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- 83rd Session (2025)
Assembly Bill No. 282–Assemblymember Orentlicher
CHAPTER..........
AN ACT relating to health care; requiring a medical facility or an
entity that bills for care provided by a provider of health care
that receives notice from a patient of an overcharge in a
medical bill to review the potential overcharge and refund
any ove rpayment; authorizing the imposition of certain
administrative fines for the failure to issue such a refund
within a certain period ; requiring the Governor’s Consumer
Health Advocate to provide certain assistance concerning
overcharges and overpayments for health care; and providing
other matters properly relating thereto.
Legislative Counsel’s Digest:
Existing law provides every patient of a medical facility with the right to examine
the bill for his or her care and receive an explanation of the bill. (NRS 449A.106)
Existing law also requires each provider of health care to timely provide a patient with
an itemized bill at no additional cost to the patient. (NRS 629.071) Sections 2 and 3
of this bill, respectively, require a medical facility or an entity that bills for care
provided by a provider of health care that receives notice from a patient that a medical
bill contains one or more overcharges to: (1) respond to the patient concerning the
overcharges, including by provid ing the contact information for the Office for
Consumer Health Assistance in the Department of Health and Human Services if the
facility or provider does not intend to refund the disputed charge; or (2) notify the
patient that more time is needed to investigate the disputed charge. Sections 2 and 3
require the medical facility or billing entity to refund any overpayment by the patient.
Sections 2 and 3 provide for the imposition of administrative fines against a medical
facility or billing entity that fails to issue such a refund. Section 2.5 of this bill
requires the Governor’s Consumer Health Advocate, who serves as the head of the
Office, to review medical bills that consumers believe to be erroneous and assist
consumers in addressing overcharges and overpayments for health care.
EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted.
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1. (Deleted by amendment.)
Sec. 2. Chapter 449A of NRS is hereby amended by adding
thereto a new section to read as follows:
1. If a patient believes that a bill from a medical facility
contains one or more overcharges and notifies the medical facility
of the specific charges the patient believes are erroneous, the
medical facility shall investigate the alleged overcharge and, not
later than 30 days after notification:
(a) Respond to the patient by:
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(1) Notifying the patient whether the medical facility will be
cancelling any amount of the bill not yet paid or refunding any
overpayment; and
(2) If the medical facility will not be cancelling or
refunding, as applicable, the full amount of the disputed charges,
providing the patient with the contact information for the Office
for Consumer Health Assistance established pursuant to NRS
232.458; or
(b) Advise the patient that more time is needed to investigate
the disputed charge.
2. If the patient contacts the Office for Consumer Health
Assistance, the Office shall notify the me dical facility of the
commencement and conclusion of any review of the disputed
charge by the Office.
3. During the investigation of a disputed charge by a medical
facility or any review of a disputed charge by the Office for
Consumer Health Assistance, the medical facility shall not bill the
patient for any care that is subject to the investigation or review,
but may bill for charges the patient incur s relating to other care
provided by the medical facility to the patient.
4. Except as otherwise provid ed in this subsection, a medical
facility that receives an overpayment from a patient shall refund
the amount of the overpayment to the patient not later than 60
days after the medical facility determines that an overpayment was
made. The medical facility may apply the amount of overpayment
due to the patient to other current outstanding bills of the patient.
5. A medical facility that fails to comply with subsection 4:
(a) Is subject to an administrative fine assessed by the Division
at a rate equal to 10 percent of the amount of the relevant
overpayment, but not to exceed $5,000; and
(b) Is not subject to any other administrative sanction.
Sec. 2.5. NRS 232.459 is hereby amended to read as follows:
232.459 1. The Advocate shall:
(a) Respond to written and telephonic inquiries received from
consumers and injured employees regarding concerns and problems
related to health care and workers’ compensation;
(b) Assist consumers and injured employees in understanding
their rights and responsibilities under health care plans, including,
without limitation, the Public Employees’ Benefits Program, and
policies of industrial insurance;
(c) Identify and investigate complaints of consumers and injured
employees regarding thei r health care plans, including, without
limitation, the Public Employees’ Benefits Program, and policies of
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industrial insurance and assist those consumers and injured
employees to resolve their complaints, including, without limitation:
(1) Referring co nsumers and injured employees to the
appropriate agency, department or other entity that is responsible for
addressing the specific complaint of the consumer or injured
employee; and
(2) Providing counseling and assistance to consumers and
injured employees concerning health care plans, including, without
limitation, the Public Employees’ Benefits Program, and policies of
industrial insurance;
(d) Provide information to consumers and injured employees
concerning health care plans, including, without limi tation, the
Public Employees’ Benefits Program, and policies of industrial
insurance in this State;
(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;
(f) Take such actions as are necessary to ensure public
awareness of the existence and purpose of the services provided by
the Advocate pursuant to this section;
(g) In appropriate cases and pursuant to the direction of the
Advocate, refer a complaint or the results of an investigation to the
Attorney General for further action;
(h) Provide information to and applications for prescription drug
programs for consumers without insurance coverage for prescription
drugs or pharmaceutical services;
(i) Establish and maintain an Internet website which includes:
(1) Information concerning purchasing prescription drugs
from Canadian pharmacies that have been recommended by the
State Board of Pharmacy for inclusion on the Internet website
pursuant to subsection 4 of NRS 639.2328;
(2) Links to websites of Canadian pharmacies which have
been recommended by the State Board of Pharmacy for inclusion on
the Internet website pursuant to subsection 4 of NRS 639.2328; and
(3) A link to the website established and maintained pursuant
to NRS 439A.270 which provides information to the general public
concerning the charges imposed and the quality of the services
provided by the hospitals and surgical centers for ambulatory
patients in this State;
(j) Assist consumers with accessing a navigator, case manager
or facilitator to help the consumer obtain health care services;
(k) Assist consumers with scheduling an appointment with a
provider of health care who is in the network of p roviders under
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contract to provide services to participants in the health care plan
under which the consumer is covered;
(l) Assist consumers with filing complaints against health care
facilities and health care professionals;
(m) Assist consumers with filing complaints with the
Commissioner of Insurance against issuers of health care plans;
[and]
(n) Review bills from medical facilities and providers of health
care that consumers believe to be erroneous , including, without
limitation, after being conta cted by a consumer pursuant to
section 2 or 3 of this act, and assist consumers in dealing with
overcharges and overpayments for health care; and
(o) On or before January 31 of each year, compile a report of
aggregated information submitted to the Office for Consumer
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:
(1) In even -numbered years, the Joint Interim Standing
Committee on Health and Human Services; and
(2) In odd -numbered years, the next regular session of the
Legislature.
