Read the full stored bill text
- 83rd Session (2025)
Senate Bill No. 257 –Senators Dondero Loop, Cruz -Crawford,
Krasner, Ohrenschall; Cannizzaro, Flores, Nguyen , Pazina
and Rogich
Joint Sponsor: Assemblymember Torres-Fossett
CHAPTER..........
AN ACT relating to autism; revising requirements governing the
statewide standard for measuring outcomes and assessing and
evaluating certain persons with autism spectrum disorders;
revising requirements governing early intervention services
for persons wi th autism spectrum disorders; requiring an
insurer to accept as dispositive certain diagnoses of persons
with autism spectrum disorders for purposes related to
required coverage for the diagnosis and treatment of such
disorders; requiring insurers to cover such diagnosis and
treatment provided by any provider of health care acting
within his or her scope of practice; and providing other
matters properly relating thereto.
Legislative Counsel’s Digest:
Existing law requires the Aging and Disability Services Division of the
Department of Health and Human Services to prescribe by regulation a statewide
standard for measuring outcomes and assessing and evaluating persons with autism
spectrum disorders through the age of 21 years who receive services through the
State or a local government or an agency thereof. Existing law requires those
regulations to designate a protocol based upon accepted best practices guidelines
which includes at least one standardized assessment instrument that requires direct
observation by the professional conducting the assessment for determining whether
a person is a person with autism spectrum disorder. Existing law requires such
direct observation to include an evaluation to measure behaviors of the person
which are consistent with au tism spectrum disorder, cognitive functioning,
language functioning and adaptive functioning. (NRS 427A.872) Section 3 of this
bill removes the requirements that the statewide standard include a specific
protocol, a standardized assessment instrument and a n evaluation to measure
behaviors which are consistent with autism spectrum disorder. Instead, section 3
requires the statewide standard to require direct observation and an assessment to
determine whether a person is a person with autism spectrum disorder . Section 3
authorizes any provider of health care acting within his or her scope of practice to
conduct such direct observation and assessment. Section 4 of this bill makes similar
revisions relating to early intervention services provided by the Division for
children with autism spectrum disorders. Specifically, section 4: (1) replaces
references to an evaluation of a child who may have autism spectrum disorder by
the Division with references to an assessment of such a child; and (2) authorizes
any provid er of health care acting within his or her scope of practice to conduct
such an assessment. Section 1 of this bill defines the term “provider of health care”
for those purposes, and section 2 of this bill prescribes the applicability of that
definition.
Existing law requires the Division to ensure that employees and contractors of
the Division who provide early intervention services to children with autism
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spectrum disorders possess the knowledge and skills necessary to serve children
with autism spectrum disorders, including the screening of a child for autism
spectrum disorder at certain age levels and frequency. (NRS 427A.878) Section 4
specifies that such persons must possess the knowledge and skills necessary to
conduct early and periodic developmental screening of a child for that purpose.
Existing law requires certain plans of health insurance, including insurance for
public employees and Medicaid managed care plans, to cover screening for and
diagnosis of autism spectrum disorders and for treatment of autism spectrum
disorders to persons under the age of 18 years or, if enrolled in high school, until
the person reaches the age of 22 years. In order for coverage of such treatment to be
required, existing law requires: (1) the diagnosis to be rendered by a licensed
physician or psychologist; (2) the treatment to be included in a treatment plan
developed by a licensed physician or psychologist; and (3) the treatment to be
provided by or under the supervision of a licensed physician, psychologist or
behavior analyst. (NRS 287.0276, 287.04335, 689A.0435, 689B.0335, 689C.1655,
695C.050, 695C.1717, 695G.1645) Sections 5-10 of this bill remove requirements
that, in order for such coverage to be required, the diagnosis must be rendered by
specific providers of health care and the treatment plan must be developed and
carried out by specific providers of health care. Instead, sections 5-10 require
certain plans of health insurance to cover such diagnosis and treatment if the
diagnosis, development of a treatment p lan and treatment are performed by any
provider of health care acting within his or her scope of practice. Sections 5-10 also
require an insurer to accept as dispositive for the purposes of such coverage any
diagnosis of an autism spectrum disorder that is rendered in accordance with the
statewide standard prescribed pursuant to section 3.
EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted.
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1. Chapter 427A of NRS is hereby amended by
adding thereto a new section to read as follows:
“Provider of health care” has the meaning ascribed to it in
NRS 629.031.
Sec. 2. NRS 427A.871 is hereby amended to read as follows:
427A.871 As used in NRS 427A.871 to 427A.8803, inclusive,
and section 1 of this act, unless the co ntext otherwise requires, the
words and terms defined in NRS 427A.8713 and 427A.8715 and
section 1 of this act have the meanings ascribed to them in those
sections.
Sec. 3. NRS 427A.872 is hereby amended to read as follows:
427A.872 1. The Division, in cooperation and guidance with
the Department of Education, representatives of the school districts
in this State and the Commission, shall prescribe by regulation a
statewide standard for measuring outcomes and assessing [and
evaluating] persons with autism spectrum disorders through the age
of 21 years who receive services through the State or a local
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government or an agency thereof. The regulations must [designate a
protocol based upon accepted ] align with best practices guidelines
[which includes at least one standardized assessment instrument that
requires] and require direct observation by [the professional ] a
provider of health care conducting [the] an assessment for
determining whether a person is a person with autism spectrum
disorder . [, which ] The statewide standard must be used by
personnel employed by the State or a local government or an agency
thereof who provide assessments, interventions and diagnoses of
persons with autism spectrum disorders through the age of 21 years
and by the persons with whom the State or a local government or an
agency thereof contracts to provide assessments, interventions and
diagnoses of persons with autism spectrum disorders through the
age of 21 years. [The protocol must require that the direct
observation conducted by a professional pursuant to this subsection
include, without limitation, an evaluation to measure behaviors of
the person which are consistent with autism spectrum disorder,
cognitive functioning, language functioning and adaptive
functioning.]
