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- 83rd Session (2025)
Senate Bill No. 494–Committee on Finance
CHAPTER..........
AN ACT relating to state government; creating the Nevada Health
Authority; creating certain divisions and offices within the
Authority; providing for the appointment of officers and the
employment of staff for the Authority; establishing
requirements governing procurement by the Authority;
creating the Nevada Health Authority Gift Fund; prescribing
the duties of the Authority a nd its divisions and officers;
transferring to the Authority the responsibility for operating
various programs and administering various provisions;
revising the name of certain agencies; revising certain
terminology; eliminating the Division of Health Car e
Financing and Policy of the Department of Health and Human
Services; revising provisions governing the operation of the
Public Employees’ Benefits Program and Medicaid; requiring
certain reporting on the costs of health insurance for retired
state employ ees; authorizing the Authority to require the
reporting of certain information on the cost of certain
prescription drugs; revising the membership and duties of the
Board of Directors of the Silver State Health Insurance
Exchange; providing for a study of opportunities for the Board
of the Public Employees’ Benefits Program to directly contract
with certain providers of health care; providing for a study of
and the development of a plan to transfer certain additional
functions to the Authority; and providing other matters
properly relating thereto.
Legislative Counsel’s Digest:
Existing law creates the Department of Health and Human Services, which
consists of the Aging and Disability Services Division, the Division of Public and
Behavioral Health, the Division of Welfare and Supportive Services, the Division of
Child and Family Services and the Division of Health Care Financing and Policy.
(NRS 232.300) This bill creates a new department within the Executive Department
of the State Government known as the Ne vada Health Authority to assume certain
responsibilities of the Department of Health and Human Services and other entities
related to the management of certain public health insurance plans, the licensing and
regulation of certain persons and entities involved in the provision of health care and
the regulation of sanitation in food establishments and certain other locations.
Section 18 of this bill creates and establishes the purposes of the Authority, and
section 32 of this bill changes the name of the De partment to the Department of
Human Services. Section 18 provides that the Authority consists of: (1) the Medicaid
Division; (2) the Health Care Purchasing and Compliance Division; and (3) the
Consumer Health Division. Section 19 of this bill requires the Governor to appoint
a Director of the Authority who possesses certain qualifications. Sections 20-23 and
29 of this bill provide for the appointment of officers and the employment of staff
for the Authority, including an administrator of each division of the Authority.
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Sections 24 and 79 of this bill exempt the Authority from provisions of law
governing state procurement, with certain exceptions, and section 24 prescribes
requirements governing procurement by the Authority. Sections 24 and 61 of this
bill provide for the confidentiality of certain information submitted to the Authority
during the procurement process. Section 25 of this bill authorizes: (1) the sharing of
confidential informa tion within the Authority; and (2) the Authority to share
confidential information with certain agencies of local governments in certain
circumstances. Sections 26 and 34 of this bill transfer from the Department to the
Authority the authority to administe r certain programs for persons with
developmental disabilities. Section 28 of this bill requires the Director or the
Director’s designee to adopt each state plan required by the Federal Government for
the administration of any program for which the Authori ty or a division thereof is
responsible. Section 31 of this bill creates the Nevada Health Authority Gift Fund to
hold gifts, grants and other property which the Authority is authorized to accept.
Sections 113 and 227 of this bill require the deposit of ce rtain money in the Fund.
Section 36 of this bill updates the name of the Department of Health and Human
Services Gift Fund, which is created by existing law, to conform to the change in the
name of the Department. (NRS 232.355)
Existing law requires the O ffice of Science, Innovation and Technology in the
Office of the Governor to administer the Graduate Medical Education Grant
Program, which is a program to award grants to institutions in this State seeking to
create, expand or retain programs for residency training and postdoctoral fellowships
for physicians. (NRS 223.631 -223.639) Sections 2-8 and 26 of this bill transfer to
the Consumer Health Division the responsibility for administering the Program.
Existing law requires the Board of the Public Employe es’ Benefits Program to
establish the Program to provide group life, accident or health insurance, or any
combination thereof, to employees of the State Government. (NRS 287.043) Section
68 of this bill places the Board within the Authority and makes revis ions governing
the appointment and membership of the Board. Section 68.5 of this bill: (1) removes
the authority of the Governor to designate the Chair of the Board and instead
requires the Board to elect a Chair annually; and (2) requires the Governor to
designate a Vice Chair of the Board. Section 69 of this bill transfers from the Board
to the Director of the Authority the responsibility for appointing the Executive
Officer of the Program. Section 65.5 of this bill requires the Board to biennially
submit to the Legislature a report concerning the cost for a retired state employee to
obtain coverage through the Program under Medicare. Section 70 of this bill requires
the Executive Officer to submit to the Authority a report regarding the administration
and operation of the Program, in addition to certain other entities that currently
receive the report. Section 71 of this bill provides that the a ppointment of officers
and unclassified employees to administer the Program is subject to the approval of
the Director of the Authority. Sections 72-74 of this bill authorize the Board to utilize
certain services of the Authority, including procurement ser vices, or to conduct
procurement in accordance with either section 24 or provisions of existing law
governing procurement by state agencies. ( Chapter 333 of NRS) Section 72
additionally requires the Board, within the limits of available resources, to take such
measures as are necessary to maximize the benefits available to participants in the
Program and the ability of participants to access available benefits.
Existing law authorizes the Board of the Program to enter into contracts with
physicians, surgeons, hospitals and rehabilitative facilities for medical, surgical and
rehabilitative care and the evaluation, treatment and nursing care of members of the
Program and covered dependents. (NRS 287.0434) Section 367.7 of this bill requires
the Authority and the Board to study and report to the Legislature concerning
opportunities to directly contract with such providers.
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Existing law requires: (1) the Department to administer Medicaid and the
Children’s Health Insurance Program; and (2) the Division of Health Care Financing
and Policy of the Department to perform certain duties related to the administration
of those programs. (Chapter 422 of NRS) Sections 26, 34, 93-96, 113-117, 120.5
and 359 of this bill transfer from the Department and the Director of the Department
to the Medicaid Division and the Director of the Authority the responsibility for
administering Medicaid and the Children’s Health Insurance Program. Sections 32,
34 and 35 of this bill abolish the Division of Health Care Financing and Policy, and
sections 94 and 359 transfer the authority, duties and responsibilities of that Division
to the Medicaid Division. Section 86 of this bill authorizes the Authority to delegate
to other governmental entities the responsibility for making determinations of
eligibility for Medicaid and the Children’s Health Insurance Program. Section 87 of
this bill creates the Office of the Medicaid Inspector General within the Authority to
perform certain duties to ensure the integrity of Medicaid and the Children’s Health
Insurance Program and to prevent waste, fraud and abuse in those programs. Sections
66, 88-91 and 371 of this bill transfer or provide to the Authority certain
responsibilities related to the administration of those programs. Sections 101-104,
109 and 110 of this bill establish provisions governing the qualifications, supervision
and activities of the Administrator of the Medicaid Division, which are similar to the
qualifications, supervision and activities of the Administrator of the Division of
Health Care Financing and Policy. (NRS 422.2354 -422.2364, 422.2372) Sections
105-108, 111 and 112 of this bill transfer to the Director certain responsibilities
relating to Medicaid and the Children’s Health Insurance Program, including the
responsibility for adopting regulations governing those programs. Section 116
requires any contract for the expenditure of federal money under Medicaid to be
signed by the Director. Section 118 of this bill requires the Authority to: (1) include
on an Internet website maintained by the Authority certain information to allow
recipients of Medicaid through managed care to compare available plans; and (2)
develop and implement a beneficiary support system for such recipients of Medicaid.
Section 371 repeals certain fiscal duties previously performed by the Administrator
of the Division of Health Care Financing and Policy.
Sections 26, 34, 141, 144-146, 194, 217-224, 245-247, 250, 260, 276, 325-327
and 360 of this bill transfer from the Division of Public and Behavioral Health to the
Health Care Purchasing and Compliance Division and from the Department of Health
and Human Services to the Nevada Health Author ity, as applicable, the
responsibilities for credentialing and regulating: (1) programs for the treatment of
persons who commit domestic violence; (2) health care facilities and certain entities
involved in the provision of personal care services; (3) nont ransplant anatomical
donation organizations; (4) naprapaths; and (5) medical laboratories and their
personnel. Section 143 of this bill authorizes the State Board of Health to establish
fees for the credentialing functions and certain other functions of th e Health Care
Purchasing and Compliance Division. Sections 26, 34 and 162-171 of this bill
transfer from the Division of Public and Behavioral Health to the Health Care
Purchasing and Compliance Division the responsibility for administering provisions
governing health and safety at health care facilities, including the reporting of
sentinel events. Section 35 reduces the number of deputy administrators in the
Division of Public and Behavioral Health to account for the duties removed from that
Division. Section 367.8 of this bill requires the Department and the Authority to
study and develop a plan to additionally transfer functions relating to behavioral
health, maternal health and public health from that Division to the Authority.
Sections 26, 34, 141, 144, 145, 147-152, 154-160, 180-187, 197-200, 226-238,
240-244 and 359 of this bill transfer from the Department to the Authority the
responsibility for administering; (1) the State Program for Oral Health; (2) provisions
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governing health information technology; (3) the programs to increase public
awareness of health care in formation concerning hospitals and surgical centers for
ambulatory patients in this State; (4) provisions governing the reporting of
information relating to the cost of certain prescription drugs and certain information
concerning pharmacies; (5) the Nevad a Health Facilities Assistance Act, which
establishes a program to construct new health facilities in this State; and (6) certain
requirements to ensure the quality of care offered by hospitals in this State and the
financial stability of such hospitals. Section 197 additionally authorizes the
Authority to require the reporting of information concerning the cost of certain
additional prescription drugs for which reporting is not currently required.
Existing law: (1) creates the Patient Protection Commission within the Office of
the Director of the Department; and (2) requires the Commission to perform certain
duties to improve the quality, accessibility and affordability of health care in this
State. (NRS 439.908, 439.918) Sections 26, 34, 172 and 173 of this bill transfer the
Commission to the Consumer Health Division. Sections 172 and 173 also transfer
from the Governor to the Director of the Authority the responsibility for appointing
the members and Executive Director of the Commission. Sections 174 and 175 of
this bill require the Commission to make certain recommendations and submit certain
reports to the Director of the Authority.
Existing law authorizes the Division of Public and Behavioral Health to establish
a secure Internet website which makes ce rtain information available for a website
client to conduct background investigations of certain persons who are required by
law to undergo such an investigation. (NRS 449.942) Sections 175.3 and 175.6 of
this bill authorize the Authority to access information on that Internet website without
restriction and without becoming a website client.
Existing law requires the Department to establish an all-payer claims database of
information relating to health insurance claims resulting from medical, dental or
pharmacy benefits provided in this State. (NRS 439B.835) Section 29 creates the
Office of Data Analytics within the Authority, and sections 26, 34, 202-204 and 359
of this bill transfer to the Office the responsibility for operating the all -payer claims
database.
Existing law: (1) requires the Division of Public and Behavioral Health to enforce
provisions governing sanitation and food establishments under certain
circumstances; and (2) requires each county where the Division provides such
enforcement to pay an assessment to the Division. (NRS 439.4905, chapters 444 and
446 of NRS) Sections 26, 34, 206-208 and 210-216 of this bill transfer to the
Authority the authority to enforce provisions governing sanitation and food
establishments, and sections 30 and 153 of this bill require counties who currently
pay to the Division an assessment for those functions to instead pay the assessment
to the Authority.
Existing law requires the State Board of Health to license and regulate music
therapists and dietitians. (Ch apters 640D and 640E of NRS) Sections 26, 283-297
and 300-323 of this bill transfer to the Health Care Purchasing and Compliance
Division the responsibilities for issuing and renewing licenses to those professionals
and enforcing provisions of law and regu lations governing those professionals and
leave the authority to adopt regulations governing those professions with the State
Board.
