Nevada 2021 Regular Session Status: In Committee 1 D cosponsors

AB 347 — Requires the Legislative Committee on Health Care to study certain issues related to the economics of health care. (BDR S-541)

Last action — (No further action taken.)

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

This bill died with 2021 Regular Session. It reached “In Committee” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.

This bill is no longer active — its legislative session has ended, so there is no live prognosis.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

Bill Text

What changed in the latest version

54 added · 1859 removed

54 line(s) added, 1859 removed.

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REQUIRES TWO-THIRDS MAJORITY VOTE (§ 6) A.B.
* EXEMPT (Reprinted with amendments adopted on April 19, 2021) FIRST REPRINT A.B.
347 A SSEMBLY B ILL NO .
347 ASSEMBLY B ILLN O.
347–A SSEMBLYMAN O RENTLICHER M ARCH 22, 2021 ____________ Referred to Committee on Health and Human Services SUMMARY—Revises provisions related to health care.
347–A SSEMBLYMAN O RENTLICHER M ARCH 22, 2021 ____________ Referred to Committee on Health and Human Services SUMMARY—Requires the Legislative Committee on Health Care to study certain issues related to the economics of health care.
(BDR 38-541) FISCAL NOTE:
(BDR S-541) FISCAL NOTE:
CONTAINS UNFUNDED MANDATE (§ 31) (NOTR EQUESTED BAFFECTEDLOCALGOVERNMENT) ~ EXPLANATION – Matter in bolded italics is new;
~ EXPLANATION – Matter in bolded italics is new;
authorizing the Division of Health Care Financing and Policy of the Department of Health and Human Services to impose an assessment on certain health care providers;
requiring the Legislative Committee on Health Care to study matters relating to the economics of health care in this State;
prescribing the authorized uses of the revenue generated by such an assessment;
requiring the Division to adopt regulations establishing administrative penalties against a health care provider who does not pay an assessment in a timely manner;
authorizing the Division to take certain measures to collect an unpaid assessment or administrative penalty;
establishing procedures for fixing the rates charged by certain hospitals, independent centers for emergency medical care, surgical centers for ambulatory patients and physicians for certain services;
authorizing the imposition of a civil penalty and initiation of disciplinary action against such a facility or a physician who fails to comply with provisions concerning rate fixing;
creating certain causes of action to enforce those provisions;
Legislative Counsel’s Digest:
LegExisting law establishes the Legislative Committee on Health Care to review and examine certain issues relating to the provision of health care in this State.
Existing law authorizes the Division of Health Care Financing and Policy of the provide personal care services in the home or medical facilities that are required to obtain a certain type of license after obtaining the approval of at least 67 percent of - *AB347* – 2 – the Division to expend the revenue generated from the assessment to provideequires increased payments to operators of agencies to provide personal care in the home and operators of medical facilities for services rendered to recipients of Medicaid and to pay administrative costs.
(NRS 439B.200, 439B.220) This bill requires the Legislative Committee on Health Care, during the 2021-2022 legislative interim, to:
(NRS 422.37945) Sections 2-8 of this bill authorize the imposition of a similar assessment on groups of health care providers who provide similar services or physicians who practice in a specialty area.
(1) study the economics of the system of setting reimbursement rates for health care services by private and public for health care services on patients;
Sections 3-5 of this bill define necessary terms.
(3) study opportunities to set rates charged for health care services at a level to allow providers of health care, including health care institutions, to cover and reduce costs and make a reasonable profit;
Section 6 of this bill provides for the imposition of the assessment upon the affirmative vote of at least 67 percent of Care Quality and Access for Patients of Certain Providers and requires the Divisionh to deposit the proceeds from the assessment into the Account.
(4) study incentives for providers of health care to provide services to recipients of Medicaid;
Section 7 authorizes the Division to use the money in the Account to:
and (5) make recommendations to the 82nd Session of the Nevada Legislature.
(1) increase the rates of reimbursement of providers in the assessed group receive from Medicaid to rates equal to those paid by Medicare;
and (2) pay administrative costs related to the assessment.
Section 8 of this bill requires the Division to adopt regulations establishing administrative penalties against a health care provider who fails to pay an assessment in a timely manner.
Section 8 also authorizes the Division, after notifying the provider, to deduct the amount of an unpaid assessment or Plan for Medicaid.
Finally, section 8 authorizes the Division to negotiate a payment plan with a health care provider before making such deductions.
Section 9 of this bill makes a conforming change to indicate the proper placement of sections 2-8 in the Nevada Revised Statutes.
Sections 14-23 of this bill establish procedures for fixing the rates charged by certain hospitals, independent centers for emergency medical care, surgical centers for ambulatory patients and physicians for services that are reimbursable through Medicare when provided to a patient who is not indigent and is not covered by Medicare or Medicaid.
Sections 15-17 of this bill define necessary terms.
Section charging rates different from those established under sections 14-23.
Section 19 of this bill requires the Division to fix rates to ensure that each health care facility and physician is able to cover reasonable costs and earn a fair and reasonable profit.
Section 19 requires the Division to generally:
(1) presume that the rates paid by Medicare allow a health care facility or physician to cover reasonable costs and earn a fair and reasonable profit;
and (2) fix rates at that amount.
However, section 19 authorizes a health care facility, physician or group of physicians to request a different rate if the health care facility, physician or group of physicians determine the rates paid by Medicare do not allow the health care facility, physician or profit.
Section 20 of this bill:
(1) requires the Administrator of the Division to appoint a panel of employees who are experienced or trained in rate fixing to evaluate such requests;
and (2) prescribes the procedure for evaluating such a request and the criteria that the panel is required to consider during the evaluation.
Section 21 of this bill prescribes requirements concerning an order relating to such a request.
Section 21 provides that such an order is valid for 1 year and authorizes a health care facility, physician or group of physicians to request to renew a rate.
Section 22 of this bill requires the Division to adopt certain regulations governing rate fixing, including regulations establishing civil penalties to be governing rate fixing.
Sections 23, 26, 32 and 33 of this bill provide for the imposition of disciplinary action against a health care facility or physician for such a violation.
