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- 83rd Session (2025)
Senate Bill No. 262 –Senators Pazina, Dondero Loop, Cannizzaro,
Doñate, Nguyen; Cruz -Crawford, Daly, Flores, Lange,
Neal, Ohrenschall, Scheible and Taylor
Joint Sponsors: Assemblymembers Marzola, Monroe -Moreno,
Brown-May, Considine, Wa tts; Anderson, Backus, Dalia,
D’Silva, Edgeworth, Flanagan, González, Goulding, Hunt,
Jackson, Jauregui, Karris, La Rue Hatch, Moore, Mosca,
Nadeem, Nguyen, Orentlicher, Roth , Torres-Fossett and
Yeager
CHAPTER..........
AN ACT relating to health care; prohibiting certain institutions from
eliminating or reducing the size of a program for residency
training and postdoctoral fellowships without the approval of
the Department of Health and Human Services; transferring
the administration of the Graduate Med ical Education Grant
Program and the Account for the Program from the Office of
Science, Innovation and Technology in the Office of the
Governor to the Department ; expanding the purposes for
which institutions that provide programs for residency
training and postdoctoral fellowships in this State may
receive grants under the Program; establishing the criteria for
prioritizing the awarding of such grants; requiring the
Department to explore ways to use federal financial
participation in Medicaid to support graduate medical
education; making an appropriation to the Account for the
Program; and providing other matters properly relating
thereto.
Legislative Counsel’s Digest:
Existing law establishes the Office of Science, Innovation and Technology in
the Office of the Governor and requires the Director of the Office to implement the
Graduate Medical Education Grant Program. (NRS 223.600, 223.610) Existing law:
(1) requires the Office to establish and administer the Program to award grants to
institutions in thi s State seeking to create, expand or retain programs for residency
training and postdoctoral fellowships for physicians; (2) creates the Account for the
Graduate Medical Education Grant Program, administered by the Director; and (3)
creates the Advisory Co uncil on Graduate Medical Education to evaluate
applications and make recommendations for such grants. (NRS 223.631 -223.639)
Sections 3-7 of this bill transfer the Advisory Council and the duties to administer
the Program and the Account from the Office to the Department of Health and
Human Services. Sections 1.5 and 2 of this bill make conforming changes to
remove the Program and the Advisory Council from the duties required to be
performed by the Director. Section 1 of this bill prohibits an institution t hat
receives a grant through the Program from eliminating or reducing the size of a
program for residency training and postdoctoral fellowships without the approval of
the Department. Sections 3 and 6 expand the grants that may be made from the
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Account under the Program to include grants to institutions which operate programs
for residency training that are training a number of residents that exceeds the
number of full -time equivalent residents for which the institution receives certain
payments from Medica re. Section 6 authorizes the Department to award limited
grants to assist in building administrative and operational capacity for a new
program for residency training and postdoctoral fellowships and recruiting
personnel essential to the operation of such a program. Section 6 also establishes
the criteria for prioritizing the awarding of grants. Section 7.7 of this bill requires
the Department, in collaboration with the Advisory Council, to explore ways to use
federal financial participation in Medicaid to support programs for residency
training and postdoctoral fellowships. Section 7.3 makes a conforming change to
require the Director of the Department to administer section 7.7 in the same
manner as other provisions governing Medicaid. Section 8 of this bil l makes an
appropriation to the Account for the Program.
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 223 of NRS is hereby amended by adding
thereto a new section to read as follows:
1. An institution that receives a grant through the Graduate
Medical Education Grant Program established pursuant to NRS
223.637 shall not eliminate or reduce the size of a program for
residency training and postdoctoral fellowships operated by the
institution without the approv al of the Department of Health and
Human Services.
