Revises provisions relating to health care records. (BDR 40-70)

EXEMPT
(Reprinted with amendments adopted on April 21, 2025)
FIRST REPRINT S.B. 250

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SENATE BILL NO. 250–SENATORS LANGE;
CRUZ-CRAWFORD AND OHRENSCHALL

FEBRUARY 27, 2025
____________

Referred to Committee on Health and Human Services

SUMMARY—Revises provisions relating to health care records.
(BDR 40-70)

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

CONTAINS UNFUNDED MANDATE (§§ 3, 8, 12, 15)
(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 health care; requiring certain entities to allow a
patient to take certain actions relating to access to his or
her electronic health records; requiring the adoption of
regulations to minimize the need for a patient to
repeatedly provide certain information; providing that the
health records of a patient are the property of a patient;
requiring the Director of the Department of Health and
Human Services to compile certain reports; providing a
penalty; and providing other matters properly relating
thereto.
Legislative Counsel’s Digest:
Existing law prescribes various requirements governing health information 1
technology and the electronic maintena nce, transmittal and exchange of electronic 2
health records and certain other electronic health information. (NRS 439.581 -3
439.597) Upon the request of a person who is authorized to request a copy of health 4
records that are maintained electronically, existin g law requires a custodian of 5
health care records to electronically transmit a copy of the health records to any 6
person or entity for a fee. (NRS 629.062) Section 15 of this bill provides that the 7
health care records of a patient are the property of the patient, and section 3 of this 8
bill requires a health care provider to allow a patient to: (1) access and forward his 9
or her electronic health records without a fee or charge; and (2) request that his or 10
her electronic health records be forwarded to any ot her person or entity in 11
accordance with existing law. Section 8 of this bill makes a conforming change to 12
remove a requirement that the Director of the Department of Health and Human 13

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Services adopt regulations governing the ownership of electronic health r ecords 14
because section 15 establishes that such records are the property of the patient. 15
With certain exceptions, existing law requires a health care provider, health 16
insurer, health insurance administrator and certain other entities to authorize a 17
person to opt out of having his or her individually identifiable health information 18
disclosed electronically to health care providers, insurers and certain other entities. 19
(NRS 439.597) Section 10 of this bill requires those persons and entities to allow a 20
patient to prohibit any person or entity from accessing his or her individually 21
identifiable health information, with similar exceptions. Section 5 of this bill makes 22
a violation of section 3 or 10, or any regulations adopted to carry out those 23
sections, a misdemeanor. A health care provider, health insurer or health insurance 24
administrator that commits such a violation would also be subject to administrative 25
sanctions. (NRS 439.589, 439.5895, 449.167, 450B.215, 629.051, 680A.225, 26
683A.0891, 695C.329) 27
Existing law requires the Director to adopt regulations that prescribe a 28
framework for the electronic maintenance, transmittal and exchange of electronic 29
health records, prescriptions, health -related information and electronic signatures. 30
Existing law requires sta te and local governmental entities, health care providers 31
and insurers and certain related entities to maintain, transmit and exchange health 32
information in accordance with that framework, with certain exceptions. (NRS 33
439.589) Existing law establishes tha t physician group practices and other business 34
entities organized for the purpose of practicing a health care profession with 20 or 35
fewer employees are not required to comply with those provisions until January 1, 36
2030. (Section 2.8 of chapter 278, Statute s of Nevada 2023, at page 1859) Section 37
8 requires the regulations adopted by the Director to include requirements to 38
minimize the need for a patient to repeatedly provide demographic information, 39
information relating to his or her medical history and the list of medications that the 40
patient is currently taking or has taken in the past. A health care provider who fails 41
to comply with those regulations would be subject to administrative sanctions but 42
would not be guilty of a misdemeanor. (NRS 439.589, 439.58 95, 449.167, 43
450B.215, 629.051) Sections 5-7, 9, 10, 12-14 and 16 of this bill make conforming 44
changes to: (1) clarify the applicability of section 3 and certain provisions of 45
existing law; and (2) indicate the proper placement of section 3 in the Nevada 46
Revised Statutes. During the 2026 calendar year, section 16.5 of this bill requires 47
the Director of the Department to publish and submit to the Governor and the 48
Legislature a quarterly report concerning the progress of the Department toward 49
implementing the provisions of this bill. Section 16.5 also requires the Dire ctor or 50
his or her designee to appear before the Joint Interim Standing Committee on 51
Health and Human Services or the Legislative Commission upon request to provide 52
information concerning the reports. 53

