Nevada 2025 Regular Session Status: In Committee Bipartisan · 2 R · 2 D cosponsors

SB 354 — Revises provisions relating to health insurance coverage of prescription drugs. (BDR 57-1041)

Last action — (No further action taken.)

Track this bill free

No card. One bill, free forever — alerts when it moves.

  1. ✓
    Introduced
  2. 2
    In Committee
  3. 3
    Passed Senate
  4. 4
    Passed Assembly
  5. 5
    To Executive
  6. 6
    Enacted

This bill died with 2025 Regular Session. It reached “In Committee” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.

This bill is no longer active — its legislative session has ended, so there is no live prognosis. It would have to be reintroduced in the current session to move again.

Bill Text

What changed in the latest version

174 added · 208 removed

174 line(s) added, 208 removed.

→
Previous
Latest
S.B.
EXEMPT (Reprinted with amendments adopted on April 21, 2025) FIRST REPRINT S.B.
354 SENATE BILL N O.
354 SENATE BILL NO .
354–SENATORS S TONE ;
354–SENATORS STONE ;
SSEMBLYMEMBER E DGEWORTH ____________ Referred to Committee on Commerce and Labor SUMMARY—Revises provisions relating to health insurance coverage of prescription drugs.
ASSEMBLYMEMBER EDGEWORTH ____________ Referred to Committee on Commerce and Labor SUMMARY—Revises provisions relating to health insurance coverage of prescription drugs.
CONTAINS UNFUNDED MANDATE (§ 2 &NRS287.010) (OT REQUESTED BAFFECTELOCALGOVERNMENT) ~ EXPLANATION – Matter in bolded italics is new;
~ EXPLANATION – Matter in bolded italics is new;
LegiExisting law requires certain public and private health plans, including Medicaid and health plans for state and local government employees, to cover:
LegExisting law requires certain public and private health plans, including the Public Employees’ Benefits Program, to cover:
(1) drugs that prevent the acquisition of human immunodeficiency virus or that treat human immunodeficiency virus or hepatitis C;
(1) drugs that prevent the acquisitionof human immunodeficiencyvirus or that treat human immunodeficiency virus or hepatitis C;
(NRS 287.010, 287.04335, 422.4025, 689A.0437, 689B.0312, 689C.1671, 695A.1843, 695B.1924, 695C.050, 695C.1743, 695G.1705) Existing law prohibits such health plans from implementing any medical management techniques on the coverage of such drugs or services, except the use of step therapy.
(NRS 287.04335, 689A.0437, 689B.0312, 689C.1671, 695A.1843, 695B.1924, 695C.050, 695C.1743, 695G.1705) Existing law prohibits such health plans from implementing any medical management techniques on the coverage of such drugs or services, except the use of step therapy.(NRS 287.010,287.04335, 689A.0437,689B.0312, 689C.1671, bill remove the exemption for step therapy for private health plans, thereby prohibiting such health plans from requiring step therapy before providing coverage for a drug that:
(NRS 287.010, 287.04335, 689A.0437, 689B.0312, 689C.1671, 695A.1843, 695B.1924, 695C.050, 695C.1743, 695G.1705) This bill removes the exemption for step therapy, thereby prohibiting such public and private health plans from requiring step therapy before providing - *SB354* – 2 – coverage for a drug that:
Sections 6-8.5 of this bill authorize the Public Employees’ Benefits Program and Medicaid managed care - *SB354_R1* – 2 – organizations to continue requiring the use of step therapy for coverage of such drugs as a medical management technique.
[, other than step therapy;] - *SB354* – 3 – (b) Limit the covered amount of a drug described in paragraph (a) of subsection 1;
[, other than step therapy;] - *SB354_R1* – 3 – (b) Limit the covered amount of a drug described in paragraph (a) of subsection 1;
A policy of health insurance subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after January 1, [2024,] 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.
A policy of health insurance subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after January 1, [2024,] 2027, 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.
- *SB354* – 4 – (c) Any service to test for, prevent or treat human immunodeficiency virus or hepatitis C provided by a provider of primary care if the service is covered when provided by a specialist and:
- *SB354_R1* – 4 – (c) Any service to test for, prevent or treat human immunodeficiency virus or hepatitis C provided by a provider of primary care if the service is covered when provided by a specialist and:
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, [2024,] 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.
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, [2024,] 2027, 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.
The term includes, without limitation, the use of step therapy, - *SB354* – 5 – prior authorization and categorizing drugs and devices based on cost, type or method of administration.
The term includes, without limitation, the use of step therapy, - *SB354_R1* – 5 – prior authorization and categorizing drugs and devices based on cost, type or method of administration.
(b) An advanced practice registered nurse or a physician assistant who participates in the network plan of the carrier for any - *SB354* – 6 – service to test for, prevent or treat human immunodeficiency virus or hepatitis C at a rate equal to the rate of reimbursement provided to a physician for similar services.
(b) An advanced practice registered nurse or a physician assistant who participates in the network plan of the carrier for any - *SB354_R1* – 6 – service to test for, prevent or treat human immunodeficiency virus or hepatitis C at a rate equal to the rate of reimbursement provided to a physician for similar services.
