Nevada 2017 Regular Session Status: To Executive

AB 382 — Establishes provisions governing payment for the provision of emergency services and care to patients. (BDR 40-570)

Last action — Vetoed by the Governor.

  1. ✓
    Introduced
  2. ✓
    In Committee
  3. ✓
    Passed Assembly
  4. ✓
    Passed Senate
  5. 5
    To Executive
  6. 6
    Enacted

This bill died with 2017 Regular Session. It reached “To Executive” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.

This bill is no longer active — its legislative session has ended, so there is no live prognosis. It would have to be reintroduced in the current session to move again.

Bill Text

What changed in the latest version

502 added · 534 removed

502 line(s) added, 534 removed.

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EXEMPT (Reprinted with amendments adopted on May 31, 2017) SECOND REPRINT A.B.
Assembly Bill No.
382 A SSEMBLY B ILLN O.
382–Assemblymen Carlton, Frierson, Araujo, Spiegel;
382–ASSEMBLYMEN CARLTON , RIERSON , A RAUJO , PIEGEL ;
Benitez-Thompson and Sprinkle Joint Sponsors:
ENITEZ -THOMPSON AND S PRINKLE M ARCH 20, 2017 ____________ JOINT SPONSORS :
Senators Ford, Parks and Cancela CHAPTER..........
ENATORS FORD , PARKS AND CANCELA ____________ Referred to Committee on Health and Human Services SUMMARY—Establishes provisions governing payment for the provision of emergency services and care to patients.
(BDR 40-570) FISCAL NOTE:
Effect on Local Government:
No.
Effect on the State:
Yes.
~ EXPLANATION – Matter in bolded italics is new;
matter between brackets [omitted material] is material to be omitted.
LegUnder existing law, a hospital is required to provide emergency services and care and to admit certain patients where appropriate, regardless of the financial status of the patient.
Legislative Counsel’s Digest:
(NRS 439B.410) Existing law also requires certain major hospitals to reduce total billed charges by at least 30 percent for hospital services provided to certain patients who have no insurance or other contractual provision bill requires an out-of-network hospital with 100 or more beds that is not operated - *AB382_R2* – 2 – by a federal, state or local governmental entity or an out-of-network independent center for emergency medical care to accept, under certain circumstances, as payment in full for the provision of emergency services and care to stabilize a patient a reasonable rate offered by the third party.
Under existing law, a hospital is required to provide emergency services and care and to admit certain patients where appropriate, regardless of the financial status of the patient.
Section 18 of this bill requires an out-of-network physician at an in-network or out-of-network hospital with 100 medical care to accept as payment in full for the provision of emergency services and care to stabilize a patient a reasonable rate which is offered by the third party.
(NRS 439B.410) Existing law also requires certain major provided to certain patients who have no insurance or other contractual provisionices for the payment of the charges by a third party.
Sections 17 and 18 further provide that, if a hospital, center or physician, as applicable, rejects the amount offered by the third party pursuant to those sections as full payment for the provision of emergency services and care to a patient, the hospital, center or physician may negotiate a different rate with the third party and the Governor’s Consumer Health Advocate.
(NRS 439B.260) Section 17 of this bill requires an out-of-network hospital with 100 or more beds that is not operated by a federal, state or local governmental entity or an out-of-network independent center for emergency medical care to accept, under certain circumstances, as patient a reasonable rate offered by the third party.
Sections 17 and 18 also authorize a with third party to file a complaint and request such mediation under similar circumstances.
Section 18 of this bill requires an out-of-network physician at an in-network or out-of-network hospital with 100 or more beds or an in-network or out-of-network independent center for emergency medical care to accept as payment in full for the provision of emergency services and care to stabilize a patient a reasonable rate which is offered by the third party.
Sections 21.4 and 22 of this bill require the Advocate to establish a procedure for filing and processing such complaints and requests for mediation.
Sections 17 and 18 further provide that, if a hospital, center or physician, as as full payment for the provision of emergency services and care to a patient, thens hospital, center or physician may negotiate a different rate with the third party and may, under certain circumstances, file a complaint and request for mediation with the Governor’s Consumer Health Advocate.