Section 23 also authorizes:
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(1) the Division or Attorney General to maintain a suit for an injunction against such a violation;
and (2) any person or entity injured by such a violation to maintain a suit for damages.
Sections 10-12, - *AB347* – 3 – 24, 25, 27-31, 34-44 and 47 of this bill make conforming changes to clarify the application of or remove existing provisions concerning the rates that a health care facility or physician may charge for certain services.
Chapter 422 of NRS is hereby amended by adding thereto the provisions set forth as sections 2 to 8, inclusive, of this act.
Sec.
2.
As used in sections 2 to 8, inclusive, of this act, unless the context otherwise requires, the words and terms defined in sections 3, 4 and 5 of this act have the meanings ascribed to them in those sections.
Sec.
3.
“Account” means the Account to Improve Health Care Quality and Access created by section 7 of this act.
Sec.
4.
“Health care provider” has the meaning ascribed to it in 42 C.F.R.
§ 433.52.
Sec.
5.
“Provider group” means:
All health care providers who provide a class of health care items or services listed in 42 C.F.R.
As part of its review of health care during the 2021-2022 legislative interim, the Legislative Committee on Health Care shall study:
§ 433.56(a)(1) to (18), inclusive;
(a) The economics of the system of setting reimbursement rates for health care services in this State by private and public health - *AB347_R1* – 2 – insurers, including, without limitation, Medicaid, and a comparison of that system with such systems in other states;
and 2.
(b) The impact of current reimbursement rates paid by health insurers for health care services on patients in this State, including, without limitation, costs relating to health care services imposed on such patients and the cost of premiums for health insurance;
All physicians who practice in a specialty area.
(c) Opportunities and options to set rates charged for health care services at a level that would allow providers of health care to cover reasonable costs of providing health care services, earn a fair and reasonable profit and reduce administrative costs relating to billing for health care;
Sec.
and of health care to provide health care services to recipients ofiders Medicaid throughout this State, including, without limitation, by:
6.
(1) Increasing reimbursement rates for Medicaid by imposing assessments on certain groups of providers of health care;
1.
and (2) Reducing administrative burdens.
Except as otherwise provided in this section, after polling the health care providers in a provider group and receiving an affirmative vote from at least 67 percent of the health care providers in that provider group, the Division may impose by regulation, against each health care provider in the provider group, an assessment in an amount equal to a percentage of the net revenue generated by the health care provider from providing care in this State during a calendar or fiscal year.
The Division shall adopt:
(a) Regulations prescribing the percentage that must be used to calculate the amount of the assessment, the date on which the assessment is due and the manner in which the assessment must be paid;
and (b) Any other regulations necessary or convenient to carry out the provisions of this section.
The revenue from an assessment imposed pursuant to subsection 1 must be deposited in the Account.
On or before September 1, 2022, the Legislative Committee on Health Care shall submit its findings and any recommendations to the Director of the Legislative Counsel Bureau for transmittal to the 82nd Session of the Nevada Legislature.
An assessment imposed pursuant to subsection 1 must comply with the provisions of 42 C.F.R.
§ 433.68.
An assessment must not be imposed pursuant to subsection 1 if federal law or regulations prohibit using the revenue generated by the assessment for the purposes prescribed in section 7 of this act.
If - *AB347* – 4 – new federal law or regulations imposing such a prohibition are enacted or adopted, as applicable:
(a) An assessment must not be collected after the effective date of the law or regulations;
and (b) Any money collected during the calendar or fiscal year, as applicable, in which the federal law or regulations become effective must be returned to the health care providers from whom it was collected.
4.
A health care provider shall submit to the Division any information requested by the Division for the purposes of carrying out the provisions of this section.
Sec.
7.
1.
The Account to Improve Health Care Quality and Access for Patients of Certain Providers is hereby created in the State General Fund.
The Division shall administer the Account.
The revenue from assessments and penalties imposed on the health care providers in each provider group must be accounted for separately in the Account.
2.
The interest and income on the money in the Account, after deducting any applicable charges, must be credited to the Account.
3.
The money in the Account must be expended to:
(a) Increase the rates of reimbursement that health care providers in the provider group upon whom an assessment is imposed would otherwise receive under the State Plan for Medicaid to rates that are equal to the rates at which such health care providers are reimbursed under the Medicare program;
and (b) Administer the provisions of sections 2 to 8, inclusive, of this act.
4.
Money in the Account must not be expended to replace money that would otherwise be used to provide reimbursement under the State Plan for Medicaid to health care providers in a provider group upon whom an assessment is imposed.
5.
Any money remaining in the Account at the end of a fiscal year does not revert to the State General Fund, and the balance of the Account must be carried forward to the next fiscal year.
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.
§§ 1395 et seq.
Sec.
8.
1.
The Division shall adopt regulations that establish administrative penalties for failure to timely pay an assessment imposed pursuant to section 6 of this act.
Any money collected from such a penalty must be deposited in the Account.
2.
If a health care provider fails to remit to the Division any penalty imposed pursuant to this section or any assessment - *AB347* – 5 – imposed pursuant to section 6 of this act within 30 days after the date on which the penalty or assessment is due, the Division may deduct the amount of the assessment or penalty, as applicable, from future payments owed to the health care provider under the State Plan for Medicaid.
Before doing so, the Division:
(a) Shall notify the health care provider of the intended deduction;
and (b) May negotiate a payment plan with the health care provider.
Sec.
9.
NRS 232.320 is hereby amended to read as follows:
232.320 1.
The Director:
(a) Shall appoint, with the consent of the Governor, administrators of the divisions of the Department, who are respectively designated as follows:
(1) The Administrator of the Aging and Disability Services Division;
(2) The Administrator of the Division of Welfare and Supportive Services;
(3) The Administrator of the Division of Child and Family Services;
(4) The Administrator of the Division of Health Care Financing and Policy;
and (5) The Administrator of the Division of Public and Behavioral Health.
