SB 378 — Makes revisions relating to health care. (BDR 40-705)

(1) make certain information concerningand independent(2) centerspost forcertain emergencyinformation medicalconcerning careindependent availablecenters uponfor request;emergencyest;

and (2) post certain information concerning independent centers for emergency medical care on an Internet website maintained by the Department.

Section 11 of this bill establishes the applicability Director on the status of thecertain programsdefinitions. to increase public awareness of information concerning hospitals and surgical centers for ambulatory patients to additionally include information on the status of the program to increase awareness of information concerning independent centers for emergency medical care.

Section 20 of this bill requires a report prepared by the Director on the status of the programs to increase public awareness of information concerning hospitals and surgical centers for ambulatory patients to additionally include information on the status of the program to increase awareness of information concerning independent centers for emergency medical care.

Section 26.5 of this bill requires the Director of the Department, to the extent that money is available, to include under Medicaid a system of value-based payments for care provided by independent centers for emergency medical care to recipients of Medicaid.

(1) has not been convicted of any additional offense, except for minor traffic violations, for a specified period of time;

(NRS 179.245) Existing law also authorizes a court, upon a petition, to order the sealing of records of an arrest where the charges were dismissed, the prosecutor declined to prosecute or the person who was arrested was acquitted.

(NRS 422.306) Section of this bill requires such a provider of services to maintain and provide certain documents to the Department for the purpose of verifying claims.

Section 27e27 certain authorizes the Department to deny a claim or recover money already paid if the Department is unable to verify the claim.

and (2) authorizes the Department to deny or recover any amount paid pursuant to such a claim or take certain actions based on such a review.

Section 22 of this bill makes a conforming change to require the Director to administer sections 26.5, 27 and 28 in the same manner as other provisions governing Medicaid.

ExistingSection law36.2 providesof thatthis abill noncompetitionmakes covenantan isappropriation voidto unless the restraintDivision thatof isHealth greaterCare thanFinancing isand requiredPolicy forof the protectionDepartment ofand authorizes the employer;expenditure of certain other money to carry out sections 26.5, 27 and 28.

Existing law provides that a noncompetition covenant is void unless the covenant:

(1) is supported by valuable consideration;

(2) does not impose any restraint that is greater than is required for the protection of the employer;

(NRS 613.195) Section- 3083rd ofSession this(2025) bill– provides4 that– a noncompetition covenant may not apply to a provider of health care, which section 30 defines as a provider of health care whose - *SB378_R1* – 4 – primary duties involve clinical care to patients and who is not employed or contracted to primarily perform administrative tasks.

EXPLANATION – Matter in bolded italics is new;

matter between brackets [omitted material] is material to be omitted.

The Director may deny an application for certification or may suspend or revoke any certification issued pursuant to subsection 2 for failure to comply with the provisions of NRS 439.581 to 439.597, inclusive, and section 1 of this act or the regulations adopted pursuant thereto or any applicable federal or state law.

A health - 83rd Session (2025) – 5 – information exchange that wishes to contest the action of the Director must file an appeal with the Director.

The Director shall adopt regulations establishing the manner in which a person may file a complaint with the Director regarding a violationvio6. of the provisions of this section.

- *SB378_R1* – 5 – 6.

(I) The use of networks and technologies that allow patients to access electronic health records directly from the health care provider of the patient and forward such electronic healthhealthhealth records electronically to other persons and entities;

(3) To maintain the confidentiality of electronic health records and health-related information, including, without limitation, standards to maintain the confidentiality of electronic health records relating to a child who has received health care services without the consent of a parent or guardian and which ensure- that83rd Session (2025) – 6 – impaired;at a child’s right to access such health care services is not impaired;(4) To ensure the privacy of individually identifiable health information, including, without limitation, standards to ensure the privacy of information relating to a child who has received health care services without the consent of a parent or guardian;

(4)(5) ToFor ensureobtaining consent from a patient before retrieving the privacypatient’s ofhealth individuallyrecords identifiablefrom a health information,information exchange, including, without limitation, standards tofor ensureobtaining thesuch privacyconsent offrom information relating to a child who has received health care services without the consent of a parent or guardian;

- *SB378_R1* – 6 – (5) For obtaining consent from a patient before retrieving the patient’s health records from a health information exchange, including, without limitation, standards for obtaining such consent from a child who has received health care services without the consent of a parent or guardian;

(8) Governing the ownership, management and use of electronic health records, health-related information and related data;

andc health records, health-related information and related (9) For the electronic transmission of prior authorizations for prescription medication;

and 17901 et seq., the Health Insurance Portability and Accountability Act of 1996, Public Law 104-191, and other applicable federal and state law;

The standards prescribed pursuant to this section must include,inc(a) withoutRequirements limitation:for the creation, maintenance and transmittal of electronic health records;

(a) Requirements for the creation, maintenance and transmittal of electronic health records;

(c) Requirements for the manner in which a patient may, through a health care provider who participates in the sharing of health records using a health information exchange, revoke his or her- consent83rd forSession a(2025) health– care7 provider– torecords retrievefrom the health information exchange;rieve the patient’s health records(d) fromA thesecure and traceable electronic audit system for identifying access points and trails to electronic health records and health information exchange;exchanges;

(d)and A(e) secureAny andother traceablerequirements electronicnecessary auditto systemcomply forwith identifyingall accessapplicable pointsfederal andlaws trailsrelating to electronic health recordsrecords, andhealth-related information, health information exchanges;exchanges and the security and confidentiality of such records and exchanges.

and (e) Any other requirements necessary to comply with all applicable federal laws relating to electronic health records, - *SB378_R1* – 7 – health-related information, health information exchanges and the security and confidentiality of such records and exchanges.