2. The statewide standard prescribed pursuant to subsection 1
must authorize a provider of health care to directly observe a
person and complete an assessment to determine whether the
person is a person with autism spectrum disorder so long as
conducting such observation and completing such an assessment
are within the scope of practice of the provider of health care.
3. The [protocol designated ] statewide standard prescribed
pursuant to subsection 1 must be used upon intake of a person
suspected of having autism spectrum disorder or at any later time if
a person is suspected of having autism spectrum disorder after
intake. The results of an assessment must be provided to the parent
or legal guardian of the person, if applicable.
[3.] 4. The Division shall prescribe the form and content of
reports relating to persons with autism spectrum disorders through
the age of 21 years that must be reported to the Division pursuant to
NRS 388.451 and 615.205. Except as otherwise provided in NRS
388.451, the Division shall ensure that the information is reported in
a manner which:
(a) Allows the Division to document the services provided to
and monitor the progress of each person with autism spectrum
disorder through the age of 21 years who receives services from the
State or an agency thereof; and
(b) Ensures that information reported for each person who
receives services which identifies the person is kept confidential,
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consistent with the Family Educational Rights and Privacy Act of
1974, 20 U.S.C. § 1232g, and any other applicable state and federal
privacy laws.
[4.] 5. The Division shall prepare annually a summary of the
reports submitted pursuant to NRS 388.451 and 615.205 and make
the summary publicly available. The Division shall ensure tha t
information contained in the summary does not identify a person
who received services.
Sec. 4. NRS 427A.878 is hereby amended to read as follows:
427A.878 1. The Division shall ensure that the personnel
employed by the Division who provide early intervention services to
children with autism spectrum disorders and the persons with whom
the Division contracts to provide early intervention services to
children with autism spectrum disorders po ssess the knowledge and
skills necessary to serve children with autism spectrum disorders,
including, without limitation:
(a) [The] Early and periodic developmental screening of a child
for autism spectrum disorder at the age levels and frequency
recommended by the American Academy of Pediatrics, or its
successor organization;
(b) The procedure for [evaluating] assessing children who
demonstrate behaviors that are consistent with autism spectrum
disorders, which procedure must require the use of the state wide
standard for measuring outcomes and assessing [and evaluating ]
persons with autism spectrum disorders through the age of 21 years
prescribed pursuant to NRS 427A.872;
(c) The procedure for enrolling a child in early intervention
services upon determining that the child has autism spectrum
disorder;
(d) Methods of providing support to children with autism
spectrum disorders and their families; and
(e) The procedure for developing an individualized family
service plan in accordance with Part C of the Individuals with
Disabilities Education Act, 20 U.S.C. §§ 1431 et seq., or other
appropriate plan for the child.
2. The Division shall ensure that the personnel employed by
the Division to provide early intervention services to children with
autism spectrum disorders and the persons with whom the Division
contracts to provide early intervention services to children with
autism spectrum disorders:
(a) Possess the knowledge and understanding of the scientific
research and support for the methods and approaches for serving
children with autism spectrum disorders and the ability to recognize
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the difference between an approach or method that is scientifically
validated and one that is not;
(b) Possess the knowledge to accurately describe to parents and
guardians the research supporting the methods and approaches,
including, without limitation, the knowledge necessary to provide an
explanation that a method or approach is experimental if it is not
supported by scientific evidence;
(c) Immediately notify a parent or legal guardian if a child is
identified as being at risk for a diagnosis of autism spectrum
disorder and refer the parent or legal guardian to the appropriate
professionals for further evaluation and simultaneously refer the
parent or legal gu ardian to any appropriate early intervention
services and strategies; and
(d) Provide the parent or legal guardian with information on
evidence-based treatments and interventions that may assist the
child in the child’s development and advancement.
3. The Division shall ensure that the personnel employed by
the Division who provide early intervention screenings to children
and the persons with whom the Division contracts to provide early
intervention screenings to children perform screenings of children
for autism spectrum disorders at the age levels and frequency
recommended by the American Academy of Pediatrics, or its
successor organization.
4. The Division shall ensure that:
(a) For a child who may have autism spectrum disorder, the
personnel employed by the Division who provide early intervention
screenings to children and the persons with whom the Division
contracts to provide early intervention screenings to children use the
[protocol designated ] statewide standard prescribed pursuant to
NRS 427A.872 for determining whether a child has autism spectrum
disorder.
(b) An initial [evaluation] assessment of the cognitive,
communicative, social, emotional and behavioral condition and
adaptive skill level of a child with autism spectrum disorder is
conducted by a provider of health care acting within his or her
scope of practice to determine the baseline of the child.
(c) A subsequent [evaluation] assessment is conducted by a
provider of health care acting within his or her scope of practice
upon the child’s conclusion of the early intervention services to
determine the progress made by the child from the time of his or her
initial screening.