Section 20 of this bill requires a third party who wishes to pay the amounts offered pursuant to sections 17 and 18 to conduct a review of the adequacy of the Health Advocate.hird party and submit certain reports to the Governor’s Consumer Section 21 of this bill requires a hospital with 100 or more beds that is not operated by a federal, state or local governmental entity or an independent center for emergency medical care to annually report certain information concerning the collection of debts, rate increases and negotiated payments for emergency services and care to the Governor’s Consumer Health Advocate.
Sections 17 and 18 also authorize a third party to file a complaint and request such mediation under similar circumstances.
Sections 21.4 and 22 of this bill require the Advocate to establish a procSection 20 of this bill requires a third party who wishes to pay the amounts offered pursuant to sections 17 and 18 to conduct a review of the adequacy of the network of the third party and submit certain reports to the Governor’s Consumer Health Advocate.
- 79th Session (2017) – 2 – Section 21 of this bill requires a hospital with 100 or more beds that is not for emergency medical care to annually report certain information concerning theer collection of debts, rate increases and negotiated payments for emergency services and care to the Governor’s Consumer Health Advocate.
EXPLANATION – Matter in bolded italics is new;
matter between brackets [omitted material] is material to be omitted.
Sec.
Secs.
4.
4 and 5.
5.
(Deleted by amendment.) Sec.
- *AB382_R2* – 3 – Sec.
Sec.
“In-network physician” means, for a particular patient, a physician who has entered into a contract with a third party for the provision of health care to persons who are covered by a policy of insurance or other contractual agreement which provides coverage to the patient and which is issued by that third party.
“In-network physician” means, for a particular patient, a physician who has entered into a contract with a third party for the provision of health care to persons who are covered by a policy of insurance or other contractual agreement which - 79th Session (2017) – 3 – provides coverage to the patient and which is issued by that third party.
patient, a hospital that has not entered into a contract with a third party for the provision of health care to persons who are covered by a policy of insurance or other contractual agreement which provides coverage to the patient and which is issued by that third party.
12.
“Out-of-network hospital” means, for a particular patient, a hospital that has not entered into a contract with a third party for the provision of health care to persons who are covered by a policy of insurance or other contractual agreement which provides coverage to the patient and which is issued by that third party.
Sec.
- *AB382_R2* – 4 – (c) A participating public agency, as defined in NRS 287.04052, and any other local governmental agency of the State of Nevada which provides a system of health insurance for the benefit of its officers and employees, and the dependents of such officers and employees, pursuant to chapter 287 of NRS;
287.04052, and any other local governmental agency of the State of Nevada which provides a system of health insurance for the benefit of its officers and employees, and the dependents of such officers and employees, pursuant to chapter 287 of NRS;
(a) A policy of health insurance sold in this State;
- 79th Session (2017) – 4 – (a) A policy of health insurance sold in this State;
Except as otherwise provided in subsections 7 and 8, an out-of-network hospital with 100 or more beds that is not operated by a federal, state or local governmental agency or an out-of-network independent center for emergency medical care shall accept as payment in full for the provision of emergency services and care to a patient to stabilize the patient a reasonable rate offered by the third-party if the patient:
Except as otherwise provided in subsections 7 and 8, an out-of-network hospital with 100 or more beds that is out-of-network independent center for emergency medical carey or an shall accept as payment in full for the provision of emergency services and care to a patient to stabilize the patient a reasonable rate offered by the third-party if the patient:
If the third party requires additional information to determine whether to approve or deny the claim submitted pursuant to subsection 1, it shall notify the out-of-network hospital or out-of-network independent center for emergency medical care of its request for the additional information within 20 days after it receives the claim.
If the third party requires additional information to determine whether to approve or deny the claim submitted pursuant to subsection 1, it shall notify the out-of-network hospital or out-of-network independent center for emergency medical care receives the claim.
The third party shall notify the out-of-network - *AB382_R2* – 5 – hospital or out-of-network independent center for emergency care of all the specific reasons for the delay in approving or denying the claim.
The third party shall notify the out-of-networkit hospital or out-of-network independent center for emergency care of all the specific reasons for the delay in approving or denying the claim.
The third party shall approve or deny the claim within 30 days after receiving the additional information.
