Revises provisions relating to public health. (BDR 40-86)

EXEMPT
(Reprinted with amendments adopted on June 1, 2025)
FOURTH REPRINT S.B. 192

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SENATE BILL NO. 192–SENATOR NEAL

FEBRUARY 6, 2025
____________

Referred to Committee on Health and Human Services

SUMMARY—Revises provisions relating to public health.
(BDR 40-86)

FISCAL NOTE: Effect on Local Government: May have Fiscal Impact.
Effect on the State: Yes.

CONTAINS UNFUNDED MANDATE (§§ 1, 22, 47 & NRS 287.010)
(NOT REQUESTED BY AFFECTED LOCAL GOVERNMENT)

~

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

AN ACT relating to public health; imposing requirements relating to
birth in a hospital or freestanding birthing center;
requiring health insurance to include certain coverage ;
requiring an independent mental health assessment of
certain children in the custody of a child welfare agency;
prohibiting the use of race -based health formulas and
race-based care standards in certain circumstances;
prohibiting a health insurer from en gaging in certain
discrimination against solo practitioners; providing for a
study of certain disparities relating to health care;
providing a penalty; and providing other matters properly
relating thereto.
Legislative Counsel’s Digest:
Existing federal r egulations require providers of health care and health care 1
facilities that receive funding or certain other assistance from the Federal 2
Government to ensure that communications with persons with disabilities are as 3
effective as communications with persons who do not have disabilities. (45 C.F.R. 4
§ 92.202) Those federal regulations: (1) prohibit such providers and facilities from 5
requiring a person with a disability to be accompanied by a person to interpret for 6
him or her; and (2) authorize such providers and facilities to provide qualified 7
interpreters through video remote interpreting services. (28 C.F.R. § 35.160, 45 8
C.F.R. § 92.202) Section 1 of this bill requires a hospital or freestanding birthing 9
center to provide a qualified sign language interpreter to a patient who is at the 10
hospital or freestanding birthing center for the purpose of giving birth , except 11
where providing such an interpret er would be impractical or delay necessary care. 12
Section 1 also requires a hospital or freestanding birthing center to allow a family 13

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member of the patient and a doula to be present in the room with the patient during 14
the birthing process. Sections 2-6 of this bill make conforming changes relating to 15
the applicability and enforcement of section 1. 16
Existing law requires Medicaid to cover doula services provided by a doula 17
who enrolls with the Division of Health Care Financing and Policy of the 18
Department of Health and Human Services. (NRS 422.27177) Sections 18, 43, 46, 19
48, 50, 51, 53, 55, 56 and 61 of this bill require various other public and private 20
insurers who cover maternity care to: (1) cover doula services; and (2) include 21
doulas in their networks of providers. Section 45 of this bill authorizes the 22
Commissioner of Insurance to require certain policies of health insurance issued by 23
a domestic insurer to a person who resides in another state to include the coverage 24
required by section 43. Section 60 of this bill authorizes the Commissioner to 25
suspend or revoke the certificate of a health maintenance organization that fails to 26
provide the coverage required by section 55. The Commissioner is also authorized 27
to take such action against other health insurer s who fail to provide the coverage 28
required by sections 43, 46, 48, 50, 51, 53 and 61. (NRS 680A.200) 29
Existing law requires certain health insurers, including Medicaid managed care 30
organizations and insurance for state and local governmental employees, t o cover 31
hormone replacement therapy to varying degrees. (NRS 287.010, 287.04335, 32
689A.0415, 689B.0376, 689C.1678, 695A.1875, 695B.1916, 695C.050, 33
695C.1694, 695G.1717) Sections 44, 47, 49, 52, 54, 58 and 64 of this bill require 34
such coverage to include coverage of testosterone replacement therapy for 35
menopausal women. Section 67.5 of this bill requires: (1) private insurers to submit 36
to the Commissioner a plan for complying with that requirement on or before 37
January 1, 2026; and (2) the Commissioner to e valuate those plans and post a 38
bulletin on or before February 1, 2026, stating whether each such insurer is likely to 39
be in compliance with that requirement. Section 42 of this bill prohibits certain 40
health insurers from denying a request to include a prov ider of health care in a 41
provider network because the provider of health care is a solo practitioner. 42
Existing law authorizes a court that finds a child to be in need of protection to 43
place the child in the temporary custody of a public or private agency or institution. 44
(NRS 432B.550) If such a child is placed in the custody of an agency which 45
provides child welfare services and has been diagnosed with a mental or behavioral 46
health condition before or after such placement, section 22 of this bill requires the 47
agency which provides child welfare services to provide for an independent 48
assessment of the child before the child leaves the custody of the agency which 49
provides child welfare services. Section 22 provides that this requirement does not 50
apply if a prior assessment conducted after the initial diagnosis has determined that 51
the child no longer has a mental or behavioral health condition. Sections 7 and 23-52
25 of this bill make conforming changes to make various provisions governing 53
child welfare proceedin gs generally applicable to any proceeding related to the 54
provisions of section 22. Section 33.5 of this bill makes a conforming change to 55
require the State Board of Nursing to establish qualifications for an advanced 56
practice registered nurse to conduct an assessment pursuant to section 22. 57
Existing law provides for the regulation of the practices of medicine, nursing 58
and osteopathic medicine by the Board of Medical Examiners, the State Board of 59
Nursing and the State Board of Osteopathic Medicine, respecti vely. (Chapters 630, 60
632 and 633 of NRS) Sections 29, 32 and 35 of this bill: (1) require those boards to 61
adopt regulations prescribing a list of race -based health formulas and race -based 62
care standards that are authorized for use by licensees in this State; (2) prohibit 63
those boards from including on that list any rac e-based health formula or race -64
based care standard if there is a race -neutral health formula or race -neutral care 65
standard that has been scientifically validated as being at least as effective for the 66
same purpose; and (3) prohibit a physician, physician assistant, nurse or osteopathic 67
physician from using or authorizing the use of a race -based health formula or 68

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race-based care standard that is not included on the list. Section 65 of this bill 69
requires the Board of Medical Examiners, the State Board of Osteopathic Medicine, 70
the University of Nevada, Reno, School of Medicine and the University of Nevada, 71
Las Vegas, School of Medicine to study disparities in health care access, the 72
provision of health care and health care outcomes. 73

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. A hospital or freestanding birthing center shall: 3
(a) Notify each patient who is deaf or hard of hearing and is in 4
labor or intends to give birth at the hospital or freestanding 5
birthing center that a qualified sign language interpreter is 6
available while the patient is in the hospital or freestanding 7
birthing center; and 8
(b) Upon the re quest of such a patient or his or her 9
representative, provide the patient with a qualified sign language 10
interpreter until the patient is discharged from the hospital or 11
freestanding birthing center , unless providing an interpreter 12
would be impractical und er the circumstances or delay necessary 13
care for the patient. 14
2. At the request of a patient who is giving birth, a hospital or 15
freestanding birthing center shall allow a family member of the 16
patient and a doula to be present in the room with the patient 17
during the birthing process so long as the family member and 18
doula comply with the policies of the hospital or freestanding 19
birthing center, as applicable. 20
3. As used in this section, “qualified sign language 21
interpreter” means an interpreter, as define d in NRS 656A.030, 22
who: 23
(a) Has demonstrated proficiency in the practice of sign 24
language interpreting, as defined in NRS 656A.060; 25
(b) Is able to interpret effectively, accurately and impartially, 26
both receptively and expressively, using any necessary specialized 27
vocabulary or terms without changes, omissions, or additions and 28
while preserving the tone, sentiment and emotional level of the 29
original statement; and 30
(c) Adheres to generally accepted ethics principles in the field 31
of sign language interpre ting, including, without limitation, client 32
confidentiality. 33
Sec. 2. NRS 449.029 is hereby amended to read as follows: 34
449.029 As used in NRS 449.029 to 449.240, inclusive, and 35
section 1 of this act, unless the context otherwise requires, “medical 36

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facility” has the meaning ascribed to it in NRS 449.0151 and 1
includes a program of hospice care described in NRS 449.196. 2
Sec. 3. NRS 449.0301 is hereby amended to read as follows: 3
449.0301 The provisions of NRS 449.029 to 449.2428, 4
inclusive, and section 1 of this act do not apply to: 5
1. Any facility conducted by and for the adherents of any 6
church or religious denomination for the purpose of providing 7
facilities for the care and treatment o f the sick who depend solely 8
upon spiritual means through prayer for healing in the practice of 9
the religion of the church or denomination, except that such a 10
facility shall comply with all regulations relative to sanitation and 11
safety applicable to other facilities of a similar category. 12
2. Foster homes as defined in NRS 424.014. 13
3. Any medical facility , facility for the dependent or facility 14
which is otherwise required by the regulations adopted by the Board 15
pursuant to NRS 449.0303 to be licensed tha t is operated and 16
maintained by the United States Government or an agency thereof. 17
Sec. 4. NRS 449.160 is hereby amended to read as follows: 18
449.160 1. The Division may deny an application for a 19
license or may suspend or revoke any license issued under the 20
provisions of NRS 449.029 to 449.2428, inclusive, and section 1 of 21
this act upon any of the following grounds: 22
(a) Violation by the applicant or the licensee of any of the 23
provisions of NRS 439B.410, 449.029 to 449.245 , inclusive, and 24
section 1 of this act, or 449A.100 to 449A.124, inclusive, and 25
449A.270 to 449A.286, inclusive, or of any other law of this State 26
or of the standards, rules and regulations adopted thereunder. 27
(b) Aiding, abetting or permitting the commis sion of any illegal 28
act. 29
(c) Conduct inimical to the public health, morals, welfare and 30
safety of the people of the State of Nevada in the maintenance and 31
operation of the premises for which a license is issued. 32
(d) Conduct or practice detrimental to the health or safety of the 33
occupants or employees of the facility. 34
(e) Failure of the applicant to obtain written approval from the 35
Director of the Department of Health and Human Services as 36
required by NRS 439A.100 or 439A.102 or as provided in any 37
regulation adopted pursuant to NRS 449.001 to 449.430, inclusive, 38
and section 1 of this act, and 449.435 to 449.531, inclusive, and 39
chapter 449A of NRS if such approval is required, including, 40
without limitation, the closure or conversion of any hospital in a 41
county whose population is 100,000 or more that is owned by the 42
licensee without approval pursuant to NRS 439A.102. 43
(f) Failure to comply with the provisions of NRS 441A.315 and 44
any regulations adopted pursuant thereto or NRS 449.2486. 45

