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- 83rd Session (2025)
Senate Bill No. 268–Senator Flores
CHAPTER..........
AN ACT relating to insurance; requiring certain health insurance to
include coverage for certain dental services when provided
by certain dental hygienists without the supervi sion of a
dentist to the same extent as if provided by a dental hygienist
under the supervision of a dentist; revising provisions
governing the services that a dental hygienist with a special
endorsement to practice public health dental hygiene may
provide; and providing other matters properly relating
thereto.
Legislative Counsel’s Digest:
Existing law authorizes the Board of Dental Examiners of Nevada to issue to a
licensed dental hygienist who meets certain qualifications prescribed by the Board a
special endorsement that allows the dental hygienist to practice public health dental
hygiene. Under existing law, a dental hygienist who holds such a special
endorsement is authorized to provide services specified by the Board by regulation
without the authori zation or supervision of a dentist. (NRS 631.287) Existing
regulations of the Board set forth: (1) various services that a dental hygienist who
holds a special endorsement may provide without authorization or supervision of a
dentist; (2) certain condition s for the provision of such services; and (3) the
circumstances under which the authorization to provide such services may be
suspended or revoked. (NAC 631.210) Section 12.5 of this bill codifies such
authorized services, conditions and circumstances into statute.
Sections 1, 3-9, 11, 12 and 14-16 of this bill require certain public and private
policies of health insurance and health plans, including Medicaid, who provide
coverage for a dental service that a qualified dental hygienist is authorized to
provide without the supervision of a dentist to provide coverage for that service
when provided by such a qualified dental hygienist without the supervision of a
dentist to the same extent as if provided by a qualified dental hygienist und er the
supervision of a dentist. Sections 1, 3, 4, 6 -8, 11, 12 and 16 define the term
“qualified dental hygienist” to mean a dental hygienist who holds a special
endorsement to practice public health dental hygiene, is employed by a nonprofit
organization and provides services within the scope of that employment.
Section 13 of this bill makes a conforming change to require the Director of the
Department of Health and Human Services to administer the provisions of section
16 in the same manner as other prov isions relating to Medicaid. Section 2 of this
bill authorizes the Commissioner of Insurance to require that certain policies of
health insurance issued by a domestic insurer to a person who resides in another
state include the coverage required by section 1.
Section 10 of this bill authorizes the Commissioner to suspend or revoke the
certificate of authority of a health maintenance organization that fails to comply
with the requirements of section 8. The Commissioner would also be authorized to
take such action against other private health insurers and organizations for dental
care that fail to comply with the requirements of sections 1, 3, 4, 6, 7, 11 and 12.
(NRS 680A.200, 695D.300)
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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 689A of NRS is hereby amended by
adding thereto a new section to read as follows:
1. An insurer that offers or issues a policy of health
insurance which includes coverage for a dental service that a
qualified dental hygienist is authorized to provide without the
supervision of a dentist shall provide coverage for that service
when provided by such a qualified dental hygienist without the
supervision of a dentist to the same extent as if provided by a
qualified dental hygienist under the supervision of a dentist.
2. A policy of health insurance subject to the provisions of
this chapter which provides coverage for a dental service described
in subsection 1 and that is delivered, issued for delivery or
renewed on or after Octobe r 1, 2025, has the legal effect of
including the coverage required by this section, and any provision
of the policy that conflicts with the provisions of this section is
void.
3. As used in this section, “qualified dental hygienist” means
a dental hygie nist who holds a special endorsement issued by the
Board of Dental Examiners of Nevada pursuant to NRS 631.287,
is employed by a nonprofit organization and provides services
within the scope of that employment.
Sec. 2. NRS 689A.330 is hereby amended to read as follows:
689A.330 If any policy is issued by a domestic insurer for
delivery to a person residing in another state, and if the insurance
commissioner or corresponding public officer of that other state has
informed the Commissioner that the policy is not subject to approval
or disapproval by that officer, the Commissioner may by ruling
require that the policy meet the standards set forth in NRS 689A.030
to 689A.320, inclusive [.] , and section 1 of this act.
