Local Reproductive Health Legislation & More

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SB122: Establishing a State-Level Granting Program for Reproductive and Family Planning Care

Click here for updates on hearings and more on SB122.

From The Nevada Independent, ‘Proposed bills would preserve preventative health care for women if ACA repealed’ published on 2/14/17:

The program is modeled off of a similar system established by the Minnesota Legislature in 1978, which provides low-income, high-risk individuals with family planning services. Minnesota appropriated $6.4 million in family planning grants in the 2016 fiscal year, according to the state’s Department of Health.

“The idea is to create something that’s sustainable over the long term,” Cancela said. “So what this bill does other than creating the program functionally enables the state to apply for grants in family planning and then re-grant those to organizations or state entities that are providing that care.”

Introduced February 13, 2017: Existing law authorizes the Division of Health Care Financing and Policy of the Department of Health and Human Services to: (1) conduct a family planning service in any county of this State; and (2) establish a policy of referral of certain persons for family planning services. (NRS 422.308) Section 5 of this bill establishes the Account for Family Planning in the State General Fund and requires the Administrator of the Division of Public and Behavioral Health of the Department of Health and Human Services to administer the Account. Section 5 requires the money in the Account to be expended to award grants of money to local governmental entities and nonprofit organizations to be used to provide certain services relating to family planning to persons who would otherwise have difficulty obtaining those services. Section 6 of this bill authorizes the Administrator to accept gifts, grants and donations for the purpose of awarding such grants. Section 7 of this bill requires the recipient of a grant to provide certain information to a person to whom the recipient provides counseling that is funded by a grant. Sections 7 and 9 of this bill provide that any personally identifiable information concerning a person to whom a grant recipient provides services is confidential. Section 8 of this bill requires the State Board of Health to adopt regulations concerning the award of grants.

Sponsors: Yvanna Cancela, Julia Ratti

SB233 & AB249: Continuing Free Contraceptive Care Post-Affordable Care Act

Click here for hearing updates and more on SB233 and AB249.

From The Nevada Independent, ‘Proposed bills would preserve preventative health care for women if ACA repealed’ (2/15/17), “Legislators are sponsoring bills to codify portions of the federal health care law in state statute and bolster family planning services in the state in the event of a repeal.”

SB233: Requires the State Plan for Medicaid and health insurance plans to provide certain benefits, including family planning care.

[SB233] sponsored by Sen. Julia Ratti, would codify some of the women’s preventative health services covered under the ACA, particularly no-copay birth control. But it will also go beyond the Affordable Care Act, such as requiring insurers to cover 12 month distribution of contraception.

AB249: the State Plan for Medicaid to provide certain benefits relating to contraception at no additional cost to the enrollee and more.

En Español.