Existing law creates the Silver State Health Insurance Exchange. (NRS 695I.200)
Existing law requires the Exchange to: (1) create and administer a state-based health
insurance exchange; (2) facilitate the purchase and sale of qualified health plans; (3)
provide for the establishment of a program to help certain small employers in Nevada
in facilitating the enrollment of employees in qualified health plans; and (4) perform
all other duties required pursuant to the federal Patient Protection and Affordable
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Care Act, the federal Health Care and Education Reconciliation Act of 2010 and any
amendments to or regulations or guidance issued pursuant to those Acts. (Pub. L. No.
111-148, Pub. L. No. 111-152; NRS 695I.200, 695I.210) The Exchange is governed
by the Board of Directors consisting of five voting members appointed by the
Governor, one voting member appointed by the Senate Majo rity Leader, one voting
member appointed by the Speaker of the Assembly and three ex officio, nonvoting
members. (NRS 695I.300) Sections 346-348 of this bill place the Exchange under
the authority of the Consumer Health Division. Section 348: (1) reduces the number
of members of the Board appointed by the Governor from five to two; (2) adds three
heads of agencies whose work relates to public health or health insurance as ex
officio, voting members of the Board; and (3) reduces the nonvoting membership of
the Board. Sections 349 and 350 of this bill make revisions governing the terms of
the members and officers of the Board. Section 352 of this bill transfers from the
Board to the Director of the Authority or his or her designee the responsibility for
appointing the Executive Director of the Exchange. Sections 351 and 352 of this bill
transfer certain duties relating to auditing and reports from the Board to the Executive
Director. Sections 353 and 354 of this bill transfer certain other duties related to the
Exchange to Authority and its Director.
Existing law requires the Director of the Department, in consultation with the
Commissioner of Insurance and the Executive Director of the Exchange, to design,
establish and operate a health benefit p lan known as the Public Option. (NRS
695K.200) Section 355 of this bill transfers the responsibility for designing,
establishing and operating the Public Option to the Director of the Authority.
Section 27 of this bill requires the Director and the Authority to: (1) take certain
actions to facilitate determinations of eligibility for and the selection of plans under
Medicaid and certain other public health insurance programs under the jurisdiction
of the Authority ; and (2) assess and recommend improvements to the Public
Employees’ Benefits Program. Sections 9-13, 38-60, 62, 77, 78, 80, 81, 83, 96-98,
100, 121, 123, 125, 128-139, 142, 161, 178, 179, 188, 189, 195, 196, 205, 209, 248,
249, 251-275, 277-280, 324, 328-336, 338-341 and 356-358 of this bill make various
conforming changes to reflect the authority transferred by the provisions of this bill.
Sections 32, 34, 38, 46, 99, 122, 127, 239, 287, 307 and 326 of this bill change the
name of the Division of Welfare and Supportive Services of the Department to the
Division of Social Services of the Department. Sections 33, 37, 82, 119, 120, 123,
124, 126-128 and 368 of this bill revise the terminology to refer to certain programs
operated by that Division from “welfare” to “public assistance.” Section 132 revises
the term “transitional assistance” to “child care assistance” to describe certain
assistance provided pursuant to federal Temporary Assistance for Needy Families
program. Sections 1, 16, 17, 64, 65, 85, 140, 176, 191, 192, 225, 240, 281, 298, 343
and 344 of this bill define certain terms, and sections 15, 67, 75, 76, 92, 177, 193,
201, 282, 299, 337 and 345 of this bill make conforming changes to indicate the
applicability of those definitions. Section 371 eliminates certain definitions that are
no longer necessary. Sections 58.5 and 120.5 of this bill authorize the Board of State
Prison Commissioners to obtain prescription drugs for the treatment of offenders
through collaborative purchasing conducted by the Authority for Medicaid and
certain public and nonprofit health plans.
Section 361 of this bill transfers to the Authority the duty to carry out any
requirements of a bill that is enacted by the Legislature during this session and
approved by the Governor to: (1) require the Depart ment of Health and Human
Services to operate a program to award money to support projects to address
shortages of providers of health care in this State; or (2) impose certain requirements
on Medicaid or the Children’s Health Insurance Program.
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EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted.
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1. Chapter 223 of NRS is hereby amended by adding
thereto a new section to read as follows:
As used in NRS 223.631 to 223.639, inclusive, unless the context
otherwise requires, “Division” means the Consumer Health
Division of the Nevada Health Authority.
Sec. 2. NRS 223.610 is hereby amended to read as follows:
223.610 The Director of the Office of Science, Innovation and
Technology shall:
1. Advise the Governor and the Executive Director of the Office
of Economic Development on matters relating to science, innovation
and technology.
2. Work in coordination with the Office of Economic
Development to establish crite ria and goals for economic
development and diversification in this State in the areas of science,
innovation and technology.
3. As directed by the Governor, identify, recommend and carry
out policies related to science, innovation and technology.
4. Report periodically to the Executive Director of the Office of
Economic Development concerning the administration of the policies
and programs of the Office of Science, Innovation and Technology.
5. Coordinate activities in this State relating to the planning,
mapping and procurement of broadband service in a competitively
neutral and nondiscriminatory manner, which must include, without
limitation:
(a) Development of a strategic plan to improve the delivery of
broadband services in this State to scho ols, libraries, providers of
health care, transportation facilities, prisons and other community
facilities;
(b) Applying for state and federal grants on behalf of eligible
entities and managing state matching money that has been
appropriated by the Legislature;
(c) Coordinating and processing applications for state and federal
money relating to broadband services;
(d) Prioritizing construction projects which affect or involve the
expansion or deployment of broadband services in this State;
(e) In consu ltation with providers of health care from various
health care settings, the expansion of telehealth services to reduce
health care costs and increase health care quality and access in this
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State, especially in rural, unserved and underserved areas of this
State;
(f) Expansion of the fiber optic infrastructure in this State for the
benefit of the public safety radio and communications systems in this
State;
(g) Collection and storage of data relating to agreements and
contracts entered into by the State for the provision of fiber optic
assets in this State;
(h) Administration of the trade policy for fiber optic infrastructure
in this State; and
(i) Establishing and administering a program of infrastructure
grants for the development or improvement of broadband services for
persons with low income and persons in rural areas of this State using
money from the Account for the Grant Program for Broadband
Infrastructure created by NRS 223.660. The Director may adopt
regulations to carry out his or duties pursuant to this paragraph.
6. [Provide support to the Advisory Council on Graduate
Medical Education and implement the Graduate Medical Education
Grant Program established pursuant to NRS 223.637.
7.] In carrying out his or her duties pursuant to this sec tion,
consult with the Executive Director of the Office of Economic
Development and cooperate with the Executive Director in
implementing the State Plan for Economic Development developed
by the Executive Director pursuant to subsection 2 of NRS 231.053.
[8.] 7. Administer such grants as are provided by legislative
appropriation.
Sec. 3. NRS 223.630 is hereby amended to read as follows:
223.630 1. The Account for the Office of Science, Innovation
and Technology is hereby created in the State General Fund. The
Account must be administered by the Director of the Office of
Science, Innovation and Technology.
2. Except as otherwise provided in NRS [223.631 and] 223.660,
any money accepted pursuant to NRS 223.620 must be deposited in
the Account.
3. The interest and income earned on the money in the Account,
after deducting any applicable charges, must be credited to the
Account.
4. The money in the Account must only be used to carry out the
duties of the Director.
5. Claims against the Account must be paid as other claims
against the State are paid.
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Sec. 4. NRS 223.631 is hereby amended to read as follows:
223.631 1. The Account for the Graduate Medical Education
Grant Program is hereby created in the State General Fund. The
Director of the [Office of Science, Innovation and Technology ]
Nevada Health Authority, or his or her designee, shall administer
the Account.
2. The Director of the [Office of Science, Innovation and
Technology] Nevada Health Authority, or his or her designee, may:
(a) Accept any gift, donation, bequest or devise; and
(b) Apply for and accept any grant, loan or other source of money,
for deposit in the Account to assist the Director in carrying out the
Graduate Medical Education Grant Program established pursuant to
NRS 223.637.
3. The interest and income earned on the money in the Account,
after deducting any applicable charges, mu st be credited to the
Account.
4. The money in the Account must only be used to:
(a) Award competitive grants to institutions in this State seeking
to create, expand or retain programs for residency training and
postdoctoral fellowships that are approve d by the Accreditation
Council for Graduate Medical Education or its successor
organization; and
(b) Defray the costs of establishing and administering the
Graduate Medical Education Grant Program established pursuant to
NRS 223.637.
5. Any money remaining in the Account at the end of the fiscal
year does not revert to the State General Fund, and the balance in the
Account must be carried forward to the next fiscal year.
6. Claims against the Account must be paid as other claims
against the State are paid.
Sec. 5. NRS 223.633 is hereby amended to read as follows:
223.633 1. The Advisory Council on Graduate Medical
Education is hereby created within the [Office of Science, Innovation
and Technology.] Division. The Council consists of:
(a) The dean of each medical school in this State that is accredited
by the Liaison Committee on Medical Education of the American
Medical Association and the Association of American Medical
Colleges or their successor organizations, or his or her designee;
(b) The dean of each school of osteopathic medicine in this State
that is accredited by the Commission on Osteopathic College
Accreditation of the American Osteopathic Association or its
successor organization, or his or her designee;
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(c) Two members appointed by the Governor who are physicians
licensed pursuant to chapter 630 or 633 of NRS;
(d) One member appointed by the Governor who represents
hospitals located in counties whose population is less than 100,000;
(e) One member appointed by the Governor w ho represents
hospitals located in counties whose population is 100,000 or more but
less than 700,000;
(f) One member appointed by the Governor who represents
hospitals located in a county whose population is 700,000 or more;
(g) One member appointed by the Governor who represents the
medical corps of any of the Armed Forces of the United States;
(h) One member appointed by the Governor who represents the
Department of [Health and] Human Services; and
(i) One member appointed by the Governor who represents the
Office of Economic Development in the Office of the Governor.
2. In addition to the members appointed by the Governor
pursuant to subsection 1, the Governor may appoint two members as
the Governor determines necessary to carry out the provisions of NRS
223.631 to 223.639, inclusive.
3. After the initial terms, the term of each member of the Council
is 3 years, and members shall serve at the pleasure of the Governor.
4. Any vacancy occurring in the membership of the Council
must be fille d in the same manner as the original appointment not
later than 30 days after the vacancy occurs.
5. The Council shall select from its members a Chair and a Vice
Chair who shall hold office for 1 year and who may be reselected.
6. The Council shall mee t at the call of the Chair as often as
necessary to evaluate applications for competitive grants for the
Graduate Medical Education Grant Program established pursuant to
NRS 223.637 and make recommendations to the [Office of Science,
Innovation and Technol ogy] Division concerning the approval of
applications for such grants.
7. A majority of the members of the Council constitutes a
quorum for the transaction of business, and a majority of those
members present at any meeting is sufficient for any official action
taken by the Council.
8. The members of the Council serve without compensation,
except that each member is entitled to receive the per diem allowance
and travel expenses provided for state officers and employees
generally while engaged in the official business of the Council.
9. A member of the Council who is an officer or employee of
this State or a political subdivision of this State must be relieved from
his or her duties without loss of regular compensation to prepare for
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and attend meetings of the Council and perform any work necessary
to carry out the duties of the Council in the most timely manner
practicable. A state agency or political subdivision of this State shall
not require an officer or employee who is a member of the Council
to:
(a) Make up the time he or she is absent from work to carry out
his or her duties as a member of the Council; or
(b) Take annual leave or compensatory time for the absence.