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(g) Violation of the provisions of NRS 458.112. 1
(h) Failure to comply with the provisions of NRS 449A.170 to 2
449A.192, inclusive, and any regulation adopted pursuant thereto. 3
(i) Violation of the provisions of NRS 629.260. 4
2. In addition to the provisions of subsection 1, the Division 5
may revoke a license to operate a facility for the dependent if, with 6
respect to that facility, the licensee that operates the facility, or an 7
agent or employee of the licensee: 8
(a) Is convicted of violating any of the provisions of 9
NRS 202.470; 10
(b) Is ordered to but fails to abate a nuisance pursuant to NRS 11
244.360, 244.3603 or 268.4124; or 12
(c) Is ordered by the appropriate governmental agency to correct 13
a violation of a building, safety or health code or regulation but fails 14
to correct the violation. 15
3. The Division shall maintain a log of any complaints that it 16
receives relating to activities for which the Division may revoke the 17
license to operate a facility for the dependent pursuant to subsection 18
2. The Division shall provide to a fa cility for the care of adults 19
during the day: 20
(a) A summary of a complaint against the facility if the 21
investigation of the complaint by the Division either substantiates 22
the complaint or is inconclusive; 23
(b) A report of any investigation conducted with respect to the 24
complaint; and 25
(c) A report of any disciplinary action taken against the facility. 26
 The facility shall make the information available to the public 27
pursuant to NRS 449.2486. 28
4. On or before February 1 of each odd -numbered year, the 29
Division shall submit to the Director of the Legislative Counsel 30
Bureau a written report setting forth, for the previous biennium: 31
(a) Any complaints included in the log maintained by the 32
Division pursuant to subsection 3; and 33
(b) Any disciplinary actions tak en by the Division pursuant to 34
subsection 2. 35
Sec. 5. NRS 449.163 is hereby amended to read as follows: 36
449.163 1. In addition to the payment of the amount required 37
by NRS 449.0308, if a medical facility, facility for the dependent or 38
facility which is required by the regulations adopted by the Board 39
pursuant to NRS 449.0303 to be licensed violates any provision 40
related to its licensure, including any provision of NRS 439B.410 or 41
449.029 to 449.2428, inclusive, and section 1 of this act, or any 42
condition, standard or regulation adopted by the Board, the 43
Division, in accordance with the regulations adopted pursuant to 44
NRS 449.165, may: 45

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(a) Prohibit the facility from admitting any patient until it 1
determines that the facility has corrected the violation; 2
(b) Limit the occupancy of the facility to the number of beds 3
occupied when the violation occurred, until it determine s that the 4
facility has corrected the violation; 5
(c) If the license of the facility limits the occupancy of the 6
facility and the facility has exceeded the approved occupancy, 7
require the facility, at its own expense, to move patients to another 8
facility that is licensed; 9
(d) Except where a greater penalty is authorized by subsection 2, 10
impose an administrative penalty of not more than $5,000 per day 11
for each violation, together with interest thereon at a rate not to 12
exceed 10 percent per annum; and 13
(e) Appoint temporary management to oversee the operation of 14
the facility and to ensure the health and safety of the patients of the 15
facility, until: 16
(1) It determines that the facility has corrected the violation 17
and has management which is capable of ensuri ng continued 18
compliance with the applicable statutes, conditions, standards and 19
regulations; or 20
(2) Improvements are made to correct the violation. 21
2. If an off -campus location of a hospital fails to obtain a 22
national provider identifier that is distinct from the national provider 23
identifier used by the main campus and any other off -campus 24
location of the hospital in violation of NRS 449.1818, the Division 25
may impose against the hospital an administrative penalty of not 26
more than $10,000 for each day of such failure, together with 27
interest thereon at a rate not to exceed 10 percent per annum, in 28
addition to any other action authorized by this chapter. 29
3. If the facility fails to pay any administrative penalty imposed 30
pursuant to paragraph (d) of subsec tion 1 or subsection 2, the 31
Division may: 32
(a) Suspend the license of the facility until the administrative 33
penalty is paid; and 34
(b) Collect court costs, reasonable attorney’s fees and other 35
costs incurred to collect the administrative penalty. 36
4. The Division may require any facility that violates any 37
provision of NRS 439B.410 or 449.029 to 449.2428, inclusive, and 38
section 1 of this act, or any condition, standard or regulation 39
adopted by the Board to make any improvements necessary to 40
correct the violation. 41
5. Any money collected as administrative penalties pursuant to 42
paragraph (d) of subsection 1 or subsection 2 must be accounted for 43
separately and used to administer and carry out the provisions of 44
NRS 449.001 to 449.430, inclusive, and section 1 of this act, 45

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449.435 to 449.531, inclusive, and chapter 449A of NRS to protect 1
the health, safety, well -being and property of the patients and 2
residents of facilities in accordance with applicable state and federal 3
standards or for any other purpose authorized by the Legislature. 4
Sec. 6. NRS 449.240 is hereby amended to read as follows: 5
449.240 The district attorney of the county in which the facility 6
is located shall, upon application by the Division, institute and 7
conduct the prosecution of any action for violation of any provisions 8
of NRS 449.029 to 449.245, inclusive [.] , and section 1 of this act. 9
Sec. 7. NRS 49.295 is hereby amended to read as follows: 10
49.295 1. Except as otherwise provided in subsections 2 and 11
3 and NRS 49.305: 12
(a) A married person cannot be examined as a witness for or 13
against his or her spouse without his or her consent. 14
(b) No spouse can be examined, during the marriage or 15
afterwards, without the cons ent of the other spouse, as to any 16
communication made by one to the other during marriage. 17
2. The provisions of subsection 1 do not apply to a: 18
(a) Civil proceeding brought by or on behalf of one spouse 19
against the other spouse; 20
(b) Proceeding to commi t or otherwise place a spouse, the 21
property of the spouse or both the spouse and the property of the 22
spouse under the control of another because of the alleged mental or 23
physical condition of the spouse; 24
(c) Proceeding brought by or on behalf of a spouse to establish 25
his or her competence; 26
(d) Proceeding in the juvenile court or family court pursuant to 27
title 5 of NRS or NRS 432B.410 to 432B.590, inclusive [;] , and 28
section 22 of this act; or 29
(e) Criminal proceeding in which one spouse is charged with: 30
(1) A crime against the person or the property of the other 31
spouse or of a child of either, or of a child in the custody or control 32
of either, whether the crime was committed before or during 33
marriage. 34
(2) Bigamy or incest. 35
(3) A crime related to aban donment of a child or nonsupport 36
of the other spouse or child. 37
3. The provisions of subsection 1 do not apply in any criminal 38
proceeding to events which took place before the spouses were 39
married. 40
Sec. 8. (Deleted by amendment.) 41
Sec. 9. (Deleted by amendment.) 42
Sec. 10. (Deleted by amendment.) 43
Sec. 11. (Deleted by amendment.) 44
Sec. 12. (Deleted by amendment.) 45

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Sec. 13. (Deleted by amendment.) 1
Sec. 14. (Deleted by amendment.) 2
Sec. 15. (Deleted by amendment.) 3
Sec. 16. (Deleted by amendment.) 4
Sec. 17. (Deleted by amendment.) 5
Sec. 18. NRS 287.04335 is hereby amended to read as 6
follows: 7
287.04335 If the Board provides health insurance through a 8
plan of sel f-insurance, it shall comply with the provisions of NRS 9
439.581 to 439.597, inclusive, 686A.135, 687B.352, 687B.409, 10
687B.692, 687B.723, 687B.725, 687B.805, 689B.0353, 689B.255, 11
695C.1723, 695G.150, 695G.155, 695G.160, 695G.162, 12
695G.1635, 695G.164, 695G.1 645, 695G.1665, 695G.167, 13
695G.1675, 695G.170 to 695G.1712, inclusive, 695G.1714 to 14
695G.174, inclusive, and section 61 of this act, 695G.176, 15
695G.177, 695G.200 to 695G.230, inclusive, 695G.241 to 16
695G.310, inclusive, 695G.405 and 695G.415, in the same ma nner 17
as an insurer that is licensed pursuant to title 57 of NRS is required 18
to comply with those provisions. 19
Sec. 19. (Deleted by amendment.) 20
Sec. 20. (Deleted by amendment.) 21
Sec. 21. (Deleted by amendment.) 22
Sec. 22. Chapter 432B of NRS is hereby amended by adding 23
thereto a new section to read as follows: 24
1. Except as otherwise provided in subsection 4, if a child 25
who has been placed in the custody of an agency which provides 26
child welfare services pursuant to NRS 432B.550 has been 27
diagnosed with a mental or behavioral health condition before or 28
after the placement, the agency which provides child welfare 29
services shall provide for an assessment of the child that: 30
(a) Meets the requirements of subsection 2; and 31
(b) Takes place with sufficient time before the date on which 32
the child leaves the custody of the agency which provides child 33
welfare services to allow for planning to meet the mental health 34
needs of the child after that date. 35
2. An assessment conducted pursuant to subsection 1 must: 36
(a) Be conducted by a psychiatrist , psychologist, advanced 37
practice registered nurse who has the psychiatric training and 38
experience prescribed by the State Board of Nursing pursuant to 39
NRS 632.120, marriage and family therapist, clinical professional 40
counselor or clinical social worker who is not receiving 41
compensation from or is not otherwise affiliated with an y person 42
or entity with which the child is currently placed; 43
(b) Be conducted in a culturally competent manner that 44
respects the race, color, religion, national origin, ancestry, age, 45

