drugs are included in and excluded from the formulary; and (2) The telephone number of the organization for making a request for information regarding the formulary pursuant to subsection 2. 2. If a managed care organization offers or issues a health care plan which provides coverage for prescription drugs and a formulary is used, the organization shall: (a) Provide to any insured or participating provider of health care, upon request: (1) Information regarding whether a specific drug is included in the formulary. (2) Access to the most current list of prescription drugs in the formulary, organized by major therapeutic category, with an indication of whether any listed drugs are preferred over other listed drugs. If more than one formulary is maintained, the organization shall notify the requester that a choice of formulary lists is available. (b) Notify each person who requests information regarding the formulary, that the inclusion of a drug in the formulary does not guarantee that a provider of health care will prescribe that drug for a particular medical condition. (Added to NRS by 2001, 866) NRS 695G.164 Required provision concerning coverage for continued medical treatment. 1. The provisions of this section apply to a health care plan offered or issued by a managed care organization if an insured covered by the health care plan receives health care through a defined set of providers of health care who are under contract with the managed care organization. 2. Except as otherwise provided in this section, if an insured who is covered by a health care plan described in subsection 1 is receiving medical treatment for a medical condition from a provider of health care whose contract with the managed care organization is terminated during the course of the medical treatment, the health care plan must provide that: (a) The insured may continue to obtain medical treatment for the medical condition from the provider of health care pursuant to this section, if: (1) The insured is actively undergoing a medically necessary course of treatment; and (2) The provider of health care and the insured agree that the continuity of care is desirable. (b) The provider of health care is entitled to receive reimbursement from the managed care organization for the medical treatment he provides to the insured pursuant to this section, if the provider of health care agrees: (1) To provide medical treatment under the terms of the contract between the provider of health care and the managed care organization with regard to the insured, including, without limitation, the rates of payment for providing medical service, as those terms existed before the termination of the contract between the provider of health care and the managed care organization; and (2) Not to seek payment from the insured for any medical service provided by the provider of health care that the provider of health care could not have received from the insured were the provider of health care still under contract with the managed care organization. 3. The coverage required by subsection 2 must be provided until the later of: (a) The 120th day after the date the contract is terminated; or (b) If the medical condition is pregnancy, the 45th day after: (1) The date of delivery; or (2) If the pregnancy does not end in delivery, the date of the end of the pregnancy. 4. The requirements of this section do not apply to a provider of health care if: (a) The provider of health care was under contract with the managed care organization and the managed care organization terminated that contract because of the medical incompetence or professional misconduct of the provider of health care; and (b) The managed care organization did not enter into another contract with the provider of health care after the contract was terminated pursuant to paragraph (a). 5. An evidence of coverage for a health care plan subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after October 1, 2003, has the legal effect of including the coverage required by this section, and any provision of the evidence of coverage or renewal thereof that is in conflict with this section is void. 6. The Commissioner shall adopt regulations to carry out the provisions of this section. (Added to NRS by 2003, 3370) NRS 695G.166 Required provision concerning coverage for prescription drug previously approved for medical condition of insured. 1. Except as otherwise provided in this section, a health care plan which provides coverage for prescription drugs must not limit or exclude coverage for a drug if the drug: (a) Had previously been approved for coverage by the managed care organization for a medical condition of an insured and the insured’s provider of health care determines, after conducting a reasonable investigation, that none of the drugs which are otherwise currently approved for coverage are medically appropriate for the insured; and (b) Is appropriately prescribed and considered safe and effective for treating the medical condition of the insured. 2. The provisions of subsection 1 do not: (a) Apply to coverage for any drug that is prescribed for a use that is different from the use for which that drug has been approved for marketing by the Food and Drug Administration; (b) Prohibit: (1) The organization from charging a deductible, copayment or coinsurance for the provision of benefits for prescription drugs to the insured or from establishing, by contract, limitations on the maximum coverage for prescription drugs; (2) A provider of health care from prescribing another drug covered by the plan that is medically appropriate for the insured; or (3) The substitution of another drug pursuant to NRS 639.23286 or 639.2583 to 639.2597, inclusive; or (c) Require any coverage for a drug after the term of the plan. 3. Any provision of a health care plan subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after October 1, 2001, which is in conflict with this section is void. (Added to NRS by 2001, 866; A 2003, 2301) NRS 695G.168 Required provision concerning coverage for screening for colorectal cancer. 1. A health care plan issued by a managed care organization that provides coverage for the treatment of colorectal cancer must provide coverage for colorectal cancer screening in accordance with: (a) The guidelines concerning colorectal cancer screening which are published by the American Cancer Society; or (b) Other guidelines or reports concerning colorectal cancer screening which are published by nationally recognized professional organizations and which include current or prevailing supporting scientific data. 2. An evidence of coverage for a health care plan subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after October 1, 2003, has the legal effect of including the coverage required by this section, and any provision of the evidence of coverage that conflicts with the provisions of this section is void. (Added to NRS by 2003, 1337) NRS 695G.170 Required provision concerning coverage for medically necessary emergency services; prohibitions. 1. Each managed care organization shall provide coverage for medically necessary emergency services provided at any hospital. 2. A managed care organization shall not require prior authorization for medically necessary emergency services. 3. As used in this section, “medically necessary emergency services” means health care services that are provided to an insured by a provider of health care after the sudden onset of a medic

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