Makes revisions relating to health care. (BDR 40-705)

- 83rd Session (2025)
Senate Bill No. 378–Senators Doñate, Cruz-Crawford, Nguyen,
Flores; Cannizzaro, Lange and Ohrenschall

Joint Sponsor: Assemblymember Gray

CHAPTER..........

AN ACT relating to health care; revising requirements governing
the electronic maintenance, transmittal and exchange of
health information; establishing a program to increase
awareness of information concerning independent centers for
emergency medical care; requiring certain facilities that are
owned or operated by, or otherwise part of, hospitals to be
licensed as independent centers for emergency medical care;
requiring certain independent centers for emergency medical
care to provide urgent care services under certain conditions;
authorizing the review of certain sealed records to determine
the suitabili ty of a person to provide services under
Medicaid; requiring Medicaid to include a system of value -
based payments for independent centers for emergency
medical care; requiring a provider of services under Medicaid
to maintain certain records; authorizing a udits of such
records, the review and denial of claims under Medicaid and
the recovery of money paid under Medicaid under certain
circumstances; prohibiting a noncompetition covenant from
applying to a patient-facing provider of health care; requiring
a custodian of health records to furnish health records within
a specified period of time and without charging a fee under
certain circumstances; making an appropriation; and
providing other matters properly relating thereto.
Legislative Counsel’s Digest:
Existing law requires the Director of the Department of Health and Human
Services to prescribe by regulation a framework for the electronic maintenance,
transmittal and exchange of electronic health records, prescriptions, health -related
information and electronic signatures and requirements for electronic equivalents of
written entries or written approvals. With certain exceptions, existing law requires
various entities involved in health care, including persons and facilities that provide
health care, to maintain, transmit and exchange health information in accordance
with those regulations. (NRS 439.589) Section 5 of this bill prohibits those
regulations from authorizing such a person or entity to comply with that
requirement by connecting with a health i nformation exchange or utilizing any
other service that charges a fee for providing electronic health records to such a
person or entity or a patient upon request. Section 33 of this bill: (1) requires a
custodian of health care records to furnish electron ic health records to a patient or
a covered entity upon the request of a patient within 7 business days; and (2)
prohibits a custodian of health care records from charging a fee to furnish health
care records under such circumstances. Section 33 defines “covered entity” to refer
to providers of health care who transmit health information in electronic form,

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health insurers and certain other entities involved in the processing of health
information. (45 C.F.R. § 160.103)
Sections 4, 31 and 40 of this bill limit the health care providers that must
maintain, transmit and exchange health information electronically to medical
facilities and high -level providers of health care. Section 1 of this bill defines the
term “high-level provider of health care” to mean a physician, physician assistant,
dentist, advanced practice registered nurse, chiropractic physician, podiatric
physician or physical therapist. Section 4 additionally exempts from requirements
to maintain, transmit and exchange health information electr onically high -level
providers of health care whose solo or group practices are under a certain size .
However, section 4 requires such high-level providers of health care to furnish the
medical records of a patient electronically to the patient or another person or entity
upon request of the patient. Section 6 of this bill makes conforming changes to
revise the applicability of a provision requiring the Department to notify the
licensing board of a provider who fails to comply with requirements governing the
electronic maintenance, transmittal and exchange of health information. Section 2
of this bill establishes the applicability of the definition set forth in section 1, and
sections 24, 25, 29, 35 and 36 of this bill make other conforming changes to
indicate the proper placement of section 1 in the Nevada Revised Statutes. Section
32 of this bill updates internal references changed by section 31.
Existing law prohibits a person or entity from operating a n independent center
for emergency medical care without a license issued by the Division of Public and
Behavioral Health of the Department. (NRS 449.030) Section 14 of this bill
requires a facility that is structurally separate from the hospital and provid es
services for the treatment of a medical emergency , including such a facility that is
owned or operated by, or otherwise part of, a hospital, to be licensed as an
independent center for emergency medical care. (NRS 449.0151, 449.030) Sections
15 and 16 of this bill prohibit the Division or the State Board of Health from
charging a fee for the issuance of such a license. Section 17 of this bill prohibits the
Division from issuing a license to operate an independent center for emergency
medical care that is located within a 5 mile radius of another independent center for
emergency medical care or a hospital with an emergency department. However,
section 37 of this bill requires the Division to issue a license to an independent
center for emergency medical ca re that: (1) is operating on the date on which this
bill is enacted; (2) is newly required by section 14 to be licensed; and (3) otherwise
meets the requirements for licensure, regardless of where the facility is located.
Section 37 additionally requires the Division to issue a license to an independent
center for emergency medical care that has not yet been constructed, but whose
owner or operator had taken certain steps toward completing construction prior to
January 1, 2025, and that otherwise meets the requirements for licensure at the time
of the application for licensure, regardless of where the facility is located. Section
18 of this bill requires an independent center for emergency medical care to provide
urgent care services during all operating hou rs and imposes certain additional
requirements related to the provision of such urgent care , except that section 36.5
of this bill exempts independent centers for emergency medical care that are
licensed on the date on which this bill is enacted from that requirement.
Existing law establishes programs to increase awareness of information
concerning hospitals and surgical centers for ambulatory patients. (NRS 439A.200 -
439A.290) Section 9 of this bill requires the Department to establish a similar
program to increase awareness of information concerning independent centers for
emergency medical care. Sections 9, 10, 12, 13 and 19 of this bill provide for the
Department to collect certain information on the operations of independent centers
for emergency medical care and the outcomes for patients treated by independent

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centers for emergency medical care. To facilitate such re porting, section 19
requires an independent center for emergency medical care to use the same form
prescribed by the Director for discharging patients as a hospital is currently
required to use. Section 34 of this bill makes a conforming change to reflect that
independent centers for emergency medical care will be using the same form.
Sections 12 and 13 require the Department to: (1) make certain information
concerning independent centers for emergency medical care available upon request;
and (2) post certa in information concerning independent centers for emergency
medical care on an Internet website maintained by the Department. Section 23 of
this bill makes a conforming change to reflect the revised content of that Internet
website. Section 8 of this bill defines the term “independent center for emergency
medical care” for that purpose. Section 11 of this bill establishes the applicability
of certain definitions. Section 20 of this bill requires a report prepared by the
Director on the status of the program s to increase public awareness of information
concerning hospitals and surgical centers for ambulatory patients to additionally
include information on the status of the program to increase awareness of
information concerning independent centers for emergen cy medical care. Section
26.5 of this bill requires the Director of the Department, to the extent that money is
available, to include under Medicaid a system of value -based payments for care
provided by independent centers for emergency medical care to rec ipients of
Medicaid.
Existing law authorizes a court, upon a petition, to order the sealing of records
of certain convictions if the person who was convicted: (1) has not been convicted
of any additional offense, except for minor traffic violations, for a specified
period of time; and (2) does not have charges pending for any offense, except for
minor traffic violations. (NRS 179.245) Existing law also authorizes a court, upon a
petition, to order the sealing of records of an arrest where the charges were
dismissed, the prosecutor declined to prosecute or the person who was arrested was
acquitted. (NRS 179.255) Section 21 of this bill authorizes the Department or the
Division of Health Care Financing and Policy of the Department to review certain
sealed records for the purpose of determining the suitability of the person to whom
the records pertain to serve as a provider of services under Medicaid or to own or
serve as an officer, managing employee or managing agent of such a provider of
services.
Existing law prescribes a procedure for conducting a hearing to review an
action taken against a provider of services under Medicaid. (NRS 422.306) Section
27 of this bill requires such a provider of services to maintain and provide certain
documents to the Depart ment for the purpose of verifying claims. Section 27
authorizes the Department to deny a claim or recover money already paid if the
Department is unable to verify the claim. Section 28 of this bill: (1) prescribes a
process for the Department to review cla ims for appropriateness and propriety; and
(2) authorizes the Department to deny or recover any amount paid pursuant to such
a claim or take certain actions based on such a review. Section 22 of this bill makes
a conforming change to require the Director t o administer sections 26.5, 27 and 28
in the same manner as other provisions governing Medicaid. Section 36.2 of this
bill makes an appropriation to the Division of Health Care Financing and Policy of
the Department and authorizes the expenditure of certain other money to carry out
sections 26.5, 27 and 28.
Existing law provides that a noncompetition covenant is void unless the
covenant: (1) is supported by valuable consideration; (2) does not impose any
restraint that is greater than is required for the protection of the employer; (3) does
not impose any undue hardship on the employee; and (4) imposes restriction s that
are appropriately related to the consideration for the covenant. (NRS 613.195)

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Section 30 of this bill provides that a noncompetition covenant may not apply to a
provider of health care, which section 30 defines as a provider of health care whose
primary duties involve clinical care to patients and who is not employed or
contracted to primarily perform administrative tasks.