2. To obtain the approval of the Department of Health and
Human Services for the elimination or reduction of the size of a
program for residency training and postdoctoral fellowships
pursuant to subsecti on 1, an institution must apply to the
Department in the form prescribed by the Department. The
application must include, without limitation:
(a) An analysis of the current and projected needs of patients
in the geographic area served by the program, including, without
limitation, the need for physicians who practice in any specialty in
which the program provides residency training;
(b) A detailed explanation of the reasons for the proposed
elimination or reduction and justification of the elimination or
reduction; and
(c) A description of efforts to mitigate the impact of the
elimination or reduction, which may include, without limitation,
transferring resources to areas of higher need.
3. The Department of Health and Human Services shall not
approve an application to eliminate or reduce the size of a
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program for residency training and postdoctoral fellowships
submitted pursuant to subsection 2 unless the application
demonstrates that the elimination or reduction:
(a) Is justified by a decrease i n the needs of patients in the
geographic area served by the program, including, without
limitation, the need for physicians who practice in any specialty in
which the program provides residency training; and
(b) Is not likely to negatively impact the ove rall availability o f
providers of health care in this State.
4. If an institution violates subsection 1, the Department of
Health and Human Services may:
(a) Suspend or revoke the grant awarded to the institution
through the Graduate Medical Education Grant Program; or
(b) Disqualify the institution from receiving future grants
through the Graduate Medical Education Grant Program.
Sec. 1.5. NRS 223.610 is hereby amended to read as follows:
223.610 The Director of t he Office of Science, Innovation and
Technology shall:
1. Advise the Governor and the Executive Director of the
Office of Economic Development on matters relating to science,
innovation and technology.
2. Work in coordination with the Office of Economic
Development to establish criteria and goals for economic
development and diversification in this State in the areas of science,
innovation and technology.
3. As directed by the Governor, identify, recommend and carry
out policies related to science, innovation and technology.
4. Report periodically to the Executive Director of the Office
of Economic Development concerning the administration of the
policies and programs of the Office of Science, Innovation and
Technology.
5. Coordinate activit ies in this State relating to the planning,
mapping and procurement of broadband service in a competitively
neutral and nondiscriminatory manner, which must include, without
limitation:
(a) Development of a strategic plan to improve the delivery of
broadband services in this State to schools, libraries, providers of
health care, transportation facilities, prisons and other community
facilities;
(b) Applying for state and federal grants on behalf of eligible
entities and managing state matching money that has been
appropriated by the Legislature;
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(c) Coordinating and processing applications for state and
federal money relating to broadband services;
(d) Prioritizing construction projects which affect or involve the
expansion or deployment of broadband services in this State;
(e) In consultation with providers of health care from various
health care settings, the expansion of telehealth services to reduce
health care costs and increase health care quality and access in this
State, especially in rural, unse rved and underserved areas of this
State;
(f) Expansion of the fiber optic infrastructure in this State for the
benefit of the public safety radio and communications systems in
this State;
(g) Collection and storage of data relating to agreements and
contracts entered into by the State for the provision of fiber optic
assets in this State;
(h) Administration of the trade policy for fiber optic
infrastructure in this State; and
(i) Establishing and administering a program of infrastructure
grants for the development or improvement of broadband services
for persons with low income and persons in rural areas of this State
using money from the Account for the Grant Program for
Broadband Infrastructure created by NRS 223.660. The Director
may adopt regulations to carry out his or her duties pursuant to this
paragraph.
6. [Provide support to the Advisory Council on Graduate
Medical Education and implement the Graduate Medical Education
Grant Program established pursuant to NRS 223.637.
7.] In carrying out h is or her duties pursuant to this section,
consult with the Executive Director of the Office of Economic
Development and cooperate with the Executive Director in
implementing the State Plan for Economic Development developed
by the Executive Director pursuant to subsection 2 of NRS 231.053.
[8.] 7. Administer such grants as are provided by legislative
appropriation.
