Makes revisions relating to reproductive health care. (BDR 40-24)

- 83rd Session (2025)
Senate Bill No. 217 –Senators Cannizzaro, Nguyen, Scheible,
Pazina, Dondero Loop; Cruz -Crawford, Daly, Doñate,
Flores, Lange, Neal, Ohrenschall and Taylor

CHAPTER..........

AN ACT relating to health care; prohibiting a governmental entity
from substantially burdening certain activity relating to
assisted reproduction under certain circumstances;
authorizing a person whose engagement in such activity has
been so burdened to assert the violation as a claim or defense
in a judicial proceeding; authorizing a court to award
damages against a governmental entity that substantially
burdens such activity in certain circumstances; providing
certain immunity from civil and criminal liab ility and
administrative sanctions for certain persons and entities
involved in the provision of assisted reproduction; providing
that a fertilized egg or human embryo that exists before
implantation in a human uterus is not a person for legal
purposes; re quiring certain health insurers to authorize a
pregnant person to enroll in a health plan during a specified
period; requiring certain public and private health insurers to
provide certain coverage for the treatment of infertility and
fertility preservatio n; providing a penalty; and providing
other matters properly relating thereto.
Legislative Counsel’s Digest:
Existing law prescribes certain rights for a patient of a medical facility or a
facility for the dependent. (NRS 449A.100 -449A.124) Sections 2-9 of this bill
establish certain rights related to assisted reproduction. Sections 3-6 define certain
terms relating to assisted reproduction. Section 7 applies the provisions of sections
2-9 to certain state laws and all local laws and ordinances and the imp lementation
of those laws and ordinances, regardless of when those laws or ordinances were
enacted. Section 8 generally prohibits a governmental entity from enacting or
implementing any limitation or requirement that singles out assisted reproduction
and substantially burdens: (1) the access of a person to assisted reproduction, any
drug or device related to assisted reproduction or information related to assisted
reproduction; (2) the ability of a provider of health care to provide assisted
reproduction, a ny drug or device related to assisted reproduction or information
related to assisted reproduction within his or her scope of practice, training and
experience; (3) the ability of a third party to provide insurance coverage of assisted
reproduction or drug s or devices related to assisted reproduction; or (4) the ability
of a person to control the use or disposition of his or her reproductive genetic
material. Section 8 creates an exception to such prohibitions if the governmental
entity demonstrates by clear and convincing evidence that the burden, as applied to
the person, provider of health care or third party who is subject to the burden: (1)
furthers a compelling interest; and (2) is the least restrictive means of furthering
that interest.
Section 8 authorizes a person, provider of health care or third party whose
ability to access, provide or cover assisted reproduction, drugs or devices related to

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assisted reproduction or information related to assisted reproduction, or a person
whose ability to contr ol the use or disposition of his or her reproductive genetic
material, is burdened to bring or defend an action in court and obtain appropriate
relief. Section 8 requires a court to award costs and attorney’s fees to a person or
entity who prevails on such a claim. Section 8 additionally authorizes the Attorney
General to bring an action to enjoin any limitation or requirement that violates
section 8.
Section 9 provides that a person or entity is not subject to civil or criminal
liability or administrative sanctions solely because the person or entity provides or
receives goods or services related to assisted reproduction. Section 9 also provides
that the manufacturer of certain goods used to facilitate assisted reproduction is not
subject to civil or criminal liability or administrative sanctions solely because of the
death of or damage to an embryo. Under section 9, a person or entity is not immune
from civil or criminal liability or administrative sanctions for acts or omissions that
independently create liability or grounds for administrative sanctions, including,
without limitation, negligence or providing services outside the scope of practice,
training or experience of the person or entity. Section 10 of this bill provides that a
fertilized egg or human embryo that exists before implantation in the uterus of a
human body is not a human being for any purpose under Nevada law.
Existing law prescribes certain requirements governing the availability of
health insurance plans in this State. (NRS 687B.480, 689A.430 -689A.460,
689B.300-689B.330, 695A.151 -695A.157, 695B.340 -695B.370, 695C.163 -
695C.169, 695F.440-695F.470) Sections 12, 13, 15, 20, 24, 27-29, 32, 36, 42 and
45 of this bill require a health insurer, including public and private employers who
provide insurance for their employees but excluding certain group plans, to provide
a special enrollment period to a person determined by a qualified provider of health
care to be pregnant, during which the pregnant person must be allowed to enroll in
a health care plan outside of the period of open enrollment. Sections 38, 38.5, 45.2
and 45.6 of this bill provide that until January 1, 2027, the requirements of sections
36 and 45 to provide such a special enrollment period do not apply to Medicaid
managed care plans. Section 17 of this bill provides for the enforcement of
section 15, which governs private employers who provid e health benefits to
employees through a self -insured plan. Section 18 of this bill establishes civil and
criminal penalties for a violation of section 15, which are the same as the penalties
for violations of other laws governing benefits provided by priv ate employers.
Sections 21, 26, 34 and 39 of this bill make conforming changes to indicate the
applicability of certain definitions to sections 20, 24, 32 and 36, respectively.
Existing law requires public and private policies of health insurance regulated
under Nevada law to include certain coverage. (NRS 287.010, 287.04335,
422.2717-422.272428, 689A.04033 -689A.0465, 689B.0303 -689B.0379,
689C.1652-689C.169, 689C.194, 689C.1945, 689C.195, 689C.425, 695A.184 -
695A.1875, 695A.265, 695B.1901 -695B.1948, 695C.050, 695C.1691 -695C.176,
695G.162-695G.177) Existing law also requires employers to provide certain
benefits for health care to employees, including the coverage required of health
insurers, if the employer provides health benefits for its employees through a self -
insured plan. (NRS 608.1555) Sections 12, 23, 31, 37 and 44 of this bill require
certain health care plans for groups of more than 50 employees or members ,
including health plans for employees of local governments, to include certain
coverage for: (1) the treatment of infertility; and (2) the preservation of fertility
where the insured has a medical condition or requires medical treatment that may
cause infertility under certain circumstances. Sections 13.5, 14, 38.7, 45.65, 45.8,
45.9 and 47 of this bill impose similar requirements on the Public Employees ’
Benefits Program and Medicaid, beginning on July 1, 2027. Sections 38 and 45.2

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exempt Medicaid managed care plans from those requirements before that date.
Section 16 of this bill exempts private employers who provide benefits for health
care for less than 51 employees through a self -insured plan from the requirements
to cover services for the treatment or preservation of fertility. Sections 12, 13.5, 14,
19, 23, 31, 37, 38.7, 44, 45.65, 45.8 and 45.9 of this bill prohibit an insurer ,
including Medicaid, from imposing conditions, including cost -sharing, prior
authorizations and waiting periods, on infertility treatment or fertility preservation
if such conditions are not required for simil ar benefits that are not related to
fertility. Section 11 of this bill makes a conforming change to require the Director
of the Department of Health and Human Services to administer the provisions of
section 14 in the same manner as other provisions relati ng to Medicaid. Sections
25, 33 and 40 of this bill make conforming changes to clarify the applicability of
provisions indicating that certain insurers are not required to cover fertility drugs.
Section 43.5 of this bill defines the term “small employer” f or the purpose of
section 44 and other provisions governing managed care. Section 45.1 of this bill
establishes the applicability of that definition, and section 45.7 of this bill removes
a duplicative definition.
Section 41 of this bill authorizes the Co mmissioner of Insurance to suspend or
revoke the certificate of a health maintenance organization that fails to provide the
coverage required by section 37. The Commissioner is also authorized to take such
action against other health insurers who fail to p rovide the coverage required by
sections 23 and 44. (NRS 680A.200)

EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted.

THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:

Section 1. Chapter 449A of NRS is hereby amended by
adding thereto the provisions set forth as sections 2 to 9, inclusive,
of this act.
Sec. 2. As used in sections 2 to 9, inclusive, of this act, unless
the context otherwise requires, the words and terms defined in
sections 3 to 6, inclusive, of this act have the meanings ascribed to
them in those sections.
Sec. 3. “Assisted reproduction” has the meaning ascribed to
it in NRS 126.510.
Sec. 4. “Gamete” has the meaning ascribed to it in
NRS 126.560.
Sec. 5. “Governmental entity” means the State of Nevada or
any of its agencies or political subdivisions.
Sec. 6. “Third party” means any insurer, governmental
entity or other organization providing health coverage or benefits
in accordance with state or federal law.
Sec. 7. 1. Except as otherwise provided in this section, the
provisions of sections 2 to 9, inclusive, of this act apply to all state
and local laws and ordinances and the implementation of those

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laws and ordinances, whether statutory or otherwise, and whether
enacted before, on or after July 1, 2025.
2. State laws that are enacted on or aft er July 1, 2025, are
subject to the provisions of sections 2 to 9, inclusive, of this act
unless the law explicitly excludes such application by reference to
this section.
3. The provisions of sections 2 to 9, inclusive, of this act do
not authorize a governmental entity to burden:
(a) The access of any person to assisted reproduction, any
drug or device related to assisted reproduction or information
related to assisted reproduction;
(b) The ability of a provider of health care to provide assisted
reproduction or information related to assisted reproduction or to
provide, administer, dispense or prescribe any drug or device
related to assisted reproduction within the scope of practice,
training and experience of the provider of health care;
(c) The ability of a third party to provide coverage of assisted
reproduction or drugs or devices related to assisted reproduction;
or
(d) The ability of a person to control the use or disposition of
his or her gametes or other reproductive genetic material.
Sec. 8. 1. Except as otherwise provided in this section, a
governmental entity shall not enact or implement any limitation or
requirement that:
(a) Expressly, effectively, implicitly or, as implemented, singles
out assisted reproduction or any drug or device related to assisted
reproduction and substantially burdens:
(1) The access of a person to assisted reproduction, any
drug or device related to assisted reproduction or information
related to assisted reproduction;
(2) The ability of a provider of health care to:
(I) Provide assisted reproduction or information related
to assisted reproduction within the scope of practice, training and
experience of the provider of health care; or
(II) Provide, administer, dispense or prescribe any drug
or dev ice related to assisted reproduction within the scope of
practice, training and experience of the provider of health care; or
(3) The ability of a third party to provide coverage of
assisted reproduction or drugs or devices related to assisted
reproduction.
(b) Expressly, effectively, implicitly or, as implemented,
substantially burdens the ability of a person to control the use or

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disposition of his or her gametes or other reproductive genetic
material.
2. A governmental entity may enact a requirement or
limitation described in subsection 1 if the governmental entity
demonstrates by clear and convincing evidence that the burden
imposed by the requirement or limitation described in subsection
1, as applied to the person, provider of health care or third party
who is subject to the burden:
(a) Furthers a compelling interest; and
(b) Is the least restrictive means of furthering that interest.
3. Notwithstanding any provision of NRS 41.0305 to 41.039,
inclusive, but subject to the limitation on an awar d for damages
set forth in NRS 41.035 when applicable, a person, provider of
health care or third party who has been substantially burdened in
violation of this section may assert that violation as a claim or
defense in a judicial proceeding and obtain app ropriate relief. A
court shall award costs and attorney’s fees to a person, provider of
health care or third party who prevails on such a claim or defense
pursuant to this section.
4. The Attorney General may bring an action in any court of
competent jurisdiction in the name of the State of Nevada on his
or her own complaint or on the complaint of any person or entity
to enjoin any violation or proposed violation of the provisions of
this section.
5. A court may find that a person, provider of health ca re or
third party is a vexatious litigant if the person, provider of health
care or third party makes a claim within the scope of sections 2 to
9, inclusive, of this act which is without merit, fraudulent or
otherwise intended to harass or annoy a person o r entity. If a
court finds that a person, provider of health care or third party is a
vexatious litigant pursuant to this subsection, the court may deny
standing to that person, provider of health care or third party to
bring further claims which allege a violation of this section.
Sec. 9. 1. Except as otherwise provided in this section, a
person or entity is not subject to civil or criminal liability, or
discipline or other administrative sanctions imposed by a
professional licensing board or other gov ernmental entity, solely
because the person or entity provides or receives goods or services
related to assisted reproduction.
2. Except as otherwise provided in this section, a person or
entity that stores or transports embryos for the purpose of assist ed
reproduction or the manufacturer of goods used to facilitate the
process of assisted reproduction or the transportation of embryos