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 439 of NRS is hereby amended by adding
thereto a new section to read as follows:
“High-level provider of health care” means a physician or
physician assistant licensed pursuant to chapter 630 or 633 of
NRS, dentist, advanced practice registered nurse, chiropractic
physician, podiatric physician or physical therapist.
Sec. 2. NRS 439.581 is hereby amended to read as follows:
439.581 As used in NRS 439.581 to 439.597, inclusive, and
section 1 of this act, unless the context otherwise requires, the
words and terms defined in NRS 439.582 to 439.585, inclusive, and
section 1 of this act have the meanings ascribed to them in those
sections.
Sec. 3. NRS 439.588 is hereby amended to read as follows:
439.588 1. A health information exchange shall not operate
in this State without first obtaining certification as provided in
subsection 2.
2. The Director shall by regulation establish the manner in
which a health information exchange may apply for certification and
the requirements for granting such certification, which must include,
without limitation, that the health information exchange demonstrate
its financial and operational sustainability, adherence to the privacy,
security and patient consent standards adopted pursuant to NRS
439.589 and capacity for interoperability with any other health
information exchange certified pursuant to this section.
3. The Director may deny an application for certification or
may suspend or revoke any certification issued pursuant to
subsection 2 for failure to comply with the provisions of NRS
439.581 to 439.597, inclusive, and section 1 of this act or the
regulations adopted pursuant thereto or any applicable federal or
state law.
4. When the Director intends to deny, suspend or revoke a
certification, he or she shall give reasonable notice to all parties by
certified mail. The notice must contain the legal author ity,
jurisdiction and reasons for the action to be taken. A health

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- 83rd Session (2025)
information exchange that wishes to contest the action of the
Director must file an appeal with the Director.
5. The Director shall adopt regulations establishing the manner
in which a person may file a complaint with the Director regarding a
violation of the provisions of this section.
6. The Director may impose an administrative fine against a
health information exchange which operates in this State without
holding a certification in a n amount established by the Director by
regulation. The Director shall afford a health information exchange
so fined an opportunity for a hearing pursuant to the provisions of
NRS 233B.121.
7. The Director may adopt such regulations as he or she
determines are necessary to carry out the provisions of this section.
Sec. 4. NRS 439.589 is hereby amended to read as follows:
439.589 1. The Director, in consultation with health care
providers, third parties and other interes ted persons and entities,
shall by regulation prescribe a framework for the electronic
maintenance, transmittal and exchange of electronic health records,
prescriptions, health -related information and electronic signatures
and requirements for electronic e quivalents of written entries or
written approvals in accordance with federal law. The regulations
must:
(a) Establish standards for networks and technologies to be used
to maintain, transmit and exchange health information, including,
without limitation, standards:
(1) That require:
(I) The use of networks and technologies that allow
patients to access electronic health records directly from the health
care provider of the patient and forward such electronic health
records electronically to other persons and entities; and
(II) The interoperability of such networks and
technologies in accordance with the applicable standards for the
interoperability of Qualified Health Information Networks
prescribed by the Office of the National Coordinator for He alth
Information Technology of the United States Department of Health
and Human Services;
(2) To ensure that electronic health records retained or shared
are secure;
(3) To maintain the confidentiality of electronic health
records and health -related i nformation, including, without
limitation, standards to maintain the confidentiality of electronic
health records relating to a child who has received health care
services without the consent of a parent or guardian and which

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ensure that a child’s right to access such health care services is not
impaired;
(4) To ensure the privacy of individually identifiable health
information, including, without limitation, standards to ensure the
privacy of information relating to a child who has received health
care services without the consent of a parent or guardian;
(5) For obtaining consent from a patient before retrieving the
patient’s health records from a health information exchange,
including, without limitation, standards for obtaining such consent
from a c hild who has received health care services without the
consent of a parent or guardian;
(6) For making any necessary corrections to information or
records;
(7) For notifying a patient if the confidentiality of
information contained in an electronic health record of the patient is
breached;
(8) Governing the ownership, management and use of
electronic health records, health -related information and related
data; and
(9) For the electronic transmission of prior authorizations for
prescription medication;
(b) Ensure compliance with the requirements, specifications and
protocols for exchanging, securing and disclosing electronic health
records, health -related information and related data prescribed
pursuant to the provisions of the Health Information Technology for
Economic and Clinical Health Act, 42 U.S.C. §§ 300jj et seq. and
17901 et seq., the Health Insurance Portability and Accountability
Act of 1996, Public Law 104 -191, and other applicable federal and
state law; and
(c) Be based on natio nally recognized best practices for
maintaining, transmitting and exchanging health information
electronically.
2. The standards prescribed pursuant to this section must
include, without limitation:
(a) Requirements for the creation, maintenance and tra nsmittal
of electronic health records;
(b) Requirements for protecting confidentiality, including
control over, access to and the collection, organization and
maintenance of electronic health records, health -related information
and individually identifiable health information;
(c) Requirements for the manner in which a patient may,
through a health care provider who participates in the sharing of
health records using a health information exchange, revoke his or

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her consent for a health care provider to re trieve the patient’s health
records from the health information exchange;
(d) A secure and traceable electronic audit system for
identifying access points and trails to electronic health records and
health information exchanges; and
(e) Any other require ments necessary to comply with all
applicable federal laws relating to electronic health records,
health-related information, health information exchanges and the
security and confidentiality of such records and exchanges.
3. The regulations adopted pur suant to this section must not
require any person or entity to use a health information exchange.
4. Except as otherwise provided in subsections 5, 6 and 7, the
Department and the divisions thereof, other state and local
governmental entities, medical fa cilities, high -level providers of
health care , [providers,] third parties, pharmacy benefit managers
and other entities licensed or certified pursuant to title 57 of NRS
shall maintain, transmit and exchange health information in
accordance with the regulations adopted pursuant to this section, the
provisions of NRS 439.581 to 439.597, inclusive, and section 1 of
this act and any other regulations adopted pursuant thereto.
5. The Federal Government and employees thereof, a provider
of health coverage fo r federal employees, a provider of health
coverage that is subject to the Employee Retirement Income
Security Act of 1974, 29 U.S.C. §§ 1001 et seq., or a Taft -Hartley
trust formed pursuant to 29 U.S.C. § 186(c)(5) is not required to but
may maintain, tran smit and exchange electronic information in
accordance with the regulations adopted pursuant to this section.
6. A high-level provider of health care [provider] may apply to
the Department for a waiver from the provisions of subsection 4 on
the basis th at the high-level provider of health care [provider] does
not have the infrastructure necessary to comply with those
provisions, including, without limitation, because the high-level
provider of health care [provider] does not have access to the
Internet. The Department shall grant a waiver if it determines that:
(a) The high-level provider of health care [provider] does not
currently have the infrastructure necessary to comply with the
provisions of subsection 4; and
(b) Obtaining such infrastructure is not reasonably practicable,
including, without limitation, because the cost of such infrastructure
would make it difficult for the high-level provider of health care
[provider] to continue to operate.
7. The provisions of subsection 4 do not apply to [the] :
(a) The Department of Corrections [.] ;

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(b) A high -level provider of health care whose solo practice
provided care to fewer than 500 patients during the immediately
preceding year and reasonably expects to prov ide care to fewer
than 500 patients during the current year; or
(c) A high -level provider of health care who, in combination
with all other members of his or her group practice provided care
to fewer than 500 patients during the immediately preceding yea r
and reasonably expects to provide care to fewer than 500 patients
during the current year.
8. A high -level provider of health care described in
paragraphs (b) and (c) of subsection 7 shall furnish the medical
records of a patient electronically to the patient or, upon the
request of the patient, another person or entity, in accordance with
NRS 629.062.
9. A violation of the provisions of this section or any
regulations adopted pursuant thereto is not a misdemeanor.
[9.] 10. As used in this section:
(a) “Medical facility” has the meaning ascribed to it in
NRS 449.0151.
(b) “Pharmacy benefit manager” has the meaning ascribed to it
in NRS 683A.174.
[(b)] (c) “Third party” means any insurer, governmental entity
or other organization providing health coverage or benefits in
accordance with state or federal law.
Sec. 5. NRS 439.589 is hereby amended to read as follows:
439.589 1. The Director, in consultation with health care
providers, third parties and other interested persons and entities,
shall by regulation prescribe a framework for the electronic
maintenance, transmittal and exchange of electronic health records,
prescriptions, health -related information and electronic signatures
and requirements for elect ronic equivalents of written entries or
written approvals in accordance with federal law. The regulations
must:
(a) Establish standards for networks and technologies to be used
to maintain, transmit and exchange health information, including,
without limitation, standards:
(1) That require:
(I) The use of networks and technologies that allow
patients to access electronic health records directly from the health
care provider of the patient and forward such electronic health
records electronically to other persons and entities; and
(II) The interoperability of such networks and
technologies in accordance with the applicable standards for the

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- 83rd Session (2025)
interoperability of Qualified Health Information Networks
prescribed by the Office of the National Coordinator for Health
Information Technology of the United States Department of Health
and Human Services;
(2) To ensure that electronic health records retained or shared
are secure;
(3) To maintain the confidentiality of electronic health
records and health -related information, including, without
limitation, standards to maintain the confidentiality of electronic
health records relating to a child who has received health care
services without the consent of a parent or guardian and which
ensure that a child’s r ight to access such health care services is not
impaired;
(4) To ensure the privacy of individually identifiable health
information, including, without limitation, standards to ensure the
privacy of information relating to a child who has received health
care services without the consent of a parent or guardian;
(5) For obtaining consent from a patient before retrieving the
patient’s health records from a health information exchange,
including, without limitation, standards for obtaining such consent
from a child who has received health care services without the
consent of a parent or guardian;
(6) For making any necessary corrections to information or
records;
(7) For notifying a patient if the confidentiality of
information contained in an electronic health record of the patient is
breached;
(8) Governing the ownership, management and use of
electronic health records, health -related information and related
data; and
(9) For the electronic transmission of prior authorizations for
prescription medication;
(b) Ensure compliance with the requirements, specifications and
protocols for exchanging, securing and disclosing electronic health
records, health -related information and related data prescribed
pursuant to the provisions of the Health Information Technology for
Economic and Clinical Health Act, 42 U.S.C. §§ 300jj et seq. and
17901 et seq., the Health Insurance Portability and Accountability
Act of 1996, Public Law 104 -191, and other applicable federal and
state law; and
(c) Be based on national ly recognized best practices for
maintaining, transmitting and exchanging health information
electronically.

