Amendment vs bill Amendment 723 vs Enrolled

Struck = removed from the bill · added = the amendment's new text.

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Senate Bill No.
Session (81st) A SB40 R1 723 Amendment No.
40–Committee on Health and Human Services CHAPTER..........
723 Senate Amendment to Senate Bill No.
40 First Reprint (BDR 40-415) Proposed by:
Senate Committee on Finance Amends:
Summary:
No Title:
Yes Preamble:
No Joint Sponsorship:
No Digest:
Yes Adoption of this amendment will ADD an appropriation where one does not currently exist in S.B.
40 R1.
ASSEMBLY ACTION Initial and Dat| SENATE ACTION Initial and Date Adopted Lost | Adopted Lost Concurred In Not | Concurred In Not Receded Not | Receded Not EXPLANATION:
Matter in (1) blue bold italics is new language in the original bill;
(2) variations of green bold underlining is language proposed to be added in this amendment;
(3) red strikethrough is deleted language in the original bill;
(4) purple double strikethrough is language proposed to be deleted in this amendment;
(5) orange double underlining is deleted language in the original bill proposed to be retained in this amendment.
TPG/EGO - Date:
5/21/2021 S.B.
No.
40—Provides for the collection of certain data relating to health care.
(BDR 40-415) Page 1 of 16 *A_SB40_R1_723* Senate Amendment No.
723 to Senate Bill No.
40 First Reprint Page 3 SENATE B ILLN O.
40–COMMITTEE ON H EALTH AND HUMAN S ERVICES (O NB EHALF OF THE PATIENT PROTECTION C OMMISSION ) PREFILED N OVEMBER 18,2020 _______________ Referred to Committee on Health and Human Services SUMMARY—Provides for the collection of certain data relating to health care.
(BDR 40-415) 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 the Department of Health and Human Services to establish an all-payer claims database containing information relating to health insurance claims for benefits provided in this State under certain circumstances;
requiring the Department of Health and Human Services to establish an all-payer claims database containing information relating to health insurance claims for benefits provided in this State [;] under certain circumstances;
Existing law creates the Patient Protection Commission, which is made up of requires the Commission to systematically review issues related to the health care needs of residents of this State and the quality, accessibility and affordability of health care.
Existing law creates the Patient Protection Commission, which is made up of certain stakeholders in the delivery of health care.
(NRS 439.908) Existing law requires the Commission to systematically review issues related to the health care needs of residents of this State and the quality, accessibility and affordability of health care.
and (2) prohibits the Executive any person or entity, including the Commission or a member thereof.
and (2) prohibits the Executive Director from disclosing confidential information Senate Amendment No.
(NRSagency to 439.914) Section 1 of this bill additionally authorizes the Commission to request not more than two reports each year concerning certain issues relating to health care from a state or local governmental entity.
723 to Senate Bill No.
Section 1 requires any governmental entity that receives such a request to submit the report to provide the report to the Executive Director of the Commission and a copy of the report to the Attorney disclosure of the information requested would not violate the Health Insurance Portability and Accountability Act of 1996, Public Law 104-191.
40 First Reprint Page 4 obtained from a state agency to any person or entity, including the Commission or a member thereof.
(NRS 439.914) Section 1 of this bill additionally authorizes the Commission to request not more than two reports each year concerning certain issues relating to health care from a state or local governmental entity.
Section 1 requires any governmental entity that receives such a request to submit the report to provide the report to the Executive Director of the Commission and a copy of the report to the Attorney General, to the extent that the entity violate the Health Insurance Portability and Accountability Act of 1996, Public Law 104-191.
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(NRS 439B.600-439B.695, 457.230- - 81st Session (2021) – 2 – 457.280) Section 9 of this bill requires, to the extent that federal money is available for this purpose, the Department of Health and Human Services to establish an all- payer claims database of information relating to health insurance claims resulting from medical, dental or pharmacy benefits provided in this State.
(NRS 439B.600-439B.695, 457.230-457.280) Section 9 of this bill requires , to the extent that federal money is available for this purpose, the Department of Health and Human Services to establish an all-payer claims database of information relating to health insurance claims resulting from medical, dental or pharmacy benefits provided in this State.
(1) requires the Department to adopt regulations to establish an advisory committee to the database, secure access to such data and the release of such data;
(1) requires the Department to adopt regulations to establish an advisory committee to make recommendations concerning the collection, analysis and reporting of data in the database, secure access to such data and the release of such data;
and (2) in authorizes the Department to establish an advisory committee to assist the Department in establishing and maintaining the database.
and (2) authorizes the Department to establish an advisory committee to assist the Department in establishing and maintaining the database.
Section 10 of this bill requires any public or private insurer that provides health benefits and is regulated under state law, with certain exceptions, to submit data to the database.
Section 10 of this bill requires any public or private insurer that data to the database.
Section 10 also authorizes certain insurers that are regulated under federal law to submit data to the database.
Section 10 also authorizes certain insurers that are regulated undermit federal law to submit data to the database.
and (2) requires the Department to release the information in the database to the Attorney General for purposes relating to unfair or deceptive trade data to certain governmental entities or an entity that submits information to theed database pursuant to section 10;
and (2) requires the Department to release the information in the database to the Attorney General for purposes relating to unfair or deceptive trade practices.
Section 13 authorizes the release from the database of:
(1) de- aggregated data to certain governmental entities or an entity that submits information to the database pursuant to section 10;
Section 13 also prohibits a person or entity to whom data is released from using or disclosing the data in a manner not specified in the request made by the person or entity.
Section in a manner not specified in the request made by the person or entity.
Section 13 requires any published document that contains or uses data from the database to contain certain information.
Section 13 requires anya published document that contains or uses data from the database to contain certain information.
Section 17 of this bill requires the Department to adopt regulations necessary for the establishment and maintenance penalties to be imposed against persons and entities that fail to comply withtive provisions of law or regulations governing the database.