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stored for the purpose of assisted reproduction is not subject to
civil or criminal liability, or discipline or other admi nistrative
sanctions imposed by a professional licensing board or other
governmental entity, solely because of the death of or damage to
an embryo.
3. The provisions of this section do not preclude:
(a) Civil liability for any act or omission that indep endently
gives rise to such liability, including, without limitation, acts or
omissions that are the result of negligence;
(b) Criminal liability for any act or omission that would
otherwise constitute a crime; or
(c) The imposition of discipline or othe r administrative
sanctions for any act or omission that would otherwise constitute
grounds for discipline or other administrative sanctions,
including, without limitation, providing services that are outside
the scope of practice, training and experience o f a person or
entity.
Sec. 10. The preliminary chapter of NRS is hereby amended
by adding thereto a new section to read as follows:
Any fertilized human egg or human embryo that exists in any
form before implantation in the uterus of a human body is not an
unborn child, a minor child, a person, a natural person or any
other term that connotes a human being for any purpose under
the law or regulations of this State or any political subdivision
thereof.
Sec. 11. NRS 232.320 is hereby amended to read as follows:
232.320 1. The Director:
(a) Shall appoint, with the consent of the Governor,
administrators of the divisions of the Department, who are
respectively designated as follows:
(1) The Administrator of the Aging and Disability Services
Division;
(2) The Administrator of the Division of Welfare and
Supportive Services;
(3) The Administrator of the Division of Child and Family
Services;
(4) The Administrator of the Division of Health Care
Financing and Policy; and
(5) The Administrator of th e Division of Public and
Behavioral Health.
(b) Shall administer, through the divisions of the Department,
the provisions of chapters 63, 424, 425, 427A, 432A to 442,
inclusive, 446 to 450, inclusive, 458A and 656A of NRS,

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NRS 127.220 to 127.310, inclusive, 422.001 to 422.410, inclusive,
and section 14 of this act, 422.580, 432.010 to 432.133, inclusive,
432B.6201 to 432B.626, inclusive, 444.002 to 444.430,
inclusive, and 445A.010 to 445A.055, inclusive, and all other
provisions of law relating to the functions of the divisions of the
Department, but is not responsible for the clinical activities of the
Division of Public and Behavioral Health or the professional line
activities of the other divisions.
(c) Shall administer any state program for per sons with
developmental disabilities established pursuant to the
Developmental Disabilities Assistance and Bill of Rights Act of
2000, 42 U.S.C. §§ 15001 et seq.
(d) Shall, after considering advice from agencies of local
governments and nonprofit organizations which provide social
services, adopt a master plan for the provision of human services in
this State. The Director shall revise the plan biennially and deliver a
copy of the plan to the Governor and the Legislature at the
beginning of each regular session. The plan must:
(1) Identify and assess the plans and programs of the
Department for the provision of human services, and any
duplication of those services by federal, state and local agencies;
(2) Set forth priorities for the provision of those services;
(3) Provide for communication and the coordination of those
services among nonprofit organizations, agencies of local
government, the State and the Federal Government;
(4) Identify the sources of funding for services provided by
the Department and the allocation of that funding;
(5) Set forth sufficient information to assist the Department
in providing those services and in the planning and budgeting for the
future provision of those services; and
(6) Contain any other information necessary for the
Department to communicate effectively with the Federal
Government concerning demographic trends, formulas for the
distribution of federal money and any need for the modification of
programs administered by the Department.
(e) May, by regulation, require nonprofit organizations and state
and local governmental agencies to provide information regarding
the programs of those organizations and agencies, excluding
detailed information relating to their budgets and payrolls, which the
Director deems necessary for the performance of the duties imposed
upon him or her pursuant to this section.
(f) Has such other powers and duties as are provided by law.

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2. Notwithstanding any other provision of law, the Director, or
the Director’s designee, is responsible for appointing and removing
subordinate officers and employees of the Department.
Sec. 12. NRS 287.010 is hereby amended to read as follows:
287.010 1. The governing body of any county, school
district, municipal corporation, political sub division, public
corporation or other local governmental agency of the State of
Nevada may:
(a) Adopt and carry into effect a system of group life, accident
or health insurance, or any combination thereof, for the benefit of its
officers and employees, an d the dependents of officers and
employees who elect to accept the insurance and who, where
necessary, have authorized the governing body to make deductions
from their compensation for the payment of premiums on the
insurance.
(b) Purchase group policies of life, accident or health insurance,
or any combination thereof, for the benefit of such officers and
employees, and the dependents of such officers and employees, as
have authorized the purchase, from insurance companies authorized
to transact the busin ess of such insurance in the State of Nevada,
and, where necessary, deduct from the compensation of officers and
employees the premiums upon insurance and pay the deductions
upon the premiums.
(c) Provide group life, accident or health coverage through a
self-insurance reserve fund and, where necessary, deduct
contributions to the maintenance of the fund from the compensation
of officers and employees and pay the deductions into the fund. The
money accumulated for this purpose through deductions from the
compensation of officers and employees and contributions of the
governing body must be maintained as an internal service fund as
defined by NRS 354.543. The money must be deposited in a state or
national bank or credit union authorized to transact business in the
State of Nevada. Any independent administrator of a fund created
under this section is subject to the licensing requirements of chapter
683A of NRS, and must be a resident of this State. Any contract
with an independent administrator must be approve d by the
Commissioner of Insurance as to the reasonableness of
administrative charges in relation to contributions collected and
benefits provided. The provisions of NRS 439.581 to 439.597,
inclusive, 686A.135, 687B.352, 687B.408, 687B.692, 687B.723,
687B.725, 687B.805, 689B.030 to 689B.0317, inclusive, and
section 23 of this act, paragraphs (b) and (c) of subsection 1 of NRS
689B.0319, subsections 2, 4, 6 and 7 of NRS 689B.0319, 689B.033

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to 689B.0369, inclusive, 689B.0375 to 689B.050, inclusive,
689B.0675, 689B.265, 689B.287 and 689B.500 and section 24 of
this act apply to coverag e provided pursuant to this paragraph,
except that the provisions of NRS 689B.0378, 689B.03785 and
689B.500 only apply to coverage for active officers and employees
of the governing body, or the dependents of such officers and
employees.
(d) Defray part o r all of the cost of maintenance of a self -
insurance fund or of the premiums upon insurance. The money for
contributions must be budgeted for in accordance with the laws
governing the county, school district, municipal corporation,
political subdivision, public corporation or other local governmental
agency of the State of Nevada.
2. If a school district offers group insurance to its officers and
employees pursuant to this section, members of the board of trustees
of the school district must not be exclud ed from participating in the
group insurance. If the amount of the deductions from compensation
required to pay for the group insurance exceeds the compensation to
which a trustee is entitled, the difference must be paid by the trustee.
3. In any county in which a legal services organization exists,
the governing body of the county, or of any school district,
municipal corporation, political subdivision, public corporation or
other local governmental agency of the State of Nevada in the
county, may enter into a contract with the legal services
organization pursuant to which the officers and employees of the
legal services organization, and the dependents of those officers and
employees, are eligible for any life, accident or health insurance
provided pursuant to this section to the officers and employees, and
the dependents of the officers and employees, of the county, school
district, municipal corporation, political subdivision, public
corporation or other local governmental agency.
4. If a contract is entered into pursuant to subsection 3, the
officers and employees of the legal services organization:
(a) Shall be deemed, solely for the purposes of this section, to be
officers and employees of the county, school district, municipal
corporation, political subdivision, public corporation or other local
governmental agency with which the legal services organization has
contracted; and
(b) Must be required by the contract to pay the premiums or
contributions for all insurance which they elect to accept or of which
they authorize the purchase.
5. A contract that is entered into pursuant to subsection 3:

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(a) Must be submitted to the Commissioner of Insurance for
approval not less than 30 days before the date on which the contract
is to become effective.
(b) Does not become effective unless approved by the
Commissioner.
(c) Shall be deemed to be approved if not disapproved by the
Commissioner within 30 days after its submission.
6. As used in this section, “legal services organization” means
an organizat ion that operates a program for legal aid and receives
money pursuant to NRS 19.031.
Sec. 13. NRS 287.04335 is hereby amended to read as
follows:
287.04335 If the Board provides health insurance through a
plan of self -insurance, it shall comply with the provisions of NRS
439.581 to 439.597, inclusive, 686A.135, 687B.352, 687B.409,
687B.692, 687B.723, 687B.725, 687B.805, 689B.0353, 689B.255,
695C.1723, 695G.150, 695G.155, 695G.160, 695G.162,
695G.1635, 695G.164, 695G.1645, 695G.1665, 695G.167,
695G.1675, 695G.170 to 695G.1712, inclusive, 695G.1714 to
695G.174, inclusive, 695G.176, 695G.177, 695G.200 to 695G.230,
inclusive, 695G.241 to 695G.310, inclusive, 695G.405 and
695G.415, and section 45 of this act in the same manner as an
insurer that is licensed pursuant to title 57 of NRS is required to
comply with those provisions.
Sec. 13.5. NRS 287.04335 is hereby amended to read as
follows:
287.04335 If the Board provides health insurance through a
plan of self -insurance, it shall comply with the provisi ons of NRS
439.581 to 439.597, inclusive, 686A.135, 687B.352, 687B.409,
687B.692, 687B.723, 687B.725, 687B.805, 689B.0353, 689B.255,
695C.1723, 695G.150, 695G.155, 695G.160, 695G.162,
695G.1635, 695G.164, 695G.1645, 695G.1665, 695G.167,
695G.1675, 695G.170 to 695G.1712, inclusive, 695G.1714 to
695G.174, inclusive, 695G.176, 695G.177, 695G.200 to 695G.230,
inclusive, 695G.241 to 695G.310, inclusive, 695G.405 and
695G.415, and [section] sections 44 and 45 of this act in the same
manner as an insurer that is l icensed pursuant to title 57 of NRS is
required to comply with those provisions.
Sec. 14. Chapter 422 of NRS is hereby amended by adding
thereto a new section to read as follows:
1. To the extent that federal financial participation is
available, the D irector shall , except as otherwise provided in
subsection 4, include under Medicaid coverage for:

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(a) Any procedure or medication determined by a qualified
provider of health care to be necessary for the diagnosis and
treatment of infertility in accordance with established medical
practice or any guidelines published by the American College of
Obstetricians and Gynecologists or the American Society for
Reproductive Medicine, or their successor organizations. Such
coverage must include, without limitation, coverage for:
(1) At least three but not more than five completed
retrievals of oocytes; and
(2) At least three but not more than five transfers of
embryos, including, without limitation, single -embryo transfer
where appropriate, in accordanc e with the guidelines of the
American Society for Reproductive Medicine, or its successor
organization.
(b) At least 5 years of s tandard fertility preservation services
that are necessary to preserve fertility because the recipient of
Medicaid:
(1) Has been diagnosed with a medical or genetic condition
that may directly or indirectly cause infertility, as determined
pursuant to paragraph (a) of subsection 2; or
(2) Is expected to receive a medical treatment that may
directly or indirectly cause infert ility, as determined pursuant to
paragraph (b) of subsection 2.
2. For the purposes of subsection 1:
(a) A medical or genetic condition may directly or indirectly
cause infertility if the condition or treatment for the condition is
likely to cause infertility, as established by the American Society of
Clinical Oncology, the American Society for Reproductive
Medicine or the American College of Obstetricians and
Gynecologists, or their successor organizations.
(b) A medical treatment may directly or in directly cause
infertility if the treatment has a potential side effect of impaired
fertility, as established by the American Society of Clinical
Oncology or the American Society for Reproductive Medicine, or
their successor organizations.
3. Medicaid must not:
(a) Require a recipient of Medicaid to pay a higher deductible,
copayment, coinsurance or other form of cost -sharing for the
benefits described in subsection 1 than is required for similar
benefits that are not related to fertility;
(b) Require a recipient of Medicaid to obtain prior
authorization for the benefits described in subsection 1 that is not
required for similar benefits that are not related to fertility;

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(c) Require a longer waiting period for the coverage required
by subsection 1 tha n is required for similar benefits that are not
related to fertility; or
(d) Impose any other exclusions, limitations, restrictions or
delays on the access of a recipient of Medicaid to the goods and
services described in subsection 1 that is not imposed on similar
benefits that are not related to fertility.
4. Medicaid is not required to provide coverage pursuant to
subsection 1 for a recipient whose infertility is solely caused by a
voluntary sterilization procedure that has not been successfully
reversed.
5. The Department shall:
(a) Apply to the Secretary of Health and Human Services for
any waiver of federal law or apply for any amendment of the State
Plan for Medicaid that is necessary for the Department to receive
federal funding to provide the coverage described in subsection 1.
(b) Fully cooperate in good faith with the Federal Government
during the application process to satisfy the requirements of the
Federal Government for obtaining a waiver or amendment
pursuant to paragraph (a).
6. As used in this section:
(a) “Infertility” means a condition characterized by:
(1) The inability of a person to achieve pregnancy, not
including conception resulting in a miscarriage, where the person
and the partner of the person or a donor have the necessary
gametes to achieve pregnancy and after:
(I) At least 12 months of regular, unprotected sexual
intercourse or therapeutic donor insemination for a person who is
less than 35 years of age; or
(II) At least 6 months of regular, unprotected sexual
intercourse or therapeutic donor insemination for a person who is
35 years of age or older;
(2) The inability of a person or the partner of the person to
reproduce or the inability of a person to reproduce with a
particular partner; or
(3) A finding by a qualified provider of health care that a
person is infertile based on:
(I) The medical, sexual and reproductive history or age
of the person;
(II) Physical findings; or
(III) Diagnostic testing.
(b) “Provider of health care” has the mea ning ascribed to it in
NRS 629.031.