Sec. 6. NRS 223.635 is hereby amended to read as follows:
223.635 The Advisory Council on Graduate Medical Education
shall:
1. Evaluate applications for competitive grants for the Graduate
Medical Education Grant Program established pursuant to NRS
223.637 and make recommendations to the [Office of Science,
Innovation and Technolo gy] Division concerning the approval of
applications for such grants. In evaluating and making
recommendations concerning such applications, the Council shall
give priority to the award of grants for the retention of programs in
this State for residency tr aining and postdoctoral fellows when the
federal funding for the support of such programs expires.
2. Study and make recommendations to the [Office of Science,
Innovation and Technology, ] Division, the Governor and the
Legislature concerning:
(a) The creation and retention of programs in this State for
residency training and postdoctoral fellows that are approved by the
Accreditation Council for Graduate Medical Education or its
successor organization; and
(b) The recruitment and retention of physicians necessary to meet
the health care needs of the residents of this State, with the emphasis
on those health care needs.
Sec. 7. NRS 223.637 is hereby amended to read as follows:
223.637 1. The [Office of Science, Innovation and
Technology] Division shall establish and administer a Graduate
Medical Education Grant Program as a competitive grant program to
award grants to institutions in this State seeking to create, expand or
retain programs for residency training and postdoctoral fellows that
are app roved by the Accreditation Council for Graduate Medical
Education or its successor organization.
2. In awarding grants pursuant to the Program established
pursuant to subsection 1, the [Office of Science, Innovation and
Technology] Division shall conside r the recommendations of the
Advisory Council on Graduate Medical Education created by
NRS 223.633 and give priority to the award of grants for the retention
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of programs in this State for residency training and postdoctoral
fellows when the federal fundin g for the support of such programs
expires.
3. The [Office of Science, Innovation and Technology] Division
shall establish a committee to develop a process, procedure and rubric
for evaluating applications for grants pursuant to the Program
established pursuant to subsection 1 to ensure that the process and
procedure are transparent, without bias, fair, equitable and accessible.
The committee established pursuant to this subsection must be
composed of persons with expertise in subject matters related to
graduate medical education who are not affiliated with any applicant
for a grant pursuant to the Program established pursuant to
subsection 1.
4. The [Office of Science, Innovation and Technology] Division
may adopt regulations necessary to carry out the Program established
pursuant to subsection 1. Such regulations may include, without
limitation, the requirements to apply for and receive a grant.
Sec. 8. NRS 223.639 is hereby amended to read as follows:
223.639 1. On or before October 1 of each year, the [Office of
Science, Innovation and Technology] Division shall submit a written
report to:
(a) The Governor; and
(b) The Director of the Legislative Counsel Bureau for transmittal
to:
(1) The Interim Finance Committee in an odd-numbered year;
or
(2) The next regular session of the Legislature in an even -
numbered year.
2. The report must include, without limitation:
(a) Information on the Graduate Medical Education Grant
Program established pursuant to NRS 223.637; and
(b) Any recommendations regarding graduate medical education
in this State, including, without limitation:
(1) The creation, expansion and retention of programs in this
State for residency training and postdoctoral fellows; and
(2) Methods by which this State may recruit and retain
physicians necessary to meet the health care needs of the residents of
this State.
Sec. 9. NRS 223.950 is hereby amended to read as follows:
223.950 1. The Public Health Resource Office is hereby
created within the Office of the Governor.
2. The Governor shall appoint a person who is knowledgeable
in the field of public health to serve as the Public Health Resource
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Officer. The Public Health Resource Officer is not in the classified or
unclassified service of the State and serves at the pleas ure of the
Governor.
3. The Public Health Resource Office may accept gifts, grants
and donations to support its duties.
4. The Public Health Resource Office shall:
(a) Analyze the existing infrastructure for meeting the public
health needs of this State and the relationships between persons and
entities involved in the provision of public health services, including,
without limitation, the Division of Public and Behavior al Health of
the Department of [Health and] Human Services, the Nevada Health
Authority, local health authorities, providers of health care, health
care facilities and nonprofit organizations; and
(b) Identify and make recommendations to the Governor, the
Legislature, the Director of the Department of [Health and] Human
Services , [and] the Administrator of the Division of Public and
Behavioral Health of the Department and the Director of the Nevada
Health Authority concerning:
(1) Unmet needs for public health services;
(2) Opportunities to obtain federal or private funding to
support public health services; and
(3) Ways in which to improve coordination between providers
of public health services and maximize efficiency in the delivery of
public health services.
Sec. 10. NRS 226.454 is hereby amended to read as follows:
226.454 “Provider of health care” means:
1. A physician;
2. A physician assistant licensed pursuant to chapter 630 or 633
of NRS;
3. A dentist;
4. A licensed nurse;
5. A person who holds a license as an attendant or is certified as
an emergency medical technician, advanced emergency medical
technician or paramedic pursuant to chapter 450B of NRS;
6. An optometrist;
7. An audiologist;
8. A practitioner of respiratory care;
9. A podiatric physician;
10. A psychologist;
11. A clinical professional counselor;
12. A perfusionist;
13. A pharmacist or pharmacy technician;
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14. An associate in social work, a social worker, a master social
worker, an independent so cial worker or a clinical social worker
licensed pursuant to chapter 641B of NRS;
15. A midwife; or
16. A provider of doula services who is enrolled with the
Medicaid Division of [Health Care Financing and Policy of the
Department of Health and Human S ervices] the Nevada Health
Authority to receive reimbursement through Medicaid pursuant to
NRS 422.27177.
Sec. 11. NRS 228.410 is hereby amended to read as follows:
228.410 1. The Attorney General has primary jurisdiction to
investigate and prosecute violations of NRS 422.540 to 422.570,
inclusive, and any fraud in the administration of the Plan or in the
provision of medical assistance pursuant to the Plan. The provisions
of th is section notwithstanding, the [Department of Health and
Human Services ] Nevada Health Authority and the Medicaid
Division of [Health Care Financing and Policy of the Department of
Health and Human Services ] the Nevada Health Authority shall
enforce the Plan and any regulations adopted pursuant thereto.
2. For this purpose, the Attorney General shall establish within
his or her office the Medicaid Fraud Control Unit. The Unit must
consist of a group of qualified persons, including, without limitation,
an attorney, an auditor and an investigator who, to the extent
practicable, have expertise in nursing, medicine and the
administration of medical facilities.
3. The Attorney General, acting through the Medicaid Fraud
Control Unit:
(a) Is the single state agency responsible for the investigation and
prosecution of violations of NRS 422.540 to 422.570, inclusive;
(b) May conduct any investigation or prosecution authorized
pursuant to 42 U.S.C. § 1396b(q);
(c) Shall review reports of abuse or criminal neglect of patients in
medical facilities which receive payments under the Plan and, when
appropriate, investigate and prosecute the persons responsible;
(d) May review and investigate reports of misappropriation of
money from the personal resources of patie nts in medical facilities
that receive payments under the Plan and, when appropriate, shall
prosecute the persons responsible;
(e) Shall cooperate with federal investigators and prosecutors in
coordinating state and federal investigations and prosecutions
involving fraud in the provision or administration of medical
assistance pursuant to the Plan, and provide those federal officers
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with any information in his or her possession regarding such an
investigation or prosecution; and
(f) Shall protect the privacy of patients and establish procedures
to prevent the misuse of information obtained in carrying out the
provisions of this section and NRS 228.411.
4. When acting pursuant to this section or NRS 228.175, the
Attorney General may commence an investigation and file a criminal
action without leave of court, and has exclusive charge of the conduct
of the prosecution.
5. The Attorney General may, by appropriate legal action,
recover any reasonable costs or expenses incurred in conducting an
investigation or prosecution pursuant to this section or NRS 228.411.
The Attorney General may retain the costs and expenses recovered
pursuant to this subsection up to an amount not exceeding, in the
aggregate, three times the amount of any money paid by this State
which matches federal grant money for the Medicaid Fraud Control
Unit. Costs and expenses recovered by the Attorney General in excess
of the amount retained by the Attorney General must be deposited in
the State General Fund for credit to the approp riate account for the
Plan.
6. As used in this section:
(a) “Medical facility” has the meaning ascribed to it in
NRS 449.0151.
(b) “Plan” means the State Plan for Medicaid established
pursuant to NRS 422.063.
Sec. 12. NRS 228.470 is hereby amended to read as follows:
228.470 1. The Committee on Domestic Violence is hereby
created. The Committee is comprised of the Attorney General or a
designee of the Attorney General and:
(a) The following members appointed by the Attorney General:
(1) One staff member of a program for victims of domestic
violence;
(2) One staff member of a program for the treatment of
persons who commit domestic violence;
(3) One representative from an office of the district attorney
with experience in prosecuting criminal offenses;
(4) One representative from an office of the city attorney with
experience in prosecuting criminal offenses;
(5) One law enforcement officer;
(6) One provider of mental health care;
(7) Two survivors of domestic violence;
(8) One justice of the peace or municipal judge;
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(9) One representative from the Office of Court
Administrator; and
(10) Any other person appointed by the Attorney General.
(b) One member who is a representative of the Health Care
Purchasing and Compliance Division of [Public and Behavioral
Health of the Department of Health and Human Services, ] the
Nevada Health Authority, who is appointed by the Administrator of
the Division and who has experience related to the certification of
programs for the treatment of pe rsons who commit domestic
violence.
Each appointed member serves a term of 2 years. Members may
be reappointed for additional terms of 2 years. At least two members
of the Committee must be residents of a county whose population is
less than 100,000.
2. The Committee shall:
(a) Increase awareness of the existence and unacceptability of
domestic violence in this State;
(b) Review and evaluate existing programs provided to peace
officers for training related to domestic violence and make
recommendations to the Peace Officers’ Standards and Training
Commission regarding such training;
(c) To the extent that money is available, provide financial
support to programs for the prevention of domestic violence in this
State;
(d) Study and review all appropr iate issues related to the
administration of the criminal justice system in rural Nevada with
respect to offenses involving domestic violence, including, without
limitation, the availability of counseling services;
(e) Study issues that relate to domesti c violence, including,
without limitation, the intersections between domestic violence and
sexual assault and domestic violence and human trafficking; and
(f) Submit on or before March 1 of each odd -numbered year a
report to the Director of the Legislati ve Counsel Bureau for
distribution to the regular session of the Legislature. In preparing the
report, the Committee shall solicit comments and recommendations
from district judges, municipal judges and justices of the peace in
rural Nevada. The report must include, without limitation:
(1) A summary of the work of the Committee and
recommendations for any necessary legislation concerning domestic
violence; and
(2) All comments and recommendations received by the
Committee.
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3. The Attorney General or the designee of the Attorney General
is the Chair of the Committee.
4. The Committee shall annually elect a Vice Chair from among
its members.
5. The Committee shall meet regularly at least three times in
each calendar year and may meet at other times upon the call of the
Chair.
6. At least one meeting in each calendar year must be held at a
location within the Fourth Judicial District, Fifth Judicial District,
Sixth Judicial District, Seventh Judicial District or Eleventh Judicial
District.
7. The Attorney General shall provide the Committee with such
staff as is necessary to carry out the duties of the Committee.
8. While engaged in the business of the Committee, each
member and employee of the Committee is entitled to receive the per
diem allowance and travel expenses provided for state officers and
employees generally.
9. The Committee may adopt regulations necessary to carry out
its duties pursuant to NRS 228.470 to 228.497, inclusive.
Sec. 13. NRS 231.3737 is hereby amended to read as follows:
231.3737 1. The financial operating plan for the qualified
project prepared in accordance with paragraph (c) of subsection 4 of
NRS 231.3727 must provide for the annual operations and
maintenance of the facility as well as the ongoing capital needs of the
facility.
