Imposes requirements concerning the use of artificial intelligence in health care. (BDR 40-780)

S.B. 186

- *SB186*

SENATE BILL NO. 186–SENATOR STONE

PREFILED FEBRUARY 3, 2025
____________

Referred to Committee on Health and Human Services

SUMMARY—Imposes requirements concerning the use of artificial
intelligence in health care. (BDR 40-780)

FISCAL NOTE: Effect on Local Government: No.
Effect on the State: No.

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EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted.

AN ACT relating to health care; requiring a medical facility or a
provider of health care who uses generative artificial
intelligence to generate certain communications to ensure
that those communications include certain information;
and providing other matters properly relating thereto.
Legislative Counsel’s Digest:
Existing law provides for the licensure and regulation of medical facilities and 1
providers of health care in this State. (Chapters 449, 450B, 629 -637B, 639 -640B 2
and 640D-641D of NRS) Sections 1 and 7 of this bill require a medical facility or 3
provider of health care who uses generative artificial intelligence to generate a 4
written or verbal communication with a patient relating to his or her clinical 5
information to ensure that the communication includes: (1) a disclaimer stating that 6
the communication was generated by generative artificial intelligence; and (2) clear 7
instructions describing how the patient may contact certain persons for further 8
assistance. Sections 1 and 7 exempt from this requirement a written 9
communication that is read and reviewed by a provider of health care. Sections 2-6 10
and 8 of this bill make conforming changes to provide for the administration and 11
enforcement of the requirements of section 1 in the same manner as other 12
requirements imposed on medical facil ities by existing law. Section 7 authorizes 13
the imposition of disciplinary action against a provider of health care who fails to 14
comply with the requirements of section 7. 15

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THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:

Section 1. Chapter 449 of NRS is hereby amended by adding 1
thereto a new section to read as follows: 2
1. Except as otherwise provided in subsection 3, a medical 3
facility that uses generative artificial intelligence to generate a 4
written or verbal communication with a patient relating to his or 5
her clinical information shall ensure that the communication 6
includes: 7
(a) A disclaimer stating that the communication was generated 8
by generative artificial intelligence; and 9
(b) Clear instructions describing how the patient may contact a 10
provider of health care, employee of the medical facility or other 11
appropriate person who can provide any assistance the patient 12
may need with respect to the information in the communication. 13
2. The disclaimer provided pursuant to subsection 1: 14
(a) For written communications, including, without limitation, 15
letters, electronic mail and other written messages, must appear 16
prominently at the beginning of each communication. 17
(b) For written communications involving continuous 18
interactions over the Internet, including, without limitation, chat -19
based telehealth, must be prominently displayed throughout the 20
interaction. 21
(c) For audio communications, must be provided verbally at 22
the beginning and the end of the interaction. 23
(d) For video communications, must be prominently displayed 24
throughout the interaction. 25
3. The requirements of this section do not apply to a written 26
communication that is generated by generative artificial 27
intelligence if the written communication is read and reviewed by 28
a provider of health care before being provided to a patient. 29
4. As used in this section: 30
(a) “Artificial intelligence” means an engineered or machine -31
based system that varies in its level of autonomy and that can, for 32
explicit or implicit objectives, infer from the input it receives how 33
to generate outpu ts that can influence physical or virtual 34
environments. 35
(b) “Generative artificial intelligence” means artificial 36
intelligence that can generate derived synthetic content, including 37
images, videos, audio, text and other digital content. 38
(c) “Telehealth” has the meaning ascribed to it in 39
NRS 629.515. 40

