mammogram for women between the ages of 35 and 40; and (c) An annual mammogram for women 40 years of age or older. 2. A health maintenance plan must not require an insured to obtain prior authorization for any service provided pursuant to subsection 1. 3. A policy subject to the provisions of this chapter which is delivered, issued for delivery or renewed on or after October 1, 1989, has the legal effect of including the coverage required by subsection 1, and any provision of the policy or the renewal which is in conflict with subsection 1 is void. (Added to NRS by 1989, 1891; A 1997, 1730) NRS 695C.1738 Required provision concerning coverage for treatment of conditions relating to severe mental illness. 1. Notwithstanding any provisions of this title to the contrary, any evidence of coverage delivered or issued for delivery in this state pursuant to this chapter must provide coverage for the treatment of conditions relating to severe mental illness. 2. The coverage required by this section: (a) Must provide: (1) Benefits for at least 40 days of hospitalization as an inpatient per year of coverage and 40 visits for treatment as an outpatient per year of coverage, excluding visits for the management of medication; and (2) That two visits for partial or respite care, or a combination thereof, may be substituted for each 1 day of hospitalization not used by the insured. In no event is the evidence of coverage required to provide coverage for more than 40 days of hospitalization as an inpatient per year of coverage. (b) Is not required to provide benefits for psychosocial rehabilitation or care received as a custodial inpatient. 3. Any deductibles and copayments required to be paid for the coverage required by this section must not be greater than 150 percent of the out-of-pocket expenses required to be paid for medical and surgical benefits provided pursuant to the evidence of coverage. 4. The provisions of this section do not apply to any evidence of coverage: (a) Delivered or issued for delivery to an employer to provide coverage for his employees if the employer has no more than 25 employees. (b) If, at the end of the year for which coverage was provided, the premiums charged for the evidence of coverage, or a standard grouping of evidence of coverage, increase by more than 2 percent as a result of providing the coverage required by this section and the health maintenance organization obtains an exemption from the Commissioner pursuant to subsection 5. 5. To obtain the exemption required by paragraph (b) of subsection 4, a health maintenance organization must submit to the Commissioner a written request therefor that is signed by an actuary and sets forth the reasons and actuarial assumptions upon which the request is based. To determine whether an exemption may be granted, the Commissioner shall subtract from the amount of premiums charged during the year for which coverage was provided the amount of premiums charged during the period immediately preceding that year and the amount of any increase in the premiums charged that is attributable to factors that are unrelated to providing the coverage required by this section. The Commissioner shall verify the information within 30 days after receiving the request. The request shall be deemed approved if the Commissioner does not deny the request within that time. 6. The provisions of this section do not: (a) Limit the provision of specialized services covered by Medicaid for persons with conditions relating to mental health or substance abuse. (b) Supersede any provision of federal law, any federal or state policy relating to Medicaid, or the terms and conditions imposed on any Medicaid waiver granted to this state with respect to the provisions of services to persons with conditions relating to mental health or substance abuse. 7. Any evidence of coverage subject to the provisions of this chapter which is delivered, issued for delivery or renewed on or after January 1, 2000, has the legal effect of including the coverage required by this section, and any provision of the evidence of coverage or the renewal which is in conflict with this section is void, unless the evidence of coverage is otherwise exempt from the provisions of this section pursuant to subsection 4. 8. As used in this section, “severe mental illness” means any of the following mental illnesses that are biologically based and for which diagnostic criteria are prescribed in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, published by the American Psychiatric Association: (a) Schizophrenia. (b) Schizoaffective disorder. (c) Bipolar disorder. (d) Major depressive disorders. (e) Panic disorder. (f ) Obsessive-compulsive disorder. (Added to NRS by 1999, 3104) NRS 695C.174 Required provision concerning benefits for treatment of abuse of alcohol or drugs. 1. The benefits provided by health maintenance plans for treatment of the abuse of alcohol or drugs as required by subparagraph (5) of paragraph (b) of subsection 3 of NRS 695C.170, must consist of: (a) Treatment for withdrawal from the physiological effects of alcohol or drugs, with a minimum benefit of $1,500 per calendar year. (b) Treatment for a patient admitted to a facility, with a minimum benefit of $9,000 per calendar year. (c) Counseling for a person, group or family who is not admitted to a facility, with a minimum benefit of $2,500 per calendar year. 2. These benefits must be paid in the same manner as benefits for any other illness covered by a similar policy are paid. 3. The insured person is entitled to these benefits if treatment is received in any: (a) Facility for the treatment of abuse of alcohol or drugs which is certified by the Health Division of the Department of Health and Human Services. (b) Hospital or other medical facility or facility for the dependent which is licensed by the Health Division of the Department of Health and Human Services, accredited by the Joint Commission on Accreditation of Healthcare Organizations and provides a program for the treatment of abuse of alcohol or drugs as part of its accredited activities. (Added to NRS by 1979, 1181; A 1983, 2042; 1985, 1571, 1778; 1993, 1922; 1997, 1302; 1999, 1890; 2001, 440) NRS 695C.1755 Required provision concerning coverage for treatment of temporomandibular joint. 1. Except as otherwise provided in this section, no evidence of coverage may be delivered or issued for delivery in this state if it contains an exclusion of coverage of the treatment of the temporomandibular joint whether by specific language in the evidence of coverage or by a claims settlement practice. An evidence of coverage may exclude coverage of those methods of treatment which are recognized as dental procedures, including, but not limited to, the extraction of teeth and the application of orthodontic devices and splints. 2. The health maintenance organization may limit its liability on the treatment of the temporomandibular joint to: (a) No more than 50 percent of the usual and customary charges for such treatment actually received by an enrollee, but in no case more than 50 percent of the maximum benefits provided by the evidence of coverage for such treatment; and (b) Treatment which is medically necessary. 3. Any provision of an evidence of coverage subject to the provisions of this chapter and issued or delivered on or after January 1, 1990, which is in conflict with this section is void. (Added to NRS by 1989, 2139) NRS 695C.176 Required provision concerning coverage for hospice care. Each health care plan must provide benefits for hospice care. (Added to NRS by 1983, 1936; A 1985, 1779; 1989, 1033) NRS 695C.1765 Reimbursement for acup

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