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- 83rd Session (2025)
Assembly Bill No. 343–Assemblymember Yeager
CHAPTER..........
AN ACT relating to health care; requiring hospitals to publish
certain information relating to the pricing of goods and
services; prohibiting a hospital from collecting medical debt
that accrued while the hospital was out of compliance with
that requirement; prescribing a pr ocedure for the correction
of violations of that requirement; authorizing certain
investigations, civil actions and the imposition of certain
administrative sanctions; providing for the publication of
certain information relating to violations; requiring c ertain
health care entities to provide certain information before
taking any action to collect a medical debt; providing a
penalty; and providing other matters properly relating thereto.
Legislative Counsel’s Digest:
Existing federal regulations require a hospital to publish: (1) a list of standard
charges for all items and services provided by the hospital; and (2) a consumer -
friendly list of standard charges for a limited set of shoppable services, which are
services provided by a hospital that can be sc heduled by a consumer in advance.
(45 C.F.R. §§ 180.20, 180.40 -180.60) Sections 13-15 of this bill codify similar
requirements into Nevada law. Specifically, section 13 requires a hospital to
compile, publish and update annually a list of standard charges for all items and
services provided by the hospital. Section 14 requires a hospital to maintain an
online price -estimator tool or compile, publish and update annually: (1) a list of
shoppable services provided by the hospital; and (2) a list of the shoppab le services
that appear on a list of certain shoppable services specified by the Federal
Government and that the hospital does not provide. Section 15 requires a hospital
to publish the most current version of each list required by sections 13 and 14 on
the most prominent publicly available Internet website maintained by the hospital .
Section 15 prescribes certain requirements governing the manner in which those
lists must be published. Section 16 of this bill requires a hospital to annually report
to the Department of Health and Human Services concerning facility fees for
outpatient services provided in off -campus facilities. Section 16 requires the
Department to publish those reports on a publicly available Internet website.
Section 17 of this bill prohibits a hospital from taking certain actions to collect
a medical debt for goods or services provided to a patient while the hospital is not
in compliance with the requirements of sections 13-15 or the corresponding federal
requirements. Section 17 provides that such prohibited actions , when taken
knowingly, constitute deceptive trade practices, thereby subjecting a hospital that
commits such a violation to the civil and criminal penalties that may be imposed for
deceptive trade practices generally. ( Chapter 598 of NRS) Section 17 also
authorizes a medical debtor who is aggrieved by such a prohibited action to file a
claim with the Bureau of Consumer Protection in the Office of the Attorney
General. Section 24.5 of this bill requires the Governor’s Consumer Health
Advocate to assist patients with the filing of such claims. If the Bureau determines
that a hospital has taken an action prohibited by section 17 to collect a medical
debt, section 17 requires the hospital to cancel the debt and refund any portion of
the debt that has been paid.
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Sections 18-21 of this bill provide for the administrative enforcement of
sections 2-21. Specifically, section 18: (1) authorizes any person or entity to file a
complaint against a hospital that fails to comply with sections 2-21; and (2)
requires the Department to monitor the compliance of hospitals with sections 2-21.
Section 19 prescribes a procedure for the correction of a violation of sections 2-21,
and section 20 requires the Department to impose administrative penalties against a
hospital that commits such a violation. Section 21 provides for the publication of
certain documents relating to violations of sections 2-21. Sections 21 and 25 of
this bill provide that a complaint alleging such a violation and certain initial
investigatory documents are confidential.
Section 22 of this bill requires certain health care entities, before taking any
action to collect a medical debt, to provide: (1) the patient with an itemized
statement of the medical debt and certain other information; and (2) the medical
debtor with a receipt for each payment made on the debt. Section 22 authorizes a
patient or medical debtor who is ag grieved by a violation of those requirements to
file a claim with the Bureau of Consumer Protection in the Office of the Attorney
General. Section 24.5 requires the Governor’s Consumer Health Advocate to assist
patients with the filing of such claims. If t he Bureau determines that a health care
entity has taken an action to collect a medical debt where prohibited by section 22,
section 22 requires the health care entity to cancel the debt and refund any portion
of the debt that has been paid. Section 22 also provides that attempting to collect a
debt under such prohibited circumstances constitutes a deceptive trade practice.
Sections 3-12 of this bill define certain terms, and section 2 of this bill establishes
the applicability of those definitions. Sections 23 and 27 of this bill make
conforming changes to clarify the applicability of an existing definition.
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. Chapter 439B of NRS is hereby amended by adding
thereto the provisions set forth as sections 2 to 22, inclusive, of this
act.
Sec. 2. As used in sections 2 to 22, inclusive, of this act,
unless the context otherwise requires, the words and terms defined
in sections 3 to 12, inclusive, of this act have the meanings
ascribed to them in those sections.
Sec. 3. “Diagnosis-related group” means groupings of
medical diagnostic categories used as a basis for hospital payment
schedules by Medicare and other health benefit plans offered by
third parties.
Sec. 4. “Healing art” means any system, treatment,
operation, diagnosis, prescription or practice for the
ascertainment, cure, relief, palliation, adjustment or correction of
any human disease, ailment, defo rmity, injury or unhealthy or
abnormal physical or mental condition for the practice of which
long periods of specialized education and training and a degree of
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specialized knowledge of an intellectual as well as physical nature
are required.
