individual health insurance issued by a domestic insurer to a person residing in another state to contain the coverage required by section 1 in certain circumstances. Section 12 of this bill makes a conforming change to require the Director of the Department to administer the provisions of section 15 in the same manner as other provisions relating to Medicaid. Section 10 of this bill authorizes the Commissioner to suspend or revoke the certificate of a health maintenance organization that fails to provide the coverage required by section 8. The Commissioner is also authorized to take such action against other health insurers who fail to provide the coverage required by sections 1, 3-8 and 11. (NRS 680A.200) – 2 – - 83rd Session (2025) EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted. THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS: Section 1. Chapter 689A of NRS is hereby amended by adding thereto a new section to read as follows: 1. Except as otherwise provided in subsection 4, an insurer that issues a policy of health insurance shall include in the policy coverage for any procedure or service for the preservation of fertility consistent with established medical practice or any guidelines published by the American Society for Reproductive Medicine or the American Society of Clinical Oncology, or their successor organizations, that is medically necessary to preserve fertility because the insured has been diagnosed with breast or ovarian cancer and: (a) The cancer may, in the judgment of a provider of health care, directly or indirectly cause infertility; or (b) The insured is expected to receive medical treatment for the cancer and such treatment may directly or indirectly cause infertility. 2. For the purposes of subsection 1, a medical treatment may directly or indirectly cause infertility if the treatment has a potential side effect of impaired fertility, as established by the American Society of Clinical Oncology or the American Society for Reproductive Medicine, or their successor organizations. 3. An insurer shall ensure that the benefits required by subsection 1 are made available to an insured through a provider of health care who participates in the network plan of the insurer. 4. An insurer that is affiliated with a religious organization is not required to provide the coverage required by subsection 1 if the insurer objects on religious grounds. Such an insurer shall, before the issuance of a policy of health insurance that is subject to the requirements of subsection 1 and before the renewal of such a policy, provide to the insured or prospective insured, as applicable, written notice of the coverage that the insurer refuses to provide pursuant to this subsection. 5. A policy of health insurance that is subject to the provisions of this chapter and is delivered, issued for delivery or renewed on or after January 1, 2026, has the legal effect of including the coverage required by subsection 1, and any provision of the policy or the renewal that conflicts with the provisions of this section is void. – 3 – - 83rd Session (2025) 6. As used in this section: (a) “Network plan” means a policy of health insurance offered by an insurer under which the financing and delivery of medical care, including items and services paid for as medical care, are provided, in whole or in part, through a defined set of providers under contract with the insurer. The term does not include an arrangement for the financing of premiums. (b) “Provider of health care” has the meaning ascribed to it in NRS 629.031. Sec. 2. NRS 689A.330 is hereby amended to read as follows: 689A.330 If any policy is issued by a domestic insurer for delivery to a person residing in another state, and if the insurance commissioner or corresponding public officer of that other state has informed the Commissioner that the policy is not subject to approval or disapproval by that officer, the Commissioner may by ruling require that the policy meet the standards set forth in NRS 689A.030 to 689A.320, inclusive [.] , and section 1 of this act. Sec. 3. Chapter 689B of NRS is hereby amended by adding thereto a new section to read as follows: 1. Except as otherwise provided in subsection 3, an insurer that issues a policy of group health insurance shall include in the policy coverage for any procedure or service for the preservation of fertility consistent with established medical practice or any guidelines published by the American Society for Reproductive Medicine or the American Society of Clinical Oncology, or their successor organizations, that is medically necessary to preserve fertility because the insured has been diagnosed with breast or ovarian cancer and: (a) The cancer may, in the judgment of a provider of health care, directly or indirectly cause infertility; or (b) The insured is expected to receive medical treatment for the cancer and such treatment may directly or indirectly cause infertility. 2. For the purposes of subsection 1, a medical treatment may directly or indirectly cause infertility if the treatment has a potential side effect of impaired fertility, as established by the American Society of Clinical Oncology or the American Society for Reproductive Medicine, or their successor organizations. 3. An insurer that is affiliated with a religious organization is not required to provide the coverage required by subsection 1 if the insurer objects on religious grounds. Such an insurer shall, before the issuance of a policy of group health insurance that is subject to the requirements of subsection 1 and before the renewal – 4 – - 83rd Session (2025) of such a policy, provide to the group policyholder or prospective insured, as applicable, written notice of the coverage that the insurer refuses to provide pursuant to this subsection. 