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Sec. 2. NRS 449.029 is hereby amended to read as follows: 1
449.029 As used in NRS 449.029 to 449.240, inclusive, and 2
section 1 of this act, unless the context otherwise requires, “medical 3
facility” has the meaning ascribed to it in NRS 449.0151 and 4
includes a program of hospice care described in NRS 449.196. 5
Sec. 3. NRS 449.0301 is hereby amended to read as follows: 6
449.0301 The provisions of NRS 449.029 to 449.2428, 7
inclusive, and section 1 of this act do not apply to: 8
1. Any facility conducted by and for the adherents of any 9
church or religious denomination for the purpose of providing 10
facilities for the care and treatment of the sick who d epend solely 11
upon spiritual means through prayer for healing in the practice of 12
the religion of the church or denomination, except that such a 13
facility shall comply with all regulations relative to sanitation and 14
safety applicable to other facilities of a similar category. 15
2. Foster homes as defined in NRS 424.014. 16
3. Any medical facility , facility for the dependent or facility 17
which is otherwise required by the regulations adopted by the Board 18
pursuant to NRS 449.0303 to be licensed that is operated an d 19
maintained by the United States Government or an agency thereof. 20
Sec. 4. NRS 449.160 is hereby amended to read as follows: 21
449.160 1. The Division may deny an application for a 22
license or may suspend or revoke any lice nse issued under the 23
provisions of NRS 449.029 to 449.2428, inclusive, and section 1 of 24
this act upon any of the following grounds: 25
(a) Violation by the applicant or the licensee of any of the 26
provisions of NRS 439B.410, 449.029 to 449.245, inclusive, and 27
section 1 of this act or 449A.100 to 449A.124, inclusive, and 28
449A.270 to 449A.286, inclusive, or of any other law of this State 29
or of the standards, rules and regulations adopted thereunder. 30
(b) Aiding, abetting or permitting the commission of any illeg al 31
act. 32
(c) Conduct inimical to the public health, morals, welfare and 33
safety of the people of the State of Nevada in the maintenance and 34
operation of the premises for which a license is issued. 35
(d) Conduct or practice detrimental to the health or safety of the 36
occupants or employees of the facility. 37
(e) Failure of the applicant to obtain written approval from the 38
Director of the Department of Health and Human Services as 39
required by NRS 439A.100 or 439A.102 or as provided in any 40
regulation adopted pursu ant to NRS 449.001 to 449.430, inclusive, 41
and section 1 of this act and 449.435 to 449.531, inclusive, and 42
chapter 449A of NRS if such approval is required, including, 43
without limitation, the closure or conversion of any hospital in a 44

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county whose populati on is 100,000 or more that is owned by the 1
licensee without approval pursuant to NRS 439A.102. 2
(f) Failure to comply with the provisions of NRS 441A.315 and 3
any regulations adopted pursuant thereto or NRS 449.2486. 4
(g) Violation of the provisions of NRS 458.112. 5
(h) Failure to comply with the provisions of NRS 449A.170 to 6
449A.192, inclusive, and any regulation adopted pursuant thereto. 7
(i) Violation of the provisions of NRS 629.260. 8
2. In addition to the provisions of subsection 1, the Division 9
may revoke a license to operate a facility for the dependent if, with 10
respect to that facility, the licensee that operates the facility, or an 11
agent or employee of the licensee: 12
(a) Is convicted of violating any of the provisions of 13
NRS 202.470; 14
(b) Is ordered to but fails to abate a nuisance pursuant to NRS 15
244.360, 244.3603 or 268.4124; or 16
(c) Is ordered by the appropriate governmental agency to correct 17
a violation of a building, safety or health code or regulation but fails 18
to correct the violation. 19
3. The Division shall maintain a log of any complaints that it 20
receives relating to activities for which the Division may revoke the 21
license to operate a facility for the dependent pursuant to subsection 22
2. The Division shall provide to a facility for the car e of adults 23
during the day: 24
(a) A summary of a complaint against the facility if the 25
investigation of the complaint by the Division either substantiates 26
the complaint or is inconclusive; 27
(b) A report of any investigation conducted with respect to the 28
complaint; and 29
(c) A report of any disciplinary action taken against the facility. 30
 The facility shall make the information available to the public 31
pursuant to NRS 449.2486. 32
4. On or before February 1 of each odd -numbered year, the 33
Division shall submit t o the Director of the Legislative Counsel 34
Bureau a written report setting forth, for the previous biennium: 35
(a) Any complaints included in the log maintained by the 36
Division pursuant to subsection 3; and 37
(b) Any disciplinary actions taken by the Division pursuant to 38
subsection 2. 39
Sec. 5. NRS 449.163 is hereby amended to read as follows: 40
449.163 1. In addition to the payment of the amount required 41
by NRS 449.0308, if a medical facility, facility for the dependent or 42
facility which is required by the regulations adopted by the Board 43
pursuant to NRS 449.0303 to be licensed violates any provision 44
related to its licensure, including any provision of NRS 439B.410 or 45