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gender, physical or mental disability, sexual orientation and 1
gender identity or expression of the child; 2
(c) Determine whether the child still suffers from the mental or 3
behavioral health condition with which the child was previously 4
diagnosed by comparing the results of the assessment to the 5
assessment which resulted in t he initial diagnosis and any other 6
prior assessment conducted after the assessment which resulted in 7
the initial diagnosis; and 8
(d) Evaluate the progress of any treatment provided to the 9
child for the mental or behavioral condition with which the child 10
was previously diagnosed. 11
3. If the psychiatrist , psychologist, advanced practice 12
registered nurse, marriage and family therapist, clinical 13
professional counselor or clinical social worker who conducts an 14
assessment of a child pursuant to this section det ermines that the 15
child still suffers from the mental or behavioral health condition 16
with which the child was previously diagnosed and the mental or 17
behavioral health condition has not improved since that diagnosis 18
was made, the psychiatrist , psychologist, advanced practice 19
registered nurse, marriage and family therapist, clinical 20
professional counselor or clinical social worker, as applicable, 21
shall record in the medical record of the child: 22
(a) The fact that the diagnosis has not changed; and 23
(b) Any recommendations for additional treatment. 24
4. An agency which provides child welfare services is not 25
required to perform an assessment in accordance with subsection 26
1 for a child described in that subsection if an assessment of the 27
child conducted after the initial diagnosis has determined that the 28
child no longer has a mental or behavioral health condition. 29
Sec. 23. NRS 432B.250 is hereby amended to read as follows: 30
432B.250 Any person who is required to make a report 31
pursuant to NRS 432B.220 may not invoke any of the privileges set 32
forth in chapter 49 of NRS: 33
1. For failure to make a report pursuant to NRS 432B.220; 34
2. In cooperating with an agency which provides child welfare 35
services or a guardian ad litem for a child; or 36
3. In any proceeding held pursuant to NRS 432B.410 to 37
432B.590, inclusive [.] , and section 22 of this act. 38
Sec. 24. NRS 432B.420 is hereby amended to read as follows: 39
432B.420 1. A parent or other person res ponsible for the 40
welfare of a child who is alleged to have abused or neglected the 41
child may be represented by an attorney at all stages of any 42
proceedings under NRS 432B.410 to 432B.590, inclusive [.] , and 43
section 22 of this act. Except as otherwise provided in subsection 3, 44

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if the person is indigent, the court may appoint an attorney to 1
represent the person. 2
2. A child who is alleged to have been abused or neglected 3
shall be deemed to be a party to any proceedings under NRS 4
432B.410 to 432B.590, inclusive [.] , and section 22 of this act. The 5
court shall appoint an attorney to represent the child. The child must 6
be represented by an attorney at all stages of any proceedings held 7
pursuant to NRS 432B.410 to 432B.590, inclusive [.] , and section 8
22 of this act. The attorney representing the child has the same 9
authority and rights as an attorney representing any other party to 10
the proceedings. 11
3. If the court determines that the parent of an Indian child for 12
whom protective custody is sought is indigent, the court: 13
(a) Shall appoint an attorney to represent the parent; and 14
(b) May apply to the Secretary of the Interior for the payment of 15
the fees and expenses of such an attorney, 16
 as provided in the Indian Child Welfare Act. 17
4. Each attorney, other than an attorney compensated through a 18
program for legal aid described in NRS 19.031 and 247.305, if 19
appointed under the provisions of subsection 1 or 2, is entitled to the 20
same compensation and payment for expenses from the county as 21
provided in NRS 7.125 and 7.135 for an attorney appointed to 22
represent a person charged with a crime. 23
Sec. 25. NRS 432B.4675 is hereby amended to read as 24
follows: 25
432B.4675 Upon the entry of a final order by the court 26
establishing a guardianship pursuant to NRS 432B.4665: 27
1. The custody of the child by the agency which has legal 28
custody of the child is terminated; 29
2. The proceedings concerning the child conducted pursuant to 30
NRS 432B.410 to 432B.590, inclusive, and section 22 of this act 31
terminate; and 32
3. Unless subsequently ordered by the court to assist the court, 33
the following agencies and persons are excused from any 34
responsibility to participate in the guardianship case: 35
(a) The agency which has legal custody of the child; 36
(b) Any counsel or guardian ad litem appointed by the court to 37
assist in the proceedings conducted pursuant to NRS 432B.410 to 38
432B.590, inclusive [;] , and section 22 of this act; and 39
(c) Any person nominated or appointed as the person who is 40
legally responsible for the psychiatric care of the child pursuant to 41
NRS 432B.4684 or 432B.4685, respectively. 42
Sec. 26. (Deleted by amendment.) 43
Sec. 26.1. (Deleted by amendment.) 44
Sec. 26.2. (Deleted by amendment.) 45

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Sec. 26.3. (Deleted by amendment.) 1
Sec. 26.35. (Deleted by amendment.) 2
Sec. 26.4. (Deleted by amendment.) 3
Sec. 26.5. (Deleted by amendment.) 4
Sec. 26.6. (Deleted by amendment.) 5
Sec. 26.7. (Deleted by amendment.) 6
Sec. 26.8. (Deleted by amendment.) 7
Sec. 26.85. (Deleted by amendment.) 8
Sec. 26.9. (Deleted by amendment.) 9
Sec. 26.95. (Deleted by amendment.) 10
Sec. 27. (Deleted by amendment.) 11
Sec. 28. (Deleted by amendment.) 12
Sec. 29. Chapter 630 of NRS is hereby amended by adding 13
thereto a new section to read as follows: 14
1. The Board, in consultation with the State Board of 15
Nursing and the State Board of Osteopathic Medicine, shall: 16
(a) Adopt regulations concerning the use of race -based health 17
formulas and race -based care standards by phy sicians and 18
physician assistants. Those regulations must list specific race -19
based health formulas and race -based care standards that 20
physicians and physician assistants are authorized to use. That list 21
must not include a race-based health formula or a race-based care 22
standard if there is a race -neutral health formula or race -neutral 23
care standard, as applicable, that is scientifically validated as 24
being at least as effective for the same purpose. 25
(b) Monitor evolving scientific research and, not later than 1 26
year after a race -based health formula or race -based care 27
standard included on the list of authorized race -based health 28
formulas and race -based care standards adopted pursuant to 29
paragraph (a) ceases to meet the requirements of that paragraph, 30
propose r egulations to remove the race -based health formula or 31
race-based care standard from that list. 32
2. A physician or physician assistant shall not use or 33
authorize the use of a race -based health formula or race -based 34
care standard that is not included on the list of authorized race -35
based health formulas and race -based care standards adopted 36
pursuant to subsection 1. 37
3. As used in this section: 38
(a) “Race-based care standard” means a standard of care that 39
requires or authorizes a physician or physician assis tant to take 40
the race of the patient into account when making determinations 41
regarding the care that will be provided to a patient. 42
(b) “Race-based health formula” means a formula for 43
determining whether a health -related condition exists or 44

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calculating he alth-related data that takes the race of the patient 1
into account. 2
(c) “Race-neutral care standard” means a standard of care 3
that does not require or authorize a physician or physician 4
assistant to take the race of the patient into account when making 5
determinations regarding the care that will be provided to a 6
patient. 7
(d) “Race-neutral health formula” means a formula for 8
determining whether a health -related condition exists or 9
calculating health-related data that does not take the race of the 10
patient into account. 11
Sec. 30. (Deleted by amendment.) 12
Sec. 31. (Deleted by amendment.) 13
Sec. 32. Chapter 632 of NRS is hereby amended by adding 14
thereto a new section to read as follows: 15
1. The Board, in consultation with the Board of Medical 16
Examiners and the State Board of Osteopathic Medicine, shall: 17
(a) Adopt regulations concerning the use of race -based health 18
formulas and race -based care standards by registered nurses and 19
licensed practical nurses. Those regulations must list specific 20
race-based health formulas and race -based care standards that 21
registered nurses and licensed practical nurses are authorized to 22
use. That list must not include a race -based health f ormula or a 23
race-based care standard if there is a race -neutral health formula 24
or race -neutral care standard, as applicable, that is scientifically 25
validated as being at least as effective for the same purpose. 26
(b) Monitor evolving scientific research and , not later than 1 27
year after a race -based health formula or race -based care 28
standard included on the list of authorized race -based health 29
formulas and race -based care standards adopted pursuant to 30
paragraph (a) ceases to meet the requirements of that para graph, 31
propose regulations to remove the race -based health formula or 32
race-based care standard from that list. 33
2. A registered nurse or licensed practical nurse shall not use 34
or authorize the use of a race -based health formula or race -based 35
care standard that is not included on the list of authorized race -36
based health formulas and race -based care standards adopted 37
pursuant to subsection 1. 38
3. As used in this section: 39
(a) “Race-based care standard” means a standard of care that 40
requires or authorizes a registered nurse or licensed practical 41
nurse to take the race of the patient into account when making 42
determinations regarding the care that will be provided to a 43
patient. 44