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Sec. 5. NRS 287.0276 is hereby amended to read as follows:
287.0276 1. The governing body of any county, school
district, municipal corporation, political subdivision, public
corporation or other local governmental agency of the State of
Nevada that provides health insurance through a plan of self-
insurance must provide coverage for screening for and diagnosis of
autism spectrum disorders and for treatment of autism spectrum
disorders to persons covered by the plan of self -insurance under the
age of 18 years or, if enrolled in high school, unti l the person
reaches the age of 22 years. For the purposes of such coverage, the
governing body of a county, school district, municipal corporation,
political subdivision, public corporation or other local
governmental agency shall accept as dispositive an y diagnosis of
an autism spectrum disorder that is rendered in accordance with
the statewide standard for measuring outcomes and assessing
persons with autism spectrum disorders through the age of 21
years prescribed pursuant to NRS 427A.872.
2. Coverage provided under this section is subject to:
(a) A maximum benefit of the actuarial equivalent of $72,000
per year for applied behavior analysis treatment; and
(b) Copayment, deductible and coinsurance provisions and any
other general exclusion or limitat ion of a plan of self -insurance to
the same extent as other medical services or prescription drugs
covered by the policy.
3. A governing body of any county, school district, municipal
corporation, political subdivision, public corporation or other local
governmental agency of the State of Nevada that provides health
insurance through a plan of self -insurance which provides coverage
for outpatient care shall not:
(a) Require an insured to pay a higher deductible, copayment or
coinsurance or require a long er waiting period for coverage for
outpatient care related to autism spectrum disorders than is required
for other outpatient care covered by the plan of self-insurance; or
(b) Refuse to issue a plan of self -insurance or cancel a plan of
self-insurance solely because the person applying for or covered by
the plan of self -insurance uses or may use in the future any of the
services listed in subsection 1.
4. Except as otherwise provided in subsections 1 and 2, a
governing body of any county, school distric t, municipal
corporation, political subdivision, public corporation or other local
governmental agency of the State of Nevada that provides health
insurance through a plan of self-insurance shall not limit the number
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of visits an insured may make to any pe rson, entity or group for
treatment of autism spectrum disorders.
5. Treatment of autism spectrum disorders must be identified in
a treatment plan and may include medically necessary habilitative or
rehabilitative care, prescription care, psychiatric car e, psychological
care, behavioral therapy or therapeutic care that is:
(a) Prescribed for a person diagnosed with an autism spectrum
disorder by a [licensed physician or licensed psychologist;] provider
of health care acting within his or her scope of practice; and
(b) Provided for a person diagnosed with an autism spectrum
disorder by a [licensed physician, licensed psychologist, licensed
behavior analyst or other provider that is supervised by the licensed
physician, psychologist or behavior analyst. ] provider of health
care acting within his or her scope of practice.
A governing body of any county, school district, municipal
corporation, political subdivision, public corporation or other local
governmental agency of the State of Nevada that provides h ealth
insurance through a plan of self -insurance may request a copy of
and review a treatment plan created pursuant to this subsection.
6. A plan of self -insurance subject to the provisions of this
chapter that is delivered, issued for delivery or renewe d on or after
[July] January 1, [2011,] 2026, has the legal effect of including the
coverage required by subsection 1, and any provision of the plan of
self-insurance or the renewal which is in conflict with subsection 1
or 2 is void.
7. Nothing in this section shall be construed as requiring a
governing body of any county, school district, municipal
corporation, political subdivision, public corporation or other local
governmental agency of the State of Nevada that provides health
insurance through a plan of self-insurance to provide reimbursement
to a school for services delivered through school services.
8. As used in this section:
(a) “Applied behavior analysis” means the design,
implementation and evaluation of environmental modifications
using behavioral stimuli and consequences to produce socially
significant improvement in human behavior, including, without
limitation, the use of direct observation, measurement and
functional analysis of the relations between environment and
behavior.
(b) “Autism spectrum disorder” has the meaning ascribed to it in
NRS 427A.875.
(c) “Behavioral therapy” means any interactive therapy derived
from evidence-based research, including, without limitation, discrete
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trial training, early intensive behavioral interve ntion, intensive
intervention programs, pivotal response training and verbal behavior
provided by a licensed psychologist, licensed behavior analyst,
licensed assistant behavior analyst or registered behavior technician.
(d) “Evidence-based research” mean s research that applies
rigorous, systematic and objective procedures to obtain valid
knowledge relevant to autism spectrum disorders.
(e) “Habilitative or rehabilitative care” means counseling,
guidance and professional services and treatment programs,
including, without limitation, applied behavior analysis, that are
necessary to develop, maintain and restore, to the maximum extent
practicable, the functioning of a person.
(f) “Licensed assistant behavior analyst” has the meaning
ascribed to the term “assistant behavior analyst” in NRS 641D.020.
(g) “Licensed behavior analyst” has the meaning ascribed to the
term “behavior analyst” in NRS 641D.030.
(h) “Prescription care” means medications prescribed by a
licensed physician and any health-related services deemed medically
necessary to determine the need or effectiveness of the medications.
(i) “Provider of health care” has the meaning ascribed to it in
NRS 629.031.
(j) “Psychiatric care” means direct or consultative services
provided by a psychiatrist licensed in the state in which the
psychiatrist practices.
[(j)] (k) “Psychological care” means direct or consultative
services provided by a psychologist licensed in the state in which
the psychologist practices.
[(k)] (l) “Registered behavior technici an” has the meaning
ascribed to it in NRS 641D.090.
[(l)] (m) “Screening for autism spectrum disorders” means all
medically appropriate assessments, evaluations or tests to diagnose
whether a person has an autism spectrum disorder.
[(m)] (n) “Therapeutic care” means services provided by
licensed or certified speech -language pathologists, occupational
therapists and physical therapists.
