Nevada 2021 Regular Session Status: Enacted 6 D cosponsors

SB 420 — Revises provisions relating to health insurance. (BDR 57-251)

Last action — Chapter 537.

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

This bill has been enacted into law. Introduced April 28, 2021. Enacted.

Odds of enactment

High chance

Based on the sponsor, cosponsors, and committee posture, this bill has a high chance of becoming law.

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Prognosis

Likely to advance 62% · moderate confidence

  • Enacted

    Current position in the legislative process.

  • 13 sponsors

    6 primary, 7 co-sponsors signed on.

  • Single-party support

    Sponsorship is currently within one party (6 D).

Based on stage, sponsorship breadth, committee status, recorded votes, and cross-state momentum — a description of the observable signals, not a prediction.

Bill Text

What changed in the latest version

1900 added · 1787 removed

1900 line(s) added, 1787 removed.

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(Reprinted with amendments adopted on May 17, 2021) FIRST REPRINT S.B.
Senate Bill No.
420 SENATE BILL NO .
420–Senators Cannizzaro, Donate, Lange, Spearman;
420–SENATORS CANNIZZARO , DONATE , ANGE , SPEARMAN ;
Brooks, Denis, Dondero Loop, D.
BROOKS , DENIS, DONDERO L OOP, D.
Harris, Ohrenschall, Ratti and Scheible Joint Sponsors:
HARRIS, O HRENSCHALL , ATTI AND SCHEIBLE APRIL 28, 2021 ____________ JOINT SPONSORS :
Assemblymen Benitez-Thompson and Frierson CHAPTER..........
ASSEMBLYMEN B ENITEZ-THOMPSON AND FRIERSON ____________ Referred to Committee on Health and Human Services SUMMARY—Revises provisions relating to health insurance.
(BDR 57-251) FISCAL NOTE:
EffeProvides for Term of Imprisonment in County or City Jail or Detention Facility.
Effect on the State:
Yes.
~ EXPLANATION – Matter in bolded italics is new;
matter between brackets [omitted material] is material to be omitted.
requiring the State Plan for Medicaid to include certain coverage relating to pregnant women;
requiring the State Plan for Medicaid to include coverage for the services of a community health worker and doula services;
requiring the establishment of a statewide Medicaid managed care program;
revising provisions relating to coverage of services for pregnant women under Medicaid;
requiring the establishment of a statewide Medicaid managed care program if money is available;
revising requirements relating to health insurance coverage of enteral formulas;
making appropriations;
- *SB420_R1* – 2 – LegExisting law requires the Department of Health and Human Services to administer the Medicaid program, which is a joint program of the state and federal governments to provide health coverage to indigent persons.
Legislative Counsel’s Digest:
(NRS 422.270, 439B.120) Existing law also creates the Silver State Health Insurance Exchange to assist natural persons and small businesses in purchasing health coverage.
Existing law requires the Department of Health and Human Services to administer the Medicaid program, which is a joint program of the state and federal governments to provide health coverage to indigent persons.
(Chapter 695I of NRS) Section 10 of this bill requires the Director of the Department, in consultation with the Executive Director of the Exchange and the Commissioner of Insurance, to design, establish and operate a public health benefit plan known as the and sections 3.5-9 of this bill define terms relevant to the Public Option.
(NRS 422.270, assist natural persons and small businesses in purchasing health coverage.
Section 10 requires the Public Option to be available to all natural persons who reside in this State through the Exchange and for direct purchase and authorizes the Director to make the Public Option available to small employers in this State or their employees.
(Chapter 695I of NRS) Section 10 of this bill requires the Director of the Department, in consultation with the Executive Director of the Exchange and the Commissioner of Insurance, to design, establish and operate a public health benefit plan known as the Public Option.
Section 2 of this bill sets forth the purposes of the Public Option, requires the Public Option to be available through the Exchange and for directction 10 purchase and authorizes the Director to make the Public Option available to small employers in this State or their employees.
Section 10 also establishes requirements governing the levels of coverage provided by the Public Option and the premiums for the Public Option.
Section 10 Public Option and the premiums for the Public Option.
Sections 38 and 41 of this bill remove the requires the Director, the Commissioner and the Executive Director of thebill Exchange to apply for certain waivers to obtain federal financial support for the Public Option.
Sections 38 and 41 of this bill remove the requirements relating to premiums on January 1, 2030.
Section 11 - 81st Session (2021) – 2 – of this bill requires the Director, the Commissioner and the Executive Director of the Exchange to apply for certain waivers to obtain federal financial support for the Public Option.
Section 39 of this bill requires the Director, the Commissioner and the Executive Director of the Exchange to contract for the performance of an actuarial study before submitting the initial waiver application.
Section 12 requires a health carrier that provides health care services to recipients of Medicaid through managed care to participate in the competitive bidding process.
Section 12 requires a health carrier that provides in the competitive bidding process.
Sections 13, 21 and 29 of this bill require providers of health care, Employees’ Benefits Program or provide care to injured employees under thec State’s workers’ compensation program to enroll in the Public Option as a participating provider of health care.
Sections 13, 21 and 29 of this bill require providers of health care, including health care facilities, who participate in Medicaid or the Public Employees’ Benefits Program or provide care to injured employees under the State’s workers’ compensation program to enroll in the Public Option as a participating provider of health care.
Sections 16, 19, 22, 32 and 34-37 of this bill make various changes so that the Public Option is treated similarly to comSection 16.5 of this bill requires the Executive Director of the Exchange to apply to the federal government for a waiver to authorize certain labor, agricultural and horticultural organizations to offer on the Exchange a policy of insurance to meet the unique needs of tradespersons that can serve as an alternative to the continuation of certain group health benefits.
Sections 16, 19, 22, 32 and 34-37 of this bill make various changes so that the Public Option is treated similarly to comparable forms of public health insurance.
Section 16.5 of this bill requires the Executive Director of the Exchange to apply to the federal government for a waiver to authorize certain labor, agricultural and horticultural organizations to offer on the Exchange a policy of insurance to continuation of certain group health benefits.
or (2) to requires the Executive Director to apply for the waiver and submit certainhis bill recommendations concerning such policies to the Legislature on or before January 1, 2025.
or (2) to be considered a qualified health plan under federal law.
Section 39.5 of this bill requires the Executive Director to apply for the waiver and submit certain recommendations concerning such policies to the Legislature on or before January 1, 2025.
Specifically, section 24 of this bill requires the Director of the - *SB420_R1* – 3 – Department to expand coverage under the State Plan for Medicaid for pregnant women by:
Specifically, section 24 of this bill requires the Director of the Department to expand coverage under the State Plan for Medicaid for pregnant women by:
(1) providing coverage for pregnant women whose household income is between 165 percent and 200 percent of the federally designated level signifying poverty;
(1) providing coverage for pregnant women whose household income is between 165 percent and 200 percent of the federally designated level signifying poverty if money is available;
(2) providing that pregnant women who are determined by certain entities to qualify for Medicaid are presumptively eligible for Medicaid for a prescribed period of time, without submitting an application for enrollment in Medicaid which includes additional proof of eligibility;
(2) providing that pregnant women who are determined by certain entities to qualify for Medicaid are presumptively eligible for enrollment in Medicaid which includes additional proof of eligibility;
and (3) prohibiting the imposition of a reside in the United States for a prescribed period of time before enrolling in Medicaid.
and (3)r prohibiting the imposition of a requirement that a pregnant woman who is otherwise eligible for Medicaid and resides in this State must reside in the United States for a prescribed period of time before enrolling in Medicaid.
Sections 17 and 33 of this bill require a registered doula to report the suspected abuse, neglect, exploitation, isolation or child.
Sections 17 and 33 of this bill require a registered doula to report the - 81st Session (2021) – 3 – suspected abuse, neglect, exploitation, isolation or abandonment of older or vulnerable persons or the suspected abuse or neglect of a child.
Section 27 of this bill requires Medicaid to reimburse services provided to recipients of Medicaid who do not receive services through managed care by an advanced practice registered nurse to the same extent as if those services were provided by a physician.
Section 27 of this do not receive services through managed care by an advanced practice registered who nurse to the same extent as if those services were provided by a physician if money is available to reimburse those services at those rates.
Section 28 of this bill requires Medicaid to cover breastfeeding supplies, certain prenatal screenings and tests and lactation consultation and support.
If money is available, section of this bill requires Medicaid to cover breastfeeding supplies, certain prenatal screenings and tests and lactation consultation and support.
care program is established in this State.
Existing law establishes certain requirements that apply if a Medicaid managed care program is established in this State.
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(NRS 422.273) Section 30 of this billd requires the Department to:
(NRS 422.273) To the extent that money is available, section 30 of this bill requires the Department to:
(1) establish such a program to provide health care services to recipients of Medicaid in all geographic areas of this State;
(1) establish such a program to provide health care services to recipients of Medicaid in all geographic maintenance organizations to provide such services.
and (2) conduct a statewide procurement process to select health maintenance organizations to provide such services.
To the extent that money ishealth available, section 30 requires the Medicaid managed care program to include a state-directed payment arrangement to require Medicaid managed care organizations to reimburse critical access hospitals and any affiliated federally- qualified health centers or rural health clinics for covered services at a rate that is equal to or greater than the rate those facilities receive for services provided to recipients of Medicaid on a fee-for-service basis.
Section 30 requires the Medicaid managed care program to include a state-directed payment arrangement to require Medicaid managed care organizations to reimburse critical access hospitals and any affiliated federally- qualified health centers or rural health clinics for covered services at a rate that is recipients of Medicaid on a fee-for-service basis.
Existing law requires certain health insurers, including local governments that adopt a system of group health insurance for their employees, to cover enteral formulas under certain conditions.
Section 31 of this bill makes ao conforming change to reflect that the Department is required by section 30 to establish a Medicaid managed care program.
(NRS 287.010, 689A.0423, 689B.0353, formulas include formulas that are ingested orally.
Section 20.5 of this bill requires the Public Employees’ Benefits Program to cover enteral formulas, including formulas that are ingested orally, under the same conditions as health insurers that are currently required to cover enteral formulas.
Section 38.3 of this bill appropriates money to the Division of Welfare and Supportive Services of the Department to pay the costs of making enhancements to its information technology system that are necessary to carry out the provisions of sections 24-28 of this bill.
Sections 38.6 and 38.8 of this bill appropriate money to the Public Option Trust Fund and the Silver State Health Insurance Exchange, respectively, to implement the Public Option.
EXPLANATION – Matter in bolded italics is new;
matter between brackets [omitted material] is material to be omitted.
- *SB420_R1* – 4 – 2.
- 81st Session (2021) – 4 – 2.
and 4.
and insurance in this State to improve the availability of coverage for residents of rural areas of this State.
Increase competition in the market for individual health insurance in this State to improve the availability of coverage for residents of rural areas of this State.
Sec.
in 42 C.F.R.
8.5.
§ 405.2401.th clinic” has the meaning ascribed to it Sec.
“Rural health clinic” has the meaning ascribed to it in 42 C.F.R.
§ 405.2401.
Sec.
(a) Shall make the Public Option available to all natural persons who reside in this State as a policy of individual health insurance through the Exchange and for direct purchase.
(a) Shall make the Public Option available:
The provisions of chapter 689A of NRS and other applicable provisions of title 57 of NRS apply to the Public Option when offered as a policy of individual health insurance.