– 13 –

- *SB192_R4*
(b) “Race-based health formula” means a formula for 1
determining whether a health -related condition exists or 2
calculating health -related data that takes the race of the patient 3
into account. 4
(c) “Race-neutral care standard” means a standard of care 5
that does not require or authorize a registered nurse or licensed 6
practical nurse to take the race of the patient into account when 7
making determinations regarding the care that will be provided to 8
a patient. 9
(d) “Race-neutral health formula” means a formula for 10
determining whether a health -related condition exists or 11
calculating health-related data that does not take the race of the 12
patient into account. 13
Sec. 33. (Deleted by amendment.) 14
Sec. 33.5. NRS 632.120 is hereby amended to read as follows: 15
632.120 1. The Board shall: 16
(a) Adopt regulations establishing reasonable standards: 17
(1) For the denial, renewal, suspension and revocation of, 18
and the placement of conditions, limitations and restrictions upon, a 19
license to practice professional or practical nursing or a certificate to 20
practice as a nursing assistant or medication aide - certified. 21
(2) Of professional conduct for the practice of nursing. 22
(3) For prescribing and dispensing controlled substances and 23
dangerous drugs in accordance with applicable statutes. 24
(4) For the psychiatric training and experience necessary for 25
an advanced practice registered nurse to be authorized to make the 26
diagnoses, evaluations , assessments and examinations described in 27
NRS 432B.6078, 432B.60816, 433A.162, 433A.240, 433A.335, 28
433A.390, 433A.430, 484C.300 and 484C.320 to 484C.350, 29
inclusive, and section 22 of this act the certifications described in 30
NRS 432B.6075, 432B.60814, 433A.170, 433A.195 and 433A.200 31
and the sworn statements or declarations described in NRS 32
433A.210 and 433A.335. 33
(b) Prepare and administer examinations for the issuance of a 34
license or certificate under this chapter. 35
(c) Investigate and determine the eligibility of an applicant for a 36
license or certificate under this chapter. 37
(d) Carry out and enforce th e provisions of this chapter and the 38
regulations adopted pursuant thereto. 39
(e) Develop and disseminate annually to each registered nurse 40
who cares for children information concerning the signs and 41
symptoms of pediatric cancer. 42
2. The Board may adopt regulations establishing reasonable: 43
(a) Qualifications for the issuance of a license or certificate 44
under this chapter. 45

– 14 –

- *SB192_R4*
(b) Standards for the continuing professional competence of 1
licensees or holders of a certificate. The Board may evaluate 2
licensees or holders of a certificate periodically for compliance with 3
those standards. 4
3. The Board may adopt regulations establishing a schedule of 5
reasonable fees and charges, in addition to those set forth in NRS 6
632.345, for: 7
(a) Investigating licensees or holders of a certificate and 8
applicants for a license or certificate under this chapter; 9
(b) Evaluating the professional competence of licensees or 10
holders of a certificate; 11
(c) Conducting hearings pursuant to this chapter; 12
(d) Duplicating and verifying records of the Board; and 13
(e) Surveying, evaluating and approving schools of practical 14
nursing, and schools and courses of professional nursing, 15
 and collect the fees established pursuant to this subsection. 16
4. For the purposes of this chapter, the Bo ard shall, by 17
regulation, define the term “in the process of obtaining 18
accreditation.” 19
5. The Board may adopt such other regulations, not 20
inconsistent with state or federal law, as may be necessary to carry 21
out the provisions of this chapter relating to nursing assistant 22
trainees, nursing assistants and medication aides - certified. 23
6. The Board may adopt such other regulations, not 24
inconsistent with state or federal law, as are necessary to enable it to 25
administer the provisions of this chapter. 26
Sec. 34. (Deleted by amendment.) 27
Sec. 35. Chapter 633 of NRS is hereby amended by adding 28
thereto a new section to read as follows: 29
1. The Board, in consultation with the Board of Medical 30
Examiners and the State Board of Nursing, shall: 31
(a) Adopt regulations concerning the use of race -based health 32
formulas and race-based care standards by osteopathic physicians 33
and physician assistants. Those regulations must list specific race -34
based healt h formulas and race -based care standards that 35
osteopathic physicians and physician assistants are authorized to 36
use. That list must not include a race -based health formula or a 37
race-based care standard if there is a race -neutral health formula 38
or race -neutral care standard, as applicable, that is scientifically 39
validated as being at least as effective for the same purpose. 40
(b) Monitor evolving scientific research and, not later than 1 41
year after a race -based health formula or race -based care 42
standard inclu ded on the list of authorized race -based health 43
formulas and race -based care standards adopted pursuant to 44
paragraph (a) ceases to meet the requirements of that paragraph, 45

– 15 –

- *SB192_R4*
propose regulations to remove the race -based health formula or 1
race-based care standard from that list. 2
2. An osteopathic physician or a physician assistant shall not 3
use a race -based health formula or race -based care standard that 4
is not included on the list of authorized race -based health 5
formulas and race -based care standards adopted pursuant to 6
subsection 1. 7
3. As used in this section: 8
(a) “Race-based care standard” means a standard of care that 9
requires or authorizes an osteopathic physician or physician 10
assistant to take the race of the patient into account when making 11
determinations regarding the care that will be provided to a 12
patient. 13
(b) “Race-based health formula” means a formula for 14
determining whether a health -related condition exists or 15
calculating health -related data that takes the race of the patient 16
into account. 17
(c) “Race-neutral care standard” means a standard of care 18
that does not require or authorize an osteopathic physician or 19
physician assistant to take the race of the patient into account 20
when making determinations regarding the care that will be 21
provided to a patient. 22
(d) “Race-neutral health formula” means a formula for 23
determining whether a health -related condition exists or 24
calculating health-related data that does not take the race of the 25
patient into account. 26
Sec. 36. (Deleted by amendment.) 27
Sec. 37. (Deleted by amendment.) 28
Sec. 38. (Deleted by amendment.) 29
Sec. 39. (Deleted by amendment.) 30
Sec. 40. (Deleted by amendment.) 31
Sec. 41. (Deleted by amendment.) 32
Sec. 42. NRS 687B.692 is hereby amended to read as follows: 33
687B.692 1. A health carrier which offers or issues a network 34
plan may not deny a request from a provider of health care to enter 35
into a provider network contract with the health carrier [if] : 36
(a) If the provider of health care: 37
[(a)] (1) Meets and accepts the terms and conditions for 38
participation in the network of the health carrier, including, without 39
limitation: 40
[(1)] (I) Meeting any credentialing requirement of the health 41
carrier; 42
[(2)] (II) Agreeing to all provisions of the provider network 43
contract, i ncluding, without limitation, provisions setting forth the 44

– 16 –

- *SB192_R4*
grounds and procedures for terminating providers of health care 1
from participation in the network; and 2
[(3)] (III) Agreeing to participate in a review of the 3
performance and experience of the pro vider of health care at least 4
once each year or as otherwise required by the health carrier; 5
[(b)] (2) Is employed by or has accepted an offer of 6
employment from a school of medicine or school of osteopathic 7
medicine in this State to serve in a position w here the provider of 8
health care teaches students studying to become providers of health 9
care or resident physicians at least 50 percent of the time the 10
provider of health care is performing his or her duties for the school; 11
[(c)] (3) Does not have a clin ical practice already established in 12
this State at the time the request to enter into a provider network 13
contract is made; and 14
[(d)] (4) Requests to be a participating provider of health care in 15
the network of the health carrier [.] ; or 16
(b) Because the provider of health care is a solo practitioner. 17
2. A health carrier which offers or issues a network plan may 18
deny a request from a provider of health care to enter into a provider 19
network contract with the health carrier if: 20
(a) The health carrier contracts with a third party for the delivery 21
of services to covered persons; 22
(b) Participating providers of health care are paid though 23
capitation agreements; or 24
(c) Accepting the provider of health care into the network plan 25
would disrupt existing provider network contracts. 26
3. A health carrier may terminate a provider network contract 27
entered into pursuant to paragraph (a) of subsection 1 for any 28
grounds authorized under the contract. Such grounds may include, 29
without limitation, failure to maintain the employment described in 30
subparagraph (2) of paragraph [(b)] (a) of subsection 1 or issues of 31
inconsistency with other particip ating providers of health care with 32
regard to: 33
(a) Access for covered persons to the services of the provider of 34
health care; 35
(b) The cost of the services of the provider of health care; 36
(c) The quality of care provided by the provider of health care; 37
or 38
(d) Other issues relating to the utilization of the services of the 39
provider of health care. 40
Sec. 43. Chapter 689A of NRS is hereby amended by adding 41
thereto a new section to read as follows: 42
1. An insurer that issues a policy of health insurance that 43
includes coverage for maternity care shall include in the policy 44
coverage for doula services. 45

– 17 –

- *SB192_R4*
2. An insurer shall ensure that the benefits required by 1
subsection 1 are made available to an insured through a doula 2
who participates in the network plan of the insurer. 3
3. A policy of health insurance subject to the provisions of 4
this chapter that is delivered, issued for delivery or renewed on or 5
after January 1, 2026, has the legal effect of including the 6
coverage required by subsection 1, and any provision of the policy 7
that conflicts with the provisions of this section is void. 8
4. As used in this section: 9
(a) “Doula services” means services to provide education and 10
support relating to childbirth, including, without limitation, 11
emotional and physical support provided during pregnancy, labor, 12
birth and the postpartum period. 13
(b) “Network plan” means a policy of health insurance offered 14
by an insurer under which the financing and delivery of medical 15
care, including it ems and services paid for as medical care, are 16
provided, in whole or in part, through a defined set of providers 17
under contract with the insurer. The term does not include an 18
arrangement for the financing of premiums. 19
Sec. 44. NRS 689A.0415 is hereby amended to read as 20
follows: 21
689A.0415 1. An insurer that offers or issues a policy of 22
health insurance which provides coverage for prescription drugs or 23
devices shall include in the policy coverage for [any] : 24
(a) Testosterone replacement therapy for menopausal women; 25
and 26
(b) Any type of hormone replacement therapy which is lawfully 27
prescribed or ordered and which has been approved by the Food and 28
Drug Administration. 29
2. An insurer that offers or issues a pol icy of health insurance 30
that provides coverage for prescription drugs shall not: 31
(a) Require an insured to pay a higher deductible, any 32
copayment or coinsurance or require a longer waiting period or 33
other condition for coverage for a prescription for horm one 34
replacement therapy; 35
(b) Refuse to issue a policy of health insurance or cancel a 36
policy of health insurance solely because the person applying for or 37
covered by the policy uses or may use in the future hormone 38
replacement therapy; 39
(c) Offer or pay a ny type of material inducement or financial 40
incentive to an insured to discourage the insured from accessing 41
hormone replacement therapy; 42
(d) Penalize a provider of health care who provides hormone 43
replacement therapy to an insured, including, without lim itation, 44
reducing the reimbursement of the provider of health care; or 45

