AB 178 — Revises provisions relating to prescription drugs. (BDR 57-71)
Last action — Approved by the Governor. Chapter 179.
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✓Introduced
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✓In Committee
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✓Passed Assembly
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✓Passed Senate
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✓To Executive
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6Enacted
This bill has been enacted into law. Introduced February 25, 2021. Enacted.
Odds of enactment
High chanceBased on the sponsor, cosponsors, and committee posture, this bill has a high chance of becoming law.
Upgrade to see the exact probability and what's driving it.
A statistical estimate from our own model of past outcomes — an insight, not a guarantee. Policymaking is volatile.
Prognosis
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Enacted
Current position in the legislative process.
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6 sponsors
3 primary, 3 co-sponsors signed on.
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Single-party support
Sponsorship is currently within one party (4 R).
Based on stage, sponsorship breadth, committee status, recorded votes, and cross-state momentum — a description of the observable signals, not a prediction.
Bill Text
What changed in the latest version
615 added · 656 removed615 line(s) added, 656 removed.
A.B.Assembly Bill No.
178178–Assemblywomen AHardy, SSEMBLYTitus; B ILLN O.
178–ASSEMBLYWOMENand HTolles ARDYJoint ,Sponsors: ITUS ;AND T OLLES FEBRUARY 25, 2021 ____________ JOINT SPONSORS :
ENATORSSenators HHardy; ARDY ;
BUCKBuck AND H AMMOND ____________ Referred to Committee on Commerce and LaborHammond SUMMARY—RevisesCHAPTER.......... provisions relating to prescription drugs.
(BDR 57-71) FISCAL NOTE:
Effect on Local Government:
May have Fiscal Impact.
Effect on the State:
Yes.
CONTAINS UNFUNDED MANDATE (§ 14) (NOTR EQUESTED AFFECTEDLOCALGOVERNMENT) ~ EXPLANATION – Matter in bolded italics is new;
matter between brackets [omitted material] is material to be omitted.
Existing law authorizes the Governor or the Legislature to declare a state of emergency or issue a declaration of disaster upon a finding that an attack upon the United States has occurred or is anticipated in the immediate future, or that a natural, technological or man-made emergency or disaster of major proportions has actually occurred within this State.
(NRS 414.070) Sections 1, 3, 4, 6-9, 11, 12 and 14-16 of this bill require insurers, including Medicaid, the Public Employees’ Benefits Program and local governments that provide coverage for their employees, to:
and (2) authorize payment for a supply of a covered prescription drug for up to 30 - *AB178* – 2 – days for any insured who requests a refill under those conditions.
Sections 1, 3, 4, 6-8, 11, 12 and 16 of this bill additionally authorize the Commissioner of Insurance 13, 17 and 18 of this bill make conforming changes to extendindicate thosethe timeplacement periodsof10, assections he1, or4, she8 determinesand necessary.16 in the Nevada Revised Statutes.
Sections 2, 5, 10, sections 1, 4, 8 and 16 in the Nevada Revised Statutes.ndicate the placement of Existing law generally authorizes a pharmacist to refill a prescription only for the number of times authorized or for the period authorized by the prescribing practitioner.
(NRS 639.2396) Sections 19 and 20 of this bill create an exception to this rule to allow a pharmacist to fill or refill a prescription in an amount that is exceedgreater athan 30-daythe supplyamount ofauthorized by the drugprescribing if:practitioner but does not listed in schedule II;
(1) the drug is not a controlled substance listed in schedule II;
- 81st Session (2021) – 2 – EXPLANATION – Matter in bolded italics is new;
matter between brackets [omitted material] is material to be omitted.
(1) Has not exceeded the number of refills authorized by the prescribingpr(2) practitioner;Resides in the area for which the emergency or disaster has been declared;
(2) Resides in the area for which the emergency or disaster has been declared;
- *AB178* – 3 – Sec.
Sec.thereto a new section to read as follows:y amended by adding 1.
3.If the Governor or the Legislature proclaims the existence of a state of emergency or issues a declaration of disaster pursuant - 81st Session (2021) – 3 – to NRS 414.070, an insurer who has issued a policy of group health insurance which provides coverage for prescription drugs shall, notwithstanding any provision of the policy to the contrary:
Chapter(a) 689BWaive any provision of NRSthe ispolicy herebyrestricting amendedthe bytime addinginsured:hich theretoan insured may refill a newcovered sectionprescription toif readthe as(1) follows:Has not exceeded the number of refills authorized by the prescribing practitioner;
1.
