Struck = removed from the bill ·
added = the amendment's new text.
AssemblySession Bill(83rd) A AB169 R1 897 Amendment No.
169–Assemblymember897 YeagerAssembly CHAPTER..........Amendment to Assembly Bill No.
169 First Reprint (BDR 57-735) Proposed by:
Assembly Committee on Ways and Means Amends:
Summary:
No Title:
No Preamble:
No Joint Sponsorship:
No Digest:
Yes Adoption of this amendment will MAINTAIN the unfunded mandate not requested by the affected local government to A.B.
169 R1 (§ 14).
ASSEMBLY ACTION Initial and Dat| SENATE ACTION Initial and Date Adopted Lost | Adopted Lost Concurred In Not | Concurred In Not Receded Not | Receded Not EXPLANATION:
Matter in (1) blue bold italics is new language in the original bill;
(2) variations of green bold underlining is language proposed to be added in this amendment;
(3) red strikethrough is deleted language in the original bill;
(4) purple double strikethrough is language proposed to be deleted in this amendment;
(5) orange double underlining is deleted language in the original bill proposed to be retained in this amendment.
DAN/EWR - Date:
5/29/2025 A.B.
No.
169—Revises provisions relating to health insurance.
(BDR 57-735) Page 1 of 15 *A_AB169_R1_897* Assembly Amendment No.
897 to Assembly Bill No.
169 First Reprint Page 3 A SSEMBLY BILLN O.
169–A SSEMBLYMEMBER Y EAGER PREFILED JANUARY 31,2025 _______________ Referred to Committee on Commerce and Labor SUMMARY—Revises provisions relating to health insurance.
(BDR 57-735) FISCAL NOTE:
Effect on Local Government:
May have Fiscal Impact.
Effect on the State:
Yes.
CONTAINS UNFUNDED MANDATE (§ 14) (NOT REQUESTED BY AFFECTED LOCAL G OVERNMENT ) ~ EXPLANATION – Matter in bolded italics is new;
matter between brackets [omitted material] is material to be omitted.
(NRS 287.010, 287.04335, 422.27172-422.272428, 689A.04033-689A.0465, 689B.0303-689B.0303-689B.0379, 689B.0379,689C.1652- 689C.1652-689C.169,689C.169, 689C.194, 689C.1945, 689C.195, 689C.425, 695A.184-695A.1875, 695A.265, 695B.1901-695B.1948, 695C.050, 695C.1691-695C.1691-695C.176, 695C.176, 695G.162-695G.177) Existing law also requires employers to provide certain benefits for health care to employees, including the coverage required of 608.1555) Sections 2.3 and 4.3 of this bill provide that certain provisions requiring a policy of individual or group health insuranceinsurers, toif includethe certainemployer coverage are inapplicable to a policy that only provides coveragehealth benefits for aits specifiedemployees. disease or illness or that only provides a limited benefit.
(NRS 608.1555) Sections 2.3 and 4.3 of this bill provide that certain provisions requiring a policy of individual or group health insurance to include certain coverage are only provides a limited benefit.ly provides coverage for a specified disease or illness or that Sections 2.7, 4.7-10, 12,12 [and] , 12.5, 14 [-16] and 16 of this bill require that certain public and private policies of health insurance and health plans, including Medicaid [,] but excluding the Public Employees’ Benefits Program, include coverage for habilitative and rehabilitative speech-language pathology as a treatment for stuttering for persons who are less than 26 years of age.
Sections 1, 2.7, 4.7-10, 12,12 , [and] 14 [-16] and 16 of this bill additionally prohibit an insurer from imposing a maximum annual limit on the coverage, limiting coverage based on the cause of the stuttering or imposing medical management techniques on those benefits.
Section 3 of this bill authorizes the Commissioner of Insurance to require that certain policies of health insurance issued by a domestic insurer to a person who resides in another state include the coverage required by sections 2.3 and 2.7.