2. To pay the operating costs of a facility within a qualified
project, the State Controller shall, on July 1 of each fiscal year,
transfer from the Homelessness Support Services Matching Account
created by NRS 231.3739 an amount of money equal to the amount
of money to be provided for that fiscal year by any participating
municipalities pursuant to paragraph (b) of subsection 2 of
NRS 231.3735, but such amount transferred by the State Controller
must not exceed $15,000,000 per fiscal year, as adjusted pursuant to
subsection 5.
3. In addition to any support provided pursuant to subsection 2,
the [Department of Health and Human Services ] Nevada Health
Authority may administratively create any necessary provider codes
to maximize Med icaid billing for the services provided by the
qualified project.
4. Nothing contained in NRS 231.3711 to 231.3737, inclusive,
shall be deemed to limit the ability of any participant in a qualified
project from accessing programmatic funding for services provided
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by the qualified project that would otherwise be available from a
government, private sector or nonprofit source.
5. The monetary amount specified in subsection 2 shall be
adjusted for each fiscal year by adding to the amount the product of
the amount multiplied by the percentage increase in the consumer
price inflation index between the calendar year ending on
December 31, 2023, and the calendar year immediately preceding the
fiscal year for which the adjustment is made.
6. For the purposes of this section, “consumer price inflation
index” means the Consumer Price Index for All Urban Consumers,
West Region (All Items), as published by the United States
Department of Labor or, if that index ceases to be published by the
United States Department of Labor, the published index selected by
the Department of Taxation pursuant to subsection 11 of
NRS 361.091.
Sec. 14. Chapter 232 of NRS is hereby amended by adding
thereto the provisions set forth as sections 15 to 31, inclusive, of this
act.
Sec. 15. As used in sections 15 to 31, inclusive, of this act,
unless the context otherwise requires, the words and terms defined
in sections 16 and 17 of this act have the meanings ascribed to them
in those sections.
Sec. 16. “Authority” means the Nevada Health Authority.
Sec. 17. “Director” means the Director of the Authority.
Sec. 18. 1. The Nevada Health Authority is hereby created
as a department within the Executive Department of the State
Government.
2. The purposes of the Authority are to:
(a) Improve access to health care that is safe, of high quality
and affordable;
(b) Promote the development of a workforce of providers of
health care that is sufficient to meet the demand for health care in
this State;
(c) Ensure the availability of affo rdable health coverage for
residents of this State, including, without limitation, current and
retired employees of the State Government;
(d) Develop effective and efficient systems for delivering health
care and value -based strategies for procuring healt h insurance
coverage in the most sustainable and responsive manner possible;
and
(e) Ensure the long -term stability of Medicaid, the Children’s
Health Insurance Program, the Public Employees’ Benefits
Program, the Silver State Health Insurance Exchange an d the
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Public Option by minimizing the financial burden of health care on
persons who receive health coverage through those programs, the
state budget and other residents of this State through the use of
measures to contain costs, maximizing the impact of s tate and
federal money and the application of innovative purchasing and
contracting strategies.
3. The Authority consists of a Director and:
(a) The Medicaid Division;
(b) The Health Care Purchasing and Compliance Division; and
(c) The Consumer Health Division.
4. The Authority is the sole agency responsible for
administering the provisions of law relating to its respective
divisions.
Sec. 19. The Director:
1. Is appointed by, is responsible to, and serves at the pleasure
of the Governor.
2. Is in the unclassified service of the State.
3. Except as otherwise provided in NRS 284.143, s hall not
engage in any other gainful employment or occupation.
4. Must have:
(a) A graduate degree from an accredited college or university
in public health, public administration, law or a related field; and
(b) Broad, responsible experience in the field of administration
or possess broad management skills or working knowledge of the
field of health care or public health administration.
5. Must be sele cted with special reference to his or her
training, experience and aptitude for coordinating related functions
of public health agencies and public health insurance programs.
The Director’s knowledge and abilities should include the
following:
(a) A compr ehensive knowledge of administrative principles,
and a working knowledge of principles of public finance and the
laws, rules and regulations pertaining to public agencies.
(b) Administrative ability to assess the operating efficiency of
component agencies and to delegate authority and duties to
responsible deputy directors or other personnel of the Authority.
(c) The ability to organize and clearly present oral and written
findings and recommendations to the Governor, the Legislature
and other officials and agencies.
Sec. 20. 1. The Director may employ, within the limits of
legislative appropriations, such staff as is necessary to the
performance of the Director’s duties.
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2. Any provider of health care who is employed by the
Authority for purposes related to Medicaid or the Children’s Health
Insurance Program must sign a form agreeing to:
(a) Avoid or minimize conflicts of interest between the personal
interests of the provider of health care and the interests of Medicaid
or the Children’s Health Insurance Program; and
(b) If a conflict of interest described in paragraph (a) arises:
(1) Report the conflict to the Administrator of the Medicaid
Division of the Authority; and
(2) Recuse himself or herself from action or deliberation on
the matter in the capacity of his or her employment with the
Authority.
3. Notwithstanding any other provision of law, except NRS
287.0424, the Director, or the Director’s designee, is responsible for
appointing and removing subordinate officers and employees of the
Authority.
Sec. 21. 1. The Director shall appoint, with the consent of
the Governor, the following Deputy Directors:
(a) The Deputy Director of Operations, who shall oversee the
operations of the Authority, including, without limitation, human
resources, the training and development of staff and the
management and improvement of agency processes; and
(b) The Deputy Director of Health Care Financing, who shall:
(1) Oversee the budgets of Medicaid, the Children’s Health
Insurance Program, the Silver St ate Health Insurance Exchange
and the Public Option; and
(2) Maximize the ability of the State to leverage federal
money to support programs under the jurisdiction of the Authority.
2. A Deputy Director appointed pursuant to this section:
(a) Is in th e unclassified service of the State, except where
otherwise required by federal law;
(b) Serves at the pleasure of the Director and is subject to the
administrative supervision of the Director; and
(c) Except as otherwise provided in NRS 284.143, shall devote
his or her entire time and attention to the business of his or her
office and shall not pursue any other business or occupation or hold
any other office of profit.
Sec. 22. 1. The Director shall appoint, with the consent of
the Governor, administrators of the divisions of the Authority, who
are respectively designated as follows:
(a) The Administrator of the Medicaid Division, who:
(1) Must possess the qualifications set forth in NRS
422.2354; and
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(2) Shall perform the duties assigned to the Administrator by
NRS 422.2354 to 422.2374, inclusive, and such other duties as
assigned by the Director.
(b) The Administrator of the Health Care Purchasing and
Compliance Division, who shall oversee activities relating to the
purchasing of health care services, the licensure and inspection of
facilities and providers of health care, activities to prevent waste and
fraud and other activities relating to compliance with state and
federal law.
(c) The Administrator of the Consumer Health Division, who
shall oversee the services and activities relating to coverage and
consumer health care that fall under the jurisdiction of the
Authority.
2. An administrator appointed pursuant to this section:
(a) Is in the unclassified service of the State;
(b) Serves at the pleasure of the Director and is subject to the
supervision of the Director; and
(c) Except as otherwise provided in NRS 284.143, shall devote
his or her entire time and attention to the business of his or her
office and shall not pursue any other business or occupation or hold
any other office of profit.
Sec. 23. 1. The Administrator of the Health Care
Purchasing and Compliance Division shall appoint, with the
consent of the Director:
(a) The Deputy Administrator of Licensure and Compliance,
who shall administer activities related to the licensure and
inspection of facilities and providers of health care regulated by the
Authority;
(b) The Deputy Administrator of Fraud and Waste Prevention,
who shall serve as the executive head of the Office of the Medicaid
Inspector General created by section 87 of this act; and
(c) The Regulatory and Compliance Counsel, who:
(1) Must be an attorney admitted to practice law in one of the
United States who is knowledgeable and experienced concerning
the performance of the activities described in subparagraph (2); and
(2) Shall ensure the compliance of all programs and
activities of the Authority with relevant state and federal laws.
2. The Administrator of the Medicaid Division may appoint,
with the consent of the Director:
(a) Two deputy administrators who shall assist in the
administration of Medicaid and the Children’s Health Insurance
Program, including, without limitation:
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(1) The daily operations of Medicaid and the Children’s
Health Insurance Program;
(2) The management of services for recipients of Medicaid
and the Children’s Health Insurance Program;
(3) The development of coverage and the delivery of covered
benefits under Medicaid and the Children’s Health Insurance
Program;
(4) Compliance with state and federal law governing
Medicaid and the Children’s Health Insurance Program;
(5) Oversight of billing and the payment of claims under
Medicaid and the Children’s Health Insurance Program; and
(6) Collaboration with the Federal Government relating to
Medicaid and the Children’s Health Insurance Program; and
(b) The following clinical officers:
(1) The Senior Pharmacy Officer, who:
(I) Must hold an active license to practice pharmacy in
this State; and
(II) Shall oversee the development of pharmacy benefits
under Medicaid and the Children’s Health Insurance Program and
assist in carrying out the provisions of NRS 422.401 to 422.406,
inclusive; and
(2) The Medical Director, who:
(I) Must hold an active license to engage in the practice
of medicine or osteopathic medicine in this State; and
(II) Shall provide clinical advice and guidance to the
Administrator and his or her deputies to support the development of
benefits, the review of claims and the processing of appeals for
Medicaid and the Children’s Health Insurance Program.
3. The officers appointed pursuant to this section:
(a) Are in the unclassified service of the State; and
(b) Serve at the pleasure of the appointing administrator and
are subject to the supervision of that administrator.
Sec. 24. 1. Except as otherwise provided in this section and
NRS 287.04345 and 695I.210 or other specific statute, the
provisions of chapter 333 of NRS do not apply to purchasing by the
Authority.
2. The Authority may, as determined by the Director, conduct
the process for procuring commodities and services, negotiating the
cost of such commodities and services and entering into contracts
for the provision of such commodities and services for the programs
under the jurisdiction of the Authority. In conducting that process,
the Authority may:
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(a) Utilize a single or simultaneous competitive procurement
process for multiple programs to provide high value for people who
receive health coverage through those programs and the State
Government;
(b) Solicit and receive responses from prospective vendors by
posting requests for proposals, bids and documents establishing the
scope of work to be performed on a project and other documents on
an Internet website maintained by the Authority; and
(c) Join contracts with public or private entities in this State, the
District of Columbia or other states or territories of the United
States as appropriate to increase value for the State Government.
3. In consultation with the Department of Administration and
the Office of the Attorney General, the Authority shall adopt
regulations to carry out the provisions of this section. Those
regulations must:
(a) Establish processes and rules governing any committee
established to evaluate proposals;
(b) Require the provision of notice to prospective vendors who
submit proposals to provide commodities or services before and
after the Authority awards a contract;
(c) Provide for the confidentiality of information submitted as
part of a proposal and any communication between a person who
submits a proposal and the Authority or any members of a
committee described in paragraph (a);
(d) Prescribe the procedure for awarding a contract, which may
include, without limitation, procedures for:
(1) An invitation to bid, a request for proposals, a request for
qualifications, a request for information, a request for a quote or
any other generally accepted procedures for awarding contracts;
(2) Soliciting, bidding and receiving proposals and bids
through an Internet website in accordance with paragraph (b) of
subsection 2; and
(3) Determining the costs of a contract for the purpose of
soliciting bids and responses;
(e) Establish preferences for bids or proposals submitted by
businesses based in this State , businesses owned and operated by
veterans with service-connected disabilities and other entities which
are given preferences under chapter 333 of NRS;
(f) Establish the duties of persons who are authorized to enter
into contracts on behalf of the Authority, which must be consistent
with the duties prescribed by NRS 333.337;
(g) Prescribe prohibitions consistent with NRS 333.339 against
entering into certain contracts;
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(h) Prescribe procedures for determining and awarding
contracts to bidders who will produce results that are high in quality
and value;
(i) Procedures consistent with NRS 333.350 for:
(1) Awarding contracts for separate items or portions or
groups of items, or for separate portions of a project;
(2) Rejecting all bids or proposals;
(3) Withdrawing bids or proposals; and
(4) Entering records of bids and proposals;
(j) Penalties consistent with NRS 333.365 for persons who enter
into contracts with the Authority and do not perform according to
the contract;
(k) Procedures for the submission of revised proposals;
(l) Procedures consistent with NRS 333.370 by which a person
who makes an unsuccessful bid or proposal may submit an appeal,
including, without limitation, requirements that such a person:
(1) File a notice of appeal wi th the Authority and the
Hearings Division of the Department of Administration; and
(2) Post a bond with good and solvent surety in a form
approved by the Director in an amount that is equal to or greater
than 25 percent of the amount of the successful b id submitted for
the same project;
(m) Procedures consistent with NRS 333.435 for purchasing
prescription drugs, pharmaceutical services or medical supplies and
related services; and
(n) Procedures for the awarding of contracts on a contingency
basis.