Except as otherwise provided in subsections 5, 6 and 7, the Department and the divisions thereof, other state and local governmental entities, medical facilities, high-level providers of health care , [providers,] third parties, pharmacy benefit managers and other entities licensed or certified pursuant to title 57 of NRS shall maintain, transmit and exchange health information in accordance with the regulations adopted pursuant to this section, the provisions of NRS 439.581 to 439.597, inclusive, and section 1 of the this act and any other regulations adopted pursuant thereto.

A high-level provider of health care [provider] may apply to the Department for a waiver from the provisions of subsection 4 on the basis that the high-level provider of health care [provider] does not have the infrastructure necessary to comply with those provisions, including, without limitation, because the high-level provider of health care [provider] does not have access to the Internet.Int(a) The high-level provider of health care [provider] does notat:

Thecurrently Departmenthave shallthe grantinfrastructure anecessary waiverto ifcomply itwith determinesthe that:provisions of subsection 4;

(a) The high-level provider of health care [provider] does not currently have the infrastructure necessary to comply with the provisions of subsection 4;

- 83rd Session (2025) – 8 – (b) A high-level provider of health care whose solo practice provided care to fewer than 500 patients during the immediately preceding year and reasonably expects to provide care to fewer than 500 patients during the current year;

or (c) A high-level provider of health care who, in combination with all other members of his or her group practice provided care to fewer than 500 patients during the immediately preceding year and reasonably expects to provide care to fewer than 500 patients during the current year.

- *SB378_R1* – 8 – 8.

The Director, in consultation with health care providers, third parties and other interested persons and entities, shall by regulation prescribe a framework for the electronic maintenance, transmittal and exchange of electronic health records, prescriptions, health-related information and electronic signatures and requirements for electronic equivalents of written entries or written approvals in accordance with federal law.

and (II) The interoperability of such networks and technologies in accordance with the applicable standards for the - 83rd Session (2025) – 9 – interoperability of Qualified Health Information Networks prescribed by the Office of the National Coordinator for Health Information Technology of the United States Department of Health and Human Services;

(2)are Tosecure;To ensure that electronic health records retained or shared are(3) secure;To maintain the confidentiality of electronic health records and health-related information, including, without limitation, standards to maintain the confidentiality of electronic health records relating to a child who has received health care services without the consent of a parent or guardian and which ensure that a child’s right to access such health care services is not impaired;

(3) To maintain the confidentiality of electronic health records and health-related information, including, without limitation, standards to maintain the confidentiality of electronic health records relating to a child who has received health care services without the consent of a parent or guardian and which - *SB378_R1* – 9 – ensure that a child’s right to access such health care services is not impaired;

(8) Governing the ownership, management and use of electronic health records, health-related information and related data;

and 17901 et seq., the Health Insurance Portability and Accountability Act of 1996, Public Law 104-191, and other applicable federal and state law;

2.- 83rd Session (2025) – 10 – include, without limitation:ed pursuant to this section must (a) Requirements for the creation, maintenance and transmittal of electronic health records;

The standards prescribed pursuant to this section must include, without limitation:

(a) Requirements for the creation, maintenance and transmittal of electronic health records;

- *SB378_R1* – 10 – (d) A secure and traceable electronic audit system for identifying access points and trails to electronic health records and health information exchanges;

and (e) Any other requirements necessary to comply with all applicable federal laws relating to electronic health records, health- related information, health information exchanges and the securitysecuritylth- and confidentiality of such records and exchanges.

Except as otherwise provided in subsections 5, 6 and 7, the Department and the divisions thereof, other state and local governmental entities, medical facilities, high-level providers of health care, third parties, pharmacy benefit managers and other entities licensed or certified pursuant to title 57 of NRS shall maintain, transmit and exchange health information in accordance with the regulations adopted pursuant to this section, the provisions of NRS 439.581 to 439.597, inclusive, and section 1 of this act and any other regulations adopted pursuant thereto.

§§ 1001 et seq., or a Taft-Hartley trust- formed83rd Session (2025) – 11 – may maintain, transmit and exchange electronic information ind to but accordance with the regulations adopted pursuant to 29this U.S.C.section.

§ 186(c)(5) is not required to but may maintain, transmit and exchange electronic information in accordance with the regulations adopted pursuant to this section.

and (b) Obtaining such infrastructure is not reasonably practicable, including, without limitation, because the cost of such infrastructure - *SB378_R1* – 11 – would make it difficult for the high-level provider of health care to continue to operate.

7.(a) The Department of Corrections;do not apply to:

The(b) provisionsA high-level provider of subsectionhealth 4care dowhose notsolo applypractice to:provided care to fewer than 500 patients during the immediately preceding year and reasonably expects to provide care to fewer than patients during the current year;

(a) The Department of Corrections;

(b) A high-level provider of health care whose solo practice provided to fewer than 500 patients during the immediately preceding year and reasonably expects to provide care to fewer than 500 patients during the current year;

A violation of the provisions of this section or any regulationsreg10. adopted pursuant thereto is not a misdemeanor.

