SB 191 — Makes certain changes relating to applied behavior analysis. (BDR 38-545)

REQUIRESSenate TWO-THIRDSBill MAJORITYNo. VOTE (§ 2) EXEMPT (Reprinted with amendments adopted on April 18, 2023) FIRST REPRINT S.B.

191191–Senator SENATESeevers BILLGansert NOCHAPTER.......... .

191–SENATOR SEEVERS GANSERT FEBRUARY 22, 2023 ____________ Referred to Committee on Health and Human Services SUMMARY—Makes certain changes relating to applied behavior analysis.

(BDR 38-545) FISCAL NOTE:

Effect on Local Government:

No.

Effect on the State:

Yes.

~ EXPLANATION – Matter in bolded italics is new;

matter between brackets [omitted material] is material to be omitted.

making appropriations to and authorizing expenditures by the Division of Health Care Financing and Policy of the Department of Health and Human Services;

ServicesExisting tolaw developrequires andthe administerDirector aof Statethe PlanDepartment forof MedicaidHealth whichand includesHuman a list of specific medical services required to be provided to Medicaid recipients.

(NRS(NRSt 422.063, 422.270-422.27497) Existing law requires the State Plan for Medicaid to include:

and (2) reasonable limits on the number of hours that such providers are authorized to bill 422.27497) Section 1 of this bill requires the Director to include in the State Plan coverage for the cost of services provided toby abehavior recipientanalysts, ofassistant behavior analysts and registered behavior technicians to Medicaid inrecipients awho 24-hourare period.less than 27 years of age.

(NRSd to bill 422.27497) Section 1 of this bill requires the Director to include in the State Plan coverage for the cost of services provided by behavior analysts, assistant behavior analysts and registered behavior technicians to Medicaid recipients who are less than 27 years of age.

-Section *SB191_R1*2.5 –of 2this –bill THEmakes PEOPLEan OFappropriation THEto, STATEand OFauthorizes NEVADA,expenditure REPRESENTEDby, INthe SENATEDivision ANDof ASSEMBLY,Health DOCare ENACTFinancing ASand FOLLOWS:Policy of the Department for the administrative and medical service costs of providing Medicaid coverage for certain services provided by behavior analysts, assistant behavior analysts and registered behavior technicians pursuant to section 1.

EXPLANATION – Matter in bolded italics is new;

matter between brackets [omitted material] is material to be omitted.

THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:

The Director shall include in the State Plan for Medicaid a requirement that the State pay the nonfederal share of expenditures incurred for services provided by behavior analysts, assistant behavior analysts and registered behavior technicians- 82nd Session (2023) – 2 – age.nicians to recipients of Medicaid who are less than 27 years of age.2.

2.

3.]4.] 2.2On or before January 31 of each year, the Division shall:

4.

On or before January 31 of each year, the Division shall:

(1) The number of recipients of Medicaid who were newly diagnosed with an autism spectrum disorder during the immediately preceding year and the number of those recipients for whom assistance with care management was provided;

(4) The number of assessments or evaluations by a behavior analyst that were reimbursed through Medicaid during thethebehavior immediately preceding year;

- *SB191_R1* – 3 – (5) The total number of claims for applied behavior analysis services provided to recipients of Medicaid made during the immediately preceding year;

(6) For the immediately preceding year, the average times that elapsed between claims for each step of the process that a recipient of Medicaid must undergo to receive treatment from a registered behavior technician, beginning with initial diagnosis with - 82nd Session (2023) – 3 – an autism spectrum disorder and including, without limitation, comprehensive diagnosis with an autism spectrum disorder, evaluation and treatment by a behavior analyst and treatment by a registered behavior technician;

(7) The number of recipients of Medicaid receiving services through Medicaid managed care who were, at the end of thetheservices immediately preceding year, on a wait list for applied behavior analysis services;

and (2)Committee Inon even-numberedHealth years,and theHuman JointServices.oint Interim Standing Committee[4.] on5. Health and Human Services.

[4.] 5.

- *SB191_R1* – 4 – (d) “Registered behavior technician” has the meaning ascribed to it in NRS 641D.100.

8- Application82nd forSession licensure(2023) as– a4 behavior– analystAppassistant or assistant behavior analyst............................................$100 Issuance of an initial license as a behavior analyst or assistant behavior analyst...................................[25] 450 Biennial renewal or reinstatement of a license as a behavior analyst ............................................................550 Biennial renewal or reinstatement of a license as an assistant behavioral analyst...........................................425 Biennial renewal or reinstatement of a registration as a registered behavior technician................................100 Placement of a license on inactive status............................100 Biennial review of a license on inactive status...................100 Restoration to active status of a license as a behavior analyst on inactive status if the restoration occurs during the first year of the biennium in which the license was issued or renewed.........................................................................300 RestorationResbehavior to active status of a license as a behavior analyst on inactive status if thethea restoration occurs during the second year of the biennium in which the license was issued or renewed.........................................................................100 Restoration to active status of a license as an assistant behavior analyst on inactive status if the restoration occurs during the first year of the biennium in which the license was issued or renewed.........................................................................175 Restoration to active status of a license as an assistant behavior analyst on inactive status if the restoration occurs during the second year of the biennium in which the license was issued or renewed...........................................................................40 Reproduction and mailing of material for an application.......................................................................25 A dishonored check..............................................................35check..............................................................35...25 A change of name on a license or registration......................25 A duplicate license or registration........................................25 - *SB191_R1* – 5 – Copies of the provisions of NRS relating to the practice of applied behavior analysis and the rules and regulations adopted by the Board..................$25Board....................25 Letter of good standing.........................................................15 RevcontinuingReview and approval of a course or program of continuing education.......................................................25 8- 82nd Session (2023) – 5 – 2.

2.5.

1.

There is hereby appropriated from the State General Fund to the Division of Health Care Financing and Policy of the Department of Health and Human Services for the administrative and medical service costs of providing Medicaid coverage for services provided by behavior analysts, assistant of Medicaid who are less than 27 years of age the following sums:ts For the Fiscal Year 2023-2024..................................$118,272 For the Fiscal Year 2024-2025..................................$671,531 2.

Expenditure of the following sums not appropriated from the State General Fund or the State Highway Fund is hereby authorized by the Division of Health Care Financing and Policy of the Department of Health and Human Services for the same purpose as set forth in subsection 1:

For the Fiscal Year 2023-2024..................................$351,662 For the Fiscal Year 2024-2025...............................$1,610,899 3.

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 20, 2024, and September 19, 2025, 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 20, 2024, and September 19, 2025, respectively.

Sec.