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2. The standards prescribed pursuant to this section must
include, without limitation:
(a) Requirements for the creation, maintenance and transm ittal
of electronic health records;
(b) Requirements for protecting confidentiality, including
control over, access to and the collection, organization and
maintenance of electronic health records, health -related information
and individually identifiable health information;
(c) Requirements for the manner in which a patient may,
through a health care provider who participates in the sharing of
health records using a health information exchange, revoke his or
her consent for a health care provider to retri eve the patient’s health
records from the health information exchange;
(d) A secure and traceable electronic audit system for
identifying access points and trails to electronic health records and
health information exchanges; and
(e) Any other requiremen ts necessary to comply with all
applicable federal laws relating to electronic health records, health -
related information, health information exchanges and the security
and confidentiality of such records and exchanges.
3. The regulations adopted pursuant to this section must not
[require] :
(a) Require any person or entity to use a health information
exchange [.] ; or
(b) Authorize a person or entity described in subsection 4 to
comply with the requirements of that subsection by:
(1) Connecting with a health information exchange; or
(2) Utilizing any other service that charges a fee to such a
person or entity or a patient for providing electronic health
records to a patient upon request in violation of NRS 629.062.
4. Except as otherwise provided in subsections 5, 6 and 7, the
Department and the divisions thereof, other state and local
governmental entities, medical facilities, high -level providers of
health care, third parties, pharmacy benefit managers and other
entities licensed or certified pursuant to title 57 of NRS shall
maintain, transmit and exchange health information in accordance
with the regulations adopted pursuant to this section, the provisions
of NRS 439.581 to 439.597, inclusive, and section 1 of this act and
any other regulations adopted pursuant thereto.
5. The Federal Government and employees thereof, a provider
of health coverage for federal employees, a provider of health
coverage that is subject to the Employee Retirement Income
Security Act of 1974, 29 U.S.C. §§ 1001 et seq., or a Taft -Hartley

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trust formed pursuant to 29 U.S.C. § 186(c)(5) is not required to but
may maintain, transmit and exchange electronic information in
accordance with the regulations adopted pursuant to this section.
6. A high -level provider of health care may apply to the
Department for a waiver from the provisions of subsection 4 on the
basis that the high -level provider of health care does not have
the infrastructure necessary to comply with those provisions,
including, without limitation, because the high -level provider of
health care does not have access to the Internet. The Department
shall grant a waiver if it determines that:
(a) The high -level provider of health care does not currently
have the infrastructure necessary to comply with the provisions of
subsection 4; and
(b) Obtaining such infrastructure is not reasonably practicable,
including, without limitation, because the cost of such infrastructure
would make it difficult for the high -level provider of he alth care to
continue to operate.
7. The provisions of subsection 4 do not apply to:
(a) The Department of Corrections;
(b) A high -level provider of health care whose solo practice
provided care to fewer than 500 patients during the immediately
preceding year and reasonably expects to provide care to fewer than
500 patients during the current year; or
(c) A high -level provider of health care who, in combination
with all other members of his or her group practice provided care to
fewer than 500 patient s during the immediately preceding year and
reasonably expects to provide care to fewer than 500 patients during
the current year.
8. A high-level provider of health care described in paragraphs
(b) and (c) of subsection 7 shall furnish the medical recor ds of a
patient electronically to the patient or, upon the request of the
patient, another person or entity, in accordance with NRS 629.062.
9. A violation of the provisions of this section or any
regulations adopted pursuant thereto is not a misdemeanor.
10. As used in this section:
(a) “Medical facility” has the meaning ascribed to it in
NRS 449.0151.
(b) “Pharmacy benefit manager” has the meaning ascribed to it
in NRS 683A.174.
(c) “Third party” means any insurer, governmental entity or
other organization providing health coverage or benefits in
accordance with state or federal law.

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Sec. 6. NRS 439.5895 is hereby amended to read as follows:
439.5895 1. The Department shall notify each regulatory
body of this State that has issued a current, valid license to a
licensed provider or insurer if:
(a) The Department determines that the licensed provider or
insurer is not in compliance with the requirements of subsection 4 of
NRS 439.589 [;] and
[(b) The] the licensed provider or insurer:
(1) Is not exempt from those requirements pursuant to
subsection 5 or 7 of NRS 439.589; and
(2) Has not received a waiver of those requirements pursuant
to subsection 6 of NRS 439.589 [.] ; or
(b) The licensed provider or insurer is a high -level provider of
health care who is exempt from the requirements of subsection 4
of NRS 439.589 pursuant to paragraph (b) or (c) of subsection 7
of NRS 439.589 and the Department determines that the high-level
provider of health care is not in compliance with subsection 8 of
NRS 439.589.
2. If the Department determines that a licensed provider or
insurer for which notice was previously provided pursuant to
subsection 1 has come into compliance with the requirements of
subsection 4 or 8, as applicable, of NRS 439.589, the Department
shall immediately notify the regulatory body that issued the license.
3. As used in this section:
(a) “License” means any license, certificate, registration, permit
or similar type of authorization to pract ice an occupation or
profession or engage in a business in this State issued to a licensed
provider or insurer.
(b) “Licensed provider or insurer” means:
(1) A medical facility licensed pursuant to chapter 449 of
NRS;
(2) [The holder of a permit to operate an ambulance, an air
ambulance or a vehicle of a fire -fighting agency pursuant to chapter
450B of NRS;
(3)] A high-level provider of health care ; [, as defined in
NRS 629.031, who is licensed pursuant to title 54 of NRS;] or
[(4)] (3) Any person licensed pursuant to title 57 of NRS.
(c) “Regulatory body” means any governmental entity that
issues a license.
Sec. 7. Chapter 439A of NRS is hereby amended by adding
thereto the provisions set forth as sections 8, 9 and 10 of this act.
Sec. 8. “Independent center for emergency medical care”
has the meaning ascribed to it in NRS 449.013.

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Sec. 9. 1. The Department shall establish and maintain a
program to increase public awareness of health care information
concerning the independent centers for emergency medical care in
this State. The program must be designed to assist consumers with
comparing the quality of care provided by the independent centers
for emergency medical care in this State and the charges for that
care.
2. The program must include, without limitation, the
collection, maintenance and provision of information concerning:
(a) Patients of each independent center for emergency medical
care in this State as reported in the forms submitted pursuant to
NRS 449.485;
(b) The quality of care provided by each independent center
for emergency medical care in this State as determined by
applying measures of quality endorsed by the entities describe d in
subparagraph (1) of paragraph (b) of subsection 1 of section 10 of
this act, expressed as a number of events and rate of occurrence, if
such measures can be applied to the information reported in the
forms submitted pursuant to NRS 449.485;
(c) How c onsistently each independent center for emergency
medical care follows recognized practices to prevent the infection
of patients, to speed the recovery of patients and to avoid medical
complications of patients;
(d) The total number of patients discharged from the
independent center for emergency medical care and the total
number of potentially preventable readmissions to a hospital or
independent center for emergency medical care, which must be
expressed as a total number and a rate of occurrence of potentially
preventable readmissions, and the average length of stay and the
average billed charges for those potentially preventable
readmissions; and
(e) Any other information relating to the charges imposed and
the quality of the services provided by the in dependent centers for
emergency medical care in this State which the Department
determines is:
(1) Useful to consumers;
(2) Nationally recognized; and
(3) Reported in a standard and reliable manner.
Sec. 10. 1. The Department shall, by regulation:
(a) Prescribe the information that each independent center for
emergency medical care in this State must submit to the
Department for the program established pursuant to section 9 of
this act.

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(b) Prescribe the measures o f quality for independent centers
for emergency medical care that are required pursuant to
paragraph (b) of subsection 2 of section 9 of this act. In adopting
the regulations, the Department shall:
(1) Use the measures of quality endorsed by the Agency f or
Healthcare Research and Quality, the National Quality Forum,
Centers for Medicare and Medicaid Services of the United States
Department of Health and Human Services, a quality
improvement organization of the Centers for Medicare and
Medicaid Services and the Joint Commission;
(2) Prescribe a reasonable number of measures of quality
which must not be unduly burdensome on the independent centers
for emergency medical care; and
(3) Take into consideration the financial burden placed on
the independent c enters for emergency medical care to comply
with the regulations.
(c) Prescribe the manner in which an independent center for
emergency medical care must determine whether the readmission
of a patient must be reported pursuant to section 9 of this act as a
potentially preventable readmission and prescribe the form for
submission of such information.
(d) Require each independent center for emergency medical
care to provide the information prescribed in paragraphs (a), (b)
and (c) in the format required by the Department.
2. The information required pursuant to this section and
section 9 of this act must be submitted to the Department not later
than 45 days after the last day of each calendar month.
3. If an independent center for emergency medical care fails
to submit the information required pursuant to this section or
section 9 of this act or submits information that is incomplete or
inaccurate, the Department shall send a notice of such failure to
the independent center for emergency medical care and to the
Division of Public and Behavioral Health of the Department.
Sec. 11. NRS 439A.200 is hereby amended to read as follows:
439A.200 As used in NRS 439A.200 to 439A.290, inclusive,
and sections 8, 9 and 10 of this act, unless the context otherwise
requires, the words and terms defined in NRS 439A.205, 439A.207
and 439A.210 and section 8 of this act have the meanings ascribed
to them in those sections.
Sec. 12. NRS 439A.260 is hereby amended to read as follows:
439A.260 1. The Department shall collect and maintain all
information that it receives from the hospitals , [and] surgical
centers for ambulatory patients and independent centers for