10.As used in this section:ereto is not a misdemeanor.

As used in this section:

- 83rd Session (2025) – 12 – Sec.

(a) The Department determines that the licensed provider or insurer is not in compliance with the requirements of subsection 4 of NRS 439.589 [;] and [(b) The] the licensed provider or insurer:

- *SB378_R1* – 12 – 2.

(a) “License” means any license, certificate, registration, permit or similar type of authorization to practice an occupation or profession or engage in a business in this State issued to a licensed pro(b) “Licensed provider or insurer.insurer” means:

(b) “Licensed provider or insurer” means:

- 83rd Session (2025) – 13 – Sec.

The program must be designed to assist consumers with comparing the quality of care provided by the independent centers for emergency medical care in this State and the charges for that care.

- *SB378_R1* – 13 – (c) How consistently each independent center for emergency medical care follows recognized practices to prevent the infection of patients, to speed the recovery of patients and to avoid medical complications of patients;

(d) The total number of patients discharged from the independent center for emergency medical care and the total number of potentially preventable readmissions to a hospital or independent center for emergency medical care, which must be expressed as a total number and a rate of occurrence of potentially preventable readmissions, and the average length of stay and thethelly average billed charges for those potentially preventable readmissions;

- 83rd Session (2025) – 14 – (b) Prescribe the measures of quality for independent centers for emergency medical care that are required pursuant to paragraph (b) of subsection 2 of section 9 of this act.

(1) Use the measures of quality endorsed by the Agency for Healthcare Research and Quality, the National Quality Forum, for Centers for Medicare and Medicaid Services of the United States Department of Health and Human Services, a quality improvement organization of the Centers for Medicare and Medicaid Services and the Joint Commission;

- *SB378_R1* – 14 – (d) Require each independent center for emergency medical care to provide the information prescribed in paragraphs (a), (b) and (c) in the format required by the Department.

3.to submit the information required pursuant to this section orls section 9 of this act or submits information that is incomplete or inaccurate, the Department shall send a notice of such failure to the independent center for emergency medical care and to the Division of Public and Behavioral Health of the Department.

If an independent center for emergency medical care fails to submit the information required pursuant to this section or section 9 of this act or submits information that is incomplete or inaccurate, the Department shall send a notice of such failure to the independent center for emergency medical care and to the Division of Public and Behavioral Health of the Department.

The Department shall collect and maintain all information that it receives from the hospitals , [and] surgical centers for ambulatory patients and independent centers for emergency- medical83rd careSession in(2025) this– State15 pursuant– to NRS 439A.220 to 439A.250, inclusive [.] and sections 9 and 10 of this act.

UponUpono request, the Department shall make a summary of the information available to:

The Department shall establish and maintain an Internet website that includes the information concerning the charges imposed and the quality of the services provided by the hospitals , [and] surgical centers for ambulatory patients and independent centers for emergency medical care in this State as required by the programs established pursuant to NRS 439A.220 and 439A.240 [.] and section 9 of this act.

- *SB378_R1* – 15 – (1) Total number of patients discharged, the average length of stay and the average billed charges, reported for the diagnosis- related groups for inpatients and the 50 medical treatments for outpatients that the Department determines are most useful for consumers;

and (3) Name of each physician who performed a surgical procedure in the hospital and the total number of surgical procedures performed by each physician in the hospital, reported for the most frequent surgical procedures that the Department determines are most useful for consumers if the information is available;

(1)- Total83rd numberSession of(2025) patients– discharged16 and– the average billed charges, reported for 50 medical treatments for outpatients that the Department determines are most useful for consumers;

and (2) Total number of potentially preventable readmissions reported pursuant to section 9 of this act, the rate of occurrence of potentially preventable readmissions, and the average length of stay and average billed charges of those potentially preventable readmissions, reported for the diagnosis for which the patient originally received treatment at an independent center for emergency medical care;

and - *SB378_R1* – 16 – (3) Type of medical treatment;

and (3)[(e)] Type(f) ofBe presented in a manner that allows a person to view and compare the information for the independent centers for emergency medical treatment;care by:

[(e)] (f) Be presented in a manner that allows a person to view and compare the information for the independent centers for emergency medical care by:

(1)- The83rd inpatientsSession and(2025) – 17 – (2) The outpatients of each hospital;surgical center for ambulatory patients;

[and] (2) The outpatients of each surgical center for ambulatory patients;

[(j)] (l) Include a link to electronic copies of all reports, summaries,NRS compilations449.450 andto supplementary449.530, inclusive;mentary reports required by NRS[(k)] 449.450(m) toInclude, 449.530,for inclusive;each hospital with 100 or more beds, a summary of financial information which is readily understandable by a member of the general public and which includes, without limitation, a summary of:

[(k)] (m) Include, for each hospital with 100 or more beds, a summary of financial information which is readily understandable by a member of the general public and which includes, without limitation, a summary of:

- *SB378_R1* – 17 – (3) The net income of the hospital;

(6)by TheMedicare ratioto of the costcharges offor providingsuch care;ing care to patients covered by(7) MedicareThe toratio of the total costs to charges forof suchthe care;hospital;

(7) The ratio of the total costs to charges of the hospital;

(2)- Nationally83rd recognized;Session (2025) – 18 – (3) Reported in a standard and reliable manner.

and (3) Reported in a standard and reliable manner.