Section 11 of this bill authorizes the Commissioner to suspendAssembly orAmendment revokeNo. the certificate of a health maintenance organization that fails to comply with the requirements of section 9.
The897 Commissioner would also be authorized to takeAssembly suchBill actionNo. against other health insurers who fail to comply with the requirements of sections 2.7, 4.7-8 or 12.
(NRS169 680A.200)First -Reprint 83rdPage Session4 (2025)with –the 2requirements –of EXPLANATIONsection –9. Matter in bolded italics is new;
matterThe betweenCommissioner bracketswould [omittedalso material]be isauthorized materialto take suchy action against other health insurers who fail to becomply omitted.with the requirements of sections 2.7, 4.7-8 or 12.
(NRS 680A.200) THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Except as otherwise provided in NRS 689A.0405, 689A.0412, 689A.0413, 689A.0418, 689A.0437, 689A.044, 689A.0445, 689A.0459, 689B.031, 689B.0312, 689B.0313, 689B.0315, 689B.0317, 689B.0319, 689B.0374, 689B.0378, 689C.1665, 689C.1671, 689C.1675, 689C.1676, 695A.1843, 695A.1856, 695A.1865, 695A.1874, 695B.1912, 695B.1913, 695B.1914, 695B.1919, 695B.19197, 695B.1924, 695B.1925, 695B.1942, 695C.1696, 695C.1699, 695C.1713, 695C.1735, 695C.1737, 695C.1743, 695C.1745, 695C.1751, 695G.170, 695G.1705, 695G.171, 695G.1714, 695G.1715, 695G.1719 , [and] 695G.177, and sections 2.7, 4.7, 5, 7, 8, 9 and 12 of this act, any contract for group, blanket or individual health insurance or any contract by a nonprofit hospital, medical or dental service corporation or organization for dental care which provides for payment of a certain part of medical or dental care may require the insured or member to obtain prior authorization for that care from the insurer or organization.
thereto the provisions set forth as sections 2.3 and 2.7 of this act.
2.
Chapter 689A of NRS is hereby amended by adding thereto the provisions set forth as sections 2.3 and 2.7 of this act.
Sec.
The Division shall not interpret the term “policy of health insurance,” for the purposes of NRS 689A.04033 to 689A.0465, - 83rd Session (2025) – 3 – inclusive, and section 2.7 of this act, in a manner contrary to the provisions of subsection 1.
An insurer that offers or issues a policy of health insurance shall include in the policy coverage for languagehabilitative speech-language pathology and rehabilitative speech-language pathology as a treatment for stuttering for insureds who are less than 26 years of age.
(a) Set a maximum annual limit on the benefits described in subsection 1, including, without limitation, a limit on the number of annual visits to a speech-languagespeech- language pathologist;
or (c)Assembly SubjectAmendment theNo. benefits described in subsection 1 to medical management techniques.
897 to Assembly Bill No.
169 First Reprint Page 5 (c) Subject the benefits described in subsection 1 to medical management techniques.
(b) “Medical management technique” means a practice which is used to control the cost or use of health care services or ofprescription stepdrugs. therapy, prior authorization and categorizing drugs anduse devices based on cost, type or method of administration.
The term includes, without limitation, the use of step therapy, prior authorization and categorizing drugs and devices based on cost, type or method of administration.
689A.330 If any policy is issued by a domestic insurer for delivery to a person residing in another state, and if the insurance commissioner or corresponding public officer of that other state has informed the Commissioner that the policy is not subject to approval or disapproval by that officer, the Commissioner may by ruling - 83rd Session (2025) – 4 – require that the policy meet the standards set forth in NRS 689A.030 to 689A.320, inclusive [.] , and sections 2.3 and 2.7 of this act.
689B.0379,Sec. inclusive, and section 4.7 of this act must not be to construed to require a policy that provides coverage only for a specified disease or illness or other limited benefit to provide the coverage set forth in those sections.
4.3.
1.
The provisions of NRS 689B.0303 to 689B.0379, inclusive, and section 4.7 of this act must not be construed to require a policy that provides coverage only for a specified disease or illness or other limited benefit to provide the coverage set forth in those sections.