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emergency medical care in this State pursuant to NRS 439A.220 to
439A.250, inclusive [.] and sections 9 and 10 of this act. Upon
request, the Department shall make a summary of the information
available to:
(a) Consumers of health care;
(b) Providers of health care;
(c) Representatives of the health insurance industry; and
(d) The general public.
2. The Department shall ensure that the information it provides
pursuant to this section is aggregated so as not to reveal the identity
of a specific inpatient or outpatient of a hospital , [or] of a surgical
center for ambulatory patients [.] or of an independent center for
emergency medical care.
Sec. 13. NRS 439A.270 is hereby amended to read as follows:
439A.270 1. The Department shall establish and mai ntain an
Internet website that includes the information concerning the
charges imposed and the quality of the services provided by the
hospitals , [and] surgical centers for ambulatory patients and
independent centers for emergency medical care in this State as
required by the programs established pursuant to NRS 439A.220
and 439A.240 [.] and section 9 of this act. The information must:
(a) Include, for each hospital in this State, the:
(1) Total number of patients discharged, the average length
of st ay and the average billed charges, reported for the diagnosis -
related groups for inpatients and the 50 medical treatments for
outpatients that the Department determines are most useful for
consumers;
(2) Total number of potentially preventable readmissio ns
reported pursuant to NRS 439A.220, the rate of occurrence of
potentially preventable readmissions, and the average length of stay
and average billed charges of those potentially preventable
readmissions, reported by the diagnosis -related group for inpat ients
for which the patient originally received treatment at a hospital; and
(3) Name of each physician who performed a surgical
procedure in the hospital and the total number of surgical
procedures performed by each physician in the hospital, reported for
the most frequent surgical procedures that the Department
determines are most useful for consumers if the information is
available;
(b) Include, for each surgical center for ambulatory patients in
this State, the:

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(1) Total number of patients dischar ged and the average
billed charges, reported for 50 medical treatments for outpatients
that the Department determines are most useful for consumers; and
(2) Name of each physician who performed a surgical
procedure in the surgical center for ambulatory patients and the total
number of surgical procedures performed by each physician in the
surgical center for ambulatory patients, reported for the most
frequent surgical procedures that the Department determines are
most useful for consumers;
(c) Include, f or each independent center for emergency
medical care in this State, the:
(1) Total number of patients discharged and the average
billed charges, reported for the 50 medical treatments for patients
of independent centers for emergency medical care that t he
Department determines are most useful for consumers; and
(2) Total number of potentially preventable readmissions
reported pursuant to section 9 of this act, the rate of occurrence of
potentially preventable readmissions, and the average length of
stay and average billed charges of those potentially preventable
readmissions, reported for the diagnosis for which the patient
originally received treatment at an independent center for
emergency medical care;
(d) Be presented in a manner that allows a pers on to view and
compare the information for the hospitals by:
(1) Geographic location of each hospital;
(2) Type of medical diagnosis; and
(3) Type of medical treatment;
[(d)] (e) Be presented in a manner that allows a person to view
and compare the information for the surgical centers for ambulatory
patients by:
(1) Geographic location of each surgical center for
ambulatory patients;
(2) Type of medical diagnosis; and
(3) Type of medical treatment;
[(e)] (f) Be presented in a manner that allows a person to view
and compare the information for the independent centers for
emergency medical care by:
(1) Geographic location of each independent center for
emergency medical care;
(2) Type of medical diagnosis; and
(3) Type of medical treatment;
(g) Be presented in a manner that allows a person to view and
compare the information separately for:

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(1) The inpatients and outpatients of each hospital; [and]
(2) The outpatients of each surgical center for ambulatory
patients; and
(3) The patients of each independent center for emergency
medical care;
[(f)] (h) Be readily accessible and understandable by a member
of the general public;
[(g)] (i) Include the annual summary of reports of sentinel
events prepared for each health facility purs uant to paragraph (c) of
subsection 1 of NRS 439.840;
[(h)] (j) Include the annual summary of reports of sentinel
events prepared pursuant to paragraph (d) of subsection 1 of
NRS 439.840;
[(i)] (k) Include the reports of information prepared for each
medical facility pursuant to paragraph (b) of subsection 4 of
NRS 439.847;
[(j)] (l) Include a link to electronic copies of all reports,
summaries, compilations and supplementary reports required by
NRS 449.450 to 449.530, inclusive;
[(k)] (m) Include, for each hospital with 100 or more beds, a
summary of financial information which is readily understandable
by a member of the general public and which includes, without
limitation, a summary of:
(1) The expenses of the hospital which are attributable to
providing community benefits and in -kind services as reported
pursuant to NRS 449.490;
(2) The capital improvement report submitted to the
Department pursuant to NRS 449.490;
(3) The net income of the hospital;
(4) The net income of the consolidated corporation, if the
hospital is owned by such a corporation and if that information is
publicly available;
(5) The operating margin of the hospital;
(6) The ratio of the cost of providing care to pa tients covered
by Medicare to the charges for such care;
(7) The ratio of the total costs to charges of the hospital; and
(8) The average daily occupancy of the hospital; and
[(l)] (n) Provide any other information relating to the charges
imposed and the quality of the services provided by the hospitals ,
[and] surgical centers for ambulatory patients and independent
centers for emergency medical care in this State which the
Department determines is:
(1) Useful to consumers;

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(2) Nationally recognized; and
(3) Reported in a standard and reliable manner.
2. The Department shall:
(a) Publicize the availability of the Internet website;
(b) Update the information contained on the Internet website at
least quarterly;
(c) Ensure that the information contained on the Internet website
is accurate and reliable;
(d) Ensure that the information reported by a hospital , [or]
surgical center for ambulatory patients or independent center for
emergency medical care for inpatients and outpatients which is
contained on the Internet website is expressed as a total number and
as a rate, and [must be] is reported in a manner so as not to reveal
the identity of a specific inpatient or outpatient of a hospital , [or]
surgical center for ambulatory patients [;] or independent center for
emergency medical care;
(e) Post a disclaimer on the Internet website indicating that the
information contained on the website is provided to assist with the
comparison of hospitals and independent centers for emergency
medical care and is not a guarantee by the Department or its
employees as to the charges imposed by the hospitals and
independent centers for emergency medical care in this State or the
quality of the services provided by the hospitals and independent
centers for emergency medical care in this State, including, without
limitation, an explanation that the actual amount charged to a person
by a particular hospital or independent center for emergency
medical care may not be the same charge as posted on the website
for that hospital [;] or independent center for emergency medical
care;
(f) Provide on the Internet website established pursuant to this
section a link to the Internet website of the Centers for Medicare and
Medicaid Services of the United States Department of Health and
Human Services; and
(g) Upon request, make the information that is contained on the
Internet website available in printed form.
3. As used in this section, “diagnosis -related group” means
groupings of medical diagnostic categories used as a basis for
hospital payment schedules by Medicare and other third-party health
care plans.
Sec. 14. NRS 449.013 is hereby amended to read as follows:
449.013 “Independent center for emergency medical care”
means a facility, structurally separate [and distinct] from a hospital,
which provides [limited] services for the treatment of a medical

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emergency. The term includes, without limitation, such a facil ity
that is owned or operated by, or otherwise part of, a hospital but is
located more than 250 yards from the hospital.
Sec. 15. NRS 449.0308 is hereby amended to read as follows:
449.0308 1. Except as otherwise provide d in this section, the
Division may charge and collect from a medical facility, facility for
the dependent or facility which is required by the regulations
adopted by the Board pursuant to NRS 449.0303 to be licensed or a
person who operates such a facilit y without a license issued by the
Division the actual costs incurred by the Division for the
enforcement of the provisions of NRS 449.029 to 449.2428,
inclusive, including, without limitation, the actual cost of
conducting an inspection or investigation of the facility.
2. The Division shall not charge and collect the actual cost for
enforcement pursuant to subsection 1 if the enforcement activity is:
(a) Related to the issuance or renewal of a license for which the
Board charges a fee pursuant to NRS 449.050 or 449.089;
(b) Related to the issuance or renewal of a license to an
independent center for emergency medical care that is owned or
operated by, or otherwise part of, a hospital; or
[(b)] (c) Conducted pursuant to an agreement with the Federal
Government which has appropriated money for that purpose.
3. Any money collected pursuant to subsection 1 may be used
by the Division to administer and carr y out the provisions of NRS
449.029 to 449.2428, inclusive, and the regulations adopted
pursuant thereto.
4. The provisions of this section do not apply to any costs
incurred by the Division for the enforcement of the provisions of
NRS 449.24185, 449.2419 or 449.24195.
Sec. 16. NRS 449.050 is hereby amended to read as follows:
449.050 1. [Each] Except as otherwise provided in this
section, each application for a license must be accompanied by such
fee as may be determined by regulation of the Board. The Board
may, by regulation, allow or require payment of a fee for a license in
installments and may fix the amount of each payment and the date
that the payment is due.
2. The fee imposed by the Board for a facili ty for transitional
living for released offenders must be based on the type of facility
that is being licensed and must be calculated to produce the revenue
estimated to cover the costs related to the license, but in no case
may a fee for a license exceed the actual cost to the Division of
issuing or renewing the license.