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(c) “Standard fertility preservation services”:
(1) Means a procedure or services for the preservation of
fertility that:
(I) Is not considered experimental or investigational by
the American Society for Reproductive Medicine, or its successor
organization, or the American Society of Clinical Oncology, or its
successor organization; and
(II) Is consistent with established medical practices or
professional guidelines published by the American Society for
Reproductive Medicine, or its successor organization, or the
American Society of Clinical Oncology, or its successor
organization.
(2) Includes, without limitation, sperm banking, oocyte
banking, embryo banking, banking of reproductive tissues and the
storage of reproductive cells and tissues.
Sec. 15. Chapter 608 of NRS is hereby amended by adding
thereto a new section to read as follows:
1. Regardless of whether an employee who is pregnant
already has health coverage, an employer who provides benef its
for health care to his or her employees shall , except as otherwise
provided in subsection 3, ensure that the employee is allowed to
enroll in any plan to provide such benefits without any additional
fee or penalty within at least 30 days after the empl oyee has been
confirmed to be pregnant by a qualified provider of health care.
2. Coverage for an employee who enrolls in a plan to provide
benefits for health care pursuant to subsection 1 must be effective:
(a) Except as otherwise provided in paragrap h (b), on the first
day of the month in which a qualified provider of health care
confirms that the employee is pregnant; or
(b) Upon the election of the employee, on the first day of the
month after the employee elects to enroll in the plan.
3. The pro visions of this section do not apply to a cafeteria
plan, as defined in 26 U.S.C. § 125(d).
4. As used in this section, “provider of health care” has the
meaning ascribed to it in NRS 629.031.
Sec. 16. NRS 608.1555 is hereby amended to read as follows:
608.1555 [Any] 1. Except as otherwise provided in this
section, any employer who provides benefits for health care to his
or her employees shall provide the same benefits and pay providers
of health care in the same manner as a policy of insurance pursuant
to chapters 689A and 689B of NRS, including, without limitation,
as required by NRS 687B.409, 687B.723 and 687B.725.

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- 83rd Session (2025)
2. An employer who employs less than 51 employees and
provides benefits for health care to his or her employees through a
plan o f self -insurance is not required to provide the coverage
described in section 23 of this act.
Sec. 17. NRS 608.180 is hereby amended to read as follows:
608.180 The Labor Commissioner or the representative of the
Labor Commissioner shall cause the prov isions of NRS 608.005 to
608.195, inclusive, and section 15 of this act and 608.215 to be
enforced, and upon notice from the Labor Commissioner or the
representative:
1. The district attorney of any county in which a violation of
those sections has occurred;
2. The Deputy Labor Commissioner, as provided in
NRS 607.050;
3. The Attorney General, as provided in NRS 607.160 or
607.220; or
4. The special counsel, as provided in NRS 607.065,
 shall prosecute the action for enforcement according to law.
Sec. 18. NRS 608.195 is hereby amended to read as follows:
608.195 1. Except as otherwise provided in NRS 608.0165,
any person who violates any provision of NRS 608.005 to 608.195,
inclusive, and section 15 of this act or 608.215, or any regulation
adopted pursuant thereto, is guilty of a misdemeanor.
2. In addition to any other remedy or penalty, the Labor
Commissioner may impose against the person an administrative
penalty of not more than $5,000 for each such violation.
Sec. 19. NRS 687B.225 is hereby amended to read as follows:
687B.225 1. Except as otherwise provided in NRS
689A.0405, 689A.0412, 689A.0413, 689A.0418, 689A.0437,
689A.044, 689A.0445, 689A.0459, 689B.031, 689B.0312,
689B.0313, 689B.0315, 689B.0317, 689B.0319, 689B.0374,
689B.0378, 689C.1665, 689C.1671, 689C.1675, 689C.1676,
695A.1843, 695A.1856, 695A.1865, 695A.1874, 695B.1912,
695B.1913, 695B.1914, 695B.1919, 695B.19197, 695B.1924,
695B.1925, 695B.1942, 695C.1696, 695C.1699, 695C.1713,
695C.1735, 695C.1737, 695C.1743, 695C.1745 , 695C.1751,
695G.170, 695G.1705, 695G.171, 695G.1714, 695G.1715,
695G.1719 and 695G.177, and sections 23, 31, 37 and 44 of this
act, any contract for group, blanket or individual health insurance or
any contract by a nonprofit hospital, medical or dental service
corporation or organization for dental care which provides for
payment of a certain part of medical or dental care may require the

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- 83rd Session (2025)
insured or member to obtain prior authorization for that care from
the insurer or organization. The insurer or organization shall:
(a) File its procedure for obtaining approval of care pursuant to
this section for approval by the Commissioner; and
(b) Unless a shorter time period is prescribed by a specific
statute, including, without limitation, NRS 689A.0446, 689B.03 61,
689C.1688, 695A.1859, 695B.19087, 695C.16932 and 695G.1703,
respond to any request for approval by the insured or member
pursuant to this section within 20 days after it receives the request.
2. The procedure for prior authorization may not discrimin ate
among persons licensed to provide the covered care.
Sec. 20. Chapter 689A of NRS is hereby amended by adding
thereto a new section to read as follows:
1. Regardless of whether a person who is pregnant already
has health coverage, an insurer shall a llow the person to enroll in
a policy of health insurance without any additional fee or penalty
within at least 60 days after the person has been confirmed to be
pregnant by a qualified provider of health care.
2. Coverage for a person who enrolls in a p olicy of health
insurance pursuant to subsection 1 must be effective:
(a) Except as otherwise provided in paragraph (b), on the first
day of the month in which a qualified provider of health care
confirms that the person is pregnant; or
(b) Upon the elec tion of the person, on the first day of the
month after the person elects to enroll in the policy.
3. As used in this section, “provider of health care” has the
meaning ascribed to it in NRS 629.031.
Sec. 21. NRS 689A.420 is hereby amended to read as follows:
689A.420 As used in NRS 689A.420 to 689A.460, inclusive,
and section 20 of this act, unless the context otherwise requires:
1. “Medicaid” means a program established in any state
pursuant to Title XIX of the Social Security Act (42 U.S.C. §§ 13 96
et seq.) to provide assistance for part or all of the cost of medical
care rendered on behalf of indigent persons.
2. “Order for medical coverage” means an order of a court or
administrative tribunal to provide coverage under a policy of health
insurance to a child pursuant to the provisions of 42 U.S.C. §
1396g-1.
Sec. 22. Chapter 689B of NRS is hereby amended by adding
thereto the provisions set forth as sections 23 and 24 of this act.
Sec. 23. 1. Except as otherwise provided in subsections 5, 6
and 7, an insurer that issues a policy of group health insurance to

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- 83rd Session (2025)
any entity other than a small employer shall include in the policy
coverage for:
(a) Any procedure or medication determined by a qualified
provider of health care to be necessary for the diagnosis and
treatment of infertility in accordance with established medical
practice or any guidelines published by the American College of
Obstetricians and Gynecologists or the American Society for
Reproductive Medicine, or their successor organizatio ns. Such
coverage must include, without limitation, coverage for:
(1) At least three but not more than five completed
retrievals of oocytes; and
(2) At least three but not more than five transfers of
embryos, including, without limitation, single-embryo transfer
where appropriate, in accordance with the guidelines of the
American Society for Reproductive Medicine, or its successor
organization.
(b) At least 5 years of s tandard fertility preservation services
that are necessary to preserve fertility because the insured:
(1) Has been diagnosed with a medical or genetic condition
that may directly or indirectly cause infertility, as determined
pursuant to paragraph (a) of subsection 2; or
(2) Is expected to receive a medical treatment that may
directly or indirectly cause infertility, as determined pursuant to
paragraph (b) of subsection 2.
2. For the purposes of subsection 1:
(a) A medical or genetic condition may directly or indirect ly
cause infertility if the condition or treatment for the condition is
likely to cause infertility, as established by the American Society of
Clinical Oncology, the American Society for Reproductive
Medicine or the American College of Obstetricians and
Gynecologists, or their successor organizations.
(b) A medical treatment may directly or indirectly cause
infertility if the treatment has a potential side effect of impaired
fertility, as established by the American Society of Clinical
Oncology or the Ame rican Society for Reproductive Medicine, or
their successor organizations.
3. An insurer shall ensure that the benefits required by
subsection 1 are made available to an insured through a provider
of health care who participates in the network plan of the insurer.
4. An insurer shall not:
(a) Require an insured to pay a higher deductible, copayment,
coinsurance or other form of cost -sharing for the benefits

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- 83rd Session (2025)
required by subsection 1 than is required for similar benefits that
are not related to fertility;
(b) Require an insured to obtain prior authorization for the
benefits described in subsection 1 that is not required for similar
benefits that are not related to fertility;
(c) Require a longer waiting period for the coverage required
by subsection 1 than is required for similar benefits that are not
related to fertility;
(d) Impose any other exclusions, limitations, restrictions or
delays on the access of an insured to any benefit described in
subsection 1 that is not imposed on similar benefits tha t are not
related to fertility;
(e) Refuse to issue a policy of group health insurance or
cancel a policy of group health insurance solely because the
person applying for or covered by the policy uses or may use in the
future any benefit described in subsection 1;
(f) Offer or pay any type of material inducement or financial
incentive to an insured to discourage the insured from accessing
any benefit described in subsection 1;
(g) Penalize a provider of health care who provides any benefit
described in s ubsection 1 to an insured, including, without
limitation, reducing the reimbursement of the provider of health
care; or
(h) 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 benefit described in subsection
1 to an insured.
5. An insurer is not required to provide the coverage required
by subsection 1 for an insured whose infertility is solely caused by
a voluntary sterilization procedure that has not been successfully
reversed.
6. An insurer that is affiliated with a religious organization is
not required to provide the coverage required by subsection 1 if
the insurer objects on religious grounds. Such an insurer shall,
before the issuance of a poli cy of group health insurance that is
subject to the requirements of subsection 1 and before the renewal
of such a policy, provide to the group policyholder or prospective
insured, as applicable, written notice of the coverage that the
insurer refuses to provide pursuant to this subsection.
7. The provisions of this section do not apply to an employee
benefit plan, as defined in 29 U.S.C. § 1002(3), that:
(a) Meets the requirements of 29 C.F.R. § 2510.3-3; and

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- 83rd Session (2025)
(b) Is established by a bona fide associat ion of employers
acting indirectly in the interest of an employer pursuant to 29
U.S.C. § 1002(5).
8. A policy of group health insurance that is subject to the
provisions of this section and is delivered, issued for delivery or
renewed on or after Januar y 1, 2026, has the legal effect of
including the coverage required by subsection 1, and any
provision of the policy or the renewal that conflicts with the
provisions of this section is void.
9. As used in this section:
(a) “Infertility” means a condition characterized by:
(1) The inability of a person to achieve pregnancy, not
including conception resulting in a miscarriage, where the person
and the partner of the person or a donor have the necessary
gametes to achieve pregnancy and after:
(I) At least 12 months of regular, unprotected sexual
intercourse or therapeutic donor insemination for a person who is
less than 35 years of age; or
(II) At least 6 months of regular, unprotected sexual
intercourse or therapeutic donor insemination for a person who is
35 years of age or older;
(2) The inability of a person or the partner of the person to
reproduce or the inability of a person to reproduce with a
particular partner; or
(3) A finding by a qualified provider of health care that a
person is infertile based on:
(I) The medical, sexual and reproductive history or age
of the person;
(II) Physical findings; or
(III) Diagnostic testing.
(b) “Network plan” means a policy of group health insurance
offered by an insurer 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 insurer. The term does not
include an arrangement for the financing of premiums.
(c) “Provider of health care” has the meaning ascribed to it in
NRS 629.031.
(d) “Small employer” has the meaning ascribed to it in
NRS 689C.095.
(e) “Standard fertility preservation services”:
(1) Means a procedure or services for the preservation of
fertility that:

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- 83rd Session (2025)
(I) Is not considered experimental or investigational by
the American Society for Reproductive Medicine, or its successo r
organization, or the American Society of Clinical Oncology, or its
successor organization; and
(II) Is consistent with established medical practices or
professional guidelines published by the American Society for
Reproductive Medicine, or its success or organization, or the
American Society of Clinical Oncology, or its successor
organization.
(2) Includes, without limitation, sperm banking, oocyte
banking, embryo banking, banking of reproductive tissues and the
storage of reproductive cells and tissues.
Sec. 24. 1. Regardless of whether a person who is pregnant
already has health coverage, an insurer shall , except as otherwise
provided in subsection 3, allow the person to enroll in a policy of
group health insurance without any additional fee or penalty
within at least 30 days after the person has been confirmed to be
pregnant by a qualified provider of health care.
2. Coverage for a person who enrolls in a policy of group
health insurance pursuant to subsection 1 must be effective:
(a) Except as otherwise provided in paragraph (b), on the first
day of the month in which a qualified provider of health care
confirms that the person is pregnant; or
(b) Upon the election of the person, on the first day of the
month after the person elects to enroll in the policy.
3. The provisions of this section do not apply to a cafeteria
plan, as defined in 26 U.S.C. § 125(d).
4. As used in this section, “provider of health care” has the
meaning ascribed to it in NRS 629.031.
Sec. 25. NRS 689B.0376 is h ereby amended to read as
follows:
689B.0376 1. An insurer that offers or issues a policy of
group health insurance which provides coverage for prescription
drugs or devices shall include in the policy coverage for any type of
hormone replacement therapy which is lawfully prescribed or
ordered and which has been approved by the Food and Drug
Administration.
2. An insurer that offers or issues a policy of group health
insurance that provides coverage for prescription drugs shall not:
(a) Require an insured to pay a higher deductible, any
copayment or coinsurance or require a longer waiting period or
other condition for coverage for a prescription for hormone
replacement therapy;

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- 83rd Session (2025)
(b) Refuse to issue a policy of group health insurance or cancel a
policy of group health insurance solely because the person applying
for or covered by the policy uses or may use in the future hormone
replacement therapy;
(c) Offer or pay any type of material inducement or financial
incentive to an insured to discourage the insured from accessing
hormone replacement therapy;
(d) Penalize a provider of health care who provides hormone
replacement therapy to an insured, 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 hormone replacement therapy to an insured.
3. A policy subject to the provisions of this chapter that is
delivered, issued for delivery or renewed on or after October 1,
1999, 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 this section is void.
4. The provisions of this section do not require an insurer to
provide coverage for fertility drugs [.] , except as required by
section 23 of this act.
5. As used in this section, “provider of health care” has the
meaning ascribed to it in NRS 629.031.
Sec. 26. NRS 689B.290 is hereby amended to read as follows:
689B.290 As used in NRS 689B.290 to 689B.330, inclusive,
and section 24 of this act, unless the context otherwise requires:
1. “Medicaid” means a program established in any state
pursuant to Title XIX of the Social Security Act (42 U.S.C. §§ 1396
et seq.) to provide assistance for part or all of the cost of medical
care rendered on behalf of indigent persons.
2. “Order for medical coverage” means an order of a court or
administrative tribunal to provide coverage under a group health
policy to a child pursuant to the provisions of 42 U.S.C. § 1396g-1.
Sec. 27. Chapter 689C of NRS is hereby amended by adding
thereto a new section to read as follows:
1. Regardless of whether a person who is pregnant alre ady
has health coverage, a carrier shall , except as otherwise provided
in subsection 3, allow the person to enroll in a health benefit plan
without any additional fee or penalty within at least 30 days after
the person has been confirmed to be pregnant by a qualified
provider of health care.
2. Coverage for a person who enrolls in a health benefit plan
pursuant to subsection 1 must be effective:

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- 83rd Session (2025)
(a) Except as otherwise provided in paragraph (b), on the first
day of the month in which a qualified provider of health care
confirms that the person is pregnant; or
(b) Upon the election of the person, on the first day of the
month after the person elects to enroll in the health benefit plan.
3. The provisions of this section do not apply to a cafeteria
plan, as defined in 26 U.S.C. § 125(d).
4. As used in this section, “provider of health care” has the
meaning ascribed to it in NRS 629.031.
Sec. 28. NRS 689C.425 is hereby amended to read as follows:
689C.425 A voluntary purchasing group and any contract
issued to such a group pursuant to NRS 689C.360 to 689C.600,
inclusive, are subject to the provisions of NRS 689C.015 to
689C.355, inclusive, and section 27 of this act to the extent
applicable and not in conflict with the express provisions of NRS
687B.408 and 689C.360 to 689C.600, inclusive.
Sec. 29. Chapter 695A of NRS is hereby amended by adding
thereto a new section to read as follows:
1. Regardless of whether a person who is pregnant already
has health coverage, a society shall allow the person to enroll in a
benefit contract without any additional fee or penalty within at
least 60 days after the person has been confirmed to be pregnant
by a qualified provider of health care.
2. Coverage for a person who enrolls in a benefit contract
pursuant to subsection 1 must be effective:
(a) Except as otherwise provided in paragraph (b), on the first
day of the month in which a qualified provider of health care
confirms that the person is pregnant; or
(b) Upon the election of the person, on the first day of the
month after the person elects to enroll in the benefit contract.
3. As used in this section, “provider of health care” has the
meaning ascribed to it in NRS 629.031.
Sec. 30. Chapter 695B of NRS is hereby amended by adding
thereto the provisions set forth as sections 31 and 32 of this act.
Sec. 31. 1. Except as otherwise provided in subsections 5, 6
and 7, a hospital or medical services corporation that issues a
policy of group health insurance to any entity other than a small
employer shall include in the policy coverage for:
(a) Any procedure or medication determined by a qualified
provider of health care to be necessary for the diagnosis and
treatment of infertility in accordance with established medical
practice or any guidelines published by the American College of
Obstetricians and Gynecologists or the American Society for

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- 83rd Session (2025)
Reproductive Medicine, or their successor organizations. Such
coverage must include, without limitation, coverage for:
(1) At least three but not more than f ive completed
retrievals of oocytes; and
(2) At least three but not more than five transfers of
embryos, including, without limitation, single -embryo transfer
where appropriate, in accordance with the guidelines of the
American Society for Reproductive Medicine, or its successor
organization.
(b) At least 5 years of s tandard fertility preservation services
that are necessary to preserve fertility because the insured:
(1) Has been diagnosed with a medical or genetic condition
that may directly or indir ectly cause infertility, as determined
pursuant to paragraph (a) of subsection 2; or
(2) Is expected to receive a medical treatment that may
directly or indirectly cause infertility, as determined pursuant to
paragraph (b) of subsection 2.
2. For the purposes of subsection 1:
(a) A medical or genetic condition may directly or indirectly
cause infertility if the condition or treatment for the condition is
likely to cause infertility, as established by the American Society of
Clinical Oncol ogy, the American Society for Reproductive
Medicine or the American College of Obstetricians and
Gynecologists, or their successor organizations.
(b) A medical treatment may directly or indirectly cause
infertility if the treatment has a potential side e ffect of impaired
fertility, as established by the American Society of Clinical
Oncology or the American Society for Reproductive Medicine, or
their successor organizations.
3. A hospital or medical services corporation shall ensure
that the benefits required by subsection 1 are made available to an
insured through a provider of health care who participates in the
network plan of the hospital or medical services corporation.
4. A hospital or medical services corporation shall not:
(a) Require an insured to pay a higher deductible, copayment,
coinsurance or other form of cost -sharing for the benefits
required by subsection 1 than is required for similar benefits that
are not related to fertility;
(b) Require an insured to obtain prior authorization fo r the
benefits described in subsection 1 that is not required for similar
benefits that are not related to fertility;

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- 83rd Session (2025)
(c) Require a longer waiting period for the coverage required
by subsection 1 than is required for similar benefits that are not
related to fertility;
(d) Impose any other exclusions, limitations, restrictions or
delays on the access of an insured to any benefit described in
subsection 1 that is not imposed on similar benefits that are not
related to fertility;
(e) Refuse to issue a polic y of group health insurance or
cancel a policy of group health insurance solely because the
person applying for or covered by the policy uses or may use in the
future any benefit described in subsection 1;
(f) Offer or pay any type of material inducement or financial
incentive to an insured to discourage the insured from accessing
any benefit described in subsection 1;
(g) Penalize a provider of health care who provides any benefit
described in subsection 1 to an insured, including, without
limitation, reducing the reimbursement of the provider of health
care; or
(h) 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 benefit described in subsection
1 to an insured.
5. A hospital or medical services corporation is not required
to provide the coverage required by subsection 1 for an insured
whose infertility is solely caused by a voluntary sterilization
procedure that has not been successfully reversed.
6. A hospital or medical services corporation that is affiliated
with a religious organization is not required to provide the
coverage required by subsection 1 if the hospital or medical
services corporation objects on religious grounds. Such a hospital
or medical services corporation shall, before the issuance of a
policy of group health insurance that is subject to the
requirements of subsection 1 and before the renewal of such a
policy, provide to the group policyholder or prospective insured, as
applicable, written notice of the coverage that the hospital or
medical services corporation refuses to provide pursuant to this
subsection.
7. The provisions of this section do not apply to an employee
benefit plan, as defined in 29 U.S.C. § 1002(3), that:
(a) Meets the requirements of 29 C.F.R. § 2510.3-3; and
(b) Is established by a bona fide association of employers
acting indirectly in the interest of an employer pursuant to 29
U.S.C. § 1002(5).

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- 83rd Session (2025)
8. A policy of group health insurance that is subject to the
provisions of this section and is delivered, issued for delivery or
renewed on or after January 1, 2026, has the legal effect of
including the coverage required by subsection 1, and any
provision of the policy or the renewal that conflicts with the
provisions of this section is void.
9. As used in this section:
(a) “Infertility” means a condition characterized by:
(1) The inability of a person to achieve pregnancy, not
including conception resulting in a miscarriage, where the person
and the partner of the person or a donor have the necessary
gametes to achieve pregnancy and after:
(I) At least 12 months of regular, unprotected sexual
intercourse or therapeutic donor insemination for a person who is
less than 35 years of age; or
(II) At least 6 months of regular, unprotected sexual
intercourse or therapeutic donor insemination for a person who is
35 years of age or older;
(2) The inability of a person or the partner of the person to
reproduce or the inability of a person to reproduce wi th a
particular partner; or
(3) A finding by a qualified provider of health care that a
person is infertile based on:
(I) The medical, sexual and reproductive history or age
of the person;
(II) Physical findings; or
(III) Diagnostic testing.
(b) “Network plan” means a policy of health insurance offered
by a hospital or medical services corporation 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 hospital
or medical services corporation. The term does not include an
arrangement for the financing of premiums.
(c) “Provider of health care” has the meaning ascribed to it in
NRS 629.031.
(d) “Small employer” has the meaning ascribed to it in
NRS 689C.095.
(e) “Standard fertility preservation services”:
(1) Means a procedure or services for the preservation of
fertility that:
(I) Is not considered experimental or investigational by
the American Society for Reproductive Medicine, or its successor

