Makes changes related to health care. (BDR 57-87)

- 83rd Session (2025)
Senate Bill No. 128–Senator Neal

CHAPTER..........

AN ACT relating to health care; prescribing requirements governing
the denial of requests for prior authorization; making certain
legislative findings and declarations ; encouraging licensed
physicians, physician assistants, advanced practice registered
nurses and osteopathic physicians to discuss with patients in
certain circumstances information relating to stem cell
treatment, storage and donation; and providing other matters
properly relating thereto.
Legislative Counsel’s Digest:
Existing law authorizes certain health insurers to require an insured to obtain
prior authorization from the insurer before receiving certain care. (NRS 687B.225)
Sections 1, 4 and 5 of this bill prohibit certain health insurers, including insurance
for public employees, from solely using, employing or relying upon an artificial
intelligence system or an automated decision tool to: (1) deny a request for prior
authorization for medical or dental care; (2) modify a request for prior authorization
for such care submitted by a provider of health care; (3) reduce the scope of
services or amount of coverage for such care that is included within a request for
prior authorization; or (4) terminate, reduce or modify coverage for previously
approved medical or dental care. Sections 1, 4 and 5 also require such health
insurers to approve a request for prior authorization for medical or dental care that
is covered by the insurer, unless a licensed health care professional with the
education, training and expertise necessary to evaluate the condition at issue
determines that the care requested is not medically necessary or is experimental or
investigational. Sections 6 and 7 of this bill make conforming changes to clarify
that certain provisions generally applicable to members of plans of self -insurance
for employees of local governments and are applicable to the provisions of sections
4 and 5, respectively.
Existing la w requires a physician, physician assistant, advanced practice
registered nurse or an osteopathic physician to counsel and provide certain
information to a patient who is diagnosed with certain conditions. (NRS 630.3737,
632.2383, 633.6947) Sections 9-11 of this bill make certain legislative findings and
declarations relating to the use of stem cell therapy, including a declaration
encouraging physicians, physician assistants, advanced practice registered nurses
and osteopathic physicians to: (1) discuss wi th a patient, upon diagnosing the
patient with arthritis, osteoarthritis or any other condition that is regularly treated
using stem cell therapy, the potential use of stem cell therapy to treat the condition;
and (2) when acting as providers of primary care during the first encounter with a
new patient, inform the patient of options that may be available to the patient for
donating, banking or storing stem cells for future use by the patient or a donee.

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- 83rd Session (2025)
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. NRS 687B.225 is hereby amended to read as
follows:
687B.225 1. Except as otherwise provided in NRS
689A.0405, 689A.0412, 689A.0413, 689A.0418, 689A.0437,
689A.044, 689A.0445, 689A.0459, 689B.031, 689B.0312,
689B.0313, 689B.0315, 689B.0317, 689B.0319, 689B.0374,
689B.0378, 689C.1665, 689C.1671, 689C.1675, 689C.1676,
695A.1843, 695A.1856, 695A.1865, 695A.1874, 695B.1912,
695B.1913, 695B.1914, 695B.1919, 695B.19197, 695 B.1924,
695B.1925, 695B.1942, 695C.1696, 695C.1699, 695C.1713,
695C.1735, 695C.1737, 695C.1743, 695C.1745, 695C.1751,
695G.170, 695G.1705, 695G.171, 695G.1714, 695G.1715,
695G.1719 and 695G.177, any contract for group, blanket or
individual health insuranc e or any contract by a nonprofit hospital,
medical or dental service corporation or organization for dental care
which provides for payment of a certain part of medical or dental
care may require the insured or member to obtain prior authorization
for that care from the insurer or organization [. The] in a manner
consistent with the provisions of this section.
2. An insurer or organization that requires an insured or
member to obtain prior authorization for medical or dental care
shall:
(a) File its proc edure for obtaining approval of care pursuant to
this section for approval by the Commissioner; and
(b) Unless a shorter time period is prescribed by a specific
statute, including, without limitation, NRS 689A.0446, 689B.0361,
689C.1688, 695A.1859, 695B.1 9087, 695C.16932 and 695G.1703,
respond to any request for approval by the insured or member
pursuant to this section within 20 days after it receives the request.
[2.] 3. The procedure for prior authorization may not
discriminate among persons licensed to provide the covered care.
4. Except as otherwise provided in subsection 6, an insurer or
organization that requires an insured or member to obtain prior
authorization for medical or dental care:
(a) Shall not solely utilize, employ or rely upon an ar tificial
intelligence system or automated decision tool to:
(1) Deny a request for prior authorization for medical or
dental care;