Bill Text

SB233 – Introduced Wednesday, March 1, 2017: Existing law requires most health insurance plans which cover prescription drugs and outpatient care to also include coverage for contraceptive drugs and devices without an additional copay, coinsurance or a higher deductible than that which may be charged for other prescription drugs and outpatient care under the plan. (NRS 689A.0415, 689A.0417, 689B.0376, 689B.0377, 695B.1916, 695B.1918, 695C.1694, 695C.1695) Existing law also requires most health insurance plans to include coverage for certain preventative services, including the human papillomavirus vaccine, cytological screenings and mammograms. (NRS 287.0272, 689A.0405, 689A.044, 689B.0313, 689B.0374, 695B.1912, 695B.1925, 695C.1735, 695C.1745, 695G.171) Certain plans, including small employer plans, benefit contracts provided by fraternal benefit societies, plans issued by a managed care organization and certain plans offered by governmental entities of this State are not currently subject to some of these requirements. (Chapters 287, 689C, 695A and 695G of NRS) The federal Patient Protection and Affordable Care Act (Public Law 111-148, as amended) requires certain preventative services to be covered by every health insurance plan without any copay, coinsurance or higher deductible, including, without limitation, contraceptive drugs, devices and services, certain vaccinations, mammograms, counseling concerning interpersonal and domestic violence, screenings for certain diseases and well-woman preventative visits. (42 U.S.C. § 300gg-13(a)(4); 45 C.F.R. § 147.130) This bill places those requirements in Nevada law, requiring all public and private health insurance plans made available in this State to provide coverage for certain preventative services without any copay, coinsurance or a higher deductible. Sections 7, 8 and 10-57 of this bill require certain additional forms of contraceptive drugs, devices, supplies and services to be covered by a health insurance plan, including up to a 12-month supply of contraceptives or a therapeutic equivalent, insertion or removal of a contraceptive device, education and counseling relating to contraception and voluntary sterilization for men and women. Existing law authorizes an insurer which is affiliated with a religious organization and which objects on religious grounds to providing coverage for contraceptive drugs and devices to exclude coverage in its policies, plans or contracts for such drugs and devices. (NRS 689A.0415, 689A.0417, 689B.0376, 689B.0377, 695B.1916, 695B.1918, 695C.1694, 695C.1695) Sections 15, 16, 24, 25, 41, 42, 48 and 49 of this bill remove that authority to exclude such coverage. In addition, sections 20, 27, 33, 38, 45 and 54 of this bill do not include such a religious exemption. Thus, all insurers are required to provide coverage for the contraceptive drugs, devices and services included in this bill. Existing law requires most health insurance plans which cover prescription drugs and outpatient care to also include coverage for hormone replacement therapy without an additional copay, coinsurance or a higher deductible than that which may be charged for other prescription drugs and outpatient care under the plan. (NRS 689A.0415, 689A.0417, 689B.0376, 689B.0377, 695B.1916, 695B.1918, 695C.1694, 695C.1695) Sections 7, 8 and 10-57 of this bill expand this requirement to all public and private health insurance plans made available in this State and require health insurance plans to provide coverage for hormone replacement therapy without any copay, coinsurance or higher deductible. Existing law requires this State to develop a State Plan for Medicaid which includes, without limitation, a list of the medical services provided to Medicaid beneficiaries. (42 U.S.C. § 1396a; NRS 422.063) Existing federal law authorizes a state to charge a copay, coinsurance or deductible for most Medicaid services, but prohibits any copay, coinsurance or deductible for contraceptive drugs, devices and services. (42 U.S.C. § 1396o-1) Existing federal law also authorizes a state to define the parameters of contraceptive coverage provided under Medicaid. (42 U.S.C. § 1396u-7) Existing law requires a number of specific medical services to be covered under Medicaid. (NRS 422.2717-422.27241) Sections 2-6 of this bill require the State Plan for Medicaid to include the preventative services currently required to be covered by private health insurance plans pursuant to existing Nevada law, the Patient Protection and Affordable Care Act (Public Law 111-148 as amended) as well as the additional drugs, devices, supplies and services required by sections 7, 8 and 10-57 without any copay, coinsurance or deductible. Existing law authorizes a pharmacist to dispense up to a 90-day supply of a drug pursuant to a valid prescription in certain circumstances. (NRS 639.2396) Section 9 of this bill requires a pharmacist to dispense up to a 12-month supply of contraceptives or their therapeutic equivalent upon the request of a patient who has a valid prescription.

Primary Sponsor(s): Senator Julia Ratti, Senator Yvanna Cancela, Senator Pat Spearman, Senator Nicole Cannizzaro, Senator Joyce Woodhouse