A health benefit plan subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after January 1, [2024,] 2026, has the 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.
A health benefit plan subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after January 1, [2024,] 2027, has the 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.
(a) All drugs approved by the United States Food and Drug Administration for preventing the acquisition of human immunodeficiency virus or treating human immunodeficiency virus - *SB354* – 7 – or hepatitis C in the form recommended by the prescribing practitioner, regardless of whether the drug is included in the formulary of the society;
(a) All drugs approved by the United States Food and Drug Administration for preventing the acquisition of human immunodeficiency virus or treating human immunodeficiency virus - *SB354_R1* – 7 – or hepatitis C in the form recommended by the prescribing practitioner, regardless of whether the drug is included in the formulary of the society;
A benefit contract subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after January 1, [2024,] 2026, has the legal effect of including the - *SB354* – 8 – coverage required by subsection 1, and any provision of the plan that conflicts with the provisions of this section is void.
A benefit contract subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after January 1, [2024,] 2027, has the legal effect of including the - *SB354_R1* – 8 – coverage required by subsection 1, and any provision of the plan that conflicts with the provisions of this section is void.
- *SB354* – 9 – (a) A pharmacist who participates in the network plan of the hospital or medical services corporation for the services described in NRS 639.28085 at a rate equal to the rate of reimbursement provided to a physician, physician assistant or advanced practice registered nurse for similar services.
- *SB354_R1* – 9 – (a) A pharmacist who participates in the network plan of the hospital or medical services corporation for the services described in NRS 639.28085 at a rate equal to the rate of reimbursement provided to a physician, physician assistant or advanced practice registered nurse for similar services.
A policy of health insurance subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after January 1, [2024,] 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.
A policy of health insurance subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after January 1, [2024,] 2027, 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.
- *SB354* – 10 – (c) “Primary care” means the practice of family medicine, pediatrics, internal medicine, obstetrics and gynecology and midwifery.
- *SB354_R1* – 10 – (c) “Primary care” means the practice of family medicine, pediatrics, internal medicine, obstetrics and gynecology and midwifery.
A health maintenance organization shall not:
[A] Except as otherwise provided in subsection 4, a health maintenance organization shall not:
[, other than step therapy;] (b) Limit the covered amount of a drug described in paragraph (a) of subsection 1;
[, other than step therapy;] - *SB354_R1* – 11 – (b) Limit the covered amount of a drug described in paragraph (a) of subsection 1;
- *SB354* – 11 – (c) Refuse to cover a drug described in paragraph (a) of subsection 1 because the drug is dispensed by a pharmacy through mail order service;
(c) Refuse to cover a drug described in paragraph (a) of subsection 1 because the drug is dispensed by a pharmacy through mail order service;
A health maintenance organization shall ensure that the benefits required by subsection 1 are made available to an enrollee through a provider of health care who participates in the network plan of the health maintenance organization.
A health maintenance organization that provides health care services to members of the Public Employees’ Benefits Program or recipients of Medicaid may subject the benefits required by subsection 1 to step therapy.
A health care plan subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after January 1, [2024,] 2026, has the 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.
A health maintenance organization shall ensure that the benefits required by subsection 1 are made available to an enrollee through a provider of health care who participates in the network plan of the health maintenance organization.
6.
[5.] 6.
A health care plan subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after January 1, [2024,] 2027, has the 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.
[6.] 7.
(a) All drugs approved by the United States Food and Drug Administration for preventing the acquisition of human immunodeficiency virus or treating human immunodeficiency virus or hepatitis C in the form recommended by the prescribing practitioner, regardless of whether the drug is included in the formulary of the managed care organization;
(a) All drugs approved by the United States Food and Drug Administration for preventing the acquisition of human immunodeficiency virus or treating human immunodeficiency virus or hepatitis C in the form recommended by the prescribing - *SB354_R1* – 12 – practitioner, regardless of whether the drug is included in the formulary of the managed care organization;
(c) Any service to test for, prevent or treat human immunodeficiency virus or hepatitis C provided by a provider of - *SB354* – 12 – primary care if the service is covered when provided by a specialist and:
(c) Any service to test for, prevent or treat human immunodeficiency virus or hepatitis C provided by a provider of primary care if the service is covered when provided by a specialist and:
A managed care organization shall ensure that the benefits required by subsection 1 are made available to an insured through a provider of health care who participates in the network plan of the managed care organization.
A managed care organization that provides health care services to members of the Public Employees’ Benefits Program or recipients of Medicaid may subject the benefits required by subsection 1 to step therapy.
A health care plan subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after January 1, [2024,] 2026, has the 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.
A managed care organization shall ensure that the benefits required by subsection 1 are made available to an insured through a - *SB354_R1* – 13 – provider of health care who participates in the network plan of the managed care organization.
6.
[5.] 6.
A health care plan subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after January 1, [2024,] 2027, has the 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.
[6.] 7.
(a) “Medical management technique” means a practice which is used to control the cost or use of health care services or prescription - *SB354* – 13 – drugs.
(a) “Medical management technique” means a practice which is used to control the cost or use of health care services or prescription drugs.
NRS 422.403 is hereby amended to read as follows:
(Deleted by amendment.) Sec.
422.403 1.
8.5.
Show all 70 changed rows (30 more)
Previous
Latest
The Department shall, by regulation, establish and manage the use by the Medicaid program of step therapy and prior authorization for prescription drugs.
NRS 287.04335 is hereby amended to read as follows:
2.
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, in the same manner as an insurer that is licensed pursuant to title 57 of NRS is required to comply with those provisions [.] , except that the Board may subject the benefits required by NRS 695G.1705 to step therapy.
The Drug Use Review Board shall:
(a) Advise the Department concerning the use by the Medicaid program of step therapy and prior authorization for prescription drugs;
(b) Develop step therapy protocols and prior authorization policies and procedures for use by the Medicaid program for prescription drugs;
and (c) Review and approve, based on clinical evidence and best clinical practice guidelines and without consideration of the cost of the prescription drugs being considered, step therapy protocols used by the Medicaid program for prescription drugs.
3.
The step therapy protocol established pursuant to this section must not apply to [a] :
(a) A drug approved by the Food and Drug Administration that is prescribed to treat a psychiatric condition of a recipient of Medicaid, if:
[(a)] (1) The drug has been approved by the Food and Drug Administration with indications for the psychiatric condition of the insured or the use of the drug to treat that psychiatric condition is otherwise supported by medical or scientific evidence;
[(b)] (2) The drug is prescribed by:
[(1)] (I) A psychiatrist;
[(2)] (II) A physician assistant under the supervision of a psychiatrist;
- *SB354* – 14 – [(3)] (III) An advanced practice registered nurse who has the psychiatric training and experience prescribed by the State Board of Nursing pursuant to NRS 632.120;
or [(4)] (IV) A primary care provider that is providing care to an insured in consultation with a practitioner listed in [subparagraph (1), (2)] sub-subparagraph (I), (II) or [(3),] (III), if the closest practitioner listed in [subparagraph (1), (2)] sub-subparagraph (I), (II) or [(3)] (III) who participates in Medicaid is located 60 miles or more from the residence of the recipient;
and [(c)] (3) The practitioner listed in [paragraph (b)] subparagraph (2) who prescribed the drug knows, based on the medical history of the recipient, or reasonably expects each alternative drug that is required to be used earlier in the step therapy protocol to be ineffective at treating the psychiatric condition [.] ;
or (b) A drug that is used to prevent the acquisition of human immunodeficiency virus or treat human immunodeficiency virus or hepatitis C.
4.
The Department shall not require the Drug Use Review Board to develop, review or approve prior authorization policies or procedures necessary for the operation of the list of preferred prescription drugs developed pursuant to NRS 422.4025.
5.
The Department shall accept recommendations from the Drug Use Review Board as the basis for developing or revising step therapy protocols and prior authorization policies and procedures used by the Medicaid program for prescription drugs.
6.
As used in this section:
(a) “Medical or scientific evidence” has the meaning ascribed to it in NRS 695G.053.
(b) “Step therapy protocol” means a procedure that requires a recipient of Medicaid to use a prescription drug or sequence of prescription drugs other than a drug that a practitioner recommends for treatment of a psychiatric condition of the recipient before Medicaid provides coverage for the recommended drug.
The provisions of NRS 354.599 do not apply to any additional expenses of a local government that are related to the provisions of this act.
(Deleted by amendment.) Sec.
Sec.
(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;
- *SB354_R1* – 14 – regulations and performing any other preparatory administrativey tasks that are necessary to carry out the provisions of this act;
and (b) On January 1, 2026, for all other purposes.
and (b) On January 1, 2027, for all other purposes.
H - *SB354*
H - *SB354_R1*
⬇ Download PDF
View plain text versions (2)