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3. If an application for a license for a facility for transitional
living for released offenders is denied, any amount of the fee paid
pursuant to this section that exceeds the expenses and costs incurred
by the Division must be refunded to the applicant.
4. The Board shall not require a fee for the issuance or
renewal of the license of an independent center for emergency
medical care that is owned or operated by, or otherwise part of, a
hospital.
Sec. 17. NRS 449.080 is hereby amended to read as follows:
449.080 1. [If,] Except as otherwise provided in this section,
if, after investigation, the Division finds that the:
(a) Applicant is in full compli ance with the provisions of NRS
449.029 to 449.2428, inclusive;
(b) Applicant is in substantial compliance with the standards and
regulations adopted by the Board;
(c) Applicant, if he or she has undertaken a project for which
approval is required pursuant to NRS 439A.100 or 439A.102, has
obtained the approval of the Director of the Department of Health
and Human Services; and
(d) Facility conforms to the applicable zoning regulations,
 the Division shall issue the license to the applicant.
2. Any investigation of an applicant for a license to provide
community-based living arrangement services conducted pursuant
to subsection 1 must include, without limitation, an inspection of
any building operated by the applicant in which the applicant
proposes to provide community-based living arrangement services.
3. The Division may not issue a license to operate an
independent center for emergency medical care that is located
within a 5 mile radius of:
(a) An existing independent center for emergency m edical
care; or
(b) A hospital with an emergency department.
4. A license applies only to the person to whom it is issued, is
valid only for the premises described in the license and is not
transferable.
Sec. 18. NRS 449.1818 is hereby amended to read as follows:
449.1818 1. Each off -campus location of a hospital shall
obtain and use , and include on all claims for reimbursement or
payment for health care services provided at the location , a national
provider ident ifier that is distinct from the national provider
identifier used by the main campus and any other off -campus
location of the hospital. If the off -campus location includes the
national provider identifier on such a claim, the off -campus location

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may also i nclude on the claim the national provider identifier used
by the main campus of the hospital. If the off -campus location
includes both the national provider identifier used by the off-campus
location and the national provider identifier used by the main
campus on a claim, the claim must clearly identify which national
provider identifier corresponds to the off -campus location and
which national provider identifier corresponds to the main campus.
2. An independent center for emergency medical care shall
include on all claims for reimbursement or payment for health care
services provided at the independent center for emergency medical
care the national provider identifier used by the independent center
for emergency medical care.
3. An independent center for emergency medical care:
(a) Shall provide urgent care during all operating hours
through:
(1) A separate urgent care unit within the independent
center for emergency medical care; or
(2) A system that uses the severity of the patient’s condition
to determine whether the patient receives emergency services or
urgent care;
(b) Shall not charge more for urgent care than the amount
customarily charged for urgent care by an urgent care center;
(c) If urgent care services are sufficient to treat or ma nage the
condition of a patient, shall inform the patient that he or she may
receive urgent care rather than emergency services; and
(d) Shall not require a patient to wait longer to receive urgent
care services than a patient with the same condition woul d be
required to wait to receive emergency services.
4. As used in this section:
(a) “National provider identifier” means the standard, unique
health identifier for health care providers that is issued by the
national provider system in accordance with 45 C.F.R. Part 162.
(b) “Off-campus location” means a facility:
(1) With operations that are directly or indirectly owned or
controlled by, in whole or in part, a hospital or which is affiliated
with a hospital, regardless of whether it is operated by t he same
governing body as the hospital;
(2) That is located more than 250 yards from the main
campus of the hospital;
(3) That provides services which are organizationally and
functionally integrated with the hospital; and
(4) That is an outpatient facility providing ambulatory
surgery, urgent care or emergency room services.

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(c) “Urgent care” means health care that is furnished to a
person whose medical condition is sufficiently acute to require
treatment unavailable through, or inappropriate to be provided by,
a clinic or the office of a provider of health care, but not so acute
as to require treatment in an emergency room.
Sec. 19. NRS 449.485 is hereby amended to read as follows:
449.485 1. Each hospital and in dependent center for
emergency medical care in this State shall use for all patients
discharged a form prescribed by the Director and shall include in the
form all information required by the Department. Any form
prescribed by the Director must be a form t hat is commonly used
nationwide by hospitals [,] and independent centers for emergency
medical care, if applicable, and comply with federal laws and
regulations.
2. Each hospital and independent center for emergency
medical care in this State shall, on a monthly basis, report to the
Department the information required to be included in the form for
each patient. The information reported must be complete, accurate
and timely.
3. Each insurance company or other payer shall accept the form
as the bill for services provided by hospitals and independent
centers for emergency medical care in this State.
4. Except as otherwise provided in subsection 5, each hospital
and independent center for emergency medical care in this State
shall provide the information required pursuant to subsection 2 in an
electronic form specified by the Department.
5. The Director may exempt a hospital or independent center
for emergency medical care from the requirements of subsection 4
if requiring the hospital or independent center for emergency
medical care, as applicable, to comply with the requirements would
cause the hospital financial hardship.
6. The Department shall use the information submitted
pursuant to this section for the [program] programs established
pursuant to NRS 439A.220 and section 9 of this act to increase
public awareness of health care information concerning the hospitals
and independent centers for emergency medical care, respectively,
in this State.
Sec. 20. NRS 449.520 is hereby amended to read as follows:
449.520 1. On or before October 1 of each year, the Director
shall prepare and transmit to the Governor, the Joint Interim
Standing Committee on Health and Human Services and the Interim
Finance Committee a report of the Department’s operations and
activities for the preceding fiscal year.

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2. The report prepared pursuant to subsection 1 must include:
(a) Copies of all reports, summaries, compilations and
supplementary reports required by NRS 44 9.450 to 449.530,
inclusive, together with such facts, suggestions and policy
recommendations as the Director deems necessary;
(b) A summary of the trends of the audits of hospitals in this
State that the Department required or performed during the previo us
year;
(c) An analysis of the trends in the costs, expenses and profits of
hospitals in this State;
(d) An analysis of the methodologies used to determine the
corporate home office allocation of hospitals in this State;
(e) An examination and analysis of the manner in which
hospitals are reporting the information that is required to be filed
pursuant to NRS 449.490, including, without limitation, an
examination and analysis of whether that information is being
reported in a standard and consistent manner, which fairly reflect the
operations of each hospital;
(f) A review and comparison of the policies and procedures used
by hospitals in this State to provide discounted services to, and to
reduce charges for services provided to, persons without health
insurance;
(g) A review and comparison of the policies and procedures
used by hospitals in this State to collect unpaid charges for services
provided by the hospitals; and
(h) A summary of the status of the programs established
pursuant to NRS 439A.220 a nd 439A.240 and section 9 of this act
to increase public awareness of health care information concerning
the hospitals , [and] surgical centers for ambulatory patients and
independent centers for emergency medical care in this State,
including, without limitation, the information that was posted in the
preceding fiscal year on the Internet website maintained for those
programs pursuant to NRS 439A.270.
3. The Joint Interim Standing Committee on Health and
Human Services shall develop a comprehensive pl an concerning the
provision of health care in this State which includes, without
limitation:
(a) A review of the health care needs in this State as identified
by state agencies, local governments, providers of health care and
the general public; and
(b) A review of the capital improvement reports submitted by
hospitals pursuant to subsection 2 of NRS 449.490.

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Sec. 21. NRS 179.301 is hereby amended to read as follows:
179.301 1. The Nevada Gaming Control Board and the
Nevada Gaming Commission and their employees, agents and
representatives may inquire into and inspect any records sealed
pursuant to NRS 179.245 or 179.255, if the event or conviction was
related to gaming, to determine the suitability or qualifications of
any person to hold a state gaming license, manufacturer’s, seller’s or
distributor’s license or registration as a gaming employee pursuant
to chapter 463 of NRS. Events and convictions, if any, which are the
subject of an order sealing records:
(a) May for m the basis for recommendation, denial or
revocation of those licenses.
(b) Must not form the basis for denial or rejection of a gaming
work permit unless the event or conviction relates to the applicant’s
suitability or qualifications to hold the work permit.
2. The Division of Insurance of the Department of Business
and Industry and its employees may inquire into and inspect any
records sealed pursuant to NRS 179.245 or 179.255, if the event
or conviction was related to insurance, to determine the suitability or
qualifications of any person to hold a license, certification or
authorization issued in accordance with title 57 of NRS. Events and
convictions, if any, which are the subject of an order sealing records
may form the basis for recommendation, d enial or revocation of
those licenses, certifications and authorizations.
3. The Department of Health and Human Services, the
Division of Health Care Financing and Policy of the Department
and their employees, agents and representatives may inquire into
and inspect any records sealed pursuant to NRS 179.245 or
179.255, if the event or conviction was related to Medicare or
Medicaid or the provision of professional services for which a
license or certification is required. Such inquiry or inspection
must be for the purpose of determining the suitability of the
person to render such professional services as a provider of
services under Medicaid or to own or serve as an officer,
managing employee or managing agent of a business seeking to
enter into a contract with the Department or a health maintenance
organization with which the Department has entered into a
contract pursuant to NRS 422.273 for the provision of services
under Medicaid. Events and convictions, if any, which are the
subject of an order sealing records may form the basis of a
decision of the Department to refuse to enter into or terminate
such a contract.