4. The Director may require that:
(a) A bid or proposal submitted pursuant to this section be
accompanied by a certified check, cashier’s check or bond in an
amount not to exceed 5 percent of the total value of the bid or
proposal, if such a request applies to all persons who submit bids or
proposals for the relevant project.
(b) A person or entity that submits a successful bid or proposal
pursuant to this section submit, as a condition to entering into a
contract with the Authority, a certified check, ca shier’s check or
bond in an amount not to exceed the total value of the contract.
5. The Authority is not liable for any expense incurred by or
loss of income sustained by any person as the result of a
requirement imposed pursuant to subsection 4.
6. The requirements of NRS 333.705, 333.800 and 333.810
apply to procurement conducted pursuant to this section.
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- 83rd Session (2025)
7. Proprietary information, as defined in NRS 333.020, is
confidential and is not a public record.
8. Except as otherwise provided in NRS 239. 0115, any
proposal submitted to the Authority under this section is
confidential and may not be disclosed until the relevant contract is
awarded.
Sec. 25. 1. The officers and divisions of the Authority, in the
performance of their official duties, may share information in their
possession amongst themselves which is otherwise declared
confidential by statute, if the confidentiality of the information is
otherwise maintained under the terms and conditions required by
law.
2. The officers and divisions of the Authority may share
confidential information with agencies of local governments which
are responsible for the collection of debts or obligations or for
aiding the Authority in its official duties, if the confidentiality of the
information is otherwi se maintained under the terms and
conditions required by law.
Sec. 26. 1. The Authority shall administer:
(a) The provisions of chapters 446, 449, 449A, 634B, 640D,
640E, 652, 695I and 695K of NRS and NRS 223.631 to 223.639,
inclusive, 287.0402 to 287. 049, inclusive, and sections 64, 65
and 65.5 of this act, 422.001 to 422.410, inclusive, and sections
85 to 91, inclusive, of this act, 422.580, 439.258, 439.271 to
439.2794, inclusive, 439.581 to 439.597, inclusive, 439.800
to 439.918, inclusive, 439A.200 to 439A.290, inclusive, 439B.600 to
439B.695, inclusive, 439B.800 to 439B.875, inclusive, and section
192 of this act, and 444.003 to 444.430, inclusive, and all other
provisions of law relating to the functions of the divisions of the
Authority; and
(b) 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.
2. The Governor may delegate functions to the Authority other
than those described in sections 15 to 31, inclusive, of this act.
Sec. 27. 1. The Director shall:
(a) Enter into a contract with one or more qualified experts to
develop and implement a plan to allow persons who are eligible for
coverage under the Public Employees’ Benefits Program,
Medicaid, the Children’s Health Insurance Program, the Silver
State Health Insurance Exchange and the Public Option to select
and, where applicable, purchase such coverage in a manner that
improves access to affordable, quality health care and minimizes
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the cost of health care to the State. The plan must include, without
limitation, strategies for:
(1) Purchasing coverage for the programs described in this
subsection; and
(2) Strengthening networks of providers established for the
programs described in this section.
(b) Periodically present the plan described in paragra ph (a) to
the Board of the Public Employees’ Benefits Program, solicit input
from the Board and make such adjustments as the Director deems
appropriate in response to such input.
(c) Within the limits of available resources, utilize the experts
contracted pursuant to paragraph (a) to:
(1) Assess and monitor the value, quality and accessibility of
services provided by the Public Employees ’ Benefits Program to
participants;
(2) Review national best practices applicable to insurance
for current and retired public employees and dependents thereof;
(3) Make recommendations to the Board of the Public
Employees’ Benefits Program concerning ways to improve the
value, quality and accessibility of services provided to participants,
including, without limitation:
(I) Ways to provide additional support to participants in
accessing and utilizing benefits;
(II) Measures to improve the health literacy of
participants, including, without limitation, participants who have
retired and have coverage through Medicare; and
(4) Provide such additional assessments and
recommendations as requested by the Board of the Public
Employees’ Benefits Program.
(d) On or before February 1 of each odd-numbered year:
(1) Compile a report concerning the development and
implementation of the plan described in paragraph (a), which must
include, without limitation, a summary of:
(I) The input received from the Board of the Public
Employees’ Benefits Program pursuant to paragraph (b); and
(II) Any actions taken by the Director in response to such
input; and
(2) Submit the report to the Governor and the Director of the
Legislative Counsel Bureau for transmittal to the next regular
session of the Legislature.
(e) Develop and implement a plan to facilitate real -time final
determinations of eligibility for and enrollment in applicable state
health subsidy programs through the Silver State Health Insurance
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- 83rd Session (2025)
Exchange in a manner that includes the ability to make the
comparisons des cribed in paragraph (a) of subsection 6 of NRS
422.273, where applicable.
2. The Authority shall:
(a) Apply to the Secretary of Health and Human Services for
any waiver of federal law or apply for any amendment to the State
Plan for Medicaid or other fe deral authority that is necessary for
the Authority to carry out the provisions of paragraph (e) of
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, amendment or other
federal authority pursuant to paragraph (a).
3. As used in this section:
(a) “Applicable state health subsidy program” has the meaning
ascribed to it in 42 U.S.C. § 18083(e).
(b) “Network” means a define d set of providers of health care
who are under contract with the Authority to provide health care
services pursuant to the Public Employees’ Benefits Program,
Medicaid, the Children’s Health Insurance Program, the Silver
State Health Insurance Exchange or the Public Option.
Sec. 28. 1. In addition to the adoption of any state plan
required pursuant to NRS 422.063 and except where otherwise
provided by a specific provision of law, the Director or the
Director’s designee shall adopt each state plan requir ed by
the Federal Government, either directly or as a condition to the
receipt of federal money, for the administration of any program for
which the Authority or any of the appropriate divisions of the
Authority is responsible. Such a plan must set forth, regarding the
particular program to which the plan applies:
(a) The requirements for eligibility;
(b) The nature and amounts of grants and other assistance
which may be provided;
(c) The conditions imposed; and
(d) Such other provisions relating to th e development and
administration of the program as the Director or the Director’s
designee deems necessary.
2. In developing and revising such a plan, the Director or the
Director’s designee shall consider, without limitation:
(a) The amount of money av ailable from the Federal
Government;
(b) The conditions attached to the acceptance of that money;
and
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(c) The limitations of legislative appropriations and
authorizations,
for the particular program to which the plan applies.
3. If a condition to the receipt of federal money is that the
program for which the money is received must apply statewide and
except as otherwise required by federal law or regulation, the
Director may adopt regulations establishing formulas for the:
(a) Distribution of the federal money; and
(b) Assessment of any penalties or other sanctions imposed on
the program.
Sec. 29. 1. The Office of Data Analytics is hereby created
within the Authority.
2. The Office shall:
(a) Oversee the all-payer claims database established pursuant
to NRS 439B.835; and
(b) Perform such other duties as delegated by the Director
relating to population health and data analysis.
3. The Director shall appoint the Chief Biostatistician as the
administrative head of the Office. The Chief Biostatistician:
(a) Is in the unclassified service of the State; and
(b) Serves at the pleasure of the Director and is subject to the
supervision of the Director.
Sec. 30. 1. Unless an exemption is approved pursuant to
subsection 3, each county shall pay an assessment to the Authority,
in an amount determined by the Authority, for the costs of services
provided in that county by the Authority pursuant to chapters 444
and 446 of NRS, regardless of whether the county has a local health
authority.
2. Each county shall pay the assessment to the Nevada Health
Authority in quarterly installments that are due on the first day of
the first month of each calendar quarter.
3. A county may submit a proposal to the Governor for the
county to carry out the services that would otherwise be provided by
the Authority pursuant to chapters 444 and 446 of NRS and the
regulations adopted pursuant to those chapters. If the Governor
approves the proposal, the Governor shall submit a
recommendation to the Interim Finance Committ ee to exempt the
county from the assessment required pursuant to subsection 1. The
Interim Finance Committee, upon receiving the recommendation
from the Governor, shall consider the proposal and determine
whether to approve the exemption. In considering wh ether to
approve the exemption, the Interim Finance Committee shall
consider, among other things, the best interests of the State, the
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effect of the exemption and the intent of the Legislature in requiring
the assessment to be paid by each county.
4. An exemption that is approved by the Interim Finance
Committee pursuant to subsection 3 must not become effective until
at least 6 months after that approval.
5. A county that receives approval pursuant to subsection 3 to
carry out the services that would o therwise be provided by the
Authority pursuant to chapters 444 and 446 of NRS and the
regulations adopted pursuant to those chapters shall carry out those
services in the manner set forth in those chapters and regulations.
6. The Authority may adopt such regulations as necessary to
carry out the provisions of this section.
Sec. 31. 1. Except for gifts or grants specifically accounted
for in another fund, all gifts or grants of money or other property
which the divisions of the Authority are authorized to accept must
be accounted for in the Nevada Health Authority Gift Fund, which
is hereby created as a special revenue fund. The Fund is a
continuing fund without reversion. The Authority may establish
such accounts in the Fund as are necessary to account properly for
gifts received. All such money received by the divisions of the
Authority must be deposited in the State Treasury for credit to the
Fund. The money in the Fund must be paid out on claims as other
claims against the State are paid. Unless other wise specifically
provided by statute, claims against the Fund must be approved by
the Director or the Director’s delegate.
2. Gifts of property other than money may be sold or
exchanged when this is deemed by the head of the agency
responsible for the gift to be in the best interest of the agency. The
sale price must not be less than 90 percent of the value determined
by a qualified appraiser appointed by the head of the agency. All
money received from the sale must be deposited in the State
Treasury to the credit of the appropriate gift account in the Nevada
Health Authority Gift Fund. The money may be spent only for the
purposes of the agency named in the title of the account. The
property may not be sold or exchanged if doing so would violate the
terms of the gift.
Sec. 32. NRS 232.300 is hereby amended to read as follows:
232.300 1. The Department of [Health and] Human Services
is hereby created.
2. The Department consists of a Director and the following
divisions:
(a) Aging and Disability Services Division.
(b) Division of Public and Behavioral Health.
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(c) Division of [Welfare and Supportive] Social Services.
(d) Division of Child and Family Services.
[(e) Division of Health Care Financing and Policy.]
3. The Department is the sole ag ency responsible for
administering the provisions of law relating to its respective
divisions.
Sec. 33. NRS 232.310 is hereby amended to read as follows:
232.310 The Director:
1. Is appointed by, is responsible to, and serves at the pleasure
of the Governor.
2. Is in the unclassified service of the State.
3. Shall not engage in any other gainful employment or
occupation.