(e) Post a disclaimer on the Internet website indicating that the information contained on the website is provided to assist with the comparison of hospitals and independent centers for emergencyemergencyth the medical care and is not a guarantee by the Department or its employees as to the charges imposed by the hospitals and independent centers for emergency medical care in this State or the quality of the services provided by the hospitals and independent centers for emergency medical care in this State, including, without limitation, an explanation that the actual amount charged to a person by a particular hospital or independent center for emergency medical care may not be the same charge as posted on the website for that hospital [;] or independent center for emergency medical care;

- *SB378_R1* – 18 – (f) Provide on the Internet website established pursuant to this section a link to the Internet website of the Centers for Medicare and Medicaid Services of the United States Department of Health and Human Services;

and (g)Internet Uponwebsite request,available makein theprinted informationform.hat that is contained on the Internet3. website available in printed form.

3.

449.013 “Independent center for emergency medical care” means a facility, structurally separate [and distinct] from a hospital, which provides [limited] services for the treatment of a medical emergency.- 83rd Session (2025) – 19 – that is owned or operated by, or otherwise part of, a hospital but is located more than 250 yards from the hospital.

The term includes, without limitation, such a facility that is owned or operated by, or otherwise part of, a hospital but is located more than 250 yards from the hospital.

(b) Related to the issuance or renewal of a license to an independent center for emergency medical care that is owned or operated by, or otherwise part of, a hospital;

- *SB378_R1* – 19 – Sec.

The Board may, by regulation, allow or require payment of a fee for a license in installments and may fix the amount of each payment and the datedatense in that the payment is due.

- 83rd Session (2025) – 20 – 3.

4.renewal of the license of an independent center for emergency medical care that is owned or operated by, or otherwise part of, a hospital.

The Board shall not require a fee for the issuance or renewal of the license of an independent center for emergency medical care that is owned or operated by, or otherwise part of, a hospital.

The Division may not issue a license to operate an independentwithin centera for5 emergencymile radius of:rgency medical care that is located within(a) aAn 5existing mileindependent radiuscenter of:for emergency medical care;

(a) An existing independent center for emergency medical care;

- *SB378_R1* – 20 – 4.

If the off-campus location includes the national provider identifier on such a claim, the off-campus location may- also83rd includeSession on(2025) the– claim21 the– national provider identifier used by the main campus of the hospital.

If the off-campus location used includes both the national provider identifier used by the off-campus location and the national provider identifier used by the main campus on a claim, the claim must clearly identify which national provider identifier corresponds to the off-campus location and which national provider identifier corresponds to the main campus.

or (2) A system that uses the severity of the patient’s condition to determine whether the patient receives emergency services orordition urgent care;

- *SB378_R1* – 21 – (1) With operations that are directly or indirectly owned or controlled by, in whole or in part, a hospital or which is affiliated with a hospital, regardless of whether it is operated by the same governing body as the hospital;

- 83rd Session (2025) – 22 – (c) “Urgent care” means health care that is furnished to a person whose medical condition is sufficiently acute to require treatment unavailable through, or inappropriate to be provided by, a clinic or the office of a provider of health care, but not so acute as toSec. require treatment in an emergency room.

Sec.

The Director may exempt a hospital or independent center for emergency medical care from the requirements of subsection 4 if requiring the hospital or independent center for emergencyemergencyn 4 medical care, as applicable, to comply with the requirements would cause the hospital financial hardship.

The Department shall use the information submitted pursuant to this section for the [program] programs established pursuant to NRS 439A.220 and section 9 of this act to increase public awareness of health care information concerning the hospitals - *SB378_R1* – 22 – and independent centers for emergency medical care, respectively, in this State.

2.- 83rd Session (2025) – 23 – (a) Copies of all reports, summaries, compilations andnclude:

Thesupplementary reportreports preparedrequired pursuantby NRS 449.450 to subsection449.530, 1inclusive, musttogether include:with such facts, suggestions and policy recommendations as the Director deems necessary;

(a) Copies of all reports, summaries, compilations and supplementary reports required by NRS 449.450 to 449.530, inclusive, together with such facts, suggestions and policy recommendations as the Director deems necessary;

(e) An examination and analysis of the manner in which hospitals are reporting the information that is required to be filed pursuant to NRS 449.490, including, without limitation, an examination and analysis of whether that information is being reported in a standard and consistent manner, which fairly reflect the operationsope(f) A review and comparison of eachthe hospital;policies and procedures used by hospitals in this State to provide discounted services to, and to reduce charges for services provided to, persons without health insurance;

(f) A review and comparison of the policies and procedures used by hospitals in this State to provide discounted services to, and to reduce charges for services provided to, persons without health insurance;

3.Human Services shall develop a comprehensive plan concerning the provision of health care in this State which includes, without limitation:

The(a) JointA Interimreview Standingof Committeethe onhealth Healthcare andneeds Humanin Servicesthis shallState developas aidentified comprehensiveby planstate concerningagencies, thelocal provisiongovernments, providers of health care inand thisthe Stategeneral whichpublic; includes, without limitation:

- *SB378_R1* – 23 – (a) A review of the health care needs in this State as identified by state agencies, local governments, providers of health care and the general public;

Sec.- 83rd Session (2025) – 24 – 179.301 1.