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4. A prosecuting attorney may inquire into and inspect any
records sealed pursuant to NRS 179.245 or 179.255 if:
(a) The records relate to a violation or alleged violation of NRS
202.485; and
(b) The person who is the subject of the records has been
arrested or issued a citation for violating NRS 202.485.
[4.] 5. The Central Repository for Nevada Records of Criminal
History and its employee s may inquire into and inspect any records
sealed pursuant to NRS 179.245 or 179.255 that constitute
information relating to sexual offenses, and may notify employers of
the information in accordance with federal laws and regulations.
[5.] 6. Records whi ch have been sealed pursuant to NRS
179.245 or 179.255 and which are retained in the statewide registry
established pursuant to NRS 179B.200 may be inspected pursuant to
chapter 179B of NRS by an officer or employee of the Central
Repository for Nevada Rec ords of Criminal History or a law
enforcement officer in the regular course of his or her duties.
[6.] 7. The State Board of Pardons Commissioners and its
agents and representatives may inquire into and inspect any records
sealed pursuant to NRS 179.245 or 179.255 if the person who is the
subject of the records has applied for a pardon from the Board.
[7.] 8. As used in this section:
(a) “Information relating to sexual offenses” means information
contained in or concerning a record relating in any way to a sexual
offense.
(b) “Sexual offense” has the meaning ascribed to it in
NRS 179A.073.
Sec. 22. 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
(5) The Administrator of the Division of Public and
Behavioral Health.

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(b) Shall administer, through the d ivisions 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 26.5, 27 and 28 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 f or 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 provide social
services, adopt a master plan for the provision of human services in
this State. The Director shall revise the plan biennially and deliver a
copy of the plan to the Governor and the Legislature at the
beginning of each regular session. The plan must:
(1) Identify and assess the plans and programs of the
Department for the provision of human services, and any
duplication of those services by federal, state and local agencies;
(2) Set forth priorities for the provision of those services;
(3) Provide for communication and the coordination of those
services among nonprofit organizations, agencies of local
government, the State and the Federal Government;
(4) Identify the sources of funding for services provided by
the Department and the allocation of that funding;
(5) Set forth sufficient informati on to assist the Department
in providing those services and in the planning and budgeting for the
future provision of those services; and
(6) Contain any other information necessary for the
Department to communicate effectively with the Federal
Government concerning demographic trends, formulas for the
distribution of federal money and any need for the modification of
programs administered by the Department.
(e) May, by regulation, require nonprofit organizations and state
and local governmental agencies to provide information regarding
the programs of those organizations and agencies, excluding
detailed information relating to their budgets and payrolls, which the

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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. 23. NRS 232.459 is hereby amended to read as follows:
232.459 1. The Advocate shall:
(a) Respond to written and telephonic inquiries received from
consumers and injured employees regarding concerns and problems
related to health care and workers’ compensation;
(b) Assist consumers and injured employees in understanding
their rights and responsibilities under health care plans, including,
without limitation, the Public Employees’ Benefits Program and the
Public Option, and policies of industrial insurance;
(c) Identify and investigate complaints of consumers and injured
employees regarding their health care plans, including, without
limitation, the Public Employees’ Benefits Program and the Public
Option, and policies of industrial insurance and assist those
consumers and injured employees to resolve their complaints,
including, without limitation:
(1) Referring consumers and injured employees to the
appropriate agency, department or other entity that is responsible for
addressing the specific complaint of the consumer or injured
employee; and
(2) Providing counseling and assistance to consumers and
injured employees concerning health care plans, including, without
limitation, the Public Employees’ Benefits Program and the Public
Option, and policies of industrial insurance;
(d) Provide information to consumers and injured employees
concerning health care plans, including, without limitation, the
Public Employees’ Benefits Program and the Public Opt ion, and
policies of industrial insurance in this State;
(e) Establish and maintain a system to collect and maintain
information pertaining to the written and telephonic inquiries
received by the Office for Consumer Health Assistance;
(f) Take such actio ns as are necessary to ensure public
awareness of the existence and purpose of the services provided by
the Advocate pursuant to this section;
(g) In appropriate cases and pursuant to the direction of the
Advocate, refer a complaint or the results of an i nvestigation to the
Attorney General for further action;

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(h) Provide information to and applications for prescription drug
programs for consumers without insurance coverage for prescription
drugs or pharmaceutical services;
(i) Establish and maintain an Internet website which includes:
(1) Information concerning purchasing prescription drugs
from Canadian pharmacies that have been recommended by the
State Board of Pharmacy for inclusion on the Internet website
pursuant to subsection 4 of NRS 639.2328;
(2) Links to websites of Canadian pharmacies which have
been recommended by the State Board of Pharmacy for inclusion on
the Internet website pursuant to subsection 4 of NRS 639.2328; and
(3) A link to the website established and maintained pursuant
to NRS 439A.270 which provides information to the general public
concerning the charges imposed and the quality of the services
provided by the hospitals , [and] surgical centers for ambulatory
patients and independent centers for emergency medical care in
this State;
(j) Assist consumers with accessing a navigator, case manager
or facilitator to help the consumer obtain health care services;
(k) Assist consumers with scheduling an appointment with a
provider of health care who is in the network of provide rs under
contract to provide services to participants in the health care plan
under which the consumer is covered;
(l) Assist consumers with filing complaints against health care
facilities and health care professionals;
(m) Assist consumers with filing complaints with the
Commissioner of Insurance against issuers of health care plans; and
(n) On or before January 31 of each year, compile a report of
aggregated information submitted to the Office for Consumer
Health Assistance pursuant to NRS 687B.675, aggregated for each
type of provider of health care for which such information is
provided and submit the report to the Director of the Legislative
Counsel Bureau for transmittal to:
(1) In even -numbered years, the Joint Interim Standing
Committee on Health and Human Services; and
(2) In odd -numbered years, the next regular session of the
Legislature.
2. The Advocate may adopt regulations to carry out the
provisions of this section and NRS 232.461 and 232.462.
3. As used in this section:
(a) “Health care facility” has the meaning ascribed to it in
NRS 162A.740.

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(b) “Navigator, case manager or facilitator” has the meaning
ascribed to it in NRS 687B.675.
(c) “Public Option” means the Public Option established
pursuant to NRS 695K.200.
Sec. 24. 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 th e 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 and employees, and the dependents of officers and
employees who elect to accept the in surance 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, fo r 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 transact 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 coverage 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 deductions 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 transact business in the
State of Nevada. Any independent administrator of a fund creat ed
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, and section 1 of this act, 686A.135, 687B.352, 687B.408,
687B.692, 687B.723, 687B.725, 687B.805, 689B.030 to
689B.0317, incl usive, paragraphs (b) and (c) of subsection 1 of

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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 apply to
coverage provided pursuant t o 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, school 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 serv ices organization exists,
the governing body of the county, or of any school district,
municipal corporation, political subdivision, public corporation or
other local governmental 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 eligible for any life, accident or health insurance
provided pursuant to this section t o 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:
(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, publi c 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:

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(a) Must be submitted to the Commissioner of Insurance for
approval not less than 30 days before the date on which the contract
is to become effective.
(b) Does not become ef fective 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 p rogram for legal aid and receives
money pursuant to NRS 19.031.
Sec. 25. 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 comp ly with the provisions of
NRS 439.581 to 439.597, inclusive, and section 1 of this act,
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, in the same manner as an insurer that is
licensed pursuant to title 57 of NRS is required to comply with those
provisions.
Sec. 26. Chapter 422 of NRS is hereby amended by adding
thereto the provisions set forth as sections 26.5, 27 and 28 of this
act.
Sec. 26.5. 1. To the extent authorized by federal law and to
the extent that money is available, the Director shall include under
Medicaid a system of value -based payments for care provided by
independent centers for emergency medical care. That system
must be designed to provide higher rates of reimbursement to
independent centers for emergency medical care that:
(a) Provide high quality of care to recipients of Medicaid; and
(b) Ensure that recipients of Medicaid receive an appropriate
level of care for the conditions with which the recipients present at
an independent center for emergency medical care.
2. To the extent that money is available to implement the
system of value -based payments described in subsection 1, 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

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federal authorization to implement the system of value -based
payments 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, “independent center for emergency
medical care” has the meaning ascribed to it in NRS 449.013.
Sec. 27. 1. A provider of services under Medicaid shall:
(a) Maintain such documents as are required by regulation of
the Administrator for the verification of claims for the period of
time specified in those regulations; and
(b) Provide the documents maintained pursuant to paragraph
(a) to the Department upon the request of the Department.
2. The Department may audit any documents provided
pursuant to paragraph (b) of subsection 1. If the Department is
unable to verify a claim using the documents maintained pursuant
to subsection 1, the Department may deny the claim or, if the
Department has already paid the claim, recover the amount of the
payment from the provider.
Sec. 28. 1. If the Department determines that a provider of
services under Medicaid may be prescribing or providing services
in a manner that exceeds the needs of recipients of Medicaid, is
unnecessary or otherwise conflicts with applicable professional
standards or the requirements of the Medicaid program, the
Department shall perform a review of the relevant claims to
evaluate the appropriaten ess and propriety of the services for
which payment is claimed. If the Department has not paid the
claims, the review must occur before the Department pays the
claims.
2. Upon deciding to conduct a review pursuant to subsection
1, the Department shall:
(a) Notify the provider of services who submitted the claims
subject to the review; and
(b) Require the provider of services to submit to the
Department within a period of time specified by the Department
any documentation necessary to substantiate the claims.
3. If a provider of services fails to submit the documentation
required by the Department pursuant to paragraph (b) of
subsection 2 within the time specified pursuant to that paragraph,
the Department may take the actions described in paragraph (a) of
subsection 5 without the opportunity for a hearing pursuant to
NRS 422.306.