– 18 –

- *SB192_R4*
(e) Offer or pay any type of material inducement, bonus or other 1
financial incentive to a provider of health care to deny, reduce, 2
withhold, limit or delay hormone replacement therapy to an insured. 3
3. A policy subject to the provisions of this chapter that is 4
delivered, issued for delivery or renewed on or after [October] 5
January 1, [1999,] 2026, has the legal effect of including the 6
coverage required by subsection 1, and any provisi on of the policy 7
or the renewal which is in conflict with this section is void. 8
4. The provisions of this section do not require an insurer to 9
provide coverage for fertility drugs. 10
5. As used in this section, “provider of health care” has the 11
meaning ascribed to it in NRS 629.031. 12
Sec. 45. NRS 689A.330 is hereby amended to read as follows: 13
689A.330 If any policy is issued by a domestic insurer for 14
delivery to a person residing in another state, and if the insurance 15
commissioner or corresponding public officer of that other state has 16
informed the Commissioner that the policy is not subject to approval 17
or disapproval by that officer, the Commissioner may by ruling 18
require that the policy meet the standards set forth in NRS 689A.030 19
to 689A.320, inclusive [.] , and section 43 of this act. 20
Sec. 46. Chapter 689B of NRS is hereby amended by adding 21
thereto a new section to read as follows: 22
1. An insurer that issues a policy of group health insurance 23
that includes coverage for maternity care shall include in the 24
policy coverage for doula services. 25
2. An insurer shall ensure that the benefits required by 26
subsection 1 are made available to an insured through a doula 27
who participates in the network plan of the insurer. 28
3. A policy of group health insurance subject to the 29
provisions of this chapter that is delivered, issued for delivery or 30
renewed on or after January 1, 2026, has the legal effect of 31
including the coverage required by subsecti on 1, and any 32
provision of the policy that conflicts with the provisions of this 33
section is void. 34
4. As used in this section: 35
(a) “Doula services” means services to provide education and 36
support relating to childbirth, including, without limitation, 37
emotional and physical support provided during pregnancy, labor, 38
birth and the postpartum period. 39
(b) “Network plan” means a policy of group health insurance 40
offered by an insurer under which the financing and delivery of 41
medical care, including items and services paid for as medical 42
care, are provided, in whole or in part, through a defined set of 43
providers under contract with the insurer. The term does not 44
include an arrangement for the financing of premiums. 45

– 19 –

- *SB192_R4*
Sec. 47. NRS 689B.0376 is hereby amended to read as 1
follows: 2
689B.0376 1. An insurer that offers or issues a policy of 3
group health insurance which provides coverage for prescription 4
drugs or devices shall include in the policy coverage for [any] : 5
(a) Testosterone replacement therapy for menopausal women; 6
and 7
(b) Any type of hormone replacement therapy which is lawfully 8
prescribed or ordered and which has been approved by the Food and 9
Drug Administration. 10
2. An insurer that offers or issues a pol icy of group health 11
insurance that provides coverage for prescription drugs shall not: 12
(a) Require an insured to pay a higher deductible, any 13
copayment or coinsurance or require a longer waiting period or 14
other condition for coverage for a prescription fo r hormone 15
replacement therapy; 16
(b) Refuse to issue a policy of group health insurance or cancel a 17
policy of group health insurance solely because the person applying 18
for or covered by the policy uses or may use in the future hormone 19
replacement therapy; 20
(c) Offer or pay any type of material inducement or financial 21
incentive to an insured to discourage the insured from accessing 22
hormone replacement therapy; 23
(d) Penalize a provider of health care who provides hormone 24
replacement therapy to an insured, incl uding, without limitation, 25
reducing the reimbursement of the provider of health care; or 26
(e) Offer or pay any type of material inducement, bonus or other 27
financial incentive to a provider of health care to deny, reduce, 28
withhold, limit or delay hormone replacement therapy to an insured. 29
3. A policy subject to the provisions of this chapter that is 30
delivered, issued for delivery or renewed on or after [October] 31
January 1, [1999,] 2026, has the legal effect of including the 32
coverage required by subsection 1, and any provision of the policy 33
or the renewal which is in conflict with this section is void. 34
4. The provisions of this section do not require an insurer to 35
provide coverage for fertility drugs. 36
5. As used in this section, “provider of health care” has the 37
meaning ascribed to it in NRS 629.031. 38
Sec. 48. Chapter 689C of NRS is hereby amended by adding 39
thereto a new section to read as follows: 40
1. A carrier that issues a health benefit plan that includes 41
coverage for maternity care shall include in the health benefit 42
plan coverage for doula services. 43

– 20 –

- *SB192_R4*
2. A carrier shall ensure that the benefits required by 1
subsection 1 are made available to an insured through a doula 2
who participates in the network plan of the carrier. 3
3. A health benefit plan subject to the provisions of this 4
chapter that is delivered, issued for delivery or renewed on or after 5
January 1, 2026, has the legal effect of including the coverage 6
required by subsection 1, and any provision of the plan th at 7
conflicts with the provisions of this section is void. 8
4. As used in this section: 9
(a) “Doula services” means services to provide education and 10
support relating to childbirth, including, without limitation, 11
emotional and physical support provided d uring pregnancy, labor, 12
birth and the postpartum period. 13
(b) “Network plan” means a health benefit plan offered by a 14
carrier under which the financing and delivery of medical care, 15
including items and services paid for as medical care, are 16
provided, in w hole or in part, through a defined set of providers 17
under contract with the carrier. The term does not include an 18
arrangement for the financing of premiums. 19
Sec. 49. NRS 689C.1678 is hereby amended to read as 20
follows: 21
689C.1678 1. A carrier that offers or issues a health benefit 22
plan shall include in the plan coverage for: 23
(a) Counseling, support and supplies for breastfeeding, 24
including breastfeeding equipment, counseling and education during 25
the antenatal, perinata l and postpartum period for not more than 1 26
year; 27
(b) Screening and counseling for interpersonal and domestic 28
violence for women at least annually, with initial intervention 29
services consisting of education, strategies to reduce harm, 30
supportive services or a referral for any other appropriate services; 31
(c) Behavioral counseling concerning sexually transmitted 32
diseases from a provider of health care for sexually active women 33
who are at increased risk for such diseases; 34
(d) Hormone replacement therapy [;] , including, without 35
limitation, testosterone replacement therapy for menopausal 36
women; 37
(e) Such prenatal screenings and tests as recommended by the 38
American College of Obstetricians and Gynecologists or its 39
successor organization; 40
(f) Screening for blo od pressure abnormalities and diabetes, 41
including gestational diabetes, after at least 24 weeks of gestation or 42
as ordered by a provider of health care; 43

– 21 –

- *SB192_R4*
(g) Screening for cervical cancer at such intervals as are 1
recommended by the American College of Obstetricians and 2
Gynecologists or its successor organization; 3
(h) Screening for depression; 4
(i) Screening and counseling for the human immunodeficiency 5
virus consisting of a risk assessment, annual education relating to 6
prevention and at least one scree ning for the virus during the 7
lifetime of the insured or as ordered by a provider of health care; 8
(j) Smoking cessation programs for an insured who is 18 years 9
of age or older consisting of not more than two cessation attempts 10
per year and four counseling sessions per year; 11
(k) All vaccinations recommended by the Advisory Committee 12
on Immunization Practices of the Centers for Disease Control and 13
Prevention of the United States Department of Health and Human 14
Services or its successor organization; and 15
(l) Such well-woman preventative visits as recommended by the 16
Health Resources and Services Administration, which must include 17
at least one such visit per year beginning at 14 years of age. 18
2. A carrier must ensure that the benefits required by 19
subsection 1 are made available to an insured through a provider of 20
health care who participates in the network plan of the carrier. 21
3. Except as otherwise provided in subsection 5, a carrier that 22
offers or issues a health benefit plan shall not: 23
(a) Require an ins ured to pay a higher deductible, any 24
copayment or coinsurance or require a longer waiting period or 25
other condition to obtain any benefit provided in the health benefit 26
plan pursuant to subsection 1; 27
(b) Refuse to issue a health benefit plan or cancel a h ealth 28
benefit plan solely because the person applying for or covered by 29
the plan uses or may use any such benefit; 30
(c) Offer or pay any type of material inducement or financial 31
incentive to an insured to discourage the insured from obtaining any 32
such benefit; 33
(d) Penalize a provider of health care who provides any such 34
benefit to an insured, including, without limitation, reducing the 35
reimbursement of the provider of health care; 36
(e) Offer or pay any type of material inducement, bonus or other 37
financial incentive to a provider of health care to deny, reduce, 38
withhold, limit or delay access to any such benefit to an insured; or 39
(f) Impose any other restrictions or delays on the access of an 40
insured to any such benefit. 41
4. A plan subject to the provisio ns of this chapter that is 42
delivered, issued for delivery or renewed on or after January 1, 43
[2018,] 2026, has the legal effect of including the coverage required 44