Sec. 3. Chapter 689B of NRS is hereby amended by adding
thereto a new section to read as follows:
1. An insurer that offers or issues a policy of group health
insurance which includes coverage for a dental service that a
qualified dental hygienist is authorized to provide without the
supervision of a dentist shall provide coverage for that service
when provided by such a qualified dental hygienist without the
supervision of a dentist to the same extent as if provided by a
qualified dental hygienist under the supervision of a dentist.
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2. A policy of group health insurance subject to the
provisions of this chapter which provides coverage for a dental
service described in subsection 1 and that is delivered, issued for
delivery or renewed on or after October 1, 2025, has the legal
effect of i ncluding the coverage required by this section, and any
provision of the policy that conflicts with the provisions of this
section is void.
3. As used in this section, “qualified dental hygienist” means
a dental hygienist who holds a special endorsement issued by the
Board of Dental Examiners of Nevada pursuant to NRS 631.287,
is employed by a nonprofit organization and provides services
within the scope of that employment.
Sec. 4. Chapter 689C of NRS is hereby amended by adding
thereto a new section to read as follows:
1. A carrier that offers or issues a health benefit plan which
includes coverage for a dental service that a qualified dental
hygienist is authorized to provide without the supervision of a
dentist shall provide coverage for that service when provided by
such a qualified dental hygienist without the supervision of a
dentist to the same extent as if provided by a qualified dental
hygienist under the supervision of a dentist.
2. A health benefit plan subj ect to the provisions of this
chapter which provides coverage for a dental service described in
subsection 1 and that is delivered, issued for delivery or renewed
on or after October 1, 2025, has the legal effect of including the
coverage required by this section, and any provision of the plan
that conflicts with the provisions of this section is void.
3. As used in this section, “qualified dental hygienist” means
a dental hygienist who holds a special endorsement issued by the
Board of Dental Examiners of Nevada pursuant to NRS 631.287,
is employed by a nonprofit organization and provides services
within the scope of that employment.
Sec. 5. NRS 689C.425 is hereby amended to read as follows:
689C.425 A voluntary purchas ing group and any contract
issued to such a group pursuant to NRS 689C.360 to 689C.600,
inclusive, are subject to the provisions of NRS 689C.015 to
689C.355, inclusive, and section 4 of this act to the extent
applicable and not in conflict with the express provisions of NRS
687B.408 and 689C.360 to 689C.600, inclusive.
Sec. 6. Chapter 695A of NRS is hereby amended by adding
thereto a new section to read as follows:
1. A society that offers or issues a benefit contract which
includes coverage for a dental service that a qualified dental
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hygienist is authorized to provide without the supervision of a
dentist shall provide coverage for that service when provided by
such a qualified dental hygienist without the supervision of a
dentist to the same extent as if provided by a qualified dental
hygienist under the supervision of a dentist.
2. A benefit contract subject to the provisions of this chapter
which provides c overage for a dental service described in
subsection 1 and that is delivered, issued for delivery or renewed
on or after October 1, 2025, has the legal effect of including the
coverage required by this section, and any provision of the
contract that conflicts with the provisions of this section is void.
3. As used in this section, “qualified dental hygienist” means
a dental hygienist who holds a special endorsement issued by the
Board of Dental Examiners of Nevada pursuant to NRS 631.287,
is employed by a nonprofit organization and provides services
within the scope of that employment.
Sec. 7. Chapter 695B of NRS is hereby amended by adding
thereto a new section to read as follows:
1. An insurer that offers or issues a contract for dental
services which includes coverage for a dental service that a
qualified dental hygienist is authorized to provide without the
supervision of a dentist shall provide coverage for that service
when provid ed by such a qualified dental hygienist without the
supervision of a dentist to the same extent as if provided by a
qualified dental hygienist under the supervision of a dentist.
2. A contract for dental services subject to the provisions of
this chapter which provides coverage for a dental service described
in subsection 1 and that is delivered, issued for delivery or
renewed on or after October 1, 2025, has the legal effect of
including the coverage required by this section, and any provision
of the co ntract that conflicts with the provisions of this section is
void.