Sec. 5. “Health benefit plan” means a policy, contract,
certificate or agreement offered or issued by a third party to
provide, deliver, arrange for, pay for or reimburse any of the costs
of health care services.
Sec. 5.5. “Health care entity” means:
1. Any facility licensed pursuant to chapter 449 of NRS;
2. A practitioner group practice;
3. An entity that provides staffing or services of practitioners;
or
4. Any other entity that provides health care specified by
regulation of the Department.
Sec. 6. (Deleted by amendment.)
Sec. 7. “Medical debt” means an obligation or alleged
obligation owed by a consumer of health care to pay money to a
health care entity or its assignee for medical services, products or
devices, regardless of whether the obligatio n is past due. The term
includes, without limitation, any amount which has been paid
toward the partial or total satisfaction of the debt.
Sec. 8. “Medical debtor” means a natural person who:
1. Owes a medical debt; or
2. Is the guarantor of a natura l person who owes a medical
debt.
Sec. 9. “National Drug Code” means the numerical code
assigned to a prescription drug by the United States Food and
Drug Administration.
Sec. 10. “Practitioner group practice” means any business
entity organized for the purpose of the practice of one or more
healing arts by more than one practitioner.
Sec. 11. “Small practitioner group practice” means a
practitioner group practice consisting of a number of practitioners
less than or equal to the maximum number of practitioners
established by regulation of the Department for a small
practitioner group practice.
Sec. 12. “Third party” means any insurer, governmental
entity or other organization providing health coverage or ben efits
in accordance with state or federal law.
Sec. 13. 1. A hospital shall compile, publish in accordance
with section 15 of this act and update annually a list of:
(a) Each item or service provided by the hospital for which the
hospital has establish ed a standard charge, including, where
applicable:
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(1) A fee for:
(I) Supplies and procedures;
(II) Room and board; or
(III) The services of physicians and other practitioners
employed by the hospital; and
(2) A fee for the use of the hospital or an item; and
(b) For each item or service described in paragraph (a):
(1) A description of the item or service;
(2) The amount, in dollars, of the charge for the item or
service that is reflected on the charge master maintained pursuant
to NRS 449.490, absent any discount;
(3) The amount, in dollars, of the highest charge that the
hospital has negotiated with a third party for the item or service,
listed without identifying the third party;
(4) The amount, in dollars, of the lowest charge that the
hospital has negotiated with a third party for the item or service,
listed without identifying the third party;
(5) The amount, in dollars, that the hospital charges a
natural person who pays immediately in cash for the item or
service;
(6) Except as otherwise provided in subsection 4, the
amount, in dollars, of each charge negotiated with a third party
for an item or service, listed in a manner that clearly associates
the negotiated charge with the third party and any applicable
health benefit plan offered by the third party; and
(7) Any code or similar identifier that the hospital uses for
the purpose of accounting or billing for the item or service, which
may include, without limitation:
(I) The code set forth in Current Procedural
Terminology published by the American Medical Association;
(II) The code set forth in the Healthcare Common
Procedure Coding System published by the Centers for Medicare
and Medicaid Services of the United States Department of Health
and Human Services;
(III) The diagnosis-related group; and
(IV) The National Drug Code.
2. If a hospital operates multiple facilities in this State, the
hospital shall compile a separate list pursuant to subsection 1 for
each facility.
3. A hospital is not required to in clude the information
described in subparagraph (6) of paragraph (b) of subsection 1 as
part of the list compiled pursuant to subsection 1 if such
information is not required to be included in the information
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published pursuant to 42 U.S.C. § 300gg-18(e) and the regulations
adopted pursuant thereto.
4. As used in this section, “standard charge” means the
regular rate established by a hospital for an item or service
provided to a specific group of patients. The term includes, without
limitation:
(a) A charge that is reflected on the charge master maintained
pursuant to NRS 449.490, absent any discount;
(b) A charge negotiated with a third party; and
(c) The amount charged to a natural person who pays
immediately in cash for the item or service.
Sec. 14. 1. Except as otherwise provided in subsection 7, a
hospital shall compile, publish in accordance with section 15 of
this act and update annually:
(a) A list of shoppable services provided by the hospital and,
for each such shoppable service, the information required by
subsection 3. The list must include at least 300 shoppable services
or, if the hospital provides fewer than 300 shoppable services, each
shoppable service that the hospital provides. Such shoppable
services must include, without lim itation, each shoppable service
provided by the hospital that appears on the list of 70 shoppable
services specified by the Centers for Medicare and Medicaid
Services of the United States Department of Health and Human
Services pursuant to 45 C.F.R. § 180.60.
(b) A list of each shoppable service that appears on the list of
70 shoppable services specified by the Centers for Medicare and
Medicaid Services of the United States Department of Health and
Human Services pursuant to 45 C.F.R. § 180.60 that is not offered
by the hospital.
2. In deciding whether to include a shoppable service on the
list compiled pursuant to paragraph (a) of subsection 1, a hospital
shall:
(a) Consider the frequency with which the hospital provides
the shoppable service and the rate that the hospital charges for the
shoppable service; and
(b) Prioritize for inclusion on the list the shoppable services
that the hospital most frequently provides.