21.The Nevada Gaming Control Board and thefollows:

Nevada Gaming Commission and their employees, agents and representatives may inquire into and inspect any records sealed pursuant to NRS 179.301179.245 isor hereby179.255, amendedif the event or conviction was related to readgaming, to determine the suitability or qualifications of any person to hold a state gaming license, manufacturer’s, seller’s or distributor’s license or registration as follows:a gaming employee pursuant to chapter 463 of NRS.

179.301 1.

The Nevada Gaming Control Board and the Nevada Gaming Commission and their employees, agents and representatives may inquire into and inspect any records sealed pursuant to NRS 179.245 or 179.255, if the event or conviction was related to gaming, to determine the suitability or qualifications of any person to hold a state gaming license, manufacturer’s, seller’s or distributor’s license or registration as a gaming employee pursuant to chapter 463 of NRS.

The Division of Insurance of the Department of Business and Industry and its employees may inquire into and inspect any records sealed pursuant to NRS 179.245 or 179.255, if the event or conviction was related to insurance, to determine the suitability or qualifications of any person to hold a license, certification or authorization issued in accordance with title 57 of NRS.

Such inquiry or inspection must be for the purpose of determining the suitability of the person to render such professional services as a provider of services under Medicaid or to own or serve as an officer, managing employee or managing agent of a business seeking to enter into a contract with the Department or a health maintenance organization with which the Department has entered into a contract pursuant to NRS 422.273 for the provision of services under Medicaid.

Events and convictions, if any, which are the subject of an order sealing records may form the basis of a - *SB378_R1* – 24 – decision of the Department to refuse to enter into or terminate such a contract.

- 83rd Session (2025) – 25 – 4.

and (b) The person who is the subject of the records has been arrested or issued a citation for violating NRS 202.485.202.485.been [4.] 5.

[4.] 5.

Sec.

22.

NRS 232.320 is hereby amended to read as follows:

The Director:Director:hereby amended to read as follows:

- *SB378_R1*83rd Session (2025) – 2526 – (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 27 and 28 of this act, 422.580, 432.010 to 432.133, inclusive, 432B.6201 to 432B.626, inclusive, 444.002 to 444.430,444.430,3, 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.

(3) Provide for communication and the coordination of those services among nonprofit organizations, agencies of local government,governm(4) Identify the Statesources of funding for services provided by the Department and the Federalallocation Government;of that funding;

(4) Identify the sources of funding for services provided by the Department and the allocation of that funding;

(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 detailed information relating to their budgets and payrolls, which the Director- deems83rd necessarySession for(2025) the– performance27 of– the duties imposed upon him or her pursuant to this section.section.nce of the duties imposed (f) Has such other powers and duties as are provided by law.

(f)2. Has such other powers and duties as are provided by law.

- *SB378_R1* – 26 – 2.

(c) Identify and investigate complaints of consumers and injured employees regarding their health care plans, including, without limitation, the Public Employees’ Benefits Program and the Public Option, and policies of industrial insurance and assist thosethoseblic consumers and injured employees to resolve their complaints, including, without limitation:

(e) Establish and maintain a system to collect and maintain information pertaining to the written and telephonic inquiries received by the Office for Consumer Health Assistance;

- 83rd Session (2025) – 28 – (h) Provide information to and applications for prescription drug programs for consumers without insurance coverage for prescription drugs or pharmaceutical services;

(1) Information concerning purchasing prescription drugs from Canadian pharmacies that have been recommended by thetherugs - *SB378_R1* – 27 – State Board of Pharmacy for inclusion on the Internet website pursuant to subsection 4 of NRS 639.2328;

and (n) On or before January 31 of each year, compile a report of aggregated information submitted to the Office for ConsumerConsumerrt of Health Assistance pursuant to NRS 687B.675, aggregated for each type of provider of health care for which such information is provided and submit the report to the Director of the Legislative Counsel Bureau for transmittal to:

- 83rd Session (2025) – 29 – (b) “Navigator, case manager or facilitator” has the meaning ascribed to it in NRS 687B.675.

Sec.

24.

NRS 287.010 is hereby amended to read as follows:

The governing body of any county, schoolschoolollows: district, municipal corporation, political subdivision, public corporation or other local governmental agency of the State of Nevada may:

-district, *SB378_R1*municipal –corporation, 28political –subdivision, (a)public Adoptcorporation and carry into effect a system of group life, accident or healthother insurance,local orgovernmental anyagency combination thereof, for the benefit of its officers and employees, and the dependentsState of officersNevada andmay: 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.

(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 ofmoney officersaccumulated andfor employeesthis andpurpose paythrough the deductions intofrom thethe. 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, and section 1 of this act, 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.0319,83rd subsectionsSession 2,(2025) 4,– 630 and– 7 of NRS 689B.0319, 689B.033 to 689B.0369, inclusive, 689B.0375 to 689B.050,689B.050,9, 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.

The money for contributions must be budgeted for in accordance with the laws governing the county, school district, municipal corporation, - *SB378_R1* – 29 – political subdivision, public corporation or other local governmental agency of the State of Nevada.