An insurer that offers or issues a policy of group health insurance shall include in the policy coverage for habilitative speech-language pathology and rehabilitative speech-speech-language language pathology as a treatment for stuttering for insureds who are less than 26 years of age.
(a) Set a maximum annual limit on the benefits described in subsection 1, including, without limitation, a limit on the number of annual visits to a speech-languagespeech- language pathologist;
A policy of group health insurance subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after January 1, 2026, has the legal effect ofiveryof or including the coverage required by subsection 1, and any provision of the policy that conflicts with the provisions of this section is void.
(a)Assembly “HabilitativeAmendment speech-languageNo. pathology” means services that constitute the practice of speech-language pathology which help a person keep, learn or improve skills and functioning for daily living.
897 to Assembly Bill No.
169 First Reprint Page 6 (a) “Habilitative speech-language pathology” means services that constitute the practice of speech-language pathology which help a person keep, learn or improve skills and functioning for daily living.
- 83rd Session (2025) – 5 – (c) “Practice of speech-language pathology” has the meaning ascribed to it in NRS 637B.060.
(d) “Rehabilitative speech-language pathology” means services that constitute the practice of speech-language pathology which help a person restore or improve skills and functioning for daily living that have been lost or impaired.
and functioning for Sec.
(a) Set a maximum annual limit on the benefits described in subsection 1, including, without limitation, a limit on the number of annual visits to a speech-languagespeech- language pathologist;
(a) “Habilitative speech-language pathology” means services that constitute the practice of speech-language pathology which help a person keep, learn or improve skills and functioning for daily living.
- 83rd Session (2025) – 6 – Sec.
689C.425 A voluntary purchasing group and any contract issued to such a group pursuant to NRS 689C.360 to 689C.600, inclusive, are subject to the provisions of NRS 689C.015 to 689C.355, inclusive, and section 5 of this act to the extent applicable and not in conflict with the express provisions of NRS 687B.408 and 689C.360 to 689C.600, inclusive.
A society that offers or issues a benefit contract shall include in the contract coverage for habilitative speech-language pathology and rehabilitative speech-languageAssembly pathologyAmendment asNo. a treatment for stuttering for insureds who are less than 26 years of age.
897 to Assembly Bill No.
169 First Reprint Page 7 speech-language pathology as a treatment for stuttering for insureds who are less than 26 years of age.
(a) Set a maximum annual limit on the benefits described in subsection 1, including, without limitation, a limit on the number of annual visits to a speech-languagespeech- language pathologist;
4.
As used in this section:
- 83rd Session (2025) – 7 – Sec.
A hospital or medical services corporation that offers or issues a policy of health insurance shall include in the policy coverage for habilitative speech- language pathology and rehabilitative speech-language pathology as a treatment foryfor and stuttering for insureds who are less than 26 years of age.
(a) Set a maximum annual limit on the benefits described in subsection 1, including, without limitation, a limit on the number of annual visits to a speech-languagespeech- language pathologist;
(b) “Medical management technique” means a practice which is used to control the cost or use of health care services or ofprescription stepdrugs. therapy, prior authorization and categorizing drugs anduse devices based on cost, type or method of administration.
(c)The “Practiceterm includes, without limitation, the use of speech-languagestep pathology”therapy, hasprior theauthorization meaningand ascribedcategorizing todrugs itand indevices NRSbased 637B.060.on cost, type or method of administration.
Assembly Amendment No.
897 to Assembly Bill No.
169 First Reprint Page 8 (c) “Practice of speech-language pathology” has the meaning ascribed to it in NRS 637B.060.
- 83rd Session (2025) – 8 – 2.
(a) Set a maximum annual limit on the benefits described in subsection 1, including, without limitation, a limit on the number of annual visits to a speech-languagespeech- language pathologist;
(b) Limit the benefits described in subsection 1 based on the cause of the stuttering;
orescribedor in subsection 1 based on the (c) Subject the benefits described in subsection 1 to medical management techniques.
