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- 83rd Session (2025)
Senate Bill No. 348–Senators Pazina; and Buck
CHAPTER..........
AN ACT relating to health care; establishing a fee the State Public
Health Laboratory is authorized to charge for certain
examinations and tests for the discovery of certain diseases in
infants; removing a requirement that the State Public Health
Laboratory hold a public hearing under certain
circumstances; requiring Medicaid to reimburse such
examinations and tests s eparately from reimbursement for
other labor and delivery services and newborn care; requiring
the Director of the Department of Health and Human
Services to request the establishment of a certain rate of
reimbursement for such examinations and tests; and
providing other matters properly relating thereto.
Legislative Counsel’s Digest:
Existing law requires the State Public Health Laboratory to make available, at
such charges as may be established, to health officials, the Director of the State
Department of Agriculture and licensed physicians of the State, proper laboratory
facilities for the prompt diagnosis of communicable diseases. (NRS 439.240)
Existing law requires the State Board of Health to adopt regulations governing
examinations and tests required for the discovery in infants of preventable or
inheritable disorders. Existing law further requires any physician, midwife, nurse,
freestanding birthing center or hospital of any nature attending or assisting any
infant, or the person who gave birth to an y infant, at childbirth to: (1) examine the
infant in accordance with those regulations; and (2) collect and send to the State
Public Health Laboratory any specimens needed for the examinations and tests that
must be performed by a laboratory. (NRS 442.008 ) Section 3 of this bill authorizes
the State Public Health Laboratory , on or after January 1, 2026, to charge a fee of
not more than $150 or the rate of reimbursement paid by Medicaid, whichever is
less, for the required examinations and tests for the discovery in infants of
preventable or inheritable disorders. Section 1 of this bill makes a conforming
change to clarify that the State Public Health Laboratory establishes the fee for such
examinations and tests pursuant to section 3. Section 3 also removes a requirement
that the State Public Health Laboratory hold a public hearing before increasing that
fee. Section 68.7 of this bill authorizes the State Public Health Laboratory, on or
after July 1, 2025 , and before January 1, 2026 , to charge a fee of no t more than
$122 for the required examinations and tests for the discovery in infants of
preventable or inheritable disorders.
Existing law requires the Department of Health and Human Services to
administer the Medicaid program. (NRS 422.270) Section 3.7 of this bill requires
the Director of the Department to provide reimbursement under Medicaid for the
required examinations and tests for the discovery in infants of preventable or
inheritable disorders separately from the reimbursement provided for other labor
and delivery services and newborn care. Section 3.4 of this bill makes a
conforming change to indicate that the provisions of section 3.7 will be
administered in the same manner as the provisions of existing law governing
Medicaid. Section 68. 3 of this bill requires the D irector to submit to the United
States Secretary of Health and Human Services, to the extent that money is
available and as soon as practicable , a request to include under Medicaid a rate of
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reimbursement of not more than $122 for such examinations and tests. Sections 3.7
and 68.3 authorize the Director to increase that rate of reimbursement to not more
than $150 on or after January 1, 2026.
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. NRS 439.240 is hereby amended to read as follows:
439.240 1. The University of Nevada School of Medicine
shall maintain the State Public Health Laboratory, and may
designate, establish or maintain such branch laboratories as may be
necessary.
2. The purpose of the State Public Health Laboratory is:
(a) To make available, at such charges as may be established [,]
or are prescribed pursuant to NRS 442.008, to health officials, the
Director of the State Department of Agriculture and licensed
physicians of the State, proper laboratory facilities for the prompt
diagnosis of communicable diseases.
(b) To make necessary examinations and analyses of water,
natural ice, sewage, milk, food and clinical material.
(c) To conduct research into the nature, cause, diagnosis and
control of diseases.
(d) To undertake such other technical and laboratory duties as
are in the interest of the health of the general public.
3. The person in charge of the State Public Hea lth Laboratory,
or the person’s designee, must be a skilled bacteriologist.
4. The person in charge of the State Public Health Laboratory
may have such technical assistants as that person, in cooperation
with the University of Nevada School of Medicine, considers
necessary.
5. Reports of investigations conducted at the State Public
Health Laboratory may be published from time to time in bulletins
and circulars.
6. If the University of Nevada School of Medicine designates a
branch laboratory pursuant t o subsection 1 that is operated or
controlled by a public agency other than the University of Nevada
School of Medicine, the public agency and the University of Nevada
School of Medicine shall enter into a cooperative agreement
pursuant to NRS 277.080 to 2 77.180, inclusive, concerning the
branch laboratory. The cooperative agreement must include, without
limitation, provisions setting forth the powers and duties of each
party to the cooperative agreement.
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Sec. 2. (Deleted by amendment.)
Sec. 3. NRS 442.008 is hereby amended to read as follows:
442.008 1. The State Board of Health shall adopt regulations
governing examinations and tests required for the discovery in
infants of preventable or inheritable disorders, including tests for the
presence of sickle cell disease and its variants and sickle cell trait.