(1) As a qualified health plan through the Exchange to natural persons who reside in this State and are eligible to enroll in such a plan through the Exchange under the provisions of 45 C.F.R.
- *SB420_R1* – 5 – (b) May make the Public Option available to small employers in this State or their employees to the extent authorized by federal law.
§ 155.305;
The provisions of chapter 689C of NRS and other applicable provisions of title 57 of NRS apply to the Public Option when it is offered as a policy of health insurance for small employers.
and - 81st Session (2021) – 5 – (2) For direct purchase as a policy of individual health insurance by any natural person who resides in this State.
(c) Shall comply with all state and federal laws and regulations applicable to insurers when carrying out the provisions of sections 2 to 15, inclusive, of this act, to the extent that such laws and regulations are not waived.
The provisions of chapter 689A of NRS and other applicable provisions of this title apply to the Public Option when offered as a policy of individual health insurance.
(b) May make the Public Option available to small employers law.
The provisions of chapter 689C of NRS and other applicablederal provisions of this title apply to the Public Option when it is offered as a policy of health insurance for small employers.
(c) Shall comply with all state and federal laws and regulations applicable to insurers when carrying out the provisions of sections to 15, inclusive, of this act, to the extent that such laws and regulations are not waived.
The Director, in consultation with the Commissioner and the Executive Director of the Exchange, may revise the requirements of subsection 4, provided that the average premiums for the Public Option must decrease by at least 15 percent over the first 4 years in which the Public Option is in operation.
The Director, in consultation with the Commissioner and the Executive Director of the Exchange, may revise the requirements of subsection 4, provided that the average premiums for the Public Option must be at least 15 percent lower than the which the Public Option is in operation.over the first 4 years in 6.
6.
(d) “Reference premium” means, for any zip code, the lower of:
- 81st Session (2021) – 6 – (d) “Reference premium” means, for any zip code, the lower of:
(1) The premium for the second-lowest cost silver level plan available through the Exchange in the zip code during the 2024 plan year, adjusted by the percentage change in the Medicare Economic Index between January 1, 2024, and January 1 of the year to which a premium applies;
available through the Exchange in the zip code during the 2024plan plan year, adjusted by the percentage change in the Medicare Economic Index between January 1, 2024, and January 1 of the year to which a premium applies;
or - *SB420_R1* – 6 – (2) The premium for the second-lowest cost silver level plan available through the Exchange in the zip code during the year immediately preceding the year to which a premium applies.
or (2) The premium for the second-lowest cost silver level plan available through the Exchange in the zip code during the year immediately preceding the year to which a premium applies.
(a) Shall collaborate to apply to the Secretary of Health and Human Services for a waiver pursuant to 42 U.S.C.
(a) Shall collaborate to apply to the Secretary of Health and obtain pass-through federal funding to carry out the provisions of sections 2 to 15, inclusive, of this act;
§ 18052 to obtain pass-through federal funding to carry out the provisions of sections 2 to 15, inclusive, of this act;
and (b) Except as otherwise provided in subsection 4, may collaboratively apply to the Secretary of Health and Human Services for any other federal waivers or approval necessary to carry out the provisions of sections 2 to 15, inclusive, of this act, including, without limitation, and to the extent necessary, a waiver pursuant to 42 U.S.C.
and (b) May collaboratively apply to the Secretary of Health and Human Services for any other federal waivers or approval necessary to carry out the provisions of sections 2 to 15, inclusive, of this act, including, without limitation, and to the extent necessary, a waiver pursuant to 42 U.S.C.
or (2) Obtain federal financial participation to subsidize the cost of health insurance for residents of this State with low incomes.
or (2) Obtain federal financial participation to subsidize the incomes.health insurance for residents of this State with low 2.
2.
The actuary must have specialized expertise or experience with state health insurance exchanges, the type of waiver for which the application is being made, measures to contain the costs of providing health coverage, reforming procedures for the purchasing and delivery of government services and Medicaid managed care programs.
The - 81st Session (2021) – 7 – actuary must have specialized expertise or experience with state health insurance exchanges, the type of waiver for which the application is being made, measures to contain the costs of providing health coverage, reforming procedures for the purchasing and delivery of government services and Medicaid managed care programs.
A contract pursuant to this subsection is exempt from the provisions of chapter 333 of NRS.
A contract pursuant to this subsection is exe3.t The Director, the Commissioner and the Executive Director of the Exchange shall:
3.
(a) Cooperate with the Federal Government in obtaining any waiver for which he or she applies pursuant to this section.
The Director, the Commissioner and the Executive Director of the Exchange shall:
- *SB420_R1* – 7 – (a) Cooperate with the Federal Government in obtaining any waiver for which he or she applies pursuant to this section.
The Director, the Commissioner and the Executive Director of the Exchange shall not apply under the provisions of subsection 1 to waive any provision of federal law prescribing conditions of eligibility to purchase a qualified health plan, as defined in 42 U.S.C.
§ 18021, through the Exchange or receive federal advanced payment of premium tax credits pursuant to 42 U.S.C.
§ 18082 for such a purchase.
5.
(b) Employ or enter into contracts with actuaries and other professionals and may enter into contracts with other state agencies, health carriers or other qualified persons and entities as are necessary to carry out the provisions of sections 2 to 15, inclusive, of this act.
(b) Employ or enter into contracts with actuaries and other professionals and may enter into contracts with other state agencies, health carriers or other qualified persons and entities as are necessary to carry out the provisions of sections 2 to 15, requirements of chapter 333 of NRS.cts are exempt from the Sec.
Such contracts are exempt from the requirements of chapter 333 of NRS.
Sec.
The competitive bidding process must coincide with the statewide procurement process for the Medicaid managed care program established pursuant to NRS 422.273.
If a statewide Medicaid managed care program is established pursuant to subsection 1 of NRS 422.273, the competitive bidding process must coincide with the statewide procurement process for that Medicaid managed care program.
Each health carrier that provides health care services through managed care to recipients of Medicaid under the State Plan for Medicaid or the Children’s Health Insurance Program shall, as a condition of continued participation in the Medicaid managed care program established pursuant to NRS 422.273, submit a good faith proposal in response to a request for proposals issued pursuant to subsection 1.
Each health carrier that provides health care services through managed care to recipients of Medicaid under the State - 81st Session (2021) – 8 – Plan for Medicaid or the Children’s Health Insurance Program shall, as a condition of continued participation in any Medicaid managed care program established in this State, submit a good faith proposal in response to a request for proposals issued pursuant to subsection 1.
Each proposal submitted pursuant to subsection 2 must demonstrate that the applicant is able to meet the requirements of section 10 of this act.
Each proposal submitted pursuant to subsection 2 must section 10 of this act.plicant is able to meet the requirements of 4.
4.
(a) Demonstrate alignment of networks of providers between the Public Option and the Medicaid managed care program established pursuant to NRS 422.273;
(a) Demonstrate alignment of networks of providers between the Public Option and Medicaid managed care, where applicable;
(b) Provide for the inclusion of critical access hospitals, rural health clinics, certified community behavioral health clinics and federally-qualified health centers in the networks of providers for the Public Option and Medicaid managed care program established pursuant to NRS 422.273;
(b) Provide for the inclusion of critical access hospitals, rural health clinics, certified community behavioral health clinics and federally-qualified health centers in the networks of providers for the Public Option and Medicaid managed care, where applicable;
- *SB420_R1* – 8 – (c) Include proposals for strengthening the workforce in this State and particularly in rural areas of this State for providers of primary care, mental health care and treatment for substance use disorders;
(c) Include proposals for strengthening the workforce in this State and particularly in rural areas of this State for providers of primary care, mental health care and treatment for substance use disorders;
Notwithstanding the provisions of subsections 1 to 4, inclusive, the Director may directly administer the Public Option if necessary to carry out the provisions of sections 2 to 15, inclusive, of this act.
Notwithstanding the provisions of subsections 1 to 4, necessary to carry out the provisions of sections 2 to 15, inclusive, of this act.
The Director shall deposit into the Trust Fund any money received from:
Any health carrier or other person or entity with which the Director contracts to administer the Public Option pursuant to this section or the Director, if the Director directly administers the Public Option pursuant to subsection 5, shall take any measures necessary to make the Public Option available as described in paragraph (a) of subsection 2 of section 10 of this act and, if required by the Director, paragraph (b) of that subsection.
(a) A health carrier or other person or entity with which the Director contracts to administer the Public Option pursuant to subsection 1 which relates to duties performed under the contract;
Such measures include, without limitation:
(a) Filing rates and supporting information with the Commissioner of Insurance as required by NRS 686B.010 to 686B.1799, inclusive;
and - 81st Session (2021) – 9 – (b) Obtaining certification as a qualified health plan pursuant to 42 U.S.C.
§ 18031.
received from:ector shall deposit into the Trust Fund any money (a) A health carrier or other person or entity with which the Director contracts to administer the Public Option pursuant to subsection 1 which relates to duties performed under the contract;
7.
8.
(b) “Health carrier” means an entity subject to the insurance laws and regulations of this State, or subject to the jurisdiction of the Commissioner, that contracts or offers to contract to provide, deliver, arrange for, pay for or reimburse any of the costs of health care services, including, without limitation, a sickness and accident health insurance company, a health maintenance organization, a nonprofit hospital and health service corporation or any other entity providing a plan of health insurance, health benefits or health care services.
(b) “Health carrier” means an entity subject to the insurance laws and regulations of this State, or subject to the jurisdiction of the Commissioner, that contracts or offers to contract to provide, health care services, including, without limitation, a sickness and accident health insurance company, a health maintenance organization, a nonprofit hospital and health service corporation or any other entity providing a plan of health insurance, health benefits or health care services.
and - *SB420_R1* – 9 – (b) Accept new patients who are enrolled in the Public Option to the same extent as the provider or facility accepts new patients who are not enrolled in the Public Option.
and (b) Accept new patients who are enrolled in the Public Option to the same extent as the provider or facility accepts new patients who are not enrolled in the Public Option.
2.
Employees’ Benefits Program may waive the requirements ofic subsection 1 when necessary to ensure that recipients of Medicaid and officers, employees and retirees of this State who receive benefits under the Public Employees’ Benefits Program have sufficient access to covered services.
The Director and the Executive Officer of the Public Employees’ Benefits Program may waive the requirements of subsection 1 when necessary to ensure that recipients of Medicaid and officers, employees and retirees of this State who receive benefits under the Public Employees’ Benefits Program have sufficient access to covered services.
- 81st Session (2021) – 10 – Sec.
Sec.
(b) Encourage the use of payment models that increase value for persons enrolled in the Public Option and the State;
for persons enrolled in the Public Option and the State;
(c) Improve health outcomes for persons enrolled in the Public Option;
value (c) Improve health outcomes for persons enrolled in the Public Option;
4.
center or a rural health clinic under the Public Option must be comparable to or better than the reimbursement rates established for patient encounters under the applicable Prospective Payment System established for Medicare by the Centers for Medicare and Medicaid Services of the United States Department of Health and Human Services.