3. The list compiled pursuant to paragraph (a) of subsection
1 must include, for each shoppable service:
(a) A description, in plain language, of the shoppable service;
(b) Except as otherwise provided in subsection 6, the amount,
in dollars, of each charge negotiated with a third party for the
shoppable service and any services ancillary to the shoppable
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service, listed in a manner that clearly associates the negotiated
charge with the third party and any applicable health benefit plan
offered by the third party;
(c) The amount, in dollars, that the hospital charges a natural
person who pays immediately in cash for the shoppable service
and any services ancillary to the shoppable service;
(d) The amount, in dollars, of the highest charge that the
hospital has negotiated with a third party for the shoppable service
and any services ancillary to the shoppable service, listed without
identifying the third party;
(e) The amount, in dollars, of the lowest charge that the
hospital has negotiated with a third party for the shoppable service
and any services ancillary to the shoppable service, listed without
identifying the third party;
(f) Any code or similar identifier that the hospital uses for the
purpose of accounting or billing for the shoppable service, wh ich
may include, without limitation:
(1) The code set forth in Current Procedural Terminology
published by the American Medical Association;
(2) The code set forth in the Healthcare Common
Procedure Coding System published by the Centers for Medicare
and Medicaid Services of the United States Department of Health
and Human Services;
(3) The diagnosis-related group; and
(4) The National Drug Code; and
(g) If the hospital provides the shoppable service to both
inpatients and outpatients, whether each charge specified
pursuant to paragraphs (b) to (e), inclusive, applies to the
shoppable service when provided to an inpatient or an outpatient.
4. If a hospital operates multiple facilities in this State, the
hospital shall compile a separate list pursu ant to subsection 1 , to
the extent required by this section, for each facility.
5. A hospital is not required to include the information
described in paragraph (b) of subsection 3 as part of the list
compiled and published pursuant to paragraph (a) of su bsection 1
if such information is not required to be included in the
information published pursuant to 42 U.S.C. § 300gg -18(e) and
the regulations adopted pursuant thereto.
6. A hospital is not required to compile and publish the list of
shoppable servic es described in paragraph (a) of subsection 1 if
the hospital maintains a price-estimator tool that:
(a) Allows a user to obtain an estimate of the amount that the
user will be obligated to pay to the hospital if the person receives a
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shoppable service or service ancillary to the shoppable service that
would otherwise be included on a list compiled and published
pursuant to subsection 1.
(b) Is available in a prominent location on the most prominent
publicly available Internet website operated by the hospital. If a
hospital operates multiple facilities with separate Internet
websites, the price-estimator tool must be available on the most
prominent publicly available Internet website of each such facility.
(c) Is available at all times and free of charge, without having
to establish a user account or password and without having to
submit personally identifiable information, enter a code or
overcome any other impediment.
(d) Is accessible to a common commercial operator of an
Internet s earch engine to the extent necessary for the search
engine to index the price-estimator tool and display the price-
estimator tool in response to a search by a user of the search
engine.
7. Any price-estimator tool that is deemed by the Centers for
Medicare and Medicaid Services of the United States Department
of Health and Human Services to meet the requirements of 45
C.F.R. § 180.60(a)(2) shall be deemed to also meet the
requirements of subsection 7.
8. As used in this section, “shoppable service” mean s a
service that a patient may schedule in advance.
Sec. 15. 1. A hospital shall:
(a) Publish the most current version of each list compiled
pursuant to section 13 or 14 of this act in a single digital file that
is presented in a machine-readable format without additional rows
or spacing between data and in the manner required by subsection
2. Each such list must be made available in a prominent location
on the most prominent publicly available Internet website operated
by the hospital. If a hospital operates multiple facilities with
separate Internet websites, the lists pertaining to each facility must
be available on the most prominent publicly available Internet
website for the facility to which the list pertains.
(b) Indicate on each list compiled pursuant to section 13 or 14
of this act or in a manner clearly associated with the list the date
on which the list was most recently updated.
2. Each list published pursuant to subsection 1 must be:
(a) Available at all times and free of charge, without having to
establish a user account or password and without having to submit
personally identifiable information, enter a code or overcome any
other impediment;
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(b) Accessible to a common commercial operator of an
Internet search engine to the extent necessary for the search
engine to index the list and display the list in response to a search
by a user of the search engine; and
(c) Digitally searchable.
3. As used in this section, “machine -readable format” means
a digital representation of information in a file that is capable of
being imported or read into a computerized system for further
processing. The term includes, without limitation, .XML, .JSON
and .CSV formats.
Sec. 16. 1. On or before July 1 of each year, a hospital
shall submit to the Department in the form prescribed by the
Department:
(a) A report which includes the information prescribed by
subsection 2; and
(b) A statement signed by a senior offi cial or executive of the
hospital under penalty of perjury affirming the accuracy and
completeness of the information in the report.