The third party shall approve or deny the claim within days after receiving the additional information.
A third party shall not request an out-of-network hospital or out-of-network independent center for emergency medical care to resubmit information that the out-of-network hospital or out-of- network independent center for emergency medical care has already provided to the third party, unless the third party provides a legitimate reason for the request and the purpose of the request is not to delay the payment of the claim, harass the claimant or discourage the filing of claims.
A third party shall not request an out-of-network hospital or out-of-network independent center for emergency medical care to resubmit information that the out-of-network hospital or out-of- network independent center for emergency medical care has already provided to the third party, unless the third party provides a legitimate reason for the request and the purpose of the request - 79th Session (2017) – 5 – is not to delay the payment of the claim, harass the claimant or discourage the filing of claims.
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6.
services and care described in subsection 1 must include aency statement that:
An offer made by a third party as payment for emergency services and care described in subsection 1 must include a statement that:
(a) If such an offer is not accepted as payment in full within days, the out-of-network hospital or out-of-network independent center for emergency medical care may file a complaint with the Advocate pursuant to NRS 223.560 and request that the Advocate mediate to determine the amount that must be paid for such emergency services and care;
(a) If such an offer is not accepted as payment in full within 90 days, the out-of-network hospital or out-of-network independent center for emergency medical care may file a complaint with the Advocate pursuant to NRS 223.560 and request that the Advocate mediate to determine the amount that must be paid for such emergency services and care;
If an out-of-network hospital or out-of-network independent center for emergency medical care rejects the amount offered by the third party as full payment to compensate the out- of-network hospital or out-of-network independent center for emergency medical care for the emergency services and care provided by the out-of-network hospital or out-of-network independent center for emergency medical care, the out-of- network hospital or out-of-network independent center for emergency medical care must, within 30 days after receiving written notice of such amount from the third party, request in writing to enter into negotiations with the third party which provides coverage to the patient to resolve the difference between the amount charged by the out-of-network hospital or out-of- network independent center for emergency medical care and the amount paid by the third party.
If an out-of-network hospital or out-of-network independent center for emergency medical care rejects the amount offered by the third party as full payment to compensate the out- of-network hospital or out-of-network independent center for emergency medical care for the emergency services and care provided by the out-of-network hospital or out-of-network independent center for emergency medical care, the out-of- network hospital or out-of-network independent center for emergency medical care must, within 30 days after receiving written notice of such amount from the third party, request in writing to enter into negotiations with the third party which provides coverage to the patient to resolve the difference between the amount charged by the out-of-network hospital or out-of- amount paid by the third party.
Such negotiations must begin within 2 weeks after the out-of-network hospital or out-of-network independent center for emergency medical care makes the request for negotiation, or at a time agreed upon by the out-of-network - *AB382_R2* – 6 – hospital or out-of-network independent center for emergency medical care and the third party.
Such negotiations must begine within 2 weeks after the out-of-network hospital or out-of-network independent center for emergency medical care makes the request for negotiation, or at a time agreed upon by the out-of-network hospital or out-of-network independent center for emergency medical care and the third party.
If an out-of-network hospital or out-of-network independent center for emergency medical care does not make a request for negotiation pursuant to subsection 7 or accept as payment in full the amount offered by the third party, the third party may file a complaint with the Advocate pursuant to NRS 223.560 and request that the Advocate mediate to determine the amount that must be paid for such emergency services and care.
If an out-of-network hospital or out-of-network independent center for emergency medical care does not make a - 79th Session (2017) – 6 – request for negotiation pursuant to subsection 7 or accept as payment in full the amount offered by the third party, the third party may file a complaint with the Advocate pursuant to NRS 223.560 and request that the Advocate mediate to determine the amo9.t In no event shall the patient who received emergencyre.
9.
services and care be:
In no event shall the patient who received emergency services and care be:
and (b) Has a policy of insurance or other contractual agreement with a third party that provides coverage to the patient for the provision of emergency services and care by more than one in- network physician in this State who provides the same type of emergency services and care other than the out-of-network physician who provided the emergency services and care at the in- network or out-of-network hospital or in-network or out-of- network independent center for emergency medical care to which the patient was presented.
and (b) Has a policy of insurance or other contractual agreement with a third party that provides coverage to the patient for the provision of emergency services and care by more than one in- network physician in this State who provides the same type of physician who provided the emergency services and care at the in- network or out-of-network hospital or in-network or out-of- network independent center for emergency medical care to which the patient was presented.