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- 83rd Session (2025)
(2) Modify a request for medical or dental care submitted
by a provider of health care;
(3) Reduce the scope of service s or the amount of coverage
for medical or dental care included within a request for prior
authorization; or
(4) Terminate, reduce or modify coverage for previously
approved medical or dental care.
(b) Shall approve, without modification, a request for prior
authorization submitted by an insured or member, or by a provider
of health care acting within the scope of his or her practice on
behalf of an insured or member , for medical or dental care that is
covered by the insurer or organization, unless a lic ensed health
care professional who possesses the education, training and
expertise necessary to evaluate the specific clinical issues relevant
to the request for prior authorization determines that the care
requested is not medically necessary or is experi mental or
investigational after reviewing all available medical
documentation, notes of the insured’s or member’s provider of
health care, test results and other relevant medical records of the
insured or member.
5. The provisions of subsection 4 do not:
(a) Prohibit an insurer or organization from utilizing an
artificial intelligence system or automated decision tool to
automatically approve a request for prior authorization.
(b) Affect the obligation of any entity to which the
requirements of NRS 695G .150 apply to comply with such
requirements.
6. The requirements of subsection 4 do not apply to a
managed care organization when providing coverage for
recipients of Medicaid or pursuant to the Children’s Health
Insurance Program pursuant to a contract with the Department of
Health and Human Services entered into pursuant to
NRS 422.273.
7. As used in this section:
(a) “Artificial intelligence system” means a machine -based
system that can, for a given set of human -defined objectives, make
predictions, recommendations or decisions influencing real or
virtual environments.
(b) “Automated decision tool” means a computational process
derived from machine learning, statistical modeling, data analytics
or artificial intelligence that, for any number of inputs, is designed
to produce a simple output or recommendation, including, without

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- 83rd Session (2025)
limitation, a score, classification or recommendation , that is used
to assist or replace human decision-making.
(c) “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, deformity, 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 specialized
knowledge of an intellectual and physical nature are required.
(d) “Licensed health care professional” means a person who is
licensed in any state or territory of the United States to perform
any healing art.
(e) “Medical or dental care” includes, without limitation, the
provision of prescription drugs.
(f) “Medically necessary” has the meaning ascribed to it in
NRS 695G.055.
(g) “Provider of health care” has the meaning ascribed to it in
NRS 695G.070.
Sec. 2. (Deleted by amendment.)
Sec. 3. Chapter 287 of NRS is hereby amended by adding
thereto the provisions set forth as sections 4 and 5 of this act.
Sec. 4. 1. The governing body of any county, school
district, municipal corporation, political subdivision, public
corporation or other loca l governmental agency of the State of
Nevada that provides health insurance t hrough a plan of
self-insurance:
(a) Shall not solely utilize, employ or rely upon an artificial
intelligence system or automated decision tool to:
(1) Deny a request for prior authorization for medical or
dental care;
(2) Modify a request for medical or dental care submitted
by a provider of health care;
(3) Reduce the scope of services or the amount of coverage
for medical or dental care included within a request for prior
authorization; or
(4) Terminate, reduce or modify coverage for previously
approved medical or dental care.
(b) Shall approve, without modification, a request for prior
authorization submitted by an insured, or by a provider of health
care acting within the scope of his or her practice on behalf of an
insured, for medical or dental care that is covered by the plan of
self-insurance, unless a licensed health care professional who
possesses the education, training and expertise necessary to

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- 83rd Session (2025)
evaluate the specific clinical issues relevant to the request for prior
authorization determines that the care requested is not medically
necessary or is experimental or investigational after reviewing all
available medical documentation, notes of the insured’s provide r
of health care, test results and other relevant medical records of
the insured.
2. The provisions of subsection 1 do not prohibit a governing
body of any county, school district, municipal corporation,
political subdivision, public corporation or other local
governmental agency of the State of Nevada that provides health
insurance through a plan of self -insurance from utilizing an
artificial intelligence system or automated decision tool to
automatically approve a request for prior authorization.
3. As used in this section:
(a) “Artificial intelligence system” has the meaning ascribed to
it in NRS 687B.225.
(b) “Automated decision tool” has the meaning ascribed to it
in NRS 687B.225.
(c) “Licensed health care professional” has the meaning
ascribed to it in NRS 687B.225.
(d) “Medical or dental care” has the meaning ascribed to it in
NRS 687B.225.
(e) “Medically necessary” has the meaning ascribed to it in
NRS 695G.055.
(f) “Provider of health care” has the meaning ascribed to it in
NRS 695G.070.
Sec. 5. 1. If the Board provides health insurance through a
plan of self-insurance, the Board:
(a) Shall not solely utilize, employ or rely upon an artificial
intelligence system or automated decision tool to:
(1) Deny a request for prior authorization for medical or
dental care;
(2) Modify a request for medical or dental care submitted
by a provider of health care;
(3) Reduce the scope of services or the amount of coverage
for medical or dental care included within a request for prior
authorization; or
(4) Terminate, reduce or modify coverage for previously
approved medical or dental care.
(b) Shall approve , without modification, a request for prior
authorization submitted by an insured, or by a provider of health
care acting within the scope of his or her practice on behalf of an
insured, for medical or dental care that is covered by the plan of