If the Governor or the Legislature proclaims the existence of a state of emergency or issues a declaration of disaster pursuant to NRS 414.070, an insurer who has issued a policy of group health insurance which provides coverage for prescription drugs shall, notwithstanding any provision of the policy to the contrary:
(a) Waive any provision of the policy restricting the time within which an insured may refill a covered prescription if the insured:
(1) Has not exceeded the number of refills authorized by the prescribing practitioner;
If the Governor or the Legislature proclaims the existence of a state of emergency or issues a declaration of disaster pursuant to NRS 414.070, a carrier who has issued a health benefit plan whichnotwithstanding providesany coverageprovision forof prescriptionthe drugsplan to the contrary:s shall, notwithstanding(a) Waive any provision of the health benefit plan torestricting the contrary:time within which an insured may refill a covered prescription if the insured:
(a)(1) WaiveHas anynot provisionexceeded of the healthnumber benefitof planrefills restrictingauthorized theby time within which an insured may refill a covered prescription if the insured:prescribing practitioner;
- *AB178* – 4 – (1) Has not exceeded the number of refills authorized by the prescribing practitioner;
- 81st Session (2021) – 4 – 2.
As used in this section, “practitioner” has the meaning ascribedascSec. to it in NRS 639.0125.
Sec.5.o iNRS 689C.425 is hereby amended to read as follows:
5.
NRS 689C.425 is hereby amended to read as follows:
and (3) Requests the refill not later than the end of the state of emergency or disaster or 30 days after the issuance of the proclamation or declaration, whichever is later;
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andandof the (b) Authorize payment for, and may apply a copayment, coinsurance or deductible to, a supply of a covered prescription drug for up to 30 days for an insured who requests a refill pursuant to paragraph (a).
- *AB178* – 5 – 2.
If the Governor or the Legislature proclaims the existence of a state of emergency or issues a declaration of disaster pursuant to NRS 414.070, a hospital or medical services corporation who has- issued81st aSession policy(2021) of– health5 insurance– which provides coverage for prescription drugs shall, notwithstanding any provision of the policy to the contrary:
2.by subsection 1 in increments of 15 or 30 days as he or sheibed determines to be necessary.
The Commissioner may extend the time periods prescribed by subsection 1 in increments of 15 or 30 days as he or she determines to be necessary.
(1)the Hasprescribing notpractitioner;e exceeded the number of refills authorized by (2) Resides in the prescribingarea practitioner;for which the emergency or disaster has been declared;
- *AB178* – 6 – (2) Resides in the area for which the emergency or disaster has been declared;
and (b) Authorize payment for, and may apply a copayment, coinsurance or deductible to, a supply of a covered prescription - 81st Session (2021) – 6 – drug for up to 30 days for an enrollee who requests a refill pursuant to paragraph (a).
The Commissioner may extend the time periods prescribed by subsection 1 in increments of 15 or 30 days as he or she determinesdet3.minAs used in this section, “practitioner” has the meaning ascribed to beit necessary.in NRS 639.0125.
3.
As used in this section, “practitioner” has the meaning ascribed to it in NRS 639.0125.
The provisions of NRS 695C.110, 695C.125, 695C.1691, 695C.1693, 695C.170, 695C.1703, 695C.1705, 695C.1709 to 695C.173, inclusive, 695C.1733, 695C.17335, 695C.1734, 695C.1751, 695C.1755, 695C.176 to 695C.200, inclusive, and 695C.265 do not apply to a health maintenance organization that provides health care services through managed care to recipients of Medicaid under the State Plan for Medicaid or insurance pursuant to the Children’s Health Insurance Program pursuant to a contract with the Division of Health Care Financing and Policy of the Department of Health and Human Services.
The provisions of NRS 695C.1694 to 695C.1698, inclusive, 695C.1701, 695C.1708, 695C.1728, 695C.1731, 695C.17345, 695C.1735, 695C.1745 and 695C.1757 and section 8 of this act apply to a health maintenance organization that provides health care - *AB178* – 7 – services through managed care to recipients of Medicaid under the State Plan for Medicaid.
The Commissioner may suspend or revoke any certificate of authority issued to a health maintenance organization - 81st Session (2021) – 7 – pursuant to the provisions of this chapter if the Commissioner finds that any of the following conditions exist:
(a) The health maintenance organization is operating significantly in contravention of its basic organizational document, its health care plan or in a manner contrary to that described in and reasonably inferred from any other information submitted pursuant and to NRS 695C.060, 695C.070 and 695C.140, unless any amendments to those submissions have been filed with and approved by the Commissioner;
(f) The health maintenance organization has failed to put into effect a mechanism affording the enrollees an opportunity to participate in matters relating to the content of programs pursuant to NRS(g) The health maintenance organization has failed to put into effect the system required by NRS 695C.110;695C.260 for:
(g) The health maintenance organization has failed to put into effect the system required by NRS 695C.260 for:
- *AB178* – 8 – (i) The continued operation of the health maintenance organization would be hazardous to its enrollees or creditors or to the general public;
or (k)- The81st healthSession maintenance(2021) organization– has8 otherwise– failed to comply substantially with the provisions of this chapter.chapter.failed to 2.