The reimbursement rates for a federally-qualified health center or a rural health clinic under the Public Option must be comparable to or better than the reimbursement rates established for patient encounters under the applicable Prospective Payment System established for Medicare by the Centers for Medicare and Medicaid Services of the United States Department of Health and Human Services.
5.
- *SB420_R1* – 10 – 5.
6.
- 81st Session (2021) – 11 – 6.
As used in this section, “Medicare” means the program of health insurance for aged persons and persons with disabilities established pursuant to Title XVIII of the Social Security Act, 42 U.S.C.
As used in this section, “Medicare” means the program of health insurance for aged persons and persons with disabilities established pursuant to Title XVIII of the Social Security Act, 42 U.SSec.
§§ 1395 et seq.
Sec.
There is hereby created in the State Treasury the Public Option Trust Fund as a nonreverting trust fund.
et sThere is hereby created in the State Treasury the Public Option Trust Fund as a nonreverting trust fund.
Except as otherwise provided in subsection 5, the money in the Trust Fund must be used to carry out the provisions of sections 2 to 15, inclusive, of this act.
Except as otherwise provided in subsection 5, the money in the Trust Fund must be used to carry out the provisions of sections to 15, inclusive, of this act.
If the State Treasurer determines that there is sufficient money in the Trust Fund to carry out the provisions of sections 2 to 15, inclusive, of this act, for the current fiscal year, the Director may use a portion determined by the State Treasurer of any additional money in the Trust Fund to increase the affordability of the Public Option.
If the State Treasurer determines that there is sufficient to 15, inclusive, of this act, for the current fiscal year, the Director may use a portion determined by the State Treasurer of any additional money in the Trust Fund to increase the affordability of the Public Option.
- *SB420_R1* – 11 – 3.
3.
A participating public agency, as that term is 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 officers and employees, pursuant to chapter 287 of NRS;
A participating public agency, as that term is 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 - 81st Session (2021) – 12 – of its officers and employees, and the dependents of officers and employees, pursuant to chapter 287 of NRS;
Any other insurer or organization that provides health coverage or benefits or coverage of prescription drugs as part of workers’ compensation insurance in accordance with state or federal law.
Any other insurer or organization that provides health coverage or benefits or coverage of prescription drugs as part of law.ers’ compensation insurance in accordance with state or federal The term does not include an insurer that provides coverage under a policy of casualty or property insurance.
 The term does not include an insurer that provides coverage under a policy of casualty or property insurance.
Any policy of insurance offered on the Silver State Health Insurance Exchange in accordance with section 16.5 of this act.
Any policy of insurance offered on the Silver State Health InsSec.
16.35.angeNRS 689A.0423 is hereby amended to read asct.
follows:
689A.0423 1.
A policy of health insurance must provide coverage for:
(a) Enteral formulas for use at home that are prescribed or ordered by a physician as medically necessary for the treatment of inherited metabolic diseases characterized by deficient metabolism, or malabsorption originating from congenital defects or defects arising shortly after birth, of amino acid, organic acid, carbohydrate or fat;
and (b) At least $2,500 per year for special food products which are prescribed or ordered by a physician as medically necessary for the treatment of a person described in paragraph (a).
- 81st Session (2021) – 13 – 2.
The coverage required by subsection 1 must be provided whether or not the condition existed when the policy was purchased.
3.
A policy subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after [January] July 1, [1998,] 2021, has the legal effect of including the coverage required by this section, and any provision of the policy or the ren4.al As used in this section:h this section is void.
(a) “Enteral formula” includes, without limitation, a formula that is ingested orally.
(b) “Inherited metabolic disease” means a disease caused by an inherited abnormality of the body chemistry of a person.
[(b)] (c) “Special food product” means a food product that is specially formulated to have less than one gram of protein per serving and is intended to be consumed under the direction of a physician for the dietary treatment of an inherited metabolic disease.
The term does not include a food that is naturally low in protein.
16.4.
NRS 689B.0353 is hereby amended to read as follows:
689B.0353 1.
A policy of group health insurance must provide coverage for:
(a) Enteral formulas for use at home that are prescribed or ordered by a physician as medically necessary for the treatment of inherited metabolic diseases characterized by deficient metabolism, or malabsorption originating from congenital defects or defects arising shortly after birth, of amino acid, organic acid, carbohydrate or fat;
and (b) At least $2,500 per year for special food products which are prescribed or ordered by a physician as medically necessary for the tre2.
The coverage required by subsection 1 must be provided whether or not the condition existed when the policy was purchased.
3.
A policy subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after [January] July 1, [1998,] 2021, has the legal effect of including the coverage required by this section, and any provision of the policy or the renewal which is in conflict with this section is void.
4.
As used in this section:
(a) “Enteral formula” includes, without limitation, a formula that is ingested orally.
(b) “Inherited metabolic disease” means a disease caused by an inherited abnormality of the body chemistry of a person.
- 81st Session (2021) – 14 – [(b)] (c) “Special food product” means a food product that is specially formulated to have less than one gram of protein per serving and is intended to be consumed under the direction of a physician for the dietary treatment of an inherited metabolic disease.
The term does not include a food that is naturally low in protein.
Sec.
16.43.
NRS 695B.1923 is hereby amended to read as fol695B.1923 1.
A contract for hospital or medical service must provide coverage for:
(a) Enteral formulas for use at home that are prescribed or ordered by a physician as medically necessary for the treatment of inherited metabolic diseases characterized by deficient metabolism, or malabsorption originating from congenital defects or defects arising shortly after birth, of amino acid, organic acid, carbohydrate or fat;
and (b) At least $2,500 per year for special food products which are prescribed or ordered by a physician as medically necessary for the treatment of a person described in paragraph (a).
2.
The coverage required by subsection 1 must be provided whether or not the condition existed when the contract was purchased.
3.
A contract subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after [January] July 1, [1998,] 2021, has the legal effect of including the coverage required by this section, and any provision of the contract or the renewal which is in conflict with this section is void.
4.
As used in this section:
(a) “Enteral formula” includes, without limitation, a formula that is ingested orally.
inherited abnormality of the body chemistry of a person.sed by an [(b)] (c) “Special food product” means a food product that is specially formulated to have less than one gram of protein per serving and is intended to be consumed under the direction of a physician for the dietary treatment of an inherited metabolic disease.
The term does not include a food that is naturally low in protein.
Sec.
16.47.
NRS 695C.1723 is hereby amended to read as follows:
695C.1723 1.
A health maintenance plan must provide coverage for:
(a) Enteral formulas for use at home that are prescribed or ordered by a physician as medically necessary for the treatment of inherited metabolic diseases characterized by deficient metabolism, - 81st Session (2021) – 15 – or malabsorption originating from congenital defects or defects arising shortly after birth, of amino acid, organic acid, carbohydrate or fat;
and (b) At least $2,500 per year for special food products which are prescribed or ordered by a physician as medically necessary for the treatment of a person described in paragraph (a).
whether or not the condition existed when the health maintenance plan was purchased.
3.
Any evidence of coverage subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after [January] July 1, [1998,] 2021, has the legal effect of including the coverage required by this section, and any provision of the evidence of coverage or the renewal which is in conflict with this section is void.
4.
As used in this section:
(a) “Enteral formula” includes, without limitation, a formula that is ingested orally.
(b) “Inherited metabolic disease” means a disease caused by an inherited abnormality of the body chemistry of a person.
[(b)] (c) “Special food product” means a food product that is specially formulated to have less than one gram of protein per serving and is intended to be consumed under the direction of a physician for the dietary treatment of an inherited metabolic disease.
The term does not include a food that is naturally low in protein.
Sec.
The Executive Director, in collaboration with the Director of the Department of Health and Human Services, shall apply to the Secretary of Health and Human Services for a waiver pursuant to 42 U.S.C.
The Executive Director, in collaboration with the Director of the Department of Health and Human Services, shall apply to pursuant to 42 U.S.C.
§ 18052 to authorize an organization described in section 501(c)(5) of the Internal Revenue Code that processes health claims in this State to offer on the Exchange a policy of insurance to meet the unique needs of tradespersons, including, without limitation, persons who work temporary or seasonal jobs, that is capable of serving as an alternative to the - *SB420_R1* – 12 – continuation of group health benefits under the Consolidated Omnibus Budget Reconciliation Act of 1985.
§ 18052 to authorize an organization described in section 501(c)(5) of the Internal Revenue Code that processes health claims in this State to offer on the Exchange a policy of insurance to meet the unique needs of tradespersons, including, without limitation, persons who work temporary or seasonal jobs, that is capable of serving as an alternative to the continuation of group health benefits under the Consolidated Omnibus Budget Reconciliation Act of 1985.
The application for a waiver submitted pursuant to subsection 1 must include, without limitation, an application for a waiver of any provisions of federal law or regulations that would otherwise require a policy described in subsection 1 to meet the requirements of chapter 689A of NRS in order to be offered on the Exchange or for persons who purchase the plan on the Exchange to receive applicable federal subsidies.
The application for a waiver submitted pursuant to subsection 1 must include, without limitation, an application for a waiver of any provisions of federal law or regulations that would otherwise require a policy described in subsection 1 to meet the requirements of chapter 689A of NRS in order to be offered on the - 81st Session (2021) – 16 – Exchange or for persons who purchase the plan on the Exchange to receive applicable federal subsidies.
(a) Meet all requirements established by the Federal Act for a qualified health plan, to the extent that those requirements do not prevent an organization described in section 501(c)(5) of the Internal Revenue Code from offering such a policy;
(a) Meet all requirements established by the Federal Act for a qualified health plan, to the extent that those requirements do not Internal Revenue Code from offering such a policy;
and (b) Be certified by the Executive Director.
and of the (b) Be certified by the Executive Director.
(a) Create and administer a health insurance exchange;
(d) [Make] Except as otherwise authorized by a waiver obtained pursuant to section 16.5 of this act, make only qualified - *SB420_R1* – 13 – health plans available to qualified individuals and qualified small employers ;
(d) [Make] Except as otherwise authorized by a waiver obtained pursuant to section 16.5 of this act, make only qualified health plans available to qualified individuals and qualified small employers ;
[on or after January 1, 2014;] and (e) Unless the Federal Act is repealed or is held to be unconstitutional or otherwise invalid or unlawful, perform all duties that are required of the Exchange to implement the requirements of the Federal Act.
[on or after January 1, 2014;] and (e) Unless the Federal Act is repealed or is held to be unconstitutional or otherwise invalid or unlawful, perform all duties - 81st Session (2021) – 17 – that are required of the Exchange to implement the requirements of the Federal Act.
2.
The Exchange may:
(a) Except as otherwise provided in subsection 2, report the abuse, neglect, exploitation, isolation or abandonment of the older person or vulnerable person to:
abuse, neglect, exploitation, isolation or abandonment of the older person or vulnerable person to:
If a person who is required to make a report pursuant to subsection 1 knows or has reasonable cause to believe that the abuse, neglect, exploitation, isolation or abandonment of the older person or vulnerable person involves an act or omission of the Aging and Disability Services Division, another division of the Department of Health and Human Services or a law enforcement agency, the person shall make the report to an agency other than the one alleged to have committed the act or omission.
