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- 83rd Session (2025)
Senate Bill No. 352–Senators Scheible, Cruz-Crawford; Cannizzaro,
Daly, Doñate, Dondero Loop, Flores, Lange, Nguyen,
Ohrenschall and Pazina
Joint Sponsors: Assemblymembers Roth,
González and Dalia
CHAPTER..........
AN ACT relating to health care; prohibiting certain health insurers
and providers of health care from engaging in certain
discriminatory actions; and providing other matters properly
relating thereto.
Legislative Counsel’s Digest:
Existing federal law prohibits certain heal th care entities from discriminating
on the basis of race, color, national origin, sex, age or disability. (45 C.F.R. §§
92.101, 92.206, 92.208, 92.209) Existing law prohibits certain public and private
policies of health insurance from discriminating agai nst any person with respect to
participation or coverage under the policy on the basis of actual or perceived gender
identity or expression. (NRS 287.010, 287.04335, 422.2701, 608.1555, 689A.033,
689B.0675, 689C.1975, 689C.425, 695A.198, 695B.3167, 695C.05 0, 695C.204,
695G.415) Sections 1-8 of this bill additionally prohibit certain public and private
policies of health insurance, including Medicaid, from discriminating against any
person on the basis of actual or perceived race, color, national origin, sex, age ,
sexual orientation or disability. Section 9 of this bill similarly proh ibits a provider
of health care from discriminating against a person on the basis of those same
characteristics, as well as gender identity or expression. Section 9 also authorizes a
board, agency or other entity in this State that licenses, certifies or r egulates
providers of health care to: (1) adopt regulations prescribing the specific types of
discrimination prohibited; and (2) discipline a provider of health care who violates
section 9.
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 689A.033 is hereby amended to read as
follows:
689A.033 1. An insurer that issues a policy of health
insurance shall not discriminate against any person with respect to
participation or coverage under the policy on the basis of an actual
or perceived [gender identity or expression. ] protected
characteristic.
2. Prohibited discrimination includes, without limitation:
[1.] (a) Denying, cancelling, limiting or refusing to issue or
renew a policy of health insurance on the basis of [the] an actual or
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perceived [gender identity or expression] protected characteristic of
a person or a family member of the person;
[2. Imposing]
(b) Except as otherwise provided by subsection 3, imposing a
payment or premium that is based on [the] an actual or perceived
[gender identity or expression ] protected characteristic of an
insured or a family member of the insured;
[3.] (c) Designating [the] an actual or perceived [gender
identity or expression ] protected characteristic of a person or a
family member of the person as grounds to deny, cancel or limit
participation or coverage; and
[4.] (d) Denying, cancelling or limiting participation or
coverage on the basis of an actual or perceived [gender identity or
expression,] protected characteristic, including, without limitation,
by limiting or denying coverage for health care services that are:
[(a)] (1) Related to gender transition, provided t hat there is
coverage under the policy for the services when the services are not
related to gender transition; or
[(b)] (2) Ordinarily or exclusively available to persons of any
sex.
3. The provisions of this section do not prohibit an insurer
from taking the age of an insured into account in a manner that is
otherwise authorized by state or federal law when determining the
applicable premium rate.
4. The provisions of this section must not be construed to
apply to a policy that provides coverage only for a specified disease
or illness or other limited benefit. The Division shall not interpret
the term “policy of health insurance” for the purposes of th is
section in a manner contrary to the provisions of this subsection.
5. As used in this section, “protected characteristic” means:
(a) Race, color, national origin, age, physical or mental
disability, sexual orientation or gender identity or expression; or
(b) Sex, including, without limitation, sex characteristics,
intersex traits and pregnancy or related conditions.
Sec. 2. NRS 689B.0675 is hereby amended to read as follows:
689B.0675 1. An insurer that issues a policy of group health
insurance shall not discriminate against any person with respect to
participation or coverage under the policy on the basis of an actual
or perceived [gender identity or expression. ] protected
characteristic.
2. Prohibited discrimination includes, without limitation:
[1.] (a) Denying, cancelling, limiting or refusing to issue or
renew a policy of group health insurance on the basis of [the] an
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actual or perceived [gender identity or expression ] protected
characteristic of a person or a family member of the person;
[2. Imposing]
(b) Except as otherwise provided by subsection 3, imposing a
payment or premium that is based on [the] an actual or perceived
[gender identity or expression ] protected characteristic of an
insured or a family member of the insured;
[3.] (c) Designating [the] an actual or perceived [gender
identity or expression ] protected characteristic of a person or a
family member of the person as grounds to deny, cancel or limit
participation or coverage; and
[4.] (d) Denying, cancelling or limiting participation or
coverage on the basis of an actual or perceived [gender identity or
expression,] protected characteristic, including, without limitation,
by limiting or denying coverage for health care services that are:
[(a)] (1) Related to gender transition, provided that there is
coverage under the policy for the services when the services are not
related to gender transition; or
[(b)] (2) Ordinarily or exclusively available to persons of any
sex.