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

(a) Shall be deemed, solely for the purposes of this section, to be officers and employees of the county, school district, municipal to be corporation, political subdivision, public corporation or other local governmental agency with which the legal services organization has contracted;

- 83rd Session (2025) – 31 – (a) Must be submitted to the Commissioner of Insurance for approval not less than 30 days before the date on which the contract is to become effective.

(b) Does not become effective unless approved by the Commissioner.Com(c) Shall be deemed to be approved if not disapproved by the Commissioner within 30 days after its submission.

(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 - *SB378_R1* – 30 – NRS 439.581 to 439.597, inclusive, and section 1 of this act, 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.

Chapter 422 of NRS is hereby amended by adding thereto the provisions set forth as sections 26.5, 27 and 28 of this act.

the extent that money is available, the Director shall include under Medicaid a system of value-based payments for care provided by independent centers for emergency medical care.

That system must be designed to provide higher rates of reimbursement to independent centers for emergency medical care that:

(a) Provide high quality of care to recipients of Medicaid;

and (b) Ensure that recipients of Medicaid receive an appropriate level of care for the conditions with which the recipients present at an independent center for emergency medical care.

2.

To the extent that money is available to implement the system of value-based payments described in subsection 1, the Department shall:

(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 - 83rd Session (2025) – 32 – federal authorization to implement the system of value-based payments described in subsection 1.

(b) Fully cooperate in good faith with the Federal Government during the application process to satisfy the requirements of the pursuant to paragraph (a).aining a waiver or amendment 3.

As used in this section, “independent center for emergency medical care” has the meaning ascribed to it in NRS 449.013.

If the Department determines that a provider of services under Medicaid may be prescribing or providing services in a manner that exceeds the needs of recipients of Medicaid, is unnecessary or otherwise conflicts with applicable professional standards or the requirements of the Medicaid program, the Department shall perform a review of the relevant claims to evaluate the appropriateness and propriety of the services for whichclaims, paymentthe isreview claimed.must occur before the Department pays the claims.

If the Department has not paid the claims, the review must occur before the Department pays the claims.

If a provider of services fails to submit the documentation required by the Department pursuant to paragraph (b) of subsection 2 within the time specified pursuant to that paragraph, the Department may take the actions described in paragraph (a) of - *SB378_R1* – 31 – subsection 5 without the opportunity for a hearing pursuant to NRS 422.306.

- 83rd Session (2025) – 33 – 4.

(a) Pay the claims that were subject to the review or, if the Department has already paid such a claim, notify the provider of services who made the claim that the claim has been upheld;

The provisions of NRS 603A.010 to 603A.290, inclusive, do not apply to the maintenance or transmittal of information in accordance with NRS 439.581 to 439.597, inclusive, and section 1 of this act and the regulations adopted pursuantpursuantve, thereto.

- *SB378_R1*83rd Session (2025) – 3234 – (c) Does not impose any undue hardship on the employee;

A noncompetition covenant may not restrict, and an employer may not bring an action to restrict, a former employee of an employer from providing service to a former customer or clientclientf if:

5.result of a reduction of force, reorganization or similar restructuring of the employer, a noncompetition covenant is only enforceable during the period in which the employer is paying the employee’s salary, benefits or equivalent compensation, including, without limitation, severance pay.

If the termination of the employment of an employee is the result of a reduction of force, reorganization or similar restructuring of the employer, a noncompetition covenant is only enforceable during the period in which the employer is paying the employee’s salary, benefits or equivalent compensation, including, without limitation, severance pay.

Such revisions must cause the limitations contained in the - 83rd Session (2025) – 35 – covenant as to time, geographical area and scope of activity to be restrained to be reasonable, to not impose undue hardship on the - *SB378_R1* – 33 – employee and to impose a restraint that is not greater than is necessary for the protection of the employer for whose benefit the restraintres7.ainIf isan imposed.employer brings an action to enforce a noncompetition covenant or an employee or contractor brings an action to challenge a noncompetition covenant and the court finds that the noncompetition covenant applies to [an employee] a person described in subsection 3 or that the employer has restricted or attempted to restrict a former employee in the manner described in subsection 2, the court shall award the employee or contractor reasonable attorney’s fees and costs.

7.

If an employer brings an action to enforce a noncompetition covenant or an employee or contractor brings an action to challenge a noncompetition covenant and the court finds that the noncompetition covenant applies to [an employee] a person described in subsection 3 or that the employer has restricted or attempted to restrict a former employee in the manner described in subsection 2, the court shall award the employee or contractor reasonable attorney’s fees and costs.

and (2) Who is not employed or contracted to primarily perform administrative tasks.

employed or contracted to primarily perform Sec.

A high-level provider of health care shall comply with the requirements of subsection 4 of NRS 439.589 concerning the - 83rd Session (2025) – 36 – maintenance, transmittal and exchange of health records.

- *SB378_R1* – 34 – (a) Must, except as otherwise provided in subsections 5 and 6 of NRS 439.589, be created, maintained, transmitted and exchanged electronicallyele(b) asMay] requiredmay bybe subsectioncreated, 4authenticated and stored in a health information exchange which meets the requirements of NRS 439.589;439.581 to 439.597, inclusive, and section 1 of this act and the regulations adopted pursuant thereto.

and (b) May] may be created, authenticated and stored in a health information exchange which meets the requirements of NRS 439.581 to 439.597, inclusive, and section 1 of this act and the regulations adopted pursuant thereto.

