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- 83rd Session (2025)
Senate Bill No. 300 –Senators Dondero Loop, Flores,
Cruz-Crawford; Cannizzaro, Daly, Ohrenschall, Pazina and
Taylor
CHAPTER..........
AN ACT relating to Medicaid; requiring Medicaid to cover the
administration of certain medication for persons with opioid
use disorder and certain mental health services provided at a
federally-qualified health center; making an appropriation;
and providing other matters properly relating thereto.
Legislative Counsel’s Digest:
Existing law requires the Department of Health and Human Services to
administer Medicaid. (NRS 422.270) Section 1.2 of this bill requires the Director
of the Department to include under Medicaid coverage for the administration of
certain medication to treat opioid use disorder. Section 1.1 of this bill defines
“medication assisted treatment” for that purpose. Section 1.3 of this bill establishes
the applicability of that definition, and section 1.5 of this bill eliminates a
duplicative definition. Section 1. 6 of this bill makes a conforming change to
require the Director to administer the provisions of sections 1.1 and 1.2 in the same
manner as the provisions of existing law governing Medicaid. Section 1.7 of this
bill requires the transfer of certain money and authorizes the expenditure of certain
money to carry out the provisions of section 1.2.
The policies of the Depa rtment of Health and Human Services provide that
Medicaid will provide coverage of services provided by a psychiatrist,
psychologist, advanced practice registered nurse, marriage and family therapist or
licensed clinical social worker at a federally -qualified health center. ( Medicaid
Services Manual 2903(B)(1)) In 2023, federal law was amended to authorize
federal financial participation for Medicaid coverage of services provided by
mental health counselors, including alcohol and drug counselors who hold a
master’s or doctoral degree and clinical professional counselors, when such
services are provided in a federally -qualified health center. (42 U.S.C. §
1396a(a)(10), 42 U.S.C. § 1396d(a)(2)(c), 42 U.S.C. § 1396d( l)(2); Consolidated
Appropriations Act of 202 3, Pub. L. No. 117 -328, § 4121) Section 1.4 of this bill:
(1) codifies into law existing requirements that Medicaid cover services provided
by a psychiatrist, psychologist, advanced practice registered nurse, marriage and
family therapist or licensed clini cal social worker at a federally -qualified health
center; (2) newly requires Medicaid to cover services provided by a clinical
professional counselor, licensed alcohol and drug counselor or licensed clinical
alcohol and drug counselor at a federally qualif ied health center; and (3) newly
requires Medicaid to cover services provided by a master’s level intern in any of
those professions practicing in a federally-qualified health center under supervision.
Section 1.8 of this bill appropriates certain money an d authorizes the expenditure
of certain money to carry out the provisions of section 1.4.
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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 422 of NRS is hereby amended by adding
thereto the provisions set forth as sections 1.1 and 1.2 of this act.
Sec. 1.1. “Medication-assisted treatment” means treatment
for opioid use disorder using medication approved by the United
States Food and Drug Administration for that purpose.
Sec. 1.2. 1. To the extent that federal financial
participation is available, the Director shall include under
Medicaid coverage for the administration of medication for
medication-assisted treatment.
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 to receive
federal funding to provide the coverage described in subsection 1.
(b) Fully cooperate in good faith with the Federal Government
during the application process to satisfy the requirements of the
Federal Government for obtaining a waiver or amendment
pursuant to paragraph (a).
Sec. 1.3. NRS 422.001 is hereby amended to read as follows:
422.001 As used in this chapter, unless the context otherwise
requires, the words and terms defined in NRS 422.003 to 422.054,
inclusive, and section 1.1 of this act have the meanings ascribed to
them in those sections.