3. As used in this section, “qualified dental hygienist” means
a dental hygienist who holds a special endorsement issued by the
Board of Dental Examiners of Nevada pursuant to NRS 631.28 7,
is employed by a nonprofit organization and provides services
within the scope of that employment.
Sec. 8. Chapter 695C of NRS is hereby amended by adding
thereto a new section to read as follows:
1. A health maintenan ce organization that offers or issues a
health care plan which includes coverage for a dental service that
a qualified dental hygienist is authorized to provide without the
supervision of a dentist shall provide coverage for that service
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when provided by s uch a qualified dental hygienist without the
supervision of a dentist to the same extent as if provided by a
qualified dental hygienist under the supervision of a dentist.
2. A health care plan subject to the provisions of this chapter
which provides co verage for a dental service described in
subsection 1 and that is delivered, issued for delivery or renewed
on or after October 1, 2025, has the legal effect of including the
coverage required by this section, and any provision of the plan
that conflicts with the provisions of this section is void.
3. As used in this section, “qualified dental hygienist” means
a dental hygienist who holds a special endorsement issued by the
Board of Dental Examiners of Nevada pursuant to NRS 631.287,
is employed by a nonprofit organization and provides services
within the scope of that employment.
Sec. 9. NRS 695C.050 is hereby amended to read as follows:
695C.050 1. Except as otherwise provided in this chapter or
in specific provisions of this title, the provisions of this title are not
applicable to any health maintenance organization granted a
certificate of authority under this chapter. This provision does not
apply to an insurer licensed and regulated pursuant to this titl e
except with respect to its activities as a health maintenance
organization authorized and regulated pursuant to this chapter.
2. Solicitation of enrollees by a health maintenance
organization granted a certificate of authority, or its representatives,
must not be construed to violate any provision of law relating to
solicitation or advertising by practitioners of a healing art.
3. Any health maintenance organization authorized under this
chapter shall not be deemed to be practicing medicine and is exempt
from the provisions of chapter 630 of NRS.
4. The provisions of NRS 695C.110, 695C.125, 695C.1691,
695C.1693, 695C.170, 695C.1703, 695C.1705, 695C.1709 to
695C.173, inclusive, 695C.1733, 695C.17335, 695C.1734,
695C.1751, 695C.1755, 695C.1759, 695C.17 6 to 695C.200,
inclusive, and 695C.265 do not apply to a health maintenance
organization that provides health care services through managed
care to recipients of Medicaid under the State Plan for Medicaid or
insurance pursuant to the Children’s Health Insu rance Program
pursuant to a contract with the Division of Health Care Financing
and Policy of the Department of Health and Human Services. This
subsection does not exempt a health maintenance organization from
any provision of this chapter for services pro vided pursuant to any
other contract.
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5. The provisions of NRS 695C.16932 to 695C.1699,
inclusive, 695C.1701, 695C.1708, 695C.1728, 695C.1731,
695C.17333, 695C.17345, 695C.17347, 695C.1736 to 695C.1745,
inclusive, 695C.1757 and 695C.204 and section 8 of this act apply
to a health maintenance organization that provides health care
services through managed care to recipients of Medicaid under the
State Plan for Medicaid.
6. The provisions of NRS 695C.17095 do not apply to a health
maintenance organization that provides health care services to
members of the Public Employees’ Benefits Program. This
subsection does not exempt a health maintenance organization from
any provision of this chapter for services provided pursuant to any
other contract.
7. The provisions of NRS 695C.1735 do not apply to a health
maintenance organization that provides health care services to:
(a) The officers and employees, and the dependents of officers
and employees, of the governing body of any county, school district,
municipal corporation, political subdivision, public corporation or
other local governmental agency of this State; or
(b) Members of the Public Employees’ Benefits Program.
This subsection does not exempt a health maintenance
organization from any provision of this chapter for services
provided pursuant to any other contract.