The third party shall approve or deny a claim submitted by an out-of-network physician for the emergency services and care - *AB382_R2* – 7 – described in subsection 1 within 30 days after the third party receives the claim.
The third party shall approve or deny a claim submitted by an out-of-network physician for the emergency services and care described in subsection 1 within 30 days after the third party receives the claim.
The third party shall notify the out- of-network physician of all the specific reasons for the delay in approving or denying the claim.
The third party shall notify the - 79th Session (2017) – 7 – out-of-network physician of all the specific reasons for the delay in approving or denying the claim.
If the claim is approved, the third party shall pay the claim within 30 days after it receives the additional information.
If the claim is approved, the third party shall pay the cla4.
4.
wiA third party shall not request an out-of-network physician to resubmit information that the out-of-network physician has already provided to the third party, unless the third party provides a legitimate reason for the request and the purpose of the request is not to delay the payment of the claim, harass the claimant or discourage the filing of claims.
A third party shall not request an out-of-network physician to resubmit information that the out-of-network physician has already provided to the third party, unless the third party provides a legitimate reason for the request and the purpose of the request is not to delay the payment of the claim, harass the claimant or discourage the filing of claims.
(a) If such an offer is not accepted as payment in full within 90 days, the out-of-network physician may file a complaint with the Advocate pursuant to NRS 223.560 and request that the Advocate mediate to determine the amount that must be paid for such emergency services and care;
(a) If such an offer is not accepted as payment in full within days, the out-of-network physician may file a complaint with the Advocate pursuant to NRS 223.560 and request that the Advocate mediate to determine the amount that must be paid for such emergency services and care;
If an out-of-network physician rejects the amount offered by the third party as full payment to compensate the out-of- network physician for the emergency services and care provided by the out-of-network physician, the out-of-network physician must, within 30 days after receiving written notice of such amount from the third party, request in writing to enter into negotiations with the third party which provides coverage to the patient to resolve the difference between the amount charged by the out-of- network physician and the amount paid by the third party.
If an out-of-network physician rejects the amount offered by the third party as full payment to compensate the out-of- network physician for the emergency services and care provided by the out-of-network physician, the out-of-network physician must, within 30 days after receiving written notice of such amount with the third party which provides coverage to the patient totions resolve the difference between the amount charged by the out-of- network physician and the amount paid by the third party.
If such negotiations do not result in an agreement on the amount that will be paid for emergency services and care, the out-of-network - *AB382_R2* – 8 – physician may file a complaint with the Advocate pursuant to NRS 223.560 and request that the Advocate mediate to determine the amount that must be paid for such emergency services and care.
If such negotiations do not result in an agreement on the amount that will be paid for emergency services and care, the out-of-network physician may file a complaint with the Advocate pursuant to NRS 223.560 and request that the Advocate mediate to determine the amount that must be paid for such emergency services and care.
If an out-of-network physician does not make a request for negotiation pursuant to subsection 7 or accept as payment in full the amount offered by the third party, the third party may file a complaint with the Advocate pursuant to NRS 223.560 and request that the Advocate mediate to determine the amount that must be paid for such emergency services and care.
If an out-of-network physician does not make a request for negotiation pursuant to subsection 7 or accept as payment in full the amount offered by the third party, the third party may file a - 79th Session (2017) – 8 – complaint with the Advocate pursuant to NRS 223.560 and request that the Advocate mediate to determine the amount that must be paid for such emergency services and care.
In no event shall the patient who received emergency services and care be:
In no event shall the patient who received emergency ser(a) Responsible for payment of any amount greater than any deductible, copayment or coinsurance paid by the patient pursuant to his or her policy of insurance;
(a) Responsible for payment of any amount greater than any deductible, copayment or coinsurance paid by the patient pursuant to his or her policy of insurance;
Review the in-network hospitals, in-network independent centers for emergency medical care and in-network physicians of the third party to determine whether a person who is covered by that policy of insurance or other contractual agreement that provides coverage for health care has adequate access to health care, including, without limitation, a review of the number and types of in-network hospitals, in-network independent centers for emergency medical care and in-network physicians, including, without limitation, emergency room physicians, anesthesiologists and specialty physicians.