2. Except as otherwise provided in this subsection, the
examinations and tests required pursuant to subsection 1 must
include tests and examinations for each disorder recommended to be
screened by the Health Resources and Services Administration of
the United States Department of Health and Human Services by not
later than 4 years after the recommendation is published. The State
Board may exclude any such disorder upon request of the Chief
Medical Officer or the person in charge of the State Public Health
Laboratory based on:
(a) Insufficient funding to conduct testing for the disorder; or
(b) Insufficient resources to address the results of the
examination and test.
3. Any examination or test required by the regulations adopted
pursuant to subsection 1 which must be performed by a laboratory
must be sent to the State Public Health Laboratory. [If the State
Public Health Laboratory i ncreases the amount charged for
performing such an examination or test pursuant to NRS 439.240,
the Division shall hold a public hearing during which the State
Public Health Laboratory shall provide to the Division a written and
verbal fiscal analysis of t he reasons for the increased charges. ] The
State Public Health Laboratory may charge a fee of not more than
$150 or the rate of reimburseme nt paid by Medicaid pursuant to
section 3.7 of this act , whichever is less, for all such examinations
and tests required for the discovery in infants of preventable or
inheritable disorders pursuant to this section.
4. Except as otherwise provided in subsection 7, the
regulations adopted pursuant to subsection 1 concerning tests for the
presence of sickle cell disease and its variants and sickle cell trait
must require the screening for sickle cell disease and its variants and
sickle cell trait of:
(a) Each newborn child who is susceptible to sickle cell disease
and its variants and sickle cell trait as determined by regulations of
the State Board of Health; and
(b) Each b iological parent of a child who wishes to undergo
such screening.
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5. Any physician, midwife, nurse, freestanding birthing center
or hospital of any nature attending or assisting in any way any
infant, or the person who gave birth to any infant, at childbirth shall:
(a) Make or cause to be made an examination of the infant,
including standard tests that do not require laboratory services, to
the extent required by regulations of the State Board of Health as is
necessary for the discovery of conditions indicating such
preventable or inheritable disorders.
(b) Collect and send to the State Public Health Laboratory or
cause to be collected and sent to the State Public Health Laboratory
any specimens needed for the examinations and tests that must be
performed by a laboratory and are required by the regulations
adopted pursuant to subsection 1.
6. If the examination and tests reveal the existence of such
conditions in an infant, the physician, midwife, nurse, freestanding
birthing center or hospital atten ding or assisting at the birth of the
infant shall immediately:
(a) Report the condition to the Chief Medical Officer or the
representative of the Chief Medical Officer, the local health officer
of the county or city within which the infant or the person who gave
birth to the infant resides, and the local health officer of the county
or city in which the child is born; and
(b) Discuss the condition with the parent, parents or other
persons responsible for the care of the infant and inform them of the
treatment necessary for the amelioration of the condition.
7. An infant is exempt from examination and testing if either
parent files a written objection with the person or institution
responsible for making the examination or tests.
8. As used in this sec tion, “sickle cell disease and its variants”
has the meaning ascribed to it in NRS 439.4927.
Sec. 3.4. 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 D ivision 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
section 3.7 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 Divisio n 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 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, age ncies 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 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 pro grams of those organizations and 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. 3.7. 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
reimbursement at a rate not to exceed $150 for all examinations
and tests required for the discovery in infants of preventable or
inheritable disorders pursuant to NRS 4 42.008. Such
reimbursement must be provided separately from the
reimbursement provided for other labor and delivery services
provided to a person or newborn care provided to an infant, as
applicable.
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 reimbursement 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).
Secs. 4-68. (Deleted by amendment.)
Sec. 68.3. 1. As soon as practicable after the effective date of
this section and to the extent that money is available, the Director of
the Department of Health and Human Services shall submit to the
United States Secretary of Health and Human Services a request to
include under Medicaid a rate of reimbursement of not more than
$122 for a ll examinations and tests required for the discovery in
infants of preventable or inheritable disorders pursuant to NRS
442.008. That rate of reimbursement must not become effective
before July 1, 2025. Notwithstanding the provisions of section 3.7
of this act, any additional increase to that rate of reimbursement
must not become effective until January 1, 2026.
2. The request submitted pursuant to subsection 1 must be
supported using methods for determining reimbursement rates
accepted by the Secretary.
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Sec. 68.7. Notwithstanding the amendatory provisions of
section 3 of this act , the State Public Health Laboratory may not,
before January 1, 2026 , charge a fee in excess of $122 for all
examinations and tests required for the discovery in infa nts of
preventable or inheritable disorders pursuant to NRS 442.008.
Sec. 69. 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. 70. 1. This section and section 68.3 of this act become
effective upon passage and approval.
2. Sections 1, 3, 3.4, 3.7, 64, 65, 66, 68.7 and 69 of this act
become effective on July 1, 2025.
3. Sections 2, 4 to 63, inclusive, 67 and 68 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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