(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, and sections 2 to 8, inclusive, of this act, 458A and 656A of NRS, NRS 127.220 to 127.310, inclusive, 422.001 to 422.410, inclusive, 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.
(c) Shall administer any state program for persons with developmental disabilities established pursuant to the Developmental Disabilities Assistance and Bill of Rights Act of 2000, 42 U.S.C.
§§ 15001 et seq.
(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 copy of the plan to the Governor and the Legislature at the beginning of each regular session.
The plan must:
- *AB347* – 6 – (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;
(2) Set forth priorities for the provision of those services;
(3) Provide for communication and the coordination of those services among nonprofit organizations, agencies of local government, the State and the Federal Government;
(4) Identify the sources of funding for services provided by the Department and the allocation of that funding;
(5) Set forth sufficient information to assist the Department in providing those services and in the planning and budgeting for the future provision of those services;
and (6) Contain any other information necessary for the Department to communicate effectively with the Federal Government concerning demographic trends, formulas for the distribution of federal money and any need for the modification of programs administered by the Department.
(e) May, by regulation, require nonprofit organizations and state and local governmental agencies to provide information regarding the programs of those organizations and agencies, excluding detailed information relating to their budgets and payrolls, which the Director deems necessary for the performance of the duties imposed upon him or her pursuant to this section.
(f) Has such other powers and duties as are provided by law.
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.
Sec.
10.
NRS 232.462 is hereby amended to read as follows:
232.462 1.
The Bureau for Hospital Patients is hereby created within the Office for Consumer Health Assistance.
2.
The Advocate:
(a) Is responsible for the operation of the Bureau, which must be easily accessible to the clientele of the Bureau.
(b) Shall appoint and supervise such additional employees as are necessary to carry out the duties of the Bureau.
The employees of the Bureau are in the unclassified service of the State.
3.
The Advocate or the Advocate’s designee may, upon request made by either party, hear, mediate, arbitrate or resolve by alternative means of dispute resolution disputes between patients and hospitals.
The Advocate or the Advocate’s designee may decline to hear a case that in the Advocate’s opinion is trivial, without merit or beyond the scope of his or her jurisdiction.
The Advocate or the Advocate’s designee may hear, mediate, arbitrate or resolve through alternative means of dispute resolution disputes regarding:
- *AB347* – 7 – (a) The accuracy or amount of charges billed to a patient;
(b) The reasonableness of arrangements made for a patient to pay any bill for medical services ;
[, including, without limitation, arrangements to pay hospital bills made pursuant to paragraph (c) of subsection 1 of NRS 439B.260;] and (c) Such other matters related to the charges for care provided to a patient as the Advocate or the Advocate’s designee determines appropriate for arbitration, mediation or other alternative means of dispute resolution.
 The Advocate’s designee must be an employee of the State and, except for the purposes of this subsection, must not be employed by, or otherwise associated with, the Bureau or the Office for Consumer Health Assistance.
4.
The decision of the Advocate or the Advocate’s designee is a final decision for the purpose of judicial review.
5.
Each hospital, other than federal and state hospitals, with 49 or more licensed or approved hospital beds shall pay an annual assessment for the support of the Bureau.
On or before July 15 of each year, the Advocate shall notify each hospital of its assessment for the fiscal year.
Payment of the assessment is due on or before September 15.
Late payments bear interest at the rate of 1 percent per month or fraction thereof.
6.
The total amount assessed pursuant to subsection 5 for a fiscal year must not be more than $100,000 adjusted by the percentage change between January 1, 1991, and January 1 of the year in which the fees are assessed, in the Consumer Price Index (All Items) published by the United States Department of Labor.
7.
The total amount assessed must be divided by the total number of patient days of care provided in the previous calendar year by the hospitals subject to the assessment.
For each hospital, the assessment must be the result of this calculation multiplied by its number of patient days of care for the preceding calendar year.
Sec.
11.
NRS 239.010 is hereby amended to read as follows:
239.010 1.
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, - *AB347* – 8 – 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, 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, - *AB347* – 9 – 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, 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 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.
This section does not supersede or in any manner affect the federal laws governing copyrights or enlarge, diminish or affect in any other manner the rights of a person in any written book or record which is copyrighted pursuant to federal law.
2.
A governmental entity may not reject a book or record which is copyrighted solely because it is copyrighted.
3.
A governmental entity that has legal custody or control of a public book or record shall not deny a request made pursuant to subsection 1 to inspect or copy or receive a copy of a public book or record on the basis that the requested public book or record contains information that is confidential if the governmental entity can - *AB347* – 10 – redact, delete, conceal or separate, including, without limitation, electronically, the confidential information from the information included in the public book or record that is not otherwise confidential.
4.
If requested, a governmental entity shall provide a copy of a public record in an electronic format by means of an electronic medium.
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:
(1) Was not created or prepared in an electronic format;
and (2) Is not available in an electronic format;
or (b) Providing the public record in an electronic format or by means of an electronic medium would:
(1) Give access to proprietary software;
or (2) Require the production of information that is confidential and that cannot be redacted, deleted, concealed or separated from information that is not otherwise confidential.
5.
An officer, employee or agent of a governmental entity who has legal custody or control of a public record:
(a) Shall not refuse to provide a copy of that public record in the medium that is requested because the officer, employee or agent has already prepared or would prefer to provide the copy in a different medium.
(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.
Sec.
12.
NRS 439A.190 is hereby amended to read as follows:
439A.190 1.
