SB 424 — Revises provisions relating to emergency medical services. (BDR 38-561)

and (b) Except where necessary pursuant to subsection 1 of section 9 of this act, must not exceed 5.5 percent of the net revenue earned by a private emergency medical transport provider from providing emergency ambulance services in this State during a calendar or fiscal year.

- *SB424_R1* – 4 – 3.

- 83rd Session (2025) – 4 – 4.

An assessment must not be imposed pursuant to subsection 1 if federal law or regulations prohibit using the revenue generated by the assessmentnew forfederal thelaw purposesor describedregulations inimposing sectionsuch 7a ofprohibition thisare. act.

If new federal law or regulations imposing such a prohibition are enacted or adopted, as applicable:

A private emergency medical transport provider shall keep and maintain accurate records as necessary to support the accuracy of information requested by the Division pursuant to this section.sec7.onAs used in this section:

7.

As used in this section:

- *SB424_R1*83rd Session (2025) – 5 – 2.

(a) Provide enhanced rates of reimbursement to private emergency medical transport providers that provide emergency ambulance services to recipients of Medicaid;

(a) Increases to rates of reimbursement paid to private emergency medical transport providers who receive such reimbursementrei(b) onThe establishment of a fee-for-serviceminimum basis.schedule of fees to be paid to private emergency medical transport providers who provide services to recipients of Medicaid under the Medicaid managed care program established pursuant to NRS 422.273.

(b) The establishment of a minimum schedule of fees to be paid to private emergency medical transport providers who provide services to recipients of Medicaid under the Medicaid managed care program established pursuant to NRS 422.273.

Money allocated for such expenditures must be used first for the purpose described in - 83rd Session (2025) – 6 – paragraph (c) of subsection 3.

If money allocated for such expenditures remains after all necessary expenditures are made - *SB424_R1* – 6 – for that purpose, the Division shall expend the remaining money for the purposes described in paragraph (b) of subsection 3.

6.year does not revert to the State General Fund, and the balance in the Account must be carried forward to the next fiscal year.

Any money remaining in the Account at the end of a 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.

If a private emergency medical transport provider fails to remit to the Division any penalty imposed pursuant to subsection 1 or any assessment imposed pursuant to section 6 of this act within 30as daysapplicable, after the dateDivision:ich on which the penalty or assessment is due, (a) May deduct the amount of the penalty or assessment, as applicable, from any future payment owed to the Division:private emergency medical transport provider under Medicaid;

(a) May deduct the amount of the penalty or assessment, as applicable, from any future payment owed to the private emergency medical transport provider under Medicaid;

and - 83rd Session (2025) – 7 – (b) May negotiate a payment plan with the private emergency medical transport provider.

-representative *SB424_R1*sample –of private emergency medical transport providers, modify the percentage of the assessment imposed on private emergency medical transport providers pursuant to section of this act, the amount of any enhanced rate of reimbursement described in paragraph (a) of subsection 3 of section 7 –of Sec.this act or any other requirement or formula established pursuant to sections 2 to 9, inclusive, of this act to the extent necessary to obtain federal financial participation for the enhanced rates of reimbursement described in paragraph (a) of subsection 3 of section 7 of this act.

9.

1.

The Division may modify the percentage of the assessment imposed on private emergency medical transport providers pursuant to section 6 of this act, the amount of any enhanced rate of reimbursement described in paragraph (a) of subsection 3 of section 7 of this act or any other requirement or formula established pursuant to sections 2 to 9, inclusive, of this act to the extent necessary to obtain federal financial participation for the enhanced rates of reimbursement described in paragraph (a) of subsection 3 of section 7 of this act.

The Division shall take the actions described in subsection 3 after determining that:

(c) Federal financial participation is not available for the payment of enhanced rates of reimbursement described in for the paragraph (a) of subsection 3 of section 7 of this act;

(a) Immediately cease imposing and collecting the assessment otherwise required to be imposed pursuant to section 6 of this act;

and (c) Return any money collected through the assessment imposed pursuant to section 6 of this act that the Division is - 83rd Session (2025) – 8 – prohibited by paragraph (b) from using for the purposes described in subsection 3 of section 7 of this act to the private emergency medical transport provider from whom it was collected.