[(n)] (o) “Treatment plan” means a plan to treat an autism
spectrum disorder that is [prescribed] developed by a [licensed
physician or licensed psychologist and may be developed pursuant
to a comprehensive evaluation in coordination with a licensed
behavior analyst.] provider of health care acting within his or her
scope of practice after he or she has assessed the person for whom
the treatment plan is developed.
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Sec. 6. NRS 689A.0435 is hereby amended to read as follows:
689A.0435 1. A health benefit plan must provide an option
of coverage for screening for and diagnosis of autism spectrum
disorders and for treatment of autism spectrum disorders for persons
covered by the policy under the age of 18 years or, if enrolled in
high school, until the person reaches the age of 22 years. For the
purposes of such coverage, an insurer shall accept as dispositive
any diagnosis o f an autism spectrum disorder that is rendered in
accordance with the statewide standard for measuring outcomes
and assessing persons with autism spectrum disorders through the
age of 21 years prescribed pursuant to NRS 427A.872.
2. Optional coverage provided pursuant to this section must be
subject to:
(a) A maximum benefit of not less than the actuarial equivalent
of $72,000 per year for applied behavior analysis treatment; and
(b) Copayment, deductible and coinsurance provisions and any
other gene ral exclusions or limitations of a policy of health
insurance to the same extent as other medical services or
prescription drugs covered by the policy.
3. A health benefit plan that offers or issues a policy of health
insurance which provides coverage for outpatient care shall not:
(a) Require an insured to pay a higher deductible, copayment or
coinsurance or require a longer waiting period for optional coverage
for outpatient care related to autism spectrum disorders than is
required for other outpatient care covered by the policy; or
(b) Refuse to issue a policy of health insurance or cancel a
policy of health insurance solely because the person applying for or
covered by the policy uses or may use in the future any of the
services listed in subsection 1.
4. Except as otherwise provided in subsections 1 and 2, an
insurer who offers optional coverage pursuant to subsection 1 shall
not limit the number of visits an insured may make to any person,
entity or group for treatment of autism spectrum disorders.
5. Treatment of autism spectrum disorders must be identified in
a treatment plan and may include medically necessary habilitative or
rehabilitative care, prescription care, psychiatric care, psychological
care, behavioral therapy or therapeutic care that is:
(a) Prescribed for a person diagnosed with an autism spectrum
disorder by a [licensed physician or licensed psychologist;] provider
of health care acting within his or her scope of practice; and
(b) Provided for a person diagnosed with an autism spectrum
disorder by a [licensed physician, licensed psychologist, licensed
behavior analyst or other provider that is supervised by the licensed
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physician, psychologist or behavior analyst. ] provider of health
care acting within his or her scope of practice.
An insurer may request a copy of and review a treatment plan
created pursuant to this subsection.
6. Nothing in this section shall be construed as requiring an
insurer to provide reimbursement to a school for services delivered
through school services.
7. As used in this section:
(a) “Applied behavior analysis” means the design,
implementation and evaluation of environmental modifications
using behavioral stimuli and consequences to produce socially
significant improvement in human behavior, including, without
limitation, the use of direct observation, measurement and
functional analysis of the relations between environment and
behavior.
(b) “Autism spectrum disorder” has the meaning ascribed to it in
NRS 427A.875.
(c) “Behavioral therapy” means any interactive therapy derived
from evidence-based research, including, without limitation, discrete
trial training, early intensive behavioral intervention, intensive
intervention programs, pivotal response training and verbal behavior
provided by a licensed psychologist, licensed behavior analyst,
licensed assistant behavior analyst or registered behavior technician.
(d) “Evidence-based research” means research that applies
rigorous, systematic and objective procedures to obtain valid
knowledge relevant to autism spectrum disorders.
(e) “Habilitative or rehabilitative care” means counseling,
guidance and professional services and treatment programs,
including, without limitation, applied behavior analysis, that are
necessary to develop, maintain and restore, to the maximum extent
practicable, the functioning of a person.
(f) “Licensed assistant behavior analyst” has the meaning
ascribed to the term “assistant behavior analyst” in NRS 641D.020.
(g) “Licensed behavior analyst” has the meaning ascr ibed to the
term “behavior analyst” in NRS 641D.030.
(h) “Prescription care” means medications prescribed by a
licensed physician and any health-related services deemed medically
necessary to determine the need or effectiveness of the medications.
(i) “Provider of health care” has the meaning ascribed to it in
NRS 629.031.
(j) “Psychiatric care” means direct or consultative services
provided by a psychiatrist licensed in the state in which the
psychiatrist practices.
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[(j)] (k) “Psychological care” means direct or consultative
services provided by a psychologist licensed in the state in which
the psychologist practices.
[(k)] (l) “Registered behavior technician” has the meaning
ascribed to it in NRS 641D.100.
[(l)] (m) “Screening for autism spectrum dis orders” means
medically necessary assessments, evaluations or tests to screen and
diagnose whether a person has an autism spectrum disorder.
[(m)] (n) “Therapeutic care” means services provided by
licensed or certified speech -language pathologists, occupa tional
therapists and physical therapists.
[(n)] (o) “Treatment plan” means a plan to treat an autism
spectrum disorder that is [prescribed] developed by a [licensed
physician or licensed psychologist and may be developed pursuant
to a comprehensive evaluation in coordination with a licensed
behavior analyst.] provider of health care acting within his or her
scope of practice after he or she has assessed the person for whom
the treatment plan is developed.
Sec. 7. NRS 689B.0335 is hereby amended to read as follows:
689B.0335 1. A health benefit plan must provide coverage
for screening for and diagnosis of autism spectrum disorders and for
treatment of autism spectrum disorders to persons covered by the
policy of group health insurance under the ag e of 18 years or, if
enrolled in high school, until the person reaches the age of 22 years.