2.
The Commissioner may, by written order, permit such further operation of the organization as the Commissioner may find to be in the best interest of enrollees to the end that enrollees are afforded the greatest practical opportunity to obtain continuing coverage forford health care.
(2) Resides in the area for which the emergency or disaster has been declared;
andandthe area for which the emergency or disaster (3) Requests the refill not later than the end of the state of emergency or disaster or 30 days after the issuance of the proclamation or declaration, whichever is later;
and (b) Authorize payment for, and may apply a copayment, coinsurance or deductible to, a supply of a covered prescription - *AB178* – 9 – drug for up to 30 days for an enrollee who requests a refill pursuant to paragraph (a).
- 81st Session (2021) – 9 – 2.
As used in this section, “practitioner” has the meaning ascribedascSec. to it in NRS 639.0125.
Sec.
2.by subsection 1 in increments of 15 or 30 days as he or sheibed determines to be necessary.
The Commissioner may extend the time periods prescribed by subsection 1 in increments of 15 or 30 days as he or she determines to be necessary.
- *AB178*81st Session (2021) – 10 – (4) The Administrator of the Division of Health Care Financing and Policy;
(b) Shall administer, through the divisions of the Department, the provisions of chapters 63, 424, 425, 427A, 432A to 442,442,tment, inclusive, 446 to 450, inclusive, 458A and 656A of NRS, NRS 127.220 to 127.310, inclusive, 422.001 to 422.410, inclusive, and section 16 of this act, 422.580, 432.010 to 432.133, inclusive, 432B.6201 to 432B.626, inclusive, 444.002 to 444.430, inclusive, and 445A.010 to 445A.055, inclusive, and all other provisions of law relating to the functions of the divisions of the Department, but is not responsible for the clinical activities of the Division of Public and Behavioral Health or the professional line activities of the other divisions.
(1) Identify and assess the plans and programs of the Department for the provision of human services, and any duplicationduplica(2) ofSet thoseforth servicespriorities byfor federal,the stateprovision andof localthose agencies;services;
(2) Set forth priorities for the provision of those services;
- 81st Session (2021) – 11 – (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 - *AB178* – 11 – detailed information relating to their budgets and payrolls, which the Directorupon deemshim necessaryor forher thepursuant performanceto this section.nce of the duties imposed upon(f) himHas orsuch herother pursuantpowers toand thisduties section.as are provided by law.
(f) Has such other powers and duties as are provided by law.
(b) Purchase group policies of life, accident or health insurance, or any combination thereof, for the benefit of such officers and employees, and the dependents of such officers and employees, as have authorized the purchase, from insurance companies authorized to transact the business of such insurance in the State of Nevada, and, where necessary, deduct from the compensation of officers and employees the premiums upon insurance and pay the deductionsdeductionsrs and upon the premiums.
Any contract with an independent administrator must be approved by the - 81st Session (2021) – 12 – Commissioner of Insurance as to the reasonableness of administrative charges in relation to contributions collected and benefits provided.
The provisions of NRS 687B.408, 689B.030 to 689B.050, inclusive, and section 3 of this act, 689B.287 and 689B.500 apply to coverage provided pursuant to this paragraph, - *AB178* – 12 – except that the provisions of NRS 689B.0378, 689B.03785 andandaph, 689B.500 only apply to coverage for active officers and employees of the governing body, or the dependents of such officers and employees.
In any county in which a legal services organization exists, the governing body of the county, or of any school district, municipal corporation, political subdivision, public corporation or other local governmental agency of the State of Nevada in the county, may enter into a contract with the legal services organization pursuant to which the officers and employees of the legal services organization, and the dependents of those officers and employees, are eligible for any life, accident or health insuranceinsuranceand provided pursuant to this section to the officers and employees, and the dependents of the officers and employees, of the county, school district, municipal corporation, political subdivision, public corporation or other local governmental agency.
5.- 81st Session (2021) – 13 – (a) Must be submitted to the Commissioner of Insurance for 3:
Aapproval contractnot thatless isthan entered30 intodays pursuantbefore the date on which the contract is to subsectionbecome 3:effective.
(a) Must be submitted to the Commissioner of Insurance for approval not less than 30 days before the date on which the contract is to become effective.
- *AB178* – 13 – (c) Shall be deemed to be approved if not disapproved by the Commissioner within 30 days after its submission.
