Nevada 2021 Regular Session Status: Enacted 2 D cosponsors

SB 329 — Revises provisions relating to competition in health care markets. (BDR 40-998)

Last action — Chapter 528.

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  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 March 22, 2021. Enacted.

Prognosis

Advancing 54% · moderate confidence

Where this bill stands today.

Odds of enactment

High

How often bills like it became law.

  • Enacted

    Current position in the legislative process.

  • 2 sponsors

    2 primary, 0 co-sponsors signed on.

  • Single-party support

    Sponsorship is currently within one party (2 D).

Prognosis reads this bill's own signals — stage, sponsorship breadth, committee status, recorded votes and cross-state momentum. Odds come from a model trained on which bills have become law.

Bill Text

What changed in the latest version

506 added · 528 removed

506 line(s) added, 528 removed.

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(Reprinted with amendments adopted on April 20, 2021) FIRST REPRINT S.B.
Senate Bill No.
329 SENATE BILL N O.
329–Senators Lange and Donate CHAPTER..........
329–SENATORS LANGE AND D ONATE M ARCH 22, 2021 ____________ Referred to Committee on Health and Human Services SUMMARY—Revises provisions relating to competition in health care markets.
(BDR 40-998) FISCAL NOTE:
Effect on Local Government:
May have Fiscal Impact.
Effect on the State:
Yes.
~ EXPLANATION – Matter in bolded italics is new;
matter between brackets [omitted material] is material to be omitted.
requiring a hospital or physician group practice to notify the Department of Health and Human Services of certain transactions;
requiring a hospital or physician group practice, or a person who owns all or substantially all of a physician group practice, to notify the Department of Health and Human Services of certain transactions;
prohibiting a provider of health care from entering into a contract that contains certain provisions;
prohibiting a provider of health care from willfully entering into a contract that contains certain provisions;
Legislative Counsel’s Digest:
LegiExisting law provides that the Department of Health and Human Services is the agency of this State for health planning and development.
Existing law provides that the Department of Health and Human Services is the 1 of this bill requires a hospital to notify the Department of any merger, acquisition or similar transaction involving the hospital.
(NRS 439A.081) Section of this bill requires a hospital to notify the Department of any merger, acquisition or similar transaction involving the hospital.
Section 1 additionally requires a physician group practice to report certain similar transactions involving the physician group practice if:
Section 1 additionally requires a physician group practice or a person who owns all or substantially all of a physician group practice to report certain similar transactions if:
(1) the physician group practices that are parties to the transaction represent at least 20 percent of the physicians who practice any specialty in a primary service area;
(1) the physician group practices that are parties to the transaction or owned by parties to the transaction represent at least 20 percent of the physicians who practice any specialty in a number of physicians of any physician group practice that is a party to theargest transaction or owned by a party to the transaction.
and (2) the physician group practice represents the transaction.
Section 1 requires the Department to post the information contained in those notices on the Internet and publish an annual report based on that information.
Section 1 requires the Department to post the information party to contained in those notices on the Internet and publish an annual report based on that information.
(NRS 598A.060) Section 20.9 of this bill prohibits a provider of health care, including a facility that provides health care, from entering into, offering to enter into or soliciting a contract that:
(NRS 598A.060) Section 20.9 of this bill prohibits a provider of health care, including a facility that provides health care, from willfully entering into, willfully offering to enter into or willfully soliciting a contract that:
(1) health care or placing providers of health care in tiers;
(1) prohibits a third party insurer from steering covered tiers;
or (2) that places certainf other restrictions on the third party insurer.
or (2) that places certain other restrictions on the third party insurer.
The Attorney General or a person injured by a violation of section 20.9 would be authorized to bring a civil action - *SB329_R1* – 2 – against a provider of health care who commits such a violation.
The Attorney General or a person injured by a violation of section 20.9 would be authorized to bring a civil action against a provider of health care who commits such a violation.
(NRS 598A.160, 598A.180-598A.210) Additionally, a provider of health care or third party insurer who commits such a violation would be subject to a civil penalty and guilty of a catExisting law requires certain business entities that have had a total of five or more investigations commenced against the entity for unfair trade practices which resulted in the imposition of certain penalties or other requirements during a 5-year period to submit to the Secretary of State:
(NRS 598A.160, 598A.180-598A.210) Sections 20.9 and 20.95 of this bill also make such a violation a misdemeanor.
Additionally, a provider of health care or third party insurer who commits such a violation would be subject to a civil penalty.
(NRS 598A.170) more investigations commenced against the entity for unfair trade practices which or resulted in the imposition of certain penalties or other requirements during a 5-year period to submit to the Secretary of State:
Existing law requires the Attorney General to use that 86.264, 86.5462, 87A.295, 87A.565, 88.397, 88.5915) Sections 20.1-20.8 of this115, bill authorize the Attorney General to use those fees to investigate contracting practices prohibited by section 20.9.
Existing law requires the Attorney General to use that fee for the purposes of investigating unfair trade practices.
(NRS 78.153, 80.115, 86.264, 86.5462, 87A.295, 87A.565, 88.397, 88.5915) Sections 20.1-20.8 of this bill authorize the Attorney General to use those fees to investigate contracting practices prohibited by section 20.9.
- 81st Session (2021) – 2 – EXPLANATION – Matter in bolded italics is new;
matter between brackets [omitted material] is material to be omitted.
A physician group practice shall notify the Department of a transaction described in subsection 3 to which the physician group practice is a party or any contract for the management of a physician group practice not later than 60 days after the finalization of the transaction or execution of the contract for management, as applicable, if:
A physician group practice or a person who owns all or substantially all of a physician group practice shall notify the Department of a transaction described in subsection 3 to which the contract for the management of the physician group practice notr any later than 60 days after the finalization of the transaction or execution of the contract for management, as applicable, if:
(a) The physician group practices that are parties to the transaction or contract for management represent at least 20 percent of the physicians who practice any specialty in a primary service area;
(a) The physician group practices that are parties to the transaction or contract for management or that are owned by those parties represent at least 20 percent of the physicians who practice any specialty in a primary service area;
and (b) The physician group practice represents the largest number of physicians of any physician group practice that is a party to the transaction or contract for management.
and (b) The physician group practice represents the largest number of physicians of any physician group practice that is a party to or owned by a party to the transaction or contract for management.
Notice must be provided pursuant to subsection 1 or 2 for any:
Notice must be provided pursuant to subsection 2 for any:
(a) Merger of, consolidation of or other affiliation between physician group practices;
(a) Merger of, consolidation of or other affiliation between physician group practices, persons who own physician group practices or any combination thereof;
- *SB329_R1* – 3 – (d) The employment of all or substantially all of the physicians in a physician group practice;
(d) The employment of all or substantially all of the physicians in a physician group practice;
4.
the form prescribed by the Department and must include, withoutn limitation:
Notice pursuant to subsection 1 or 2 must be provided in the form prescribed by the Department and must include, without limitation:
- 81st Session (2021) – 3 – (a) The name of each party to the transaction or contract for management, as applicable;
(a) The name of each party to the transaction or contract for management, as applicable;
(b) A description of the nature of the proposed relationship of the parties to the transaction or contract for management, as app(c) The names and any specialties of each physician who is a party or employed by or affiliated with a physician group practice that is a party to or is owned by a party to the transaction or contract for management, as applicable;
(b) A description of the nature of the proposed relationship of the parties to the transaction or contract for management, as applicable;
(c) The names and any specialties of each physician who is a party or employed by or affiliated with a physician group practice that is a party to the transaction or contract for management, as applicable;
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(a) “Physician group practice” means any business entity organized for the purpose of the practice of medicine or osteopathic medicine by more than one physician.
(a) “Physician group practice” means any business entity organized for the purpose of the practice of medicine or ost(b) “Primary service area” means an area comprising the smallest number of zip codes from which the hospital or physician group practice draws at least 75 percent of patients.
(b) “Primary service area” means an area comprising the smallest number of zip codes from which the hospital or physician group practice draws at least 75 percent of patients.