A primary care practice shall not represent itself as a patient-centered medical home unless the primary care practice is certified, accredited or otherwise officially recognized as a patient-centered medical home by a nationally recognized organization for the accrediting of patient-centered medical homes.
2.
The Department shall post on an Internet website maintained by the Department links to nationally recognized organizations for the accrediting of patient-centered medical homes and any other information specified by the Department to allow patients to find a patient-centered medical home that meets the requirements of this section and any regulations adopted pursuant thereto.
3.
Any coordination between an insurer and a patient-centered medical home or acceptance of an incentive from an insurer by a patient-centered medical home that is authorized by federal law and is not prohibited by sections 14 to 23, inclusive, of this act shall not be deemed to be an unfair method of competition or an unfair or - *AB347* – 11 – deceptive trade practice or other act or practice prohibited by the provisions of chapter 598 or 686A of NRS.
4.
(a) “Patient-centered medical home” means a primary care practice that:
(a) “Health care services” has the meaning ascribed to it in NRS 695G.022.
(1) Offers patient-centered, continuous, culturally competent, evidence-based, comprehensive health care that is led by a provider of primary care and a team of health care providers, coordinates the health care needs of the patient and uses enhanced communication strategies and health information technology;
(b) “Provider of health care” has the meaning ascribed to it in NRS 695G.070.
and (2) Emphasizes enhanced access to practitioners and preventive care to improve the outcomes for and experiences of patients and lower the costs of health services.
(b) “Primary care practice” means a federally qualified health center, as defined in 42 U.S.C.
§ 1396d(l)(2)(B), or a business where health services are provided by one or more advanced practice registered nurses or one or more physicians who are licensed pursuant to chapter 630 or 633 of NRS and who practice in the area of family practice, internal medicine or pediatrics.
13.
Chapter 439B of NRS is hereby amended by adding thereto the provisions set forth as sections 14 to 23, inclusive, of this act.
Sec.
14.
As used in sections 14 to 23, inclusive, of this act, unless the context otherwise requires, the words and terms defined in sections 15, 16 and 17 of this act have the meanings ascribed to them in those sections.
Sec.
15.
“Division” means the Division of Health Care Financing and Policy of the Department.
Sec.
16.
“Health care facility” means:
1.
A hospital, as defined in NRS 449.012, other than 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.
§ 1395i-4(e).
An independent center for emergency medical care, as defined in NRS 449.013.
This act becomes effective on July 1, 2021.
3.
H - *AB347_R1*
A surgical center for ambulatory patients, as defined in NRS 449.019.
Sec.
17.
“Similarly situated” means that the factors prescribed by subsection 2 of section 20 of this act apply similarly to all physicians in the group.
Sec.
18.
1.
A health care facility or physician shall charge rates determined in accordance with sections 14 to 23, inclusive, of this act for any goods or services described in subsection 2 that are provided to a patient who is not covered by Medicare, Medicaid or - *AB347* – 12 – the Children’s Health Insurance Program and is not entitled to relief under the provisions of chapter 428 of NRS.
2.
The provisions of sections 14 to 23, inclusive, of this act apply to goods and services that are reimbursable through Medicare as if provided to a patient who is covered by Medicare.
3.
A health care facility or physician shall not provide any person with a discount, incentive or price reduction or enter into any arrangement where the effective amount paid to the health care facility or physician for goods or services is different from the rate established for those goods or services pursuant to sections 14 to 23, inclusive, of this act.
4.
To the extent of their applicability, the provisions of sections 14 to 23, inclusive, of this act supersede any other provision of law relating to the rates charged by a health care facility or physician, including, without limitation, provisions requiring or authorizing reduced or discounted rates.
Sec.
19.
1.
The Division shall fix rates pursuant to sections 14 to 23, inclusive, of this act to ensure that each health care facility and physician is able to cover reasonable costs and earn a fair and reasonable profit.
If a health care facility or physician does not request a different rate pursuant to subsection 2, the Division shall:
(a) Presume that the rates at which Medicare provides reimbursement for the goods and services provided by a health care facility or physician allow the health care facility or physician to cover reasonable costs and earn a fair and reasonable profit;
and (b) Fix the rates that the health care facility or physician may charge for goods or services at rates equal to the rates set forth in paragraph (a).
2.
A health care facility or a physician who determines that the rates set forth in paragraph (a) of subsection 1 do not allow the health care facility or physician to cover reasonable costs and earn a fair and reasonable profit may, on or before March 1 of any year, submit to the Division a request for a rate different than the rate set forth in paragraph (a) of subsection 1.
A group of similarly situated physicians may submit a request for different rates that apply to each physician in that group, and the Division may, after notice and the opportunity for a hearing for each affected physician, consolidate proceedings concerning requests submitted by similarly situated physicians.
A request for different rates:
(a) May apply to particular goods or services provided by the health care facility, physician or physicians in the group, as applicable, or to all such goods and services.
- *AB347* – 13 – (b) Must include, without limitation:
(1) The goods and services for which the health care facility, physician or group of physicians is requesting a different rate;
(2) An explanation of why the health care facility, the physician or the physicians in the group are unable to cover reasonable costs and earn a fair and reasonable profit charging the rates set forth in paragraph (a) of subsection 1;
(3) The rates that the health care facility, physician or group of physicians has determined are necessary to cover reasonable costs and earn a fair and reasonable profit;
and (4) Any other information required by the Division pursuant to section 22 of this act.
Sec.
20.
1.
The Administrator of the Division shall appoint a panel of employees to evaluate requests made pursuant to subsection 2 of section 19 of this act.
The employees on the panel must be persons who are experienced or trained in setting rates of reimbursement for Medicaid.
2.
When evaluating requests made pursuant to subsection 2 of section 19 of this act, the panel shall ensure that each health care facility or physician is able to cover reasonable costs and earn a fair and reasonable profit.
The health care facility, physician or group of physicians that submitted the request has the burden of demonstrating that the health care facility, the physician or the physicians in the group, as applicable, will not cover reasonable costs and earn a fair and reasonable profit charging the rates set forth in paragraph (a) of subsection 1 of section 19 of this act.