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

Section 1. Chapter 439 of NRS is hereby amended by adding 1
thereto the provisions set forth as sections 2, 3 and 4 of this act. 2
Sec. 2. (Deleted by amendment.) 3
Sec. 3. A health care provider shall: 4
1. Allow a patient unimpeded, secure access to his or her 5
electronic health records without a fee or charge. 6

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2. Allow a patient to forward his or her electronic health 1
records to any other person or entity without a fee or charge. 2
3. Ensure that, upon the request of a patient to furnish his or 3
her electronic health records to himself or herself or another 4
person or entity, the electronic health records of the patient are 5
transmitted to the requested person or entity in accordance with 6
NRS 629.062. 7
Sec. 4. (Deleted by amendment.) 8
Sec. 5. NRS 439.580 is hereby amended to read as follows: 9
439.580 1. Any local health officer or a deputy of a local 10
health officer who neglects or fails to enforce the provisions of this 11
chapter in his or her jurisdiction, or neglects or refuses to perform 12
any of the duties imposed upon him or her by this chapter or by the 13
instructions and directions of the Division shall be pun ished by a 14
fine of not more than $250. 15
2. Except as otherwise provided in NRS 439.589, each person 16
who violates any of the provisions of this chapter or refuses or 17
neglects to obey any lawful order, rule or regulation of the: 18
(a) State Board of Health o r violates any rule or regulation 19
approved by the State Board of Health pursuant to NRS 439.350, 20
439.366, 439.410 and 439.460; or 21
(b) Director adopted pursuant to NRS 439.581 to 439.597, 22
inclusive, and section 3 of this act, 23
 is guilty of a misdemeanor. 24
Sec. 6. NRS 439.581 is hereby amended to read as follows: 25
439.581 As used in NRS 439.581 to 439.597, inclusive, and 26
section 3 of this act, unless the context otherwise requires, the 27
words and terms defined in NRS 439.582 to 439.585, inclusive, 28
have the meanings ascribed to them in those sections. 29
Sec. 7. NRS 439.588 is hereby amended to read as follows: 30
439.588 1. A health information exchange shall not operate 31
in this State without first obtaining certification as provided in 32
subsection 2. 33
2. The Director shall by regulation establish the manner in 34
which a health information exchange may apply for certification and 35
the requirements for granting such certification, which must include, 36
without limitation, that the health information exchange demonstrate 37
its financial and operational sustainability, adherence to the privacy, 38
security and patient consent standards adopted pursuant to NRS 39
439.589 and capacity for interoperability with an y other health 40
information exchange certified pursuant to this section. 41
3. The Director may deny an application for certification or 42
may suspend or revoke any certification issued pursuant to 43
subsection 2 for failure to comply with the provisions of NRS 44
439.581 to 439.597, inclusive, and section 3 of this act or the 45

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regulations adopted pursuant thereto or any applicable federal or 1
state law. 2
4. When the Director intends to deny, suspend or revoke a 3
certification, he or she shall give reasonable notice t o all parties by 4
certified mail. The notice must contain the legal authority, 5
jurisdiction and reasons for the action to be taken. A health 6
information exchange that wishes to contest the action of the 7
Director must file an appeal with the Director. 8
5. The Director shall adopt regulations establishing the manner 9
in which a person may file a complaint with the Director regarding a 10
violation of the provisions of this section. 11
6. The Director may impose an administrative fine against a 12
health information e xchange which operates in this State without 13
holding a certification in an amount established by the Director by 14
regulation. The Director shall afford a health information exchange 15
so fined an opportunity for a hearing pursuant to the provisions of 16
NRS 233B.121. 17
7. The Director may adopt such regulations as he or she 18
determines are necessary to carry out the provisions of this section. 19
Sec. 8. NRS 439.589 is hereby amended to read as follows: 20
439.589 1. The Director, in consultation with health care 21
providers, third parties and other interested persons and entities, 22
shall by regulation prescribe a framework for the electronic 23
maintenance, transmittal and exchange of electronic health records, 24
prescriptions, health -related information and electronic signatures 25
and requirements for electronic equivalents of written entries or 26
written approvals in accordance with federal law. The regulations 27
must: 28
(a) Establish standards for networks and technologies to be used 29
to maintain, transmit and exchange health information, including, 30
without limitation, standards: 31
(1) That require: 32
(I) The use of networks and technologies that allow 33
patients to access electronic health records directly from the health 34
care provider of the patient and forward such electronic health 35
records electronically to other persons and entities; and 36
(II) The interoperability of such networks and 37
technologies in accordance with the applicable standards for the 38
interoperability of Qualified Health Information Networks 39
prescribed by the Office of the National Coordinator for Health 40
Information Technology of the United States Department of Health 41
and Human Services; 42
(2) To ensure that electronic health records retained or shared 43
are secure; 44