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- 81st Session (2021) – 4 – 2.
(a) Holds 25 percent or more of the share of the market within this State for any product sold or distributed by the corporation within this State;
(a) Holds 25 percent or more of the share of the market within this State for any product sold or distributed by the corporation wit(b) Has had, during the previous 5-year period, a total of five or more investigations commenced against the corporation, its parent or its subsidiaries in any jurisdiction within the United States, including all state and federal investigations:
and (b) Has had, during the previous 5-year period, a total of five or more investigations commenced against the corporation, its parent or its subsidiaries in any jurisdiction within the United States, including all state and federal investigations:
- *SB329_R1* – 5 – (c) If the investigation resulted in criminal or civil litigation, a copy of all pleadings filed in the investigation by any party to the litigation.
(c) If the investigation resulted in criminal or civil litigation, a copy of all pleadings filed in the investigation by any party to the litigation.
(d) A summary of the outcome of the investigation, including specific information concerning whether any fine or penalty was imposed against the corporation and whether the corporation was required to divest any holdings or was unable to acquire any holdings as a condition for the settlement, dismissal or resolution of the investigation.
specific information concerning whether any fine or penalty was imposed against the corporation and whether the corporation was required to divest any holdings or was unable to acquire any holdings as a condition for the settlement, dismissal or resolution of the investigation.
(a) The statement required pursuant to subsection 3, accompanied by a declaration under penalty of perjury attesting that the statement does not contain any material misrepresentation of fact;
- 81st Session (2021) – 5 – (a) The statement required pursuant to subsection 3, accompanied by a declaration under penalty of perjury attesting that the statement does not contain any material misrepresentation of fact;
and (b) A fee of $100,000, to be distributed in the manner provided pursuant to subsection 4.
and pursuant to subsection 4.
2.
to be distributed in the manner provided 2.
- *SB329_R1* – 6 – 3.
3.
(a) The jurisdiction in which the investigation was commenced.
The fee collected pursuant to subsection 1 must be deposited in the Attorney General’s Administration Budget Account and used solely for the purpose of investigating any alleged contract, combination or conspiracy in restraint of trade, as described in subsection 1 of NRS 598A.060 [.] and subsection 1 of section 20.9 of this act.
The fee collected pursuant to subsection 1 must be deposited in the Attorney General’s Administration Budget Account and used solely for the purpose of investigating any alleged contract, combination or conspiracy in restraint of trade, as described in - 81st Session (2021) – 6 – subsection 1 of NRS 598A.060 [.] and subsection 1 of section 20.9 of this act.
At the time of submitting any list required pursuant to NRS 86.263, a limited-liability company that meets the criteria set forth in subsection 2 must submit:
At the time of submitting any list required pursuant set forth in subsection 2 must submit:pany that meets the criteria (a) The statement required pursuant to subsection 3, accompanied by a declaration under penalty of perjury attesting that the statement does not contain any material misrepresentation of fact;
(a) The statement required pursuant to subsection 3, accompanied by a declaration under penalty of perjury attesting that the statement does not contain any material misrepresentation of fact;
and - *SB329_R1* – 7 – (2) Which resulted in the limited-liability company being fined or otherwise penalized or which resulted in the limited- liability company being required to divest any holdings or being unable to acquire any holdings as a condition for the settlement, dismissal or resolution of those investigations.
and (2) Which resulted in the limited-liability company being liability company being required to divest any holdings or being unable to acquire any holdings as a condition for the settlement, dismissal or resolution of those investigations.
(d) A summary of the outcome of the investigation, including specific information concerning whether any fine or penalty was imposed against the limited-liability company and whether the limited-liability company was required to divest any holdings or was unable to acquire any holdings as a condition for the settlement, dismissal or resolution of the investigation.
(d) A summary of the outcome of the investigation, including specific information concerning whether any fine or penalty was imposed against the limited-liability company and whether the - 81st Session (2021) – 7 – limited-liability company was required to divest any holdings or was unable to acquire any holdings as a condition for the settlement, dismissal or resolution of the investigation.