4. Must have broad, responsible experience in the field of
administration or possess broad management skills or working
knowledge of the field of social services administration.
5. Must be selected with special reference to his or her training,
experience and aptitude for coordinating related functions of public
health, [welfare] public assistance and social service agenc ies. The
Director’s knowledge and abilities should include the following:
(a) A comprehensive knowledge of administrative principles, and
a working knowledge of principles of public finance and the laws,
rules and regulations pertaining to public agencies.
(b) Administrative ability to assess the operating efficiency of
component agencies and to delegate authority and duties to
responsible division and agency heads.
(c) Ability to organize and clearly present oral and written
findings and recommendations to the Governor, the Legislature and
other officials and agencies.
Sec. 34. 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 Depart ment, 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] Social Services;
(3) The Administrator of the Division of Child and Family
Services; and
(4) [The Administrator of the Division of Health Care
Financing and Policy; and
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(5)] The Administrator of the Division of Public and
Behavioral Health.
(b) Shall administer, through the divisions of the Department, the
provisions of chapters 63, 424, 425, 427A, 432A to 437, 440, 441A,
442, [inclusive, 446 to ] 447, 450, [inclusive,] 458A and 656A of
NRS, NRS 127.220 to 127.310, inclusive, [422.001 to 422.410,
inclusive, 422.580, ] 432.010 to 432.133, inclusive, 432B.6201 to
432B.626, inclusive, [444.002 to 444.430, ] 439.010 to 439.255,
inclusive, 439.259 to 439.265, inclusive, 439.280 to
439.580, inclusive, 439.600, 439.620, 439.630, 439.942 to 439.994,
inclusive, 439A.010 to 439A.190, inclusive, 439B.260 to 439B.500,
inclusive, 439B.700 to 439B.760, inclusive, and 445A.010 to
445A.055, inclusive, and all other provisions of law relating to the
functions of the divisions of the Department, but is not responsible
for the clinical activities of the Division of Public and Behavioral
Health or the professional line activities of the other divisions.
(c) [Shall administer any state program for persons with
developmental disabilities established pursuant to the Developmental
Disabilities Assistance and Bill of Rights Act of 2000, 42 U.S .C. §§
15001 et seq.
(d)] Shall, after considering advice from agencies of local
governments and nonprofit organizations which provide social
services, adopt a master plan for the provision of human services in
this State. The Director shall revise the pl an biennially and deliver a
copy of the plan to the Governor and the Legislature at the beginning
of each regular session. The plan must:
(1) Identify and assess the plans and programs of the
Department for the provision of human services, and any duplication
of those services by federal, state and local agencies;
(2) Set forth priorities for the provision of those services;
(3) Provide for communication and the coordination of those
services among nonprofit organizations, agencies of local
government, the State and the Federal Government;
(4) Identify the sources of funding for services provided by the
Department and the allocation of that funding;
(5) Set forth sufficient information to assist the Department in
providing those services and in the planning and budgeting for the
future provision of those services; and
(6) Contain any other information necessary for the
Department to communicate effectively with the Federal Government
concerning demographic trends, formulas for the distri bution of
federal money and any need for the modification of programs
administered by the Department.
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[(e)] (d) May, by regulation, require nonprofit organizations and
state and local governmental agencies to provide information
regarding the programs of those organizations and agencies,
excluding detailed information relating to their budgets and payrolls,
which the Director deems necessary for the performance of the duties
imposed upon him or her pursuant to this section.
[(f)] (e) 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. 35. NRS 232.350 is hereby amended to read as follows:
232.350 Unless federal law or regulation requires otherwise:
1. The administrators of the divisions of the Department, except
as otherwise provided in subsections [2,] 2 and 3 , [and 4,] may each
appoint, with the consent of the Director, a deputy and a chief
assistant in the unclassified service of the State.
2. The Administrator of the Division of Child and Family
Services of the Department shall appoint, with the consent of the
Director, four deputies in the unclassified service of the State, one of
whom is the Deputy Administrator for Youth Corrections who is
responsible only for correctional services for youths for which the
Division is responsible, including, without limitation, ju venile
correctional institutions, parole of juveniles, administration of
juvenile justice and programs for juvenile justice.
3. [The Administrator of the Division of Health Care Financing
and Policy of the Department may appoint, with the consent of the
Director, two deputies in the unclassified service of the State.
4.] The Administrator of the Division of Public and Behavioral
Health shall appoint, with the consent of the Director, [four] three
deputies in the unclassified service of the State, one of whom must
have expertise or experience in mental health services.
Sec. 36. NRS 232.355 is hereby amended to read as follows:
232.355 1. Except for gifts or grants specifically accounted for
in another fund, all gifts or grants of money or other prope rty which
the divisions of the Department are authorized to accept must be
accounted for in the Department of [Health and] Human Services’
Gift Fund, which is hereby created as a special revenue fund. The
Fund is a continuing fund without reversion. The Department may
establish such accounts in the Fund as are necessary to account
properly for gifts received. All such money received by the divisions
must be deposited in the State Treasury for credit to the Fund. The
money in the Fund must be paid out on claims as other claims against
the State are paid. Unless otherwise specifically provided by statute,
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claims against the Fund must be approved by the Director or the
Director’s delegate.
2. Gifts of property other than money may be sold or exchanged
when this is deemed by the head of the facility or agency responsible
for the gift to be in the best interest of the facility or agency. The sale
price must not be less than 90 percent of the value determined by a
qualified appraiser appointed by the head of the facility or agency.
All money received from the sale must be deposited in the State
Treasury to the credit of the appropri ate gift account in the
Department of [Health and] Human Services’ Gift Fund. The money
may be spent only for the purposes of the facility or agency named in
the title of the account. The property may not be sold or exchanged if
to do so would violate the terms of the gift.
Sec. 37. NRS 232.359 is hereby amended to read as follows:
232.359 1. The Department, in collaboration with any state or
local agencies or community -based organizations which provide
information and referral services concerning health, [welfare,] public
assistance, human and social services and any group established by
the Governor to implement a statewide information and referral
system concerning health, [welfare,] public assistance, human and
social services, shall establish and m aintain a statewide information
and referral system to provide nonemergency information and
referrals to the general public concerning the health, [welfare,] public
assistance, human and social services provided by public or private
entities in this State. The system must:
(a) Integrate any information and referral systems previously
established by state agencies, local agencies or community -based
organizations with the system established pursuant to this section;
(b) Be the sole system in this State which is accessible to a person
by dialing the digits 2 -1-1 and which provides nonemergency
information and referrals to the general public concerning the health,
[welfare,] public assistance, human and social services provided by
public or private entities in this State;
(c) Be accessible to a person using the public telephone system
by dialing the digits 2-1-1;
(d) Include information concerning service-connected disabilities
and diseases, including, without limitation, diseases presumed to be
service-connected pursuant to 38 C.F.R. §§ 3.303 to 3.344, inclusive;
(e) Except as otherwise provided in paragraph (f), include
information that is updated periodically; and
(f) Include information concerning the licensing status of any
entity licensed pursuant to chapter 449 of NRS that is reviewed and
updated at least quarterly.
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2. In establishing the statewide information and referral system,
the Department, any state or local agencies or community -based
organizations which provide information and r eferral services
concerning health, [welfare,] public assistance, human and social
services and any group established by the Governor to implement a
statewide information and referral system concerning health,
[welfare,] public assistance, human and social services shall consult
with representatives of:
(a) The Public Utilities Commission of Nevada;
(b) Telephone companies which provide service through a local
exchange in this State;
(c) Companies that provide wireless phone services in this State;
(d) Existing information and referral services established by state
agencies, local agencies or community-based organizations;
(e) State and local agencies or other organizations that provide
health, [welfare,] public assistance, human and social services;
(f) Nonprofit organizations; and
(g) Such other agencies, entities and organizations as determined
necessary by the Department, any state or local agencies or
community-based organizations which provide information and
referral services concerning health, [welfare,] public assistance,
human and social services or any group established by the Governor
to implement a statewide information and referral system concerning
health, [welfare,] public assistance, human and social services.
3. The Public Utilities Commission of Nevada, each telephone
company which provides service through a local exchange in this
State and each company that provides wireless phone services in this
State shall cooperate with the Department, any state or local agencies
or community -based organizations which provide information and
referral services concerning health, [welfare,] public assistance,
human and social services and any group established by the Governor
to implement a statewide information and referral system concerning
health, [welfare,] public assistance, human and social services in the
establishment of the statewide information and referral system.
Sec. 38. NRS 233B.039 is hereby amended to read as follows:
233B.039 1. The following agencies are e ntirely exempted
from the requirements of this chapter:
(a) The Governor.
(b) Except as otherwise provided in subsection 7 and NRS
209.221 and 209.2473, the Department of Corrections.
(c) The Nevada System of Higher Education.
(d) The Office of the Military.
(e) The Nevada Gaming Control Board.
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(f) Except as otherwise provided in NRS 368A.140 and 463.765,
the Nevada Gaming Commission.
(g) Except as otherwise provided in NRS 425.620, the Division
of [Welfare and Supportive ] Social Services of the D epartment of
[Health and] Human Services.
(h) [Except as otherwise provided in NRS 422.390, the Division
of Health Care Financing and Policy of the Department of Health and
Human Services.
(i)] Except as otherwise provided in NRS 533.365, the Office of
the State Engineer.
[(j)] (i) The Division of Industrial Relations of the Department of
Business and Industry acting to enforce the provisions of
NRS 618.375.
[(k)] (j) The Administrator of the Division of Industrial Relations
of the Department of Busin ess and Industry in establishing and
adjusting the schedule of fees and charges for accident benefits
pursuant to subsection 2 of NRS 616C.260.
[(l)] (k) The Board to Review Claims in adopting resolutions to
carry out its duties pursuant to NRS 445C.310.
[(m)] (l) The Silver State Health Insurance Exchange.
2. Except as otherwise provided in subsection 5 and NRS
391.323, the Department of Education, the Board of the Public
Employees’ Benefits Program and the Commission on Professional
Standards in Educa tion are subject to the provisions of this chapter
for the purpose of adopting regulations but not with respect to any
contested case.
3. The special provisions of:
(a) Chapter 612 of NRS for the adoption of an emergency
regulation or the distribution of regulations by and the judicial review
of decisions of the Employment Security Division of the Department
of Employment, Training and Rehabilitation;
(b) Chapters 616A to 617, inclusive, of NRS for the
determination of contested claims;
(c) Chapter 91 of NRS for the judicial review of decisions of the
Administrator of the Securities Division of the Office of the Secretary
of State; and
(d) NRS 90.800 for the use of summary orders in contested cases,
prevail over the general provisions of this chapter.
4. The provisions of NRS 233B.122, 233B.124, 233B.125 and
233B.126 do not apply to the [Department of Health and Human
Services] Nevada Health Authority in the adjudication of contested
cases involving the issuance of letters of approval for health facilities
and agencies.