Sec. 2. NRS 223.630 is hereby amended to read as follows:
223.630 1. The Account for the Office of Science, Innovation
and Technology is hereby created in the State General Fund. The
Account must be administered by the Director of the Office of
Science, Innovation and Technology.
2. Except as otherwise provided in NRS [223.631 and ]
223.660, any money accepted pursuant to NRS 223.620 must be
deposited in the Account.
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3. The interest and income earned on the money in the
Account, after deducting any applicable charges, must be credited to
the Account.
4. The money in the Account must only be used to carry out
the duties of the Director.
5. Claims against the Account must be paid as other claims
against the State are paid.
Sec. 3. NRS 223.631 is hereby amended to read as follows:
223.631 1. The Account for the Graduate Medical Education
Grant Program is hereby created in the State General Fund. The
Director of the [Office of Science, Innovation and Technology ]
Department of Health and Human Services shall administer the
Account.
2. The Dire ctor of the [Office of Science, Innovation and
Technology] Department of Health and Human Services may:
(a) Accept any gift, donation, bequest or devise; and
(b) Apply for and accept any grant, loan or other source of
money,
for deposit in the Account to assist the Director in carrying out
the Graduate Medical Education Grant Program established
pursuant to NRS 223.637.
3. The interest and income earned on the money in the
Account, after deducting any applicable charges, must be credited to
the Account.
4. The money in the Account must only be used to:
(a) Award competitive grants to institutions in this State
[seeking] :
(1) Seeking to create, expand or retain programs for
residency training and postdoctoral fellowships that are approved by
the Accreditation Council for Graduate Medical Education or its
successor organization; [and] or
(2) Operating programs for residency training t hat are
approved by the Accreditation Council for Graduate Medical
Education, or its successor organization, and that are training a
number of residents that exceeds the maximum number of full -
time equivalent resident positions for which the institution receives
direct graduate medical education or indirect medical education
payments from Medicare; and
(b) Defray the costs of establishing and administering the
Graduate Medical Education Grant Program established pursuant to
NRS 223.637.
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5. Any money remaining in the Account at the end of the fiscal
year does not revert to the State General Fund, and the balance in
the Account must be carried forward to the next fiscal year.
6. Claims against the Account must be paid as other claims
against the State are paid.
Sec. 4. NRS 223.633 is hereby amended to read as follows:
223.633 1. The Advisory Council on Graduate Medical
Education is hereby created within the [Office of Science,
Innovation and Technology. ] Department of Health and Human
Services. The Council consists of:
(a) The dean of each medical school in this State that is
accredited by the Liaison Committee on Medical Education of the
American Medical Association and the Association of American
Medical Colleges or their successor organizations, or his or her
designee;
(b) The dean of each school of osteopathic medicine in this State
that is accredited by the Commission on Osteopathic College
Accreditation of the American Osteopathic Association or it s
successor organization, or his or her designee;
(c) Two members appointed by the Governor who are
physicians licensed pursuant to chapter 630 or 633 of NRS;
(d) One member appointed by the Governor who represents
hospitals located in counties whose population is less than 100,000;
(e) One member appointed by the Governor who represents
hospitals located in counties whose population is 100,000 or more
but less than 700,000;
(f) One member appointed by the Governor who represents
hospitals located in a county whose population is 700,000 or more;
(g) One member appointed by the Governor who represents the
medical corps of any of the Armed Forces of the United States;
(h) One member appointed by the Governor who represents the
Department of Health and Human Services; and
(i) One member appointed by the Governor who represents the
Office of Economic Development in the Office of the Governor.
2. In addition to the members appointed by the Governor
pursuant to subsection 1, the Governor may appoint two members as
the Governor determines necessary to carry out the provisions of
NRS 223.631 to 223.639, inclusive [.] , and section 1 of this act.
3. After the initial terms, the term of each member of the
Council is 3 years, and members shall serve at the p leasure of the
Governor.
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4. Any vacancy occurring in the membership of the Council
must be filled in the same manner as the original appointment not
later than 30 days after the vacancy occurs.