3. The provisions of this section do not prohibit an insurer
from taking the age of an insured into account in a manner that is
otherwise authorized by state or federal law when determining the
applicable premium rate.
4. The provisions of this section must not be construed to
apply to a policy that provides coverage only for a specified disease
or illness or other limited benefit. The Division shall not interpret
the term “policy of group health insurance” for the purposes of
this section in a manner contrary to the provisions of this
subsection.
5. As used in this section, “protected characteristic” means:
(a) Race, color, national origin, age, physical or mental
disability, sexual orientation or gender identity or expression; or
(b) Sex, including, without limitation, sex characteristics,
intersex traits and pregnancy or related conditions.
Sec. 3. NRS 689C.1975 is hereby amended to read as follows:
689C.1975 1. A carrier that issu es a health benefit plan shall
not discriminate against any person with respect to participation or
coverage under the plan on the basis of an actual or perceived
[gender identity or expression.] protected characteristic.
2. Prohibited discrimination includes, without limitation:
[1.] (a) Denying, cancelling, limiting or refusing to issue or
renew a health benefit plan on the basis of [the] an actual or
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perceived [gender identity or expression] protected characteristic of
a person or a family member of the person;
[2. Imposing]
(b) Except as otherwise provided by subsection 3, imposing a
payment or premium that is based on [the] an actual or perceived
[gender identity or expression ] protected characteristic of an
insured or a family member of the insured;
[3.] (c) Designating [the] an actual or perceived [gender
identity or expression ] protected characteristic of a person or a
family member of the person as grounds to deny, cancel or limit
participation or coverage; and
[4.] (d) Denying, cancelling or limiting participation or
coverage on the basis of an actual or perceived [gender identity or
expression,] protected characteristic, including, without limitation,
by limiting or denying coverage for health care services that are:
[(a)] (1) Related to gender transition, provided that there is
coverage under the plan for the services when the services are not
related to gender transition; or
[(b)] (2) Ordinarily or exclusively available to persons of any
sex.
3. The provisions of this section do not prohibit a carrier
from taking the age of an insured into account in a manner that is
otherwise authorized by state or federal law when determining the
applicable premium rate.
4. As used in this section, “protected characteristic” means:
(a) Race, color, national origin, age, physical or mental
disability, sexual orientation or gender identity or expression; or
(b) Sex, including, without limitation, sex characteristics,
intersex traits and pregnancy or related conditions.
Sec. 4. NRS 695A.198 is hereby amended to read as follows:
695A.198 1. A society that issues a benefit contract shall not
discriminate against any person with respect to participation or
coverage under the contract on the basi s of an actual or perceived
[gender identity or expression.] protected characteristic.
2. Prohibited discrimination includes, without limitation:
[1.] (a) Denying, cancelling, limiting or refusing to issue or
renew a benefit contract on the basis of [the] an actual or perceived
[gender identity or expression ] protected characteristic of a person
or a family member of the person;
[2. Imposing]
(b) Except as otherwise provided by subsection 3, imposing a
payment or premium that is based on [the] an actual or perceived
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[gender identity or expression ] protected characteristic of an
insured or a family member of the insured;
[3.] (c) Designating [the] an actual or perceived [gender
identity or expression ] protected characteristic of a person or a
family member of the person as grounds to deny, cancel or limit
participation or coverage; and
[4.] (d) Denying, cancelling or limiting participation or
coverage on the basis of an actual or perceived [gender identity or
expression,] protected characteristic, including, without limitation,
by limiting or denying coverage for health care services that are:
[(a)] (1) Related to gender transition, provided that there is
coverage under the contract for the services when the services are
not related to gender transition; or
[(b)] (2) Ordinarily or exclusively available to persons of any
sex.
3. The provisions of this section do not prohibit a society from
taking the age of an insured into account in a manner that is
otherwise authorized by state or federal law when determining the
applicable premium rate.
4. As used in this section, “protected characteristic” means:
(a) Race, color, national origin, age, physical or mental
disability, sexual orientation or gender identity or expression; or
(b) Sex, including, without limitation, sex characteristics,
intersex traits and pregnancy or related conditions.