2. A report submitted pursuant to paragraph (a) of subsection
1 must include, for the immediately preceding calendar year:
(a) The name and location of each health care facility, other
than a small practitioner group practice, owned or operated by the
hospital that charges a facility fee for any service;
(b) The number of patient visits to each health care facility
described in paragraph (a);
(c) The number, total amount and types of facility fees paid at
each health care facility described in paragraph (a) by Medicare;
(d) The number, total amount and types of facility fees paid at
each health care facility described in paragraph (a) by
nongovernmental third parties;
(e) For each health care facility described in paragraph (a),
the total number of facility fees charged and the total amount of
revenue received from facility fees;
(f) The total amount of facility fees ch arged and the total
amount of revenue received from facility fees by the hospital for
all health care facilities described in paragraph (a);
(g) The 10 services provided by the hospital, including, without
limitation, all health care facilities owned or o perated by the
hospital, that generated the largest amount of gross revenue
through facility fees and, for each such service:
(1) The code set forth in Current Procedural Terminology
published by the American Medical Association;
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(2) The total number of times the hospital provided the
service;
(3) The gross and net revenue generated by the hospital
through the provision of the service; and
(4) The net revenue received by the hospital through facility
fees associated with the service;
(h) The 10 se rvices provided by the hospital most frequently
for which the hospital charged a facility fee and, for each such
service:
(1) The code set forth in Current Procedural Terminology
published by the American Medical Association;
(2) The total number of t imes the hospital provided the
service;
(3) The gross and net revenue generated by the hospital
through the provision of the service; and
(4) The net revenue received by the hospital through facility
fees associated with the service; and
(i) Any other information prescribed by regulation of the
Department.
3. The Department shall publish each report received
pursuant to subsection 1 available on a publicly accessible
Internet website maintained by the Department not later than 45
days after receiving the report.
4. As used in this section:
(a) “Facility fee” means a fee that is charged by a hospital for
outpatient services provided in an off -campus health care facility
operated by the hospital and that is intended to compensate the
hospital for the expenses of providing health care. The term does
not include a fee charged by a practitioner for medical services.
(b) “Health care facility” means:
(1) An off-campus location of a hospital;
(2) Any facility independently licensed pursuant to chapter
449 of NRS;
(3) A practitioner group practice; and
(4) Any other facility that provides health care specified by
regulation of the Department.
Sec. 17. 1. A hospital shall not take any action described in
subsection 2 with regard to any medical deb t while the hospital is
not in compliance with any provision of section 13, 14 or 15 of this
act or 45 C.F.R. § 180.40, 180.50 or 180.60.
2. A hospital shall not, with regard to any medical debt
described in subsection 1:
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(a) Refer the medical debt to a collection agency or other third
party for collection;
(b) File a civil action or seek arbitration or mediation to collect
the medical debt; or
(c) Directly or indirectly cause the reporting of the medical
debt to a reporting agency.
3. If a medical d ebtor believes that a hospital has taken an
action described in subsection 2 in violation of subsection 1 with
respect to a medical debt owed by the medical debtor, the medical
debtor may file a claim with the Bureau of Consumer Protection
in the Office of the Attorney General. A medical debtor who files
such a claim shall immediately notify the hospital that he or she
has filed the claim.
4. Upon the filing of a claim pursuant to subsection 3, the
Bureau of Consumer Protection shall investigate the claim . The
hospital shall not take any action described in subsection 2 to
collect the medical debt that is the subject of the investigation
while the investigation is pending.
5. If, at the conclusion of an investigation pursuant to
subsection 4, the Bureau of Consumer Protection determines that
the hospital has taken an action described in subsection 2 in
violation of subsection 1, the hospital shall cancel the medical debt
that is the subject of the investigation and any related medical debt
and refund any amount of the medical debt or any related medical
debt which has been paid by the medical debtor.
6. A knowing violation of this section constitutes a deceptive
trade practice for the purposes of NRS 598.0903 to 598.0999,
inclusive.
7. As used in this section , “reporting agency” has the
meaning ascribed to it in NRS 598C.100.
Sec. 18. 1. Any person who believes that a hospital has
failed to comply with the provisions of sections 2 to 21, inclusive,
of this act may submit a complaint to the Department. The
Department shall:
(a) Create an electronic form for the submission of such
complaints and post the form on an Internet website operated by
the Department; and
(b) Accept such complaints through a telephone number
dedicated for that purpose.
2. The Department shall monitor the compliance of hospitals
with the provisions of sections 2 to 21, inclusive, of this act by:
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(a) Evaluating complaints submitted pursuant to subsection 1
and other available information concerning compliance with
sections 2 to 21, inclusive, of this act;
(b) Reviewing any available analysis of noncompliance with
sections 2 to 21, inclusive, of this act prepared in good faith by a
qualified person or entity; and
(c) Auditing the Internet websites maintained by hospi tals in
this State.
3. The Department shall adopt such regulations as are
necessary to carry out the provisions of sections 17 to 21,
inclusive, of this act, including, without limitation, regulations
prescribing the procedure to appeal any action taken by the
Department pursuant to section 19 or 20 of this act. That
procedure must include, without limitation, the opportunity for a
hearing.