Sec. 10. NRS 695C.330 is hereby amended to read as follows:
695C.330 1. The Commissioner may suspend or revoke any
certificate of authority issued to a health maintenance organization
pursuant to the provisions of this chapter if the Commissioner finds
that any of the following conditions exist:
(a) The health maintenance organization is operating
significantly in contravention of its basic organizationa l document,
its health care plan or in a manner contrary to that described in and
reasonably inferred from any other information submitted pursuant
to NRS 695C.060, 695C.070 and 695C.140, unless any amendments
to those submissions have been filed with and approved by the
Commissioner;
(b) The health maintenance organization issues evidence of
coverage or uses a schedule of charges for health care services
which do not comply with the requirements of NRS 695C.1691 to
695C.200, inclusive, and section 8 of th is act, 695C.204 or
695C.207;
(c) The health care plan does not furnish comprehensive health
care services as provided for in NRS 695C.060;
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(d) The Commissioner certifies that the health maintenance
organization:
(1) Does not meet the requirements of s ubsection 1 of NRS
695C.080; or
(2) Is unable to fulfill its obligations to furnish health care
services as required under its health care plan;
(e) The health maintenance organization is no longer financially
responsible and may reasonably be expected to be unable to meet its
obligations to enrollees or prospective enrollees;
(f) The health maintenance organization has failed to put into
effect a mechanism affording the enrollees an opportunity to
participate in matters relating to the content of progr ams pursuant to
NRS 695C.110;
(g) The health maintenance organization has failed to put into
effect the system required by NRS 695C.260 for:
(1) Resolving complaints in a manner reasonably to dispose
of valid complaints; and
(2) Conducting external re views of adverse determinations
that comply with the provisions of NRS 695G.241 to 695G.310,
inclusive;
(h) The health maintenance organization or any person on its
behalf has advertised or merchandised its services in an untrue,
misrepresentative, misleading, deceptive or unfair manner;
(i) The continued operation of the health maintenance
organization would be hazardous to its enrollees or creditors or to
the general public;
(j) The health maintenance organization fails to provide the
coverage required by NRS 695C.1691; or
(k) The health maintenance organization has otherwise failed to
comply substantially with the provisions of this chapter.
2. A certificate of authority must be suspended or revoked only
after compliance with the requirements of NRS 695C.340.
3. If the certificate of authority of a health maintenance
organization is suspended, the health maintenance organization shall
not, during the period of that suspension, enroll any additional
groups or new individual contracts, unless those g roups or persons
were contracted for before the date of suspension.
4. If the certificate of authority of a health maintenance
organization is revoked, the organization shall proceed, immediately
following the effective date of the order of revocation, to wind up its
affairs and shall conduct no further business except as may be
essential to the orderly conclusion of the affairs of the organization.
It shall engage in no further advertising or solicitation of any kind.
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The Commissioner may, by written order, permit such further
operation of the organization as the Commissioner may find to be in
the best interest of enrollees to the end that enrollees are afforded
the greatest practical opportunity to obtain continuing coverage for
health care.
Sec. 11. Chapter 695D of NRS is hereby amended by ad ding
thereto a new section to read as follows:
1. An organization for dental care that offers or issues a plan
for dental care which includes coverage for a dental service that a
qualified dental hygienist is authorized to provide without the
supervision of a dentist shall provide coverage for that service
when provided by such a qualified dental hygienist without the
supervision of a dentist to the same extent as if provided by a
qualified dental hygienist under the supervision of a dentist.
2. A plan for dental care subject to the provisions of this
chapter which provides coverage for a dental service described in
subsection 1 and that is delivered, issued for delivery or renewed
on or after October 1, 2025, has the legal effect of including the
coverage required by this section, and any provision of the plan
that conflicts with the provisions of this section is void.
3. As used in this section, “qualified dental hygienist” means
a dental hygienist who holds a special endorsement issued by the
Board of Dental Examiners of Nevada pursuant to NRS 631.287,
is employed by a nonprofit organization and provides services
within the scope of that employment.
Sec. 12. Chapter 695G of NRS is hereby amended by adding
thereto a new section to read as follows:
1. A managed care organization that offers or issues a health
care plan which includes coverage for a dental service that a
qualified dental hygienist is authorized to provide without the
supervision of a dentist shall provide coverage for that service
when provided by such a qualified dental hygienist without the
supervision of a dentist to the same extent as if provided by a
qualified dental hygienist under the supervision of a dentist.