When determining whether a health care facility, physician or group of physicians has met that burden and, if so, the appropriate rate, the panel shall consider, without limitation:
(a) The relative populations of persons and entities who pay for goods and services provided by the health care facility, physician or physicians in the group and the relative amounts of reimbursement paid by those persons and entities;
(b) Where applicable, the disparities in income between providers of primary care and specialty services or between providers of different types of specialty services;
(c) The effectiveness and efficiency of the services provided by the health care facility, physician or physicians in the group;
(d) Any financial hardship that rapidly reducing the rates that a health care facility or physician is authorized to charge would impose upon the health care facility or physician;
- *AB347* – 14 – (e) The extent to which the facility, physician or physicians in the group provide care to patients who are more vulnerable or who suffer from comorbidities that make treatment more difficult;
(f) The emphasis placed by the facility, physician or physicians in the group on promoting population health;
and (g) Any other criteria prescribed by the Division pursuant to section 22 of this act.
3.
When considering a request pursuant to subsection 2 of section 19 of this act, the panel:
(a) May request from the health care facility, physician or group of physicians any information that the panel determines to be necessary to render its decision;
and (b) Shall solicit input on the request from affected persons and entities, including, without limitation, insurers and patients.
Sec.
21.
1.
After considering a request pursuant to subsection 2 of section 19 of this act, the panel shall issue an order:
(a) Denying the request, fixing rates for the health care facility, physician or group of physicians in the amount set forth in paragraph (a) of subsection 1 of section 19 of this act and stating the reasons therefor;
(b) Adopting the rates requested by the health care facility, physician or group of physicians pursuant to subsection 2 of section 19 of this act;
or (c) Fixing rates for the health care facility, physician or group of physicians that are different from the rates requested by the health care facility, physician or group, as applicable, pursuant to subsection 2 of section 19 of this act.
2.
An order issued pursuant to subsection 1 concerning a request pursuant to subsection 2 of section 19 of this act must be issued on or before May 1 of the year in which the request was filed.
All rates fixed by the panel are in force, and are prima facie lawful, from the date of the order until 1 year after that date.
3.
A health care facility, physician or group of physicians may request to renew a fixed rate on or before March 1 of the year in which the rate is set to expire.
The health care facility, physician or group of physicians has the burden of demonstrating that the health care facility, physician or physicians in the group will not cover reasonable costs and earn a fair and reasonable profit charging the rates set forth in paragraph (a) of subsection 1 of section 19 of this act.
4.
A physician that is not part of a group of physicians for which a rate was fixed pursuant to this section may request to the Division to join that group for the purposes of inclusion in an application to renew that rate pursuant to subsection 3.
The - *AB347* – 15 – Division must grant the request if it determines that the physician is similarly situated to members of the group.
Sec.
22.
The Division shall adopt any regulations necessary to carry out the provisions of sections 14 to 23, inclusive, of this act.
Those regulations must include, without limitation, regulations prescribing:
1.
Any information that must be included in a request made pursuant to subsection 2 of section 19 of this act;
2.
The procedure and specific criteria, in addition to those prescribed by section 20 of this act, that the panel established pursuant to that section must use when considering such a request;
3.
A streamlined process for making and considering a request pursuant to subsection 3 of section 21 of this act to renew a rate established by the panel;
and 4.
Civil penalties that may be imposed against a health care facility or physician who charges rates different from those established for the health care facility or physician pursuant to sections 14 to 23, inclusive, of this act.
Sec.
23.
1.
The Division may report any failure by a health care facility or physician to comply with the provisions of sections 14 to 23, inclusive, of this act to the Division of Public and Behavioral Health of the Department, the Board of Medical Examiners or the State Board of Osteopathic Medicine, as applicable, for the initiation of disciplinary proceedings.
2.
The Division or the Attorney General may maintain in any court of competent jurisdiction a suit to enjoin any person from charging rates different from those established for the health care facility or physician under the provisions of sections 14 to 23, inclusive, of this act.
Such an injunction:
(a) May be issued without proof of actual damage sustained by any person as a preventive or punitive measure.
(b) Does not relieve any person or business entity from any other legal action.
3.
Any person or entity injured by the failure of a health care facility or physician to charge rates in accordance with the provisions of sections 14 to 23, inclusive, of this act may maintain in any court of competent jurisdiction a suit to recover:
(a) Damages resulting from such failure;
and (b) Attorney’s fees and costs.
Sec.
24.
NRS 439B.260 is hereby amended to read as follows:
439B.260 [1.
A major hospital shall reduce or discount the total billed charge by at least 30 percent for hospital services provided to an inpatient who:
- *AB347* – 16 – (a) Has no policy of health insurance or other contractual agreement with a third party that provides health coverage for the charge;
(b) Is not eligible for coverage by a state or federal program of public assistance that would provide for the payment of the charge;
and (c) Makes reasonable arrangements within 30 days after the date that notice was sent pursuant to subsection 2 to pay the hospital bill.
2.
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.
3.
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.
4.] A major hospital shall reduce or discount the total billed charge of its outpatient pharmacy by at least 30 percent to a patient who is eligible for Medicare.
[5.
As used in this section, “third party” means:
(a) An insurer, as that term is defined in NRS 679B.540;
(b) A health benefit plan, as that term is defined in NRS 687B.470, for employees which provides coverage for services and care at a hospital;
(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;
or (d) Any other insurer or organization providing health coverage or benefits in accordance with state or federal law.
 The term does not include an insurer that provides coverage under a policy of casualty or property insurance.] Sec.
25.
NRS 439B.400 is hereby amended to read as follows:
439B.400 Each hospital in this State shall maintain and use a uniform list of billed charges for that hospital for units of service or goods provided to all inpatients.