Sec. 19. 1. If the Department determines that a hospital has
failed to comply with the provisions of sections 2 to 21, inclusive,
of this act, the Department shall issue to the hospital a notice of
the violation. The notice must include, without limitation:
(a) A description of the violation;
(b) A requirement that the hospital:
(1) Take action to correct the vi olation within 30 days after
the date of the notice, if the Department determines that the
violation is capable of correction within that time period; or
(2) Submit a plan of correction within 30 days after the date
of the notice, in all other cases; and
(c) If the Department requires a hospital to submit a plan of
correction, notice of:
(1) The form and manner in which the hospital must
submit the plan of correction;
(2) The date by which the hospital must submit the plan of
correction or a notice of appeal; and
(3) The date by which the hospital must correct the
violation.
2. If the Department requires a hospital to take action to
correct a violation pursuant to subparagraph (1) of paragraph (b)
of subsection 1, the hospital shall, within 30 da ys after the date of
the notice, submit to the Department written confirmation that the
hospital has taken such action or a notice of appeal.
3. A plan of correction submitted pursuant to subparagraph
(2) of paragraph (b) of subsection 1 must state:
(a) The manner in which the hospital will correct the violation
identified in the notice provided pursuant to subsection 1; and
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(b) The date by which the hospital will correct the violation.
4. Upon the submission of a plan of correction pursuant to
subparagraph (2) of paragraph (b) of subsection 1, the
Department may:
(a) Approve the plan of correction as submitted; or
(b) Notify the hospital that additional corrective actions are
necessary and require the hospital to submit a revised plan of
correction.
5. The Department must approve a plan of correction before
it becomes effective. After approving a plan of correction, the
Department shall monitor and evaluate the compliance of the
hospital with the plan of correction.
Sec. 20. 1. The Department s hall impose an administrative
penalty against a hospital that the Department determines, after
notice and the opportunity for a hearing in accordance with
sections 18 and 19 of this act and any regulations adopted
pursuant thereto, has violated any provision of sections 2 to 21,
inclusive, of this act, or failed to comply with any requirement
imposed by the Department pursuant to section 19 of this act or
any plan of correction approved by the Department pursuant to
section 19 of this act.
2. An administrative penalty imposed pursuant to this section
must be in an amount of:
(a) Not less than $600 for a hospital with not more than 30
beds;
(b) Not less than $20 for each bed in a hospital with at least 31
and not more than 550 beds; and
(c) Not less than $11,000 for a hospital with more than 550
beds.
3. For the purposes of this section, each day that a hospital
has failed to correct a violation beyond the date prescribed
pursuant to subparagraph (1) of paragraph (b) of subsectio n 1 of
section 19 of this act or subparagraph (3) of paragraph (c) of
subsection 1 of section 19 of this act, as applicable, or failed to
submit a plan of correction or a notice of appeal beyond the date
prescribed pursuant to subparagraph (2) of paragraph (b) of
subsection 1 of section 19 of this act constitutes a separate
violation.
4. In determining the amount of an administrative penalty
imposed pursuant to this section, the Department shall consider:
(a) Previous violations by the operator of the hospital;
(b) The seriousness of the violation;
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(c) The demonstrated good faith of the operator of the
hospital; and
(d) Such other matters as justice may require.
5. Any money collected as administrative penalties pursuant
to this section must be accou nted for separately and used by the
Department to carry out the provisions of sections 2 to 22,
inclusive, of this act.
Sec. 21. 1. The Department shall:
(a) Maintain a publicly available Internet website to inform
the public concerning violations of sections 2 to 21, inclusive, of
this act; and
(b) Not later than 30 days after finding, after notice and the
opportunity for a hearing in accordance with sections 18 and 19 of
this act and the regulations adopted pursuant thereto, that a
hospital has violated any provision of sections 2 to 21, inclusive, of
this act, post to the Internet website maintained pursuant to
paragraph (a):
(1) The name of the hospital;
(2) A description of the violation that the hospital was
found to have committed;
(3) Any corrective action that the hospital was ordered to
take pursuant to section 19 of this act or included in a plan of
correction approved pursuant to that section and, if applicable, the
date on which the hospital took such corrective action; and
(4) The amount of any administrative penalty imposed on
the hospital pursuant to section 20 of this act.
2. Except as otherwise provided in subsection 3 and NRS
239.0115, a complaint filed with the Department pursuant to
section 18 of this act, all docum ents and other information filed
with the complaint and all documents and other information
compiled as a result of an investigation conducted to determine
whether to issue a notice of violation pursuant to section 19 of this
act are confidential.
3. Any notice provided by the Department, plan of correction
approved by the Department or confirmation that a hospital has
taken a corrective action required by the Department pursuant to
section 19 of this act, any order of the Department imposing an
administrative penalty pursuant to section 20 of this act and any
documents or information considered by the Department when
determining whether to approve a plan of correction or impose an
administrative penalty are public records.
Sec. 22. 1. Before taking any action to collect a medical
debt or authorizing a collection agency or any other person or
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entity to take any action to collect a medical debt, a health care
entity shall provide to the patient in writing, electronically or
through an Internet portal:
(a) An itemized statement of the medical debt owed by the
patient to the health care entity, which must:
(1) Be easy to understand;
(2) Where applicable, comply with the requirements of NRS
449.193, 449.243 or 629.071 or any other requirements of state or
federal law regarding billing for health care; and
(3) Include, without limitation, the applicable billing codes,
including modifiers, for each item or service for which the medical
debt is owed. Those codes must use a commonly recognized system
of billing codes that is identified in the statement.
