NRS 695G.1709 Required provisions concerning coverage of certain gynecological and obstetrical services without prior authorization or referral from primary care physician; designation of obstetrician or gynecologist as primary care physician.

271 words·~1 min read·/nv/chapter-695g-managed-care/695g-1709·

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

1. A managed care organization that offers or issues a health care plan shall include in the plan 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 managed care organization;

(2)Satisfies the criteria established by the managed care organization for designation as a primary care provider under the health care plan; and

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

2. A health care plan 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 plan or renewal of the plan which is in conflict with this section is void.

3. As used in this section, “network plan” means a health care plan offered by a managed care organization 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 managed care organization. The term does not include an arrangement for the financing of premiums.