5. The Council shall select from its members a Chair and a
Vice Chair who shall hold office for 1 year and who may be
reselected.
6. The Council shall meet at the call of the Chair as often as
necessary to evaluate applications for competitive grants for the
Graduate Medical Education Grant Program established pursuant to
NRS 223.637 and make recommendations to the [Office of Science,
Innovation and Technology ] Department of Health and Human
Services concerning the approval of applications for such grants.
7. A majority of the members of the Council constitute s a
quorum for the transaction of business, and a majority of those
members present at any meeting is sufficient for any official action
taken by the Council.
8. The members of the Council serve without compensation,
except that each member is entitled t o receive the per diem
allowance and travel expenses provided for state officers and
employees generally while engaged in the official business of the
Council.
9. A member of the Council who is an officer or employee of
this State or a political subdivis ion of this State must be relieved
from his or her duties without loss of regular compensation to
prepare for and attend meetings of the Council and perform any
work necessary to carry out the duties of the Council in the most
timely manner practicable. A state agency or political subdivision of
this State shall not require an officer or employee who is a member
of the Council to:
(a) Make up the time he or she is absent from work to carry out
his or her duties as a member of the Council; or
(b) Take annual leave or compensatory time for the absence.
Sec. 5. NRS 223.635 is hereby amended to read as follows:
223.635 The Advisory Council on Graduate Medical Education
shall:
1. Evaluate applications for competitive grants for the Graduate
Medical Education Grant Program established pursuant to NRS
223.637 and make recommendations to the [Office of Science,
Innovation and Technology ] Department of Health and Human
Services concerning the approval of applications for such grants. In
evaluating and making recommendations concerning such
applications, the Council shall give priority to the award of grants
[for the retention of programs in this State for residency training and
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postdoctoral fellows when the federal funding for the support of
such programs expires. ] in accordance with paragraph (b) of
subsection 3 of NRS 223.637.
2. Study and make recommendations to the [Office of Science,
Innovation and Technology, ] Department of H ealth and Human
Services, the Governor and the Legislature concerning:
(a) The creation and retention of programs in this State for
residency training and postdoctoral [fellows] fellowships that are
approved by the Accreditation Council for Graduate Medic al
Education or its successor organization; and
(b) The recruitment and retention of physicians necessary to
meet the health care needs of the residents of this State, with the
emphasis on those health care needs.
Sec. 6. NRS 223.637 is hereby amended to read as follows:
223.637 1. The [Office of Science, Innovation and
Technology] Department of Health and Human Services shall
establish and administer a Graduate Medical Education Grant
Program as a competitive grant prog ram to award grants to
institutions in this State [seeking] :
(a) Seeking to create, expand or retain programs for residency
training and postdoctoral [fellows] fellowships that are approved by
the Accreditation Council for Graduate Medical Education or i ts
successor organization [.] ; or
(b) Which operate programs for residency training that are
approved by the Accreditation Council for Graduate Medical
Education, or its successor organization, and that are training a
number of residents that exceeds the maximum number of full -
time equivalent resident positions for which the institution receives
direct graduate medical education or indirect medical education
payments from Medicare.
2. The Department of Health and Human Services may
award limited grants pursuant to the Program established
pursuant to subsection 1 to:
(a) Assist institutions in building administrative and
operational capacity as necessary to establish a new program for
residency training and postdoctoral fellowships.
(b) Recruit personnel essential to the operation of a program
for residency training and postdoctoral fellowships, including,
without limitation, program directors and resident faculty. Such
recruitment may consist of paying relocation expenses, providing
supplements to salaries and providing professional development.
