Clarification on Cost Sharing for Individuals Enrolled in Nevada’s Early Intervention Services Program

STEVE SISOLAK Governor STATE OF NEVADA TERRY REYNOLDS Director BARBARA D. RICHARDSON Commissioner DEPARTMENT OF BUSINESS AND INDUSTRY DIVISION OF INSURANCE 1818 East College Pkwy., Suite 103 Carson City, Nevada 89706 (775) 687-0700 ⚫ Fax (775) 687-0787 Website: doi.nv.gov E-mail: insinfo@doi.nv.gov Bulletin 21-002 October 12, 2021 Clarification on Cost Sharing for Individuals Enrolled in Nevada’s Early Intervention Services Program The Division of Insurance (Division) is providing guidance related to individuals who are participating in the State’s Early Intervention Services Program (Program) as specified in Title 34 of the Code of Federal Regulations (CFR), section 303. Title 34 of the CFR, section 5201, includes the provisions related to the use of public benefits or private insurance to pay for Part C services under the Program. As outlined in the CFR and specified in the system of payments and fees section of the State of Nevada Early Intervention Policy Manual2, Early Intervention Services (EIS) funding can be provided through private insurance as long as there is no direct cost to the family for the covered service. To ensure appropriate compliance with the policies of the Program administered by Nevada’s Department of Health and Human Services, carriers offering health insurance plans in Nevada’s commercial health insurance markets may not require providers to collect any cost sharing for services administered under Part C of the Program by Aging and Disability Services Division and contracted Comprehensive Early Intervention Providers3. Cost sharing includes any share of the cost which is the responsibility of the insured, including copays, coinsurance and deductibles. Nothing in this bulletin requires a carrier to reimburse a provider for uncollected cost share. _________________________ BARBARA D. RICHARDSON Commissioner of Insurance 1 CFR-2020-title34-vol2-sec303-520.pdf (govinfo.gov) 2 IDEA Part C Early Intervention Policy Manual (nv.gov), Appendix III, B2.5.V System of payments and fees 3 A list of contracted Comprehensive Early Intervention Providers can be found under the heading Community Partners at https://adsd.nv.gov/Programs/InfantsToddlers/Infants_Toddlers/