How this bill changes current law

3 changes Share ↗

Compared against the Nevada Revised Statutes as published AI-generated reading aid — verify against the official bill.

The bill removes the step therapy requirement for certain health plans before providing coverage for drugs related to HIV and hepatitis C.

  • NRS 689A.0437

    other than step therapy;

    This change prohibits insurers from using step therapy as a medical management technique for certain drugs.

  • NRS 689B.0312

    other than step therapy;

    This change prohibits insurers from using step therapy as a medical management technique for certain drugs.

  • NRS 689C.1671

    other than step therapy;

    This change prohibits insurers from using step therapy as a medical management technique for certain drugs.

Amendments

1 amendment

Click Show changes on an amendment above to see how it modifies the bill.

Action History

  1. (No further action taken.)

  2. From printer. To engrossment. Engrossed. First reprint. To committee.

  3. Notice of eligibility for exemption. Taken from General File. Re-referred to Committee on Finance. Exemption effective. To printer.

  4. From committee: Amend, and do pass as amended. Placed on Second Reading File. Read second time. Amended. (Amend. No. 315.) Reprinting dispensed with.

  5. From printer. To committee.

  6. Read first time. Referred to Committee on Commerce and Labor. To printer.

Sponsors

Sponsorship breakdown

Export CSV (upgrade) →

1 sponsors · 3 co-sponsors · 63 not signed on

Sponsors (1)

Co-sponsors (3)

Not signed on (63)

63 members have not signed on to this bill.

Show all 63 →

"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.

Whip count is in markup. Polling the chamber and every recorded vote this session. Only the first open is slow. It’s instant for you after this. Calling the roll · Tallying · Engrossing

Subjects

healthcare health-insurance
Cross-referencing the record. Reading this bill against every other bill in the corpus by meaning, not keywords. Only the first open is slow. It’s instant for you after this. Matching · Ranking · Engrossing

Frequently asked questions

Who sponsors SB 354?
SB 354 is sponsored by Edgeworth, Rebecca (Republican), Scheible, Melanie (Democratic), Ohrenschall, James (Democratic), and Stone, Jeff (Republican).
What is the current status of SB 354?
This bill died with 2025 Regular Session. It reached “In Committee” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.
Where can I track SB 354?
Track SB 354 free on One Click Politics — get push/email alerts when it moves.

Make your voice heard on SB 354

Find the representatives who decide this bill and tell them where you stand — for yourself, or mobilize your whole list in one click with One Click Politics advocacy software.

Find my representatives → Run a campaign

Stay ahead of SB 354

Last checked for changes 3 months ago · updated continuously

One Click Politics tracks every bill in Congress and all 50 states.

Track this bill →