287.04335 If the Board provides health insurance through a plan of self-insurance, it shall comply with the provisions of NRS 687B.409, 689B.255, 695G.150, 695G.155, 695G.160, 695G.162, 695G.164, 695G.1645, 695G.1665, 695G.167, 695G.170 to 695G.174, inclusive, 695G.177, 695G.200 to 695G.230, inclusive, 695G.241 to 695G.310, inclusive, and 695G.405 [,] and section 12 of this act, in the same manner as an insurer that is licensed pursuant to title 57 of NRS is required to comply with those provisions.
(b) Resides in the area for which the emergency or disaster has beenbee(c) declared;Requests the refill not later than the end of the state of emergency or disaster or 30 days after the issuance of the proclamation or declaration, whichever is later.
and (c) Requests the refill not later than the end of the state of emergency or disaster or 30 days after the issuance of the proclamation or declaration, whichever is later.
- 81st Session (2021) – 14 – 3.
4.ascribed to it in NRS 639.0125.
As used in this section, “practitioner” has the meaning ascribedSec. to it in NRS 639.0125.
Sec.
422.401 As used in NRS 422.401 to 422.406, inclusive, and section 16 of this act, unless the context otherwise requires, the - *AB178* – 14 – words and terms defined in NRS 422.4015 to 422.4024, inclusive, have the meanings ascribed to them in those sections.
A pharmacist may, pursuant to a valid prescription that specifies an initial amount of less than a 30-day supply of a drug that is not a controlled substance listed in schedule II or periodic refills of an amount less than a 30-day supply of such a drug, dispense an amount of the drug that exceeds the amount a drug, authorized by the prescribing practitioner but does not exceed a 30-day supply of the drug if:
2.- 81st Session (2021) – 15 – shall:A pharmacist who dispenses a drug pursuant to subsection (a) Issue and sign a written order for the dispensing of the drug that contains the information described in subsection 2 of NRS 639.2353.
A pharmacist who dispenses a drug pursuant to subsection 1 shall:
(a) Issue and sign a written order for the dispensing of the drug that contains the information described in subsection 2 of NRS 639.2353.
Except as otherwise provided by subsection 2 [,] and section 19 of this act, a prescription which bears specific - *AB178* – 15 – authorization to refill, given by the prescribing practitioner at the time he or she issued the original prescription, or a prescription which bears authorization permitting the pharmacist to refill the prescription as needed by the patient, may be refilled for the number of times authorized or for the period authorized if it was refilled in accordanceuse.rdance with the number of doses ordered and the directions for use.2.
2.
and (c) The prescribing practitioner has not specified on the prescription that dispensing the prescription in an initial amount of less than a 90-day supply followed by periodic refills of the initial amount of the drug is medically necessary.
- 81st Session (2021) – 16 – Sec.
H~~~~~ 21 - *AB178*81st Session (2021)
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Action History
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Approved by the Governor. Chapter 179.
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Enrolled and delivered to Governor.
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In Assembly. To enrollment.
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Read third time. Passed. Title approved. (Yeas: 20, Nays: None, Excused: 1.) To Assembly.
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Taken from General File. Placed on General File for next legislative day.
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Taken from General File. Placed on General File for next legislative day.
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Read second time.
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From committee: Do pass.
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In Senate. Read first time. Referred to Committee on Health and Human Services. To committee.
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Read third time. Passed. Title approved. (Yeas: 40, Nays: None, Excused: 2.) To Senate.
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From committee: Do pass. Placed on Second Reading File. Read second time.
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From printer. To committee.
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Read first time. Referred to Committee on Commerce and Labor. To printer.
Sponsors
- Melissa R.. Hardy · Primary
- Melissa R.. Hardy · Primary
- Robin L. Titus · Primary
- Carrie Ann Buck · Cosponsor
- Scott Hammond · Cosponsor
- Jill Tolles · Cosponsor
Sponsorship breakdown
Export CSV (upgrade) →3 sponsors · 3 co-sponsors · 61 not signed on
Sponsors (3)
- Hardy, Melissa R.. Republican
- Hardy, Melissa R.. Republican
- Titus, Robin L. Republican
Co-sponsors (3)
- Buck, Carrie Ann Republican
- Scott Hammond
- Jill Tolles
Not signed on (61)
61 members have not signed on to this bill.
Show all 61 →"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.
Subjects
Frequently asked questions
- Who sponsors AB 178?
- AB 178 is sponsored by Hardy, Melissa R.. (Republican), Titus, Robin L. (Republican), Buck, Carrie Ann (Republican), Scott Hammond, and Jill Tolles.
- What is the current status of AB 178?
- This bill has been enacted into law. Introduced February 25, 2021. Enacted.
- Where can I track AB 178?
- Track AB 178 free on One Click Politics — get push/email alerts when it moves.
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