For the purposes of such coverage, an insurer shall accept as
dispositive any diagnosis of an autism spectrum disorder that is
rendered in accordance with the statewide standard for measuring
outcomes and assessing persons with autism spectrum disorders
through the age of 21 years prescribed pursuant to NRS 427A.872.
2. Coverage provided under this section is subject to:
(a) A maximum benefit of the actuarial equi valent of $72,000
per year for applied behavior analysis treatment; and
(b) Copayment, deductible and coinsurance provisions and any
other general exclusion or limitation of a policy of group health
insurance to the same extent as other medical services o r
prescription drugs covered by the policy.
3. A health benefit plan that offers or issues a policy of group
health insurance which provides coverage for outpatient care shall
not:
(a) Require an insured to pay a higher deductible, copayment or
coinsurance or require a longer waiting period for coverage for
outpatient care related to autism spectrum disorders than is required
for other outpatient care covered by the policy; or
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(b) Refuse to issue a policy of group health insurance or cancel a
policy of group health insurance solely because the person applying
for or covered by the policy uses or may use in the future any of the
services listed in subsection 1.
4. Except as otherwise provided in subsections 1 and 2, an
insurer shall not limit th e number of visits an insured may make to
any person, entity or group for treatment of autism spectrum
disorders.
5. Treatment of autism spectrum disorders must be identified in
a treatment plan and may include medically necessary habilitative or
rehabilitative care, prescription care, psychiatric care, psychological
care, behavioral therapy or therapeutic care that is:
(a) Prescribed for a person diagnosed with an autism spectrum
disorder by a [licensed physician or licensed psychologist;] provider
of health care acting within his or her scope of practice; and
(b) Provided for a person diagnosed with an autism spectrum
disorder by a [licensed physician, licensed psychologist, licensed
behavior analyst or other provider that is supervised by the licensed
physician, psychologist or behavior analyst. ] provider of health
care acting within his or her scope of practice.
An insurer may request a copy of and review a treatment plan
created pursuant to this subsection.
6. A policy subject to the provisions of this chapter that is
delivered, issued for delivery or renewed on or after January 1,
[2011,] 2026, has the legal effect of including the coverage required
by subsection 1, and any provision of the policy or the renewal
which is in conflict with subsection 1 or 2 is void.
7. Nothing in this section shall be construed as requiring an
insurer to provide reimbursement to a school for services delivered
through school services.
8. As used in this section:
(a) “Applied behavior analysis” mean s the design,
implementation and evaluation of environmental modifications
using behavioral stimuli and consequences to produce socially
significant improvement in human behavior, including, without
limitation, the use of direct observation, measurement an d
functional analysis of the relations between environment and
behavior.
(b) “Autism spectrum disorder” has the meaning ascribed to it in
NRS 427A.875.
(c) “Behavioral therapy” means any interactive therapy derived
from evidence-based research, including, without limitation, discrete
trial training, early intensive behavioral intervention, intensive
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intervention programs, pivotal response training and verbal behavior
provided by a licensed psychologist, licensed behavior analyst,
licensed assistant behavior analyst or registered behavior technician.
(d) “Evidence-based research” means research that applies
rigorous, systematic and objective procedures to obtain valid
knowledge relevant to autism spectrum disorders.
(e) “Habilitative or rehabilitative care” means counseling,
guidance and professional services and treatment programs,
including, without limitation, applied behavior analysis, that are
necessary to develop, maintain and restore, to the maximum extent
practicable, the functioning of a person.
(f) “Licensed assistant behavior analyst” has the meaning
ascribed to the term “assistant behavior analyst” in NRS 641D.020.
(g) “Licensed behavior analyst” has the meaning ascribed to the
term “behavior analyst” in NRS 641D.030.
(h) “Prescription car e” means medications prescribed by a
licensed physician and any health-related services deemed medically
necessary to determine the need or effectiveness of the medications.
(i) “Provider of health care” has the meaning ascribed to it in
NRS 629.031.
(j) “Psychiatric care” means direct or consultative services
provided by a psychiatrist licensed in the state in which the
psychiatrist practices.
[(j)] (k) “Psychological care” means direct or consultative
services provided by a psychologist licensed in the state in which
the psychologist practices.
[(k)] (l) “Registered behavior technician” has the meaning
ascribed to it in NRS 641D.100.
[(l)] (m) “Screening for autism spectrum disorders” means
medically necessary assessments, evaluations or tests to scre en and
diagnose whether a person has an autism spectrum disorder.
[(m)] (n) “Therapeutic care” means services provided by
licensed or certified speech -language pathologists, occupational
therapists and physical therapists.
[(n)] (o) “Treatment plan” mean s a plan to treat an autism
spectrum disorder that is [prescribed] developed by a [licensed
physician or licensed psychologist and may be developed pursuant
to a comprehensive evaluation in coordination with a licensed
behavior analyst.] provider of health care acting within his or her
scope of practice after he or she has assessed the person for whom
the treatment plan is developed.
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Sec. 8. NRS 689C.1655 is hereby amended to read as follows:
689C.1655 1. A health benefit plan must provide coverage
for screening for and diagnosis of autism spectrum disorders and for
treatment of autism spectrum disorders to persons covered by the
health benefit plan under the age of 18 years or, if enrolled in high
school, until the person reaches the age of 22 years. For the
purposes of such coverage, a carrier shall accept as dispositive any
diagnosis of an autism spectrum disorder that is rendered in
accordance with the statewide standard for measuring outcomes
and assessing persons with autism spectrum disorders thro ugh the
age of 21 years prescribed pursuant to NRS 427A.872.