Section 17 of this bill requires the Department to adopt regulations necessary for the establishment and maintenance of the database.
Section 17 authorizes the Department to use those administrative penalties to:
Section 17 requires such regulations to establish administrative penalties to be imposed against persons and entities that fail to the Department to use those administrative penalties to:
Section of this bill authorizes the use of administrative penalties collected for failure to comply with requirements to provide certain information relating to prescription drugs for similar purposes.
Section 18 of this bill authorizes the use of administrative penalties collected for failure to comply with requirements to provide certain information relating to prescription drugs for similar purposes.
Section 19.5 of this bill also authorizes the Commissioner of Insurance to refuse to continue, suspend, limit or revoke an - 81st Session (2021) – 3 – insurer’s certificate of authority for failure to comply with provisions of law or regulations governing the database.
Section 19.5 of this bill also authorizes the Commissioner of Insurance to refuse to continue, suspend, limit or revoke an insurer’s certificate of authority for failure to comply with provisions of law or regulations governing the database.
and the Division of Insurance of the Department of Business and Industry toices develop and submit to the Patient Protection Commission and the Legislature a report containing an inventory of certain types of data reported to the Department of Health and Human Services or the Division of Insurance of the Department of Business and Industry.
Senate Amendment No.
Financing and Policy of the Department of Health and Human Services for theth Care development of the all-payer claims database if the database is established pursuant to section 9.
723 to Senate Bill No.
EXPLANATION – Matter in bolded italics is new;
40 First Reprint Page 5 Division of Insurance of the Department of Business and Industry to develop and submit to the Patient Protection Commission and the Legislature a report containing an inventory of certain types of data reported to the Department of Health and Human Services or the Division of Insurance of the Department of Business and Industry.
matter between brackets [omitted material] is material to be omitted.
Section 19.7 of this bill makes an appropriation to the Division of Health Care Financing and Policy of the Department of Health and Human Services for the development of the all-payer claims database if the database is established pursuant to section 9.
THE SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:D IN Section 1.
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1.
(g) Reviewing the effect of any changes to Medicaid, including, without limitation, the expansion of Medicaid pursuant to the - 81st Session (2021) – 4 – Patient Protection and Affordable Care Act, Public Law 111-148, on the cost and availability of health care and health insurance in this State.
(g) Reviewing the effect of any changes to Medicaid, including, without limitation, the expansion of Medicaid pursuant to the Patient Protection and Affordable Care Act, Public Law 111-148, on the cost and availability of health care and health insurance in this State.
(h) Reviewing proposed and enacted legislation, regulations and State.changes to state and local policy related to health care in this (i) Researching possible changes to state or local policy in this State that may improve the quality, accessibility or affordability of health care in this State, including, without limitation:
(h) Reviewing proposed and enacted legislation, regulations and other changes to state and local policy related to health care in this State.
(i) Researching possible changes to state or local policy in this State that may improve the quality, accessibility or affordability of health care in this State, including, without limitation:
(5) Resolving problems relating to the billing of patients for medical services;
Senate Amendment No.
723 to Senate Bill No.
40 First Reprint Page 6 (5) Resolving problems relating to the billing of patients for medical services;
(j) Monitoring and evaluating proposed and enacted federal legislation and regulations and other proposed and actual changes to on the cost of health care in this State.he impact of such changes (k) Evaluating the degree to which the role, structure and duties of the Commission facilitate the oversight of the provision of health care in this State by the Commission and allow the Commission to perform activities necessary to promote the health care needs of residents of this State.
(j) Monitoring and evaluating proposed and enacted federal legislation and regulations and other proposed and actual changes to federal health care policy to determine the impact of such changes on the cost of health care in this State.
(k) Evaluating the degree to which the role, structure and duties of the Commission facilitate the oversight of the provision of health care in this State by the Commission and allow the Commission to perform activities necessary to promote the health care needs of residents of this State.
The Commission may request that any state or local governmental entity submit not more than two reports each year containing or analyzing information that is not confidential by law - 81st Session (2021) – 5 – concerning the cost of health care, consolidation among entities that provide or pay for health care or other issues related to access to health care.
The Commission may request that any state or local governmental entity submit not more than two reports each year containing or analyzing information that is not confidential by law concerning the cost of health care, consolidation among entities that provide or pay for health care or other issues related to access to health care.
To the extent that a governmental entity from which such a report is requested has the resources to compile the authorized by the Health Insurance Portability and Accountability Act of 1996, Public Law 104-191, the governmental entity shall provide the report to the Executive Director of the Commission and submit a copy of the report to the Attorney General.
To the extent that a governmental entity from which such a report is requested has the resources to compile the report and the disclosure of the information requested is authorized by the Health Insurance Portability and Accountability Act of 1996, Public Law 104-191, the governmental entity shall provide the report to the Executive Director of the Commission and submit a copy of the report to the Attorney General.
“Covered entity” has the meaning ascribed to it in C.F.R.
“Covered entity” has the meaning ascribed to it in 45 C.F.R.
“Direct patient identifier” means data that directly identifies a patient, including, without limitation, a name, telephone number, social security number, number associated electronic mail address.ealth plan beneficiary number or Sec.
“Direct patient identifier” means data that directly identifies a patient, including, without limitation, a name, telephone number, social security number, number associated with a medical record, health plan beneficiary number or electronic mail address.
Sec.
or 2.
or Senate Amendment No.
723 to Senate Bill No.
40 First Reprint Page 7 2.
“Unique identifier” means an identifier that is guaranteed to be unique for a patient and can be used to track - 81st Session (2021) – 6 – information relating to the patient but is not a direct patient identifier.
“Unique identifier” means an identifier that is guaranteed to be unique for a patient and can be used to track information relating to the patient but is not a direct patient identifier.