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- 83rd Session (2025)
organization, or the American Society of Clinical Oncology, or its
successor organization; and
(II) Is consistent with established medical practices or
professional guidelines published by the American Society for
Reproductive Medicine, or its successor organization, or the
American Society of Clinical Oncology, or its successor
organization.
(2) Includes, without limitation, sperm banking, oocyte
banking, embryo banking, banking of reproductive tissues and the
storage of reproductive cells and tissues.
Sec. 32. 1. Regardless of whether a person who is pregnant
already has health coverage, a corporation shall , except as
otherwise provided in subsection 3, allow the person to enroll in a
policy of health insurance without any additional fee or penalty
within at least:
(a) Sixty days after the person has been confirmed to be
pregnant by a qualified provider of health care, if the policy is
offered on the individual market; or
(b) Thirty day s after the person has been confirmed to be
pregnant by a qualified provider of health care, if the policy is
offered on the group market.
2. Coverage for a person who enrolls in a policy of health
insurance pursuant to subsection 1 must be effective:
(a) Except as otherwise provided in paragraph (b), on the first
day of the month in which a qualified provider of health care
confirms that the person is pregnant; or
(b) Upon the election of the person, on the first day of the
month after the person elects to enroll in the policy.
3. The provisions of this section do not apply to a cafeteria
plan, as defined in 26 U.S.C. § 125(d).
4. As used in this section, “provider of health care” has the
meaning ascribed to it in NRS 629.031.
Sec. 33. NRS 695B.19 16 is hereby amended to read as
follows:
695B.1916 1. An insurer that offers or issues a contract for
hospital or medical service which provides coverage for prescription
drugs or devices shall include in the contract coverage for any type
of hormone replacement therapy which is lawfully prescribed or
ordered and which has been approved by the Food and Drug
Administration.
2. An insurer that offers or issues a contract for hospital or
medical service that provides coverage for prescription drugs shal l
not:

– 26 –

- 83rd Session (2025)
(a) Require an insured to pay a higher deductible, any
copayment or coinsurance or require a longer waiting period or
other condition for coverage for a prescription for hormone
replacement therapy;
(b) Refuse to issue a contract for hospital or m edical service or
cancel a contract for hospital or medical service solely because the
person applying for or covered by the contract uses or may use in
the future hormone replacement therapy;
(c) Offer or pay any type of material inducement or financial
incentive to an insured to discourage the insured from accessing
hormone replacement therapy;
(d) Penalize a provider of health care who provides hormone
replacement therapy to an insured, 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 hormone replacement therapy to an insured.
3. A contract for hospital or medical service subject to the
provisions of this chapter that is delivered, issued for delivery or
renewed on or after October 1, 1999, has the legal effect of
including the coverage required by subsection 1, and any provision
of the contract or the renewal which is in conflict with this section is
void.
4. The provisions of this section do not require an insurer to
provide coverage for fertility drugs [.] , except as required by
section 31 of this act.
5. As used in this section, “provider of healt h care” has the
meaning ascribed to it in NRS 629.031.
Sec. 34. NRS 695B.330 is hereby amended to read as follows:
695B.330 As used in NRS 695B.330 to 695B.370, inclusive,
and section 32 of this act, unless the context otherwise requires:
1. “Contract” means a contract for hospital, medical or dental
services issued pursuant to this chapter.
2. “Corporation” means a corporation organized pursuant to
this chapter.
3. “Medicaid” means a program established in any state
pursuant to Title XIX of the Social Security Act (42 U.S.C. §§ 1396
et seq.) to provide assistance for part or all of the cost of medical
care rendered on behalf of indigent persons.
4. “Order for medical coverage” means an order of a court or
administrative tribunal to provi de coverage under a contract to a
child pursuant to the provisions of 42 U.S.C. § 1396g-1.

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- 83rd Session (2025)
Sec. 35. Chapter 695C of NRS is hereby amended by adding
thereto the provisions set forth as sections 36 and 37 of this act.
Sec. 36. 1. Regardless of whether a person who is pregnant
already has health coverage, a health maintenance organization
shall, except as otherwise provided in subsection 3, allow the
person to enroll in a health care plan without any additional fee or
penalty within at least:
(a) Sixty d ays after the person has been confirmed to be
pregnant by a qualified provider of health care, if the health care
plan is offered on the individual market; or
(b) Thirty days after the person has been confirmed to be
pregnant by a qualified provider of he alth care, if the health care
plan is offered on the group market.
2. Coverage for a person who enrolls in a health care plan
pursuant to subsection 1 must be effective:
(a) Except as otherwise provided in paragraph (b), on the first
day of the month in which a qualified provider of health care
confirms that the person is pregnant; or
(b) Upon the election of the person, on the first day of the
month after the person elects to enroll in the plan.
3. The provisions of this section do not apply to a cafeteria
plan, as defined in 26 U.S.C. § 125(d).
4. As used in this section, “provider of health care” has the
meaning ascribed to it in NRS 629.031.
Sec. 37. 1. Except as otherwise provided in subsections 5, 6
and 7, a health maintenance organizatio n that issues a group
health care plan to any entity other than a small employer shall
include in the plan coverage for:
(a) Any procedure or medication determined by a qualified
provider of health care to be necessary for the diagnosis and
treatment of i nfertility in accordance with established medical
practice or any guidelines published by the American College of
Obstetricians and Gynecologists or the American Society for
Reproductive Medicine, or their successor organizations. Such
coverage must include, without limitation, coverage for:
(1) At least three but not more than five completed
retrievals of oocytes; and
(2) At least three but not more than five transfers of
embryos, including, without limitation, single -embryo transfer
where appropriate, in accordance with the guidelines of the
American Society for Reproductive Medicine, or its successor
organization.

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- 83rd Session (2025)
(b) At least 5 years of s tandard fertility preservation services
that are necessary to preserve fertility because the enrollee:
(1) Has been diagnosed with a medical or genetic condition
that may directly or indirectly cause infertility, as determined
pursuant to paragraph (a) of subsection 2; or
(2) Is expected to receive a medical treatment that may
directly or indirectly cause infertility, as determined pursuant to
paragraph (b) of subsection 2.
2. For the purposes of subsection 1:
(a) A medical or genetic condition may directly or indirectly
cause infertility if the condition or treatment for the condition is
likely to cause infertility, as established by the American Society of
Clinical Oncology, the American Society for Reproductive
Medicine or the American College of Obstetricians and
Gynecologists, or their successor organizations.
(b) A medical treatment may di rectly or indirectly cause
infertility if the treatment has a potential side effect of impaired
fertility, as established by the American Society of Clinical
Oncology or the American Society for Reproductive Medicine, or
their successor organizations.
3. A health maintenance organization shall ensure that the
benefits required by subsection 1 are made available to an enrollee
through a provider of health care who participates in the network
plan of the health maintenance organization.
4. A health maintenance organization shall not:
(a) Require an enrollee to pay a higher deductible, copayment,
coinsurance or other form of cost -sharing for the benefits
required by subsection 1 than is required for similar benefits that
are not related to fertility;
(b) Require an enrollee to obtain prior authorization for the
benefits described in subsection 1 that is not required for similar
benefits that are not related to fertility;
(c) Require a longer waiting period for the coverage required
by subsection 1 tha n is required for similar benefits that are not
related to fertility;
(d) Impose any other exclusions, limitations, restrictions or
delays on the access of an enrollee to any benefit described in
subsection 1 that is not imposed on similar benefits that a re not
related to fertility;
(e) 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 benefit described in
subsection 1;

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- 83rd Session (2025)
(f) Offer or pay any type of material inducement or financial
incentive to an enrollee to discourage the enrollee from accessing
any benefit described in subsection 1;
(g) Penalize a provider of health care who provides any benefit
described in subsection 1 to an enrollee, includ ing, without
limitation, reducing the reimbursement of the provider of health
care; or
(h) 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 benefit described in subsection
1 to an enrollee.
5. A health maintenance organization is not required to
provide the coverage required by subsection 1 for an enrollee
whose infertility is solely caused by a voluntary sterilization
procedure that has not been successfully reversed.
6. A health maintenance organization which is affiliated with
a religious organization is not required to provide the coverage
required by subsection 1 if the health maintenance organization
objects on religious grounds. Such a health maintenance
organization shall, before the issuance of a group health care plan
that is subject to the requirements of subsection 1 and before the
renewal of such a plan, provide to the group policyholder or
prospective enrollee, as applicable, written notice of the coverage
that the health maintenance organization refuses to provide
pursuant to this subsection.
7. The provisions of this section do not apply to an employee
benefit plan, as defined in 29 U.S.C. § 1002(3), that:
(a) Meets the requirements of 29 C.F.R. § 2510.3-3; and
(b) Is established by a bona fide association of employers
acting indirectly in the interest of an employer pursuant to 29
U.S.C. § 1002(5).
8. A group health care plan that is subject to the provisions of
this section and is delivered, issued for delivery or renewed on or
after January 1, 2026, has the legal effect of including the
coverage required by subsection 1, and any provision of the plan
or the renewal that conflicts with the provisions of this section i s
void.
9. As used in this section:
(a) “Infertility” means a condition characterized by:
(1) The inability of a person to achieve pregnancy, not
including conception resulting in a miscarriage, where the person
and the partner of the person or a do nor have the necessary
gametes to achieve pregnancy and after:

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- 83rd Session (2025)
(I) At least 12 months of regular, unprotected sexual
intercourse or therapeutic donor insemination for a person who is
less than 35 years of age; or
(II) At least 6 months of regular, un protected sexual
intercourse or therapeutic donor insemination for a person who is
35 years of age or older;
(2) The inability of a person or the partner of the person to
reproduce or the inability of a person to reproduce with a
particular partner; or
(3) A finding by a qualified provider of health care that a
person is infertile based on:
(I) The medical, sexual and reproductive history or age
of the person;
(II) Physical findings; or
(III) Diagnostic testing.
(b) “Network plan” means a heal th 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 wi th the health maintenance
organization. The term does not include an arrangement for the
financing of premiums.
(c) “Provider of health care” has the meaning ascribed to it in
NRS 629.031.
(d) “Small employer” has the meaning ascribed to it in
NRS 689C.095.
(e) “Standard fertility preservation services”:
(1) Means a procedure or services for the preservation of
fertility that:
(I) Is not considered experimental or investigational by
the American Society for Reproductive Medicine, or its successor
organization, or the American Society of Clinical Oncology, or its
successor organization; and
(II) Is consistent with established medical practices or
professional guidelines published by the American Society for
Reproductive Medicine, or its successor organization, or the
American Society of Clinical Oncology, or its successor
organization.
(2) Includes, without limitation, sperm banking, oocyte
banking, embryo banking, banking of reproductive tissues and the
storage of reproductive cells and tissues.

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- 83rd Session (2025)
Sec. 38. NRS 695C.050 is hereby amended to read as follows:
695C.050 1. Except as otherwise provided in this chapter or
in specific provisions of this title, the provisions of this title are not
applicable to any health maintenance organi zation granted a
certificate of authority under this chapter. This provision does not
apply to an insurer licensed and regulated pursuant to this title
except with respect to its activities as a health maintenance
organization authorized and regulated pursuant to this chapter.
2. Solicitation of enrollees by a health maintenance
organization granted a certificate of authority, or its representatives,
must not be construed to violate any provision of law relating to
solicitation or advertising by practitioners of a healing art.
3. Any health maintenance organization authorized under this
chapter shall not be deemed to be practicing medicine and is exempt
from the provisions of chapter 630 of NRS.
4. The provisions of NRS 695C.110, 695C.125, 695C.1691,
695C.1693, 695C.170, 695C.1703, 695C.1705, 695C.1709 to
695C.173, inclusive, 695C.1733, 695C.17335, 695C.1734,
695C.1751, 695C.1755, 695C.1759, 695C.176 to 695C.200,
inclusive, and 695C.265 and sections 36 and 37 of this act do not
apply to a health maintenance organization that provides health care
services through managed care to recipients of Medicaid under the
State Plan for Medicaid or insurance pursuant to the Children’s
Health Insurance Program pursuant to a contract with the Division
of Health Care F inancing and Policy of the Department of Health
and Human Services. This subsection does not exempt a health
maintenance organization from any provision of this chapter for
services provided pursuant to any other contract.
5. The provisions of NRS 695C.16932 to 695C.1699,
inclusive, 695C.1701, 695C.1708, 695C.1728, 695C.1731,
695C.17333, 695C.17345, 695C.17347, 695C.1736 to 695C.1745,
inclusive, 695C.1757 and 695C.204 apply to a health maintenance
organization that provides health care services thro ugh managed
care to recipients of Medicaid under the State Plan for Medicaid.
6. The provisions of NRS 695C.17095 do not apply to a health
maintenance organization that provides health care services to
members of the Public Employees’ Benefits Program. T his
subsection does not exempt a health maintenance organization from
any provision of this chapter for services provided pursuant to any
other contract.
7. The provisions of NRS 695C.1735 do not apply to a health
maintenance organization that provides health care services to:

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- 83rd Session (2025)
(a) The officers and employees, and the dependents of officers
and employees, of the governing body of any county, school district,
municipal corporation, political subdivision, public corporation or
other local governmental agency of this State; or
(b) Members of the Public Employees’ Benefits Program.
 This subsection does not exempt a health maintenance
organization from any provision of this chapter for services
provided pursuant to any other contract.
Sec. 38.5. NRS 695C.0 50 is hereby amended to read as
follows:
695C.050 1. Except as otherwise provided in this chapter or
in specific provisions of this title, the provisions of this title are not
applicable to any health maintenance organization granted a
certificate of au thority under this chapter. This provision does not
apply to an insurer licensed and regulated pursuant to this title
except with respect to its activities as a health maintenance
organization authorized and regulated pursuant to this chapter.
2. Solicitation of enrollees by a health maintenance
organization granted a certificate of authority, or its representatives,
must not be construed to violate any provision of law relating to
solicitation or advertising by practitioners of a healing art.
3. Any health maintenance organization authorized under this
chapter shall not be deemed to be practicing medicine and is exempt
from the provisions of chapter 630 of NRS.
4. The provisions of NRS 695C.110, 695C.125, 695C.1691,
695C.1693, 695C.170, 695C.1703, 695 C.1705, 695C.1709 to
695C.173, inclusive, 695C.1733, 695C.17335, 695C.1734,
695C.1751, 695C.1755, 695C.1759, 695C.176 to 695C.200,
inclusive, and 695C.265 and [sections 36 and] section 37 of this act
do not apply to a health maintenance organization that provides
health care services through managed care to recipients of Medicaid
under the State Plan for Medicaid or insurance pursuant to the
Children’s Health Insurance Program pursuant to a contract with the
Division of Health Care Financing and Policy of the Department of
Health and Human Services. This subsection does not exempt a
health maintenance organization from any provision of this chapter
for services provided pursuant to any other contract.
5. The provisions of NRS 695C.16932 to 695C.1699,
inclusive, 695C.1701, 695C.1708, 695C.1728, 695C.1731,
695C.17333, 695C.17345, 695C.17347, 695C.1736 to 695C.1745,
inclusive, 695C.1757 and 695C.204 and section 36 of this act apply
to a health maintenance organization that provides health care

– 33 –

- 83rd Session (2025)
services through managed care to recipients of Medicaid under the
State Plan for Medicaid.
6. The provisions of NRS 695C.17095 do not apply to a health
maintenance organization that provides health care services to
members of the Public Employees’ Benefits Program. Thi s
subsection does not exempt a health maintenance organization from
any provision of this chapter for services provided pursuant to any
other contract.
7. The provisions of NRS 695C.1735 do not apply to a health
maintenance organization that provides health care services to:
(a) The officers and employees, and the dependents of officers
and employees, of the governing body of any county, school district,
municipal corporation, political subdivision, public corporation or
other local governmental agency of this State; or
(b) Members of the Public Employees’ Benefits Program.
 This subsection does not exempt a health maintenance
organization from any provision of this chapter for services
provided pursuant to any other contract.
Sec. 38.7. NRS 695C.050 is hereby amended to read as
follows:
695C.050 1. Except as otherwise provided in this chapter or
in specific provisions of this title, the provisions of this title are not
applicable to any health maintenance organization granted a
certificate of authority under this chapter. This provision does not
apply to an insurer licensed and regulated pursuant to this title
except with respect to its activities as a health maintenance
organization authorized and regulated pursuant to this chapter.
2. Solicitation of enrollees by a health maintenance
organization granted a certificate of authority, or its representatives,
must not be construed to violate any provision of law relating to
solicitation or advertising by practitioners of a healing art.
3. Any health maintenance organization authorized under this
chapter shall not be deemed to be practicing medicine and is exempt
from the provisions of chapter 630 of NRS.
4. The provisions of NRS 695C.110, 695C.125, 695C.1691,
695C.1693, 695C.170, 695C.1703, 6 95C.1705, 695C.1709 to
695C.173, inclusive, 695C.1733, 695C.17335, 695C.1734,
695C.1751, 695C.1755, 695C.1759, 695C.176 to 695C.200,
inclusive, and 695C.265 [and section 37 of this act ] do not apply to
a health maintenance organization that provides health care services
through managed care to recipients of Medicaid under the State Plan
for Medicaid or insurance pursuant to the Children’s Health
Insurance Program pursuant to a contract with the Division of

– 34 –

- 83rd Session (2025)
Health Care Financing and Policy of the Department of Health and
Human Services. This subsection does not exempt a health
maintenance organization from any provision of this chapter for
services provided pursuant to any other contract.
5. The provisions of NRS 695C.16932 to 695C.1699,
inclusive, 695C.170 1, 695C.1708, 695C.1728, 695C.1731,
695C.17333, 695C.17345, 695C.17347, 695C.1736 to 695C.1745,
inclusive, 695C.1757 and 695C.204 and [section] sections 36 and
37 of this act apply to a health maintenance organization that
provides health care services thr ough managed care to recipients of
Medicaid under the State Plan for Medicaid.
6. The provisions of NRS 695C.17095 do not apply to a health
maintenance organization that provides health care services to
members of the Public Employees’ Benefits Program. This
subsection does not exempt a health maintenance organization from
any provision of this chapter for services provided pursuant to any
other contract.
7. The provisions of NRS 695C.1735 do not apply to a health
maintenance organization that provides health care services to:
(a) The officers and employees, and the dependents of officers
and employees, of the governing body of any county, school district,
municipal corporation, political subdivision, public corporation or
other local governmental agency of this State; or
(b) Members of the Public Employees’ Benefits Program.
 This subsection does not exempt a health maintenance
organization from any provision of this chapter for services
provided pursuant to any other contract.
Sec. 39. NRS 695C.161 is hereby amended to read as follows:
695C.161 As used in NRS 695C.161 to 695C.169, inclusive,
and section 36 of this act, unless the context otherwise requires:
1. “Medicaid” means a program established in any state
pursuant to Title XIX of the Social Security Act (42 U.S.C. §§ 1396
et seq.) to provide assistance for part or all of the cost of medical
care rendered on behalf of indigent persons.
2. “Order for medical coverage” means an order of a court or
administrative tribunal to provide cove rage under a health care plan
to a child pursuant to the provisions of 42 U.S.C. § 1396g-1.
Sec. 40. NRS 695C.1694 is hereby amended to read as
follows:
695C.1694 1. A health maintenance organization which
offers or issues a health care plan that prov ides coverage for
prescription drugs or devices shall include in the plan coverage for
any type of hormone replacement therapy which is lawfully

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- 83rd Session (2025)
prescribed or ordered and which has been approved by the Food and
Drug Administration.
2. A health maintenanc e 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, any
copayment or coinsurance or require a longer waiting period or
other condition for coverage for hormone replacement therapy;
(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 hormone replacement therapy;
(c) Offer or pay any type of material inducement or financial
incentive to an enrollee to discourage the enrollee from accessing
hormone replacement therapy;
(d) Penalize a provider of health care who provides hormone
replacement therapy to an enrollee, including, without limitati on,
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 hormone replacement therapy to an
enrollee.
3. Evidence of coverage subject to the provisions of this
chapter that is delivered, issued for delivery or renewed on or after
October 1, 1999, has the legal effect of including the coverage
required by subsection 1, and any provision of the evidence of
coverage or the renewal which is in conflict with this section is void.
4. The provisions of this section do not require a health
maintenance organization to provide coverage for fertility drugs [.] ,
except as required by section 37 of this act.
5. As used in this section, “provider of health care” has the
meaning ascribed to it in NRS 629.031.
Sec. 41. NRS 695C.330 is hereby amended to read as follows:
695C.330 1. The Commissioner may suspend or revoke any
certificate of auth ority issued to a health maintenance organization
pursuant to the provisions of this chapter if the Commissioner finds
that any of the following conditions exist:
(a) The health maintenance organization is operating
significantly in contravention of its basic organizational document,
its health care plan or in a manner contrary to that described in and
reasonably inferred from any other information submitted pursuant
to NRS 695C.060, 695C.070 and 695C.140, unless any amendments
to those submissions have b een filed with and approved by the
Commissioner;

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- 83rd Session (2025)
(b) The health maintenance organization issues evidence of
coverage or uses a schedule of charges for health care services
which do not comply with the requirements of NRS 695C.1691 to
695C.200, inclusive, and section 37 of this act, 695C.204 or
695C.207;
(c) The health care plan does not furnish comprehensive health
care services as provided for in NRS 695C.060;
(d) The Commissioner certifies that the health maintenance
organization:
(1) Does not meet t he requirements of subsection 1 of NRS
695C.080; or
(2) Is unable to fulfill its obligations to furnish health care
services as required under its health care plan;
(e) The health maintenance organization is no longer financially
responsible and may reasonably be expected to be unable to meet its
obligations to enrollees or prospective enrollees;
(f) The health maintenance organization has failed to put into
effect a mechanism affording the enrollees an opportunity to
participate in matters relating to the content of programs pursuant to
NRS 695C.110;
(g) The health maintenance organization has failed to put into
effect the system required by NRS 695C.260 for:
(1) Resolving complaints in a manner reasonably to dispose
of valid complaints; and
(2) Conducting external reviews of adverse determinations
that comply with the provisions of NRS 695G.241 to 695G.310,
inclusive;
(h) The health maintenance organization or any person on its
behalf has advertised or merchandised its services in an untrue,
misrepresentative, misleading, deceptive or unfair manner;
(i) The continued operation of the health maintenance
organization would be hazardous to its enrollees or creditors or to
the general public;
(j) The health maintenance organization fails to provide the
coverage required by NRS 695C.1691; or
(k) The health maintenance organization has otherwise failed to
comply substantially with the provisions of this chapter.
2. A certificate of authority must be suspended or revoked only
after compliance with the requirements of NRS 695C.340.
3. If the certificate of authority of a health maintenance
organization is suspended, the health maintenance organization shall
not, during the period of that suspension, enroll any additional

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- 83rd Session (2025)
groups or new individual con tracts, unless those groups or persons
were contracted for before the date of suspension.
4. If the certificate of authority of a health maintenance
organization is revoked, the organization shall proceed, immediately
following the effective date of the order of revocation, to wind up its
affairs and shall conduct no further business except as may be
essential to the orderly conclusion of the affairs of the organization.
It shall engage in no further advertising or solicitation of any kind.
The Commission er may, by written order, permit such further
operation of the organization as the Commissioner may find to be in
the best interest of enrollees to the end that enrollees are afforded
the greatest practical opportunity to obtain continuing coverage for
health care.
Sec. 42. Chapter 695F of NRS is hereby amended by adding
thereto a new section to read as follows:
1. Regardless of whether a person who is pregnant already
has health coverage, a prepaid limited health service organization
that offers covera ge for pregnancy and childbirth shall allow the
person to enroll in such coverage without any additional fee or
penalty within at least 60 days after the person has been confirmed
to be pregnant by a qualified provider of health care.
2. Coverage for a person who enrolls in coverage pursuant to
subsection 1 must be effective:
(a) Except as otherwise provided in paragraph (b), on the first
day of the month in which a qualified provider of health care
confirms that the person is pregnant; or
(b) Upon the election of the person, on the first day of the
month after the person elects to enroll in the coverage.
3. As used in this section, “provider of health care” has the
meaning ascribed to it in NRS 629.031.
Sec. 43. Chapter 695G of NRS is hereby amended by adding
thereto the provisions set forth as sections 43.5, 44 and 45 of this
act.
Sec. 43.5. “Small employer” has the meaning ascribed to it
in NRS 689C.095.
Sec. 44. 1. Except as otherwise provided in subsections 5, 6
and 7, a managed care organization that issues a group health
care plan to any entity other than a small employer shall include
in the plan coverage for:
(a) Any procedure or medication determined by a qualified
provider of health care to be necessary for the diagnosis and
treatment of infertility in accordance with established medical
practice or any guidelines published by the American College of