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449.029 to 449.2428, inclusive, and section 1 of this act or any 1
condition, standard or regulation adopted by the Board, the 2
Division, in accordance with the regulations adopted pursuant to 3
NRS 449.165, may: 4
(a) Prohibit the facility from admitting any patient until it 5
determines that the facility has corrected the violation; 6
(b) Limit the occupancy of the facility to the number of beds 7
occupied when the violation occurred, until it determines that the 8
facility has corrected the violation; 9
(c) If the license of the facility limits the occupancy of the 10
facility and the facility has exceeded the approved occupancy, 11
require the facility, at its own expense, to move patients to another 12
facility that is licensed; 13
(d) Except where a greater penalty is authorized by subsection 2, 14
impose an administrative penalty of not more than $5,000 per day 15
for each violation, together with interest thereon at a rate not to 16
exceed 10 percent per annum; and 17
(e) Appoint temporary management to oversee the operation of 18
the facility and to ensure the health and safety of the patients of the 19
facility, until: 20
(1) It determines that the facility has corrected the violation 21
and has management which is capable of ensurin g continued 22
compliance with the applicable statutes, conditions, standards and 23
regulations; or 24
(2) Improvements are made to correct the violation. 25
2. If an off -campus location of a hospital fails to obtain a 26
national provider identifier that is distinct from the national provider 27
identifier used by the main campus and any other off -campus 28
location of the hospital in violation of NRS 449.1818, the Division 29
may impose against the hospital an administrative penalty of not 30
more than $10,000 for each day of such failure, together with 31
interest thereon at a rate not to exceed 10 percent per annum, in 32
addition to any other action authorized by this chapter. 33
3. If the facility fails to pay any administrative penalty imposed 34
pursuant to paragraph (d) of subsect ion 1 or subsection 2, the 35
Division may: 36
(a) Suspend the license of the facility until the administrative 37
penalty is paid; and 38
(b) Collect court costs, reasonable attorney’s fees and other 39
costs incurred to collect the administrative penalty. 40
4. The Di vision may require any facility that violates any 41
provision of NRS 439B.410 or 449.029 to 449.2428, inclusive, and 42
section 1 of this act or any condition, standard or regulation adopted 43
by the Board to make any improvements necessary to correct the 44
violation. 45

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5. Any money collected as administrative penalties pursuant to 1
paragraph (d) of subsection 1 or subsection 2 must be accounted for 2
separately and used to administer and carry out the provisions of 3
NRS 449.001 to 449.430, inclusive, and section 1 of this act, 4
449.435 to 449.531, inclusive, and chapter 449A of NRS to protect 5
the health, safety, well -being and property of the patients and 6
residents of facilities in accordance with applicable state and federal 7
standards or for any other purpose authorized by the Legislature. 8
Sec. 6. NRS 449.240 is hereby amended to read as follows: 9
449.240 The district attorney of the county in which the facility 10
is located shall, upon application by the Division, insti tute and 11
conduct the prosecution of any action for violation of any provisions 12
of NRS 449.029 to 449.245, inclusive [.] , and section 1 of this act. 13
Sec. 7. Chapter 629 of NRS is hereby amended by adding 14
thereto a new section to read as follows: 15
1. Except as otherwise provided in subsection 3, a provider of 16
health care who uses generative artificial intelligence to generate 17
a written or verbal communication with a patient relating to his or 18
her clinical information shall e nsure that the communication 19
includes: 20
(a) A disclaimer stating that the communication was generated 21
by generative artificial intelligence; and 22
(b) Clear instructions describing how the patient may contact a 23
provider of health care, employee of the provi der of health care or 24
other appropriate person who can provide any assistance the 25
patient may need with respect to the information in the 26
communication. 27
2. The disclaimer provided pursuant to subsection 1: 28
(a) For written communications, including, without limitation, 29
letters, electronic mail and other written messages, must appear 30
prominently at the beginning of each communication. 31
(b) For written communications involving continuous 32
interactions over the Internet, including, without limitation, chat -33
based telehealth, must be prominently displayed throughout the 34
interaction. 35
(c) For audio communications, must be provided verbally at 36
the beginning and the end of the interaction. 37
(d) For video communications, must be prominently displayed 38
throughout the interaction. 39
3. The requirements of this section do not apply to a written 40
communication that is generated by generative artificial 41
intelligence if the communication is read and reviewed by a 42
provider of health care before being provided to a patient. 43
4. A provider of health care who violates any provision of this 44
section is guilty of unprofessional conduct and is subject to 45

