NRS 695A.18445 Coverage for certain gynecological or obstetrical services required without prior authorization or referral from primary care physician; designation of obstetrician or gynecologist as primary care physician.

270 words·~1 min read·/nv/chapter-695a-fraternal-benefit-societies/695a-18445·

A research copy — for the controlling text, always check the official state or federal source. Not legal advice.

1. A society that offers or issues a benefit contract shall include in the contract a provision authorizing a woman covered by the plan to:

(a)Obtain covered gynecological or obstetrical services without first receiving authorization or a referral from her primary care physician.

(b)Designate as her primary care physician an obstetrician or gynecologist who:

(1)Participates in the network plan of the society;

(2)Satisfies the criteria established by the society for designation as a primary care provider under the benefit contract; and

(3)Agrees to abide by all terms and conditions imposed by the society on other primary care physicians generally.

2. A benefit contract subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after January 1, 2026, has the legal effect of including the coverage required by this section, and any provision of the benefit contract or renewal of the benefit contract which is in conflict with this section is void.

3. 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)“Primary care physician” has the meaning ascribed to it in NRS 695G.060 .