If a person who is required to make a report pursuant to subsection 1 knows or has reasonable cause to believe that the abuse, neglect, exploitation, isolation or abandonment of the older person or vulnerable person involves an act or omission of the Department of Health and Human Services or a law enforcementthe agency, the person shall make the report to an agency other than the one alleged to have committed the act or omission.
Each agency, after reducing a report to writing, shall forward a copy of the report to the Aging and Disability Services Division of - *SB420_R1* – 14 – the Department of Health and Human Services and the Unit for the Investigation and Prosecution of Crimes.
Each agency, after reducing a report to writing, shall forward a copy of the report to the Aging and Disability Services Division of the Department of Health and Human Services and the Unit for the Investigation and Prosecution of Crimes.
4.
- 81st Session (2021) – 18 – 4.
(a) Every physician, dentist, dental hygienist, chiropractor, optometrist, podiatric physician, medical examiner, resident, intern, professional or practical nurse, physician assistant licensed pursuant to chapter 630 or 633 of NRS, perfusionist, psychiatrist, psychologist, marriage and family therapist, clinical professional counselor, clinical alcohol and drug counselor, alcohol and drug counselor, music therapist, athletic trainer, driver of an ambulance, paramedic, licensed dietitian, holder of a license or a limited license issued under the provisions of chapter 653 of NRS or other person providing medical services licensed or certified to practice in this State, who examines, attends or treats an older person or vulnerable person who appears to have been abused, neglected, exploited, isolated or abandoned.
optometrist, podiatric physician, medical examiner, resident, intern, professional or practical nurse, physician assistant licensed pursuant to chapter 630 or 633 of NRS, perfusionist, psychiatrist, psychologist, marriage and family therapist, clinical professional counselor, clinical alcohol and drug counselor, alcohol and drug counselor, music therapist, athletic trainer, driver of an ambulance, paramedic, licensed dietitian, holder of a license or a limited license issued under the provisions of chapter 653 of NRS or other person providing medical services licensed or certified to practice in this State, who examines, attends or treats an older person or vulnerable person who appears to have been abused, neglected, exploited, isolated or abandoned.
(b) Any personnel of a hospital or similar institution engaged in the admission, examination, care or treatment of persons or an administrator, manager or other person in charge of a hospital or similar institution upon notification of the suspected abuse, neglect, exploitation, isolation or abandonment of an older person or vulnerable person by a member of the staff of the hospital.
(b) Any personnel of a hospital or similar institution engaged in the admission, examination, care or treatment of persons or an administrator, manager or other person in charge of a hospital or exploitation, isolation or abandonment of an older person or, neglect, vulnerable person by a member of the staff of the hospital.
(g) Any employee of the Department of Health and Human Services, except the State Long-Term Care Ombudsman appointed pursuant to NRS 427A.125 and any of his or her advocates or volunteers where prohibited from making such a report pursuant to 45 C.F.R.
(g) Any employee of the Department of Health and Human Services, except the State Long-Term Care Ombudsman appointed pursuant to NRS 427A.125 and any of his or her advocates or volunteers where prohibited from making such a report pursuant to C.F.R.
(h) Any employee of a law enforcement agency or a county’s office for protective services or an adult or juvenile probation officer.
(h) Any employee of a law enforcement agency or a county’s officer.or protective services or an adult or juvenile probation (i) Any person who maintains or is employed by a facility or establishment that provides care for older persons or vulnerable persons.
(i) Any person who maintains or is employed by a facility or establishment that provides care for older persons or vulnerable persons.
(j) Any person who maintains, is employed by or serves as a volunteer for an agency or service which advises persons regarding the abuse, neglect, exploitation, isolation or abandonment of an - 81st Session (2021) – 19 – older person or vulnerable person and refers them to persons and agencies where their requests and needs can be met.
(j) Any person who maintains, is employed by or serves as a volunteer for an agency or service which advises persons regarding the abuse, neglect, exploitation, isolation or abandonment of an - *SB420_R1* – 15 – older person or vulnerable person and refers them to persons and agencies where their requests and needs can be met.
(m) Every person who operates or is employed by a peer support recovery organization, as defined in NRS 449.01563.
(m) Every person who operates or is employed by a peer support rec(n) Every person who operates or is employed by a community health worker pool, as defined in NRS 449.0028, or with whom a community health worker pool contracts to provide the services of a community health worker, as defined in NRS 449.0027.
(n) Every person who operates or is employed by a community health worker pool, as defined in NRS 449.0028, or with whom a community health worker pool contracts to provide the services of a community health worker, as defined in NRS 449.0027.
7.
pursuant to this section shall cause the investigation of the report to commence within 3 working days.
A division, office or department which receives a report pursuant to this section shall cause the investigation of the report to commence within 3 working days.
If the investigation of a report results in the belief that an older person or vulnerable person is abused, neglected, exploited, isolated or abandoned, the Aging and Disability Services Division of the Department of Health and Human Services or the county’s - *SB420_R1* – 16 – office for protective services may provide protective services to the older person or vulnerable person if the older person or vulnerable person is able and willing to accept them.
If the investigation of a report results in the belief that an older person or vulnerable person is abused, neglected, exploited, - 81st Session (2021) – 20 – isolated or abandoned, the Aging and Disability Services Division of the Department of Health and Human Services or the county’s office for protective services may provide protective services to the older person or vulnerable person if the older person or vulnerable person is able and willing to accept them.
A person who knowingly and willfully violates any of the provisions of this section is guilty of a misdemeanor.
A person who knowingly and willfully violates any of the pro10.
10.
(b) Shall administer, through the divisions of the Department, the provisions of chapters 63, 424, 425, 427A, 432A to 442, inclusive, 446 to 450, inclusive, 458A and 656A of NRS, NRS 127.220 to 127.310, inclusive, 422.001 to 422.410, inclusive, and sections 24 to 28, inclusive, of this act, 422.580, 432.010 to 432.133, inclusive, 432B.6201 to 432B.626, inclusive, 444.002 to 444.430, inclusive, and 445A.010 to 445A.055, inclusive, and all other provisions of law relating to the functions of the divisions of the Department, but is not responsible for the clinical activities of the Division of Public and Behavioral Health or the professional line activities of the other divisions.
(b) Shall administer, through the divisions of the Department, the provisions of chapters 63, 424, 425, 427A, 432A to 442, 127.220 to 127.310, inclusive, 422.001 to 422.410, inclusive, and sections 24 to 28, inclusive, of this act, 422.580, 432.010 to 432.133, inclusive, 432B.6201 to 432B.626, inclusive, 444.002 to 444.430, inclusive, and 445A.010 to 445A.055, inclusive, and all other provisions of law relating to the functions of the divisions of the Department, but is not responsible for the clinical activities of the Division of Public and Behavioral Health or the professional line activities of the other divisions.
(d) Shall, after considering advice from agencies of local governments and nonprofit organizations which provide social services, adopt a master plan for the provision of human services in this State.
- 81st Session (2021) – 21 – (d) Shall, after considering advice from agencies of local governments and nonprofit organizations which provide social services, adopt a master plan for the provision of human services in this State.
The Director shall revise the plan biennially and deliver a - *SB420_R1* – 17 – copy of the plan to the Governor and the Legislature at the beginning of each regular session.
The Director shall revise the plan biennially and deliver a copy of the plan to the Governor and the Legislature at the beginning of each regular session.
(1) Identify and assess the plans and programs of the Department for the provision of human services, and any duplication of those services by federal, state and local agencies;
Department for the provision of human services, and anyf the duplication of those services by federal, state and local agencies;
(f) Has such other powers and duties as are provided by law.
2.) HNotwithstanding any other provision of law, the Director, or the Director’s designee, is responsible for appointing and removing subordinate officers and employees of the Department.
2.
Notwithstanding any other provision of law, the Director, or the Director’s designee, is responsible for appointing and removing subordinate officers and employees of the Department.
(c) Identify and investigate complaints of consumers and injured employees regarding their health care plans, including, without limitation, the Public Employees’ Benefits Program [,] and the Public Option, and policies of industrial insurance and assist those consumers and injured employees to resolve their complaints, including, without limitation:
- 81st Session (2021) – 22 – (c) Identify and investigate complaints of consumers and injured employees regarding their health care plans, including, without Public Option, and policies of industrial insurance and assist those consumers and injured employees to resolve their complaints, including, without limitation:
- *SB420_R1* – 18 – (1) Referring consumers and injured employees to the appropriate agency, department or other entity that is responsible for addressing the specific complaint of the consumer or injured employee;
(1) Referring consumers and injured employees to the appropriate agency, department or other entity that is responsible for addressing the specific complaint of the consumer or injured employee;
(e) Establish and maintain a system to collect and maintain information pertaining to the written and telephonic inquiries received by the Office for Consumer Health Assistance;
information pertaining to the written and telephonic inquiries received by the Office for Consumer Health Assistance;
(2) Links to websites of Canadian pharmacies which have been recommended by the State Board of Pharmacy for inclusion on the Internet website pursuant to subsection 4 of NRS 639.2328;
been recommended by the State Board of Pharmacy for inclusion on the Internet website pursuant to subsection 4 of NRS 639.2328;
(j) Assist consumers with accessing a navigator, case manager or facilitator to help the consumer obtain health care services;
- 81st Session (2021) – 23 – (j) Assist consumers with accessing a navigator, case manager or facilitator to help the consumer obtain health care services;
(l) Assist consumers with filing complaints against health care facilities and health care professionals;
facilities and health care professionals;aints against health care (m) Assist consumers with filing complaints with the Commissioner of Insurance against issuers of health care plans;
- *SB420_R1* – 19 – (m) Assist consumers with filing complaints with the Commissioner of Insurance against issuers of health care plans;
Sec.
233B.039 NRS1.
20.
NRS 233B.039 is hereby amended to read as follows:
233B.039 1.
(h) Except as otherwise provided in NRS 422.390, the Division of Health Care Financing and Policy of the Department of Health and Human Services.
- 81st Session (2021) – 24 – (h) Except as otherwise provided in NRS 422.390, the Division of Health Care Financing and Policy of the Department of Health and(i) Except as otherwise provided in NRS 533.365, the Office of the State Engineer.
(i) Except as otherwise provided in NRS 533.365, the Office of the State Engineer.
(k) The Administrator of the Division of Industrial Relations of the Department of Business and Industry in establishing and - *SB420_R1* – 20 – adjusting the schedule of fees and charges for accident benefits pursuant to subsection 2 of NRS 616C.260.
(k) The Administrator of the Division of Industrial Relations of the Department of Business and Industry in establishing and adjusting the schedule of fees and charges for accident benefits pursuant to subsection 2 of NRS 616C.260.
Except as otherwise provided in subsection 5 and NRS 391.323, the Department of Education, the Board of the Public Employees’ Benefits Program and the Commission on Professional Standards in Education are subject to the provisions of this chapter for the purpose of adopting regulations but not with respect to any contested case.
Except as otherwise provided in subsection 5 and NRS 391.323, the Department of Education, the Board of the Public Standards in Education are subject to the provisions of this chapter for the purpose of adopting regulations but not with respect to any contested case.
4.