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- 83rd Session (2025)
Obstetricians and Gynecologists or the American Society for
Reproductive Medicine, or their succ essor organizations. Such
coverage must include, without limitation, coverage for:
(1) At least three but not more than five completed
retrievals of oocytes; and
(2) At least three but not more than five transfers of
embryos, including, without limita tion, single -embryo transfer
where appropriate, in accordance with the guidelines of the
American Society for Reproductive Medicine, or its successor
organization.
(b) At least 5 years of s tandard fertility preservation services
that are necessary to preserve fertility because the insured:
(1) Has been diagnosed with a medical or genetic condition
that may directly or indirectly cause infertility, as determined
pursuant to paragraph (a) of subsection 2; or
(2) Is expected to receive a medical treatmen t that may
directly or indirectly cause infertility, as determined pursuant to
paragraph (b) of subsection 2.
2. For the purposes of subsection 1:
(a) A medical or genetic condition may directly or indirectly
cause infertility if the condition or trea tment for the condition is
likely to cause infertility, as established by the American Society of
Clinical Oncology, the American Society for Reproductive
Medicine or the American College of Obstetricians and
Gynecologists, or their successor organizations.
(b) A medical treatment may directly or indirectly cause
infertility if the treatment has a potential side effect of impaired
fertility, as established by the American Society of Clinical
Oncology or the American Society for Reproductive Medicine, or
their successor organizations.
3. A managed care organization shall ensure that the benefits
required by subsection 1 are made available to an insured through
a provider of health care who participates in the network plan of
the managed care organization.
4. A managed care organization shall not:
(a) Require an insured to pay a higher deductible, copayment,
coinsurance or other form of cost -sharing for the benefits
required by subsection 1 than is required for similar benefits that
are not related to fertility;
(b) Require an insured to obtain prior authorization for the
benefits described in subsection 1 that is not required for similar
benefits that are not related to fertility;

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- 83rd Session (2025)
(c) Require a longer waiting period for the coverage required
by subsection 1 than is required for similar benefits that are not
related to fertility;
(d) Impose any other exclusions, limitations, restrictions or
delays on the access of an insured to any benefit described in
subsection 1 that is not imposed on similar benefits that are not
related to fertility;
(e) Refuse to issue a group health care plan or cancel a group
health care plan solely because the person applying for or covered
by the plan uses or may use in the future any benefit described in
subsection 1;
(f) Offer or pay any type of material inducement or financial
incentive to an insured to discourage the insured from accessing
any benefit described in subsection 1;
(g) Penalize a provider of health care who provides any benefit
described in subsection 1 to an insured, including, without
limitation, reducing the reimbursement of the provider of health
care; or
(h) 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 benefit described in subsection
1 to an insured.
5. A managed care organization is not required to provide the
coverage required by subsection 1 for an insured whose infertility
is solely caused by a voluntary sterilization procedure that has not
been successfully reversed.
6. A managed care organization that is affiliated with a
religious organization is not required to provide the coverage
required by subsection 1 if the managed care organization objects
on religious grounds. Such a managed care organization shall,
before the issuance of a group health care plan that is subject to
the requirements of subsection 1 and before the renewal of such a
plan, provide to the group policyholder or prospective insured, as
applicable, written notice of the coverage that the managed care
organization refuses to provide pursuant to this subsection.
7. The provisions of this section do not apply to an employee
benefit plan, as defined in 29 U.S.C. § 1002(3), that:
(a) Meets the requirements of 29 C.F.R. § 2510.3-3; and
(b) Is established by a bona fide association of employers
acting indirectly in the interest of an employer pursuant to 29
U.S.C. § 1002(5).
8. A group health care plan that is subject to the provisions of
this section and is deliv ered, issued for delivery or renewed on or

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- 83rd Session (2025)
after January 1, 2026, has the legal effect of including the
coverage required by subsection 1, and any provision of the plan
or the renewal that conflicts with the provisions of this section is
void.
9. As used in this section:
(a) “Infertility” means a condition characterized by:
(1) The inability of a person to achieve pregnancy, not
including conception resulting in a miscarriage, where the person
and the partner of the person or a donor have the necessa ry
gametes to achieve pregnancy and after:
(I) At least 12 months of regular, unprotected sexual
intercourse or therapeutic donor insemination for a person who is
less than 35 years of age; or
(II) At least 6 months of regular, unprotected sexual
intercourse or therapeutic donor insemination for a person who is
35 years of age or older;
(2) The inability of a person or the partner of the person to
reproduce or the inability of a person to reproduce with a
particular partner; or
(3) A finding by a qualified provider of health care that a
person is infertile based on:
(I) The medical, sexual and reproductive history or age
of the person;
(II) Physical findings; or
(III) Diagnostic testing.
(b) “Network plan” means a health care plan offe red 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.
(c) “Provider of health care” has the meaning ascribed to it in
NRS 629.031.
(d) “Standard fertility preservation services”:
(1) Means a procedure or services for the preservation of
fertility that:
(I) Is not considered experimental or investigational by
the American Society for Reproductive Medicine, or its successor
organization, or the American Society of Clinical Oncology, or its
successor organization; and
(II) Is consistent with established medical practices or
professional guidelines published by the American Society for

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- 83rd Session (2025)
Reproductive Medicine, or its successor organization, or the
American Society of Clinical Oncology, or its successor
organization.
(2) Includes, without limitation, sperm banking, oocyte
banking, embryo banking, banking of reproductive tissues and the
storage of reproductive cells and tissues.
Sec. 45. 1. Regardless of whether a person who is pregnant
already has health coverage, a man aged care organization shall ,
except as otherwise provided in subsection 3, allow the person to
enroll in a health care plan without any additional fee or penalty
within at least:
(a) Sixty days after the person has been confirmed to be
pregnant by a qual ified provider of health care, if the health care
plan is offered on the individual market; or
(b) Thirty days after the person has been confirmed to be
pregnant by a qualified provider of health care, if the health care
plan is offered on the group market.
2. Coverage for a person who enrolls in a health care plan
pursuant to subsection 1 must be effective:
(a) Except as otherwise provided in paragraph (b), on the first
day of the month in which a qualified provider of health care
confirms that the person is pregnant; or
(b) Upon the election of the person, on the first day of the
month after the person elects to enroll in the plan.
3. The provisions of this section do not apply to a cafeteria
plan, as defined in 26 U.S.C. § 125(d).
4. As used in t his section, “provider of health care” has the
meaning ascribed to it in NRS 629.031.
Sec. 45.1. NRS 695G.010 is hereby amended to read as
follows:
695G.010 As used in this chapter, unless the context otherwise
requires, the words and terms defined in NRS 695G.012 to
695G.085, inclusive, and section 43.5 of this act have the meanings
ascribed to them in those sections.
Sec. 45.2. NRS 695G.090 is he reby amended to read as
follows:
695G.090 1. Except as otherwise provided in subsection 3,
the provisions of this chapter apply to each organization and insurer
that operates as a managed care organization and may include,
without limitation, an insurer that issues a policy of health
insurance, an insurer that issues a policy of individual or group
health insurance, a carrier serving small employers, a fraternal

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- 83rd Session (2025)
benefit society, a hospital or medical service corporation and a
health maintenance organization.
2. In addition to the provisions of this chapter, each managed
care organization shall comply with:
(a) The provisions of chapter 686A of NRS, including all
obligations and remedies set forth therein; and
(b) Any other applicable provision of this title.
3. The provisions of NRS 695G.127, 695G.1639, 695G.164,
695G.1645, 695G.167 and 695G.200 to 695G.230, inclusive, and
sections 44 and 45 of this act do not apply to a managed care
organization that provides health care services to recipients of
Medicaid under the State Plan for Medicaid or insurance pursuant to
the Children’s Health Insurance Program pursuant to a contract with
the Division of Health Care Financing and Policy of the Department
of Health and Human Services.
4. The provisions of NRS 695C.1735 and 695G.1639 do not
apply to a managed care organization that provides health care
services to members of the Public Employees’ Benefits Program.
5. Subsections 3 and 4 do not exempt a managed care
organization from any provision of this chapter for services
provided pursuant to any other contract.
Sec. 45.6. NRS 695G.090 is hereby amended to read as
follows:
695G.090 1. Except as otherwise provided in subsection 3,
the provisions of this chapter apply to each organization and insurer
that operates as a managed care organization and may include,
without limitation, an insurer that issues a policy of health
insurance, an insurer that issues a policy of individual or group
health insurance, a carrier serving small employers, a fraternal
benefit society, a hospital or medical service corporation and a
health maintenance organization.
2. In addition to the provisions of this chapter, each manag ed
care organization shall comply with:
(a) The provisions of chapter 686A of NRS, including all
obligations and remedies set forth therein; and
(b) Any other applicable provision of this title.
3. The provisions of NRS 695G.127, 695G.1639, 695G.164,
695G.1645, 695G.167 and 695G.200 to 695G.230, inclusive, and
[sections] section 44 [and 45] of this act do not apply to a managed
care organization that provides health care services to recipients of
Medicaid under the State Plan for Medicaid or insurance pursuant to
the Children’s Health Insurance Program pursuant to a contract with

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- 83rd Session (2025)
the Division of Health Care Financing and Policy of the Department
of Health and Human Services.
4. The provisions of NRS 695C.1735 and 695G.1639 do not
apply to a managed care organization that provides health care
services to members of the Public Employees’ Benefits Program.
5. Subsections 3 and 4 do not exempt a managed care
organization from any provision of this chapter for services
provided pursuant to any other contract.
Sec. 45.65. NRS 695G.090 is hereby amended to read as
follows:
695G.090 1. Except as otherwise provided in subsection 3,
the provisions of this chapter apply to each organization and insurer
that operates as a managed care organization and may include,
without limitation, an insurer that issues a policy of health
insurance, an insurer that issues a policy of individual or group
health insurance, a carrier serving small employers, a fraternal
benefit society, a hospital or medical service corporation and a
health maintenance organization.
2. In addition to the provisions of this chapt er, each managed
care organization shall comply with:
(a) The provisions of chapter 686A of NRS, including all
obligations and remedies set forth therein; and
(b) Any other applicable provision of this title.
3. The provisions of NRS 695G.127, 695G.163 9, 695G.164,
695G.1645, 695G.167 and 695G.200 to 695G.230, inclusive, [and
section 44 of this act ] do not apply to a managed care organization
that provides health care services to recipients of Medicaid under
the State Plan for Medicaid or insurance pursuant to the Children’s
Health Insurance Program pursuant to a contract with the Division
of Health Care Financing and Policy of the Department of Health
and Human Services.
4. The provisions of NRS 695C.1735 and 695G.1639 do not
apply to a managed care organization that provides health care
services to members of the Public Employees’ Benefits Program.
5. Subsections 3 and 4 do not exempt a managed care
organization from any provision of this chapter for services
provided pursuant to any other contract.
Sec. 45.7. NRS 695G.130 is hereby amended to read as
follows:
695G.130 1. In addition to any other report which is required
to be filed with the Commissioner, each managed care organization
shall file with the Commissioner, with its annual filing made
pursuant to NRS 686B.070 of forms and rates relating to policies of

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- 83rd Session (2025)
insurance for individuals an d small employer groups, a report
regarding its methods for reviewing the quality of health care
services provided to its insureds. The report must be submitted on a
form prescribed by the Commissioner.
2. A report filed pursuant to this section must be made
available for public inspection within a reasonable time after it is
received by the Commissioner.
[3. As used in this section, “small employer” has the meaning
ascribed to it in NRS 689C.095.]
Sec. 45.8. Section 37 of this act is hereby amended to read as
follows:
Sec. 37. 1. Except as otherwise provided in
subsections 5, 6 and 7, a health maintenance organization that
issues a group health care plan to any entity other than a small
employer or a plan that provides health care services
through managed care to recipients of Medicaid under the
State Plan for Medicaid shall include in the plan coverage
for:
(a) Any procedure or medication determined by a
qualified provider of health care to be necessary for the
diagnosis and treatment of infertility in accordance with
established medical practice or any guidelines published by
the American College of Obstetricians and Gynecologists or
the American Society for Reproductive Medicine, or their
successor organizations. Such coverage must include, without
limitation, coverage for:
(1) At least three but not more than five completed
retrievals of oocytes; and
(2) At least three but not more than five transfers of
embryos, including, without limitation, single -embryo
transfer where appropriate, in accordance with the guidelines
of the American Society for Reproductive Medicine, or its
successor organization.
(b) At least 5 years of standard fertility preservation
services that are necessary to preserve fertility because the
enrollee:
(1) Has been diagnosed with a medical or genetic
condition that may directly or indirectly cause infertility, as
determined pursuant to paragraph (a) of subsection 2; or
(2) Is expected to receive a medical treatment that may
directly or indirectly cause infe rtility, as determined pursuant
to paragraph (b) of subsection 2.
2. For the purposes of subsection 1:

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- 83rd Session (2025)
(a) A medical or genetic condition may directly or
indirectly cause infertility if the condition or treatment for the
condition is likely to cause i nfertility, as established by the
American Society of Clinical Oncology, the American
Society for Reproductive Medicine or the American College
of Obstetricians and Gynecologists, or their successor
organizations.
(b) A medical treatment may directly or indirectly cause
infertility if the treatment has a potential side effect of
impaired fertility, as established by the American Society of
Clinical Oncology or the American Society for Reproductive
Medicine, or their successor organizations.
3. A health maintenance organization shall ensure that
the benefits required by subsection 1 are made available to an
enrollee through a provider of health care who participates in
the network plan of the health maintenance organization.
4. A health maintenance organization shall not:
(a) Require an enrollee to pay a higher deductible,
copayment, coinsurance or other form of cost -sharing for the
benefits required by subsection 1 than is required for similar
benefits that are not related to fertility;
(b) Require an enrollee to obtain prior authorization for
the benefits described in subsection 1 that is not required for
similar benefits that are not related to fertility;
(c) Require a longer waiting period for the coverage
required by subsection 1 than is require d for similar benefits
that are not related to fertility;
(d) Impose any other exclusions, limitations, restrictions
or delays on the access of an enrollee to any benefit described
in subsection 1 that is not imposed on similar benefits that are
not related to fertility;
(e) 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 f uture any benefit
described in subsection 1;
(f) Offer or pay any type of material inducement or
financial incentive to an enrollee to discourage the enrollee
from accessing any benefit described in subsection 1;
(g) Penalize a provider of health care who provides any
benefit described in subsection 1 to an enrollee, including,
without limitation, reducing the reimbursement of the
provider of health care; or

– 46 –

- 83rd Session (2025)
(h) 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 benefit described in
subsection 1 to an enrollee.
5. A health maintenance organization is not required to
provide the coverage required by subsection 1 for an enrollee
whose infertility is solely caused by a voluntary sterilization
procedure that has not been successfully reversed.
6. A health maintenance organization which is affiliated
with a religious organization is not required to provide the
coverage required by subsection 1 if the health maintenance
organization objects on religious grounds. Such a health
maintenance organization shall, before the issuance of a
group health care plan that is subject to the requirements of
subsection 1 and before the renewal of such a plan, provide to
the group policyholder or prospective enrollee, as applicable,
written notice of the coverage that the health maintenance
organization refuses to provide pursuant to this subsection.
7. The provisions of this section do not apply to an
employee benefit plan, as defined in 29 U.S.C. § 1002(3),
that:
(a) Meets the requirements of 29 C.F.R. § 2510.3-3; and
(b) Is established by a bona fide association of employers
acting indirectly in the interest of an employer pursuant to 29
U.S.C. § 1002(5).
8. A group health care plan that is subject to the
provisions of this section and is deliver ed, issued for delivery
or renewed on or after [January] July 1, [2026,] 2027, has the
legal effect of including the coverage required by subsection
1, and any provision of the plan or the renewal that conflicts
with the provisions of this section is void.
9. As used in this section:
(a) “Infertility” means a condition characterized by:
(1) The inability of a person to achieve pregnancy, not
including conception resulting in a miscarriage, where the
person and the partner of the person or a donor have the
necessary gametes to achieve pregnancy and after:
(I) At least 12 months of regular, unprotected
sexual intercourse or therapeutic donor insemination for a
person who is less than 35 years of age; or
(II) At least 6 months of regular, unprotected
sexual intercourse or therapeutic donor insemination for a
person who is 35 years of age or older;

– 47 –

- 83rd Session (2025)
(2) The inability of a person or the partner of the
person to reproduce or the inability of a person to reproduce
with a particular partner; or
(3) A finding by a qualified provider of health care
that a person is infertile based on:
(I) The medical, sexual and reproductive history or
age of the person;
(II) Physical findings; or
(III) Diagnostic testing.
(b) “Network plan” means a health care plan offered by a
health maintenance organization under which the financin g
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.
(c) “Provider of health care” has the meaning ascribed to
it in NRS 629.031.
(d) “Small employer” has the meaning ascribed to it in
NRS 689C.095.
(e) “Standard fertility preservation services”:
(1) Means a procedure or services for the preservation
of fertility that:
(I) Is not considered experimental or
investigational by the American Society for Reproductive
Medicine, or its successor organization, or the American
Society of Clinical Oncology, or its successor organ ization;
and
(II) Is consistent with established medical practices
or professional guidelines published by the American Society
for Reproductive Medicine, or its successor organization, or
the American Society of Clinical Oncology, or its successor
organization.
(2) Includes, without limitation, sperm banking,
oocyte banking, embryo banking, banking of reproductive
tissues and the storage of reproductive cells and tissues.
Sec. 45.9. Section 44 of this act is hereby amended to read as
follows:
Sec. 44. 1. Except as otherwise provided in
subsections 5, 6 and 7, a managed care organization that
issues a group health care plan to any entity other than a small
employer or a plan that provides health care services
through managed care to recipients of Medicaid under the

– 48 –

- 83rd Session (2025)
State Plan for Medicaid shall include in the plan coverage
for:
(a) Any procedure or medication determined by a
qualified provider of health care to be necessary for the
diagnosis and treatment of infertility in accordance with
established medical practice or any guidelines published by
the American College of Obstetricians and Gynecologists or
the American Society for Reproductive Medicine, or their
successor organizations. Such coverage must include, without
limitation, coverage for:
(1) At least three but not more than five completed
retrievals of oocytes; and
(2) At least three but not more than five transfers of
embryos, including, without limitation, single -embryo
transfer where appropriate, in accordance with the guidelines
of the American Society for Reproductive Medicine, or its
successor organization.
(b) At least 5 years of standard fertility preservation
services that are necessary to preserve fertility because the
insured:
(1) Has been diagnosed with a medical or genet ic
condition that may directly or indirectly cause infertility, as
determined pursuant to paragraph (a) of subsection 2; or
(2) Is expected to receive a medical treatment that may
directly or indirectly cause infertility, as determined pursuant
to paragraph (b) of subsection 2.
2. For the purposes of subsection 1:
(a) A medical or genetic condition may directly or
indirectly cause infertility if the condition or treatment for the
condition is likely to cause infertility, as established by the
American Society of Clinical Oncology, the American
Society for Reproductive Medicine or the American College
of Obstetricians and Gynecologists, or their successor
organizations.
(b) A medical treatment may directly or indirectly cause
infertility if the treatment has a potential side effect of
impaired fertility, as established by the American Society of
Clinical Oncology or the American Society for Reproductive
Medicine, or their successor organizations.
3. A managed care organization shall ensure that the
benefits required by subsection 1 are made available to an
insured through a provider of health care who participates in
the network plan of the managed care organization.

– 49 –

- 83rd Session (2025)
4. A managed care organization shall not:
(a) Require an insured to pay a higher deductible,
copayment, coinsurance or other form of cost -sharing for the
benefits required by subsection 1 than is required for similar
benefits that are not related to fertility;
(b) Require an insured to obtain prior authorization for
the benefits described in subsection 1 that is not required for
similar benefits that are not related to fertility;
(c) Require a longer waiting period for the coverage
required by subsection 1 than is required for similar benefits
that are not related to fertility;
(d) Impose any other exclusions, limitations, restrictions
or delays on the access of an insured to any benefit described
in subsection 1 that is not imposed on similar benefits that are
not related to fertility;
(e) Refuse to issue a group health care plan or cancel a
group health care plan solely because the person applying for
or covered by the plan uses or may use in the future any
benefit described in subsection 1;
(f) Offer or pay any type of material inducement or
financial incentive to an insured to discourage the insured
from accessing any benefit described in subsection 1;
(g) Penalize a provider of health care who provides any
benefit described in subsection 1 to an in sured, including,
without limitation, reducing the reimbursement of the
provider of health care; or
(h) 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 benefit described in
subsection 1 to an insured.
5. A managed care organization is not required to
provide the coverage required by subsection 1 for an insured
whose infertility is solely caused by a voluntary sterilization
procedure that has not been successfully reversed.
6. A managed care organization that is affiliated with a
religious organization is not required to provide the coverage
required by subsection 1 if the managed care organization
objects on religious grounds. Such a managed care
organization shall, before the issuance of a group health care
plan that is subject to the requirements of subsection 1 and
before the renewal of such a plan, provide to the group
policyholder or prospective insured, as applicable, written

– 50 –

- 83rd Session (2025)
notice of the coverage that the managed care organization
refuses to provide pursuant to this subsection.
7. The provisions of this section do not apply to an
employee benefit plan, as defined in 29 U.S.C. § 1002(3),
that:
(a) Meets the requirements of 29 C.F.R. § 2510.3-3; and
(b) Is established by a bona fide association of employers
acting indirectly in the interest of an employer pursuant to 29
U.S.C. § 1002(5).
8. A group health care plan that is subject to the
provisions of this section and is de livered, issued for delivery
or renewed on or after [January] July 1, [2026,] 2027, has the
legal effect of including the coverage required by subsection
1, and any provision of the plan or the renewal that conflicts
with the provisions of this section is void.
9. As used in this section:
(a) “Infertility” means a condition characterized by:
(1) The inability of a person to achieve pregnancy, not
including conception resulting in a miscarriage, where the
person and the partner of the person or a dono r have the
necessary gametes to achieve pregnancy and after:
(I) At least 12 months of regular, unprotected
sexual intercourse or therapeutic donor insemination for a
person who is less than 35 years of age; or
(II) At least 6 months of regular, unpr otected
sexual intercourse or therapeutic donor insemination for a
person who is 35 years of age or older;
(2) The inability of a person or the partner of the
person to reproduce or the inability of a person to reproduce
with a particular partner; or
(3) A finding by a qualified provider of health care
that a person is infertile based on:
(I) The medical, sexual and reproductive history or
age of the person;
(II) Physical findings; or
(III) Diagnostic testing.
(b) “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 pr oviders under contract with the managed
care organization. The term does not include an arrangement
for the financing of premiums.

– 51 –

- 83rd Session (2025)
(c) “Provider of health care” has the meaning ascribed to
it in NRS 629.031.
(d) “Standard fertility preservation services”:
(1) Means a procedure or services for the preservation
of fertility that:
(I) Is not considered experimental or
investigational by the American Society for Reproductive
Medicine, or its successor organization, or the American
Society of Clinical O ncology, or its successor organization;
and
(II) Is consistent with established medical practices
or professional guidelines published by the American Society
for Reproductive Medicine, or its successor organization, or
the American Society of Clinical Oncology, or its successor
organization.
(2) Includes, without limitation, sperm banking,
oocyte banking, embryo banking, banking of reproductive
tissues and the storage of reproductive cells and tissues.
Sec. 46. The provisions of subsection 1 of NRS 354.599 do
not apply to any additional expenses of a local government which
are related to the provisions of this act.
Sec. 47. 1. This section and section 10 of this act become
effective upon passage and approval.
2. Sections 1 to 9, inclusive, of th is act become effective on
July 1, 2025.
3. Sections 12, 13 , 15 to 38, inclusive, 39 to 45.2, inclusive ,
45.7 and 46 of this act become effective:
(a) Upon passage and approval for the purpose of adopting any
regulations and performing any other preparatory administrative
tasks that are necessary to carry out the provisions of this act; and
(b) On January 1, 2026, for all other purposes.
4. Sections 38.5 and 45.6 of this act become effective:
(a) Upon passage and approval for the purpose of ad opting any
regulations and performing any other preparatory administrative
tasks that are necessary to carry out the provisions of this act; and
(b) On January 1, 2027, for all other purposes.
5. Sections 11, 13 .5, 14, 38.7 , 45.65, 45.8 and 45.9 of this act
become effective:
(a) Upon passage and approval for the purpose of adopting any
regulations, applying for and obtaining any waiver of federal law or
any amendment of the State Plan for Medicaid that is necessary for
the Department of Health and Human Services to receive federal
funding to provide the coverage under Medicaid described in section

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- 83rd Session (2025)
14 of this act and performing any other preparatory administrative
tasks that are necessary to carry out the provisions of this act; and
(b) On July 1, 2027, for all other purposes.

20 ~~~~~ 25