Review the in-network hospitals, in-network independent centers for emergency medical care and in-network physicians of the third party to determine whether a person who is covered by that policy of insurance or other contractual agreement that provides coverage for health care has adequate access to health care, including, without limitation, a review of the number and types of in-network hospitals, in-network independent centers for emergency medical care and in-network physicians, including, without limitation, emergency room physicians, anesthesiologists and2.peReview the frequency with which persons covered by the policy of insurance or other contractual agreement that provides coverage for the provision of health care are treated for emergency services and care by out-of-network physicians at in- network hospitals and in-network independent centers for emergency medical care.
2.
Review the frequency with which persons covered by the policy of insurance or other contractual agreement that provides coverage for the provision of health care are treated for emergency services and care by out-of-network physicians at in- network hospitals and in-network independent centers for emergency medical care.
Ensure that persons covered by the policy of insurance or other contractual agreement that provides coverage for the provision of health care receive adequate information regarding in-network hospitals, in-network independent centers for - *AB382_R2* – 9 – emergency medical care and in-network physicians and the financial impact of receiving emergency services and care from out-of-network hospitals, out-of-network independent centers for emergency medical care and out-of-network physicians, including, without limitation, the financial impact of receiving emergency services and care from an out-of-network physician at an in- network hospital or in-network independent center for emergency medical care.
Ensure that persons covered by the policy of insurance or other contractual agreement that provides coverage for the provision of health care receive adequate information regarding in-network hospitals, in-network independent centers for emergency medical care and in-network physicians and the financial impact of receiving emergency services and care from out-of-network hospitals, out-of-network independent centers for emergency medical care and out-of-network physicians, including, - 79th Session (2017) – 9 – without limitation, the financial impact of receiving emergency services and care from an out-of-network physician at an in- network hospital or in-network independent center for emergency medical care.
The information must be provided in a format that is meaningful for persons making an informed decision concerning emergency services and care and must be accessible to persons covered by the policy of insurance or other contractual agreement.
The information must be provided in a format that is emergency services and care and must be accessible to persons covered by the policy of insurance or other contractual agreement.
The amount of any increase in the rate negotiated with a third party for emergency services and care that exceeds the percentage of increase in the Consumer Price Index, Medical Care Component, for the year in which the rate is increased and any justification for the increase;
The amount of any increase in the rate negotiated with a third party for emergency services and care that exceeds the Care Component, for the year in which the rate is increased and any justification for the increase;
The procedure established by regulation pursuant to paragraph (j) of subsection 1 of NRS 223.560 for - *AB382_R2* – 10 – filing and processing complaints concerning the rate of payment offered pursuant to sections 17 and 18 of this act and the mediation of those complaints must:
The procedure established by regulation pursuant to paragraph (j) of subsection 1 of NRS 223.560 for filing and processing complaints concerning the rate of payment - 79th Session (2017) – 10 – offered pursuant to sections 17 and 18 of this act and the mediation of those complaints must:
(a) Require the Advocate or the Advocate’s designee to determine, if an agreement between the parties cannot be reached, an acceptable rate that must be paid to the hospital, independent center for emergency medical care or physician within 10 days of the conclusion of the mediation;
(a) Require the Advocate or the Advocate’s designee to determine, if an agreement between the parties cannot be reached, center for emergency medical care or physician within 10 days oft the conclusion of the mediation;
and (c) The usual and customary charges for the same or similar emergency services and care rendered by an out-of-network hospital, out-of-network independent center for emergency medical care or out-of-network physician in the geographic region in which the services were rendered.
and (c) The usual and customary charges for the same or similar emergency services and care rendered by an out-of-network hospital, out-of-network independent center for emergency in which the services were rendered.cian in the geographic region 3.
3.
223.500 As used in NRS 223.500 to 223.575, inclusive, and sections 21.4 and 21.5 of this act, unless the context otherwise requires, the words and terms defined in NRS 223.505 to 223.535, inclusive, have the meanings ascribed to them in those sections.