[6.]this 7.section may be included with other written informationsuant to delivered to the patient by a provider of health care.

A written statement delivered to a patient pursuant to this section may be included with other written information delivered to the patient by a provider of health care.

If a health care licensing board receives notification from the Department of Health and Human Services pursuant to NRS 439.5895 that a high-level provider of health care to which the health care licensing board has issued a license is not in compliance with the requirements of subsection 4 or 8, as applicable, of NRS 439.589, the health care licensing board may, after notice and the opportunity- for83rd aSession hearing(2025) in– accordance37 with– the provisions of this title, require corrective action or impose an administrative penalty in an amount not to exceed the maximum penalty that the health care licensing board is authorized to impose for other violations.

The - *SB378_R1* – 35 – health care licensing board shall not suspend or revoke a license for failure to comply with the requirements of subsection 4 or 8 of NRS 439.589.

(a) “Health(1) careA licensingboard board”created means:pursuant to chapter 630, 630A, 631, 632, 633, 634, 634A, 635, 636, 637, 637B, 639, 640, 640A, 640B, 640C, 641, 641A, 641B, 641C or 641D of NRS.

(1) A board created pursuant to chapter 630, 630A, 631, 632, 633, 634, 634A, 635, 636, 637, 637B, 639, 640, 640A, 640B, 640C, 641, 641A, 641B, 641C or 641D of NRS.

The State Board of Health and each board created pursuant to chapter 630, 630A, 631, 632, 633, 634, 634A, 635, 636, 637, 637B, 640, 640A, 640B, 640C, 641, 641A, 641B, 641C or 641D of NRS shall post on its website on the Internet, if any, a statementsta(a) whichPursuant disclosesto that:the provisions of subsection [7] 8 of NRS 629.051:

(a) Pursuant to the provisions of subsection [7] 8 of NRS 629.051:

and (b)- Except83rd asSession otherwise(2025) provided– in38 subsection– [7] 8 of NRS 629.051 and unless a longer period is provided by federal law, the health care records of a patient who is 23 years of age or older may be destroyed after 5 years pursuant to subsection 1 of NRS 629.051.

- *SB378_R1* – 36 – Sec.

If a patient requests that a copy his or her health care records be furnished electronically to the patient or any othercovered person or entity, the custodian of health records shall furnish the copy not later than the end of the secondseventh business day after the request is made.

A custodian of health care records shall not charge a fee to furnish health care records to a patient or, if the patient has requested a copy of his or her health care records to be furnished to anotherany personcovered or entity, to that personcovered or entity.

If the total amount of the fee chargeable pursuant to subsection 2 for the furnishing of health care records electronically is less than $5, a custodian of health care records, other than a custodian of the health care records of a state or local governmental entity, may charge a fee of $5 for the furnishing of those health care records.

(a)- A83rd feeSession of(2025) $5– for39 – records were found.for written confirmation that no health care records(b) wereA found.fee of $5 for furnishing a copy of a certificate of the custodian of health care records.

(b) A fee of $5 for furnishing a copy of a certificate of the custodian of health care records.

(a) “Custodian“Covered ofentity” health care records” has the meaning ascribed to it in NRS 629.016 and additionally includes a covered entity or - *SB378_R1* – 37 – business associate, as those terms are defined in 45 C.F.R.

(b) “Health“Custodian of health care records” has the meaning ascribed to it in NRS 629.021629.016 and additionally includes individuallya identifiablecovered healthentity information,or business associate, as those terms are defined in 45 C.F.R.

[(b)] (c) “Secure“Health electroniccare transmission”records” meanshas the sendingmeaning ofascribed informationto fromit onein computerNRS system629.021 toand anotheradditionally computerincludes systemindividually inidentifiable suchhealth ainformation, manner as todefined ensurein that:45 C.F.R.

§ 160.103.

information from one computer system to another computer system of in such a manner as to ensure that:

Any person who misrepresents or falsifies essential information requested on this form may, upon conviction, be subject to a fine and imprisonment under state or federal law, or both.

If a person who is licensed to practice one of the health professions regulated by title 54 of NRS submits to an insurer the form commonly referred to as the “HCFA-1500” for a patient who is not covered by any governmental program which offers insurance coverage- for83rd healthSession care,(2025) the– form40 must– bestatement accompaniedthat reads substantially as follows:ompanied by a Any person who knowingly files a statement thatof readsclaim substantiallycontaining asany follows:misrepresentation or any false, incomplete or misleading information may be guilty of a criminal act punishable under state or federal law, or both, and may be subject to civil penalties.

Any person who knowingly files a statement of claim containing any misrepresentation or any false, incomplete or misleading information may be guilty of a criminal act punishable under state or federal law, or both, and may be subject to civil penalties.

- *SB378_R1* – 38 – Sec.

The provisions of this chapter do not apply to a transaction to (a) Except as otherwise specifically provided by law, a law governing the extentcreation itand isexecution governedof by:wills, codicils or testamentary trusts;

(a) Except as otherwise specifically provided by law, a law governing the creation and execution of wills, codicils or testamentary trusts;

720.140the 1.provisions of this chapter apply to any transaction for which a digital signature is used to sign an electronic record.