– 22 –

- *SB192_R4*
by subsection 1, and any provision of the plan or the renewal which 1
is in conflict with this section is void. 2
5. Except as otherwise provided in this section and federal law, 3
a carrier may use medical management techniques, including, 4
without limitation, any available clinical evidence, to determine the 5
frequency of or treatment relating to any benefit required by this 6
section or the type of provider of health care to use for such 7
treatment. 8
6. As used in this section: 9
(a) “Medical management technique” means a practice which is 10
used to control the cost or utilization of health care services o r 11
prescription drug use. The term includes, without limitation, the use 12
of step therapy, prior authorization or categorizing drugs and 13
devices based on cost, type or method of administration. 14
(b) “Network plan” means a health benefit plan offered by a 15
carrier under which the financing and delivery of medical care, 16
including items and services paid for as medical care, are provided, 17
in whole or in part, through a defined set of providers under contract 18
with the carrier. The term does not include an arrangem ent for the 19
financing of premiums. 20
(c) “Provider of health care” has the meaning ascribed to it in 21
NRS 629.031. 22
Sec. 50. NRS 689C.425 is hereby amended to read as follows: 23
689C.425 A voluntary purchasing group and any contract 24
issued to such a group pursuant to NRS 689C.360 to 689C.600, 25
inclusive, are subject to the provisions of NRS 689C.015 to 26
689C.355, inclusive, and section 48 of this act, to the extent 27
applicable and not in conflict with the express provisions of NRS 28
687B.408 and 689C.360 to 689C.600, inclusive. 29
Sec. 51. Chapter 695A of NRS is hereby amended by adding 30
thereto a new section to read as follows: 31
1. A society that issues a benefit contract that includes 32
coverage for maternity care shall include in the contract coverage 33
for doula services. 34
2. A society shall ensure that the benefits required by 35
subsection 1 are made available to an insured th rough a doula 36
who participates in the network plan of the society. 37
3. A benefit contract subject to the provisions of this chapter 38
that is delivered, issued for delivery or renewed on or after 39
January 1, 2026, has the legal effect of including the cover age 40
required by subsection 1, and any provision of the benefit contract 41
or renewal which is in conflict with the provisions of this section is 42
void. 43
4. As used in this section: 44

– 23 –

- *SB192_R4*
(a) “Doula services” means services to provide education and 1
support relati ng to childbirth, including, without limitation, 2
emotional and physical support provided during pregnancy, labor, 3
birth and the postpartum period. 4
(b) “Network plan” means a benefit contract offered by a 5
society under which the financing and delivery of medical care, 6
including items and services paid for as medical care, are 7
provided, in whole or in part, through a defined set of providers 8
under contract with the society. The term does not include an 9
arrangement for the financing of premiums. 10
Sec. 52. NRS 695A.1875 is hereby amended to read as 11
follows: 12
695A.1875 1. A society that offers or issues a benefit 13
contract shall include in the contract coverage for: 14
(a) Counseling, support and supplies for breastfeeding, 15
including breastfeeding equipment, counseling and education during 16
the antenatal, perinatal and postpartum period for not more than 1 17
year; 18
(b) Screening and counseling for interpersonal and domestic 19
violence for women at least annually with initial interventio n 20
services consisting of education, strategies to reduce harm, 21
supportive services or a referral for any other appropriate services; 22
(c) Behavioral counseling concerning sexually transmitted 23
diseases from a provider of health care for sexually active wome n 24
who are at increased risk for such diseases; 25
(d) Hormone replacement therapy [;] , including, without 26
limitation, testosterone replacement therapy for menopausal 27
women; 28
(e) Such prenatal screenings and tests as recommended by the 29
American College of Ob stetricians and Gynecologists or its 30
successor organization; 31
(f) Screening for blood pressure abnormalities and diabetes, 32
including gestational diabetes, after at least 24 weeks of gestation or 33
as ordered by a provider of health care; 34
(g) Screening for cervical cancer at such intervals as are 35
recommended by the American College of Obstetricians and 36
Gynecologists or its successor organization; 37
(h) Screening for depression; 38
(i) Screening and counseling for the human immunodeficiency 39
virus consisting of a risk assessment, annual education relating to 40
prevention and at least one screening for the virus during the 41
lifetime of the insured or as ordered by a provider of health care; 42
(j) Smoking cessation programs for an insured who is 18 years 43
of age or older consisting of not more than two cessation attempts 44
per year and four counseling sessions per year; 45

– 24 –

- *SB192_R4*
(k) All vaccinations recommended by the Advisory Committee 1
on Immunization Practices of the Centers for Disease Control and 2
Prevention of the United States Department of Health and Human 3
Services or its successor organization; and 4
(l) Such well-woman preventative visits as recommended by the 5
Health Resources and Services Administration, which must include 6
at least one such visit per year beginning at 14 years of age. 7
2. A society must ensure that the benefits required by 8
subsection 1 are made available to an insured through a provider of 9
health care who participates in the network plan of the society. 10
3. Except as otherwise provided in subsection 5, a so ciety that 11
offers or issues a benefit contract shall not: 12
(a) Require an insured to pay a higher deductible, any 13
copayment or coinsurance or require a longer waiting period or 14
other condition to obtain any benefit provided in the benefit contract 15
pursuant to subsection 1; 16
(b) Refuse to issue a benefit contract or cancel a benefit contract 17
solely because the person applying for or covered by the contract 18
uses or may use any such benefit; 19
(c) Offer or pay any type of material inducement or financial 20
incentive to an insured to discourage the insured from obtaining any 21
such benefit; 22
(d) Penalize a provider of health care who provides any such 23
benefit to an insured, including, without limitation, reducing the 24
reimbursement of the provider of health care; 25
(e) Offer or pay any type of material inducement, bonus or other 26
financial incentive to a provider of health care to deny, reduce, 27
withhold, limit or delay access to any such benefit to an insured; or 28
(f) Impose any other restrictions or delays on the access of an 29
insured to any such benefit. 30
4. A benefit contract subject to the provisions of this chapter 31
that is delivered, issued for delivery or renewed on or after 32
January 1, [2018,] 2026, has the legal effect of including the 33
coverage required by subsection 1, and any provision of the benefit 34
contract or the renewal which is in conflict with this section is void. 35
5. Except as otherwise provided in this section and federal law, 36
a society may use medical management techniques, including, 37
without limitation, any available clinical evidence, to determine the 38
frequency of or treatment relating to any benefit required by this 39
section or the type of provider of health care to use for such 40
treatment. 41
6. As used in this section: 42
(a) “Medical management technique” means a practice which is 43
used to control the cost or utilization of health care services or 44
prescription drug use. The term includes, without limitation, the use 45

– 25 –

- *SB192_R4*
of step therapy, prior authorization or categorizing drugs and 1
devices based on cost, type or method of administration. 2
(b) “Network plan” means a benefit contract offered by a society 3
under which the financing and delivery of medical care, including 4
items and services paid for as medical care, are provided, in whole 5
or in part, through a defined set of providers under contract with the 6
society. The term does not include an arrangement for the financing 7
of premiums. 8
(c) “Provider of health care” has the meaning ascribed to it in 9
NRS 629.031. 10
Sec. 53. Chapter 695B of NRS is hereby amended by adding 11
thereto a new section to read as follows: 12
1. A hospital or medical services corporation that issues a 13
policy of health insurance that includes coverage for maternity 14
care shall include in the policy coverage for doula services. 15
2. A hospital or medical services corporation shall ensure 16
that the benefits required by subsection 1 are made available to an 17
insured through a doula who participates in the network plan of 18
the hospital or medical services corporation. 19
3. A policy of health insurance subject to the provisions of 20
this chapter that is delivered, issued for delivery or renewed on or 21
after January 1, 2026, has the legal effect of including the 22
coverage required by subsection 1, and any provision of the policy 23
that conflicts with the provisions of this section is void. 24
4. As used in this section: 25
(a) “Doula services” means services to provide education and 26
support relating to childbirth, including, without limitation, 27
emotional and physical support provided during pregnancy, labor, 28
birth and the postpartum period. 29
(b) “Network plan” means a policy of health insurance offered 30
by a hospital or medical services corporation under which the 31
financing and delivery of medical care, including items and 32
services paid for as medical care, are provided, in whole or in part, 33
through a defined set of providers under contract with the hospital 34
or medical services corporation. The term does not include an 35
arrangement for the financing of premiums. 36
Sec. 54. NRS 695B.1916 is hereby amended to read as 37
follows: 38
695B.1916 1. An insurer that offers or issues a contract for 39
hospital or medical service which provides coverage for prescription 40
drugs or devices shall include in the contract coverage for [any] : 41
(a) Testosterone replacement therapy for menopausal women; 42
and 43

– 26 –

- *SB192_R4*
(b) Any type of hormone replacement therapy which is lawfully 1
prescribed or ordered and which has been approved by the Food and 2
Drug Administration. 3
2. An insurer that offers or issues a contract for hospital or 4
medical service that provides coverage for prescription drugs shall 5
not: 6
(a) Require an insured to pay a higher deductible, any 7
copayment or coinsurance or require a longer waiting period or 8
other condition for coverage for a prescription for hormone 9
replacement therapy; 10
(b) Refuse to issue a contract for hospital or medical service or 11
cancel a contract for hospital or medical service solely because the 12
person applying for or covered by the contract uses or may use in 13
the future hormone replacement therapy; 14
(c) Offer or pay any type of material inducement or financial 15
incentive to an insured to discourage the insured from accessing 16
hormone replacement therapy; 17
(d) Penalize a provider of health care who pro vides hormone 18
replacement therapy to an insured, including, without limitation, 19
reducing the reimbursement of the provider of health care; or 20
(e) Offer or pay any type of material inducement, bonus or other 21
financial incentive to a provider of health care to deny, reduce, 22
withhold, limit or delay hormone replacement therapy to an insured. 23
3. A contract for hospital or medical service subject to the 24
provisions of this chapter that is delivered, issued for delivery or 25
renewed on or after [October] January 1, [1999,] 2026, has the 26
legal effect of including the coverage required by subsection 1, and 27
any provision of the contract or the renewal which is in conflict with 28
this section is void. 29
4. The provisions of this section do not require an insurer to 30
provide coverage for fertility drugs. 31
5. As used in this section, “provider of health care” has the 32
meaning ascribed to it in NRS 629.031. 33
Sec. 55. Chapter 695C of NRS is hereby amended by adding 34
thereto a new section to read as follows: 35
1. A health maintenance organization that issues a health 36
care plan that includes coverage for maternity care shall include 37
in the health care plan coverage for doula services. 38
2. A health maintenance organization shall ensure that the 39
benefits required by subsection 1 are made available to an enrollee 40
through a doula who participates in the network plan of the health 41
maintenance organization. 42
3. A health care plan subject to the provisions of this chapter 43
that is delivered, issued for d elivery or renewed on or after 44
January 1, 2026, has the legal effect of including the coverage 45