233B.126 do not apply to the Department of Health and Humand Services in the adjudication of contested cases involving the issuance of letters of approval for health facilities and agencies.
The provisions of NRS 233B.122, 233B.124, 233B.125 and 233B.126 do not apply to the Department of Health and Human Services in the adjudication of contested cases involving the issuance of letters of approval for health facilities and agencies.
(a) Any order for immediate action, including, but not limited to, quarantine and the treatment or cleansing of infected or infested animals, objects or premises, made under the authority of the State Board of Agriculture, the State Board of Health, or any other agency of this State in the discharge of a responsibility for the preservation of human or animal health or for insect or pest control;
(a) Any order for immediate action, including, but not limited to, quarantine and the treatment or cleansing of infected or infested animals, objects or premises, made under the authority of the State - 81st Session (2021) – 25 – Board of Agriculture, the State Board of Health, or any other agency of this State in the discharge of a responsibility for the preservation of human or animal health or for insect or pest control;
(c) A regulation adopted by the State Board of Education pursuant to NRS 388.255 or 394.1694;
(c) A regulation adopted by the State Board of Education pur(d) The judicial review of decisions of the Public Utilities Commission of Nevada;
(d) The judicial review of decisions of the Public Utilities Commission of Nevada;
- *SB420_R1* – 21 – (f) The adoption or amendment of a rule or regulation to be included in the State Plan for Services for Victims of Crime by the Department of Health and Human Services pursuant to NRS 217.130;
(f) The adoption or amendment of a rule or regulation to be included in the State Plan for Services for Victims of Crime by the Department of Health and Human Services pursuant to NRS 217.130;
20.5.
NRS 287.04335 is hereby amended to read as fol287.04335 If the Board provides health insurance through a plan of self-insurance, it shall comply with the provisions of NRS 687B.409, 689B.0353, 689B.255, 695C.1723, 695G.150, 695G.155, 695G.160, 695G.162, 695G.164, 695G.1645, 695G.1665, 695G.167, 695G.170 to 695G.174, inclusive, 695G.177, 695G.200 to 695G.230, inclusive, 695G.241 to 695G.310, inclusive, and 695G.405, in the same manner as an insurer that is licensed pursuant to title 57 of NRS is required to comply with those provisions.
Sec.
2.
- 81st Session (2021) – 26 – 2.
Enter into contracts relating to the administration of the Program, including, without limitation, contracts with licensed administrators and qualified actuaries.
Enter into contracts relating to the administration of the Program, including, without limitation, contracts with licensed licensed administrator:ified actuaries.
Each such contract with a licensed administrator:
Each such contract with a (a) Must be submitted to the Commissioner of Insurance not less than 30 days before the date on which the contract is to become effective for approval as to the licensing and fiscal status of the licensed administrator and status of any legal or administrative actions in this State against the licensed administrator that may impair his or her ability to provide the services in the contract.
(a) Must be submitted to the Commissioner of Insurance not less than 30 days before the date on which the contract is to become effective for approval as to the licensing and fiscal status of the licensed administrator and status of any legal or administrative actions in this State against the licensed administrator that may impair his or her ability to provide the services in the contract.
The Board shall not enter into a contract pursuant to this subsection unless:
unless:rd shall not enter into a contract pursuant to this subsection (a) Provision is made by the Board to offer all the services specified in the request for proposals, either by a health maintenance organization or through separate action of the Board.
(a) Provision is made by the Board to offer all the services specified in the request for proposals, either by a health maintenance organization or through separate action of the Board.
- *SB420_R1* – 22 – (1) For active and retired state officers and employees and their dependents, the commingled claims experience of such active and retired officers and employees and their dependents for whom the Program provides primary health insurance coverage in a single risk pool;
(1) For active and retired state officers and employees and their dependents, the commingled claims experience of such active and retired officers and employees and their dependents for whom the Program provides primary health insurance coverage in a single risk pool;
and (2) For active and retired officers and employees of public agencies enumerated in NRS 287.010 that contract with the Program to obtain group insurance by participation in the Program and their dependents, the commingled claims experience of such active and retired officers and employees and their dependents for whom the Program provides primary health insurance coverage in a single risk pool.
and (2) For active and retired officers and employees of public agencies enumerated in NRS 287.010 that contract with the Program to obtain group insurance by participation in the Program and their dependents, the commingled claims experience of such active and retired officers and employees and their dependents for whom the Program provides primary health insurance coverage in a single risk poo(c) For a contract with a physician, surgeon, hospital or rehabilitative facility, the physician, surgeon, hospital or rehabilitative facility has also complied with the requirements of section 13 of this act.
(c) For a contract with a physician, surgeon, hospital or rehabilitative facility, the physician, surgeon, hospital or rehabilitative facility has also complied with the requirements of section 13 of this act.
5.
- 81st Session (2021) – 27 – 5.
Charge and collect from an insurer, health maintenance organization, organization for dental care or nonprofit medical service corporation, a fee for the actual expenses incurred by the Board or a participating public agency in administering a plan of insurance offered by that insurer, organization or corporation.
Charge and collect from an insurer, health maintenance organization, organization for dental care or nonprofit medical Board or a participating public agency in administering a plan ofe insurance offered by that insurer, organization or corporation.
(b) The person is a former employee of an agency of this State and less than 2 years have expired since the termination of the person’s employment with the State;
(b) The person is a former employee of an agency of this State and less than 2 years have expired since the termination of the per(c) The person is employed by the Department of Transportation for a transportation project that is entirely funded by federal money and the term of the contract is for more than 4 years, unless the using agency submits a written disclosure to the State Board of Examiners indicating the services to be provided pursuant to the contract and the person who will be providing those services and, after reviewing the disclosure, the State Board of Examiners approves entering into a contract with the person.
or (c) The person is employed by the Department of Transportation for a transportation project that is entirely funded by federal money and the term of the contract is for more than 4 years, unless the using agency submits a written disclosure to the State Board of Examiners indicating the services to be provided pursuant to the contract and the person who will be providing those services and, after reviewing the disclosure, the State Board of Examiners approves entering into a contract with the person.
The requirements of this subsection apply to any person employed by a business or other entity that enters into a contract to provide services for a using agency if the person will be performing or producing the services for which the business or entity is employed.
The requirements - *SB420_R1* – 23 – of this subsection apply to any person employed by a business or other entity that enters into a contract to provide services for a using agency if the person will be performing or producing the services for which the business or entity is employed.
A temporary employment service providing employees for a using agency shall provide the using agency with the names of the employees to be provided to the agency.
A temporary employment service providing employees for a using agency shall provide the using agency with the names of the employees to be approve a contract pursuant to paragraph (b) of subsection 1 unless the Board determines that one or more of the following circumstances exist:
The State Board of Examiners shall not approve a contract pursuant to paragraph (b) of subsection 1 unless the Board determines that one or more of the following circumstances exist:
or (b) A short-term need or unusual economic circumstance exists for the using agency to contract with the person.
or - 81st Session (2021) – 28 – (b) A short-term need or unusual economic circumstance exists for the using agency to contract with the person.
3.
with a person pursuant to subsection 1:f Examiners to contract (a) May occur at the same time and in the same manner as the approval by the State Board of Examiners of a proposed contract pursuant to subsection 7 of NRS 333.700;
The approval by the State Board of Examiners to contract with a person pursuant to subsection 1:
(a) May occur at the same time and in the same manner as the approval by the State Board of Examiners of a proposed contract pursuant to subsection 7 of NRS 333.700;
If a using agency contracts with a person pursuant to this subsection, the using agency shall submit a copy of the contract and a description of the emergency to the State Board of Examiners, which shall review the contract and the description of the emergency and notify the using agency whether the State Board of Examiners would have approved the contract if it had not been entered into pursuant to this subsection.
If a using agency contracts with a person pursuant to this subsection, the using agency shall submit a copy of the contract and a description of the emergency to the State Board of Examiners, which shall review the contract and the description of the emergency and notify the using the contract if it had not been entered into pursuant to thised subsection.
Except as otherwise provided in subsection 9, a using agency shall not contract with a temporary employment service - *SB420_R1* – 24 – unless the contracting process is controlled by rules of open competitive bidding.
Except as otherwise provided in subsection 9, a using agency shall not contract with a temporary employment service unless the contracting process is controlled by rules of open competitive bidding.
Each board or commission of this State and each institution of the Nevada System of Higher Education that employs a consultant shall, at least once every 6 months, submit to the Interim Finance Committee a report setting forth:
Each board or commission of this State and each institution of the Nevada System of Higher Education that employs a consultant shall, at least once every 6 months, submit to the Interim Fin(a) The number of consultants employed by the board, commission or institution;
(a) The number of consultants employed by the board, commission or institution;
and (d) The length of time each consultant has been employed by the board, commission or institution.
and - 81st Session (2021) – 29 – (d) The length of time each consultant has been employed by the board, commission or institution.
(a) Shall make every effort to limit the number of contracts it enters into with persons to provide services which have a term of more than 2 years and which are in the amount of less than $1,000,000;
(a) Shall make every effort to limit the number of contracts it enters into with persons to provide services which have a term of $1,000,000;
and (b) Shall not enter into a contract with a person to provide services without ensuring that the person is in active and good standing with the Secretary of State.
andrs and which are in the amount of less than (b) Shall not enter into a contract with a person to provide services without ensuring that the person is in active and good standing with the Secretary of State.
(e) The employment of a former employee of an agency of this State who is not receiving retirement benefits under the Public Employees’ Retirement System during the duration of the contract.
State who is not receiving retirement benefits under the Public Employees’ Retirement System during the duration of the contract.
- *SB420_R1* – 25 – Sec.
Sec.
The Director shall, to the extent authorized by federal law, include in the State Plan for Medicaid authorization for:
The Director shall, to the extent authorized by federal law, include in the State Plan for Medicaid authorization for a pregnant woman who is determined by a qualified provider to be presumptively eligible for Medicaid to enroll in Medicaid until the last day of the month immediately following the month of enrollment without submitting an application for enrollment in Medicaid which includes additional proof of eligibility.
(a) A pregnant woman whose household income is at or below 200 percent of the federally designated level signifying poverty to enroll in Medicaid.
- 81st Session (2021) – 30 – 2.
(b) A pregnant woman who is determined by a qualified provider to be presumptively eligible for Medicaid to enroll in Medicaid until the last day of the month immediately following the month of enrollment without submitting an application for enrollment in Medicaid which includes additional proof of eligibility.