(b) Information concerning any available language assistance
services for persons with limited English proficiency.
(c) The name, telephone number and electronic mail address
of a person or office at the health care entity that is authorized to
discuss the itemized statement described in paragraph (a) with the
patient and make changes relating to the medical debt, including,
without limitation, reducing or cancelling the medical debt.
2. Not later than 3 0 days after a medical debtor makes any
payment related to a medical debt to the health care entity or a
collection agency acting on behalf of the health care entity, the
health care entity shall provide an itemized receipt to the medical
debtor. A health care entity shall not take any action to collect a
medical debt or authorize a collection agency or other entity to
take any action to collect a medical debt if the health care entity
has failed to timely provide any receipt required by this subsection
to the medical debtor.
3. If a medical debtor believes that a h ealth care entity has
taken an action in violation of subsection 1 or 2 with respect to a
medical debt owed by the medical debtor, the medical debtor may
file a claim with the Bureau of Consumer Protection in the Office
of the Attorney General. A medical debtor who files such a claim
shall immediately notify the health care entity that he or she has
filed the claim.
4. Upon the filing of a claim pursuant to subsection 3, the
Bureau of Consumer Protection shall investigate the claim. The
health care entity shall not take any action to collect the medical
debt that is the subject of the investigation or authorize a
collection agency or other entity to take any action to collect that
medical debt while the investigation is pending.
– 15 –
- 83rd Session (2025)
5. If, at the conclusion of an investigation pursuant to
subsection 4, the Bureau of Consumer Protection determines that
the h ealth care entity has taken an action in violation of
subsection 1 or 2, the h ealth care enti ty shall cancel the medical
debt that is the subject of the investigation and any related medical
debt and refund any amount of the medical debt or any related
medical debt which has been paid by the medical debtor.
6. A knowing violation of this sectio n constitutes a deceptive
trade practice for the purposes of NRS 598.0903 to 598.0999,
inclusive.
7. The provisions of this section do not apply to a small
practitioner group practice.
8. As used in this section “collection agency” has the
meaning ascribed to it in NRS 649.020.
Sec. 23. NRS 439B.320 is hereby amended to read as follows:
439B.320 1. A hospital shall provide, without charge, in each
fiscal year, care for indigent inpatients in an amount which
represents 0.6 percent of its net revenue for the hospital’s preceding
fiscal year.
2. The Department shall compute the obligation of each
hospital for care of indigent inpatients for each fiscal year based
upon the net revenue of the hospital in its preceding fiscal year and
shall provide this information to the board of county commissioners
of the county in which the hospital is located.
3. The board of county commissioners shall maintain a record
of discharge forms submitted by each hospital located within the
county, together with the amou nt accruing to the hospital. The
amount accruing to the hospital for the care, until the hospital has
met its obligation pursuant to this section, is the highest amount the
county is paying to any hospital in the county for that care. Except
as otherwise p rovided in subsection 2 of NRS 439B.330, no
payment for indigent care may be made to the hospital until the total
amount so accruing to the hospital exceeds the minimum obligation
of the hospital for the fiscal year, and a hospital may only receive
payment from the county for indigent care provided in excess of its
obligation pursuant to this section. After a hospital has met its
obligation pursuant to this section, the county may reimburse the
hospital for care of indigent inpatients at any rate otherwise
authorized by law.
4. As used in this section, “net revenue” means all revenues
earned from inpatient medical care provided to patients by a
hospital.
Sec. 24. (Deleted by amendment.)
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- 83rd Session (2025)
Sec. 24.5. 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 the
Public Option, and policies of industrial insurance;
(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 those
consumers and injured employees to resolve their complaints,
including, without limitation:
(1) Referring consumers 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 the Public
Option, and policies of industrial insurance;
(d) Provide informatio n to consumers and injured employees
concerning health care plans, including, without limitation, the
Public Employees’ Benefits Program and the Public Option, and
policies of industrial insurance in this State;
(e) Establish and maintain a system to coll ect 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 Cana dian pharmacies that have been recommended by the
– 17 –
- 83rd Session (2025)
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 cons umers with scheduling an appointment with a
provider of health care who is in the network of providers under
contract to provide services to participants in the health care plan
under which the consumer is covered;
(l) Assist consumers with filing complai nts against health care
facilities and health care professionals;
(m) Assist consumers with filing claims with the Bureau of
Consumer Protection in the Office of the Attorney General
pursuant to sections 17 and 22 of this act;
(n) Assist consumers with filing complaints with the
Commissioner of Insurance against issuers of health care plans; and
[(n)] (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 NR S 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.
(c) “Public Option” means the Public Option established
pursuant to NRS 695K.200.