– 27 –

- *SB192_R4*
required by subsection 1, and any provision of the health care plan 1
that conflicts with the provisions of this section is void. 2
4. As used in this section: 3
(a) “Doula services” means services to provide education and 4
support relating to childbirth, including, without limitation, 5
emotional and physical support provided during pregnancy, labor, 6
birth and the postpartum period. 7
(b) “Network plan” means a healt h care plan offered by a 8
health maintenance organization under which the financing and 9
delivery of medical care, including items and services paid for as 10
medical care, are provided, in whole or in part, through a defined 11
set of providers under contract wit h the health maintenance 12
organization. The term does not include an arrangement for the 13
financing of premiums. 14
Sec. 56. NRS 695C.050 is hereby amended to read as follows: 15
695C.050 1. Except as otherwise provided in this chapter or 16
in specific provisions of this title, the provisions of this title are not 17
applicable to any health maintenance organization granted a 18
certificate of authority under this chapter. This provision does not 19
apply to an insurer licensed and regulate d pursuant to this title 20
except with respect to its activities as a health maintenance 21
organization authorized and regulated pursuant to this chapter. 22
2. Solicitation of enrollees by a health maintenance 23
organization granted a certificate of authority, o r its representatives, 24
must not be construed to violate any provision of law relating to 25
solicitation or advertising by practitioners of a healing art. 26
3. Any health maintenance organization authorized under this 27
chapter shall not be deemed to be practicing medicine and is exempt 28
from the provisions of chapter 630 of NRS. 29
4. The provisions of NRS 695C.110, 695C.125, 695C.1691, 30
695C.1693, 695C.170, 695C.1703, 695C.1705, 695C.1709 to 31
695C.173, inclusive, 695C.1733, 695C.17335, 695C.1734, 32
695C.1751, 695C.1 755, 695C.1759, 695C.176 to 695C.200, 33
inclusive, and 695C.265 do not apply to a health maintenance 34
organization that provides health care services through managed 35
care to recipients of Medicaid under the State Plan for Medicaid or 36
insurance pursuant to the Children’s Health Insurance Program 37
pursuant to a contract with the Division of Health Care Financing 38
and Policy of the Department of Health and Human Services. This 39
subsection does not exempt a health maintenance organization from 40
any provision of this c hapter for services provided pursuant to any 41
other contract. 42
5. The provisions of NRS 695C.16932 to 695C.1699, 43
inclusive, 695C.1701, 695C.1708, 695C.1728, 695C.1731, 44
695C.17333, 695C.17345, 695C.17347, 695C.1736 to 695C.1745, 45

– 28 –

- *SB192_R4*
inclusive, 695C.1757 and 695C.204 and section 55 of this act apply 1
to a health maintenance organization that provides health care 2
services through managed care to recipients of Medicaid under the 3
State Plan for Medicaid. 4
6. The provisions of NRS 695C.17095 do not apply to a health 5
maintenance organization that provides health care services to 6
members of the Public Employees’ Benefits Program. This 7
subsection does not exempt a health maintenance organization from 8
any provision of this chapter for services provided pursuant to any 9
other contract. 10
7. The provisions of NRS 695C.1735 do not apply to a health 11
maintenance organization that provides health care services to: 12
(a) The officers and employees, and the dependents of officers 13
and employees, of the governing body of any county, school district, 14
municipal corporation, political subdivision, public corporation or 15
other local governmental agency of this State; or 16
(b) Members of the Public Employees’ Benefits Program. 17
 This subsection does not exempt a health maintenance 18
organization from any provision of this chapter for services 19
provided pursuant to any other contract. 20
Sec. 57. (Deleted by amendment.) 21
Sec. 58. NRS 695C.1694 is hereby amended to read as 22
follows: 23
695C.1694 1. A health maintenance organization which 24
offers or issues a health care plan that provides coverage for 25
prescription drugs or devices shall include in the plan coverage for 26
[any] : 27
(a) Testosterone replacement therapy for menopausal women; 28
and 29
(b) Any type of hormone replacement therapy which is lawfully 30
prescribed or ordered and which has been approved by the Food and 31
Drug Administration. 32
2. A health maintenance organization tha t offers or issues a 33
health care plan that provides coverage for prescription drugs shall 34
not: 35
(a) Require an enrollee to pay a higher deductible, any 36
copayment or coinsurance or require a longer waiting period or 37
other condition for coverage for hormone replacement therapy; 38
(b) Refuse to issue a health care plan or cancel a health care plan 39
solely because the person applying for or covered by the plan uses 40
or may use in the future hormone replacement therapy; 41
(c) Offer or pay any type of material induce ment or financial 42
incentive to an enrollee to discourage the enrollee from accessing 43
hormone replacement therapy; 44

– 29 –

- *SB192_R4*
(d) Penalize a provider of health care who provides hormone 1
replacement therapy to an enrollee, including, without limitation, 2
reducing the reimbursement of the provider of health care; or 3
(e) Offer or pay any type of material inducement, bonus or other 4
financial incentive to a provider of health care to deny, reduce, 5
withhold, limit or delay hormone replacement therapy to an 6
enrollee. 7
3. Evidence of coverage subject to the provisions of this 8
chapter that is delivered, issued for delivery or renewed on or after 9
[October] January 1, [1999,] 2026, has the legal effect of including 10
the coverage required by subsection 1, and any provision of the 11
evidence of coverage or the renewal which is in conflict with this 12
section is void. 13
4. The provisions of this section do not require a health 14
maintenance organization to provide coverage for fertility drugs. 15
5. As used in this section, “provider of hea lth care” has the 16
meaning ascribed to it in NRS 629.031. 17
Sec. 59. (Deleted by amendment.) 18
Sec. 60. NRS 695C.330 is hereby amended to read as follows: 19
695C.330 1. The Commissioner may suspend or revoke any 20
certificate of authority issued to a health maintenance organization 21
pursuant to the provisions of this chapter if the Commissioner finds 22
that any of the following conditions exist: 23
(a) The health maintenance organization is operatin g 24
significantly in contravention of its basic organizational document, 25
its health care plan or in a manner contrary to that described in and 26
reasonably inferred from any other information submitted pursuant 27
to NRS 695C.060, 695C.070 and 695C.140, unless any amendments 28
to those submissions have been filed with and approved by the 29
Commissioner; 30
(b) The health maintenance organization issues evidence of 31
coverage or uses a schedule of charges for health care services 32
which do not comply with the requirements o f NRS 695C.1691 to 33
695C.200, inclusive, and section 55 of this act, 695C.204 or 34
695C.207; 35
(c) The health care plan does not furnish comprehensive health 36
care services as provided for in NRS 695C.060; 37
(d) The Commissioner certifies that the health mainten ance 38
organization: 39
(1) Does not meet the requirements of subsection 1 of NRS 40
695C.080; or 41
(2) Is unable to fulfill its obligations to furnish health care 42
services as required under its health care plan; 43

– 30 –

- *SB192_R4*
(e) The health maintenance organization is no lo nger financially 1
responsible and may reasonably be expected to be unable to meet its 2
obligations to enrollees or prospective enrollees; 3
(f) The health maintenance organization has failed to put into 4
effect a mechanism affording the enrollees an opportunit y to 5
participate in matters relating to the content of programs pursuant to 6
NRS 695C.110; 7
(g) The health maintenance organization has failed to put into 8
effect the system required by NRS 695C.260 for: 9
(1) Resolving complaints in a manner reasonably to dispose 10
of valid complaints; and 11
(2) Conducting external reviews of adverse determinations 12
that comply with the provisions of NRS 695G.241 to 695G.310, 13
inclusive; 14
(h) The health maintenance organization or any person on its 15
behalf has advertised or merc handised its services in an untrue, 16
misrepresentative, misleading, deceptive or unfair manner; 17
(i) The continued operation of the health maintenance 18
organization would be hazardous to its enrollees or creditors or to 19
the general public; 20
(j) The health ma intenance organization fails to provide the 21
coverage required by NRS 695C.1691; or 22
(k) The health maintenance organization has otherwise failed to 23
comply substantially with the provisions of this chapter. 24
2. A certificate of authority must be suspended or revoked only 25
after compliance with the requirements of NRS 695C.340. 26
3. If the certificate of authority of a health maintenance 27
organization is suspended, the health maintenance organization shall 28
not, during the period of that suspension, enroll any additional 29
groups or new individual contracts, unless those groups or persons 30
were contracted for before the date of suspension. 31
4. If the certificate of authority of a health maintenance 32
organization is revoked, the organization shall proceed, immediately 33
following the effective date of the order of revocation, to wind up its 34
affairs and shall conduct no further business except as may be 35
essential to the orderly conclusion of the affairs of the organization. 36
It shall engage in no further advertising or s olicitation of any kind. 37
The Commissioner may, by written order, permit such further 38
operation of the organization as the Commissioner may find to be in 39
the best interest of enrollees to the end that enrollees are afforded 40
the greatest practical opportunit y to obtain continuing coverage for 41
health care. 42