The Department shall, to the extent that federal money is available for this purpose, establish an all-payer claims resulting from medical, dental or pharmacy benefits provided in this State.
The Department shall , to the extent that federal money is available for this purpose, establish an all-payer claims database of information relating to health insurance claims resulting from medical, dental or pharmacy benefits provided in this State.
If the Department establishes an all-payer claims database pursuant to subsection 1, the Department shall:
[The] If the Department establishes an all-payer claims database pursuant to subsection 1, the Department shall:
If the Department establishes an all-payer claims database pursuant to subsection 1, the Department:
[The] If the Department [:] establishes an all-payer claims database pursuant to subsection 1, the Department:
(b) May adopt regulations to establish any other advisory committee if necessary to assist the Department in carrying out the pro4.sioThe membership of any advisory committee established pursuant to subsection 3 must include, without limitation, representatives of providers of health care, health facilities, health authorities, as defined in NRS 439.005, health maintenance organizations, private insurers, nonprofit organizations that represent consumers of health care services and each of the two entities that submit data concerning the largest number of claims to the database.
(b) May adopt regulations to establish any other advisory committee if necessary to assist the Department in carrying out the provisions of sections 3 to 17, inclusive, of this act.
4.
The membership of any advisory committee established pursuant to subsection 3 must include, without limitation, representatives of providers of health care, health facilities, health authorities, as defined in NRS 439.005, health maintenance organizations, private insurers, nonprofit organizations that represent consumers of health care services and each of the two entities that submit data concerning the largest number of claims to the database.
Except as otherwise provided in this section, each health carrier, governing body of a local governmental agency that provides health insurance through a self-insurance reserve fund pursuant to NRS 287.010 or entity required by the regulations adopted pursuant to section 17 of this act to submit data to the - 81st Session (2021) – 7 – database and the Public Employees’ Benefits Program shall submit to the all-payer claims database the data prescribed by the Department pursuant to section 17 of this act in the format prescribed by the Department pursuant to that section.
Except as otherwise provided in this section, each health carrier, governing body of a local governmental agency that provides health insurance through a self-insurance reserve fund pursuant to NRS 287.010 or entity required by the regulations adopted pursuant to section 17 of this act to submit data to the database and the Public Employees’ Benefits Program shall submit to the all-payer claims database the data prescribed by the Department pursuant to section 17 of this act in the format prescribed by the Department pursuant to that section.
The pro(a) An issuer of insurance that only provides limited-scope dental or vision benefits or coverage that is only for a specified disease or illness, with respect to such coverage;
The provisions of this subsection do not apply to:
(a) An issuer of insurance that only provides limited-scope dental or vision benefits or coverage that is only for a specified disease or illness, with respect to such coverage;
2.
Senate Amendment No.
723 to Senate Bill No.
40 First Reprint Page 8 2.
(a) “Health carrier” means an entity subject to the insurance the Commissioner of Insurance, that contracts or offers tosdiction of 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.
(a) “Health carrier” means an entity subject to the insurance laws and regulations of this State, or subject to the jurisdiction of the Commissioner of Insurance, 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.
Except as otherwise provided in subsection 3 and section 13 of this act, data contained in the all-payer claims database, if established pursuant to section 9 of this act, is confidential and is not a public record or subject to subpoena.
Except as otherwise provided in subsection 3 and section 13 of this act, data contained in the all-payer claims database , if established pursuant to section 9 of this act, is confidential and is not a public record or subject to subpoena.
- 81st Session (2021) – 8 – 2.
2.
The Department shall comply with the provisions of the Health Insurance Portability and Accountability Act of 1996, Public Law 104-191, and any regulations adopted pursuant thereto as if the Department were a covered entity maintaining with regard to the collection of data pursuant to section 10 of this act, the storage of data in the all-payer claims database and the procedures for releasing data from the all-payer claims database pursuant to section 13 of this act.
The Department shall comply with the provisions of the Health Insurance Portability and Accountability Act of 1996, Public Law 104-191, and any regulations adopted pursuant thereto as if the Department were a covered entity maintaining protected health information, as defined in 45 C.F.R.
§ 160.103, with regard to the collection of data pursuant to section 10 of this act, the storage of data in the all-payer claims database and the procedures for releasing data from the all-payer claims database pursuant to section 13 of this act.
To obtain data pursuant to subsection 3 of section of this act from the all-payer claims database, if established pursuant to section 9 of this act, a person or entity must submit a request to the Department.
To obtain data [from the all-payer claims database] pursuant to subsection 3 of section 13 of this act [,] from the all-payer claims database, if established pursuant to section 9 of this act, a person or entity must submit a request to the Department.
and (b) The names of any persons or entities to whom the applicant plans to disclose data from the all-payer claims database and the rea4.ns The measures that the requester plans to take to ensure the security of the data and prevent unauthorized use of the data in accordance with section 13 of this act and the regulations adopted pursuant to section 17 of this act;
and (b) The names of any persons or entities to whom the applicant plans to disclose data from the all-payer claims database and the reasons for the proposed disclosure;
and 5.
4.
The measures that the requester plans to take to ensure the security of the data and prevent unauthorized use of the data in accordance with section 13 of this act and the regulations adopted pursuant to section 17 of this act;
and Senate Amendment No.
723 to Senate Bill No.
40 First Reprint Page 9 5.
- 81st Session (2021) – 9 – 3.
3.
(a) In de-aggregated form with unique identifiers upon the of this act to:
(a) In de-aggregated form with unique identifiers upon the submission of a request that meets the requirements of section 12 of this act to:
request that meets the requirements of section 12 (1) A state or federal governmental entity, including, without limitation, a college or university within the Nevada System of Higher Education;
(1) A state or federal governmental entity, including, without limitation, a college or university within the Nevada System of Higher Education;
The Department shall not release data from the all-payer claims database in any form to any entity that is required or authorized to submit data to the all-payer claims database pursuant to section 10 of this act and fails to submit substantially complete data in accordance with the regulations adopted pursuant to section 17 of this act.