4. A policy of group health insurance that is subject to the provisions of this chapter and is delivered, issued for delivery or renewed on or after January 1, 2026, has the legal effect of including the coverage required by subsection 1, and any provision of the policy or the renewal that conflicts with the provisions of this section is void. Sec. 4. Chapter 689C of NRS is hereby amended by adding thereto a new section to read as follows: 1. Except as otherwise provided in subsection 4, a carrier that issues a health benefit plan shall include in the plan coverage for any procedure or service for the preservation of fertility consistent with established medical practice or any guidelines published by the American Society for Reproductive Medicine or the American Society of Clinical Oncology, or their successor organizations, that is medically necessary to preserve fertility because the insured has been diagnosed with breast or ovarian cancer and: (a) The cancer may, in the judgment of a provider of health care, directly or indirectly cause infertility; or (b) The insured is expected to receive medical treatment for the cancer and such treatment may directly or indirectly cause infertility. 2. For the purposes of subsection 1, a medical treatment may directly or indirectly cause infertility if the treatment has a potential side effect of impaired fertility, as established by the American Society of Clinical Oncology or the American Society for Reproductive Medicine, or their successor organizations. 3. A carrier shall ensure that the benefits required by subsection 1 are made available to an insured through a provider of health care who participates in the network plan of the carrier. 4. A carrier that is affiliated with a religious organization is not required to provide the coverage required by subsection 1 if the carrier objects on religious grounds. Such a carrier shall, before the issuance of a health benefit plan that is subject to the requirements of subsection 1 and before the renewal of such a plan, provide to the insured or prospective insured, as applicable, written notice of the coverage that the carrier refuses to provide pursuant to this subsection. 5. A health benefit plan that is subject to the provisions of this chapter and is delivered, issued for delivery or renewed on or after January 1, 2026, has the legal effect of including the – 5 – - 83rd Session (2025) coverage required by subsection 1, and any provision of the plan or the renewal that conflicts with the provisions of this section is void. 6. As used in this section: (a) “Network plan” means a health benefit plan offered by a carrier under which the financing and delivery of medical care, including items and services paid for as medical care, are provided, in whole or in part, through a defined set of providers under contract with the carrier. The term does not include an arrangement for the financing of premiums. (b) “Provider of health care” has the meaning ascribed to it in NRS 629.031. Sec. 5. NRS 689C.425 is hereby amended to read as follows: 689C.425 A voluntary purchasing group and any contract issued to such a group pursuant to NRS 689C.360 to 689C.600, inclusive, are subject to the provisions of NRS 689C.015 to 689C.355, inclusive, and section 4 of this act, to the extent applicable and not in conflict with the express provisions of NRS 687B.408 and 689C.360 to 689C.600, inclusive. Sec. 6. Chapter 695A of NRS is hereby amended by adding thereto a new section to read as follows: 1. Except as otherwise provided in subsection 4, a society that issues a benefit contract shall include in the contract coverage for any procedure or service for the preservation of fertility consistent with established medical practice or any guidelines published by the American Society for Reproductive Medicine or the American Society of Clinical Oncology, or their successor organizations, that is medically necessary to preserve fertility because the insured has been diagnosed with breast or ovarian cancer and: (a) The cancer may, in the judgment of a provider of health care, directly or indirectly cause infertility; or (b) The insured is expected to receive medical treatment for the cancer and such treatment may directly or indirectly cause infertility. 2. For the purposes of subsection 1, a medical treatment may directly or indirectly cause infertility if the treatment has a potential side effect of impaired fertility, as established by the American Society of Clinical Oncology or the American Society for Reproductive Medicine, or their successor organizations. 3. A society shall ensure that the benefits required by subsection 1 are made available to an insured through a provider of health care who participates in the network plan of the society. – 6 – - 83rd Session (2025) 4. A society that is affiliated with a religious organization is not required to provide the coverage required by subsection 1 if the society objects on religious grounds. Such a society shall, before the issuance of a benefit contract that is subject to the requirements of subsection 1 and before the renewal of such a contract, provide to the insured or prospective insured, as applicable, written notice of the coverage that the society refuses to provide pursuant to this subsection. 5. A benefit contract that is subject to the provisions of this chapter and is delivered, issued for delivery or renewed on or after January 1, 2026, has the legal effect of including the coverage required by subsection 1, and any provision of the contract or the renewal that conflicts with the provisions of this section is void. 6. As used in this section: (a) “Network plan” means a benefit contract offered by a society under which the financing and delivery of medical care, including items and services paid for as medical care, are provided, in whole or in part, through a defined set of providers under contract with the society. The term does not include an arrangement for the financing of premiums. (b) “Provider of health care” has the meaning ascribed to it in NRS 629.031. Sec. 7. Chapter 695B of NRS is he [Text truncated for display. Full text available on LegiScan.]