2. Coverage provided under this section is subject to:
(a) A maximum benefit of the actuarial equivalent of $72,000
per year for applied behavior analysis treatment; and
(b) Copayment, deductible and coinsurance provisions and any
other general exclusion or limitation of a health benefit plan to the
same extent as other medical services or prescription drugs covered
by the plan.
3. A health benefit plan that offers or issues a policy of grou p
health insurance which provides coverage for outpatient care shall
not:
(a) Require an insured to pay a higher deductible, copayment or
coinsurance or require a longer waiting period for coverage for
outpatient care related to autism spectrum disorders than is required
for other outpatient care covered by the plan; or
(b) Refuse to issue a health benefit plan or cancel a health
benefit plan solely because the person applying for or covered by
the plan uses or may use in the future any of the services listed in
subsection 1.
4. Except as otherwise provided in subsections 1 and 2, a
carrier shall not limit the number of visits an insured may make to
any person, entity or group for treatment of autism spectrum
disorders.
5. Treatment of autism spectrum disorders must be identified in
a treatment plan and may include medically necessary habilitative or
rehabilitative care, prescription care, psychiatric care, psychological
care, behavioral therapy or therapeutic care that is:
(a) Prescribed for a perso n diagnosed with an autism spectrum
disorder by a [licensed physician or licensed psychologist;] provider
of health care acting within his or her scope of practice; and
(b) Provided for a person diagnosed with an autism spectrum
disorder by a [licensed physician, licensed psychologist, licensed
behavior analyst or other provider that is supervised by the licensed
– 15 –
- 83rd Session (2025)
physician, psychologist or behavior analyst. ] provider of health
care acting within his or her scope of practice.
A carrier may request a cop y of and review a treatment plan
created pursuant to this subsection.
6. A health benefit plan subject to the provisions of this chapter
that is delivered, issued for delivery or renewed on or after
January 1, [2011,] 2026, has the legal effect of inclu ding the
coverage required by subsection 1, and any provision of the plan or
the renewal which is in conflict with subsection 1 or 2 is void.
7. Nothing in this section shall be construed as requiring a
carrier to provide reimbursement to a school for se rvices delivered
through school services.
8. As used in this section:
(a) “Applied behavior analysis” means the design,
implementation and evaluation of environmental modifications
using behavioral stimuli and consequences to produce socially
significant improvement in human behavior, including, without
limitation, the use of direct observation, measurement and
functional analysis of the relations between environment and
behavior.
(b) “Autism spectrum disorder” has the meaning ascribed to it in
NRS 427A.875.
(c) “Behavioral therapy” means any interactive therapy derived
from evidence-based research, including, without limitation, discrete
trial training, early intensive behavioral intervention, intensive
intervention programs, pivotal response training and verbal behavior
provided by a licensed psychologist, licensed behavior analyst,
licensed assistant behavior analyst or registered behavior technician.
(d) “Evidence-based research” means research that applies
rigorous, systematic and objective procedu res to obtain valid
knowledge relevant to autism spectrum disorders.
(e) “Habilitative or rehabilitative care” means counseling,
guidance and professional services and treatment programs,
including, without limitation, applied behavior analysis, that are
necessary to develop, maintain and restore, to the maximum extent
practicable, the functioning of a person.
(f) “Licensed assistant behavior analyst” has the meaning
ascribed to the term “assistant behavior analyst” in NRS 641D.020.
(g) “Licensed behavior analyst” has the meaning ascribed to the
term “behavior analyst” in NRS 641D.030.
(h) “Prescription care” means medications prescribed by a
licensed physician and any health-related services deemed medically
necessary to determine the need or effectiveness of the medications.
– 16 –
- 83rd Session (2025)
(i) “Provider of health care” has the meaning ascribed to it in
NRS 629.031.
(j) “Psychiatric care” means direct or consultative services
provided by a psychiatrist licensed in the state in which the
psychiatrist practices.
[(j)] (k) “Psychological care” means direct or consultative
services provided by a psychologist licensed in the state in which
the psychologist practices.
[(k)] (l) “Registered behavior technician” has the meaning
ascribed to it in NRS 641D.100.
[(l)] (m) “Screening for autism spectrum disorders” means
medically necessary assessments, evaluations or tests to screen and
diagnose whether a person has an autism spectrum disorder.
[(m)] (n) “Therapeutic care” means services provided by
licensed or certified sp eech-language pathologists, occupational
therapists and physical therapists.
[(n)] (o) “Treatment plan” means a plan to treat an autism
spectrum disorder that is [prescribed] developed by a [licensed
physician or licensed psychologist and may be developed pursuant
to a comprehensive evaluation in coordination with a licensed
behavior analyst.] provider of health care acting within his or her
scope of practice after he or she has assessed the person for whom
the treatment plan is developed.
Sec. 9. NRS 695C.1717 is hereby amended to read as follows:
695C.1717 1. A health care plan issued by a health
maintenance organization must provide coverage for screening for
and diagnosis of autism spectrum disorders and for treatment of
autism spectrum disorders to persons covered by the health care
plan under the age of 18 years or, if enrolled in high school, until the
person reaches the age of 22 years. For the purposes of such
coverage, a health maintenance organization shall accept as
dispositive any diagnosi s of an autism spectrum disorder that is
rendered in accordance with the statewide standard for measuring
outcomes and assessing persons with autism spectrum disorders
through the age of 21 years prescribed pursuant to NRS 427A.872.