3. In awarding grants pursuant to the Program established
pursuant to subsection 1, the [Office of Science, Innovation and
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Technology] Department of Health and Human Services shall
[consider] :
(a) Consider the recommendations of the Advisory Council on
Graduate Medical Education created by NRS 223.633 ; and [give]
(b) Give priority to the award of grants [for] :
(1) For the retention of programs in this State for residency
training and postdoctoral [fellows] fellowships when the federal
funding for the support of such programs expires [.] ; and
(2) To programs that:
(I) Will leverage funds from the Federal Government or
private persons to maximize the impact of the grants;
(II) Incorporate inn ovative delivery models, including,
without limitation, telehealth, rotations in rural areas and training
in underserved settings;
(III) Provide logistical support, which may include,
without limitation, transportation, housing and accommodations
for fa mily members of residents and fellows, to facilitate the
placement of residents and fellows in rural areas and other
underserved areas;
(IV) Demonstrate collaboration with rural hospitals,
community health centers and other local entities that provide
health care; and
(V) Address geographic areas and populations of this
State where the shortage of providers of health care is most
critical and specialties for which the need in those areas and
among those populations is most critical in this State.
[3.] 4. The [Office of Science, Innovation and Technology ]
Department of Health and Human Services shall establish a
committee to develop a process, procedure and rubric for evaluating
applications for grants pursuant to the Program established pursuant
to subsection 1 to ensure that the process and procedure are
transparent, without bias, fair, equitable and accessible. The
committee established pursuant to this subsection must be composed
of persons with expertise in subject matters related to graduate
medical education who are not affiliated with any applicant for a
grant pursuant to the Program established pursuant to subsection 1.
[4.] 5. The [Office of Science, Innovation and Technology ]
Department of Health and Human Services may adopt regulations
necessary to carry out the Program established pursuant to
subsection 1. Such regulations may include, without limitation, the
requirements to apply for and receive a grant.
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Sec. 7. NRS 223.639 is hereby amended to read as follows:
223.639 1. On or before October 1 of each year, the [Office
of Science, Innovation and Technology] Department of Health and
Human Services shall submit a written report to:
(a) The Governor; and
(b) The Director of the Legislative Counsel Bureau for
transmittal to:
(1) The Interim Finance Committee in an odd -numbered
year; or
(2) The next regular session of the Legislature in an even -
numbered year.
2. The report must include, without limitation:
(a) Information on the Graduate Medica l Education Grant
Program established pursuant to NRS 223.637; and
(b) Any recommendations regarding graduate medical education
in this State, including, without limitation:
(1) The creation, expansion and retention of programs in this
State for residency training and postdoctoral [fellows;] fellowships;
and
(2) Methods by which this State may recruit and retain
physicians necessary to meet the health care needs of the residents
of this State.
Sec. 7.3. NRS 232.320 is hereby amended to read as follows:
232.320 1. The Director:
(a) Shall appoint, with the consent of the Governor,
administrators of the divisions of the Department, who are
respectively designated as follows:
(1) The Administrator of the Aging and Di sability Services
Division;
(2) The Administrator of the Division of Welfare and
Supportive Services;
(3) The Administrator of the Division of Child and Family
Services;
(4) The Administrator of the Division of Health Care
Financing and Policy; and
(5) The Administrator of the Division of Public and
Behavioral Health.
(b) Shall administer, through the divisions of the Department,
the provisions of chapters 63, 424, 425, 427A, 432A to 442,
inclusive, 446 to 450, inclusive, 458A and 656A of NRS, NRS
127.220 to 127.310, inclusive, 422.001 to 422.410, inclusive, and
section 7.7 of this act, 422.580, 432.010 to 432.133, inclusive,
432B.6201 to 432B.626, inclusive, 444.002 to 444.430, inclusive,
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and 445A.010 to 445A.055, inclusive, and all other provision s of
law relating to the functions of the divisions of the Department, but
is not responsible for the clinical activities of the Division of Public
and Behavioral Health or the professional line activities of the other
divisions.
