SB 262 — Revises provisions relating to graduate medical education. (BDR 18-120)

3.

The Department of Health and Human Services shall not approve an application to eliminate or reduce the size of a - 83rd Session (2025) – 3 – program for residency training and postdoctoral fellowships submitted pursuant to subsection 2 unless the application demonstrates that the elimination or reduction:

(a) Is justified by a decrease in the needs of patients in the limitation, the need for physicians who practice in any specialty in which the program provides residency training;

and (b) Is not likely to negatively impact the overall availability of providers of health care in this State.

4.

If an institution violates subsection 1, the Department of Health and Human Services may:

(a) Suspend or revoke the grant awarded to the institution through the Graduate Medical Education Grant Program;

or (b) Disqualify the institution from receiving future grants through the Graduate Medical Education Grant Program.

Sec.

1.5.

4.of Economic Development concerning the administration of the Office policies and programs of the Office of Science, Innovation and Technology.

Report periodically to the Executive Director of the Office of Economic Development concerning the administration of the policies and programs of the Office of Science, Innovation and Technology.

- *SB262_R1*83rd Session (2025) – 34 – (c) Coordinating and processing applications for state and federal money relating to broadband services;

(e) In consultation with providers of health care from various health care settings, the expansion of telehealth services to reduce health care costs and increase health care quality and access in this State, especially in rural, unserved and underserved areas of this State;

7.] In carrying out his or her duties pursuant to this section, consult with the Executive Director of the Office of EconomicEconomicction, Development and cooperate with the Executive Director in implementing the State Plan for Economic Development developed by the Executive Director pursuant to subsection 2 of NRS 231.053.

3.- 83rd Session (2025) – 5 – Account, after deducting any applicable charges, must be credited to the Account.

The4. interest and income earned on the money in the Account, after deducting any applicable charges, must be credited to the Account.

- *SB262_R1* – 4 – 4.

and (b) Apply for and accept any grant, loan or other source of money,  for deposit in the Account to assist the Director in carrying out the Graduate Medical Education Grant Program established pursuant to NRS 223.637.

[and] or (2) Operating programs for residency training that are approved by the Accreditation Council for Graduate Medical Education, or its successor organization, and that are training a number of residents that exceeds the maximum number of full-full-ing a time equivalent resident positions for which the institution receives direct graduate medical education or indirect medical education payments from Medicare;

5.- 83rd Session (2025) – 6 – year does not revert to the State General Fund, and the balance inl the Account must be carried forward to the next fiscal year.

Any money remaining in the Account at the end of the fiscal year does not revert to the State General Fund, and the balance in the Account must be carried forward to the next fiscal year.

- *SB262_R1* – 5 – Sec.

(b) The dean of each school of osteopathic medicine in this State that is accredited by the Commission on Osteopathic College Accreditationsuccessor oforganization, theor Americanhis Osteopathicor Associationher designee;iation or its successor(c) organization,Two ormembers hisappointed by the Governor who are physicians licensed pursuant to chapter 630 or her633 designee;of NRS;

(c) Two members appointed by the Governor who are physicians licensed pursuant to chapter 630 or 633 of NRS;

and (i) One member appointed by the Governor who represents the OfficeOff2.e ofoIn Economicaddition Developmentto in the Officemembers ofappointed by the Governor.

2.pursuant to subsection 1, the Governor may appoint two members as the Governor determines necessary to carry out the provisions of NRS 223.631 to 223.639, inclusive [.] , and section 1 of this act.

In addition to the members appointed by the Governor pursuant to subsection 1, the Governor may appoint two members as the Governor determines necessary to carry out the provisions of NRS 223.631 to 223.639, inclusive.

- 83rd Session (2025) – 7 – 4.

The Council shall select from its members a Chair and a Vicereselected.who Chair who shall hold office for 1 year and who may be reselected.6.

6.The Council shall meet at the call of the Chair as often as necessary to evaluate applications for competitive grants for the Graduate Medical Education Grant Program established pursuant to NRS 223.637 and make recommendations to the [Office of Science, Innovation and Technology] Department of Health and Human Services concerning the approval of applications for such grants.

The Council shall meet at the call of the Chair as often as necessary to evaluate applications for competitive grants for the Graduate Medical Education Grant Program established pursuant to - *SB262_R1* – 6 – NRS 223.637 and make recommendations to the [Office of Science, Innovation and Technology] Department of Health and Human Services concerning the approval of applications for such grants.

A state agency or political subdivision of thisof Statethe shallCouncil notto:ot require an officer or employee who is a member of(a) Make up the Counciltime to:he or she is absent from work to carry out his or her duties as a member of the Council;

(a) Make up the time he or she is absent from work to carry out his or her duties as a member of the Council;

In evaluating and making recommendations concerning such applications, the Council shall give priority to the award of grants for[for the retention of programs in this State for residency training and postdoctoral- [fellows]83rd fellowshipsSession (2025) – 8 – postdoctoral fellows when the federal funding for the support of such programs expires.expires.] in accordance with paragraph (b) of subsection 3 of NRS 223.637.