2. Coverage provided under this section is subject to:
(a) A maximum benefit of the actuarial equivalent of $72,000
per year for applied behavior analysis treatment; and
(b) Copayment, deductible and coinsurance provisions and any
other general exclusion or limitation of a health care plan to the
same extent as other medical services or prescription drugs covered
by the plan.
– 17 –
- 83rd Session (2025)
3. A health care plan issued by a health maintenance
organization that provides coverage for outpatient care shall not:
(a) Require an enrollee to pay a higher deductible, copayment or
coinsurance or require a longer waiting period for coverage for
outpatient care related to autism spectrum disorders than is required
for other outpatient care covered by the plan; or
(b) Refuse to issue a health care plan or cancel a health care plan
solely because the person applying for or covered by the plan uses
or may use in the future any of the services listed in subsection 1.
4. Except as otherwise provided in subsections 1 and 2, a
health maintenance organization shall not limit the number of visits
an enrollee may make to any person, entity or group for treatment of
autism spectrum disorders.
5. Treatment of autism spectrum disorders must be identified in
a treatment plan and may include medically necessary habilitative or
rehabilitative care, prescription care, psychiatric care, psychological
care, behavioral therapy or therapeutic care that is:
(a) Prescribed for a person diagnosed with an autism spectrum
disorder by a [licensed physician or licensed psychologist;] provider
of health care acting within his or her scope of practice; and
(b) Provided for a person diagnosed with an autism spectrum
disorder by a [licensed physician, licensed psychologist, licensed
behavior analyst or other provider that is s upervised by the licensed
physician, psychologist or behavior analyst. ] provider of health
care acting within his or her scope of practice.
A health maintenance organization may request a copy of and
review a treatment plan created pursuant to this subsection.
6. Evidence of coverage subject to the provisions of this
chapter that is delivered, issued for delivery or renewed on or after
January 1, [2011,] 2026, has the legal effect of including the
coverage required by subsection 1, and any provision of the
evidence of coverage or the renewal which is in conflict with
subsection 1 or 2 is void.
7. Nothing in this section shall be construed as requiring a
health maintenance organization to provide reimbursement to a
school for services delivered through school services.
8. As used in this section:
(a) “Applied behavior analysis” means the design,
implementation and evaluation of environmen tal modifications
using behavioral stimuli and consequences to produce socially
significant improvement in human behavior, including, without
limitation, the use of direct observation, measurement and
– 18 –
- 83rd Session (2025)
functional analysis of the relations between environmen t and
behavior.
(b) “Autism spectrum disorder” has the meaning ascribed to it in
NRS 427A.875.
(c) “Behavioral therapy” means any interactive therapy derived
from evidence-based research, including, without limitation, discrete
trial training, early inte nsive behavioral intervention, intensive
intervention programs, pivotal response training and verbal behavior
provided by a licensed psychologist, licensed behavior analyst,
licensed assistant behavior analyst or registered behavior technician.
(d) “Evidence-based research” means research that applies
rigorous, systematic and objective procedures to obtain valid
knowledge relevant to autism spectrum disorders.
(e) “Habilitative or rehabilitative care” means counseling,
guidance and professional services a nd treatment programs,
including, without limitation, applied behavior analysis, that are
necessary to develop, maintain and restore, to the maximum extent
practicable, the functioning of a person.
(f) “Licensed assistant behavior analyst” has the meaning
ascribed to the term “assistant behavior analyst” in NRS 641D.020.
(g) “Licensed behavior analyst” has the meaning ascribed to the
term “behavior analyst” in NRS 641D.030.
(h) “Prescription care” means medications prescribed by a
licensed physician and any health-related services deemed medically
necessary to determine the need or effectiveness of the medications.
(i) “Provider of health care” has the meaning ascribed to it in
NRS 629.031.
(j) “Psychiatric care” means direct or consultative services
provided by a psychiatrist licensed in the state in which the
psychiatrist practices.
[(j)] (k) “Psychological care” means direct or consultative
services provided by a psychologist licensed in the state in which
the psychologist practices.
[(k)] (l) “Registered behavior technician” has the meaning
ascribed to it in NRS 641D.100.
[(l)] (m) “Screening for autism spectrum disorders” means
medically necessary assessments, evaluations or tests to screen and
diagnose whether a person has an autism spectrum disorder.
[(m)] (n) “Therapeutic care” means services provided by
licensed or certified speech -language pathologists, occupational
therapists and physical therapists.
[(n)] (o) “Treatment plan” means a plan to treat an autism
spectrum disorder that is [prescribed] developed by a [licensed
– 19 –
- 83rd Session (2025)
physician or licensed psychologist and may be developed pursuant
to a comprehensive evaluation in coordination with a licensed
behavior analyst.] provider of health care acting within his or her
scope of practice after he or she has assessed the person for whom
the treatment plan is developed.
Sec. 10. NRS 695G.1645 is hereby amended to read as
follows:
695G.1645 1. A health care plan issued by a managed care
organization for group coverage must provide coverage for
screening for and diagnosis of autism spectrum disorders and for
treatment of autism spectrum disorders to persons covered by the
health care plan under the age of 18 years or, if enrolled in high
school, until the person reaches the age of 22 years. For t he
purposes of such coverage, a managed care organization shall
accept as dispositive any diagnosis of an autism spectrum disorder
that is rendered in accordance with the statewide standard for
measuring outcomes and assessing persons with autism spectrum
disorders through the age of 21 years prescribed pursuant to
NRS 427A.872.