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(3) To maintain the confidentiality of electronic health 1
records and health -related information, including, without 2
limitation, standards to maintain the confidentiality of electronic 3
health records relating to a child who has received health care 4
services without the consent of a parent or guardian and which 5
ensure that a child’s right to access such health care services i s not 6
impaired; 7
(4) To ensure the privacy of individually identifiable health 8
information, including, without limitation, standards to ensure the 9
privacy of information relating to a child who has received health 10
care services without the consent of a parent or guardian; 11
(5) For obtaining consent from a patient before retrieving the 12
patient’s health records from a health information exchange, 13
including, without limitation, standards for obtaining such consent 14
from a child who has received health care se rvices without the 15
consent of a parent or guardian; 16
(6) For making any necessary corrections to information or 17
records; 18
(7) For notifying a patient if the confidentiality of 19
information contained in an electronic health record of the patient is 20
breached; 21
(8) Governing the ownership, management and use of 22
[electronic health records, ] health-related information and related 23
data [;] and the management and use of electronic health records; 24
and 25
(9) For the electronic transmission of prior authorizations for 26
prescription medication; 27
(b) Ensure compliance with the requirements, specifications and 28
protocols for exchanging, securing and disclosing electronic health 29
records, health -related information and related data prescribed 30
pursuant to the provisions of the Health Information Technology for 31
Economic and Clinical Health Act, 42 U.S.C. §§ 300jj et seq. and 32
17901 et seq., the Health Insurance Portability and Accountability 33
Act of 1996, Public Law 104 -191, and other applicable federal and 34
state law; and 35
(c) Be based on nationally recognized best practices for 36
maintaining, transmitting and exchanging health information 37
electronically. 38
2. The standards prescribed pursuant to this section must 39
include, without limitation: 40
(a) Requirements for the creation, ma intenance and transmittal 41
of electronic health records; 42
(b) Requirements for protecting confidentiality, including 43
control over, access to and the collection, organization and 44

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maintenance of electronic health records, health -related information 1
and individually identifiable health information; 2
(c) Requirements for the manner in which a patient may, 3
through a health care provider who participates in the sharing of 4
health records using a health information exchange, revoke his or 5
her consent for a health ca re provider to retrieve the patient’s health 6
records from the health information exchange; 7
(d) A secure and traceable electronic audit system for 8
identifying access points and trails to electronic health records and 9
health information exchanges; 10
(e) Requirements to minimize the need for a patient to 11
repeatedly provide demographic information, information relating 12
to his or her medical history and the list of medications that the 13
patient is currently taking or has taken in the past; and 14
[(e)] (f) Any oth er requirements necessary to comply with all 15
applicable federal laws relating to electronic health records, health -16
related information, health information exchanges and the security 17
and confidentiality of such records and exchanges. 18
3. The regulations ad opted pursuant to this section must not 19
require any person or entity to use a health information exchange. 20
4. Except as otherwise provided in subsections 5, 6 and 7 , the 21
Department and the divisions thereof, other state and local 22
governmental entities, health care providers, third parties, pharmacy 23
benefit managers and other entities licensed or certified pursuant to 24
title 57 of NRS shall maintain, transmit and exchange health 25
information in accordance with the regulations adopted pursuant to 26
this section, the provisions of NRS 439.581 to 439.597, inclusive, 27
and section 3 of this act and any other regulations adopted pursuant 28
thereto. 29
5. The Federal Government and employees thereof, a provider 30
of health coverage for federal employees, a provider of h ealth 31
coverage that is subject to the Employee Retirement Income 32
Security Act of 1974, 29 U.S.C. §§ 1001 et seq., or a Taft -Hartley 33
trust formed pursuant to 29 U.S.C. § 186(c)(5) is not required to but 34
may maintain, transmit and exchange electronic informa tion in 35
accordance with the regulations adopted pursuant to this section. 36
6. A health care provider may apply to the Department for a 37
waiver from the provisions of subsection 4 on the basis that the 38
health care provider does not have the infrastructure necessary to 39
comply with those provisions, including, without limitation, because 40
the health care provider does not have access to the Internet. The 41
Department shall grant a waiver if it determines that: 42
(a) The health care provider does not currently hav e the 43
infrastructure necessary to comply with the provisions of subsection 44
4; and 45