A hospital may not use a billed charge for an inpatient that is different than the billed charge used for another inpatient for the same service or goods provided.
This section does not restrict the ability of a hospital or other person to negotiate a discounted rate from the hospital’s billed charges or to contract for a different rate or mechanism for payment of the hospital [.] for goods and services that are not subject to the provisions of sections 14 to 23, inclusive, of this act.
- *AB347* – 17 – Sec.
26.
NRS 449.160 is hereby amended to read as follows:
449.160 1.
The Division may deny an application for a license or may suspend or revoke any license issued under the provisions of NRS 449.029 to 449.2428, inclusive, upon any of the following grounds:
(a) Violation by the applicant or the licensee of any of the provisions of NRS 439B.410 or 449.029 to 449.245, inclusive, or of any other law of this State or of the standards, rules and regulations adopted thereunder.
(b) Aiding, abetting or permitting the commission of any illegal act.
(c) Conduct inimical to the public health, morals, welfare and safety of the people of the State of Nevada in the maintenance and operation of the premises for which a license is issued.
(d) Conduct or practice detrimental to the health or safety of the occupants or employees of the facility.
(e) Failure of the applicant to obtain written approval from the Director of the Department of Health and Human Services as required by NRS 439A.100 or as provided in any regulation adopted pursuant to NRS 449.001 to 449.430, inclusive, and 449.435 to 449.531, inclusive, and chapter 449A of NRS if such approval is required.
(f) Failure to comply with the provisions of NRS 449.2486.
(g) Violation of the provisions of NRS 458.112.
(h) Failure to comply with the provisions of sections 14 to 23, inclusive, of this act, any regulations adopted pursuant thereto or any order issued pursuant thereto.
2.
In addition to the provisions of subsection 1, the Division may revoke a license to operate a facility for the dependent if, with respect to that facility, the licensee that operates the facility, or an agent or employee of the licensee:
(a) Is convicted of violating any of the provisions of NRS 202.470;
(b) Is ordered to but fails to abate a nuisance pursuant to NRS 244.360, 244.3603 or 268.4124;
or (c) Is ordered by the appropriate governmental agency to correct a violation of a building, safety or health code or regulation but fails to correct the violation.
3.
The Division shall maintain a log of any complaints that it receives relating to activities for which the Division may revoke the license to operate a facility for the dependent pursuant to subsection 2.
The Division shall provide to a facility for the care of adults during the day:
- *AB347* – 18 – (a) A summary of a complaint against the facility if the investigation of the complaint by the Division either substantiates the complaint or is inconclusive;
(b) A report of any investigation conducted with respect to the complaint;
and (c) A report of any disciplinary action taken against the facility.
 The facility shall make the information available to the public pursuant to NRS 449.2486.
4.
On or before February 1 of each odd-numbered year, the Division shall submit to the Director of the Legislative Counsel Bureau a written report setting forth, for the previous biennium:
(a) Any complaints included in the log maintained by the Division pursuant to subsection 3;
and (b) Any disciplinary actions taken by the Division pursuant to subsection 2.
Sec.
27.
NRS 449.243 is hereby amended to read as follows:
449.243 Every hospital licensed pursuant to the provisions of NRS 449.029 to 449.2428, inclusive:
1.
May, except as otherwise provided in subsection 2, utilize the Uniform Billing and Claims Forms established by the American Hospital Association.
2.
Shall, except as otherwise provided in this section, on its billings to patients, itemize, on a daily basis, all charges for services, and charges for equipment used and the supplies and medicines provided incident to the provision of those services with specificity and in language that is understandable to an ordinary lay person.
This itemized list must be timely provided after the patient is discharged at no additional cost.
3.
[Except as otherwise provided in this subsection, if a patient is charged a rate, pursuant to a contract or other agreement, that is different than the billed charges, shall provide to the patient either:
(a) A copy of the billing prepared pursuant to subsection 2;
(b) A statement specifying the agreed rate for the services;
or (c) If the patient is not obligated to pay any portion of the bill, a statement of the total charges.
 In any case, the hospital shall] Shall include on the billing [or statement] prepared pursuant to subsection 2 any copayment or deductible for which the patient is responsible.
The hospital shall answer any questions regarding the bill.
4.
[If the hospital is paid by the insurer of a patient a rate that is based on the number of persons treated and not on the services actually rendered, shall, upon the discharge of the patient, advise the patient of the status of any copayment or deductible for which the patient is responsible.
- *AB347* – 19 – 5.] Shall prepare a summary of charges for common services for patients admitted to the hospital and make it available to the public.
[6.] 5.
Shall provide to any patient upon request a copy of the billing prepared pursuant to subsection 2.
Sec.
28.
NRS 449.490 is hereby amended to read as follows:
449.490 1.
Every institution which is subject to the provisions of NRS 449.450 to 449.530, inclusive, shall file with the Department the following financial statements or reports in a form and at intervals specified by the Director but at least annually:
(a) A balance sheet detailing the assets, liabilities and net worth of the institution for its fiscal year;
and (b) A statement of income and expenses for the fiscal year.
2.
Each hospital with 100 or more beds shall file with the Department, in a form and at intervals specified by the Director but at least annually, a capital improvement report which includes, without limitation, any major service line that the hospital has added or is in the process of adding since the previous report was filed, any major expansion of the existing facilities of the hospital that has been completed or is in the process of being completed since the previous report was filed, and any major piece of equipment that the hospital has acquired or is in the process of acquiring since the previous report was filed.
3.
In addition to the information required to be filed pursuant to subsections 1 and 2, each hospital with 100 or more beds shall file with the Department, in a form and at intervals specified by the Director but at least annually:
(a) The expenses that the hospital has incurred for providing community benefits and the in-kind services that the hospital has provided to the community in which it is located.
These expenses must be reported as the total amount expended for community benefits and in-kind services and reported as a percentage of the total net revenues of the hospital.
