Nevada Code § 287.0276

Coverage for screening for and diagnosis and treatment of autism spectrum disorders required to be provided by local governmental agency that provides health insurance through plan of self-insurance
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1. The governing body of any county, school
district, municipal corporation, political subdivision, public corporation or
other local governmental agency of the State of Nevada that provides health
insurance through a plan of self-insurance must provide coverage for screening
for and diagnosis of autism spectrum disorders and for treatment of autism
spectrum disorders to persons covered by the plan of self-insurance under the
age of 18 years or, if enrolled in high school, until the person reaches the
age of 22 years. For the purposes of such coverage, the governing body of a
county, school district, municipal corporation, political subdivision, public
corporation or other local governmental agency shall accept as dispositive any
diagnosis of an autism spectrum disorder that is rendered in accordance with
the statewide standard for measuring outcomes and assessing persons with autism
spectrum disorders through the age of 21 years prescribed pursuant to NRS 427A.872 .
2. Coverage provided under this section is
subject to:
(a) A maximum benefit of the actuarial equivalent
of $72,000 per year for applied behavior analysis treatment; and
(b) Copayment, deductible and coinsurance
provisions and any other general exclusion or limitation of a plan of
self-insurance to the same extent as other medical services or prescription
drugs covered by the policy.
3. A governing body of any county, school
district, municipal corporation, political subdivision, public corporation or
other local governmental agency of the State of Nevada that provides health
insurance through a plan of self-insurance which provides coverage for
outpatient care shall not:
(a) Require an insured to pay a higher
deductible, copayment or coinsurance or require a longer waiting period for
coverage for outpatient care related to autism spectrum disorders than is
required for other outpatient care covered by the plan of self-insurance; or
(b) Refuse to issue a plan of self-insurance or
cancel a plan of self-insurance solely because the person applying for or
covered by the plan of self-insurance uses or may use in the future any of the
services listed in subsection 1.
4. Except as otherwise provided in
subsections 1 and 2, a governing body of any county, school district, municipal
corporation, political subdivision, public corporation or other local
governmental agency of the State of Nevada that provides health insurance
through a plan of self-insurance shall not limit the number of visits an
insured may make to any person, entity or group for treatment of autism
spectrum disorders.
5. Treatment of autism spectrum disorders
must be identified in a treatment plan and may include medically necessary
habilitative or rehabilitative care, prescription care, psychiatric care,
psychological care, behavioral therapy or therapeutic care that is:
(a) Prescribed for a person diagnosed with an
autism spectrum disorder by a provider of health care acting within his or her
scope of practice; and
(b) Provided for a person diagnosed with an
autism spectrum disorder by a provider of health care acting within his or her
scope of practice.
A governing
body of any county, school district, municipal corporation, political
subdivision, public corporation or other local governmental agency of the State
of Nevada that provides health insurance through a plan of self-insurance may
request a copy of and review a treatment plan created pursuant to this
subsection.
6. A plan of self-insurance subject to the
provisions of this chapter that is delivered, issued for delivery or renewed on
or after January 1, 2026, has the legal effect of including the coverage
required by subsection 1, and any provision of the plan of self-insurance or
the renewal which is in conflict with subsection 1 or 2 is void.
7. Nothing in this section shall be
construed as requiring a governing body of any county, school district,
municipal corporation, political subdivision, public corporation or other local
governmental agency of the State of Nevada that provides health insurance
through a plan of self-insurance to provide reimbursement to a school for
services delivered through school services.
8. As used in this section:
(a) Applied behavior analysis means the design,
implementation and evaluation of environmental modifications using behavioral
stimuli and consequences to produce socially significant improvement in human
behavior, including, without limitation, the use of direct observation,
measurement and functional analysis of the relations between environment and
behavior.
(b) Autism spectrum disorder has the meaning
ascribed to it in NRS 427A.875 .
(c) Behavioral therapy means any interactive
therapy derived from evidence-based research, including, without limitation,
discrete trial training, early intensive behavioral intervention, intensive
intervention programs, pivotal response training and verbal behavior provided
by a licensed psychologist, licensed behavior analyst, licensed assistant
behavior analyst or registered behavior technician.
(d) Evidence-based research means research that
applies rigorous, systematic and objective procedures to obtain valid knowledge
relevant to autism spectrum disorders.
(e) Habilitative or rehabilitative care means
counseling, guidance and professional services and treatment programs,
including, without limitation, applied behavior analysis, that are necessary to
develop, maintain and restore, to the maximum extent practicable, the
functioning of a person.
(f) Licensed assistant behavior analyst has the
meaning ascribed to the term assistant behavior analyst in NRS 641D.020 .
(g) Licensed behavior analyst has the meaning
ascribed to the term behavior analyst in NRS
641D.030 .
(h) Prescription care means medications
prescribed by a licensed physician and any health-related services deemed
medically necessary to determine the need or effectiveness of the medications.
(i) Provider of health care has the meaning
ascribed to it in NRS 629.031 .
(j) Psychiatric care means direct or
consultative services provided by a psychiatrist licensed in the state in which
the psychiatrist practices.
(k) Psychological care means direct or
consultative services provided by a psychologist licensed in the state in which
the psychologist practices.
(l) Registered behavior technician has the
meaning ascribed to it in NRS 641D.100 .
(m) Screening for autism spectrum disorders
means all medically appropriate assessments, evaluations or tests to diagnose
whether a person has an autism spectrum disorder.
(n) Therapeutic care means services provided by
licensed or certified speech-language pathologists, occupational therapists and
physical therapists.
(o) Treatment plan means a plan to treat an
autism spectrum disorder that is developed by a provider of health care acting
within his or her scope of practice after he or she has assessed the person for
whom the treatment plan is developed.

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