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(b) Obtaining such infrastructure is not reasonably practicable, 1
including, without limitation, because the cost of such infrastructure 2
would make it difficult for the healt h care provider to continue to 3
operate. 4
7. The provisions of subsection 4 do not apply to the 5
Department of Corrections. 6
8. A violation of the provisions of this section or any 7
regulations adopted pursuant thereto is not a misdemeanor. 8
9. As used in this section: 9
(a) “Pharmacy benefit manager” has the meaning ascribed to it 10
in NRS 683A.174. 11
(b) “Third party” means any insurer, governmental entity or 12
other organization providing health coverage or benefits in 13
accordance with state or federal law. 14
Sec. 9. NRS 439.593 is hereby amended to read as follows: 15
439.593 A health care provider who with reasonable care 16
transmits, accesses, utilizes, discloses, relies upon or provides to a 17
patient an apparently genuine electronic health record in accordance 18
with NRS 439.581 to 439.597, inclusive, and section 3 of this act 19
and the regulations adopted pursuant thereto is immune from civil or 20
criminal liability for any decision concerning the provision of health 21
care to a patient and any civil or criminal liability resulting from the 22
provision of the record to a patient if: 23
1. The electronic health record is inaccurate; 24
2. The inaccuracy was not caused by the health care provider; 25
3. The inaccuracy resulted in an inappropriate health care 26
decision; and 27
4. The health care decision was appropriate based upon the 28
information contained in the inaccurate electronic health record. 29
Sec. 10. NRS 439.597 is hereby amended to read as follows: 30
439.597 1. If a covered entity transmits electronically 31
individually identifiable health information in compliance with the 32
provisions of: 33
(a) The Health Insurance Portability and Accountability Act of 34
1996, Public Law 104-191; and 35
(b) NRS 439.581 to 439.597, inclusive, and section 3 of this act 36
and the regulations adopted pursuant thereto, 37
 which govern the electronic transmission of such information, the 38
covered entity is, for purposes of the electronic transmission, 39
exempt from any state law that contains more stringent requirements 40
or provisions concerning the privacy or confidentiality of 41
individually identifiable health information. 42
2. A covered entity that makes individually identifiable health 43
information available electronically pursuant to subsection 1 shall 44
allow any person to opt out of having his or her individually 45

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identifiable health inform ation disclosed electronically to other 1
covered entities [,] or to prohibit any person or entity from 2
accessing his or her individually identifiable health information, 3
except: 4
(a) As required by the administrative simplification provisions 5
of the Health Insurance Portability and Accountability Act of 1996, 6
Public Law 104-191. 7
(b) As otherwise required by a state law. 8
(c) That a person who is a recipient of Medicaid or insurance 9
pursuant to the Children’s Health Insurance Program may not [opt] : 10
(1) Opt out of having his or her individually identifiable 11
health information disclosed electronically [.] ; or 12
(2) Prohibit any person or entity from accessing his or her 13
individually identifiable health information where access for that 14
person or entity is deemed necessary by the Department for 15
purposes of Medicaid or the Children’s Health Insurance 16
Program. 17
3. As used in this section, “covered entity” has the meaning 18
ascribed to it in 45 C.F.R. § 160.103. 19
Sec. 11. (Deleted by amendment.) 20
Sec. 12. NRS 287.010 is hereby amended to read as follows: 21
287.010 1. The governing body of any county, school 22
district, municipal corporation, political subdivision, public 23
corporation or other local governmental agency of the State of 24
Nevada may: 25
(a) Adopt and carry into effect a system of group life, accident 26
or health insurance, or any combination thereof, for the benefit of its 27
officers and employees, and the dependents of officers and 28
employees w ho elect to accept the insurance and who, where 29
necessary, have authorized the governing body to make deductions 30
from their compensation for the payment of premiums on the 31
insurance. 32
(b) Purchase group policies of life, accident or health insurance, 33
or an y combination thereof, for the benefit of such officers and 34
employees, and the dependents of such officers and employees, as 35
have authorized the purchase, from insurance companies authorized 36
to transact the business of such insurance in the State of Nevada , 37
and, where necessary, deduct from the compensation of officers and 38
employees the premiums upon insurance and pay the deductions 39
upon the premiums. 40
(c) Provide group life, accident or health coverage through a 41
self-insurance reserve fund and, where neces sary, deduct 42
contributions to the maintenance of the fund from the compensation 43
of officers and employees and pay the deductions into the fund. The 44
money accumulated for this purpose through deductions from the 45