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disciplinary action by the board, agency or other entity in this 1
State by which he or she is licensed, certified or regulated. 2
5. As used in this section: 3
(a) “Artificial intelligence” means an engineered or machine -4
based system that varies in its level of autonomy and that can, for 5
explicit or implicit objectives, infer from the input it receives how 6
to generate outputs that can influence physical or virtual 7
environments. 8
(b) “Generative artificial intelligence” means artificial 9
intelligence that can generate derived synthetic content, including 10
images, videos, audio, text and other digital content. 11
(c) “Telehealth” has the meaning ascribed to it in 12
NRS 629.515. 13
Sec. 8. NRS 654.190 is hereby amended to read as follows: 14
654.190 1. The Board may, after notice and an opportunity 15
for a hearing as required by law, impose an administrative fine o f 16
not more than $10,000 for each violation on, recover reasonable 17
investigative fees and costs incurred from, suspend, revoke, deny 18
the issuance or renewal of or place conditions on the license of, and 19
place on probation or impose any combination of the fo regoing on 20
any licensee who: 21
(a) Is convicted of a felony relating to the practice of 22
administering a facility for skilled nursing or facility for 23
intermediate care or residential facility for groups or of any offense 24
involving moral turpitude. 25
(b) Has obtained his or her license by the use of fraud or deceit. 26
(c) Violates any of the provisions of this chapter. 27
(d) Aids or abets any person in the violation of any of the 28
provisions of NRS 449.029 to 449.2428, inclusive, and section 1 of 29
this act or 449A. 100 to 449A.124, inclusive, and 449A.270 to 30
449A.286, inclusive, as those provisions pertain to a facility for 31
skilled nursing, facility for intermediate care or residential facility 32
for groups. 33
(e) Violates any regulation of the Board prescribing additio nal 34
standards of conduct for licensees, including, without limitation, a 35
code of ethics. 36
(f) Engages in conduct that violates the trust of a patient or 37
resident or exploits the relationship between the licensee and the 38
patient or resident for the financial or other gain of the licensee. 39
2. If a licensee requests a hearing pursuant to subsection 1, the 40
Board shall give the licensee written notice of a hearing pursuant to 41
NRS 233B.121 and 241.0333. A licensee may waive, in writing, his 42
or her right to attend the hearing. 43
3. The Board may compel the attendance of witnesses or the 44
production of documents or objects by subpoena. The Board may 45

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adopt regulations that set forth a procedure pursuant to which the 1
Chair of the Board may issue subpoenas on behalf of the Board. 2
Any person who is subpoenaed pursuant to this subsection may 3
request the Board to modify the terms of the subpoena or grant 4
additional time for compliance. 5
4. An order that imposes discipline and the findings of fact and 6
conclusions of law supporting that order are public records. 7
5. The expiration of a license by operation of law or by order 8
or decision of the Board or a court, or the voluntary surrender of a 9
license, does not deprive the Board of jurisdiction to proceed with 10
any investigation of, or action or disciplinary proceeding against, the 11
licensee or to render a decision suspending or revoking the license. 12

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