223.500 As used in NRS 223.500 to 223.575, inclusive, and sections 21.4 and 21.5 of this act, unless the context otherwise - 79th Session (2017) – 11 – requires, the words and terms defined in NRS 223.505 to 223.535, inclusive, have the meanings ascribed to them in those sections.
- *AB382_R2* – 11 – Sec.
Sec.
223.540 The provisions of NRS 223.085 do not apply to the provisions of NRS 223.500 to 223.575, inclusive [.] , and sections 21.4 and 21.5 of this act.
223.540 The provisions of NRS 223.085 do not apply to the 21.4 and 21.5 of this act.to 223.575, inclusive [.] , and sections Sec.
Sec.
(d) Provide information to consumers and injured employees concerning health care plans, including, without limitation, the Public Employees’ Benefits Program, and policies of industrial insurance in this State;
concerning health care plans, including, without limitation, the Public Employees’ Benefits Program, and policies of industrial insurance in this State;
(h) Provide information to and applications for prescription drug programs for consumers without insurance coverage for prescription drugs or pharmaceutical services;
- 79th Session (2017) – 12 – (h) Provide information to and applications for prescription drug programs for consumers without insurance coverage for prescription drugs or pharmaceutical services;
(1) Information concerning purchasing prescription drugs from Canadian pharmacies that have been recommended by the - *AB382_R2* – 12 – State Board of Pharmacy for inclusion on the Internet website pursuant to subsection 4 of NRS 639.2328;
from Canadian pharmacies that have been recommended by therugs State Board of Pharmacy for inclusion on the Internet website pursuant to subsection 4 of NRS 639.2328;
and (k) Assist consumers with filing complaints against health care facilities and health care professionals.
and (k) Assist consumers with filing complaints against health care “health care facility” has the meaning ascribed to it ins paragraph, NRS 162A.740.
As used in this paragraph, “health care facility” has the meaning ascribed to it in NRS 162A.740.
Sec.
Secs.
22.5.
22.5 and 23.
23.
(Deleted by amendment.) Sec.
Sec.
- 79th Session (2017) – 13 – Sec.
H - *AB382_R2*
~~~~~ 17 - 79th Session (2017)
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Action History

  1. Vetoed by the Governor.

  2. Enrolled and delivered to Governor.

  3. In Assembly. To enrollment.

  4. Read third time. Passed. Title approved. (Yeas: 12, Nays: 9.) To Assembly.

  5. Read second time.

  6. Placed on Second Reading File.

  7. From committee: Do pass.

  8. Read first time. Referred to Committee on Health and Human Services. To committee.

  9. In Senate.

  10. To Senate.

  11. From printer. To reengrossment. Reengrossed. Second reprint .

  12. To printer.

  13. Read third time. Passed, as amended. Title approved, as amended. (Yeas: 31, Nays: 10, Excused: 1.)

  14. Dispensed with reprinting.

  15. Read third time. Amended. (Amend. No. 1065.)

  16. Placed on General File.

  17. From committee: Amend, and do pass as amended.

  18. From printer. To engrossment. Engrossed. First reprint . To committee.

  19. Read second time. Amended. (Amend. No. 427.) Rereferred to Committee on Ways and Means. Exemption effective. To printer.

  20. From committee: Amend, and do pass as amended.

  21. Notice of eligibility for exemption.

  22. From printer. To committee.

  23. Read first time. Referred to Committee on Health and Human Services. To printer.

Sponsors

Sponsorship breakdown

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7 sponsors · 2 co-sponsors · 58 not signed on

Sponsors (7)

Co-sponsors (2)

Not signed on (58)

58 members have not signed on to this bill.

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"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.

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Subjects

public-safety healthcare health-insurance
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Frequently asked questions

Who sponsors AB 382?
AB 382 is sponsored by Cancela, Parks, Ford, Sprinkle, Spiegel, Jason Frierson, Maggie Carlton, Teresa Benitez-Thompson, and Nelson Araujo.
What is the current status of AB 382?
This bill died with 2017 Regular Session. It reached “To Executive” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.
Where can I track AB 382?
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