– 31 –

- *SB192_R4*
Sec. 61. Chapter 695G of NRS is hereby amended by adding 1
thereto a new section to read as follows: 2
1. A managed care organization that issues a health care 3
plan that includes coverage for maternity care shall include in the 4
health care plan coverage for doula services. 5
2. A managed care organization shall ensure that the benefits 6
required by subsection 1 are made available to an insured through 7
a doula who participates in the network plan of the managed care 8
organization. 9
3. A health care plan subject to the provisions of this chapter 10
that is delivered, issued for delivery or renewed on or after 11
January 1, 2026, has the legal effect of including the coverage 12
required by subsection 1, and any provision of the health care plan 13
that conflicts with the provisions of this section is void. 14
4. As used in this section: 15
(a) “Doula services” means services to provide education and 16
support relating to childbirth, including, wit hout limitation, 17
emotional and physical support provided during pregnancy, labor, 18
birth and the postpartum period. 19
(b) “Network plan” means a health care plan offered by a 20
managed care organization under which the financing and 21
delivery of medical care, including items and services paid for as 22
medical care, are provided, in whole or in part, through a defined 23
set of providers under contract with the managed care 24
organization. The term does not include an arrangement for the 25
financing of premiums. 26
Sec. 62. (Deleted by amendment.) 27
Sec. 63. (Deleted by amendment.) 28
Sec. 64. NRS 695G.1717 is hereby amended to read as 29
follows: 30
695G.1717 1. A managed care organization that offers or 31
issues a health care plan shall include in the plan coverage for: 32
(a) Counseling, support and supplies for breastfeeding, 33
including breastfeeding equipment, counseling and education during 34
the antenatal, perinatal and postpartu m period for not more than 1 35
year; 36
(b) Screening and counseling for interpersonal and domestic 37
violence for women at least annually with initial intervention 38
services consisting of education, strategies to reduce harm, 39
supportive services or a referral for any other appropriate services; 40
(c) Behavioral counseling concerning sexually transmitted 41
diseases from a provider of health care for sexually active women 42
who are at increased risk for such diseases; 43

– 32 –

- *SB192_R4*
(d) Hormone replacement therapy [;] , including, wi thout 1
limitation, testosterone replacement therapy for menopausal 2
women; 3
(e) Such prenatal screenings and tests as recommended by the 4
American College of Obstetricians and Gynecologists or its 5
successor organization; 6
(f) Screening for blood pressure abno rmalities and diabetes, 7
including gestational diabetes, after at least 24 weeks of gestation or 8
as ordered by a provider of health care; 9
(g) Screening for cervical cancer at such intervals as are 10
recommended by the American College of Obstetricians and 11
Gynecologists or its successor organization; 12
(h) Screening for depression; 13
(i) Screening and counseling for the human immunodeficiency 14
virus consisting of a risk assessment, annual education relating to 15
prevention and at least one screening for the virus during the 16
lifetime of the insured or as ordered by a provider of health care; 17
(j) Smoking cessation programs for an insured who is 18 years 18
of age or older consisting of not more than two cessation attempts 19
per year and four counseling sessions per year; 20
(k) All vaccinations recommended by the Advisory Committee 21
on Immunization Practices of the Centers for Disease Control and 22
Prevention of the United States Department of Health and Human 23
Services or its successor organization; and 24
(l) Such well-woman preventative visits as recommended by the 25
Health Resources and Services Administration, which must include 26
at least one such visit per year beginning at 14 years of age. 27
2. A managed care organization must ensure that the benefits 28
required by subsection 1 are made available to an insured through a 29
provider of health care who participates in the network plan of the 30
managed care organization. 31
3. Except as otherwise provided in subsection 5, a managed 32
care organization that offers or issues a health care plan shall not: 33
(a) Require an insured to pay a higher deductible, any 34
copayment or coinsurance or require a longer waiting period or 35
other condition to obtain any benefit provided in the health care plan 36
pursuant to subsection 1; 37
(b) Refuse to issue a health care plan or cancel a health care plan 38
solely because the person applying for or covered by the plan uses 39
or may use any such benefit; 40
(c) Offer or pay any type of material inducement or financial 41
incentive to an insured to discourage the insured f rom obtaining any 42
such benefit; 43

– 33 –

- *SB192_R4*
(d) Penalize a provider of health care who provides any such 1
benefit to an insured, including, without limitation, reducing the 2
reimbursement of the provider of health care; 3
(e) Offer or pay any type of material inducement, bonus or other 4
financial incentive to a provider of health care to deny, reduce, 5
withhold, limit or delay access to any such benefit to an insured; or 6
(f) Impose any other restrictions or delays on the access of an 7
insured to any such benefit. 8
4. A health care plan subject to the provisions of this chapter 9
that is delivered, issued for delivery or renewed on or after 10
January 1, 2018, has the legal effect of including the coverage 11
required by subsection 1, and any provision of the plan or the 12
renewal which is in conflict with this section is void. 13
5. Except as otherwise provided in this section and federal law, 14
a managed care organization may use medical management 15
techniques, including, without limitation, any available clinical 16
evidence, to determine the frequency of or treatment relating to any 17
benefit required by this section or the type of provider of health care 18
to use for such treatment. 19
6. As used in this section: 20
(a) “Medical management technique” means a practice which is 21
used to control the cost or utilization of health care services or 22
prescription drug use. The term includes, without limitation, the use 23
of step therapy, prior authorization or categorizing drugs and 24
devices based on cost, type or method of administration. 25
(b) “Network p lan” means a health care plan offered by a 26
managed care organization under which the financing and delivery 27
of medical care, including items and services paid for as medical 28
care, are provided, in whole or in part, through a defined set of 29
providers under contract with the managed care organization. The 30
term does not include an arrangement for the financing of 31
premiums. 32
(c) “Provider of health care” has the meaning ascribed to it in 33
NRS 629.031. 34
Sec. 65. 1. On or before Fe bruary 1, 2027, the Board of 35
Medical Examiners, the State Board of Osteopathic Medicine, the 36
University of Nevada, Reno, School of Medicine and the University 37
of Nevada, Las Vegas, School of Medicine shall: 38
(a) Study disparities in health care access, the provision of 39
health care and health care outcomes. The study must include, 40
without limitation, the analyses of: 41
(1) The historical use of race-based health formulas and race-42
based care standards; 43
(2) The current use of race -based health formulas and r ace-44
based care standards; 45

– 34 –

- *SB192_R4*
(3) The effect of the use of race -based health formulas and 1
race-based care standards on: 2
(I) Outcomes for patients; 3
(II) Diagnoses of patients, including, without limitation, 4
classifications of diseases; 5
(III) The proc edures, medications and other treatment 6
prescribed or recommended for patients; 7
(IV) Insurance coverage of the conditions and symptoms 8
with which patients have been diagnosed and the procedures, 9
medications and other treatments prescribed or recommended to 10
treat those conditions and symptoms; and 11
(V) The eligibility of patients for compensation for 12
disabilities, including, without limitation, compensation for work -13
related injuries and occupational diseases pursuant to title 53 of 14
NRS and disability in surance benefits under the federal Social 15
Security Act, and the amounts received through those programs. 16
(b) Publish a report of the study performed pursuant to 17
paragraph (a) on the Internet websites maintained by the Board of 18
Medical Examiners and the State Board of Osteopathic Medicine. 19
(c) Submit the report published pursuant to paragraph (b) to the 20
Director of the Legislative Counsel Bureau for transmittal to the 21
next regular session of the Legislature. 22
2. As used in this section: 23
(a) “Provider of health care” has the meaning ascribed to it in 24
NRS 629.031. 25
(b) “Race-based care standard” means a standard of care that 26
requires or authorizes a provider of health care to take the race of 27
the patient into account when making determinations regarding the 28
care that will be provided to a patient. 29
(c) “Race-based health formula” means a formula for 30
determining whether a health -related condition exists or calculating 31
health-related data that takes the race of the patient into account. 32
(d) “Race-neutral care standard” means a standard of care that 33
does not require or authorize a provider of health care to take the 34
race of the patient into account when making determinations 35
regarding the care that will be provided to a patient. 36
(e) “Race-neutral health formul a” means a formula for 37
determining whether a health -related condition exists or calculating 38
health-related data that does not take the race of the patient into 39
account. 40
Sec. 66. (Deleted by amendment.) 41
Sec. 67. (Deleted by amendment.) 42
Sec. 67.5. 1. On or before January 1, 2026, an insurer , as 43
defined in NRS 679A.100, that is subject to NRS 689A.0415, as 44
amended by section 44 of this act, NRS 689B.0376, as amended by 45

– 35 –

- *SB192_R4*
section 47 of this act or NRS 695B.1916, as amended by section 54 1
of this act, a carrier that is subject to NRS 689C.1678, as amended 2
by section 49 of this act, a society that is subject to NRS 695A.1875, 3
as amended by section 52 of this act, a health maintenance 4
organization that is subject to NRS 695C.1694, as amended by 5
section 58 of this act and a managed care organization that is subject 6
to the provisions of NRS 695G.1717, as amended by section 64 of 7
this act, shall submit to the Commissione r of Insurance a plan for 8
complying with the amendatory provisions of section 44, 47, 49, 52, 9
54, 58 or 64 of this act, as applicable. 10
2. On or before February 1, 2026, the Commissioner shall: 11
(a) Evaluate the plans submitted pursuant to subsection 1 to 12
determine whether the actions described in those plans will result in 13
compliance with the amendatory provisions of section 44, 47, 49, 14
52, 54, 58 or 64 of this act, as applicable; and 15
(b) Post on an Internet website maintained by the Commissioner 16
a bulle tin stating, for each entity that is required to submit a plan 17
pursuant to subsection 1, whether the entity is likely to be in 18
compliance with amendatory provisions of section 44, 47, 49, 52, 19
54, 58 or 64 of this act, as applicable. 20
Sec. 68. The provisions of NRS 354.599 do not apply to any 21
additional expenses of a local government that are related to the 22
provisions of this act. 23
Sec. 69. 1. This section and sections 37, 65, 67, 67.5 and 68 24
of this act become effective upon passage and approval. 25
2. Section 19 of this act becomes effective: 26
(a) Upon passage and approval for the purpose of adopting any 27
regulations and performing any other preparatory administrative 28
tasks that are necessary to carry out the provisions of this act; and 29
(b) On July 1, 2025, for all other purposes. 30
3. Sections 1 to 18, inclusive, 20 to 36, inclusive, 38 to 64, 31
inclusive, and 66 of this act become effective: 32
(a) Upon passage and approval for the purpose of adopting any 33
regulations and performing any other preparatory administrative 34
tasks that are necessary to carry out the provisions of this act; and 35
(b) On January 1, 2026, for all other purposes. 36

H