2. The Advocate may adopt regulations to carry out the
provisions of this section and NRS 232.461 and 232.462.
3. As used in this section:
(a) “Health care facility” has the meaning ascribed to it in
NRS 162A.740.
(b) “Navigator, case manager or facilitator” has the meaning
ascribed to it in NRS 687B.675.
Sec. 3. Chapter 629 of NRS is hereby amended by adding
thereto a new section to read as follows:
1. If a patient believes that a bill for goods or services
provided by a provider of health care contains one or more
overcharges and notifies the relevant billing entity of the specific
charges the patient believes are erroneous, the billing entity shall
investigate the alleged overcharge and, not later than 30 days after
notification:
(a) Respond to the patient by:
(1) Notifying the patient whether the billing entity will be
cancelling any amount of the bill not yet paid or refunding any
overpayment; and
(2) If the billing entity will not be cancelling or refunding,
as applicable, the full amount of the disputed charges, providing
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the patient with the contact information for the Office for
Consumer Health Assistance established pursuant to NRS
232.458; or
(b) Advise the patient that more time is needed to investigate
the disputed charge.
2. If the patient contacts the Office for Consumer Health
Assistance, the Office shall notify the provider of health care and
the billing entity of the commencement and conclusion of any
review of the disputed charge by the Office.
3. During the investigation of a disputed charge by a billing
entity or any review o f a disputed charge by the Office for
Consumer Health Assistance, the provider of health care and the
billing entity shall not bill the patient for any care that is subject to
the investigation or review, but may bill for charges the patient
incurs relating to other care provided by the provider of health
care to the patient.
4. Except as otherwise provided in this subsection, a billing
entity that receives an overpayment from a patient shall refund the
amount of the overpayment to the patient not l ater than 60 days
after the billing entity determines that an overpayment was made.
The billing entity may apply the amount of overpayment due to the
patient to other current outstanding bills of the patient for care
provided by the same provider of health care who provided the
care for which the overpayment was made.
5. A billing entity that violates subsection 4:
(a) Is subject to an administrative fine assessed by the entity
authorized by subsection 6 at a rate equal to 10 percent of the
amount of the relevant overpayment, but not to exceed $5,000; and
(b) Is not subject to any other administrative sanction.
6. If a billing entity is:
(a) A facility licensed pursuant to chapter 449 of NRS, a fine
pursuant to subsection 5 may be assessed by the Division of Public
and Behavioral Health of the Department of Health and Human
Services.
(b) A provider of health care who practices as a solo
practitioner, a group practice of providers of health care or
an employer of a provider of health car e not described in
paragraph (a), a fine pursuant to subsection 5 may be assessed by
the health care licensing board responsible for regulating the
provider of health care who provided the care for which the
relevant overpayment was made.
7. Any adminis trative proceedings concerning an
administrative fine assessed by a health care licensing board
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pursuant to subsection 5 must be conducted in the same manner
as disciplinary proceedings conducted by that health care
licensing board against providers of hea lth care regulated by the
health care licensing board.
8. An entity described in subsection 6 shall treat any money
from an administrative fine assessed pursuant to subsection 5 in
the same manner as other administrative fines paid to the entity.
9. As used in this section:
(a) “Billing entity” means:
(1) A provider of health care who practices as a solo
practitioner;
(2) A group practice of providers of health care to which a
provider of health care belongs; or
(3) An employer of a provider of health care,
that receives payment for goods or services provided by the
provider of health care.
(b) “Health care licensing board” means:
(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.
(2) The Division of Public and Behavioral Health of the
Department of Health and Human Services.
(3) The State Board of Health with respect to providers of
health care licensed pursuant to chapter 640D or 640E of NRS.
Secs. 4-18. (Deleted by amendment.)
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