The Department shall not release data from the all-payer claims database in any form to any entity that is required or authorized to submit data to the all- payer claims database pursuant to section 10 of this act and fails to submit substantially complete data in accordance with the regulations adopted pursuant to section 17 of this act.
data is released pursuant to subsection 3 of the percentage ofhom residents of this State who have health coverage for which data was submitted to the all-payer claims database for the time period to which the released data pertains.
6.
The Department shall notify each person or entity to whom data is released pursuant to subsection 3 of the percentage of residents of this State who have health coverage for which data was submitted to the all-payer claims database for the time period to which the released data pertains.
The Department shall, at least annually, publish a report concerning the quality, efficiency and cost of health care in this State based on the data in the all-payer claims database, if the all-payer claims database is established pursuant to section 9 - 81st Session (2021) – 10 – of this act.
The Department shall, at least annually, publish a report concerning the quality, efficiency and cost of health care in this State based on the data in the all-payer claims database [.] , if the all-payer claims database is established pursuant to section 9 of this act.
439.908;
(b) The Patient Protection Commission created by NRS 439.908;
andatient Protection Commission created by NRS (c) The Director of the Legislative Counsel Bureau for transmittal to the Legislative Committee on Health Care and the next regular session of the Legislature.
and (c) The Director of the Legislative Counsel Bureau for transmittal to the Legislative Committee on Health Care and the next regular session of the Legislature.
A report published pursuant to subsection 1 must, where feasible, separate data by demographics, income, health status and the geography of, and the language spoken by, patients to assist in the identification of variations in the efficiency and quality of care.
A report published pursuant to subsection 1 must, where feasible, separate data by demographics, income, health status and the geography of, and Senate Amendment No.
723 to Senate Bill No.
40 First Reprint Page 10 the language spoken by, patients to assist in the identification of variations in the efficiency and quality of care.
(b) Include in any comparison of the performance of providers of health care information concerning a provider of health care four providers.ractitioner or practices in a group of fewer than 5.
(b) Include in any comparison of the performance of providers of health care information concerning a provider of health care who is a solo practitioner or practices in a group of fewer than four providers.
5.
- 81st Session (2021) – 11 – Sec.
Sec.
On or before December 31 of each even-numbered year, the Department shall submit to the Director of the Legislative Legislature a report concerning the cost, performance andn of the effectiveness of the all-payer claims database and any recommendations to improve the all-payer claims database.
On or before December 31 of each even-numbered year, the Department shall submit to the Director of the Legislative Counsel Bureau for transmittal to the next regular session of the Legislature a report concerning the cost, performance and effectiveness of the all-payer claims database and any recommendations to improve the all-payer claims database.
No person or entity providing information to the Department, including, without limitation, data submitted to the all-payer claims database, if established pursuant to section 9 of this act, in accordance with sections 3 to 17, inclusive, of this act, may be held liable in a civil or criminal action for disclosing confidential information unless the person or entity has done so in bad faith or with malicious purpose.
No person or entity providing information to the Department, including, without limitation, data submitted to the all-payer claims database , if established pursuant to section 9 of this act, in accordance with sections 3 to 17, inclusive, of this act, may be held liable in a civil or criminal action for disclosing confidential information unless the person or entity has done so in bad faith or with malicious purpose.
The Department and its members, officers and employees are not liable in any civil or criminal action for any damages causes incorrect information from the all-payer claims database to be provided to any person or entity.
The Department and its members, officers and employees are not liable in any civil or criminal action for any damages resulting from any act, omission, error or technical problem that causes incorrect information from the all-payer claims database to be provided to any person or entity.
Sec.
Senate Amendment No.
723 to Senate Bill No.
40 First Reprint Page 11 Sec.
(b) The privacy and security of data maintained in the all- payer claims database and the procedure for releasing data from - 81st Session (2021) – 12 – section 13 of this act, which must ensure compliance with subsection 2 of section 11 of this act.
(b) The privacy and security of data maintained in the all-payer claims database and the procedure for releasing data from the all-payer claims database pursuant to subsection 3 of section 13 of this act, which must ensure compliance with subsection 2 of section 11 of this act.
Any penalties for the failure to comply with the requirements of section of this act or the regulations adopted pursuant to this section concerning the submission of data to the all-payer claims database must not exceed $5,000 for each day of such failure.
Any penalties for the failure to comply with the requirements of section 10 of this act or the regulations adopted pursuant to this section concerning the submission of data to the all-payer claims database must not exceed $5,000 for each day of such failure.
(a) Regulations that require entities that provide health coverage in this State, in addition to the entities required by section 10 of this act but not including entities exempt from to the all-payer claims database;
(a) Regulations that require entities that provide health coverage in this State, in addition to the entities required by section 10 of this act but not including entities exempt from reporting pursuant to subsection 1 of that section, to upload data to the all-payer claims database;
and that section, to upload data (b) Any other regulations necessary to carry out the provisions of sections 3 to 17, inclusive, of this act.
and (b) Any other regulations necessary to carry out the provisions of sections 3 to 17, inclusive, of this act.
successor organization and maintain such certification for the term of the contract;
(1) Obtain certification by the HITRUST Alliance or its successor organization and maintain such certification for the term of the contract;
(2) Comply with the requirements of subsection 2 of section of this act to the same extent as the Department;
(2) Comply with the requirements of subsection 2 of section 11 of this act to the same extent as the Department;
- 81st Session (2021) – 13 – 5.
5.
(a) Carry out the provisions of NRS 439B.600 to 439B.695, inc(b) Establish and carry out programs to educate patientsd concerning ways to reduce the cost of health care and prescription drugs.