2. A health care plan subject to the provisions of this chapter
which provides coverage for a dental service described in
subsection 1 and that is delivered, issued for delivery or renewed
on or after October 1, 2025, has the legal effect of including the
coverage required by this section, and any provision of the plan
that conflicts with the provisions of this section is void.
3. As used in this section, “qualified dental hygienist” means
a dental hygienist who hol ds a special endorsement issued by the
Board of Dental Examiners of Nevada pursuant to NRS 631.287,
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is employed by a nonprofit organization and provides services
within the scope of that employment.
Sec. 12.5. NRS 631.287 is hereby amended to read as follows:
631.287 1. The Board shall, upon application by a dental
hygienist who is licensed pursuant to this chapter and has such
qualifications as the Board specifies by regulation, issue a special
endorsement of the licen se allowing the dental hygienist to practice
public health dental hygiene. The special endorsement may be
renewed biennially upon the renewal of the license of the dental
hygienist.
2. [A] Except as otherwise provided in subsections 4 and 5, a
dental hygienist who holds a special endorsement issued pursuant to
subsection 1 may provide services without the authorization or
supervision of a dentist only as specified by regulations adopted by
the Board.
3. As part of a program for the provision of publi c health
dental hygiene approved by the Board, a dental hygienist with a
special endorsement to practice public health dental hygiene may
authorize a dental assistant or expanded function dental assistant
under his or her direct supervision to:
(a) Apply dental sealants;
(b) Apply topical fluoride;
(c) Perform coronal polishing;
(d) Take radiographs; and
(e) Provide oral health education.
4. Except as otherwise provided in subsection 6, a dental
hygienist who holds a special endorsement issued pursua nt to
subsection 1 may perform the services set forth in subsection 5
without supervision by a dentist and without authorization from
the licensed dentist of the patient on whom the services are to be
performed, if:
(a) The services are performed at a hea lth facility, a school or
a place in this State approved by the Board; and
(b) The Board approves the treatment protocol submitted by
the dental hygienist which includes an explanation of the methods
that the dental hygienist will use to:
(1) Treat patients; and
(2) Refer patients to a dentist for:
(I) Follow-up care;
(II) Diagnostic services; and
(III) Any service that the dental hygienist is not
authorized to perform.
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5. In compliance with the requirements of subsection 4, a
dental hygienist described in subsection 4 may:
(a) Expose radiographs.
(b) Conduct an assessment of the oral health of the patient
through medical and dental histories, radiographs, indices, risk
assessments and intraoral and extraoral procedures that analyze
and identify the oral health needs and problems of the patient.
(c) After conducting an assessment pursuant to paragraph (b),
develop a dental hygiene care plan to address the oral health
needs and problems of the patient described in paragraph (b).
(d) Provide dental hygiene care that includes:
(1) Implementation of a dental hygiene care plan described
in paragraph (c).
(2) Evaluation of oral and periodontal health after the
implementation of the dental hygiene care plan as described in
subparagraph (1) in order to identify the subsequent treatment,
continued care and referral needs of the patient.
(e) Remove stains, deposits and accretions, including dental
calculus.
(f) Smooth the natural and restored surface of a tooth by using
the procedures and instruments commonly used in oral
prophylaxis, except that an abrasive stone, disc or bur may be used
only to polish a restoration.
(g) Take the following type of impressions:
(1) Those used for the preparation of diagnostic models;
(2) Those used fo r the fabrication of temporary crowns or
bridges; and
(3) Those used for the fabrication of temporary removable
appliances, provided no missing teeth are replaced by those
appliances.
(h) Perform subgingival curettage.
(i) Remove sutures.
(j) Place and remove a periodontal pack.
(k) Remove excess cement from cemented restorations and
orthodontic appliances. A dental hygienist may not use a rotary
cutting instrument to remove excess cement from restorations or
orthodontic appliances.
(l) Train and instruct persons in the techniques of oral hygiene
and preventative procedures.
(m) Recement and repair temporary crowns and bridges.
(n) Recement permanent crowns and bridges with
nonpermanent material as a palliative treatment.
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(o) Place a temporary restoration with nonpermanent material
as a palliative treatment.