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- 83rd Session (2025)
Sec. 25. NRS 239.010 is hereby amended to read as follows:
239.010 1. Except as otherwise provided in this section and
NRS 1.4683, 1.4687, 1A.110, 3.2203, 41.0397, 41.071, 49.095,
49.293, 62D.420, 62D.440, 62E.516, 62E.620, 62H.025, 62H.030,
62H.170, 62H.220, 62H.320, 75A.100, 75A.150, 76.160, 78.152,
80.113, 81.850, 82.183, 86.246, 86.54615, 87.515, 87.54 13,
87A.200, 87A.580, 87A.640, 88.3355, 88.5927, 88.6067, 88A.345,
88A.7345, 89.045, 89.251, 90.730, 91.160, 116.757, 116A.270,
116B.880, 118B.026, 119.260, 119.265, 119.267, 119.280,
119A.280, 119A.653, 119A.677, 119B.370, 119B.382, 120A.640,
120A.690, 125.130, 125B.140, 126.141, 126.161, 126.163, 126.730,
127.007, 127.057, 127.130, 127.140, 127.2817, 128.090, 130.312,
130.712, 136.050, 159.044, 159A.044, 164.041, 172.075, 172.245,
176.01334, 176.01385, 176.015, 176.0625, 176.09129, 176.156,
176A.630, 178. 39801, 178.4715, 178.5691, 178.5717, 179.495,
179A.070, 179A.165, 179D.160, 180.600, 200.3771, 200.3772,
200.5095, 200.604, 202.3662, 205.4651, 209.392, 209.3923,
209.3925, 209.419, 209.429, 209.521, 211A.140, 213.010, 213.040,
213.095, 213.131, 217.105, 2 17.110, 217.464, 217.475, 218A.350,
218E.625, 218F.150, 218G.130, 218G.240, 218G.350, 218G.615,
224.240, 226.462, 226.796, 228.270, 228.450, 228.495, 228.570,
231.069, 231.1285, 231.1473, 232.1369, 233.190, 237.300,
239.0105, 239.0113, 239.014, 239B.026, 2 39B.030, 239B.040,
239B.050, 239C.140, 239C.210, 239C.230, 239C.250, 239C.270,
239C.420, 240.007, 241.020, 241.030, 241.039, 242.105, 244.264,
244.335, 247.540, 247.545, 247.550, 247.560, 250.087, 250.130,
250.140, 250.145, 250.150, 268.095, 268.0978, 268. 490, 268.910,
269.174, 271A.105, 281.195, 281.805, 281A.350, 281A.680,
281A.685, 281A.750, 281A.755, 281A.780, 284.4068, 284.4086,
286.110, 286.118, 287.0438, 289.025, 289.080, 289.387, 289.830,
293.4855, 293.5002, 293.503, 293.504, 293.558, 293.5757, 293.870,
293.906, 293.908, 293.909, 293.910, 293B.135, 293D.510, 331.110,
332.061, 332.351, 333.333, 333.335, 338.070, 338.1379, 338.1593,
338.1725, 338.1727, 348.420, 349.597, 349.775, 353.205,
353A.049, 353A.085, 353A.100, 353C.240, 353D.250, 360.240,
360.247, 360.255, 360.755, 361.044, 361.2242, 361.610, 365.138,
366.160, 368A.180, 370.257, 370.327, 372A.080, 378.290, 378.300,
379.0075, 379.008, 379.1495, 385A.830, 385B.100, 387.626,
387.631, 388.1455, 388.259, 388.501, 388.503, 388.513, 388.750,
388A.247, 3 88A.249, 391.033, 391.035, 391.0365, 391.120,
391.925, 392.029, 392.147, 392.264, 392.271, 392.315, 392.317,
392.325, 392.327, 392.335, 392.850, 393.045, 394.167, 394.16975,
394.1698, 394.447, 394.460, 394.465, 396.1415, 396.1425, 396.143,
– 19 –
- 83rd Session (2025)
396.159, 396.329 5, 396.405, 396.525, 396.535, 396.9685,
398A.115, 408.3885, 408.3886, 408.3888, 408.5484, 412.153,
414.280, 416.070, 422.2749, 422.305, 422A.342, 422A.350,
425.400, 427A.1236, 427A.872, 427A.940, 432.028, 432.205,
432B.175, 432B.280, 432B.290, 432B.4018, 4 32B.407, 432B.430,
432B.560, 432B.5902, 432C.140, 432C.150, 433.534, 433A.360,
439.4941, 439.4988, 439.5282, 439.840, 439.914, 439A.116,
439A.124, 439B.420, 439B.754, 439B.760, 439B.845, 440.170,
441A.195, 441A.220, 441A.230, 442.330, 442.395, 442.735,
442.774, 445A.665, 445B.570, 445B.7773, 449.209, 449.245,
449.4315, 449A.112, 450.140, 450B.188, 450B.805, 453.164,
453.720, 458.055, 458.280, 459.050, 459.3866, 459.555, 459.7056,
459.846, 463.120, 463.15993, 463.240, 463.3403, 463.3407,
463.790, 467.1005, 4 80.535, 480.545, 480.935, 480.940, 481.063,
481.091, 481.093, 482.170, 482.368, 482.5536, 483.340, 483.363,
483.575, 483.659, 483.800, 484A.469, 484B.830, 484B.833,
484E.070, 485.316, 501.344, 503.452, 522.040, 534A.031, 561.285,
571.160, 584.655, 587.877, 598.0964, 598.098, 598A.110,
598A.420, 599B.090, 603.070, 603A.210, 604A.303, 604A.710,
604D.500, 604D.600, 612.265, 616B.012, 616B.015, 616B.315,
616B.350, 618.341, 618.425, 622.238, 622.310, 623.131, 623A.137,
624.110, 624.265, 624.327, 625.425, 625A.185, 628.418, 628B.230,
628B.760, 629.043, 629.047, 629.069, 630.133, 630.2671,
630.2672, 630.2673, 630.2687, 630.30665, 630.336, 630A.327,
630A.555, 631.332, 631.368, 632.121, 632.125, 632.3415,
632.3423, 632.405, 633.283, 633.301, 633.427, 633.4715, 633.4716,
633.4717, 633.524, 634.055, 634.1303, 634.214, 634A.169,
634A.185, 634B.730, 635.111, 635.158, 636.262, 636.342, 637.085,
637.145, 637B.192, 637B.288, 638.087, 638.089, 639.183,
639.2485, 639.570, 640.075, 640.152, 640A.185, 640A.220,
640B.405, 640B.73 0, 640C.580, 640C.600, 640C.620, 640C.745,