(a) Carry out the provisions of NRS 439B.600 to 439B.695, inclusive, and sections 3 to 17, inclusive, of this act;
Sec.
and (b) Establish and carry out programs to educate patients concerning ways to reduce the cost of health care and prescription drugs.
Senate Amendment No.
723 to Senate Bill No.
40 First Reprint Page 12 Sec.
If a manufacturer fails to provide to the Department the information required by NRS 439B.635, 439B.640 or 439B.660, a pharmacy benefit manager fails to provide to the Department the information required by NRS 439B.645, a nonprofit organization fails to post or provide to the Department, as applicable, the information required by NRS 439B.665 or a manufacturer, pharmacy benefit manager or nonprofit organization fails to post or provide, as applicable, such information on a timely basis, and the failure was not caused by excusable neglect, technical problems or against the manufacturer, pharmacy benefit manager or nonprofit organization, as applicable, an administrative penalty of not more than $5,000 for each day of such failure.
If a manufacturer fails to provide to the Department the information required by NRS 439B.635, 439B.640 or 439B.660, a pharmacy benefit manager fails to provide to the Department the information required by NRS 439B.645, a nonprofit organization fails to post or provide to the Department, as applicable, the information required by NRS 439B.665 or a manufacturer, pharmacy benefit manager or nonprofit organization fails to post or provide, as applicable, such information on a timely basis, and the failure was not caused by excusable neglect, technical problems or other extenuating circumstances, the Department may impose against the manufacturer, pharmacy benefit manager or nonprofit organization, as applicable, an administrative penalty of not more than $5,000 for each day of such failure.
and - 81st Session (2021) – 14 – (2) Provide education concerning asthma and diabetes and prevent those diseases.
and (2) Provide education concerning asthma and diabetes and prevent those diseases.
Except as otherwise provided in this section and 62D.420, 62D.440, 62E.516, 62E.620, 62H.025, 62H.030, 62H.170, 62H.220, 62H.320, 75A.100, 75A.150, 76.160, 78.152, 80.113, 81.850, 82.183, 86.246, 86.54615, 87.515, 87.5413, 87A.200, 87A.580, 87A.640, 88.3355, 88.5927, 88.6067, 88A.345, 88A.7345, 89.045, 89.251, 90.730, 91.160, 116.757, 116A.270, 116B.880, 118B.026, 119.260, 119.265, 119.267, 119.280, 119A.280, 119A.653, 119A.677, 119B.370, 119B.382, 120A.690, 125.130, 125B.140, 126.141, 126.161, 126.163, 126.730, 127.007, 127.057, 127.130, 127.140, 127.2817, 128.090, 130.312, 130.712, 136.050, 159.044, 159A.044, 172.075, 172.245, 176.01249, 176.015, 176.0625, 176.09129, 176.156, 176A.630, 178.39801, 178.4715, 178.5691, 179.495, 179A.070, 179A.165, 179D.160, 200.3771, 200.3772, 200.5095, 200.604, 202.3662, 205.4651, 209.392, 209.3923, 209.3925, 209.419, 209.429, 209.521, 211A.140, 213.010, 213.040, 213.095, 213.131, 217.105, 217.110, 217.464, 217.475, 218A.350, 218E.625, 218F.150, 218G.130, 218G.240, 218G.350, 226.300, 228.270, 228.450, 228.495, 228.570, 231.069, 231.1473, 233.190, 237.300, 239.0105, 239.0113, 239.014, 239B.030, 239B.040, 239B.050, 239C.140, 239C.210, 239C.230, 239C.250, 239C.270, 239C.420, 240.007, 241.020, 241.030, 241.039, 242.105, 244.264, 244.335, 247.540, 247.550, 247.560, 250.087, 250.130, 250.140, 250.150, 268.095, 268.0978, 268.490, 281A.680, 281A.685, 281A.750, 281A.755, 281A.780, 284.4068,.350, 286.110, 286.118, 287.0438, 289.025, 289.080, 289.387, 289.830, 293.4855, 293.5002, 293.503, 293.504, 293.558, 293.5757, 293.870, 293.906, 293.908, 293.910, 293B.135, 293D.510, 331.110, 332.061, 332.351, 333.333, 333.335, 338.070, 338.1379, 338.1593, 338.1725, 338.1727, 348.420, 349.597, 349.775, 353.205, 353A.049, 353A.085, 353A.100, 353C.240, 360.240, 360.247, 360.255, 360.755, 361.044, 361.2242, 361.610, 365.138, 366.160, 368A.180, 370.257, 370.327, 372A.080, 378.290, 378.300, 379.0075, 379.008, 379.1495, 385A.830, 385B.100, 387.626, 387.631, 388.1455, 388.259, 388.501, 388.503, 388.513, 388.750, 388A.247, 388A.249, 391.033, 391.035, 391.0365, 391.120, 391.925, 392.029, 392.147, 392.264, 392.271, 392.315, 392.317, 392.325, 392.327, 392.335, 392.850, 393.045, 394.167, 394.16975, 394.1698, 394.447, 394.460, 394.465, 396.3295, 396.405, 396.525, 396.535, 396.9685, - 81st Session (2021) – 15 – 398A.115, 408.3885, 408.3886, 408.3888, 