(p) Administer local intraoral chemotherapeutic agents in any
form except aerosol, including, but not limited to:
(1) Antimicrobial agents;
(2) Fluoride preparations;
(3) Topical antibiotics; and
(4) Topical desensitizing agents.
(q) Apply pit and fissure sealant to the dentition for the
prevention of decay.
6. The Board may suspend or revoke the authorization
described in subsection 4 if the:
(a) Dental hygienist fails to renew his or her license or it is
canceled, suspended or revoked;
(b) Board receives a complaint filed against the dental
hygienist;
(c) Dental hygienist commits an act which constitutes a cause
for disciplinary action; or
(d) Dental hygienist violates any provis ion of this chapter or
the regulations adopted pursuant thereto.
Nothing in this subsection prohibits a dental hygienist from
applying for reinstatement of the authorization to perform the
services described in subsection 4 if the Board suspends or revokes
the authorization pursuant to this subsection.
7. As used in this section:
(a) “Health care facility” has the meaning ascribed to it in
NRS 162A.740.
(b) “Health facility” has the meaning ascribed to it in
NRS 449.260.
(c) “Oral prophylaxis” means the preventive dental procedure
of scaling and polishing which includes the removal of calculus,
soft deposits, plaques and stains and the smoothing of unattached
tooth surfaces in order to create an environment in which hard
and soft tissues can be maintained in good health by the patient.
(d) “School” means an elementary, secondary or
postsecondary educational facility, public or private, in this State.
Sec. 13. 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 Disability Services
Division;
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(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 Divisio n 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, 422.00 1 to 422.410, inclusive, and
section 16 of this act, 422.580, 432.010 to 432.133, inclusive,
432B.6201 to 432B.626, inclusive, 444.002 to 444.430, inclusive,
and 445A.010 to 445A.055, inclusive, and all other provisions 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 and nonprofit organizations which provi de 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 provided 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
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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.
Sec. 14. NRS 287.010 is hereby amended to read as follows:
287.010 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 may:
(a) Adopt and carry into effect a system of group life, accident
or health insurance, or any combination thereof, for the benefit of its
officers an d employees, and the dependents of officers and
employees who elect to accept the insurance and who, where
necessary, have authorized the governing body to make deductions
from their compensation for the payment of premiums on the
insurance.
(b) Purchase group policies of life, accident or health insurance,
or any combination thereof, for the benefit of such officers and
employees, and the dependents of such officers and employees, as
have authorized the purchase, from insurance companies authorized
to tra nsact the business of such insurance in the State of Nevada,
and, where necessary, deduct from the compensation of officers and
employees the premiums upon insurance and pay the deductions
upon the premiums.
(c) Provide group life, accident or health cove rage through a
self-insurance reserve fund and, where necessary, deduct
contributions to the maintenance of the fund from the compensation
of officers and employees and pay the deductions into the fund. The
money accumulated for this purpose through deduct ions from the
compensation of officers and employees and contributions of the
governing body must be maintained as an internal service fund as
defined by NRS 354.543. The money must be deposited in a state or
national bank or credit union authorized to tra nsact business in the
State of Nevada. Any independent administrator of a fund created
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under this section is subject to the licensing requirements of chapter
683A of NRS, and must be a resident of this State. Any contract
with an independent administrator must be approved by the
Commissioner of Insurance as to the reasonableness of
administrative charges in relation to contributions collected and
benefits provided. The provisions of NRS 439.581 to 439.597,
inclusive, 686A.135, 687B.352, 687B.408, 687B.692, 687B.723,
687B.725, 687B.805, 689B.030 to 689B.0317, inclusive, paragraphs
(b) and (c) of subsection 1 of NRS 689B.0319, subsections 2, 4, 6
and 7 of NRS 689B.0319, 689B.033 to 689B.0369, inclusive,
689B.0375 to 689B.050, inclusive, 689B.0675, 689B.265, 689B.287
and 689B.500 and section 3 of this act apply to coverage provided
pursuant to this paragraph, except that the provisions of NRS
689B.0378, 689B.03785 and 689B.500 only apply to coverage for
active officers and employees of the governing body, or the
dependents of such officers and employees.
