Nevada Division of Insurance Seeking Public Input on Essential Health Benefits

Carson City, NV March 13, 2024

The Nevada Division of Insurance (NVDOI) is seeking public input on revisions to Nevada’s essential health benefits (EHB) plan.

The essential health benefits plan for Nevada is the benchmark set of health care services that is required in all individual and small group health insurance plans.  Since 2017, Nevada’s EHB benchmark plan has been Health Plan of Nevada’s HPN Solutions HMO Platinum small group plan.

The Centers for Medicare and Medicaid Services (CMS) gave states three options to define their EHB benchmark plan moving forward:

Option 1: Select another state’s entire EHB benchmark,

Option 2: Replace a category of benefits in the current benchmark with the same category of benefits used in another state's EHB plan, or

Option 3: Select a set of benefits to become the Nevada’s EHB plan.

States that want to make changes are required by federal law (ecfr.gov) to have an actuarial analysis of the benefits, a public comment on the proposed changes, and then apply to CMS for approval.

Nevada is considering updating its EHB benchmark plan under Option 3 to reflect legislatively mandated changes in the insurance market.  The NVDOI seeks comment on the following possible coverage revisions:

  •  Add all FDA-approved drugs to treat opioid use disorder.
  •  Add all FDA-approved drugs for testing, treating, and preventing human immunodeficiency virus.
  • Add all FDA-approved drugs for testing, treating, and preventing hepatitis B and C.

Public comment can be submitted directly through the NVDOI’s website at: https://doi.nv.gov/Healthcare-Reform/Individuals-Families/Essential-Health-Benefits/ or in writing to the Commissioner of Insurance at 1818 E. College Parkway, Suite 103, Carson City, NV 89706 or by fax at (775) 687-0788 or email to Glenn Shippey at gshippey@doi.nv.gov.  All public comments must be received by April 12, 2024, at 5:00 p.m.

About the Nevada Division of Insurance
The mission of the Nevada Division of Insurance is to protect the rights of Nevada consumers in their experiences with the insurance industry and to ensure the financial solvency of insurers. For more information about the Division of Insurance, visit DOI.NV.GOV or follow the Division on X (Twitter), Facebook, LinkedIn, Instagram or YouTube.

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Contact

Glenn Shippey