408.5484, 412.153, 414.280, 416.070, 422.2749, 422.305, 422A.342, 422A.350, 425.400, 427A.1236, 427A.872, 432.028, 432.205, 432B.175, 432B.280, 432B.290, 432B.407, 432B.430, 432B.560, 432B.5902, 439.4941, 439.840, 439.914, 439B.420, 439B.754, 439B.760, 440.170, 441A.195, 441A.220, 441A.230, 442.330, 442.395, 442.735, 442.774, 445A.665, 445B.570, 445B.7773, 447.345, 449.209, 449.245, 449.4315, 449A.112, 450.140, 450B.188, 453.164, 453.720, 453A.610, 453A.700, 458.055, 458.280, 459.050, 459.3866, 459.555, 459.7056, 459.846, 463.120, 463.15993, 463.240, 463.3403, 463.3407, 463.790, 467.1005, 480.535, 480.545, 480.935, 480.940, 481.063, 481.091, 481.093, 482.170, 482.5536, 483.340, 483.363, 483.575, 483.659, 483.800, 484A.469, 484E.070, 485.316, 501.344, 503.452, 522.040, 534A.031, 561.285, 571.160, 584.655, 587.877, 598.0964, 598.098, 598A.110, 599B.090, 603.070, 603A.210, 604A.303, 604A.710, 612.265, 616B.012, 616B.015, 616B.315, 616B.350, 618.341, 618.425, 622.238, 622.310, 623.131, 623A.137, 624.110, 624.265, 624.327, 625.425, 625A.185, 628.418, 628B.230, 628B.760, 629.047, 629.069, 630.133, 630.2673, 630.30665, 630.336, 630A.555, 631.368, 632.121, 632.125, 632.3415, 632.405, 633.283, 633.301, 633.4715, 633.524, 634.055, 634.214, 634A.185, 635.158, 636.107, 637.085, 637B.288, 638.087, 638.089, 639.2485, 639.570, 640.075, 640A.220, 640B.730, 640C.580, 640C.600, 640C.620, 640C.745, 640C.760, 640D.190, 640E.340, 641.090, 641.221, 641.325, 641A.191, 641A.262, 641A.289, 641B.170, 641B.282, 641B.460, 645.625, 645A.050, 645A.082, 645B.060, 645B.092, 645C.220, 645C.225, 645D.130, 645D.135, 645G.510, 645H.320, 645H.330, 647.0945, 647.0947, 648.033, 648.197, 649.065, 649.067, 652.228, 653.900, 654.110, 656.105, 657A.510, 661.115, 665.130, 665.133, 669.275, 669.285, 669A.310, 671.170, 673.450, 673.480, 675.380, 676A.340, 676A.370, 677.243, 678A.470, 678C.710, 678C.800, 679B.122, 679B.124, 679B.152, 679B.159, 679B.190, 679B.285, 679B.690, 680A.270, 681A.440, 681B.260, 681B.410, 681B.540, 683A.0873, 685A.077, 686A.289, 686B.170, 686C.306, 687A.110, 687A.115, 687C.010, 688C.230, 688C.480, 688C.490, 689A.696, 692A.117, 692C.190, 692C.3507, 692C.3536, 692C.3538, 692C.354, 692C.420, 693A.480, 693A.615, 696B.550, 696C.120, 703.196, 704B.325, 706.1725, 706A.230, 710.159, 711.600, and section 11 of this act, sections 35, 38 and 41 of chapter 478, Statutes of Nevada 2011 and section 2 of chapter 391, Statutes of - 81st Session (2021) – 16 – Nevada 2013 and unless otherwise declared by law to be confidential, all public books and public records of a governmental entity must be open at all times during office hours to inspection by any person, and may be fully copied or an abstract or memorandum such copies, abstracts or memoranda may be used to supply theny general public with copies, abstracts or memoranda of the records or may be used in any other way to the advantage of the governmental entity or of the general public.
Except as otherwise provided in this section and NRS 1.4683, 1.4687, 1A.110, 3.2203, 41.071, 49.095, 49.293, 62D.420, 62D.440, 62E.516, 62E.620, 62H.025, 62H.030, 62H.170, 62H.220, 62H.320, 75A.100, 75A.150, 76.160, 78.152, 80.113, 81.850, 82.183, 86.246, 86.54615, 87.515, 87.5413, 87A.200, 87A.580, 87A.640, 88.3355, 88.5927, 88.6067, 88A.345, 88A.7345, 89.045, 89.251, 90.730, 91.160, 116.757, 116A.270, 116B.880, 118B.026, 119.260, 119.265, 119.267, 119.280, 119A.280, 119A.653, 119A.677, 119B.370, 119B.382, 120A.690, 125.130, 125B.140, 126.141, 126.161, 126.163, 126.730, 127.007, 127.057, 127.130, 127.140, 127.2817, 128.090, 130.312, 130.712, 136.050, 159.044, 159A.044, 172.075, 172.245, 176.01249, 176.015, 176.0625, 176.09129, 176.156, 176A.630, 178.39801, 178.4715, 178.5691, 179.495, 179A.070, 179A.165, 179D.160, 200.3771, 200.3772, 200.5095, 200.604, 202.3662, 205.4651, 209.392, 209.3923, 209.3925, 209.419, 209.429, 209.521, 211A.140, 213.010, 213.040, 213.095, 213.131, 217.105, 217.110, 217.464, 217.475, 218A.350, 218E.625, 218F.150, 218G.130, 218G.240, 218G.350, 226.300, 228.270, 228.450, 228.495, 228.570, 231.069, 231.1473, 233.190, 237.300, 239.0105, 239.0113, 239.014, 239B.030, 239B.040, 239B.050, 239C.140, 239C.210, 239C.230, 239C.250, 239C.270, 239C.420, 240.007, 241.020, 241.030, 241.039, 242.105, 244.264, 244.335, 247.540, 247.550, 247.560, 250.087, 250.130, 250.140, 250.150, 268.095, 268.0978, 268.490, 268.910, 269.174, 271A.105, Senate Amendment No.
723 to Senate Bill No.
