Struck = removed from the bill ·
added = the amendment's new text.
AssemblySession Bill(83rd) A AB169 83 Amendment No.
169–Assemblymember83 YeagerAssembly CHAPTER..........Amendment to Assembly Bill No.
169 (BDR 57-735) Proposed by:
Assembly Committee on Commerce and Labor Amends:
Summary:
Yes Title:
Yes 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 (§ 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.
CCP/BJF - Date:
4/17/2025 A.B.
No.
169—Requires that certain health insurance policies and health plans cover speech-language pathology for certain purposes.
(BDR 57-735) Page 1 of 14 *A_AB169_83* Assembly Amendment No.
83 to Assembly Bill No.
169 Page 3 A SSEMBLY B ILLN O.
169–ASSEMBLYMEMBER YEAGER PREFILED JANUARY 31,2025 _______________ Referred to Committee on Commerce and Labor SUMMARY—[Requires that certain] Revises provisions relating to health insurance .
[policies and health plans cover speech-language pathology for certain purposes.] (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 GOVERNMENT ) ~ EXPLANATION – Matter in bolded italics is new;
matter between brackets [omitted material] is material to be omitted.
requiring that certain health insurance policies and health plans include coverage for certain forms of speech-language pathology as treatment for stuttering for persons who are less than [18] 26 years of age;
(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.
Sections(NRS 2.7,608.1555) 4.7-10,Sections 12,2.3 12.5, 14 and 164.3 of this bill requireprovide that certain publicprovisions andrequiring privatea policiespolicy of healthindividual insuranceor andgroup health plans,insurance includingto Medicaidinclude butcertain excludingcoverage theare Publicinapplicable Employees’to Benefitsa Program,policy includethat only provides coverage for stutteringa forspecified personsdisease whoor areillness lessor thanthat 26only yearsprovides ofa age.limited benefit.
Sections 1,[2, 4-10,] 2.7, 4.7-10, 12,12 and 1614-16 of this bill additionallyrequire prohibitthat ancertain insurerpublic fromand imposingprivate apolicies maximumof annualhealth limitinsurance onand thehealth coverage,plans, limitingincluding Medicaid, include coverage basedfor onhabilitative theand causerehabilitative ofspeech-language thepathology as a treatment for stuttering orfor imposingpersons medicalwho managementare techniquesless onthan those[18] benefits.26 years of age.
SectionSections 131, [2, 4-10,] 2.7, 4.7-10, 12 and 14- 16 of this bill makesadditionally prohibit an insurer from imposing a conformingmaximum changeannual limit on the coverage, limiting coverage based on the cause of the stuttering or imposing medical to require the Director of the Department of Health and Human Services to administer thethege provisions of section 16 in the same manner as other provisions relating to Medicaid.
Section 3 of this bill authorizes the Commissioner of Insurance to require that certain policies of health insurance coverageissued required by sectionsa 2.3domestic andinsurer 2.7.to a person who resides in another state include Assembly Amendment No.
Section83 11 of this bill authorizes the Commissioner to suspendAssembly orBill revokeNo. the certificate of a health maintenance organization that fails to comply with the requirements of section 9.
The169 CommissionerPage would4 alsothe beCommissioner authorized to takesuspend suchor actionrevoke againstthe othercertificate of a health insurersmaintenance whoorganizationizes failthat fails to comply with the requirements of sectionssection 2.7,9. 4.7-8 or 12.
(NRSThe 680A.200)Commissioner -would 83rdalso Sessionbe (2025)authorized –to 2take –such EXPLANATIONaction –against Matterother inhealth boldedinsurers italicswho isfail new;to comply with the requirements of sections [2, 4-8] 2.7, 4.7-8 or 12.
matter(NRS between680A.200) bracketsTHE [omittedPEOPLE material]OF isTHE materialSTATE toOF beNEVADA, omitted.REPRESENTED IN SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
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, 4,] 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 [a new section to read as follows:] 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 [18] 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)Assembly LimitAmendment theNo. benefits described in subsection 1 based on the cause of the stuttering;
83 to Assembly Bill No.
169 Page 5 (b) Limit the benefits described in subsection 1 based on the cause of the stuttering;
(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 [section 2] sections 2.3 and 2.7 of this act.
Chapter 689B of NRS is hereby amended by adding thereto [a new section to read as follows:] the provisions set forth as sections 4.3 and 4.7 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 [18] 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 renewedprovisions onof orthis afterchapter Januarythat 1,is 2026,delivered, hasissued thefor legaldelivery effect ofivery or includingrenewed theon coverageor requiredafter byJanuary subsection 1, andAssembly anyAmendment provisionNo. of the policy that conflicts with the provisions of this section is void.
83 to Assembly Bill No.
169 Page 6 2026, has the legal effect of including the coverage required by subsection 1, and any provision of the policy that conflicts with the provisions of this section is void.
- 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 carrier that offers or issues a health benefit plan shall include in the plan coverage for habilitative speech-language pathology and rehabilitative speech-language pathology as a treatment for stuttering for insureds who are less than [18] 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) “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.