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4. Not later than 60 days after receiving the documentation
requested pursuant to paragraph (b) of subsection 2, the
Department shall complete a review pursuant to this secti on and
either:
(a) Pay the claims that were subject to the review or, if the
Department has already paid such a claim, notify the provider of
services who made the claim that the claim has been upheld; or
(b) Take an action described in paragraph (a) of subsection 5
with respect to the claims that were subject to the review.
5. If the Department determines after conducting a review
pursuant to this section that a provider of services has prescribed
or provided services in a manner that exceeds the needs of
recipients of Medicaid, is unnecessary or otherwise conflicts with
applicable professional standards or the requirements of the
Medicaid program, the Department may, after the opportunity for
a hearing pursuant to NRS 422.306:
(a) Deny the affected cl aims or, if the Department has already
paid an affected claim, recover the amount of the payment from
the provider;
(b) Require the provider to request and receive authorization
for the delivery of services to recipients of Medicaid before
delivering the services; or
(c) Take any other action authorized by this chapter and the
regulations adopted pursuant thereto.
Sec. 29. NRS 603A.100 is hereby amended to read as follows:
603A.100 1. The provisions of NRS 603A.010 to 6 03A.290,
inclusive, do not apply to the maintenance or transmittal of
information in accordance with NRS 439.581 to 439.597, inclusive,
and section 1 of this act and the regulations adopted pursuant
thereto.
2. A data collector who is also an operator, as defined in NRS
603A.330, shall comply with the provisions of NRS 603A.300 to
603A.360, inclusive.
3. Any waiver of the provisions of NRS 603A.010 to
603A.290, inclusive, is contrary to public policy, void and
unenforceable.
Sec. 30. NRS 613.195 is hereby amended to read as follows:
613.195 1. A noncompetition covenant is void and
unenforceable unless the noncompetition covenant:
(a) Is supported by valuable consideration;
(b) Does not impose any restraint that is g reater than is required
for the protection of the employer for whose benefit the restraint is
imposed;

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(c) Does not impose any undue hardship on the employee; and
(d) Imposes restrictions that are appropriate in relation to the
valuable consideration supporting the noncompetition covenant.
2. A noncompetition covenant may not restrict, and an
employer may not bring an action to restrict, a former employee of
an employer from providing service to a former customer or client
if:
(a) The former employee did not solicit the former customer or
client;
(b) The customer or client voluntarily chose to leave and seek
services from the former employee; and
(c) The former employee is otherwise complying with the
limitations in the covenant as to time, geographi cal area and scope
of activity to be restrained, other than any limitation on providing
services to a former customer or client who seeks the services of the
former employee without any contact instigated by the former
employee.
 Any provision in a noncompetition covenant which violates the
provisions of this subsection is void and unenforceable.
3. A noncompetition covenant may not apply to [an] :
(a) An employee who is paid solely on an hourly wage basis,
exclusive of any tips or gratuities [.] ; or
(b) A patient-facing provider of health care.
4. An employer in this State who negotiates, executes or
attempts to enforce a noncompetition covenant that is void and
unenforceable under this section does not violate the provisions of
NRS 613.200.
5. If the termination of the employment of an employee is the
result of a reduction of force, reorganization or similar restructuring
of the employer, a noncompetition covenant is only enforceable
during the period in which the employer is paying the employee’s
salary, benefits or equivalent compensation, including, without
limitation, severance pay.
6. If an employer brings an action to enforce a noncompetition
covenant or an employee brings an action to challenge a
noncompetition covenant and the court finds the covenant is
supported by valuable consideration but contains limitations as to
time, geographical area or scope of activity to be restrained that are
not reasonable, imposes a greater restraint than is necessary for t he
protection of the employer for whose benefit the restraint is imposed
or imposes undue hardship on the employee, the court shall revise
the covenant to the extent necessary and enforce the covenant as
revised. Such revisions must cause the limitations c ontained in the

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covenant as to time, geographical area and scope of activity to be
restrained to be reasonable, to not impose undue hardship on the
employee and to impose a restraint that is not greater than is
necessary for the protection of the employer for whose benefit the
restraint is imposed.
7. If an employer brings an action to enforce a noncompetition
covenant or an employee or contractor brings an action to challenge
a noncompetition covenant and the court finds that the
noncompetition covenant applies to [an employee ] a person
described in subsection 3 or that the employer has restricted or
attempted to restrict a former employee in the manner described in
subsection 2, the court shall award the employee or contractor
reasonable attorney’s fees and costs. Nothing in this subsection shall
be construed as prohibiting a court from otherwise awarding
attorney’s fees to a prevailing party pursuant to NRS 18.010.
8. As used in this section:
(a) “Employer” means every person having control or custody of
any employment, place of employment or any employee.
(b) “Noncompetition covenant” means an agreement between an
employer and employee which, upon termination of the employment
of the employee, prohibits the employee from p ursuing a similar
vocation in competition with or becoming employed by a competitor
of the employer.
(c) “Patient-facing provider of health care ” means a provider
of health care, as defined in NRS 629.031:
(1) Whose primary duties involve providing clinical care to
patients; and
(2) Who is not employed or contracted to primarily perform
administrative tasks.
Sec. 31. NRS 629.051 is hereby amended to read as follows:
629.051 1. Except as otherwise provided in this section and
in regulations adopted by the State Board of Health pursuant to NRS
652.135 with regard to the records of a medical laboratory and
unless a longer period is provided by federal law, each custodian of
health care records shall retain the health care records of patients as
part of the regularly maintained records of the custodian for 5 years
after their receipt or production. Health care records may be retained
in written form, or by microfilm or any other reco gnized form of
size reduction, including, without limitation, microfiche, computer
disc, magnetic tape and optical disc, which does not adversely affect
their use for the purposes of NRS 629.061.
2. A high-level provider of health care shall comply with the
requirements of subsection 4 of NRS 439.589 concerning the

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maintenance, transmittal and exchange of health records. Health
care records [:
(a) Must, except as otherwise provided in subsections 5 and 6 of
NRS 439.589, be created, maintained, transmitt ed and exchanged
electronically as required by subsection 4 of NRS 439.589; and
(b) May] may be created, authenticated and stored in a health
information exchange which meets the requirements of NRS
439.581 to 439.597, inclusive, and section 1 of this act and the
regulations adopted pursuant thereto.
[2.] 3. A provider of health care shall post, in a conspicuous
place in each location at which the provider of health care performs
health care services, a sign which discloses to patients that their
health care records may be destroyed after the period set forth in
subsection 1.
[3.] 4. When a provider of health care performs health care
services for a patient for the first time, the provider of health care
shall deliver to the patient a written statement which discloses to the
patient that the health care records of the patient may be destroyed
after the period set forth in subsection 1.
[4.] 5. If a provider of health care fails to deliver the written
statement to the patient pursuant to subsection [3,] 4, the provider of
health care shall deliver to the patient the written statement
described in subsection [3] 4 when the provider of health care next
performs health care services for the patient.
[5.] 6. In addition to delivering a written statement p ursuant to
subsection [3 or] 4 [,] or 5, a provider of health care may deliver
such a written statement to a patient at any other time.
[6.] 7. A written statement delivered to a patient pursuant to
this section may be included with other written informa tion
delivered to the patient by a provider of health care.
[7.] 8. A custodian of health care records shall not destroy the
health care records of a person who is less than 23 years of age on
the date of the proposed destruction of the records. The heal th care
records of a person who has attained the age of 23 years may be
destroyed in accordance with this section for those records which
have been retained for at least 5 years or for any longer period
provided by federal law.
[8.] 9. If a health care l icensing board receives notification
from the Department of Health and Human Services pursuant to
NRS 439.5895 that a high-level provider of health care to which the
health care licensing board has issued a license is not in compliance
with the requirement s of subsection 4 or 8, as applicable, of NRS
439.589, the health care licensing board may, after notice and the

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opportunity for a hearing in accordance with the provisions of this
title, require corrective action or impose an administrative penalty in
an amount not to exceed the maximum penalty that the health care
licensing board is authorized to impose for other violations. The
health care licensing board shall not suspend or revoke a license for
failure to comply with the requirements of subsection 4 or 8 of
NRS 439.589.
[9. The provisions of this section, except for the provisions of
paragraph (a) of subsection 1 and subsection 8, do not apply to a
pharmacist.]
10. The State Board of Health shall adopt:
(a) Regulations prescribing the form, size, contents and
placement of the signs and written statements required pursuant to
this section; and
(b) Any other regulations necessary to carry out the provisions
of this section.
11. As used in this section:
(a) “Health care licensing board” means:
(1) A board created pursuant to chapter 630, 630A, 631, 632,
633, 634, 634A, 635, 636, 637, 637B, 639, 640, 640A, 640B, 640C,
641, 641A, 641B, 641C or 641D of NRS.
(2) The Division of Public and Behavioral Health of the
Department of Health and Human Services.
(3) The State Board of Health with respect to licenses issued
pursuant to chapter 640D or 640E of NRS.
(b) “High-level provider of health care” has the meaning
ascribed to it in section 1 of this act.
(c) “License” has the meaning ascribed to it in NRS 439.5895.
Sec. 32. NRS 629.053 is hereby amended to read as follows:
629.053 1. The State Board of Health and each board created
pursuant to chapter 630, 630A, 631, 632, 633, 634, 634A, 635, 636,
637, 637B, 640, 640A, 640B, 640C, 641, 641A, 641B, 641C or
641D of NRS shall post on its website on the Internet, if any, a
statement which discloses that:
(a) Pursuant to the provisions of subsection [7] 8 of
NRS 629.051:
(1) The health care records of a person who is less than 23
years of age may not be destroyed; and
(2) The health care records of a person who has attained the
age of 23 years may be destroyed for those records which have been
retained for at least 5 years or for any longer period provided by
federal law; and