To the extent that money is available, the Director shall, to the extent authorized by federal law, include in the State Plan for Medicaid authorization for a pregnant woman whose household income is at or below 200 percent of the federally designated level signifying poverty to enroll in Medicaid.
2.
Unless otherwise required by federal law, the Director shall not include in the State Plan for Medicaid a requirement that a pregnant woman who is otherwise eligible for Medicaid must reside in the United States for a prescribed period of time before enrolling in Medicaid.
Unless otherwise required by federal law, the Director a pregnant woman who resides in this State and who is otherwisethat eligible for Medicaid must reside in the United States for a prescribed period of time before enrolling in Medicaid.
4.
§ 1315 or apply for an amendment of the State Plan for Medicaid that authorizes the Department to receive federal funding to include in the State Plan for Medicaid coverage of doula services provided by an enrolled doula.
§ or apply for an amendment of the State Plan for Medicaid that authorizes the Department to receive federal funding to include in the State Plan for Medicaid coverage of doula services cooperate in good faith with the Federal Government during the application process to satisfy the requirements of the Federal Government for obtaining a waiver or amendment pursuant to this section.
The Department shall fully cooperate in good faith with the Federal Government during the application process to satisfy the requirements of the Federal Government for obtaining a waiver or amendment pursuant to this section.
3.
- *SB420_R1* – 26 – 3.
The Division, in consultation with community-based organizations that provide services to pregnant women in this State, shall prescribe the required training and qualifications for enrollment pursuant to subsection 3 to receive reimbursement through Medicaid for doula services.
The Division, in consultation with community-based organizations that provide services to pregnant women in this - 81st Session (2021) – 31 – State, shall prescribe the required training and qualifications for enrollment pursuant to subsection 3 to receive reimbursement through Medicaid for doula services.
(a) “Doula services” means services to provide education and support relating to childbirth, including, without limitation, emotional and physical support provided during pregnancy, labor, birth and the postpartum period.
(a) “Doula services” means services to provide education and support relating to childbirth, including, without limitation, birth and the postpartum period.rovided during pregnancy, labor, (b) “Enrolled doula” means a doula who is enrolled with the Division pursuant to this section to receive reimbursement through Medicaid for doula services.
(b) “Enrolled doula” means a doula who is enrolled with the Division pursuant to this section to receive reimbursement through Medicaid for doula services.
The Director shall include in the State Plan for Medicaid a requirement that, except as otherwise provided in subsection 2, the State must provide reimbursement for the services of an advanced practice registered nurse, including, without limitation, a certified nurse-midwife, to the same extent as if the services were provided by a physician.
To the extent that money is available, the Director shall include in the State Plan for Medicaid a requirement that, except as otherwise provided in subsection 2, the State must provide reimbursement for the services of an advanced practice registered nurse, including, without limitation, a certified nurse-midwife, to the same extent as if the services were provided by a physician.
The provisions of subsection 1 do not apply to services provided to a recipient of Medicaid who receives health care services through the Medicaid managed care program established pursuant to NRS 422.273.
The provisions of subsection 1 do not apply to services provided to a recipient of Medicaid who receives health care services through a Medicaid managed care program.
To the extent that money is available, the Director shall include in the State Plan for Medicaid a requirement that the State pay the nonfederal share of expenditures incurred for:
To the extent that money is available, the Director shall include in the State Plan for Medicaid a expenditures incurred for:
(a) Supplies for breastfeeding a child until the child’s first birthday.
pay the nonfederal share of (a) Supplies for breastfeeding a child until the child’s first birthday.
and - *SB420_R1* – 27 – (2) Are medically necessary or are necessary for the mother of the child to return to work.
and (2) Are medically necessary for the mother or the child.
The Director shall include in the State Plan for Medicaid a requirement that, to the extent that federal financial participation is available, the State must pay the nonfederal share of expenditures incurred for lactation consultation and support.
The Director shall include in the State Plan for Medicaid a requirement that, to the extent that money and federal financial participation are available, the State must pay the nonfederal - 81st Session (2021) – 32 – share of expenditures incurred for lactation consultation and support.
(b) “Provider of health care” has the meaning ascribed to it in NRS 629.031.
(b) “Provider of health care” has the meaning ascribed to it in NRSSec.
Sec.
Exclude from participation in Medicaid any provider of health care that fails to comply with the requirements of section 13 of this act.
Exclude from participation in Medicaid any provider of of this act.that fails to comply with the requirements of section 13 9.
9.
The Department shall:
To the extent that money is available, the Department shall:
(a) Establish a Medicaid managed care program to provide health care services to recipients of Medicaid in all geographic - *SB420_R1* – 28 – areas of this State.
(a) Establish a Medicaid managed care program to provide health care services to recipients of Medicaid in all geographic areas of this State.
(b) Conduct a statewide procurement process to select health maintenance organizations to provide the services described in paragraph (a).
- 81st Session (2021) – 33 – (b) Conduct a statewide procurement process to select health maintenance organizations to provide the services described in paragraph (a).
For [any] the Medicaid managed care program established [in the State of Nevada,] pursuant to subsection 1, the Department shall contract only with a health maintenance organization that has:
For any Medicaid managed care program established in the State of Nevada, the Department shall contract only with a health maintenance organization that has:
(a) Negotiated in good faith with a federally-qualified health center to provide health care services for the health maintenance organization;
center to provide health care services for the health maintenance organization;
During the development and implementation of [any] the Medicaid managed care program, the Department shall cooperate with the University of Nevada School of Medicine by assisting in the provision of an adequate and diverse group of patients upon which the school may base its educational programs.
During the development and implementation of any Medicaid managed care program, the Department shall cooperate with the University of Nevada School of Medicine by assisting in the provision of an adequate and diverse group of patients upon which the school may base its educational programs.
The University of Nevada School of Medicine may establish a nonprofit organization to assist in any research necessary for the development of [a] the Medicaid managed care program, receive and accept gifts, grants and donations to support such a program and assist in establishing educational services about the program for recipients of Medicaid.
The University of Nevada School of Medicine may establish a nonprofit organization to assist in any research necessary and accept gifts, grants and donations to support such a program and assist in establishing educational services about the program for recipients of Medicaid.
For the purpose of contracting with [a] the Medicaid managed care program pursuant to this section, a health maintenance organization is exempt from the provisions of NRS 695C.123.
For the purpose of contracting with a Medicaid managed care program pursuant to this section, a health maintenance organization is exempt from the provisions of NRS 695C.123.
The Medicaid managed care program must include, without limitation, a state-directed payment arrangement established in accordance with 42 C.F.R.
To the extent that money is available, a Medicaid managed care program must include, without limitation, a state- directed payment arrangement established in accordance with 42 C.F.R.
§ 438.6(c) to require a Medicaid managed care organization to reimburse a critical access hospital and any federally-qualified health center or rural - *SB420_R1* – 29 – health clinic affiliated with a critical access hospital for covered services at a rate that is equal to or greater than the rate received by the critical access hospital, federally-qualified health center or rural health clinic, as applicable, for services provided to recipients of Medicaid on a fee-for-service basis.
§ 438.6(c) to require a Medicaid managed care organization to reimburse a critical access hospital and any federally-qualified health center or rural health clinic affiliated - 81st Session (2021) – 34 – with a critical access hospital for covered services at a rate that is equal to or greater than the rate received by the critical access applicable, for services provided to recipients of Medicaid on a fee-s for-service basis.
(a) “Critical access hospital” means a hospital which has been certified as a critical access hospital by the Secretary of Health and Human Services pursuant to 42 U.S.C.
certified as a critical access hospital by the Secretary of Health and Human Services pursuant to 42 U.S.C.
NRS 422.4053 is hereby amended to read as follows:
(Deleted by amendment.) Sec.
422.4053 1.
Except as otherwise provided in subsection 2, the Department shall directly manage, direct and coordinate all payments and rebates for prescription drugs and all other services and payments relating to the provision of prescription drugs under the State Plan for Medicaid and the Children’s Health Insurance Program.
2.
The Department may enter into a contract with:
(a) A pharmacy benefit manager for the provision of any services described in subsection 1.
(b) A health maintenance organization pursuant to NRS 422.273 for the provision of any of the services described in subsection 1 for recipients of Medicaid or recipients of insurance through the Children’s Health Insurance Program who receive coverage through [a] the Medicaid managed care program [.] established pursuant to NRS 422.273.
- *SB420_R1* – 30 – 3.
A contract entered into pursuant to subsection 2 must:
(a) Include the provisions required by NRS 422.4056;
and (b) Require the pharmacy benefit manager or health maintenance organization, as applicable, to disclose to the Department any information relating to the services covered by the contract, including, without limitation, information concerning dispensing fees, measures for the control of costs, rebates collected and paid and any fees and charges imposed by the pharmacy benefit manager or health maintenance organization pursuant to the contract.
4.
In addition to meeting the requirements of subsection 3, a contract entered into pursuant to:
(a) Paragraph (a) of subsection 2 may require the pharmacy benefit manager to provide the entire amount of any rebates received for the purchase of prescription drugs, including, without limitation, rebates for the purchase of prescription drugs by an entity other than the Department, to the Department.
(b) Paragraph (b) of subsection 2 must require the health maintenance organization to provide to the Department the entire amount of any rebates received for the purchase of prescription drugs, including, without limitation, rebates for the purchase of prescription drugs by an entity other than the Department, less an administrative fee in an amount prescribed by the contract.
The Department shall adopt policies prescribing the maximum amount of such an administrative fee.
Sec.
The Director may establish a program to negotiate discounts and rebates for hearing devices and related costs, including, without limitation, ear molds, batteries and FM systems, for children in this State who are deaf or hard of hearing on behalf of entities described in subsection 2 who participate in the program.
The Director may establish a program to negotiate discounts and rebates for hearing devices and related costs, including, without limitation, ear molds, batteries and FM systems, for children in this State who are deaf or hard of hearing on program.f entities described in subsection 2 who participate in the 2.
2.
(b) A governing body of a county, school district, municipal corporation, political subdivision, public corporation or other local governmental agency that provides health coverage to employees through a self-insurance reserve fund pursuant to NRS 287.010;
(b) A governing body of a county, school district, municipal corporation, political subdivision, public corporation or other local - 81st Session (2021) – 35 – governmental agency that provides health coverage to employees through a self-insurance reserve fund pursuant to NRS 287.010;
(c) An insurer that holds a certificate of authority to transact insurance in this State pursuant to chapter 680A of NRS;
insurance in this State pursuant to chapter 680A of NRS;to transact (d) An employer or employee organization based in this State that provides health coverage to employees through a self-insurance reserve fund;
(d) An employer or employee organization based in this State that provides health coverage to employees through a self-insurance reserve fund;