Sec.Assembly Amendment No.
83 to Assembly Bill No.
169 Page 7 Sec.
A society that offers or issues a benefit contract shall include in the contract coverage for habilitative speech-language pathology and rehabilitative speech-language pathology as a treatment for stuttering for insureds who are less than [18] 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 [18] 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)Assembly “MedicalAmendment managementNo. technique” means a practice which is used to control the cost or use of health care services or of step therapy, prior authorization and categorizing drugs anduse devices based on cost, type or method of administration.
83 to Assembly Bill No.
169 Page 8 (b) “Medical management technique” means a practice which is used to control the cost or use of health care services or prescription drugs.
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.
A health maintenance organization that offers or issues a health care plan shall include in the plan coverage for habilitative speech-language pathology and rehabilitative speech-language pathology as a treatment for stuttering for enrollees who are less than [18] 26 years of age.
- 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.
-Assembly 83rdAmendment SessionNo. (2025) – 9 – 3.
83 to Assembly Bill No.
169 Page 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.1705, 695C.1709 to 695C.173, inclusive, 695C.1733, 695C.17335, 695C.1734, 695C.1751, 695C.1755, 695C.1759, 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.17095 and section 9 of this act do not apply to a health maintenance organization that provides health care services to members of the Public Employees’ Benefits Program.
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;
(e)Assembly TheAmendment healthNo. maintenance organization is no longer financially responsible and may reasonably be expected to be unable to meet its obligations to enrollees or prospective enrollees;
(f)83 The health maintenance organization has failed to putAssembly intoBill effectNo. a mechanism affording the enrollees an opportunity to NRS 695C.110;n 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.260 for:
169 Page 10 (e) The health maintenance organization is no longer financially responsible and may reasonably be expected to be unable to meet its obligations to enrollees or prospective enrollees;
(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 695C.110;
(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 [18] 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;
A health care plan subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after January 1, 2026, has the legalAssembly effectAmendment ofNo. including the coverage required by subsection 1, and any provision of the plan that conflicts with the provisions of this section is void.
83 to Assembly Bill No.
169 Page 11 legal effect of including the coverage required by subsection 1, and any provision of the plan that conflicts with the provisions of this section is void.
- 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.
(b) “Medical management technique” means a practice which is used to control the cost or use of health care services or prescription drugs.
12.5.
NRS 695G.090 is hereby amended to read as follows:
695G.090 1.
Except as otherwise provided in subsection 3, the provisions of this chapter apply to each organization and insurer that operates as a managed care organization and may include, without limitation, an insurer that issues a policy of health insurance, an insurer that issues a policy of individual or group health insurance, a carrier serving small employers, a fraternal benefit society, a hospital or medical service corporation and a health maintenance organization.
2.
In addition to the provisions of this chapter, each managed care organization shall comply with:
obligations and remedies set forth therein;
andncluding all (b) Any other applicable provision of this title.
3.
The provisions of NRS 695G.127, 695G.1639, 695G.164, 695G.1645, 695G.167 and 695G.200 to 695G.230, inclusive, do not apply to a managed care organization that provides health care services 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.
4.
The provisions of NRS 695C.1735 and 695G.1639 and section 12 of this act do not apply to a managed care organization that provides health care services to members of the Public Employees’ Benefits Program.
- 83rd Session (2025) – 13 – 5.
Subsections 3 and 4 do not exempt a managed care organization from any provision of this chapter for services provided pursuant to any other contract.
Sec.
(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.
(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;
Assembly Amendment No.
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169 Page 12 (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 money accumulated for this purpose through deductions from the 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.
The provisions of NRS 439.581 to 439.597, inclusive, 686A.135, 687B.352, 687B.408, 687B.692, 687B.723, 687B.725, 687B.805, 689B.030 to 689B.0317, inclusive, paragraphs (b) and (c) of subsection 1 of NRS 689B.0319, subsections 2, 4, 6 and 7 of NRS 689B.0319, 689B.033 to 689B.0369, inclusive, and section [4] 4.7 of this act, 689B.0375 to 689B.050, inclusive, 689B.0675, 689B.265, 689B.287 and 689B.500 apply to coverage provided pursuant to this paragraph, except that the provisions of NRS 689B.0378, 689B.03785 and 689B.500 only apply to coverage for active officers and employees of the governing body, or the dependents of such officers and employees.
(d)Assembly DefrayAmendment partNo. or all of the cost of maintenance of a self- contributions 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 State of Nevada.
83 to Assembly Bill No.
169 Page 13 (d) Defray part or all of the cost of maintenance of a self-insurance fund or of the premiums upon 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.
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.
a program for legal aid and receives Sec.
(DeletedNRS 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.
Sec.
To the extent federal financial participation is available, the Director shall include under Medicaid coverage for habilitative speech-language pathologyAssembly andAmendment rehabilitativeNo. speech- language pathology as a treatment for stuttering for persons who are less than 26 years of age.
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169 Page 14 pathology and rehabilitative speech-language pathology as a treatment for stuttering for persons who are less than [18] 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).
~~~~~ 25 - 83rd Session (2025)