(c) Shall administer any state program for persons with
developmental disabilities established pursuant to the
Developmental Disabilities Assistance and Bill of Rights Act of
2000, 42 U.S.C. §§ 15001 et seq.
(d) Shall, after considering advice from agencies of local
governments a nd nonprofit organizations which provide social
services, adopt a master plan for the provision of human services in
this State. The Director shall revise the plan biennially and deliver a
copy of the plan to the Governor and the Legislature at the
beginning of each regular session. The plan must:
(1) Identify and assess the plans and programs of the
Department for the provision of human services, and any
duplication of those services by federal, state and local agencies;
(2) Set forth priorities for the provision of those services;
(3) Provide for communication and the coordination of those
services among nonprofit organizations, agencies of local
government, the State and the Federal Government;
(4) Identify the sources of funding for services prov ided by
the Department and the allocation of that funding;
(5) Set forth sufficient information to assist the Department
in providing those services and in the planning and budgeting for the
future provision of those services; and
(6) Contain any other information necessary for the
Department to communicate effectively with the Federal
Government concerning demographic trends, formulas for the
distribution of federal money and any need for the modification of
programs administered by the Department.
(e) May, by regulation, require nonprofit organizations and state
and local governmental agencies to provide information regarding
the programs of those organizations and agencies, excluding
detailed information relating to their budgets and payrolls, which the
Director deems necessary for the performance of the duties imposed
upon him or her pursuant to this section.
(f) Has such other powers and duties as are provided by law.
2. Notwithstanding any other provision of law, the Director, or
the Director’s designee, is responsible for appointing and removing
subordinate officers and employees of the Department.
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Sec. 7.7. Chapter 422 of NRS is hereby amended by adding
thereto a new section to read as follows:
1. The Depart ment, in collaboration with the Advisory
Council on Graduate Medical Education created by NRS 223.633,
shall explore ways to use federal financial participation in
Medicaid to support programs for medical residency training and
postdoctoral fellowships in this State.
2. In allocating federal money pursuant to subsection 1, the
Department:
(a) May prioritize programs for medical residency training and
postdoctoral fellowships serving geographical areas and
populations of this State where the shortage of providers of health
care is most critical or which provide training in the specialties for
which the need is most critical; and
(b) Shall not use or authorize the use of such federal money to
supplant existing methods of funding that are available to
programs for medical residency training and postdoctoral
fellowship.
Sec. 8. There is hereby appropriated from the State General
Fund to the Account for the Graduate Medical Education Grant
Program created by NRS 223.631 the following sums for the
Graduate Medical Education Grant Program established pursuant to
NRS 223.637:
For the Fiscal Year 2025-2026 ............................... $4,500,000
For the Fiscal Year 2026-2027 ............................... $4,500,000
Sec. 9. 1. Any administrative regulatio ns adopted by an
officer or an agency whose name has been changed or whose
responsibilities have been transferred pursuant to the provisions of
this act to another officer or agency remain in force until amended
by the officer or agency to which the respon sibility for the adoption
of the regulations has been transferred.
2. Any contracts or other agreements entered into by an officer
or agency whose name has been changed or whose responsibilities
have been transferred pursuant to the provisions of this ac t to
another officer or agency are binding upon the officer or agency to
which the responsibility for the administration of the provisions of
the contract or other agreement has been transferred. Such contracts
and other agreements may be enforced by the o fficer or agency to
which the responsibility for the enforcement of the provisions of the
contract or other agreement has been transferred.
3. Any action taken by an officer or agency whose name has
been changed or whose responsibilities have been transf erred
pursuant to the provisions of this act to another officer or agency
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remains in effect as if taken by the officer or agency to which the
responsibility for the enforcement of such actions has been
transferred.
Sec. 10. The provisions of subsection 1 of NRS 218D.380 do
not apply to any provision of this act which adds or revises a
requirement to submit a report to the Legislature.
Sec. 11. This act becomes effective on July 1, 2025.
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