(e) A governmental agency or nonprofit organization that purchases hearing devices for children in this State who are deaf or hard of hearing;
- *SB420_R1* – 31 – (e) A governmental agency or nonprofit organization that purchases hearing devices for children in this State who are deaf or hard of hearing;
A person or entity described in subsection 2 may participate in any program established pursuant to subsection 1 by submitting an application to the Department in the form prescribed by the Department.
A person or entity described in subsection 2 may participate an application to the Department in the form prescribed by theing Department.
(a) A person directly responsible or serving as a volunteer for or an employee of a public or private home, institution or facility where the child is receiving child care outside of the home for a portion of the day, the person shall make the report to a law enforcement agency.
an employee of a public or private home, institution or facilityor or where the child is receiving child care outside of the home for a portion of the day, the person shall make the report to a law enforcement agency.
(b) An agency which provides child welfare services or a law enforcement agency, the person shall make the report to an agency other than the one alleged to have committed the act or omission, and the investigation of the abuse or neglect of the child must be made by an agency other than the one alleged to have committed the act or omission.
(b) An agency which provides child welfare services or a law enforcement agency, the person shall make the report to an agency other than the one alleged to have committed the act or omission, - 81st Session (2021) – 36 – and the investigation of the abuse or neglect of the child must be made by an agency other than the one alleged to have committed the act3.r oAny person who is described in paragraph (a) of subsection who delivers or provides medical services to a newborn infant and who, in his or her professional or occupational capacity, knows or has reasonable cause to believe that the newborn infant has been affected by a fetal alcohol spectrum disorder or prenatal substance use disorder or has withdrawal symptoms resulting from prenatal substance exposure shall, as soon as reasonably practicable but not later than 24 hours after the person knows or has reasonable cause to believe that the newborn infant is so affected or has such symptoms, notify an agency which provides child welfare services of the condition of the infant and refer each person who is responsible for the welfare of the infant to an agency which provides child welfare services for appropriate counseling, training or other services.
3.
A notification and referral to an agency which provides child welfare services pursuant to this subsection shall not be construed to require pro4.cutA report must be made pursuant to subsection 1 by the following persons:
Any person who is described in paragraph (a) of subsection 4 who delivers or provides medical services to a newborn infant and who, in his or her professional or occupational capacity, knows or has reasonable cause to believe that the newborn infant has been affected by a fetal alcohol spectrum disorder or prenatal substance use disorder or has withdrawal symptoms resulting from prenatal - *SB420_R1* – 32 – substance exposure shall, as soon as reasonably practicable but not later than 24 hours after the person knows or has reasonable cause to believe that the newborn infant is so affected or has such symptoms, notify an agency which provides child welfare services of the condition of the infant and refer each person who is responsible for the welfare of the infant to an agency which provides child welfare services for appropriate counseling, training or other services.
A notification and referral to an agency which provides child welfare services pursuant to this subsection shall not be construed to require prosecution for any illegal action.
4.
A report must be made pursuant to subsection 1 by the following persons:
(e) A person employed by a public school or private school and any person who serves as a volunteer at such a school.
any person who serves as a volunteer at such a school.
(f) Any person who maintains or is employed by a facility or establishment that provides care for children, children’s camp or other public or private facility, institution or agency furnishing care to a child.
school and (f) Any person who maintains or is employed by a facility or establishment that provides care for children, children’s camp or other public or private facility, institution or agency furnishing care to a child.
(h) Any officer or employee of a law enforcement agency or an adult or juvenile probation officer.
- 81st Session (2021) – 37 – (h) Any officer or employee of a law enforcement agency or an adult or juvenile probation officer.
(i) Except as otherwise provided in NRS 432B.225, an attorney.
(j) Any person who maintains, is employed by or serves as aey.
(j) Any person who maintains, is employed by or serves as a volunteer for an agency or service which advises persons regarding abuse or neglect of a child and refers them to persons and agencies where their requests and needs can be met.
volunteer for an agency or service which advises persons regarding abuse or neglect of a child and refers them to persons and agencies where their requests and needs can be met.
- *SB420_R1* – 33 – (l) Any adult person who is employed by an entity that provides organized activities for children, including, without limitation, a person who is employed by a school district or public school.
(l) Any adult person who is employed by an entity that provides organized activities for children, including, without limitation, a person who is employed by a school district or public school.
6.
subsection 1 knows or has reasonable cause to believe that a child has died as a result of abuse or neglect, the person shall, as soon as reasonably practicable, report this belief to an agency which provides child welfare services or a law enforcement agency.
If a person who is required to make a report pursuant to subsection 1 knows or has reasonable cause to believe that a child has died as a result of abuse or neglect, the person shall, as soon as reasonably practicable, report this belief to an agency which provides child welfare services or a law enforcement agency.
The written findings must include, if obtainable, the information required pursuant to the provisions of subsection 2 of NRS 432B.230.
The written findings must include, if obtainable, the information required pursuant to the provisions of sub7.
7.
(a) Inform the person, in writing or by electronic communication, of his or her duty as a mandatory reporter pursuant to this section;
- 81st Session (2021) – 38 – (a) Inform the person, in writing or by electronic communication, of his or her duty as a mandatory reporter pursuant to this section;
and (c) Maintain a copy of the written acknowledgment or electronic record for as long as the person is licensed, certified or endorsed in this State.
and record for as long as the person is licensed, certified or endorsed in this State.
The employer of a person who is described in subsection 4 and who is not required in his or her professional or occupational - *SB420_R1* – 34 – capacity to be licensed, certified or endorsed in this State must, upon initial employment of the person:
The employer of a person who is described in subsection 4 and who is not required in his or her professional or occupational capacity to be licensed, certified or endorsed in this State must, upon initial employment of the person:
and (c) Maintain a copy of the written acknowledgment or electronic record for as long as the person serves as a volunteer at the school.
and record for as long as the person serves as a volunteer at the school.
(b) Is not eligible for coverage by a state or federal program of public assistance that would provide for the payment of the charge;
- 81st Session (2021) – 39 – (b) Is not eligible for coverage by a state or federal program of public assistance that would provide for the payment of the charge;
A major hospital shall include on or with the first statement of the hospital bill provided to the patient after his or her discharge a notice of the reduction or discount available pursuant to this section, including, without limitation, notice of the criteria a patient must satisfy to qualify for a reduction or discount.
A major hospital shall include on or with the first statement notice of the reduction or discount available pursuant to this section, a including, without limitation, notice of the criteria a patient must satisfy to qualify for a reduction or discount.
A major hospital or patient who disputes the reasonableness of arrangements made pursuant to paragraph (c) of subsection 1 may - *SB420_R1* – 35 – submit the dispute to the Bureau for Hospital Patients for resolution as provided in NRS 232.462.
A major hospital or patient who disputes the reasonableness of arrangements made pursuant to paragraph (c) of subsection 1 may submit the dispute to the Bureau for Hospital Patients for resolution as provided in NRS 232.462.
or (e) Any other insurer or organization providing health coverage or benefits in accordance with state or federal law.
or or benefits in accordance with state or federal law.ealth coverage The term does not include an insurer that provides coverage under a policy of casualty or property insurance.
 The term does not include an insurer that provides coverage under a policy of casualty or property insurance.
(1) For each such contribution, the amount of the contribution and the manufacturer, third party or pharmacy benefit manager or group that provided the payment, donation, subsidy or other contribution;
- 81st Session (2021) – 40 – (1) For each such contribution, the amount of the contribution and the manufacturer, third party or pharmacy benefit other contribution;
and (2) The percentage of the total gross income of the organization during the immediately preceding calendar year attributable to payments, donations, subsidies or other contributions from each manufacturer, third party, pharmacy benefit manager or group;
androvided the payment, donation, subsidy or (2) The percentage of the total gross income of the organization during the immediately preceding calendar year attributable to payments, donations, subsidies or other contributions from each manufacturer, third party, pharmacy benefit manager or group;
- *SB420_R1* – 36 – 2.
2.
(b) A health benefit plan, as that term is defined in NRS 687B.470, for employees which provides coverage for prescription drugs;
(b) A health benefit plan, as that term is defined in NRS drugs;70, for employees which provides coverage for prescription (c) A participating public agency, as that term is 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 officers and employees, pursuant to chapter 287 of NRS;
(c) A participating public agency, as that term is 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 officers and employees, pursuant to chapter 287 of NRS;
(a) The issuer of a health benefit plan, as defined in NRS 695G.019, which provides coverage for medically necessary emergency services;
(a) The issuer of a health benefit plan, as defined in NRS 695G.019, which provides coverage for medically necessary eme(b) The Public Employees’ Benefits Program established pursuant to subsection 1 of NRS 287.043;
(b) The Public Employees’ Benefits Program established pursuant to subsection 1 of NRS 287.043;
and (d) Any other entity or organization that elects pursuant to NRS 439B.757 for the provisions of NRS 439B.700 to 439B.760, inclusive, to apply to the provision of medically necessary emergency services by out-of-network providers to covered persons.
and (d) Any other entity or organization that elects pursuant to NRS 439B.757 for the provisions of NRS 439B.700 to 439B.760, - 81st Session (2021) – 41 – inclusive, to apply to the provision of medically necessary emergency services by out-of-network providers to covered persons.
2.
Children’s Health Insurance Program or a health maintenance, the organization, as defined in NRS 695C.030, or managed care organization, as defined in NRS 695G.050, when providing health care services through managed care to recipients of Medicaid under the State Plan for Medicaid or insurance pursuant to the Children’s Health Insurance Program pursuant to a contract with the Division of Health Care Financing and Policy of the Department.
The term does not include the State Plan for Medicaid, the Children’s Health Insurance Program or a health maintenance organization, as defined in NRS 695C.030, or managed care organization, as defined in NRS 695G.050, when providing health care services through managed care to recipients of Medicaid under the State Plan for Medicaid or insurance pursuant to the Children’s Health Insurance Program pursuant to a contract with the Division of Health Care Financing and Policy of the Department.
- *SB420_R1* – 37 – (a) Shall proceed with any efforts to collect on any amount owed to the hospital for the hospital care in accordance with the provisions of NRS 449A.159.
(a) Shall proceed with any efforts to collect on any amount owed to the hospital for the hospital care in accordance with the pro(b) Shall not collect or attempt to collect from the patient or other responsible party more than the sum of the amounts of any deductible, copayment or coinsurance payable by or on behalf of the patient under the policy of health insurance.
(b) Shall not collect or attempt to collect from the patient or other responsible party more than the sum of the amounts of any deductible, copayment or coinsurance payable by or on behalf of the patient under the policy of health insurance.