(d) Defray part or all of the cost of maintenance of a self -
insurance fund or of the premiums upon insurance. The money for
contributions must be budgeted for in accordance with the laws
governing the county, sc hool district, municipal corporation,
political subdivision, public corporation or other local governmental
agency of the State of Nevada.
2. If a school district offers group insurance to its officers and
employees pursuant to this section, members of the board of trustees
of the school district must not be excluded from participating in the
group insurance. If the amount of the deductions from compensation
required to pay for the group insurance exceeds the compensation to
which a trustee is entitled, the difference must be paid by the trustee.
3. In any county in which a legal services organization exists,
the governing body of the county, or of any school district,
municipal corporation, political subdivision, public corporation or
other local govern mental agency of the State of Nevada in the
county, may enter into a contract with the legal services
organization pursuant to which the officers and employees of the
legal services organization, and the dependents of those officers and
employees, are elig ible for any life, accident or health insurance
provided pursuant to this section to the officers and employees, and
the dependents of the officers and employees, of the county, school
district, municipal corporation, political subdivision, public
corporation or other local governmental agency.
4. If a contract is entered into pursuant to subsection 3, the
officers and employees of the legal services organization:
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(a) Shall be deemed, solely for the purposes of this section, to be
officers and employees of the county, school district, municipal
corporation, political subdivision, public corporation or other local
governmental agency with which the legal services organization has
contracted; and
(b) Must be required by the contract to pay the premiums or
contributions for all insurance which they elect to accept or of which
they authorize the purchase.
5. A contract that is entered into pursuant to subsection 3:
(a) Must be submitted to the Commissioner of Insurance for
approval not less than 30 days be fore the date on which the contract
is to become effective.
(b) Does not become effective unless approved by the
Commissioner.
(c) Shall be deemed to be approved if not disapproved by the
Commissioner within 30 days after its submission.
6. As used in this section, “legal services organization” means
an organization that operates a program for legal aid and receives
money pursuant to NRS 19.031.
Sec. 15. NRS 287.04335 is hereby amended to read as
follows:
287.04335 If the Board provides health insurance through a
plan of self -insurance, it shall comply with the provisions of NRS
439.581 to 439.597, inclusive, 686A.135, 687B.352, 687B.409,
687B.692, 687B.723, 687B.725, 687B.805, 689B.0353, 689B.255,
695C.1723, 695G.150, 695G.155, 695G.160, 695G.162,
695G.1635, 695G.164, 695G.1645, 695G.1665, 695G.167,
695G.1675, 695G.170 to 695G.1712, inclusive, 695G.1714 to
695G.174, inclusive, 695G.176, 695G.177, 695G.200 to 695G.230,
inclusive, 695G.241 to 695G.310, inclusive, 695G.405 and
695G.415, and section 12 of this act, in the same manner as an
insurer that is licensed pursuant to title 57 of NRS is required to
comply with those provisions.
Sec. 16. Chapter 422 of NRS is hereby amended by adding
thereto a new section to read as follows:
1. To the extent that federal financial participation is
available, the Director shall include under Medicaid a
requirement that the State must provide reimbursement for any
dental service covered by Medicaid that a qualified dental
hygienist is authorized to provide without the supervision of a
dentist when provided by such a qualified dental hygienist without
the supervision of a dentist to the same extent as if the service was
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provided by a qualified dental hygienist under the supervision of a
dentist.
2. The Department shall:
(a) Apply to the Secretary of Health and Human Services for
any waiver of federal law or apply for any amendment of the State
Plan for Medicaid that is necessary for the Department t o receive
federal funding to provide the reimbursement described in
subsection 1.
(b) Fully cooperate in good faith with the Federal Government
during the application process to satisfy the requirements for
obtaining a waiver or amendment pursuant to paragraph (a).
3. As used in this section, “qualified dental hygienist” means
a dental hygienist who holds a special endorsement issued by the
Board of Dental Examiners of Nevada pursuant to NRS 631.287,
is employed by a nonprofit organization and provides services
within the scope of that employment.
Sec. 17. 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.
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