SB 268 — Revises provisions relating to insurance coverage for certain dental services. (BDR 57-329)

The provisions of NRS 695C.16932 to 695C.1699, inclusive, 695C.1701, 695C.1708, 695C.1728, 695C.1731, 695C.17333, 695C.17345, 695C.17347, 695C.1736 to 695C.1745, inclusive, 695C.1757 and 695C.204 and section 8 of this act apply to a health maintenance organization that provides health care services through managed care to recipients of Medicaid under the State Plan for Medicaid.

The Commissioner may suspend or revoke any certificate of authority issued to a health maintenance organization pursuant to the provisions of this chapter if the Commissioner finds tha(a) Thef thhealthowimaintenancens eorganization 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 ofother theinformation followingsubmitted conditionspursuant exist:to NRS 695C.060, 695C.070 and 695C.140, unless any amendments to those submissions have been filed with and approved by the Commissioner;

(a)(b) The health maintenance organization isissues operatingevidence significantly in contravention of itscoverage basic organizational document, its health care plan or inuses a mannerschedule contraryof tocharges thatfor describedhealth incare andservices reasonablywhich inferreddo fromnot anycomply otherwith informationthe submittedrequirements pursuantof to NRS 695C.060,695C.1691 695C.070 and 695C.140, unless any amendments to those695C.200, submissionsinclusive, haveand beensection filed8 withof andthis approvedact, by695C.204 theor Commissioner;695C.207;

(b) The health maintenance organization issues evidence of coverage or uses a schedule of charges for health care services which do not comply with the requirements of NRS 695C.1691 to - *SB268_R1* – 7 – 695C.200, inclusive, and section 8 of this act, 695C.204 or 695C.207;

(d)- The83rd CommissionerSession (2025) – 7 – organization:mmissioner certifies that the health maintenance organization:(1) Does not meet the requirements of subsection 1 of NRS 695C.080;

(1) Does not meet the requirements of subsection 1 of NRS 695C.080;

and (2) Conducting external reviews of adverse determinations that comply with the provisions of NRS 695G.241 to 695G.310,695G.310,ions inclusive;

If the certificate of authority of a health maintenance organization is suspended, the health maintenance organization shall not, during the period of that suspension, enroll any additionaladditionalhall groups or new individual contracts, unless those groups or persons were contracted for before the date of suspension.

If the certificate of authority of a health maintenance organization is revoked, the organization shall proceed, immediately following the effective date of the order of revocation, to wind up its affairs and shall conduct no further business except as may be - *SB268_R1* – 8 – essential to the orderly conclusion of the affairs of the organization.

- 83rd Session (2025) – 8 – The Commissioner may, by written order, permit such further operation of the organization as the Commissioner may find to be in the best interest of enrollees to the end that enrollees are afforded the greatest practical opportunity to obtain continuing coverage for healthheaSec. care.

Sec.

1.care plan which includes coverage for a dental service that aealth qualified dental hygienist is authorized to provide without the supervision of a dentist shall provide coverage for that service when provided by such a qualified dental hygienist without the supervision of a dentist to the same extent as if provided by a qualified dental hygienist under the supervision of a dentist.

A managed care organization that offers or issues a health care plan which includes coverage for a dental service that a qualified dental hygienist is authorized to provide without the supervision of a dentist shall provide coverage for that service when provided by such a qualified dental hygienist without the supervision of a dentist to the same extent as if provided by a qualified dental hygienist under the supervision of a dentist.

As used in this section, “qualified dental hygienist” means a dental hygienist who holds a special endorsement issued by the Board of Dental Examiners of Nevada pursuant to NRS 631.287, - *SB268_R1*83rd Session (2025) – 9 – iswithin employedthe byscope aof nonprofitthat organizationemployment.ion and provides services withinSec. the scope of that employment.

Sec.

As part of a program for the provision of public health dental hygiene approved by the Board, a dental hygienist with a special endorsement to practice public health dental hygiene may authorize a dental assistant or expanded function dental assistant under his or her direct supervision to:

and (b) The Board approves the treatment protocol submitted by the dental hygienist which includes an explanation of the methods that the dental hygienist will use to:

- 83rd Session (2025) – 10 – 5.

- *SB268_R1* – 10 – (b) Conduct an assessment of the oral health of the patient through medical and dental histories, radiographs, indices, risk assessments and intraoral and extraoral procedures that analyzeanalyzek and identify the oral health needs and problems of the patient.

and (3) Those used for the fabrication of temporary removable appliances, provided no missing teeth are replaced by thosethoseable appliances.