(d) “Rehabilitative speech-language pathology” means services that constitute the practice of speech-language pathology which help a person restore or improve skills and functioning for daily living that have been lost or impaired.
and functioning for Sec.
- 83rd Session (2025) – 9 – 3.
The provisions of NRS 695C.110, 695C.125, 695C.1691, 695C.173,,695C.1693, 69inclusive,5C695C.1733,C.17695C.17335,09695C.170, to695C.1734,695C.1703, 695C.1751,695C.1705, 695C.1755,695C.1709 695C.1759, 695C.176 to 695C.200,695C.173, inclusive, and695C.1733, 695C.265695C.17335, do695C.1734, not695C.1751, apply695C.1755, to695C.1759, a695C.176 health maintenance organization that provides health care services through managed care to recipientsAssembly ofAmendment MedicaidNo. 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.
897 to Assembly Bill No.
169 First Reprint Page 9 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.
This subsection does not exempt a health maintenance providedorganization pursuantfrom to any otherprovision contract.chapterof this chapter for services 7.provided pursuant to any other contract.
7.
The Commissioner may suspend or revoke any certificate of authority issued to a health maintenance organization - 83rd Session (2025) – 10 – 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 NRSparticipate 695C.110;nin matters relating to the content of programs pursuant to (g) The health maintenance organization has failed to put into effect the system required by NRS 695C.260695C.110; for:
Assembly Amendment No.
897 to Assembly Bill No.
169 First Reprint Page 10 (g) The health maintenance organization has failed to put into effect the system required by NRS 695C.260 for:
- 83rd Session (2025) – 11 – (j) The health maintenance organization fails to provide the coverage required by NRS 695C.1691;
after2. compliance with the requirements of NRS 695C.340.
A certificate of authority must be suspended or revoked only 3.after compliance with the requirements of NRS 695C.340.
3.
A managed care organization that offers or issues a health care plan shall include in the plan coverage for habilitative speech-language pathology and rehabilitative speech-language thanpathology 26as yearsa oftreatment age.ent for stuttering for insureds who are less 2.than 26 years of age.
2.
(a) Set a maximum annual limit on the benefits described in subsection 1, including, without limitation, a limit on the number of annual visits to a speech-languagespeech- language pathologist;
- 83rd Session (2025) – 12 – (a) “Habilitative speech-language pathology” means services that constitute the practice of speech-language pathology which help a person keep, learn or improve skills and functioning for daily living.
isAssembly usedAmendment toNo. control the cost or use of health care services or prescription drugs.
897 to Assembly Bill No.
169 First Reprint Page 11 (b) “Medical management technique” means a practice which is used to control the cost or use of health care services or prescription drugs.
(a) The provisions of chapter 686A of NRS, including all obligations and remedies set forth therein;
andncludingand all (b) Any other applicable provision of this title.
- 83rd Session (2025) – 13 – 5.
(a)232.320 Shall.1.
Tappoint,towithThe theDirector: consent of the Governor, administrators of the divisions of the Department, who are respectively designated as follows:
(a) Shall appoint, with the consent of the Governor, administrators of the divisions of the Department, who are respectively designated as follows:
(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 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 divisions.oraland Behavioral Health or the professional line activities of the other (c)divisions. 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.
Assembly Amendment No.
897 to Assembly Bill No.
169 First Reprint Page 12 (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.
- 83rd Session (2025) – 14 – (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 Dep(5) Set forth sufficient information to assist the Department in providing those services and in the planningallocation and budgeting for the future provision of thosethat services;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;
The governing body of any county, school district, municipal corporation, political subdivision, public corporation or other local governmental agency of the State of Nev(a)Nevada Adoptmay: and carry into effect a system of group life, accident or health insurance, or any combination thereof, for the benefit of its officers and employees, and the dependents of officers and employees who elect to accept the insurance and who, where necessary, have authorized the governing body to make deductions from their compensation for the payment of premiums on the insurance.