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5. The provisions of this chapter do not apply to:
(a) Any order for immediate action, including, but not limited to,
quarantine and the treatment or cleansing of infected or infested
animals, objects or premises, made under the au thority of the State
Board of Agriculture, the State Board of Health, or any other agency
of this State in the discharge of a responsibility for the preservation
of human or animal health or for insect or pest control;
(b) An extraordinary regulation of t he State Board of Pharmacy
adopted pursuant to NRS 453.2184;
(c) A regulation adopted by the State Board of Education
pursuant to NRS 388.255 or 394.1694;
(d) The judicial review of decisions of the Public Utilities
Commission of Nevada;
(e) The adoptio n, amendment or repeal of policies by the
Rehabilitation Division of the Department of Employment, Training
and Rehabilitation pursuant to NRS 426.561 or 615.178;
(f) The adoption or amendment of a rule or regulation to be
included in the State Plan for S ervices for Victims of Crime by the
Department of [Health and ] Human Services pursuant to
NRS 217.130;
(g) The adoption, amendment or repeal of rules governing the
conduct of contests and exhibitions of unarmed combat by the
Nevada Athletic Commission pursuant to NRS 467.075;
(h) The adoption, amendment or repeal of standards of content
and performance for courses of study in public schools by the Council
to Establish Academic Standards for Public Schools and the State
Board of Education pursuant to NRS 389.520;
(i) The adoption, amendment or repeal of the statewide plan to
allocate money from the Fund for a Resilient Nevada created by NRS
433.732 established by the Department of [Health and ] Human
Services pursuant to paragraph (b) of subsection 1 of NR S 433.734;
[or]
(j) The adoption or amendment of a data request by the
Commissioner of Insurance pursuant to NRS 687B.404 [.] ; or
(k) Except as otherwise provided in NRS 422.390, the adoption
of any regulation by the Nevada Health Authority or the Director
or Medicaid Division thereof pursuant to chapter 422 of NRS.
6. The State Board of Parole Commissioners is subject to the
provisions of this chapter for the purpose of adopting regulations but
not with respect to any contested case.
7. The Department of Corrections is subject to the provisions of
this chapter for the purpose of adopting regulations relating to fiscal
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policy, correspondence with inmates and visitation with inmates of
the Department of Corrections.
Sec. 39. NRS 21.090 is hereby amended to read as follows:
21.090 1. The following property is exempt from execution,
except as otherwise specifically provided in this section or required
by federal law:
(a) Private libraries, works of art, musical instruments and
jewelry not to ex ceed $5,000 in value, belonging to the judgment
debtor or a dependent of the judgment debtor, to be selected by the
judgment debtor, and all family pictures and keepsakes.
(b) Necessary household goods, furnishings, electronics, wearing
apparel, other per sonal effects and yard equipment, not to exceed
$12,000 in value, belonging to the judgment debtor or a dependent of
the judgment debtor, to be selected by the judgment debtor.
(c) Farm trucks, farm stock, farm tools, farm equipment, supplies
and seed not to exceed $4,500 in value, belonging to the judgment
debtor to be selected by the judgment debtor.
(d) Professional libraries, equipment, supplies, and the tools,
inventory, instruments and materials used to carry on the trade or
business of the judgment debtor for the support of the judgment
debtor and his or her family not to exceed $10,000 in value.
(e) The cabin or dwelling of a miner or prospector, the miner’s or
prospector’s cars, implements and appliances necessary for carrying
on any mining opera tions and the mining claim actually worked by
the miner or prospector, not exceeding $4,500 in total value.
(f) Except as otherwise provided in paragraph (p), one vehicle if
the judgment debtor’s equity does not exceed $15,000 or the creditor
is paid an amount equal to any excess above that equity.
(g) For any workweek, 82 percent of the disposable earnings of a
judgment debtor during that week if the gross weekly salary or wage
of the judgment debtor on the date the most recent writ of garnishment
was issued was $770 or less, 75 percent of the disposable earnings of
a judgment debtor during that week if the gross weekly salary or wage
of the judgment debtor on the date the most recent writ of garnishment
was issued exceeded $770, or 50 times the minimum hourly wage
prescribed by section 206(a)(1) of the federal Fair Labor Standards
Act of 1938, 29 U.S.C. §§ 201 et seq., and in effect at the time the
earnings are payable, whichever is greater. Except as otherwise
provided in paragraphs (o), (s) and (t), the exemption provided in this
paragraph does not apply in the case of any order of a court of
competent jurisdiction for the support of any person, any order of a
court of bankruptcy or of any debt due for any state or federal tax. As
used in this paragraph:
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(1) “Disposable earnings” means that part of the earnings of a
judgment debtor remaining after the deduction from those earnings of
any amounts required by law to be withheld.
(2) “Earnings” means compensation paid or payable for
personal services p erformed by a judgment debtor in the regular
course of business, including, without limitation, compensation
designated as income, wages, tips, a salary, a commission or a bonus.
The term includes compensation received by a judgment debtor that
is in the p ossession of the judgment debtor, compensation held in
accounts maintained in a bank or any other financial institution or, in
the case of a receivable, compensation that is due the judgment
debtor.
(h) All fire engines, hooks and ladders, with the carts, trucks and
carriages, hose, buckets, implements and apparatus thereunto
appertaining, and all furniture and uniforms of any fire company or
department organized under the laws of this State.
(i) All arms, uniforms and accouterments required by law to be
kept by any person, and also one gun, to be selected by the debtor.
(j) All courthouses, jails, public offices and buildings, lots,
grounds and personal property, the fixtures, furniture, books, papers
and appurtenances belonging and pertaining to the cou rthouse, jail
and public offices belonging to any county of this State, all
cemeteries, public squares, parks and places, public buildings, town
halls, markets, buildings for the use of fire departments and military
organizations, and the lots and grounds thereto belonging and
appertaining, owned or held by any town or incorporated city, or
dedicated by the town or city to health, ornament or public use, or for
the use of any fire or military company organized under the laws of
this State and all lots, buildings and other school property owned by
a school district and devoted to public school purposes.
(k) All money, benefits, privileges or immunities accruing or in
any manner growing out of any life insurance.
(l) The homestead as provided for by law, including:
(1) Subject to the provisions of NRS 115.055, the sum of
$605,000 that is paid to the defendant in execution pursuant to
subsection 2 of NRS 115.050 or to a spouse pursuant to subsection 3
of NRS 115.050; and
(2) A homestead for which allodial title has been established
and not relinquished and for which a waiver executed pursuant to
NRS 115.010 is not applicable.
(m) The dwelling of the judgment debtor occupied as a home for
himself or herself and family, where the amount of equity held by the
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judgment debtor in the home does not exceed $605,000 in value and
the dwelling is situated upon lands not owned by the judgment debtor.
(n) All money reasonably deposited with a landlord by the
judgment debtor to secure an agreement to rent or lease a dw elling
that is used by the judgment debtor as his or her primary residence,
except that such money is not exempt with respect to a landlord or the
landlord’s successor in interest who seeks to enforce the terms of the
agreement to rent or lease the dwelling.
(o) All property in this State of the judgment debtor where the
judgment is in favor of any state for failure to pay that state’s income
tax on benefits received from a pension or other retirement plan.
(p) Any vehicle owned by the judgment debtor for use by the
judgment debtor or the judgment debtor’s dependent that is equipped
or modified to provide mobility for a person with a permanent
disability.
(q) Any prosthesis or equipment prescribed by a physician or
dentist for the judgment debtor or a dependent of the debtor.
(r) Money, not to exceed $1,000,000 in present value, held in:
(1) An individual retirement arrangement which conforms
with or is maintained pursuant to the applicable limitations and
requirements of section 408 or 408A of the Internal Revenue Code,
26 U.S.C. §§ 408 and 408A, including, without limitation, an
inherited individual retirement arrangement;
(2) A written simplified employee pension plan which
conforms with or is maintained pursuant to the applicable limitations
and requirements of section 408 of the Internal Revenue Code, 26
U.S.C. § 408, including, without limitation, an inherited simplified
employee pension plan;
(3) A cash or deferred arrangement plan which is qualified and
maintained pursuant to the Internal Revenue Code, including, without
limitation, an inherited cash or deferred arrangement plan;
(4) A trust forming part of a stock bonus, pension or profit -
sharing plan which is qualified and maintained pursuant to sections
401 et seq. of the Internal Reve nue Code, 26 U.S.C. §§ 401 et seq.;
and
(5) A trust forming part of a qualified tuition program pursuant
to chapter 353B of NRS, any applicable regulations adopted pursuant
to chapter 353B of NRS and section 529 of the Internal Revenue
Code, 26 U.S.C. § 529, unless the money is deposited after the entry
of a judgment against the purchaser or account owner or the money
will not be used by any beneficiary to attend a college or university.
(s) All money and other benefits paid pursuant to the order of a
court of competent jurisdiction for the support, education and
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maintenance of a child, whether collected by the judgment debtor or
the State.
(t) All money and other benefits paid pursuant to the order of a
court of competent jurisdiction for the support and maintenance of a
former spouse, including the amount of any arrearages in the payment
of such support and maintenance to which the former spouse may be
entitled.
(u) Payments, in an amount not to exceed $16,150, received as
compensation for personal i njury, not including compensation for
pain and suffering or actual pecuniary loss, by the judgment debtor or
by a person upon whom the judgment debtor is dependent at the time
the payment is received.
(v) Payments received as compensation for the wrongful death of
a person upon whom the judgment debtor was dependent at the time
of the wrongful death, to the extent reasonably necessary for the
support of the judgment debtor and any dependent of the judgment
debtor.
(w) Payments received as compensation for the loss of future
earnings of the judgment debtor or of a person upon whom the
judgment debtor is dependent at the time the payment is received, to
the extent reasonably necessary for the support of the judgment
debtor and any dependent of the judgment debtor.
(x) Payments received as restitution for a criminal act.
(y) Payments received pursuant to the federal Social Security Act,
including, without limitation, retirement and survivors’ benefits,
supplemental security income benefits and disability ins urance
benefits.
(z) Any personal property not otherwise exempt from execution
pursuant to this subsection belonging to the judgment debtor,
including, without limitation, the judgment debtor’s equity in any
property, money, stocks, bonds or other funds o n deposit with a
financial institution, not to exceed $10,000 in total value, to be
selected by the judgment debtor.
(aa) Any tax refund received by the judgment debtor that is
derived from the earned income credit described in section 32 of the
Internal Revenue Code, 26 U.S.C. § 32, or a similar credit provided
pursuant to a state law.
(bb) Stock of a corporation described in subsection 2 of NRS
78.746 except as set forth in that section.
(cc) Regardless of whether a trust contains a spendthrift
provision:
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- 83rd Session (2025)
(1) A distribution interest in the trust as defined in NRS
163.4155 that is a contingent interest, if the contingency has not been
satisfied or removed;
(2) A distribution interest in the trust as defined in NRS
163.4155 that is a discretionary int erest as described in NRS
163.4185, if the interest has not been distributed;
(3) A power of appointment in the trust as defined in NRS
163.4157 regardless of whether the power has been exercised;
(4) A power listed in NRS 163.5553 that is held by a t rust
protector as defined in NRS 163.5547 or any other person regardless
of whether the power has been exercised; and
(5) A reserved power in the trust as defined in NRS 163.4165
regardless of whether the power has been exercised.
(dd) If a trust contains a spendthrift provision:
(1) A distribution interest in the trust as defined in NRS
163.4155 that is a mandatory interest as described in NRS 163.4185,
if the interest has not been distributed; and
(2) Notwithstanding a beneficiary’s right to enforce a support
interest, a distribution interest in the trust as defined in NRS 163.4155
that is a support interest as described in NRS 163.4185, if the interest
has not been distributed.
(ee) Proceeds received from a private disability insurance plan.
(ff) Money in a trust fund for funeral or burial services pursuant
to NRS 689.700.
(gg) Compensation that was payable or paid pursuant to chapters
616A to 616D, inclusive, or chapter 617 of NRS as provided in
NRS 616C.205.
(hh) Unemployment compensation benefits received pursuant to
NRS 612.710.
(ii) Benefits or refunds payable or paid from the Public
Employees’ Retirement System pursuant to NRS 286.670.
(jj) Money paid or rights existing for vocational rehabilitation
pursuant to NRS 615.270.
(kk) Public assistance provided through the Nevada Health
Authority and the Department of [Health and ] Human Services
pursuant to NRS 422.291 and 422A.325 [.] , respectively.
(ll) Child welfare assistance provided pursuant to NRS 432.036.