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- 83rd Session (2025)
(b) Except as otherwise provided in subsection [7] 8 of NRS
629.051 and unless a longer period is provided by federal law, the
health care records of a patient who is 23 years of age or older may
be destroyed after 5 years pursuant to subsection 1 of NRS 629.051.
2. The State Board of Health shall adopt regulations
prescribing the contents of the statements required pursuant to this
section.
Sec. 33. NRS 629.062 is hereby amended to read as follows:
629.062 1. If a person who is authorized to request a copy of
health care records of a patient pursuant to NRS 629.061 requests
that a copy of such records be furnished electronically, the custodian
of health care records must electronically transmit a copy of t he
requested records to the person or, if the patient has provided
written authorization for records to be furnished to another person or
entity, to that person or entity. Such records must be furnished in an
electronic format using a method of secure elec tronic transmission
that complies with applicable federal and state law. If a patient
requests that a copy of his or her health care records be furnished
electronically to the patient or any covered entity, the custodian of
health records shall furnish the copy not later than the end of the
seventh business day after the request is made.
2. Except as otherwise provided in this subsection and
subsections 3 and 4, if a custodian of health care records maintains
health care records electronically, any fee t o furnish those records
electronically pursuant to subsection 1 must not exceed $40 or the
amount per page prescribed by NRS 629.061, whichever is less. A
custodian of health care records shall not charge a fee to furnish
health care records to a patient o r, if the patient has requested a
copy of his or her health care records to be furnished to any
covered entity, to that covered entity.
3. If the total amount of the fee chargeable pursuant to
subsection 2 for the furnishing of health care records elect ronically
is less than $5, a custodian of health care records, other than a
custodian of the health care records of a state or local governmental
entity, may charge a fee of $5 for the furnishing of those health care
records.
4. [A] Except as otherwise provided in subsection 2, a
custodian of health care records, other than a custodian of the health
care records of a state or local governmental entity, may charge the
following fees to furnish health care records electronically, in
addition to the total a mount of the fee charged pursuant to
subsection 2 or 3:

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- 83rd Session (2025)
(a) A fee of $5 for written confirmation that no health care
records were found.
(b) A fee of $5 for furnishing a copy of a certificate of the
custodian of health care records.
(c) A fee of $20 for a copy of a printed film sheet.
(d) A fee of $25 for furnishing a copy of radiologic images in
any form other than a printed film sheet.
5. As used in this section:
(a) “Covered entity” has the meaning ascribed to it in 45
C.F.R. § 160.103.
(b) “Custodian of health care records” has the meaning ascribed
to it in NRS 629.016 and additionally includes a covered entity or
business associate, as those terms are defined in 45 C.F.R.
§ 160.103.
[(b)] (c) “Health care records” has the meaning ascribed to it in
NRS 629.021 and additionally includes individually identifiable
health information, as defined in 45 C.F.R. § 160.103.
[(c)] (d) “Secure electronic transmission” means the sending of
information from one computer system to another computer system
in such a manner as to ensure that:
(1) No person other than the intended recipient receives the
information;
(2) The identity and signature of the sender of the
information can be authenticated; and
(3) The information which is received by the intended
recipient is identical to the information that was sent.
Sec. 34. NRS 686A.315 is hereby amended to read as follows:
686A.315 1. If a hospital or independent center for
emergency medical care submits to an insur er the form prescribed
by the Director of the Department of Health and Human Services
pursuant to NRS 449.485, that form must contain or be
accompanied by a statement that reads substantially as follows:

Any person who misrepresents or falsifies essentia l
information requested on this form may, upon conviction, be
subject to a fine and imprisonment under state or federal law,
or both.

2. If a person who is licensed to practice one of the health
professions regulated by title 54 of NRS submits to an ins urer the
form commonly referred to as the “HCFA -1500” for a patient who
is not covered by any governmental program which offers insurance

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- 83rd Session (2025)
coverage for health care, the form must be accompanied by a
statement that reads substantially as follows:

Any person who knowingly files a statement of claim
containing any misrepresentation or any false, incomplete or
misleading information may be guilty of a criminal act
punishable under state or federal law, or both, and may be
subject to civil penalties.

3. The failure to provide any of the statements required by this
section is not a defense in a prosecution for insurance fraud pursuant
to NRS 686A.291.
Sec. 35. NRS 719.200 is hereby amended to read as follows:
719.200 1. Except as otherwise provided in subsection 2, the
provisions of this chapter apply to electronic records and electronic
signatures relating to a transaction.
2. The provisions of this chapter do not apply to a transaction
to the extent it is governed by:
(a) Except as otherwise specifically provided by law, a law
governing the creation and execution of wills, codicils or
testamentary trusts;
(b) The Uniform Commercial Code other than NRS 104.1306,
104.2101 to 104.2725, inclusive, and 104A.2101 to 104A. 2532,
inclusive; or
(c) The provisions of NRS 439.581 to 439.597, inclusive, and
section 1 of this act and the regulations adopted pursuant thereto.
3. The provisions of this chapter apply to an electronic record
or electronic signature otherwise exclud ed from the application of
this chapter under subsection 2 to the extent it is governed by a law
other than those specified in subsection 2.
4. A transaction subject to the provisions of this chapter is also
subject to other applicable substantive law.
Sec. 36. NRS 720.140 is hereby amended to read as follows:
720.140 1. Except as otherwise provided in this subsection,
the provisions of this chapter apply to any transaction for which a
digital signature is used to sign an electronic record. The provisions
of this chapter do not apply to a digital signature that is used to sign
an electronic health record in accordance with NRS 439.581 to
439.597, inclusive, and section 1 of this act and the regulations
adopted pursuant thereto.
2. As used in this section, “electronic record” has the meaning
ascribed to it in NRS 719.090.

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- 83rd Session (2025)
Sec. 36.2. 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 the sum of
$291,296 to carry out the provisions of sections 26.5, 27 and 28 of
this act.
2. Expenditure of $1,149,153 not appropriated from the State
General Fund or the State Highway Fund is hereby authorized
during Fiscal Year 2026 -2027 by the Division of Health Care
Financing and Policy of the Department of Health and Human
Services for the same purpose as set forth in subsection 1.
3. Any remaining balance of the appropriation made by
subsection 1 must not be committed for expenditure after June 30,
2027, by the entity to which the appropriation is made or any entity
to which money from the appropriation is granted or otherwise
transferred in any manner, and any portion of the appropriated
money remaining must not be spent for any purpose after
September 17, 2027, by 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 17, 2027.
Sec. 36.5. 1. An independent center for emergency medical
care that was licensed on the date on which this act was enacted is
exempt from the requirements of subsection 3 of NRS 449.1818, as
amended by section 18 of this act.
2. As used in this section, “independent center for emergency
medical care” has the meaning ascribed to it in NRS 449.013, as that
section existed on January 1, 2025.
Sec. 37. 1. Notwithstanding the amendatory provisions of
section 14 of this act, an independent center for emergency medical
care that is owned or operated by, or otherwise part of, a hospital
may continue to operate without obtaining a license separate from
the license of the hospital pursuant to NRS 449.080 until July 1,
2026.
2. Notwithstanding the amendatory provisions of section 17 of
this act, the Division of Public and Behavioral Health of the
Department of Health and Human Services shall issue a license to
operate an independent center for emergency medical care that was
operating on the date on which this act was enacted and is located
within 5 miles of another independent center for emergency medical
care or a hospital with an emergency department if the independent
center for emergency medical care otherwise qualifies for licensure
pursuant to NRS 449.080.

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- 83rd Session (2025)
3. Notwithstanding the amendatory provisions of section 17 of
this act, the Division of Public and Behavioral Health of the
Department of Health and Human Se rvices shall issue a license to
operate an independent center for emergency medical care that is
located within 5 miles of another independent center for emergency
medical care or a hospital with an emergency department and that
otherwise qualifies for lic ensure pursuant to NRS 449.080 at the
time of the application for licensure if, on or before January 1, 2025,
the owner or operator of the independent center for emergency
medical care had:
(a) Acquired the land upon which the independent center for
emergency medical care is to be constructed;
(b) Obtained or was in the process of obtaining all necessary
permits, licenses or other required approvals necessary for the
construction of the independent center for emergency medical care;
and
(c) Commenced the process of obtaining approval from the
Director of the Department of Health and Human Services pursuant
to NRS 439A.100 or 439A.102, if applicable.
4. As used in this section, “independent center for emergency
medical care” has the meaning ascribed to i t in NRS 449.013, as
amended by section 14 of this act.
Sec. 38. The provisions of subsection 1 of NRS 218D.380 do
not apply to any provision of this act which adds or revises a
requirement to submit a report to the Legislature.
Sec. 39. 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. 40. NRS 450B.215 is hereby repealed.
Sec. 41. 1. This section and sections 1 to 4, inclusive, 6, 21,
24, 25, 29 to 32, inclusive, 35, 36 and 40 of this act become
effective upon passage and approval.
2. Sections 5, 7 to 20, inclusive, 22, 23, 26, 26.5, 33, 34 and
36.5 to 39, inclusive, of this act become effective:
(a) Upon passage and approval for the purpose of adopting any
regulations and performing any other preliminary administrative
tasks that are necessary to carry out the provisions of this act; and
(b) On January 1, 2026, for all other purposes.
3. Section 36.2 of this act becomes effective on July 1, 2026.
4. Sections 27 and 28 of this act become effective:
(a) Upon passage and approval for the purpose of adopting any
regulations and performing any other preliminary administrative
tasks that are necessary to carry out the provisions of this act; and

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- 83rd Session (2025)
(b) On October 1, 2026, for all other purposes.

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