40 First Reprint Page 13 281.195, 281.805, 281A.350, 281A.680, 281A.685, 281A.750, 281A.755, 281A.780, 284.4068, 286.110, 286.118, 287.0438, 289.025, 289.080, 289.387, 289.830, 293.4855, 293.5002, 293.503, 293.504, 293.558, 293.5757, 293.870, 293.906, 293.908, 293.910, 293B.135, 293D.510, 331.110, 332.061, 332.351, 333.333, 333.335, 338.070, 338.1379, 338.1593, 338.1725, 338.1727, 348.420, 349.597, 349.775, 353.205, 353A.049, 353A.085, 353A.100, 353C.240, 360.240, 360.247, 360.255, 360.755, 361.044, 361.2242, 361.610, 365.138, 366.160, 368A.180, 370.257, 370.327, 372A.080, 378.290, 378.300, 379.0075, 379.008, 379.1495, 385A.830, 385B.100, 387.626, 387.631, 388.1455, 388.259, 388.501, 388.503, 388.513, 388.750, 388A.247, 388A.249, 391.033, 391.035, 391.0365, 391.120, 391.925, 392.029, 392.147, 392.264, 392.271, 392.315, 392.317, 392.325, 392.327, 392.335, 392.850, 393.045, 394.167, 394.16975, 394.1698, 394.447, 394.460, 394.465, 396.3295, 396.405, 396.525, 396.535, 396.9685, 398A.115, 408.3885, 408.3886, 408.3888, 408.5484, 412.153, 414.280, 416.070, 422.2749, 422.305, 422A.342, 422A.350, 425.400, 427A.1236, 427A.872, 432.028, 432.205, 432B.175, 432B.280, 432B.290, 432B.407, 432B.430, 432B.560, 432B.5902, 432C.140, 432C.150, 433.534, 433A.360, 437.145, 437.207, 439.4941, 439.840, 439.914, 439B.420, 439B.754, 439B.760, 440.170, 441A.195, 441A.220, 441A.230, 442.330, 442.395, 442.735, 442.774, 445A.665, 445B.570, 445B.7773, 447.345, 449.209, 449.245, 449.4315, 449A.112, 450.140, 450B.188, 453.164, 453.720, 453A.610, 453A.700, 458.055, 458.280, 459.050, 459.3866, 459.555, 459.7056, 459.846, 463.120, 463.15993, 463.240, 463.3403, 463.3407, 463.790, 467.1005, 480.535, 480.545, 480.935, 480.940, 481.063, 481.091, 481.093, 482.170, 482.5536, 483.340, 483.363, 483.575, 483.659, 483.800, 484A.469, 484E.070, 485.316, 501.344, 503.452, 522.040, 534A.031, 561.285, 571.160, 584.655, 587.877, 598.0964, 598.098, 598A.110, 599B.090, 603.070, 603A.210, 604A.303, 604A.710, 612.265, 616B.012, 616B.015, 616B.315, 616B.350, 618.341, 618.425, 622.238, 622.310, 623.131, 623A.137, 624.110, 624.265, 624.327, 625.425, 625A.185, 628.418, 628B.230, 628B.760, 629.047, 629.069, 630.133, 630.2673, 630.30665, 630.336, 630A.555, 631.368, 632.121, 632.125, 632.3415, 632.405, 633.283, 633.301, 633.4715, 633.524, 634.055, 634.214, 634A.185, 635.158, 636.107, 637.085, 637B.288, 638.087, 638.089, 639.2485, 639.570, 640.075, 640A.220, 640B.730, 640C.580, 640C.600, 640C.620, 640C.745, 640C.760, 640D.190, 640E.340, 641.090, 641.221, 641.325, 641A.191, 641A.262, 641A.289, 641B.170, 641B.282, 641B.460, 641C.760, 641C.800, 642.524, 643.189, 644A.870, 645.180, 645.625, 645A.050, 645A.082, 645B.060, 645B.092, 645C.220, 645C.225, 645D.130, 645D.135, 645G.510, 645H.320, 645H.330, 647.0945, 647.0947, 648.033, 648.197, 649.065, 649.067, 652.228, 653.900, 654.110, 656.105, 657A.510, 661.115, 665.130, 665.133, 669.275, 669.285, 669A.310, 671.170, 673.450, 673.480, 675.380, 676A.340, 676A.370, 677.243, 678A.470, 678C.710, 678C.800, 679B.122, 679B.124, 679B.152, 679B.159, 679B.190, 679B.285, 679B.690, 680A.270, 681A.440, 681B.260, 681B.410, 681B.540, 683A.0873, 685A.077, 686A.289, 686B.170, 686C.306, 687A.110, 687A.115, 687C.010, 688C.230, 688C.480, 688C.490, 689A.696, 692A.117, 692C.190, 692C.3507, 692C.3536, 692C.3538, 692C.354, 692C.420, 693A.480, 693A.615, 696B.550, 696C.120, 703.196, 704B.325, 706.1725, 706A.230, 710.159, 711.600, and section 11 of this act, sections 35, 38 and 41 of chapter 478, Statutes of Nevada 2011 and section 2 of chapter 391, Statutes of Nevada 2013 and unless otherwise declared by law to be confidential, all public books and public records of a governmental entity must be open at all times during office hours to inspection by any person, and may be fully copied or an abstract or memorandum may be prepared from those public books and public records.
Any such copies, abstracts or memoranda may be used to supply the general public with Senate Amendment No.
723 to Senate Bill No.
40 First Reprint Page 14 copies, abstracts or memoranda of the records or may be used in any other way to the advantage of the governmental entity or of the general public.
Nothing in this subsection requires a governmental entity to provide a copy of a public record in an electronic format or by mea(a) The public record:dium if:
Nothing in this subsection requires a governmental entity to provide a copy of a public record in an electronic format or by means of an electronic medium if:
(a) The public record:
- 81st Session (2021) – 17 – request, prepare the copy of the public record and shall not require the person who has requested the copy to prepare the copy himself or herself.