2. A health care plan issued by a managed care organization for
individual coverage must provide an option for c overage for
screening for and diagnosis of autism spectrum disorders and
for treatment of autism spectrum disorders to persons covered by the
health care plan under the age of 18 years or, if enrolled in high
school, until the person reaches the age of 22 years. For the
purposes of that coverage, the managed care organization shall
accept as dispositive any diagnosis of an autism spectrum disorder
that is rendered in accordance with the statewide standard for
measuring outcomes and assessing persons with a utism spectrum
disorders through the age of 21 years prescribed pursuant to
NRS 427A.872.
3. Coverage provided under this section is subject to:
(a) A maximum benefit of the actuarial equivalent of $72,000
per year for applied behavior analysis treatment; and
(b) Copayment, deductible and coinsurance provisions and any
other general exclusion or limitation of a health care plan to the
same extent as other medical services or prescription drugs covered
by the plan.
4. A managed care organization that offers or issues a health
care plan which provides coverage for outpatient care shall not:
(a) Require an insured to pay a higher deductible, copayment or
coinsurance or require a longer waiting period for coverage for
– 20 –
- 83rd Session (2025)
outpatient care related to autism sp ectrum disorders than is required
for other outpatient care covered by the plan; or
(b) Refuse to issue a health care plan or cancel a health care plan
solely because the person applying for or covered by the plan uses
or may use in the future any of the services listed in subsection 1.
5. Except as otherwise provided in subsections 1, 2 and 3, a
managed care organization shall not limit the number of visits an
insured may make to any person, entity or group for treatment of
autism spectrum disorders.
6. Treatment of autism spectrum disorders must be identified in
a treatment plan and may include medically necessary habilitative or
rehabilitative care, prescription care, psychiatric care, psychological
care, behavioral therapy or therapeutic care that is:
(a) Prescribed for a person diagnosed with an autism spectrum
disorder by a [licensed physician or licensed psychologist;] provider
of health care acting within his or her scope of practice; and
(b) Provided for a person diagnosed with an autism spec trum
disorder by [a licensed physician, licensed psychologist, licensed
behavior analyst or other provider that is supervised by the licensed
physician, psychologist or behavior analyst. ] provider of health
care acting within his or her scope of practice.
A managed care organization may request a copy of and review a
treatment plan created pursuant to this subsection.
7. An evidence of coverage subject to the provisions of this
chapter that is delivered, issued for delivery or renewed on or after
January 1, [2011,] 2026, has the legal effect of including the
coverage required by subsection 1, and any provision of the
evidence of coverage or the renewal which is in conflict with
subsection 1 or 3 is void.
8. Nothing in this section shall be construed as requiring a
managed care organization to provide reimbursement to a school for
services delivered through school services.
9. As used in this section:
(a) “Applied behavior analysis” means the design,
implementation and evaluation of environmental modi fications
using behavioral stimuli and consequences to produce socially
significant improvement in human behavior, including, without
limitation, the use of direct observation, measurement and
functional analysis of the relations between environment and
behavior.
(b) “Autism spectrum disorder” has the meaning ascribed to it in
NRS 427A.875.
– 21 –
- 83rd Session (2025)
(c) “Behavioral therapy” means any interactive therapy derived
from evidence-based research, including, without limitation, discrete
trial training, early intensive be havioral intervention, intensive
intervention programs, pivotal response training and verbal behavior
provided by a licensed psychologist, licensed behavior analyst,
licensed assistant behavior analyst or registered behavior technician.
(d) “Evidence-based research” means research that applies
rigorous, systematic and objective procedures to obtain valid
knowledge relevant to autism spectrum disorders.
(e) “Habilitative or rehabilitative care” means counseling,
guidance and professional services and treat ment programs,
including, without limitation, applied behavior analysis, that are
necessary to develop, maintain and restore, to the maximum extent
practicable, the functioning of a person.
(f) “Licensed assistant behavior analyst” has the meaning
ascribed to the term “assistant behavior analyst” in NRS 641D.020.
(g) “Licensed behavior analyst” has the meaning ascribed to the
term “behavior analyst” in NRS 641D.030.
(h) “Prescription care” means medications prescribed by a
licensed physician and any health-related services deemed medically
necessary to determine the need or effectiveness of the medications.
(i) “Provider of health care” has the meaning ascribed to it in
NRS 629.031.
(j) “Psychiatric care” means direct or consultative services
provided b y a psychiatrist licensed in the state in which the
psychiatrist practices.
[(j)] (k) “Psychological care” means direct or consultative
services provided by a psychologist licensed in the state in which
the psychologist practices.
[(k)] (l) “Registered behavior technician” has the meaning
ascribed to it in NRS 641D.100.
[(l)] (m) “Screening for autism spectrum disorders” means
medically necessary assessments, evaluations or tests to screen and
diagnose whether a person has an autism spectrum disorder.
[(m)] (n) “Therapeutic care” means services provided by
licensed or certified speech -language pathologists, occupational
therapists and physical therapists.
[(n)] (o) “Treatment plan” means a plan to treat an autism
spectrum disorder that is [prescribed] developed by a [licensed
physician or licensed psychologist and may be developed pursuant
to a comprehensive evaluation in coordination with a licensed
behavior analyst.] provider of health care acting within his or her
– 22 –
- 83rd Session (2025)
scope of practice after he or she has assessed the person for whom
the treatment plan is developed.
Sec. 11. The provisions of NRS 354.599 do not apply to any
additional expenses of a local government that are related to the
provisions of this act.
Sec. 12. 1. This section becomes effective upon passage and
approval.
2. Sections 1 to 11, inclusive, of this act become effective:
(a) Upon passage and approval for the purpose of adopting any
regulations and performing any other preparatory administrative
tasks that are necessary to carry out the provisions of this act; and
(b) On January 1, 2026, for all other purposes.
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