The fee collected pursuant to subsection 1 must be deposited in the Attorney General’s Administration Budget Account and used solely for the purpose of investigating any alleged contract, combination or conspiracy in restraint of trade, as described in subsection 1 of NRS 598A.060 [.] and subsection 1 of section 20.9 of this act.
The fee collected pursuant to subsection 1 must be deposited solely for the purpose of investigating any alleged contract,sed combination or conspiracy in restraint of trade, as described in subsection 1 of NRS 598A.060 [.] and subsection 1 of section 20.9 of this act.
and (b) Has had, during the previous 5-year period, a total of five or more investigations commenced against the foreign limited-liability - *SB329_R1* – 8 – company, its parent or its subsidiaries in any jurisdiction within the United States, including all state and federal investigations:
and (b) Has had, during the previous 5-year period, a total of five or more investigations commenced against the foreign limited-liability United States, including all state and federal investigations:thin the (1) Which concern any alleged contract, combination or conspiracy in restraint of trade, as described in subsection 1 of NRS 598A.060, or which concern similar activities prohibited by a substantially similar law of another jurisdiction;
(1) Which concern any alleged contract, combination or conspiracy in restraint of trade, as described in subsection 1 of NRS 598A.060, or which concern similar activities prohibited by a substantially similar law of another jurisdiction;
(b) A summary of the nature of the investigation and the facts and circumstances surrounding the investigation.
- 81st Session (2021) – 8 – (b) A summary of the nature of the investigation and the facts and circumstances surrounding the investigation.
(c) If the investigation resulted in criminal or civil litigation, a copy of all pleadings filed in the investigation by any party to the litigation.
(c) If the investigation resulted in criminal or civil litigation, a copy of all pleadings filed in the investigation by any party to the lit(d) A summary of the outcome of the investigation, including specific information concerning whether any fine or penalty was imposed against the foreign limited-liability company and whether the foreign limited-liability company was required to divest any holdings or was unable to acquire any holdings as a condition for the settlement, dismissal or resolution of the investigation.
(d) A summary of the outcome of the investigation, including specific information concerning whether any fine or penalty was imposed against the foreign limited-liability company and whether the foreign limited-liability company was required to divest any holdings or was unable to acquire any holdings as a condition for the settlement, dismissal or resolution of the investigation.
and (b) A fee of $100,000, to be distributed in the manner provided pursuant to subsection 4.
and (b) A fee of $100,000, to be distributed in the manner provided pur2.antA limited partnership must submit a statement pursuant to this section if the limited partnership, including its parent and all subsidiaries:
- *SB329_R1* – 9 – 2.
A limited partnership must submit a statement pursuant to this section if the limited partnership, including its parent and all subsidiaries:
and (2) Which resulted in the limited partnership being fined or otherwise penalized or which resulted in the limited partnership being required to divest any holdings or being unable to acquire any holdings as a condition for the settlement, dismissal or resolution of those investigations.
and - 81st Session (2021) – 9 – (2) Which resulted in the limited partnership being fined or otherwise penalized or which resulted in the limited partnership being required to divest any holdings or being unable to acquire any holdings as a condition for the settlement, dismissal or resolution of tho3.
3.
inA limited partnership that meets the criteria set forth in subsection 2 shall submit a statement which includes the following information with respect to each investigation:
A limited partnership that meets the criteria set forth in subsection 2 shall submit a statement which includes the following information with respect to each investigation:
NRS 87A.565 is hereby amended to read as follows:
NRS 87A.565 is hereby amended to read as fol87A.565 1.
87A.565 1.
- *SB329_R1* – 10 – (a) The statement required pursuant to subsection 3, accompanied by a declaration under penalty of perjury attesting that the statement does not contain any material misrepresentation of fact;
(a) The statement required pursuant to subsection 3, accompanied by a declaration under penalty of perjury attesting that the statement does not contain any material misrepresentation of fact;
and (b) Has had, during the previous 5-year period, a total of five or more investigations commenced against the foreign limited partnership, its parent or its subsidiaries in any jurisdiction within the United States, including all state and federal investigations:
and - 81st Session (2021) – 10 – (b) Has had, during the previous 5-year period, a total of five or more investigations commenced against the foreign limited partnership, its parent or its subsidiaries in any jurisdiction within the United States, including all state and federal investigations:
(1) Which concern any alleged contract, combination or conspiracy in restraint of trade, as described in subsection 1 of NRS 598A.060, or which concern similar activities prohibited by a substantially similar law of another jurisdiction;
conspiracy in restraint of trade, as described in subsection 1 of NRS 598A.060, or which concern similar activities prohibited by a substantially similar law of another jurisdiction;
(d) A summary of the outcome of the investigation, including specific information concerning whether any fine or penalty was imposed against the foreign limited partnership and whether the foreign limited partnership was required to divest any holdings or was unable to acquire any holdings as a condition for the settlement, dismissal or resolution of the investigation.
(d) A summary of the outcome of the investigation, including specific information concerning whether any fine or penalty was imposed against the foreign limited partnership and whether the foreign limited partnership was required to divest any holdings or was unable to acquire any holdings as a condition for the settlement, dis4.
4.
The fee collected pursuant to subsection 1 must be deposited in the Attorney General’s Administration Budget Account and used solely for the purpose of investigating any alleged contract, combination or conspiracy in restraint of trade, as described in subsection 1 of NRS 598A.060 [.] and subsection 1 of section 20.9 of this act.
The fee collected pursuant to subsection 1 must be deposited in the Attorney General’s Administration Budget Account and used solely for the purpose of investigating any alleged contract, combination or conspiracy in restraint of trade, as described in - *SB329_R1* – 11 – subsection 1 of NRS 598A.060 [.] and subsection 1 of section 20.9 of this act.
and (b) A fee of $100,000, to be distributed in the manner provided pursuant to subsection 4.
and - 81st Session (2021) – 11 – pursuant to subsection 4.
2.
to be distributed in the manner provided 2.
and (2) Which resulted in the limited partnership being fined or otherwise penalized or which resulted in the limited partnership being required to divest any holdings or being unable to acquire any holdings as a condition for the settlement, dismissal or resolution of those investigations.
and (2) Which resulted in the limited partnership being fined or being required to divest any holdings or being unable to acquire any holdings as a condition for the settlement, dismissal or resolution of those investigations.
(d) A summary of the outcome of the investigation, including specific information concerning whether any fine or penalty was imposed against the limited partnership and whether the limited partnership was required to divest any holdings or was unable to - *SB329_R1* – 12 – acquire any holdings as a condition for the settlement, dismissal or resolution of the investigation.
(d) A summary of the outcome of the investigation, including specific information concerning whether any fine or penalty was imposed against the limited partnership and whether the limited acquire any holdings as a condition for the settlement, dismissal or resolution of the investigation.
Sec.
- 81st Session (2021) – 12 – Sec.
(a) The statement required pursuant to subsection 3, accompanied by a declaration under penalty of perjury attesting that the statement does not contain any material misrepresentation of fact;
accompanied by a declaration under penalty of perjury attesting that 3, the statement does not contain any material misrepresentation of fact;
and (2) Which resulted in the foreign limited partnership being fined or otherwise penalized or which resulted in the foreign limited partnership being required to divest any holdings or being unable to acquire any holdings as a condition for the settlement, dismissal or resolution of those investigations.
and (2) Which resulted in the foreign limited partnership being fined or otherwise penalized or which resulted in the foreign limited partnership being required to divest any holdings or being unable to resolution of those investigations.
3.
for the settlement, dismissal or 3.
- *SB329_R1* – 13 – (c) If the investigation resulted in criminal or civil litigation, a copy of all pleadings filed in the investigation by any party to the litigation.
(c) If the investigation resulted in criminal or civil litigation, a copy of all pleadings filed in the investigation by any party to the litigation.
(d) A summary of the outcome of the investigation, including specific information concerning whether any fine or penalty was imposed against the foreign limited partnership and whether the foreign limited partnership was required to divest any holdings or was unable to acquire any holdings as a condition for the settlement, dismissal or resolution of the investigation.
(d) A summary of the outcome of the investigation, including specific information concerning whether any fine or penalty was imposed against the foreign limited partnership and whether the foreign limited partnership was required to divest any holdings or - 81st Session (2021) – 13 – was unable to acquire any holdings as a condition for the settlement, dismissal or resolution of the investigation.