640C.760, 640D.135, 640D.190, 640E.225, 640E.340, 641.090,
641.221, 641.2215, 641A.191, 641A.217, 641A.262, 641B.170,
641B.281, 641B.282, 641C.455, 641C.760, 641D.260, 641D.320,
642.524, 643.189, 644A.870, 645.180 , 645.625, 645A.050,
645A.082, 645B.060, 645B.092, 645C.220, 645C.225, 645D.130,
645D.135, 645G.510, 645H.320, 645H.330, 647.0945, 647.0947,
648.033, 648.197, 649.065, 649.067, 652.126, 652.228, 653.900,
654.110, 656.105, 657A.510, 661.115, 665.130, 665.13 3, 669.275,
669.285, 669A.310, 670B.680, 671.365, 671.415, 673.450, 673.480,
675.380, 676A.340, 676A.370, 677.243, 678A.470, 678C.710,
678C.800, 679B.122, 679B.124, 679B.152, 679B.159, 679B.190,
679B.285, 679B.690, 680A.270, 681A.440, 681B.260, 681B.410,
– 20 –
- 83rd Session (2025)
681B.540, 683A.0873, 685A.077, 686A.289, 686B.170, 686C.306,
687A.060, 687A.115, 687B.404, 687C.010, 688C.230, 688C.480,
688C.490, 689A.696, 692A.117, 692C.190, 692C.3507, 692C.3536,
692C.3538, 692C.354, 692C.420, 693A.480, 693A.615, 696B.550,
696C.120, 703 .196, 704B.325, 706.1725, 706A.230, 710.159,
711.600, and section 21 of this act, sections 35, 38 and 41 of
chapter 478, Statutes of Nevada 2011 and section 2 of chapter 391,
Statutes of Nevada 2013 and unless otherwise declared by law to be
confidential, all public books and public records of a governmental
entity must be open at all times during office hours to inspection by
any person, and may be fully copied or an abstract or memorandum
may be prepared from those public books and public records. Any
such copies, abstracts or memoranda may be used to supply the
general public with copies, abstracts or memoranda of the records or
may be used in any other way to the advantage of the governmental
entity or of the general public. This section does not superse de or in
any manner affect the federal laws governing copyrights or enlarge,
diminish or affect in any other manner the rights of a person in any
written book or record which is copyrighted pursuant to federal law.
2. A governmental entity may not reject a book or record
which is copyrighted solely because it is copyrighted.
3. A governmental entity that has legal custody or control of a
public book or record shall not deny a request made pursuant to
subsection 1 to inspect or copy or receive a copy of a public book or
record on the basis that the requested public book or record contains
information that is confidential if the governmental entity can
redact, delete, conceal or separate, including, without limitation,
electronically, the confidential info rmation from the information
included in the public book or record that is not otherwise
confidential.
4. If requested, a governmental entity shall provide a copy of a
public record in an electronic format by means of an electronic
medium. Nothing in thi s subsection requires a governmental entity
to provide a copy of a public record in an electronic format or by
means of an electronic medium if:
(a) The public record:
(1) Was not created or prepared in an electronic format; and
(2) Is not available in an electronic format; or
(b) Providing the public record in an electronic format or by
means of an electronic medium would:
(1) Give access to proprietary software; or
– 21 –
- 83rd Session (2025)
(2) Require the production of information that is confidential
and that cannot be redacted, deleted, concealed or separated from
information that is not otherwise confidential.
5. An officer, employee or agent of a governmental entity who
has legal custody or control of a public record:
(a) Shall not refuse to provide a copy of that public record in the
medium that is requested because the officer, employee or agent has
already prepared or would prefer to provide the copy in a different
medium.
(b) Except as otherwise provided in NRS 239.030, shall, upon
request, prepare the copy of the public record and shall not require
the person who has requested the copy to prepare the copy himself
or herself.
Sec. 26. 1. The provisions of section 17 of this act apply to
any medical debt incurred before, on or after January 1, 2026.
2. The provisions of section 22 of this act apply to any medical
debt incurred on or after January 1, 2026.
3. As used in this section, “medical debt” has the meaning
ascribed to it in NRS 649.036.
Sec. 27. NRS 439B.140 is hereby repealed.
Sec. 28. 1. This section becomes effective upon passage and
approval.
2. Sections 1 to 27, inclusive, of this act become effective:
(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; and
(b) On January 1, 2026, for all other purposes.
20 ~~~~~ 25