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compensation of officers and employees and co ntributions of the 1
governing body must be maintained as an internal service fund as 2
defined by NRS 354.543. The money must be deposited in a state or 3
national bank or credit union authorized to transact business in the 4
State of Nevada. Any independent admi nistrator of a fund created 5
under this section is subject to the licensing requirements of chapter 6
683A of NRS, and must be a resident of this State. Any contract 7
with an independent administrator must be approved by the 8
Commissioner of Insurance as to the reasonableness of 9
administrative charges in relation to contributions collected and 10
benefits provided. The provisions of NRS 439.581 to 439.597, 11
inclusive, and section 3 of this act, 686A.135, 687B.352, 687B.408, 12
687B.692, 687B.723, 687B.725, 687B.805, 68 9B.030 to 13
689B.0317, inclusive, paragraphs (b) and (c) of subsection 1 of NRS 14
689B.0319, subsections 2, 4, 6 and 7 of NRS 689B.0319, 689B.033 15
to 689B.0369, inclusive, 689B.0375 to 689B.050, inclusive, 16
689B.0675, 689B.265, 689B.287 and 689B.500 apply to cov erage 17
provided pursuant to this paragraph, except that the provisions of 18
NRS 689B.0378, 689B.03785 and 689B.500 only apply to coverage 19
for active officers and employees of the governing body, or the 20
dependents of such officers and employees. 21
(d) Defray pa rt or all of the cost of maintenance of a self -22
insurance fund or of the premiums upon insurance. The money for 23
contributions must be budgeted for in accordance with the laws 24
governing the county, school district, municipal corporation, 25
political subdivision, public corporation or other local governmental 26
agency of the State of Nevada. 27
2. If a school district offers group insurance to its officers and 28
employees pursuant to this section, members of the board of trustees 29
of the school district must not be excluded from participating in the 30
group insurance. If the amount of the deductions from compensation 31
required to pay for the group insurance exceeds the compensation to 32
which a trustee is entitled, the difference must be paid by the trustee. 33
3. In any county in which a legal services organization exists, 34
the governing body of the county, or of any school district, 35
municipal corporation, political subdivision, public corporation or 36
other local governmental agency of the State of Nevada in the 37
county, may enter into a contract with the legal services 38
organization pursuant to which the officers and employees of the 39
legal services organization, and the dependents of those officers and 40
employees, are eligible for any life, accident or health insurance 41
provided pursuant to this section to the officers and employees, and 42
the dependents of the officers and employees, of the county, school 43
district, municipal corporation, political subdivision, public 44
corporation or other local governmental agency. 45

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4. If a contr act is entered into pursuant to subsection 3, the 1
officers and employees of the legal services organization: 2
(a) Shall be deemed, solely for the purposes of this section, to be 3
officers and employees of the county, school district, municipal 4
corporation, political subdivision, public corporation or other local 5
governmental agency with which the legal services organization has 6
contracted; and 7
(b) Must be required by the contract to pay the premiums or 8
contributions for all insurance which they elect to accept or of which 9
they authorize the purchase. 10
5. A contract that is entered into pursuant to subsection 3: 11
(a) Must be submitted to the Commissioner of Insurance for 12
approval not less than 30 days before the date on which the contract 13
is to become effective. 14
(b) Does not become effective unless approved by the 15
Commissioner. 16
(c) Shall be deemed to be approved if not disapproved by the 17
Commissioner within 30 days after its submission. 18
6. As used in this section, “legal services organization” means 19
an or ganization that operates a program for legal aid and receives 20
money pursuant to NRS 19.031. 21
Sec. 13. NRS 287.04335 is hereby amended to read as 22
follows: 23
287.04335 If the Board provides health insurance through a 24
plan of s elf-insurance, it shall comply with the provisions of NRS 25
439.581 to 439.597, inclusive, and section 3 of this act, 686A.135, 26
687B.352, 687B.409, 687B.692, 687B.723, 687B.725, 687B.805, 27
689B.0353, 689B.255, 695C.1723, 695G.150, 695G.155, 695G.160, 28
695G.162, 695G.1635, 695G.164, 695G.1645, 695G.1665, 29
695G.167, 695G.1675, 695G.170 to 695G.1712, inclusive, 30
695G.1714 to 695G.174, inclusive, 695G.176, 695G.177, 695G.200 31
to 695G.230, inclusive, 695G.241 to 695G.310, inclusive, 695G.405 32
and 695G.415, in the same manner as an insurer that is licensed 33
pursuant to title 57 of NRS is required to comply with those 34
provisions. 35
Sec. 14. NRS 603A.100 is hereby amended to read as follows: 36
603A.100 1. The provisions of NRS 603A.010 to 603A.290, 37
inclusive, do not apply to the maintenance or transmittal of 38
information in accordance with NRS 439.581 to 43 9.597, inclusive, 39
and section 3 of this act, and the regulations adopted pursuant 40
thereto. 41
2. A data collector who is also an operator, as defined in NRS 42
603A.330, shall comply with the provisions of NRS 603A.300 to 43
603A.360, inclusive. 44