- 83rd Session (2025) – 11 – (o) Place a temporary restoration with nonpermanent material as a palliative treatment.

(1) Antimicrobial agents;

- *SB268_R1* – 11 – (3) Topical antibiotics;

(b)NRS “Health449.260.th facility” has the meaning ascribed to it in NRS(c) 449.260.“Oral prophylaxis” means the preventive dental procedure of scaling and polishing which includes the removal of calculus, soft deposits, plaques and stains and the smoothing of unattached tooth surfaces in order to create an environment in which hard and soft tissues can be maintained in good health by the patient.

(c) “Oral prophylaxis” means the preventive dental procedure of scaling and polishing which includes the removal of calculus, soft deposits, plaques and stains and the smoothing of unattached tooth surfaces in order to create an environment in which hard and soft tissues can be maintained in good health by the patient.

- 83rd Session (2025) – 12 – (2) The Administrator of the Division of Welfare and Supportive Services;

(4) The Administrator of the Division of Health Care Financing and Policy;

andandtor of the Division of Health Care (5) The Administrator of the Division of Public and Behavioral Health.

- *SB268_R1* – 12 – (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 and Behavioral Health or the professional line activities of the other divisions.

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:must:ure at the (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;

(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;

and (6) Contain any other information necessary for the Department to communicate effectively with the Federal - 83rd Session (2025) – 13 – 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, excludingexcludingrding 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.

- *SB268_R1* – 13 – 2.

(b) Purchase group policies of life, accident or health insurance, or any combination thereof, for the benefit of such officers and employees, and the dependents of such officers and employees, as have authorized the purchase, from insurance companies authorized to transact the business of such insurance in the State of Nevada, and, where necessary, deduct from the compensation of officers and employees the premiums upon insurance and pay the deductions upon the premiums.

Any independent administrator of a fund created - 83rd Session (2025) – 14 – under this section is subject to the licensing requirements of chapter 683A of NRS, and must be a resident of this State.

Any contract with an independent administrator must be approved by the Commissioner of Insurance as to the reasonableness of administrative charges in relation to contributions collected and benefits provided.

The provisions of NRS 439.581 to 439.597,439.597,d and 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, 689B.0375 to 689B.050, inclusive, 689B.0675, 689B.265, 689B.287 and 689B.500 and section 3 of this act apply to coverage provided - *SB268_R1* – 14 – 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.

If the amount of the deductions from compensation required to pay for the group insurance exceeds the compensation to whichwhi3. a trustee is entitled, the difference must be paid by the trustee.

3.a In any county in which a legal services organization exists,tee.

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 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, school district, municipal corporation, political subdivision, public corporation or other local governmental agency.

- 83rd Session (2025) – 15 – (a) Shall be deemed, solely for the purposes of this section, to be officers and employees of the county, school district, municipal corporation, political subdivision, public corporation or other local governmental agency with which the legal services organization has contracted;con(b) Must be required by the contract to pay the premiums or contributions for all insurance which they elect to accept or of which they authorize the purchase.

and (b) Must be required by the contract to pay the premiums or contributions for all insurance which they elect to accept or of which they authorize the purchase.

- *SB268_R1* – 15 – (c) Shall be deemed to be approved if not disapproved by the Commissioner within 30 days after its submission.

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, 695G.176, 695G.177, 695G.200 to 695G.230, inclusive, 695G.241 to 695G.310, inclusive, 695G.405 and 695G.415, and section 12 of this act, in the same manner as an insurer that is licensed pursuant to title 57 of NRS is required to comply with those provisions.

To the extent that federal financial participation is available, the Director shall include under Medicaid a requirement that the State must provide reimbursement for any dental service covered by Medicaid that a qualified dental hygienist is authorized to provide without the supervision of a dentist when provided by such a qualified dental hygienist without the supervision of a dentist to the same extent as if the service was - 83rd Session (2025) – 16 – provided by a qualified dental hygienist under the supervision of a dentist.

(a) Apply to the Secretary of Health and Human Services for any waiver of federal law or apply for any amendment of the State Plan for Medicaid that is necessary for the Department to receive federal funding to provide the reimbursement described in subsection 1.

- *SB268_R1* – 16 – Sec.

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