(b) Except as otherwise provided in NRS 239.030, shall, upon request, prepare the copy of the public record and shall not require the person who has requested the copy to prepare the copy himself or herself.
or (d) Violated any provision of this Code other than one for In lieu of such a suspension or revocation, the Commissioner may levy upon the insurer, and the insurer shall pay forthwith, an administrative fine of not more than $2,000 for each act or violation.
or (d) Violated any provision of this Code other than one for violation of which suspension or revocation is mandatory.
 In lieu of such a suspension or revocation, the Commissioner may levy upon the insurer, and the insurer shall pay forthwith, an administrative fine of not more than $2,000 for each act or violation.
(a) Is in unsound condition, is being fraudulently conducted, or is in such a condition or is using such methods and practices in the conduct of its business as to render its further transaction of insurance in this State currently or prospectively hazardous or injurious to policyholders or to the public.
Senate Amendment No.
723 to Senate Bill No.
40 First Reprint Page 15 (a) Is in unsound condition, is being fraudulently conducted, or is in such a condition or is using such methods and practices in the conduct of its business as to render its further transaction of insurance in this State currently or prospectively hazardous or injurious to policyholders or to the public.
(1) Has without just cause failed to pay, or delayed in favor of an insured or in favor of a third person with respect to the liability of an insured to the third person;
(1) Has without just cause failed to pay, or delayed payment of, claims arising under its policies, whether the claims are in favor of an insured or in favor of a third person with respect to the liability of an insured to the third person;
(c) Refuses to be examined, or its directors, officers, employees or representatives refuse to submit to examination relative to its affairs, or to produce its books, papers, records, contracts, - 81st Session (2021) – 18 – correspondence or other documents for examination by the Commissioner when required, or refuse to perform any legal obligation relative to the examination.
(c) Refuses to be examined, or its directors, officers, employees or representatives refuse to submit to examination relative to its affairs, or to produce its books, papers, records, contracts, correspondence or other documents for examination by the Commissioner when required, or refuse to perform any legal obligation relative to the examination.
(d) Except as otherwise provided in NRS 681A.110, has rei(e) Has failed to pay any final judgment rendered against it in this State upon any policy, bond, recognizance or undertaking as issued or guaranteed by it, within 30 days after the judgment became final or within 30 days after dismissal of an appeal before final determination, whichever date is the later.
(d) Except as otherwise provided in NRS 681A.110, has reinsured all its risks in their entirety in another insurer.
(e) Has failed to pay any final judgment rendered against it in this State upon any policy, bond, recognizance or undertaking as issued or guaranteed by it, within 30 days after the judgment became final or within 30 days after dismissal of an appeal before final determination, whichever date is the later.
This limitation evasion of taxes.
This limitation does not apply if the Commissioner finds fraudulent or willful evasion of taxes.
the Commissioner finds fraudulent or willful Sec.
Sec.
For the Fiscal Year 2021-2022....................................$24,970 For the Fiscal Year 2022-2023..................................$300,188 2.
For the Fiscal Year 2021-2022 .......................................................$24,970 For the Fiscal Year 2022-2023 .....................................................$300,188 2.
Any balance of the sums appropriated by subsection 1 remaining at the end of the respective fiscal years must not be committed for expenditure after June 30 of the respective fiscal years 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 - 81st Session (2021) – 19 – September 16, 2022, and September 15, 2023, respectively, 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 16,Sec.
Any balance of the sums appropriated by subsection 1 remaining at the end of the respective fiscal years must not be committed for expenditure after June 30 of the respective fiscal years 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 16, 2022, and September 15, 2023, respectively, by either the entity Senate Amendment No.
723 to Senate Bill No.
40 First Reprint Page 16 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 16, 2022, and September 15, 2023, respectively.
Sec.
On or before December 1, 2021, and December 1, 2022, the Department of Health and Human Services shall, if the all- payer claims database is established pursuant to section 9 of this act:
On or before December 1, 2021, and December 1, 2022, the Department of Health and Human Services shall [:] , if the all-payer claims database is established pursuant to section 9 of this act:
(a) Develop a report concerning the implementation of sections to 17, inclusive, of this act, including, without limitation, the cost of implementing the all-payer claims database and the technical progress made toward full implementation of the all-payer claims database;
(a) Develop a report concerning the implementation of sections 3 to 17, inclusive, of this act, including, without limitation, the cost of implementing the all- payer claims database and the technical progress made toward full implementation of the all-payer claims database;
and created by NRS 439.908 and the Director of the Legislative Counsel Bureau for transmittal to:
and (b) Submit the report to the Patient Protection Commission created by NRS 439.908 and the Director of the Legislative Counsel Bureau for transmittal to:
The Department of Health and Human Services shall not release any data pursuant to subsection 3 of section 13 of this act from the all-payer claims database, if the database is established pursuant to section 9 of this act, until 6 months after the approval by the Legislative Commission or the Subcommittee to Review Regulations pursuant to NRS 233.067 of regulations adopted pursuant to section 17 of this act relating to the collection, privacy and security of data.
The Department of Health and Human Services shall not release any data [from the all-payer claims database] pursuant to subsection 3 of section 13 of this act from the all-payer claims database, if the database is established pursuant to section 9 of this act, until 6 months after the approval by the Legislative Commission or the Subcommittee to Review Regulations pursuant to NRS 233.067 of regulations adopted pursuant to section 17 of this act relating to the collection, privacy and security of data.
- 81st Session (2021) – 20 – 2.
2.
The provisions of subsection 1 of NRS 218D.380 do not apply to any provision of this act which adds or revises a reqSec.
The provisions of subsection 1 of NRS 218D.380 do not apply to any provision of this act which adds or revises a requirement to submit a report to the Legislature.
Sec.
Sections 1, 18 and 19.7 to 22, inclusive, of this act become effective on July 1, 2021.
Sections 1, 18 [, 20, 21, 21.5] and 19.7 to 22 , inclusive, of this act become effective on July 1, 2021.
~~~~~ 21 - 81st Session (2021)