(a) Adopt and carry into effect a system of group life, accident or health insurance, or any combination thereof, for the benefit of its officers and employees, and the dependents of officers and employees who elect to accept the insurance and who, where necessary, have authorized the governing body to make deductions from their compensation for the payment of premiums on the insurance.
- 83rd Session (2025) – 15 – (c) Provide group life, accident or health coverage through a self-insurance reserve fund and, where necessary, deduct contributions to the maintenance of the fund from the compensation of officers and employees and pay the deductions into the fund.
The compensationmoney ofaccumulated officersfor andthis employeespurpose andthrough contributionsdeductions offrom the governingAssembly bodyAmendment mustNo. be maintained as an internal service fund as defined by NRS 354.543.
897 to Assembly Bill No.
169 First Reprint Page 13 compensation of officers and employees and contributions of the governing body must be maintained as an internal service fund as defined by NRS 354.543.
(d) Defray part or all of the cost of maintenance of a self-self-insurance contributionsfund must be budgeted for in accordance with the lawsr governing the county, school district, municipal corporation, political subdivision, public corporation or other local governmental agency of the Statepremiums ofupon Nevada.insurance.
The money for contributions must be budgeted for in accordance with the laws governing the county, school district, municipal corporation, political subdivision, public corporation or other local governmental agency of the State of Nevada.
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 - 83rd Session (2025) – 16 – 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 insurance provided pursuant to this section to the officers and employees, and the dependents of the officers and employees, of the county, schooldschool district, municipal corporation, political subdivision, public corporation or other local governmental agency.
6.Assembly Amendment No.
As897 used in this section, “legal services organization” means money pursuant to NRSAssembly 19.031.Bill No.
a169 programFirst forReprint legalPage aid14 and6. receives Sec.
As used in this section, “legal services organization” means an organization that operates a program for legal aid and receives money pursuant to NRS 19.031.
Sec.
(Deleted[NRS by287.04335 amendment.)is Sec.hereby amended to read as follows:
287.04335 If the Board provides health insurance through a plan of self- insurance, it shall comply with the provisions of NRS 439.581 to 439.597, inclusive, 686A.135, 687B.352, 687B.409, 687B.692, 687B.723, 687B.725, 687B.805, 689B.0353, 689B.255, 695C.1723, 695G.150, 695G.155, 695G.160, 695G.162, 695G.1635, 695G.164, 695G.1645, 695G.1665, 695G.167, 695G.1675, 695G.170 to 695G.1712, inclusive, 695G.1714 to 695G.174, inclusive, and section 12 of this act, 695G.176, 695G.177, 695G.200 to 695G.230, inclusive, 695G.241 to 695G.310, inclusive, 695G.405 and 695G.415, in the same manner as an insurer that is licensed pursuant to title 57 of NRS is required to comply with those provisions.] (Deleted by amendment.) Sec.
To the extent federal financial participation is available, the Director shall include under Medicaid coverage for habilitative speech-language pathology and rehabilitative speech-speech-language language pathology as a treatment for stuttering for persons who are less than 26 years of age.
(a) Set a maximum annual limit on the benefits described in subsection 1, including, without limitation, a limit on the number of annual visits to a speech-languagespeech- language pathologist;
- 83rd Session (2025) – 17 – (b) Limit the benefits described in subsection 1 based on the cause of the stuttering;
(b) Fully cooperate in good faith with the Federal Government during the application process to satisfy the requirements of the Federal Government for obtaining a waiver or amendmententsamendment of the pursuant to paragraph (a).
(a)Assembly UponAmendment passageNo. and approval for the purpose of adopting any regulations and performing any other preparatory administrative tasks that are necessary to carry out the provisions of this act;
897 to Assembly Bill No.
169 First Reprint Page 15 (a) Upon passage and approval for the purpose of adopting any regulations and performing any other preparatory administrative tasks that are necessary to carry out the provisions of this act;
~~~~~ 25 - 83rd Session (2025)