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- 83rd Session (2025)
self-insurance, unless a licensed health care professional who
possesses the education, training and expertise necessary to
evaluate the specific clinical issues relevant to the request for prior
authorization determines that the care requested is not medically
necessary or is experimental or investigational after reviewing all
available medical documentation, notes of the insured’s provider
of health care , test results and other relevant medical records of
the insured.
2. The provisions of subsection 1 do not:
(a) Prohibit the Board from utilizing an artificial intelligence
system or automated decision tool to automatically approve a
request for prior authorization.
(b) Affect the obligation of the Board to comply with the
requirements of NRS 695G.150.
3. As used in this section:
(a) “Artificial intelligence system” has the meaning ascribed to
it in NRS 687B.225.
(b) “Automated decision tool” has th e meaning ascribed to it
in NRS 687B.225.
(c) “Licensed health care professional” has the meaning
ascribed to it in NRS 687B.225.
(d) “Medical or dental care” has the meaning ascribed to it in
NRS 687B.225.
(e) “Medically necessary” has the meaning ascr ibed to it in
NRS 695G.055.
(f) “Provider of health care” has the meaning ascribed to it in
NRS 695G.070.
Sec. 6. NRS 287.040 is hereby amended to read as follows:
287.040 The provisions of NRS 287.010 to 287.040, inclusive,
and section 4 of this act do not make it compulsory upon any
governing body of any county, school district, municipal
corporation, political subdivision, public corporation or other local
governmental agency of the State of Nevada, except as otherwise
provided in NRS 287.021 or sub section 4 of NRS 287.023 or in an
agreement entered into pursuant to subsection 3 of NRS 287.015, to
pay any premiums, contributions or other costs for group insurance,
a plan of benefits or medical or hospital services established
pursuant to NRS 287.010, 287.015, 287.020 or paragraph (b), (c) or
(d) of subsection 1 of NRS 287.025, for coverage under the Public
Employees’ Benefits Program, or to make any contributions to a
trust fund established pursuant to NRS 287.017, or upon any officer
or employee of a ny county, school district, municipal corporation,
political subdivision, public corporation or other local governmental

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- 83rd Session (2025)
agency of this State to accept any such coverage or to assign his or
her wages or salary in payment of premiums or contributions
therefor.
Sec. 7. NRS 287.0402 is hereby amended to read as follows:
287.0402 As used in NRS 287.0402 to 287.049, inclusive, and
section 5 of this act, unless the context otherwise requires, the
words and terms defined in NRS 287.0404 to 287.04064, inclusive ,
have the meanings ascribed to them in those sections.
Sec. 8. (Deleted by amendment.)
Sec. 9. Chapter 630 of NRS is hereby amended by adding
thereto a new section to read as follows:
1. The Legislature hereby finds and declares that:
(a) Stem cell therapy is currently utilized to treat and provide
therapeutic relief for certain chronic and painful conditions,
including, without limitation, arthritis and osteoarthritis;
(b) Recent research relating to stem cell-based therapies and
treatments indicates that such therapies and treatments could be
used in the future to treat an even wider range of debilitating
diseases, including, without limitation, type I diabetes, various
forms of cancer and various neurological and neurodegenerative
diseases;
(c) Persons may currently store and bank their own stem cells
to use in the future or to donate to others who have been
diagnosed with a disease that is regularly treated using stem cell
therapy;
(d) Patients may be unaware of the potential medical benefi ts
arising from the banking and donation of their own stem cells;
and
(e) It is the public policy of this State to encourage:
(1) Physicians and physician assistant s, upon diagnosing a
patient with arthritis, osteoarthritis or any other condition that is
regularly treated using stem cell therapy, to discuss with the
patient the potential use of stem cell therapy to treat the condition ;
and
(2) Each p rovider of primary care, during the first
encounter with a new patient, to inform the patient of options that
may be available to the patient for donating, banking or storing
stem cells for future use by the patient or a donee.
2. As used in this section:
(a) “Provider of health care” has the meaning ascribed to it in
NRS 629.031.

