vided pursuant to paragraphs (b), (c), (e) and (f) must be covered only if the services are provided by a provider with whom the health maintenance organization has contracted for such services. If the health maintenance organization has not contracted for the provision of such services, the health maintenance organization shall pay the provider the rate of reimbursement that is paid to other providers with whom the health maintenance organization has contracted for similar services and the provider shall accept that rate of reimbursement as payment in full. 3. Particular medical treatment described in subsection 2 and provided to an enrollee is not required to be covered pursuant to this section if that particular medical treatment is provided by the sponsor of the clinical trial or study free of charge to the enrollee. 4. The coverage for medical treatment required by this section does not include: (a) Any portion of the clinical trial or study that is customarily paid for by a government or a biotechnical, pharmaceutical or medical industry. (b) Coverage for a drug or device described in paragraph (a) of subsection 2 which is paid for by the manufacturer, distributor or provider of the drug or device. (c) Health care services that are specifically excluded from coverage under the enrollee’s health care plan, regardless of whether such services are provided under the clinical trial or study. (d) Health care services that are customarily provided by the sponsors of the clinical trial or study free of charge to the participants in the trial or study. (e) Extraneous expenses related to participation in the clinical trial or study including, without limitation, travel, housing and other expenses that a participant may incur. (f) Any expenses incurred by a person who accompanies the enrollee during the clinical trial or study. (g) Any item or service that is provided solely to satisfy a need or desire for data collection or analysis that is not directly related to the clinical management of the enrollee. (h) Any costs for the management of research relating to the clinical trial or study. 5. A health maintenance organization that delivers or issues for delivery a health care plan specified in subsection 1 may require copies of the approval or certification issued pursuant to paragraph (b) of subsection 1, the statement of consent signed by the enrollee, protocols for the clinical trial or study and any other materials related to the scope of the clinical trial or study relevant to the coverage of medical treatment pursuant to this section. 6. A health maintenance organization that delivers or issues for delivery a health care plan specified in subsection 1 shall: (a) Include in the disclosure required pursuant to NRS 695C.193 notice to each enrollee of the availability of the benefits required by this section. (b) Provide the coverage required by this section subject to the same deductible, copayment, coinsurance and other such conditions for coverage that are required under the plan. 7. A health care plan subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after January 1, 2006, has the legal effect of including the coverage required by this section, and any provision of the plan that conflicts with this section is void. 8. A health maintenance organization that delivers or issues for delivery a health care plan specified in subsection 1 is immune from liability for: (a) Any injury to an enrollee caused by: (1) Any medical treatment provided to the enrollee in connection with his participation in a clinical trial or study described in this section; or (2) An act or omission by a provider of health care who provides medical treatment or supervises the provision of medical treatment to the enrollee in connection with his participation in a clinical trial or study described in this section. (b) Any adverse or unanticipated outcome arising out of an enrollee’s participation in a clinical trial or study described in this section. 9. As used in this section: (a) “Cooperative group” means a network of facilities that collaborate on research projects and has established a peer review program approved by the National Institutes of Health. The term includes: (1) The Clinical Trials Cooperative Group Program; and (2) The Community Clinical Oncology Program. (b) “Facility authorized to conduct Phase I clinical trials or studies for the treatment of cancer” means a facility or an affiliate of a facility that: (1) Has in place a Phase I program which permits only selective participation in the program and which uses clear-cut criteria to determine eligibility for participation in the program; (2) Operates a protocol review and monitoring system which conforms to the standards set forth in the Policies and Guidelines Relating to the Cancer-Center Support Grant published by the Cancer Centers Branch of the National Cancer Institute; (3) Employs at least two researchers and at least one of those researchers receives funding from a federal grant; (4) Employs at least three clinical investigators who have experience working in Phase I clinical trials or studies conducted at a facility designated as a comprehensive cancer center by the National Cancer Institute; (5) Possesses specialized resources for use in Phase I clinical trials or studies, including, without limitation, equipment that facilitates research and analysis in proteomics, genomics and pharmacokinetics; (6) Is capable of gathering, maintaining and reporting electronic data; and (7) Is capable of responding to audits instituted by federal and state agencies. (c) “Provider of health care” means: (1) A hospital; or (2) A person licensed pursuant to chapter 630, 631 or 633 of NRS. (Added to NRS by 2003, 3528; A 2005, 2018) NRS 695C.1694 Required provision concerning coverage of drug or device for contraception and of hormone replacement therapy in certain circumstances; prohibited actions by health maintenance organization; exceptions. 1. Except as otherwise provided in subsection 5, a health maintenance organization which offers or issues a health care plan that provides coverage for prescription drugs or devices shall include in the plan coverage for: (a) Any type of drug or device for contraception; and (b) Any type of hormone replacement therapy, which is lawfully prescribed or ordered and which has been approved by the Food and Drug Administration. 2. A health maintenance organization that offers or issues a health care plan that provides coverage for prescription drugs shall not: (a) Require an enrollee to pay a higher deductible, copayment or coinsurance or require a longer waiting period or other condition for coverage for a prescription for a contraceptive or hormone replacement therapy than is required for other prescription drugs covered by the plan; (b) Refuse to issue a health care plan or cancel a health care plan solely because the person applying for or covered by the plan uses or may use in the future any of the services listed in subsection 1; (c) Offer or pay any type of material inducement or financial incentive to an enrollee to discourage the enrollee from accessing any of the services listed in subsection 1; (d) Penalize a provider of health care who provides any of the services listed in subsection 1 to an enrollee, including, without limitation, reducing the reimbursement of the provider of health care; or (e) Offer or pay any type of material inducement, bonus or other financial incentive to a provider of health care to deny, reduce, withhold, limit or delay any of the services listed in subsection 1 to an enrollee.

Vegas Law