For the purposes of this paragraph, “community benefits” includes, without limitation, goods, services and resources provided by a hospital to a community to address the specific needs and concerns of that community, services provided by a hospital to the uninsured and underserved persons in that community, training programs for employees in a community and health care services provided in areas of a community that have a critical shortage of such services, for which the hospital does not receive full reimbursement.
(b) [A statement of its policies and procedures for providing discounted services to, or reducing charges for services provided to, persons without health insurance that are in addition to any - *AB347* – 20 – reduction or discount required to be provided pursuant to NRS 439B.260.
(c)] A list of the services which the hospital purchased from its corporate home office.
[(d)] (c) A report of the cost to the hospital of providing services to patients covered by Medicare.
[(e)] (d) Financial information from the consolidated corporation, if the hospital is owned by such a corporation and if that information is publicly available, including, without limitation, the annual report of the consolidated corporation.
[(f)] (e) A statement of its policies regarding patients’ account receivables, including, without limitation, the manner in which a hospital collects or makes payment arrangements for patients’ account receivables, the factors that initiate collections and the method by which unpaid account receivables are collected.
4.
A complete current charge master must be available at each hospital during normal business hours for review by the Director, any payor that has a contract with the hospital to pay for services provided by the hospital, any payor that has received a bill from the hospital and any state agency that is authorized to review such information.
The complete and current charge master must be made available to the Department, at the request of the Director, in an electronic format specified by the Department.
The Department may use the electronic copy of the charge master to review and analyze the data contained in the charge master and, except as otherwise provided in NRS 439A.200 to 439A.290, inclusive, shall not release or publish the information contained in the charge master.
5.
The Director shall require the certification of specified financial reports by an independent certified public accountant and may require attestations from responsible officers of the institution that the reports are, to the best of their knowledge and belief, accurate and complete to the extent that the certifications and attestations are not required by federal law.
6.
The Director shall require:
(a) The filing of all reports by specified dates, and may adopt regulations which assess penalties for failure to file as required;
and (b) The submission of a final annual report not later than 6 months after the close of the fiscal year,  and may grant extensions to institutions which can show that the required information is not available on the required reporting date.
7.
All reports, except privileged medical information, filed under any provisions of NRS 449.450 to 449.530, inclusive:
(a) Are open to public inspection;
(b) Must be in a form which is readily understandable by a member of the general public;
- *AB347* – 21 – (c) Must, as soon as practicable after those reports become available, be posted on the Internet website maintained pursuant to NRS 439A.270;
and (d) Must be available for examination at the office of the Department during regular business hours.
Sec.
29.
NRS 449.520 is hereby amended to read as follows:
449.520 1.
On or before October 1 of each year, the Director shall prepare and transmit to the Governor, the Legislative Committee on Health Care and the Interim Finance Committee a report of the Department’s operations and activities for the preceding fiscal year.
2.
The report prepared pursuant to subsection 1 must include:
(a) Copies of all reports, summaries, compilations and supplementary reports required by NRS 449.450 to 449.530, inclusive, together with such facts, suggestions and policy recommendations as the Director deems necessary;
(b) A summary of the trends of the audits of hospitals in this State that the Department required or performed during the previous year;
(c) An analysis of the trends in the costs, expenses and profits of hospitals in this State;
(d) An analysis of the methodologies used to determine the corporate home office allocation of hospitals in this State;
(e) An examination and analysis of the manner in which hospitals are reporting the information that is required to be filed pursuant to NRS 449.490, including, without limitation, an examination and analysis of whether that information is being reported in a standard and consistent manner, which fairly reflect the operations of each hospital;
(f) [A review and comparison of the policies and procedures used by hospitals in this State to provide discounted services to, and to reduce charges for services provided to, persons without health insurance;
(g)] A review and comparison of the policies and procedures used by hospitals in this State to collect unpaid charges for services provided by the hospitals;
and [(h)] (g) A summary of the status of the programs established pursuant to NRS 439A.220 and 439A.240 to increase public awareness of health care information concerning the hospitals and surgical centers for ambulatory patients in this State, including, without limitation, the information that was posted in the preceding fiscal year on the Internet website maintained for those programs pursuant to NRS 439A.270.
- *AB347* – 22 – 3.
The Legislative Committee on Health Care shall develop a comprehensive plan concerning the provision of health care in this State which includes, without limitation:
(a) A review of the health care needs in this State as identified by state agencies, local governments, providers of health care and the general public;
and (b) A review of the capital improvement reports submitted by hospitals pursuant to subsection 2 of NRS 449.490.
Sec.
30.
NRS 449A.118 is hereby amended to read as follows:
449A.118 1.
Every medical facility and facility for the dependent shall inform each patient or the patient’s legal representative, upon the admission of the patient to the facility, of the patient’s rights as listed in NRS 449A.100 and 449A.106 to 449A.115, inclusive.
2.
In addition to the requirements of subsection 1, if a person with a disability is a patient at a facility, as that term is defined in NRS 449A.218, the facility shall inform the patient of his or her rights pursuant to NRS 449A.200 to 449A.263, inclusive.
3.
In addition to the requirements of subsections 1 and 2, every hospital shall, upon the admission of a patient to the hospital, provide to the patient or the patient’s legal representative:
(a) Notice of the right of the patient to:
(1) Designate a caregiver pursuant to NRS 449A.300 to 449A.330, inclusive;
and (2) Express complaints and grievances as described in paragraphs (b) to (f), inclusive;
(b) The name and contact information for persons to whom such complaints and grievances may be expressed, including, without limitation, a patient representative or hospital social worker;
(c) Instructions for filing a complaint with the Division;
(d) The name and contact information of any entity responsible for accrediting the hospital;
(e) A written disclosure approved by the Director of the Department of Health and Human Services, which written disclosure must set forth:
(1) Notice of the existence of the Bureau for Hospital Patients created pursuant to NRS 232.462;
(2) The address and telephone number of the Bureau;
and (3) An explanation of the services provided by the Bureau, including, without limitation, the services for dispute resolution described in subsection 3 of NRS 232.462;
and (f) Contact information for any other state or local entity that investigates complaints concerning the abuse or neglect of patients.
[4.
In addition to the requirements of subsections 1, 2 and 3, every hospital shall, upon the discharge of a patient from the - *AB347* – 23 – hospital, provide to the patient or the patient’s legal representative a written disclosure approved by the Director, which written disclosure must set forth:
(a) If the hospital is a major hospital:
(1) Notice of the reduction or discount available pursuant to NRS 439B.260, including, without limitation, notice of the criteria a patient must satisfy to qualify for a reduction or discount under that section;
and (2) Notice of any policies and procedures the hospital may have adopted to reduce charges for services provided to persons or to provide discounted services to persons, which policies and procedures are in addition to any reduction or discount required to be provided pursuant to NRS 439B.260.
The notice required by this subparagraph must describe the criteria a patient must satisfy to qualify for the additional reduction or discount, including, without limitation, any relevant limitations on income and any relevant requirements as to the period within which the patient must arrange to make payment.
(b) If the hospital is not a major hospital, notice of any policies and procedures the hospital may have adopted to reduce charges for services provided to persons or to provide discounted services to persons.
The notice required by this paragraph must describe the criteria a patient must satisfy to qualify for the reduction or discount, including, without limitation, any relevant limitations on income and any relevant requirements as to the period within which the patient must arrange to make payment.
 As used in this subsection, “major hospital” has the meaning ascribed to it in NRS 439B.115.
5.
In addition to the requirements of subsections 1 to 4, inclusive, every hospital shall post in a conspicuous place in each public waiting room in the hospital a legible sign or notice in 14- point type or larger, which sign or notice must:
(a) Provide a brief description of any policies and procedures the hospital may have adopted to reduce charges for services provided to persons or to provide discounted services to persons, including, without limitation:
(1) Instructions for receiving additional information regarding such policies and procedures;
and (2) Instructions for arranging to make payment;
(b) Be written in language that is easy to understand;
and (c) Be written in English and Spanish.] Sec.
31.
NRS 450.420 is hereby amended to read as follows:
450.420 1.
The board of county commissioners of the county in which a public hospital is located may determine whether patients presented to the public hospital for treatment are subjects of charity.
- *AB347* – 24 – Except as otherwise provided in NRS 439B.330, the board of county commissioners shall establish by ordinance criteria and procedures to be used in the determination of eligibility for medical care as medical indigents or subjects of charity.
2.
The board of hospital trustees shall fix the charges for [treatment of] the provision of goods and services that are not subject to the provisions of sections 14 to 23, inclusive, of this act to those persons able to pay for the charges, as the board deems just and proper.
The board of hospital trustees may impose an interest charge of not more than 12 percent per annum on unpaid accounts.
The receipts must be paid to the county treasurer and credited to the hospital fund.
In fixing charges pursuant to this subsection the board of hospital trustees shall not include, or seek to recover from paying patients, any portion of the expense of the hospital which is properly attributable to the care of indigent patients.
3.
Except as provided in subsection 4 of this section and subsection 3 of NRS 439B.320, the county is chargeable with the entire cost of services rendered by the hospital and any salaried staff physician or employee to any person admitted for emergency treatment, including all reasonably necessary recovery, convalescent and follow-up inpatient care required for any such person as determined by the board of trustees of the hospital, but the hospital shall use reasonable diligence to collect the charges from the emergency patient or any other person responsible for the support of the patient.
Any amount collected must be reimbursed or credited to the county.
4.
The county is not chargeable with the cost of services rendered by the hospital or any attending staff physician or surgeon to the extent the hospital is reimbursed for those services pursuant to NRS 428.115 to 428.255, inclusive.
Sec.
32.
NRS 630.3062 is hereby amended to read as follows:
630.3062 1.
The following acts, among others, constitute grounds for initiating disciplinary action or denying licensure:
(a) Failure to maintain timely, legible, accurate and complete medical records relating to the diagnosis, treatment and care of a patient.
(b) Altering medical records of a patient.
(c) Making or filing a report which the licensee knows to be false, failing to file a record or report as required by law or knowingly or willfully obstructing or inducing another to obstruct such filing.
(d) Failure to make the medical records of a patient available for inspection and copying as provided in NRS 629.061, if the licensee is the custodian of health care records with respect to those records.
(e) Failure to comply with the requirements of NRS 630.3068.
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  1. (No further action taken.)

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

  3. From committee: Amend, and do pass as amended. Placed on Second Reading File. Read second time. Amended. (Amend. No. 345.) Rereferred to Committee on Ways and Means. Exemption effective. To printer.

  4. Notice of eligibility for exemption.

  5. From printer. To committee.

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

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Whip count is in markup. Polling the chamber and every recorded vote this session. Only the first open is slow. It’s instant for you after this. Calling the roll · Tallying · Engrossing

Subjects

healthcare health-insurance
Cross-referencing the record. Reading this bill against every other bill in the corpus by meaning, not keywords. Only the first open is slow. It’s instant for you after this. Matching · Ranking · Engrossing

Frequently asked questions

Who sponsors AB 347?
AB 347 is sponsored by Orentlicher, David (Democratic).
What is the current status of AB 347?
This bill died with 2021 Regular Session. It reached “In Committee” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.
Where can I track AB 347?
Track AB 347 free on One Click Politics — get push/email alerts when it moves.

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Last checked for changes 2 months ago · updated continuously

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