Study and make recommendations to the [Office of Science, InnovationServices, the Governor and Technology,]the DepartmentLegislature ofconcerning:uman Health(a) The creation and Humanretention Services,of theprograms Governorin this State for residency training and postdoctoral [fellows] fellowships that are approved by the LegislatureAccreditation concerning:Council for Graduate Medical Education or its successor organization;

(a)and (b) The creationrecruitment and retention of programsphysicians innecessary thisto Statemeet forthe residencyhealth trainingcare andneeds postdoctoralof [fellows]the fellowshipsresidents thatof arethis approvedState, bywith the Accreditationemphasis Councilon forthose Graduatehealth Medicalcare Educationneeds. or its successor organization;

and - *SB262_R1* – 7 – (b) The recruitment and retention of physicians necessary to meet the health care needs of the residents of this State, with the emphasis on those health care needs.

or (b) Which operate programs for residency training that are approved by the Accreditation Council for Graduate Medical Education, or its successor organization, and that are training a number of residents that exceeds the maximum number of full- time equivalent resident positions for which the institution receives direct graduate medical education or indirect medical educationeducationceives payments from Medicare.

InThe awarding grants pursuant to the Program established pursuant to subsection 1, the [Office of Science, Innovation and Technology] Department of Health and Human Services shallmay consider the recommendations of the Advisory Council on Graduate Medical Education created by NRS 223.633 and give priority to the award oflimited grants forpursuant theto retention of programs in this State for residency training and postdoctoral [fellows] fellowships when the federalProgram fundingestablished forpursuant theto supportsubsection of1 suchto: programs expires.

(a) Assist institutions in building administrative and operational capacity as necessary to establish a new program for residency training and postdoctoral fellowships.

(b) Recruit personnel essential to the operation of a program for residency training and postdoctoral fellowships, including, without limitation, program directors and resident faculty.

Such recruitment may consist of paying relocation expenses, providing supplements to salaries and providing professional development.

In awarding grants pursuant to the Program established pursuant to subsection 1, the [Office of Science, Innovation and - 83rd Session (2025) – 9 – [consider] :Department of Health and Human Services shall (a) Consider the recommendations of the Advisory Council on Graduate Medical Education created by NRS 223.633 ;

and [give] (b) Give priority to the award of grants [for] :

(1) For the retention of programs in this State for residency training and postdoctoral [fellows] fellowships when the federal funding for the support of such programs expires [.] ;

and (2) To programs that:

(I) Will leverage funds from the Federal Government or private persons to maximize the impact of the grants;

(II) Incorporate innovative delivery models, including, without limitation, telehealth, rotations in rural areas and training in underserved settings;

(III) Provide logistical support, which may include, without limitation, transportation, housing and accommodations for family members of residents and fellows, to facilitate the underserved areas;ents and fellows in rural areas and other (IV) Demonstrate collaboration with rural hospitals, community health centers and other local entities that provide health care;

and (V) Address geographic areas and populations of this State where the shortage of providers of health care is most critical and specialties for which the need in those areas and among those populations is most critical in this State.

[3.] 4.

The committee established pursuant to this subsection must be composed of persons with expertise in subject matters related to graduate medical education who are not affiliated with any applicant for a grant pursuant to the Program established pursuant to subsection 1.

4.[4.] 5.

- *SB262_R1*83rd Session (2025) – 810 – Sec.

(a)(b) The Governor;Director of the Legislative Counsel Bureau for transmittal to:

and (b) The Director of the Legislative Counsel Bureau for transmittal to:

7.3.

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:

Division;

The Administrator of the Aging and Disability Services (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, 458A and 656A of NRS, NRS 127.220 to 127.310, inclusive, 422.001 to 422.410, inclusive, and section 7.7 of this act, 422.580, 432.010 to 432.133, inclusive, 432B.6201 to 432B.626, inclusive, 444.002 to 444.430, inclusive, - 83rd Session (2025) – 11 – 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 div(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:

(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 Department Contton communicatenformaeffectivelyarwithr ththe 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.

- 83rd Session (2025) – 12 – Sec.

7.7.

Chapter 422 of NRS is hereby amended by adding thereto a new section to read as follows:

1.

The Department, in collaboration with the Advisory Council on Graduate Medical Education created by NRS 223.633, Medicaid to support programs for medical residency training and postdoctoral fellowships in this State.

2.

In allocating federal money pursuant to subsection 1, the Department:

(a) May prioritize programs for medical residency training and postdoctoral fellowships serving geographical areas and populations of this State where the shortage of providers of health care is most critical or which provide training in the specialties for which the need is most critical;

and (b) Shall not use or authorize the use of such federal money to supplant existing methods of funding that are available to programs for medical residency training and postdoctoral fellowship.

Sec.

Any administrative regulations adopted by an officer or an agency whose name has been changed or whose responsibilities have been transferred pursuant to the provisions of this act to another officer or agency remain in force until amendedamendedf by the officer or agency to which the responsibility for the adoption of the regulations has been transferred.

- *SB262_R1* – 9 – 3.

Any action taken by an officer or agency whose name has been changed or whose responsibilities have been transferred pursuant to the provisions of this act to another officer or agency - 83rd Session (2025) – 13 – remains in effect as if taken by the officer or agency to which the responsibility for the enforcement of such actions has been transferred.

The provisions of subsection 1 of NRS 218D.380 do not apply to any provision of this act which adds or revises a reqSec.requirement to submit a report to the Legislature.

Sec.

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