Sec. 5. NRS 695B.3167 is hereby amended to read as follows:
695B.3167 1. A hospital or medical services corporation that
issues a policy of health insurance shall not discriminate against any
person with respect to participation or coverage under the policy on
the basis of an actual or perceived [gender identity or expression. ]
protected characteristic.
2. Prohibited discrimination includes, without limitation:
[1.] (a) Denying, cancelling, limiting or refusing to issue or
renew a policy of health insurance on the basis of [the] an actual or
perceived [gender identity or expression] protected characteristic of
a person or a family member of the person;
[2. Imposing]
(b) Except as otherwise provided by subsection 3, imposing a
payment or premium that is based on [the] an actual or perceived
[gender identity or expression ] protected characteristic of an
insured or a family member of the insured;
[3.] (c) Designating [the] an actual or perceived [gender
identity or expression ] protected characteristic of a person or a
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family member of the person as grounds to deny, cancel or limit
participation or coverage; and
[4.] (d) Denying, cancelling or limiting participation or
coverage on the basis of an actual or perceived [gender identity or
expression,] protected characteristic, including, without limitation,
by limiting or denying coverage for health care services that are:
[(a)] (1) Related to gender transition, provided that there is
coverage under the policy for the services when the services are not
related to gender transition; or
[(b)] (2) Ordinarily or exclusively available to persons of any
sex.
3. The provisions of this section do not prohibit a hospital or
medical services corporation from taking the age of an insured
into account in a manner that is otherwise authorized by state or
federal law when determining the applicable premium rate.
4. As used in this section, “protected characteristic” means:
(a) Race, color, national origin, age, physical or mental
disability, sexual orientation or gender identity or expression; or
(b) Sex, including, without limitation, sex characteristics,
intersex traits and pregnancy or related conditions.
Sec. 6. NRS 695C.204 is hereby amended to read as follows:
695C.204 1. A health maintenance organization that issues a
health care plan shall not discriminate against any person with
respect to participation or coverage under the plan on the basis of an
actual or perceived [gender identity or expression. ] protected
characteristic.
2. Prohibited discrimination includes, without limitation:
[1.] (a) Denying, cancelling, limiting or refusing to issue or
renew a health care plan on the basis of [the] an actual or perceived
[gender identity or expression ] protected characteristic of a person
or a family member of the person;
[2. Imposing]
(b) Except as otherwise provided by subsection 3, imposing a
payment or premium that is based on [the] an actual or perceived
[gender identity or expression ] protected characteristic of an
enrollee or a family member of the enrollee;
[3.] (c) Designating [the] an actual or perceived [gender
identity or expression ] protected characteristic of a person or a
family member of the person as grounds to deny, cancel or limit
participation or coverage; and
[4.] (d) Denying, cancelling or limiting participation or
coverage on the basis of an actual or perceived [gender identity or
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expression,] protected characteristic, including, without limitation,
by limiting or denying coverage for health care services that are:
[(a)] (1) Related to gender transition, provided that there is
coverage under the plan for the services when the services are not
related to gender transition; or
[(b)] (2) Ordinarily or exclusively available to persons of any
sex.
3. The provisions of this section do not prohibit a health
maintenance organization from taking the age of an enrollee into
account in a manner that is otherwise authorized by state or
federal law when determining the applicable premium rate.
4. As used in this section, “protected characteristic” means:
(a) Race, color, national origin, age, physical or mental
disability, sexual orientation or gender identity or expression; or
(b) Sex, including, without limitation, sex characteristics,
intersex traits and pregnancy or related conditions.
Sec. 7. NRS 695G.415 is hereby amended to read as follows:
695G.415 1. A managed care organization that issues a
health care plan shall not discriminate against any person with
respect to participation or coverage under the plan on the basis of an
actual or perceived [gender identity or expression. ] protected
characteristic.
2. Prohibited discrimination includes, without limitation:
[1.] (a) Denying, cancelling, limiting or refusing to issue or
renew a health care plan on the basis of [the] an actual or perceived
[gender identity or expression ] protected characteristic of a person
or a family member of the person;
[2. Imposing]
(b) Except as otherwise provided by subsection 3, imposing a
payment or premium that is based on [the] an actual or perceived
[gender identity or expression ] protected characteristic of an
insured or a family member of the insured;
[3.] (c) Designating [the] an actual or perceived [gender
identity or expression ] protected characteristic of a person or a
family member of the person as grounds to deny, cancel or limit
participation or coverage; and
[4.] (d) Denying, cancelling or limiting participation or
coverage on the basis of an actual or perceived [gender identity or
expression,] protected characteristic, including, without limitation,
by limiting or denying coverage for health care services that are:
[(a)] (1) Related to gender transition, provided that there is
coverage under the plan for the services when the services are not
related to gender transition; or
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[(b)] (2) Ordinarily or exclusively available to persons of any
sex.