Except as otherwise provided in this subsection, the provisions of this chapter apply to any transaction for which a digital signature is used to sign an electronic record.

- 83rd Session (2025) – 41 – Sec.

36.2.

1.

There is hereby appropriated from the State General Fund to the Division of Health Care Financing and Policy of the Department of Health and Human Services the sum of $291,296 to carry out the provisions of sections 26.5, 27 and 28 of thi2.actExpenditure of $1,149,153 not appropriated from the State General Fund or the State Highway Fund is hereby authorized during Fiscal Year 2026-2027 by the Division of Health Care Financing and Policy of the Department of Health and Human Services for the same purpose as set forth in subsection 1.

3.

Any remaining balance of the appropriation made by subsection 1 must not be committed for expenditure after June 30, 2027, by the entity to which the appropriation is made or any entity to which money from the appropriation is granted or otherwise transferred in any manner, and any portion of the appropriated money remaining must not be spent for any purpose after September 17, 2027, by either the entity to which the money was appropriated or the entity to which the money was subsequently granted or transferred, and must be reverted to the State General Fund on or before September 17, 2027.

37.36.5.

NotwithstandingAn the amendatory provisions of section 14 of this act, an independent center for emergency medical care that iswas ownedlicensed oron operatedthe by,date oron otherwisewhich partthis of,act awas hospitalenacted mayis continueexempt tofrom operatethe withoutrequirements obtainingof asubsection license3 separate from the license of theNRS hospital449.1818, pursuantas toamended NRSby 449.080section until18 Julyof 1,this 2026.act.

NotwithstandingAs theused amendatoryin provisions of section 17 of this act,section, the“independent Division of Public and Behavioral Health of the Department of Health and Human Services shall issue a license to operate an independent center for emergency medical carecare” thathas isthe ownedmeaning orascribed operatedto by,it orin otherwiseNRS part449.013, of,as athat hospital,section isexisted operating on January 1, 2026,2025. and is located within 5 miles of another independent center for emergency medical care or a hospital with an emergency department if the independent center for emergency - *SB378_R1* – 39 – medical care otherwise qualifies for licensure pursuant to NRS 449.080.

3.section 14 of this act, an independent center for emergency medical care that is owned or operated by, or otherwise part of, a hospital may continue to operate without obtaining a license separate from the license of the hospital pursuant to NRS 449.080 until July 1, 2026.

Notwithstanding2. the amendatory provisions of section 17 of this act, the Division of Public and Behavioral Health of the Department of Health and Human Services shall issue a license to operate an independent center for emergency medical care that is located within 5 miles of another independent center for emergency medical care or a hospital with an emergency department and that otherwise qualifies for licensure pursuant to NRS 449.080 at the time of the application for licensure if, on or before January 1, 2026, the owner or operator of the independent center for emergency medical care has:

Notwithstanding the amendatory provisions of section 17 of this act, the Division of Public and Behavioral Health of the Department of Health and Human Services shall issue a license to operate an independent center for emergency medical care that was operating on the date on which this act was enacted and is located within 5 miles of another independent center for emergency medical care or a hospital with an emergency department if the independent center for emergency medical care otherwise qualifies for licensure pursuant to NRS 449.080.

- 83rd Session (2025) – 42 – 3.

Notwithstanding the amendatory provisions of section 17 of this act, the Division of Public and Behavioral Health of the Department of Health and Human Services shall issue a license to operate an independent center for emergency medical care that is medical care or a hospital with an emergency department and thatcy otherwise qualifies for licensure pursuant to NRS 449.080 at the time of the application for licensure if, on or before January 1, 2025, the owner or operator of the independent center for emergency medical care had:

(b) Obtained or iswas in the process of obtaining all necessary permits, licenses or other required approvals necessary for the construction of the independent center for emergency medical care;

The provisions of NRS 354.599 do not apply to any additional expenses of a local government that are related to the provisionsproSec. of this act.

Sec.

This section and sections 1 to 4, inclusive, 6, 21, 22,24, 2425, 29 to 32, inclusive, 35, 36 and 40 of this act become effective upon passage and approval.

Sections 5, 7 to 20, inclusive, 22, 23, 33,26, 34,26.5, 37,33, 3834 and 3936.5 to 39, inclusive, of this act become effective:

-3. *SB378_R1* – 40 – TEXT OF REPEALED SECTION with requirements concerning electronic health information.ly 1.

IfSection the36.2 health authority receives notification from the Department of Health and Human Services pursuant to NRS 439.5895 that the holder of a permit to operate an ambulance, air ambulance or vehicle of a fire-fighting agency is not in compliance with the requirements of subsection 4 of NRS 439.589, the health accordance with the provisions of this chapter,act requirebecomes correctiveeffective actionon orJuly impose1, an2026. administrative penalty in an amount established by regulation of the board.

2.4.

TheSections health27 authorityand shall28 not suspend or revoke a permit for failure to comply with the requirements of subsectionthis 4act ofbecome NRSeffective: 439.589.

H(a) -Upon *SB378_R1*passage and approval for the purpose of adopting any regulations and performing any other preliminary administrative tasks that are necessary to carry out the provisions of this act;

and - 83rd Session (2025) – 43 – (b) On October 1, 2026, for all other purposes.

~~~~~ 25 - 83rd Session (2025)