Scott J. Kipper | Insurance Commissioner | Nevada DOI
The Nevada Division of Insurance is seeking public input on proposed changes to the state's essential health benefits (EHB) plan. This plan determines the healthcare services that all individual and small group health insurance plans in Nevada must cover. Since 2017, the benchmark has been based on the Health Plan of Nevada’s HPN Solutions HMO Platinum small group plan.
The Centers for Medicare and Medicaid Services (CMS) have allowed states three options since 2020 for defining their EHB benchmark plan: adopting another state’s EHB benchmark, replacing a category of benefits with those from another state, or selecting a new set of benefits. Nevada is considering Option 3 to update its EHB benchmark plan.
Proposed revisions include adding all FDA-approved drugs for treating opioid use disorder, HIV, and hepatitis B and C. "Ensuring that Nevada’s essential health benefits align with the evolving needs of consumers is a top priority," said Insurance Commissioner Scott Kipper. "Public participation in this process is crucial, and we encourage all stakeholders to share their insights so we can make informed decisions that promote access to necessary healthcare services."
The Division emphasizes the importance of public comment in shaping health benefit requirements in Nevada. Consumers, healthcare providers, insurers, and other stakeholders are encouraged to participate.
Public meetings will be held both in-person and virtually on Wednesday, February 26, from 10:00 AM to 11:00 AM at locations in Las Vegas and Carson City. Virtual participation details are available online.
Comments can be submitted through the Division's website or by mail, fax, or email until March 19, 2025.
The mission of the Nevada Division of Insurance is to protect consumer rights within the insurance industry and ensure insurer solvency.
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