Nev. Rev. Stat. § 695D.216

Current through 82nd (2023) Legislative Session Chapter 535 and 34th (2023) Special Session Chapter 1 and 35th (2023) Special Session Chapter 1
Section 695D.216 - Required provision concerning coverage for services provided through telehealth to same extent as though provided in person or by other means; required provision concerning reimbursement for certain services provided through telehealth in same amount as though provided in person or by other means; prohibited acts
1. A plan for dental care must include coverage for services provided to a member through telehealth to the same extent as though provided in person or by other means.
2. A plan for dental care must provide reimbursement for services described in subsection 1 in the same amount as though provided in person or by other means if the services:
(a) Are received at an originating site described in 42 U.S.C. § 1395m(m)(4)(C) or furnished by a federally-qualified health center or a rural health clinic; and
(b) Are not provided through audio-only interaction.
3. An organization for dental care shall not:
(a) Require a member to establish a relationship in person with a provider of health care or provide any additional consent to or reason for obtaining services through telehealth as a condition to providing the coverage described in subsection 1 or the reimbursement described in subsection 2;
(b) Require a provider of health care to demonstrate that it is necessary to provide services to a member through telehealth or receive any additional type of certification or license to provide services through telehealth as a condition to providing the coverage described in subsection 1 or the reimbursement described in subsection 2;
(c) Refuse to provide the coverage described in subsection 1 or the reimbursement described in subsection 2 because of:
(1) The distant site from which a provider of health care provides services through telehealth or the originating site at which a member receives services through telehealth; or
(2) The technology used to provide the services:
(d) Require covered services to be provided through telehealth as a condition to providing coverage for such services; or
(e) Categorize a service provided through telehealth differently for purposes relating to coverage or reimbursement than if the service had been provided in person or through other means.
4. A plan for dental care must not require a member to obtain prior authorization for any service provided through telehealth that is not required for the service when provided in person. A plan for dental care may require prior authorization for a service provided through telehealth if such prior authorization would be required if the service were provided in person or by other means.
5. The provisions of this section do not require an organization for dental care to:
(a) Ensure that covered services are available to a member through telehealth at a particular originating site;
(b) Provide coverage for a service that is not a covered service or that is not provided by a covered provider of health care; or
(c) Enter into a contract with any provider of health care or cover any service if the organization for dental care is not otherwise required by law to do so.
6. A plan for dental care subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after July 1, 2023, has the legal effect of including the coverage required by this section, and any provision of the plan or the renewal which is in conflict with this section is void.
7. As used in this section:
(a) "Distant site" has the meaning ascribed to it in NRS 629.515.
(b) "Federally-qualified health center" has the meaning ascribed to it in 42 U.S.C. § 1396d(l)(2)(B).
(c) "Originating site" has the meaning ascribed to it in NRS 629.515.
(d) "Provider of health care" has the meaning ascribed to it in NRS 439.820.
(e) "Rural health clinic" has the meaning ascribed to it in 42 U.S.C. § 1395x(aa)(2).
(f) "Telehealth" has the meaning ascribed to it in NRS 629.515.

NRS 695D.216

Added to NRS by 2015, 645; A 2021, 3040, 3041; 2023, 233, 237
Amended by 2023, Ch. 51,§2, eff. 5/29/2023, app. 5/20/2023.
Amended by 2023, Ch. 51,§1.7, eff. 7/1/2023.
Amended by 2021, Ch. 479,§15.5, eff. 5/20/2023.
Amended by 2021, Ch. 479,§15, eff. 10/1/2021.
Added by 2015, Ch. 153,§41, eff. 7/1/2015.