AB249 – Introduced Wednesday, March 1, 2017: Existing law requires most health insurance plans which cover prescription drugs and outpatient care to also include coverage for contraceptive drugs and devices without an additional copay, coinsurance or a higher deductible than that which may be charged for other prescription drugs and outpatient care under the plan. (NRS 689A.0415, 689A.0417, 689B.0376, 689B.0377, 695B.1916, 695B.1918, 695C.1694, 695C.1695) Certain plans, including small employer plans, benefit contracts provided by fraternal benefit societies, plans issued by a managed care organization and certain plans offered by governmental entities of this State are not currently subject to these requirements. (Chapters 287, 689C, 695A and 695G of NRS) The federal Patient Protection and Affordable Care Act, Pub. L. 111-148, as amended, requires certain contraceptive drugs, devices and services to be covered by every health insurance plan without any copay, coinsurance or higher deductible. (42 U.S.C. § 300gg-13(a)(4); 45 C.F.R. § 147.130) Sections 3, 4 and 6-25 of this bill align Nevada law with federal law, requiring all public and private health insurance plans made available in this State to provide coverage for certain benefits relating to contraception without any copay, coinsurance or a higher deductible. Sections 3, 4 and 6-25 require certain additional forms of contraceptive drugs, devices and services to be covered by a health insurance plan, including, without limitation, up to a 12-month supply of contraceptives or its therapeutic equivalent, insertion or removal of a contraceptive device, education and counseling relating to contraception, management of side effects relating to contraception and voluntary sterilization for men and women. Sections 3, 4 and 6-25 prohibit the use of a program of step therapy or prior authorization requirements relating to the contraceptive drugs, devices and services required by this bill. Sections 3, 4 and 6-25 also require a health insurance plan to provide coverage for certain therapeutic equivalent drugs and devices relating to contraception when a therapeutic equivalent covered by the plan is deemed to be medically inappropriate by a provider of health care. Additionally, sections 3, 4 and 6-25 require that benefits provided by a health insurance plan relating to contraception which are provided to the insured must also be provided to the spouse or dependent of an insured. Existing law allows an insurer that is affiliated with a religious organization and which objects on religious grounds to providing coverage for contraceptive drugs and devices to exclude coverage in its policies, plans or contracts for such drugs and devices. (NRS 689A.0415, 689B.0376, 695B.1916, 695C.1694) Sections 7, 11, 14, 16, 17, 20 and 25 of this bill remove the religious exemption and require all insurers to provide coverage for the contraceptive drugs, devices and services required by this bill. Existing law requires this State to develop a State Plan for Medicaid which includes, without limitation, a list of the medical services provided to Medicaid beneficiaries. (42 U.S.C. § 1396a; NRS 422.063) Existing federal law authorizes a state to charge a copay, coinsurance or deductible for most Medicaid services, but prohibits any copay, coinsurance or deductible for certain family planning services and supplies. (42 U.S.C. § 1396o-1) Existing federal law also authorizes a state to define the parameters of contraceptive coverage provided under Medicaid. (42 U.S.C. § 1396u-7) Existing Nevada law requires a number of specific medical services to be covered under Medicaid. (NRS 422.2717-422.27241) Sections 1 and 2 of this bill require the State Plan for Medicaid to include certain benefits relating to contraception currently required to be covered by private health insurance plans pursuant to existing Nevada law and the Patient Protection and Affordable Care Act, Pub. L. 111-148, as amended, as well as the additional benefits related to contraception required by sections 3, 4 and 6-25 without any copay, coinsurance or deductible. Sections 1 and 2 also prohibit the use of a program of step therapy and any requirement to obtain prior authorization relating to such benefits which are covered under the State Plan for Medicaid. Existing law authorizes a pharmacist to dispense up to a 90-day supply of a drug pursuant to a valid prescription in certain circumstances. (NRS 639.2396) Section 5 of this bill requires a pharmacist to dispense up to a 12-month supply of contraceptives or a therapeutic equivalent upon the request of a patient and pursuant to a valid prescription.

Primary Sponsor(s): Assemblyman Jason Frierson, Assemblywoman Shannon Bilbray-Axelrod, Assemblyman Michael Sprinkle, Assemblywoman Teresa Benitez-Thompson, Assemblyman Steve Yeager

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A pro-family planning sign at the Reno Women’s March on January 21, 2017.
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