Sec. 1.4. NRS 422.272366 is hereby amended to read as
follows:
422.272366 1. [The] To the extent that federal financial
participation is available, the Director shall include [in the State
Plan for] under Medicaid [a requirement that the State must pay the
nonfederal share of expenditures incurred ] coverage for behavioral
health services, including, without limitation, mental health services
and services for the treatment of a substance use disorder, that are
delivered [through] :
(a) Through evidence-based, behavioral health integration
models, including, without limitation, collaborative care
management services [.] ; or
(b) In a federally-qualified health center by:
(1) A psychiatrist, psycholog ist, advanced practice
registered nurse, licensed marriage and family therapist, licensed
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clinical social worker , clinical professional counselor, licensed
alcohol and drug counselor or licensed clinical alcohol and drug
counselor; or
(2) A master’s leve l intern practicing under the direct
supervision of a provider of health care listed in sub paragraph 1
who practices the same profession as the master’s level intern.
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 to receive
federal funding to provide the coverage described in subsection 1.
(b) Fully cooperate in good faith with the Federal Government
during the application process to satisfy the requirements of the
Federal Government for obtaining a waiver or amendment
pursuant to paragraph (a).
3. As used in this section:
(a) “Behavioral health integration model” means a model of
delivering b ehavioral health services that integrates such services
with primary care. The term includes, without limitation, the
delivery of behavioral health services using collaborative care
management services.
(b) “Collaborative care management services” means a
combination of services and structured care management with
regular assessments directed and provided by a team of providers of
primary care and providers of behavioral health care.
(c) “Federally-qualified health center” has the meaning
ascribed to it in 42 U.S.C. § 1396d(l)(2)(B).
(d) “Master’s level intern” means:
(1) A physician licensed pursuant to chapter 630 or 633 of
NRS who is completing a residency or fellowship in psychiatry;
(2) A registered nurse who holds a master’s or doctoral
degree i n nursing and is completing the training necessary for
licensure as an advanced practice registered nurse;
(3) A psychological assistant, as defined in NRS 641.0263,
a psychological intern , as defined in NRS 641.0265, or a
psychological trainee, as defined in NRS 641.0267;
(4) A licensed marriage and family therapist intern;
(5) A licensed clinical professional counselor intern;
(6) A social worker who holds a master’s or doctoral degree
in social work, is licensed to engage in social work and is
completing the training necessary for licensure as a clinical social
worker;
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(7) A certified clinical alcohol and drug counselor inte rn;
or
(8) A certified alcohol and drug counselor who holds a
master’s degree or a doctoral degree in a field of social science
approved by the Board of Examiners for Alcohol, Drug and
Gambling Counselors and is completing the supervised counseling
required for licensure as an alcohol and drug counselor.
Sec. 1.5. NRS 422.272428 is hereby amended to read as
follows:
422.272428 1. The Director shall, to the extent that federal
financial participation is available, include under Medicaid coverage
for limited services for persons described in subsection 2 who are
incarcerated, for not more than 90 days before the scheduled release
of such persons. Such services must include, without limitation:
(a) Case management;
(b) Consultations with providers of physical and behavioral
health care;
(c) Laboratory and radiology services;
(d) Prescription drugs, including, without limitation,
medication-assisted treatment; and
(e) The services of a community health worker.
2. A person is eligible for the coverage described in subsection
1 if the person would otherwise be eligible for Medicaid if he or she
were not incarcerated and:
(a) Is under 18 years of age;
(b) Has been diagnosed with:
(1) A mental illness;
(2) Substance use disorder;
(3) A chronic disease or other significant disease;
(4) An intellectual disability;
(5) A developmental disability;
(6) A traumatic brain injury; or
(7) Human immunodeficiency virus; or
(c) Is pregnant or not more than 12 weeks postpartum.
3. The Department shall apply to the Secretary of Health and
Human Services for a waiver granted pursuant to 42 U.S.C. § 1315
that authorizes the Department to receive federal funding to provide
the coverage required by this sectio n. The Department shall fully
cooperate in good faith with the Federal Government during the
application process to satisfy the requirements of the Federal
Government for obtaining a waiver pursuant to this section.
4. If the Secretary of Health and Huma n Services grants the
waiver applied for pursuant to subsection 3, the Department of
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Corrections shall c oordinate with the Department of Health and
Human Services on an ongoing basis to ensure persons described in
subsection 2 who are incarcerated are scre ened and identified for
eligibility to receive the coverage described in subsection 1.
