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Nev. Rev. Stat. § 695C.1713

Required provision concerning coverage of certain gynecological and obstetrical services without authorization or referral from primary care physician; designation of obstetrician or gynecologist as primary care physician

Nevada · Nevada Revised Statutes Chapter 695C — Health Maintenance Organizations · Status: effective

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Nev. Rev. Stat. § 695C.1713, Required provision concerning coverage of certain gynecological and obstetrical services without authorization or referral from primary care physician; designation of obstetrician or gynecologist as primary care physician, Nevada, version 1 as recorded 2026-10-03, yourstate.us, https://yourstate.us/provision/2149989
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1. A health care plan must include 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 health maintenance organization; (2) Satisfies the criteria established by the health maintenance 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 health maintenance organization on other primary care physicians generally. 2. An evidence of coverage 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 evidence of coverage or the renewal which is in conflict with this section is void. 3. As used in this section: (a) “Network plan” means a health care plan offered by a health maintenance 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 health maintenance organization. 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.