If the hospital collects or receives any payments from an insurer that provides coverage for medical payments under a policy of casualty insurance, the hospital shall, not later than 30 days after a determination is made concerning coverage, return to the patient any amount collected or received that is in excess of the deductible, copayment or coinsurance payable by or on behalf of the patient under the policy of health insurance.
If the hospital collects or receives any payments from an insurer that provides coverage for medical payments under a policy of casualty insurance, the hospital shall, not later than 30 days after a determination is made concerning coverage, return to the patient any amount collected or received that is in excess of the deductible, under the policy of health insurance.r on behalf of the patient 3.
3.
4.
- 81st Session (2021) – 42 – 4.
This section does not limit any rights of a patient to contest an attempt to collect an amount owed to a hospital, including, without limitation, contesting a lien obtained by a hospital.
This section does not limit any rights of a patient to contest an attempt to collect an amount owed to a hospital, including, wit5.ut As used in this section, “third party” means:ospital.
5.
As used in this section, “third party” means:
- *SB420_R1* – 38 – Sec.
Sec.
(a) Shall make the Public Option available to all natural persons who reside in this State as a policy of individual health insurance through the Exchange and for direct purchase.
(a) Shall make the Public Option available:
The provisions of chapter 689A of NRS and other applicable provisions of title 57 of NRS apply to the Public Option when offered as a policy of individual health insurance.
(1) As a qualified health plan through the Exchange to natural persons who reside in this State and are eligible to enroll in such a plan through the Exchange under the provisions of 45 C.F.R.
(b) May make the Public Option available to small employers in this State or their employees to the extent authorized by federal law.
§ 155.305;
The provisions of chapter 689C of NRS and other applicable provisions of title 57 of NRS apply to the Public Option when it is offered as a policy of health insurance for small employers.
and (2) For direct purchase as a policy of individual health insurance by any natural person who resides in this State.
(c) Shall comply with all state and federal laws and regulations applicable to insurers when carrying out the provisions of sections 2 to 15, inclusive, of this act, to the extent that such laws and regulations are not waived.
The provisions of chapter 689A of NRS and other applicable provisions of this title apply to the Public Option when offered as a policy of individual health insurance.
3.
(b) May make the Public Option available to small authorized by federal law.
The Public Option must:
The provisions of chapter 689C of NRS and other applicable provisions of this title apply to the Public Option when it is offered as a policy of health insurance for small employers.
(c) Shall comply with all state and federal laws and regulations applicable to insurers when carrying out the - 81st Session (2021) – 43 – provisions of sections 2 to 15, inclusive, of this act, to the extent that such laws and regulations are not waived.
The Director, in consultation with the Commissioner and the Executive Director of the Exchange, may revise the requirements of subsection 4, provided that the average premiums for the Public Option must decrease by at least 15 percent over the first 4 years in which the Public Option is in operation.
The Director, in consultation with the Commissioner and the Executive Director of the Exchange, may revise the requirements of subsection 4, provided that the average premiums for the Public Option must be at least 15 percent the first 4 years in which the Public Option is in operation.
- *SB420_R1* – 39 – (a) “Gold plan” means a qualified health plan that meets the requirements established by 42 U.S.C.
(a) “Gold plan” means a qualified health plan that meets the requirements established by 42 U.S.C.
(1) The premium for the second-lowest cost silver level plan available through the Exchange in the zip code during the 2024 plan year, adjusted by the percentage change in the Medicare Economic Index between January 1, 2024, and January 1 of the year to which a premium applies;
(1) The premium for the second-lowest cost silver level plan available through the Exchange in the zip code in the Medicare Economic Index between January 1, 2024,hange and January 1 of the year to which a premium applies;
(e) “Silver plan” means a qualified health plan that meets the requirements established by 42 U.S.C.
- 81st Session (2021) – 44 – (e) “Silver plan” means a qualified health plan that meets the requirements established by 42 U.S.C.
39.
38.3.
The Director of the Department of Health and Human Services, the Commissioner of Insurance and the Executive Director of the Silver State Health Insurance Exchange shall apply for the waiver described in paragraph (a) of subsection 1 of section 11 of this act not later than January 1, 2024;
There is hereby appropriated from the State the Department of Health and Human Services the sum of $167,850 of to pay the costs for enhancements to the information technology system of the Division that are necessary to carry out the provisions of sections 24 to 28, inclusive, of this act.
and 2.
2.
The Director of the Department of Health and Human Services shall make the Public Option available to natural persons who reside in this State in accordance with the provisions of section 10 of this act for the coverage year that begins on January 1, 2026.
Any remaining balance of the appropriation made by subsection 1 must not be committed for expenditure after June 30, 2023, by the entity to which the appropriation is made or any entity to which money from the appropriation is granted or otherwise transferred in any manner, and any portion of the appropriated money remaining must not be spent for any purpose after September 15, 2023, by either the entity to which the money was appropriated or the entity to which the money was subsequently granted or transferred, and must be reverted to the State General Fund on or before September 15, 2023.
39.5.
38.6.
On or before January 1, 2025, the Executive Director of the Silver State Health Insurance Exchange, in collaboration with the Department of Health and Human Services, shall:
There is hereby appropriated from the State General Fund to the Public Option Trust Fund created by section 15 of this act the sum of $1,639,366 to pay the costs of carrying out the provisions of sections 2 to 15, inclusive, and 39 of this act.
2.
Any remaining balance of the appropriation made by subsection 1 must not be committed for expenditure after June 30, 2023, by the entity to which the appropriation is made or any entity to which money from the appropriation is granted or otherwise money remaining must not be spent for any purpose afterpriated September 15, 2023, by either the entity to which the money was appropriated or the entity to which the money was subsequently granted or transferred, and must be reverted to the State General Fund on or before September 15, 2023.
Sec.
38.8.
1.
There is hereby appropriated from the State General Fund to the Silver State Health Insurance Exchange the sum of $600,000 to pay the costs of carrying out the provisions of sections 2 to 15, inclusive, and 39 of this act.
2.
Any remaining balance of the appropriation made by subsection 1 must not be committed for expenditure after June 30, 2023, by the entity to which the appropriation is made or any entity to which money from the appropriation is granted or otherwise - 81st Session (2021) – 45 – transferred in any manner, and any portion of the appropriated money remaining must not be spent for any purpose after appropriated or the entity to which the money was subsequentlys granted or transferred, and must be reverted to the State General Fund on or before September 15, 2023.
Sec.
39.
1.
The Director of the Department of Health and Human Services, the Commissioner of Insurance and the Executive Director of the Silver State Health Insurance Exchange shall apply for the waiver described in paragraph (a) of subsection 1 of section of this act not later than January 1, 2024.
2.
In preparing the initial application for the waiver described in paragraph (a) of subsection 1 of section 11 of this act, the Director of the Department of Health and Human Services, the Commissioner of Insurance and the Executive Director of the Silver State Health Insurance Exchange shall contract with an independent actuary to conduct an actuarial assessment pursuant to subsection 2 of section 11 of this act.
The actuarial assessment:
submitted;
and completed before the application for the waiver is (b) Must include, without limitation, an analysis of the likely effect on premiums for health insurance in this State of:
(1) The provisions of subsection 1 of section 13 of this act, as those provisions apply to providers of health care, as defined in NRS 695G.070, who participate in the Public Employees’ Benefits Program established pursuant to subsection 1 of NRS 287.043 or provide care to an injured employee pursuant to the provisions of chapters 616A to 616D, inclusive, or chapter 617 of NRS, and the amendatory provisions of section 21 of this act;
and (2) Repealing the provisions described in subparagraph (1).
3.
The Director of the Department of Health and Human Services shall make the Public Option available to natural persons who reside in this State in accordance with the provisions of section of this act for the coverage year that begins on January 1, 2026.
4.
As used in this section, “Public Option” has the meaning ascSec.
39.5.t iOn or before January 1, 2025, the Executive Director of the Silver State Health Insurance Exchange, in collaboration with the Department of Health and Human Services, shall:
1.
and 2.
and - 81st Session (2021) – 46 – 2.
- *SB420_R1* – 40 – (a) Authorize an organization described in section 501(c)(5) of the Internal Revenue Code to offer a policy of insurance described in subsection 1 of section 16.5 of this act for direct purchase outside the Exchange as a policy of individual health insurance;
(a) Authorize an organization described in section 501(c)(5) of the Internal Revenue Code to offer a policy of insurance described in subsection 1 of section 16.5 of this act for direct purchase outside the Exchange as a policy of individual health insurance;
40.5.
The provisions of NRS 354.599 do not apply to any additional expenses of a local government that are related to the provisions of this act.
Sec.
This section and sections 16.3, 16.5, 16.8, 39, 39.5 and 40 become effective upon passage and approval.
This section and sections 16.3, 16.5, 16.8 and 39 to 40.5, inclusive, of this act become effective upon passage and approval.
Sections 1 to 16, inclusive, 17, 19 to 22, inclusive, and 29 to 37, inclusive, of this act become effective:
Sections 1 to 14, inclusive, 16, 19, 20, 21, 22, 29 to 32, inclusive, and 34 to 37, inclusive, of this act become effective:
Sections 18, 23 and 25 to 28, inclusive, of this act become effective on July 1, 2021.
Sections 15, 16.35 to 16.47, inclusive, 20.5, 38.3 and 38.6 of this act become effective on July 1, 2021.
Section 24 of this act becomes effective on July 1, 2022.
Sections 17, 18, 23 to 28, inclusive, 33 and 38.8 of this act become effective on January 1, 2022.
H - *SB420_R1*
~~~~~ 21 - 81st Session (2021)
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Amendments

3 amendments

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Action History

  1. Chapter 537.

  2. Approved by the Governor. Chapter 537.

  3. Enrolled and delivered to Governor.

  4. In Senate. Assembly Amendment No. 833 concurred in. To enrollment.

  5. From committee: Amend, and do pass as amended. Declared an emergency measure under the Constitution. Read third time. Amended. (Amend. No. 833.) Dispensed with reprinting. Read third time. Passed, as amended. Title approved, as amended. (Yeas: 26, Nays: 15, Excused: 1.) To printer. From printer. To reengrossment. Reengrossed. Third reprint. To Senate.

  6. In Assembly. Read first time. Referred to Committee on Ways and Means. To committee.

  7. From committee: Amend, and do pass as amended. Placed on General File. Read third time. Amended. (Amend. No. 752.) Reprinting dispensed with. Read third time. Passed, as amended. Title approved, as amended. (Yeas: 12, Nays: 9.) To printer. From printer. To re-engrossment. Re-engrossed. Second reprint. To Assembly.

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

  9. From committee: Amend, and do pass as amended. Placed on Second Reading File. Read second time. Amended. (Amend. No. 519.) Taken from General File. Re-referred to Committee on Finance. To printer.

  10. From printer. To committee.

  11. Read first time. Referred to Committee on Health and Human Services. To printer. Waiver granted effective: April 28, 2021.

Sponsors

Sponsorship breakdown

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6 sponsors · 7 co-sponsors · 54 not signed on

Sponsors (6)

Co-sponsors (7)

Not signed on (54)

54 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

healthcare health-insurance
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Frequently asked questions

Who sponsors SB 420?
SB 420 is sponsored by Cannizzaro, Nicole J. (Democratic), Doñate, Fabian (Democratic), Lange, Roberta (Democratic), Moises Denis, Dondero Loop, Marilyn (Democratic), Ohrenschall, James (Democratic), Scheible, Melanie (Democratic), Julia Ratti, Harris, Dallas, Chris Brooks, Jason Frierson, Teresa Benitez-Thompson, and Pat Spearman.
What is the current status of SB 420?
This bill has been enacted into law. Introduced April 28, 2021. Enacted.
Where can I track SB 420?
Track SB 420 free on One Click Politics — get push/email alerts when it moves.

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