The fee collected pursuant to subsection 1 must be deposited in the Attorney General’s Administration Budget Account and used solely for the purpose of investigating any alleged contract, combination or conspiracy in restraint of trade, as described in subsection 1 of NRS 598A.060 [.] and subsection 1 of section 20.9 of this act.
The fee collected pursuant to subsection 1 must be deposited in the Attorney General’s Administration Budget Account and used combination or conspiracy in restraint of trade, as described in subsection 1 of NRS 598A.060 [.] and subsection 1 of section 20.9 of this act.
A provider of health care shall not enter into, offer to enter into or solicit a contract with a third party that directly or indirectly:
A provider of health care shall not willfully enter into, willfully offer to enter into or willfully solicit a contract with a third party that directly or indirectly:
or (e) Prohibits the third party from contracting with a provider of health care that is not a party to the contract or penalizes the third party for entering into such a contract.
or (e) Prohibits the third party from contracting with a provider third party for entering into such a contract.ract or penalizes the 2.
2.
Any provision of a contract that violates the provisions of subsection 1 is void and severable from the contract.
The provisions of this section do not authorize a third party to subcontract for the performance of obligations under a contract with a provider of health care or delegate such obligations in a manner that is inconsistent with the terms of the contract.
Any provision of a contract that is described in paragraphs (a) to (e), inclusive, of subsection 1 is void and severable from the contract.
5.
Any person who conspires to, or does, violate any of the provisions of this section is guilty of a misdemeanor.
6.
(a) “Covered person” means a policyholder, subscriber, enrollee or other person covered by a third party.
- 81st Session (2021) – 14 – (a) “Affiliated” means any entity or person who directly, or indirectly through one or more intermediaries, controls or is controlled by or is under common control with a specified entity or person.
(b) “Provider of health care” means:
(b) “Covered person” means a policyholder, subscriber, enrollee or other person covered by a third party.
- *SB329_R1* – 14 – (1) A physician or other health care practitioner who is licensed or otherwise authorized in this State to furnish any health care service;
(c) “Provider of health care” means:
(1) A physician or other health care practitioner who is licensed or otherwise authorized in this State to furnish any health care service;
(c) “Third party” means any insurer, governmental entity or other organization providing health coverage or benefits in accordance with state or federal law.
(d) “Third party” means any insurer, governmental entity or other organization providing health coverage or benefits in accordance with state or federal law.
20.95.
NRS 598A.280 is hereby amended to read as follows:
598A.280 [A] Except as otherwise provided in section 20.9 of this act, a person who conspires to, or does, violate any of the provisions of this chapter is guilty of a category D felony and shall be punished as provided in NRS 193.130.
Sec.
H - *SB329_R1*
~~~~~ 21 - 81st Session (2021)
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Amendments

2 amendments

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Action History

  1. Chapter 528.

  2. Approved by the Governor.

  3. Enrolled and delivered to Governor.

  4. In Senate. Assembly Amendment No. 614 concurred in. To enrollment.

  5. Read third time. Passed, as amended. Title approved, as amended. (Yeas: 26, Nays: 15, Absent: 1.) To Senate.

  6. Taken from General File. Placed on General File for next legislative day.

  7. From printer. To reengrossment. Reengrossed. Second reprint. Taken from General File. Placed on General File for next legislative day.

  8. From committee: Amend, and do pass as amended. Placed on Second Reading File. Read second time. Amended. (Amend. No. 614.) To printer.

  9. In Assembly. Read first time. Referred to Committee on Health and Human Services. To committee.

  10. From printer. To engrossment. Engrossed. First reprint. To Assembly.

  11. Read third time. Amended. (Amend. No. 447.) Reprinting dispensed with. Read third time. Passed, as amended. Title approved, as amended. (Yeas: 12, Nays: 9.) To printer.

  12. From committee: Amend, and do pass as amended. Placed on Second Reading File. Read second time.

  13. From printer. To committee.

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

Sponsors

Sponsorship breakdown

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2 sponsors · 0 co-sponsors · 65 not signed on

Sponsors (2)

Co-sponsors (0)

None.

Not signed on (65)

65 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 329?
SB 329 is sponsored by Lange, Roberta (Democratic) and Doñate, Fabian (Democratic).
What is the current status of SB 329?
This bill has been enacted into law. Introduced March 22, 2021. Enacted.
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