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3. Any waiver of the provisions of NRS 603A.010 to 1
603A.290, inclusive, is contrary to public policy, void and 2
unenforceable. 3
Sec. 15. NRS 629.051 is hereby amended to read as follows: 4
629.051 1. Except as otherwise provided in this s ection and 5
in regulations adopted by the State Board of Health pursuant to NRS 6
652.135 with regard to the records of a medical laboratory and 7
unless a longer period is provided by federal law, each custodian of 8
health care records shall retain the health c are records of patients as 9
part of the regularly maintained records of the custodian for 5 years 10
after their receipt or production. Health care records may be retained 11
in written form, or by microfilm or any other recognized form of 12
size reduction, includi ng, without limitation, microfiche, computer 13
disc, magnetic tape and optical disc, which does not adversely affect 14
their use for the purposes of NRS 629.061. Health care records: 15
(a) Must, except as otherwise provided in subsections 5 and 6 of 16
NRS 439.589 , be created, maintained, transmitted and exchanged 17
electronically as required by subsection 4 of NRS 439.589; and 18
(b) May be created, authenticated and stored in a health 19
information exchange which meets the requirements of NRS 20
439.581 to 439.597, inclus ive, and section 3 of this act and the 21
regulations adopted pursuant thereto. 22
2. A provider of health care shall post, in a conspicuous place 23
in each location at which the provider of health care performs health 24
care services, a sign which discloses to patients that their health care 25
records may be destroyed after the period set forth in subsection 1. 26
3. When a provider of health care performs health care services 27
for a patient for the first time, the provider of health care shall 28
deliver to the patient a written statement which discloses to the 29
patient that the health care records of the patient may be destroyed 30
after the period set forth in subsection 1. 31
4. If a provider of health care fails to deliver the written 32
statement to the patient pursuant to subsection 3, the provider of 33
health care shall deliver to the patient the written statement 34
described in subsection 3 when the provider of health care next 35
performs health care services for the patient. 36
5. In addition to delivering a written statement p ursuant to 37
subsection 3 or 4, a provider of health care may deliver such a 38
written statement to a patient at any other time. 39
6. A written statement delivered to a patient pursuant to this 40
section may be included with other written information delivered t o 41
the patient by a provider of health care. 42
7. A custodian of health care records shall not destroy the 43
health care records of a person who is less than 23 years of age on 44
the date of the proposed destruction of the records. The health care 45