5. As used in this section:
(a) “Chronic disease” means a health condition or disease which
presents for a period of 3 months or more or is persistent, indefinite
or incurable.
(b) “Community health worker” has the meaning ascribed to it
in NRS 449.0027.
(c) “Developmental disability” has the meaning ascribed to it in
NRS 433.069.
(d) “Intellectual disability” has the meaning ascribed to it in
NRS 433.099.
(e) [“Medication-assisted treatment” means treatment for an
opioid use disorder using medication approved by the United States
Food and Drug Administration for that purpose.
(f)] “Mental illness” means any mental dysfunction leading to
the impaired ability of a person to maintain himself or herself and to
function effectively in his or her life situation without external
support.
[(g)] (f) “Traumatic brain injury” means a sudden shock or
damage to the brain or its coverings which is not of a degenerative
nature and produces an altered state of consciousness or temporarily
or permanently impairs the mental, cognitive, behavioral or physical
functioning of the brain. The term does not include:
(1) A cerebral vascular accident;
(2) An aneurism; or
(3) A congenital defect.
Sec. 1.6. 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;
(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
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(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
sections 1.1 and 1.2 of this act, 422.580, 432.010 to 432.133,
inclusive, 432B.6201 to 432B.626, inclusive, 44 4.002 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 Heal th 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 provide social
services, adopt a master plan for the provision of human services in
this State. The Director shall revise the plan bie nnially 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
Government concerning demographic trends, formulas for the
distribution of federa l 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 an d agencies, excluding
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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. 1.7. 1. The Division of Health Care Financing and
Policy of the Department of Health and Human Services shall
transfer the following sums from the Account to Improve Health
Care Quality and Access created by NRS 422.37945 to the Nevada
Medicaid budget account to carry out the provisions of section 1 .2
of this act:
For the Fiscal Year 2025-2026 .................................. $121,684
For the Fiscal Year 2026-2027 .................................. $382,542
2. Expenditure of the following sums not appropriated from the
State General Fund or the State Highway Fund is hereby authorized
by the Division of Health Care Financing and Policy of the
Department of Health and Human Services for the same purposes as
set forth in subsection 1:
For the Fiscal Year 2025-2026 .................................. $545,735
For the Fiscal Year 2026-2027 ............................... $1,686,686
Sec. 1.8. 1. There is hereby appropriated from the State
General Fund to the Division of Health Care Financing and Policy
of the Department of Health and Human Services to carry out the
provisions of section 1.4 of this act the following sums:
For the Fiscal Year 2025-2026 .................................... $77,943
For the Fiscal Year 2026-2027 .................................. $104,981
2. Expenditure of the following sums not appropriated from the
State General Fund or the State Highway Fund is hereby authorized
by the Division of Health Care Financing and Policy of the
Department of Health and Human Services for the same purposes as
set forth in subsection 1:
For the Fiscal Year 2025-2026 .................................. $179,425
For the Fiscal Year 2026-2027 .................................. $240,812
3. Any balance of the sums appropriated by subsection 1
remaining at the end of the respective fiscal years must not be
committed for expenditure after June 30 of the respective fiscal
years by the entity to which the appropriation is made or any entity
to which money from the appropriation is granted or other wise
transferred in any manner, and any portion of the appropriated
money remaining must not be spent for any purpose after
September 18, 2026, and September 17, 2027, respectively, by
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either the entity to which the money was appropriated or the entity
to which the money was subsequently granted or transferred, and
must be reverted to the State General Fund on or before
September 18, 2026, and September 17, 2027, respectively.
Sec. 2. 1. This section becomes effective upo n passage and
approval.
2. Sections 1.7 and 1.8 of this act become effective on July 1,
2025.
3. Section 1.4 of this act becomes 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 October 1, 2025, for all other purposes.
4. Sections 1 to 1.3 , inclusive, 1.5 and 1.6 of this act become
effective on March 1, 2026.
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