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- 83rd Session (2025)
(b) “Provider of prima ry care” means a physician, physician
assistant or group of providers of health care that includes a
physician or physician assistant which:
(1) Provides initial and primary health care services to a
patient; and
(2) Maintains the continuity of care for the patient.
(c) “Stem cell therapy” means therapy involving the use of
human cells, tissues or cellular or tissue-based products.
Sec. 10. Chapter 632 of NRS is hereby amended by adding
thereto a new section to read as follows:
1. The Legislature hereby finds and declares that:
(a) Stem cell therapy is currently utilized to treat and provide
therapeutic relief for certain chronic and painful conditions,
including, without limitation, arthritis and osteoarthritis;
(b) Recent research relating to st em cell-based therapies and
treatments indicates that such therapies and treatments could be
used in the future to treat an even wider range of debilitating
diseases, including, without limitation, type I diabetes, various
forms of cancer and various neurological and neurodegenerative
diseases;
(c) Persons may currently store and bank their own stem cells
to use in the future or to donate to others who have been
diagnosed with a disease that is regularly treated using stem cell
therapy;
(d) Patients may be unaware of the potential medical benefits
arising from the banking and donation of their own stem cells;
and
(e) It is the public policy of this State to encourage:
(1) Advanced practice registered nurses, upon diagnosing a
patient with arthritis, osteoarthritis or any other condition that is
regularly treated using stem cell therapy, to discuss with the
patient the potential use of stem cell therapy to treat the condition ;
and
(2) Each provider of primary care, during the first
encounter with a new patient, to inform the patient of options that
may be available to the patient for donating, banking or storing
stem cells for future use by the patient or a donee.
2. As used in this section:
(a) “Provider of health care” has the meaning ascribed to it in
NRS 629.031.
(b) “Provider of primary care” means an advanced practice
registered nurse or a group of providers of health care that
includes an advanced practice registered nurse which:

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- 83rd Session (2025)
(1) Provides initial and primary health care services to a
patient; and
(2) Maintains the continuity of care for the patient.
(c) “Stem cell therapy” means therapy involving the use of
human cells, tissues or cellular or tissue-based products.
Sec. 11. Chapter 6 33 of NRS is hereby amended by adding
thereto a new section to read as follows:
1. The Legislature hereby finds and declares that:
(a) Stem cell therapy is currently utilized to treat and provide
therapeutic relief for certain chronic and painful condit ions,
including, without limitation, arthritis and osteoarthritis;
(b) Recent research relating to stem cell-based therapies and
treatments indicates that such therapies and treatments could be
used in the future to treat an even wider range of debilitating
diseases, including, without limitation, type I diabetes, various
forms of cancer and various neurological and neurodegenerative
diseases;
(c) Persons may currently store and bank their own stem cells
to use in the future or to donate to others who have been
diagnosed with a disease that is regularly treated using stem cell
therapy;
(d) Patients may be unaware of the potential medical benefits
arising from the banking and donation of their own stem cells;
and
(e) It is the public policy of this State to encourage:
(1) Osteopathic physicians and physician assistants, upon
diagnosing a patient with arthritis, osteoarthritis or any other
condition that is regularly treated using stem cell therapy, to
discuss with the patient the potential use of stem cell therapy to
treat the condition; and
(2) Each provider of primary care, during the first
encounter with a new patient, to inform the patient of o ptions that
may be available to the patient for donating, banking or storing
stem cells for future use by the patient or a donee.
2. As used in this section:
(a) “Provider of health care” has the meaning ascribed to it in
NRS 629.031.
(b) “Provider of primary care” means an osteopathic
physician, physician assistant or group of providers of health care
that includes an osteopathic physician or physician assistant
which:
(1) Provides initial and primary health care services to a
patient; and

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- 83rd Session (2025)
(2) Maintains the continuity of care for the patient.
(c) “Stem cell therapy” means therapy involving the use of
human cells, tissues or cellular or tissue-based products.
Sec. 12. The provisions of NRS 354.599 do not apply to any
additional expenses of a local government that are related to the
provisions of this act.
Sec. 13. 1. This section becomes effective upon passage and
approval.
2. Sections 1 to 12, 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.

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