If the Division, after suspending the collection of assessments and the payment of enhanced rates of reimbursement pursuant to subsection 3, determines that the provisions ofofent subsection 2 no longer apply, the Division shall:

- *SB424_R1* – 8 – (a) Resume collecting assessments pursuant to section 6 of this act;

Sec.5.

As used in this section, “representative sample of private emergency medical transport providers” means:

(a) A group of private emergency medical transport providers which have collectively provided not less than 67 percent of the emergency ambulance trips provided in this State in the immediately preceding calendar year;

or (b) An association which represents private emergency medical transport providers which have collectively provided not this State in the immediately preceding calendar year.provided in Sec.

and - 83rd Session (2025) – 9 – (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 sections 2 to 9, inclusive, 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.

(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 - *SB424_R1* – 9 – this State.

(3)services) Provide for communication and the coordination of those services among nonprofit organizations, agenciesagenciesination ofofofholocal local government, the State and the Federal Government;

(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 - 83rd Session (2025) – 10 – 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.

2.the Director’s designee, is responsible for appointing and removingr subordinate officers and employees of the Department.

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.

If the health authority receives a notification from the Division of Health Care Financing and Policy of the Department - *SB424_R1* – 10 – of Health and Human Services pursuant to section 8 of this act that the holder of a permit to operate an ambulance has failed to pay an assessment imposed pursuant to section 6 of this act or an administrative penalty imposed pursuant to section 8 of this act, the health authority may, after notice and the opportunity for a hearinghea(a) inRequire accordancecorrective withaction;ovisions the provisions of this chapter:

(a) Require corrective action;

11.5.

NRS 450B.850 is hereby amended to read as follows:

450B.850 1.

The health authority may operate training programs and may contract with others to operate training programs for ambulance attendants, ambulance service operators, firefighters, law enforcement officers, physicians, nurses and others in emergency first aid, emergency care and any other techniques associated with emergency care, transportation and treatment of the sick and injured and the proper operation of an ambulance service.

2.

The health authority may establish a program of evidence- based training which focuses on the identification of and proper - 83rd Session (2025) – 11 – response to victims of human trafficking, including, without limitation, sex trafficking.

3.

Any program of training established pursuant to subsection 2 must:

education that:oped in coordination with an institution of higher (1) Has met the standards required by an accrediting body recognized by the United States Department of Education;

or (2) Is recognized as accredited by the United States Department of Education;

(b) Utilize curriculum which:

(1) Is consistent with the standards of care for anti- trafficking providers published by the Office for Victims of Crime of the United States Department of Justice and the Office on Trafficking in Persons of the United States Department of Health and Human Services, if such standards have been published;

and (2) Includes instruction on the core components of responding and providing services to victims of human trafficking, including, without limitation:

(I) Outreach to persons affected by human trafficking;

(II) Identifying victims of human trafficking;

(III) Protocols for screening victims of human trafficking;

(IV) Delivering services to victims of human trafficking using trauma-informed methods;

(V) Pathways for referrals;

and (VI) Best practices for ensuring the privacy and con(c) Provide not less than 1 hour of instruction to persons attending the program;

and (d) Be offered by the health authority to:

(1) Any emergency response employee, including, without limitation, a person who currently holds a license or certificate, as applicable, as an ambulance attendant, emergency medical technician, advanced emergency medical technician or paramedic;

or (2) An applicant for a license or certificate described in subparagraph (1), as applicable.

Sec.

The provisions of subsections 3 and 4 of section 9 of this act apply to any period described in subsection 2 of section 9 of this act that occurs on or after July 1, 2025, including, without 9 of limitation, a period where federal financial participation is not available for the payment of enhanced rates of reimbursement described- in83rd paragraphSession (a)(2025) of– subsection12 3– of section 7 of this act because the Department of Health and Human Services has not yet act obtained approval from the United States Secretary of Health and Human Services to pay such enhanced rates of reimbursement.

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