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records of a person who has attained the age of 23 years may be 1
destroyed in accordance with this section for those records which 2
have been retained for at least 5 years or for any longer period 3
provided by federal law. 4
8. The health care records of a patient are the property of the 5
patient. 6
9. If a health care licensing board receives notification from the 7
Department of Health and Human Services pursuant to NRS 8
439.5895 that a provider of health care to which the health care 9
licensing b oard has issued a license is not in compliance with the 10
requirements of subsection 4 of NRS 439.589, the health care 11
licensing board may, after notice and the opportunity for a hearing 12
in accordance with the provisions of this title, require corrective 13
action or impose an administrative penalty in an amount not to 14
exceed the maximum penalty that the health care licensing board is 15
authorized to impose for other violations. The health care licensing 16
board shall not suspend or revoke a license for failure to c omply 17
with the requirements of subsection 4 of NRS 439.589. 18
[9.] 10. The provisions of this section, except for the 19
provisions of paragraph (a) of subsection 1 and subsection [8,] 9, do 20
not apply to a pharmacist. 21
[10.] 11. The State Board of Health shall adopt: 22
(a) Regulations prescribing the form, size, contents and 23
placement of the signs and written statements required pursuant to 24
this section; and 25
(b) Any other regulations necessary to carry out the provisions 26
of this section. 27
[11.] 12. As used in this section: 28
(a) “Health care licensing board” means: 29
(1) A board created pursuant to chapter 630, 630A, 631, 632, 30
633, 634, 634A, 635, 636, 637, 637B, 639, 640, 640A, 640B, 640C, 31
641, 641A, 641B, 641C or 641D of NRS. 32
(2) The Division of Public and Behavioral Health of the 33
Department of Health and Human Services. 34
(3) The State Board of Health with respect to licenses issued 35
pursuant to chapter 640D or 640E of NRS. 36
(b) “License” has the meaning ascribed to it in NRS 439.5895. 37
Sec. 16. NRS 719.200 is hereby amended to read as follows: 38
719.200 1. Except as otherwise provided in subsection 2, the 39
provisions of this chapter apply to electronic records and electronic 40
signatures relating to a transaction. 41
2. The provisions of this chapter do not apply to a transaction 42
to the extent it is governed by: 43

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(a) Except as otherwise specifically provided by law, a law 1
governing the creation and execution of wills, codicils or 2
testamentary trusts; 3
(b) The Unifo rm Commercial Code other than NRS 104.1306, 4
104.2101 to 104.2725, inclusive, and 104A.2101 to 104A.2532, 5
inclusive; or 6
(c) The provisions of NRS 439.581 to 439.597, inclusive, and 7
section 3 of this act and the regulations adopted pursuant thereto. 8
3. The provisions of this chapter apply to an electronic record 9
or electronic signature otherwise excluded from the application of 10
this chapter under subsection 2 to the extent it is governed by a law 11
other than those specified in subsection 2. 12
4. A transaction subject to the provisions of this chapter is also 13
subject to other applicable substantive law. 14
Sec. 16.5. 1. On or before April 30, 2026, July 3 1, 2026, 15
October 3 1, 2026 , and December 3 1, 2026, the Director o f the 16
Department of Health and Human Services shall: 17
(a) Compile a report concerning the progress made by the 18
Department toward implementing the provisions of this act. The 19
report must include, without limitation: 20
(1) A summary of the actions taken duri ng the immediately 21
preceding calendar quarter to implement the provisions of this act; 22
(2) Identification of any challenges encountered during the 23
implementation of the provisions of this act and the strategies that 24
the Department is using to address those challenges; 25
(3) A timeline of the dates that the Department has 26
completed tasks necessary to implement the provisions of this act 27
and the dates that the Department expects to complete such tasks 28
that are yet to be completed; 29
(4) An assessment of the adequacy of resources allocated for 30
implementing the provisions of this act, including, without 31
limitation, money, staff and technology; and 32
(5) Any recommendations for legislation or administrative 33
actions necessary to effectively implement the provisions of this act. 34
(b) Submit the report to the Governor and the Director of the 35
Legislative Counsel Bureau for transmittal to: 36
(1) For the reports submitted on or before April 30, 2026 , 37
and July 31, 2026, the Joint Interim Standing Committee on Health 38
and Human Services; and 39
(2) For the reports submitted on or before October 3 1, 2026, 40
and December 3 1, 2026, the Legislative Commission and the 84th 41
Session of the Legislature. 42
(c) Post the report on an Internet website maintained by the 43
Department. 44

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2. The Director of the Department of Health and Human 1
Services or his or her designee shall appear before the Joint Interim 2
Standing Committee on Health and Human Services or the 3
Legislative Commission upon request to provide information 4
relating to any report submitted pursuant to this section. 5
Sec. 17. (Deleted by amendment.) 6
Sec. 18. The provisions of NRS 354.599 do not apply to any 7
additional expenses of a local government that are related to the 8
provisions of this act. 9
Sec. 19. 1. This section becomes effective upon passage and 10
approval. 11
2. Sections 1 to 18, inclusive, of this act become effective: 12
(a) Upon passage and approval for the purpose of adopting any 13
regulations and performing any other preliminary administrative 14
tasks that are necessary to carry out the provisions of this act; and 15
(b) On January 1, 2026, for all other purposes. 16

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