3. The pro visions of this section do not prohibit a managed
care organization from taking the age of an insured into account
in a manner that is otherwise authorized by state or federal law
when determining the applicable premium rate.
4. As used in this section, “protected characteristic” means:
(a) Race, color, national origin, age, physical or mental
disability, sexual orientation or gender identity or expression; or
(b) Sex, including, without limitation, sex characteristics,
intersex traits and pregnancy or related conditions.
Sec. 8. NRS 422.2701 is hereby amended to read as follows:
422.2701 1. The Department shall not discriminate against
any person with respect to participation or coverage under Medicaid
on the basis of an actual or perceived [gender identity or
expression.] protected characteristic.
2. Prohibited discrimination includes, without limitation:
[1.] (a) Denying, cancelling, limiting or refusing to issue a
payment or coverage on the basis of [the] an actual or perceived
[gender identity or expression ] protected characteristic of a person
or a family member of the person;
[2.] (b) Imposing a payment that is based on [the] an actual or
perceived [gender identity or expression] protected characteristic of
a recipient of Medicaid or a family member of the recipient;
[3.] (c) Designating [the] an actual or perceived [gender
identity or expression ] protected characteristic of a person or a
family member of the person as grounds to deny, cancel or limit
participation or coverage; and
[4.] (d) Denying, cancelling or limiting participation or
coverage on the basis of an actual or perceiv ed [gender identity or
expression,] protected characteristic, including, without limitation,
by limiting or denying payment or coverage for health care services
that are:
[(a)] (1) Related to gender transition, provided that there is
coverage under Medicaid for the services when the services are not
related to gender transition; or
[(b)] (2) Ordinarily or exclusively available to persons of any
sex.
3. The provisions of this section do not prohibit the
Department from determining the eligibility of a person for
participation or coverage under Medicaid in a manner that is
otherwise authorized by state or federal law.
4. As used in this section, “protected characteristic” means:
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(a) Race, color, national origin, age, physical or mental
disability, sexual orientation or gender identity or expression; or
(b) Sex, including, without limitation, sex characteristics,
intersex traits and pregnancy or related conditions.
Sec. 9. Chapter 629 of NRS is hereby amended by adding
thereto a new section to read as follows:
1. A provider of health care shall not discriminate in the
provision of services to a person seeking to receive or receiving
services from the provider of health care based wholly or partially
on the actual or perceived:
(a) Race, color, national origin, age, physical or mental
disability, sexual orientation or gender identity or expression of
the person, family member of the person or a person with whom
the person associates; or
(b) Sex, including, without li mitation, sex characteristics,
intersex traits and pregnancy or related conditions of the person, a
family member of the person or a person with whom the person
associates.
2. A health care licensing board may adopt regulations
prescribing the specific t ypes of discrimination prohibited by
subsection 1.
3. A provider of health care who violates any provision of this
section or any regulation adopted pursuant thereto is guilty of
unprofessional conduct and is subject to disciplinary action by the
health care licensing board by which he or she is licensed,
certified or regulated.
4. The provisions of this section shall not be construed to:
(a) Require a provider of health care to take or refrain from
taking any action in violation of reasonable medical standards;
(b) Require a provider of health care to engage in any
diagnosis, treatment or other conduct which the provider of health
care is not qualified to perform; or
(c) Prohibit a provider of health care from adopting a policy
that is applied uniformly and in a nondiscriminatory manner.
5. As used in this section, “health care licensing board”
means:
(a) A board created pursuant to chapter 630, 630A, 631, 632,
633, 634, 634A, 635, 636, 637, 637B, 639, 640, 640A, 640B, 641,
641A, 641B, 641C or 641D of NRS.
(b) The State Board of Health with respect to licenses issued
pursuant to chapter 640D or 640E of NRS.
(c) The Division of Public and Behavioral Health of the
Department of Health and Human Services.
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Sec. 10. 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. 11. 1. This section and section 10 of this act become
effective upon passage and approval.
2. Sections 1 to 9, inclusive, of this act become effective:
(a) Upon passage and approval for the purpose of adopting any
regulations and performing any other preparatory administrative
tasks that are necessary to carry out the provisions of this act; and
(b) On January 1, 2026, for all other purposes.
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