2. Except as otherwise provided in NRS 115.010, no article or
species of property mentioned in this section is exempt from
execution issued upon a judgment to recover for its price, or upon a
judgment of foreclosure of a mortgage or other lien thereon.
3. Any exemptions specified in subsection (d) of section 522 of
the Bankruptcy Reform Act of 1978, 11 U.S.C. §§ 101 et seq., do not
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apply to property owned by a resident of this State unless conferred
also by subsection 1, as limited by subsection 2.
Sec. 40. NRS 108.850 is hereby amended to read as follows:
108.850 1. A petition to the district court for the imposition of
a lien as described and limited in NRS 422.29306 to recover money
owed to the [Department of Health and Human Services ] Nevada
Health Authority as a result of payment of benefits for Medicaid must
set forth:
(a) The facts concerning the giving of assistance;
(b) The name and address of the person who is receiving or who
received the benefits for Medicaid;
(c) A description of the property, sufficient for identification;
(d) The names, ages, residences and relationship of all persons
who are claiming an interest in the property or who are listed as
having any interest in the property, so far as known to the petitioner;
and
(e) An itemized list of the amount owed to the [Department of
Health and Human Services] Nevada Health Authority as a result of
payment of benefits for Medicaid.
2. No defect of form or in the statement of facts actually existing
voids the petition for the lien.
Sec. 41. NRS 108.860 is hereby amended to read as follows:
108.860 1. A petition for the imposition of a lien must be
signed by or on behalf of the Director of the [Department of Health
and Human Services ] Nevada Health Authority or the Attorney
General and filed with the clerk of the court, who shall set the petition
for hearing.
2. Notice of a petition for the imposition of a lien must be given
by registered or certified mail, postage prepaid, at least 10 days before
the date set for hearing or other action by the court. Each such notice
must be addressed to the intended recipient at the last address known
to the Director, receipt for delivery requested. The Director shall
cause the notice to be published, at least once a week for 3 successive
weeks, in one newspaper published in the county, and if there is no
newspaper published in the county, then in such mode as the court
may determine, notifying all persons claiming any interest in the
property of the filing of the petition, the object and the location, date
and time of the hearing.
3. Notice of a petition for the imposition of a lien must be given
to:
(a) Each person who has requested notice;
(b) The person who is receiving or has received benefits for
Medicaid;
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(c) The legal guardian o r representative of a person who is
receiving or has received benefits for Medicaid, if any;
(d) Each executor, administrator or trustee of the estate of a
decedent who received benefits for Medicaid, if any;
(e) The heirs of such a decedent known to the Director; and
(f) Each person who is claiming any interest in the property or
who is listed as having any interest in the subject property,
and must state the filing of the petition, the object, and the time set
for hearing.
4. At the time appointed, or at any other time to which the
hearing may be continued, upon proof being made by affidavit or
otherwise to the satisfaction of the court that notice has been given as
required by this chapter, the court shall proceed to hear the testimony
in support o f the petition. Each witness who appears and is sworn
shall testify orally.
5. The court shall make findings as to the appropriateness of the
lien and the amount of the lien.
6. At the time of the filing of the petition for imposition of a lien,
the Director shall file a notice of pendency of the action in the manner
provided in NRS 14.010.
7. Upon imposition of the lien by the court, the Director shall
serve the notice of lien upon the owner by certified or registered mail
and file it with the office of the county recorder of each county where
real property subject to the lien is located.
8. The notice of lien must contain:
(a) The amount due;
(b) The name of the owner of record of the property; and
(c) A description of the property sufficient for identification.
9. If the amount due as stated in the notice of lien is reduced by
a payment, the Director shall amend the notice of lien, stating the
amount then due, within 20 days after receiving the payment.
Sec. 42. NRS 108.870 is hereby amended to read as follows:
108.870 The Director of the [Department of Health and Human
Services] Nevada Health Authority may, to the extent not prohibited
by 42 U.S.C. § 1396p(b), foreclose upon a lien for money owed to the
[Department of Health and Human Services] Nevada Health
Authority as a result of the payment of benefits for Medicaid by
action in the district court in the same manner as for foreclosure of
any other lien.
Sec. 43. NRS 111.689 is hereby amended to read as follows:
111.689 1. To the extent the grantor’s probate estate is
insufficient to satisfy an allowed claim against the estate or a statutory
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allowance to a surviving spouse or child, the estate may enforce the
liability against property transferred pursuant to a deed upon death.
2. If more than one property is transferred pursuant to one or
more deeds upon death, the liability for any claim must be
apportioned among the properties in proportion to their net values at
the grantor’s death.
3. The beneficiary or beneficiaries under a deed upon death
must, after the death of the grantor, cause to be published a notice in
the manner specified in paragraph (b) of subsection 1 of NRS 155.020
and mail a copy of the notice to:
(a) The personal representative of the grantor, if known;
(b) The [Department of Health and Human Services; ] Nevada
Health Authority; and
(c) Known or readily ascertainable creditors of the grantor or the
probate estate of the grantor.
4. The notice published pursuant to subsection 3 must be in
substantially the following form:
NOTICE TO CREDITORS
Notice is hereby given that the undersigned is/are the
beneficiary or beneficiaries under a deed upon death executed
by ................................. (grantor(s)) on the ......... day of
............................., ..........., and that said grantor(s) died on the
......... day of ............................., ............, and that said
grantor(s) had a date of birth of the ......... day of
............................., ............ A creditor having a clai m against
the grantor(s) or their estate must file a claim with the
undersigned at the address given below within 90 days after
the first publication of this notice.
Dated this ........... day of .................................... , ............ .
Beneficiary or Beneficiaries: ...............................
Address: ...............................................................
...............................................................
5. A person or entity having a claim, due or to become due,
against a grantor or his or her probate estate, as applicable, must file
the claim with the beneficiary or beneficiaries within 90 days after
the mailing, for those required to be mailed, or 90 d ays after
publication of the first notice to creditors pursuant to subsection 3.
Any claim against a grantor or the probate estate of a grantor, as
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applicable, not filed within that time is forever barred. After the
expiration of the time to file a claim a s provided in this section, the
beneficiary or beneficiaries may sell or distribute the property
transferred pursuant to the deed upon death, without personal liability
for any claim which has not been timely filed with the beneficiary or
beneficiaries if, in accordance with subsection 6, the beneficiary or
beneficiaries have received a waiver of claim after providing written
notice to the [Department of Health and Human Services ] Nevada
Health Authority as required by subsection 3.
6. If notice to the [Department of Health and Human Services ]
Nevada Health Authority is not given, the property transferred by the
deed upon death remains subject to the right of the [Department]
Authority to recover public assistance received by the grantor. The
[Department] Authority may initiate an action to impose a lien on the
real property transferred by the deed upon death pursuant to NRS
422.29306, take any other action allowable by law to secure the future
recovery of benefits or make a written demand for payment, as
applicable. The [Department] Authority shall notify the beneficiary
or beneficiaries in writing within 45 days after receipt of a notice
pursuant to subsection 3 whether the grantor was a recipient of public
assistance and, if he or she was not a recipient of assistance, provide
an original waiver of claim to the beneficiaries for the purposes of
recording the deed upon death.
7. For claims not originating with the [Department of Health and
Human Services,] Nevada Health Authority, if a claim is rejected by
the beneficiary or beneficiaries under the deed upon death, in whole
or in part, the beneficiary or beneficiaries must, within 10 days after
the rejection, notify the claimant of the rejection by written notice
sent by registered or certified mail to the mailing address of the
claimant. The claimant must bring suit in the proper court against the
beneficiary or beneficiaries within 30 days after the notice is sent,
whether the claim is due or not, or the claim is barred forever and the
beneficiary or beneficiaries under the deed upon death may distribute
the property transferred by the deed upon death without personal
liability to any creditor whose claim is barred forever.
8. A title company that is engaged regarding the transfer of the
property identif ied in a deed upon death may recognize that the
notices provided pursuant to this section constitute adequate notice
required by law. A title company is not liable for claims of which the
title company is not made aware by the beneficiaries.
9. A person dealing with a beneficiary of a deed upon death has
the same rights and protections as the person would have if the
beneficiary had been named as a distributee of the property in an order
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for distribution of the grantor’s estate that had become final if both of
the following conditions are satisfied:
(a) The person acted in good faith and for valuable consideration;
and
(b) A Death of Grantor Affidavit was recorded pursuant to
NRS 111.699.
Sec. 44. NRS 111.779 is hereby amended to read as follows:
111.779 1. Except as otherwise provided in NRS 21.090 and
other applicable law, a transferee of a nonprobate transfer is liable to
the probate estate of the decedent for allowed claims against that
decedent’s probate estate to the extent the estate is in sufficient to
satisfy those claims.
2. The liability of a nonprobate transferee may not exceed the
value of nonprobate transfers received or controlled by that
transferee.
3. Nonprobate transferees are liable for the insufficiency
described in subsection 1 in the following order of priority:
(a) A transferee specified in the decedent’s will or any other
governing instrument as being liable for such an insufficiency, in the
order of priority provided in the will or other governing instrument;
(b) The t rustee of a trust serving as the principal nonprobate
instrument in the decedent’s estate plan as shown by its designation
as devisee of the decedent’s residuary estate or by other facts or
circumstances, to the extent of the value of the nonprobate transf er
received or controlled; and
(c) Other nonprobate transferees, in proportion to the values
received.
4. Unless otherwise provided by the trust instrument, interests of
beneficiaries in all trusts incurring liabilities under this section abate
as necessary to satisfy the liability, as if all the trust instruments were
a single will and the interests were devises under it.
5. If a nonprobate transferee is a spouse or a minor child, the
nonprobate transferee may petition the court to be excluded from the
liability imposed by this section as if the nonprobate property
received by the spouse or minor child were part of the decedent’s
estate. Such a petition may be made pursuant to the applicable
provisions of chapter 146 of NRS, including, without limitati on, the
provisions of NRS 146.010 and 146.020 and subsection 2 of
NRS 146.070.
6. A provision made in one instrument may direct the
apportionment of the liability among the nonprobate transferees
taking under that or any other governing instrument. If a provision in
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one instrument conflicts with a provision in another, the later one
prevails.
7. Upon due notice to a nonprobate transferee, the liability
imposed by this section is enforceable in probate proceedings in this
State, whether or not the transferee is located in this State.
8. If a probate proceeding is pending at the time of filing and it
has been determined by a final order issued by the probate court that
there are insufficient assets to pay a valid creditor, a proceeding under
this section may be commenced by one of the following persons:
(a) The personal representative of the decedent’s estate. A
personal representative who declines in good faith to commence a
proceeding incurs no personal liability for declining.
(b) A creditor of the estate, if the personal representative has
declined or refused to commence an action within 30 days after
receiving a written demand by a creditor. Such demand must identify
the nonprobate transfers known to the creditor. If the creditor is
unaware of any nonprobate transfers, in the probate proceeding, the
creditor may, pursuant to NRS 155.170, obtain discovery, perpetuate
testimony or conduct examinations in any manner authorized by law
or by the Nevada Rules of Civil Procedure to ascertain whether any
nonprobate transfers exist. If the creditor is unable to identify any
nonprobate transfers within a reasonable time after conducting
discovery, the creditor may not proceed under this section. If a
creditor commences an action under this section:
(1) The creditor must proceed at the expense of the creditor
and not of the estate.
(2) If a creditor successfully establishes an entitlement to
payment under this section and collects nonprobate transfers, the
court must order the reimbursement of the costs rea sonably incurred
by the creditor, including attorney’s fees, from the transferee from
whom the payment is to be made, subject to the limitations of
subsection 2, or from the estate as a cost of administration, or partially
from each, as the court deems just.
9. If a probate proceeding is not pending, a proceeding under
this section may be commenced as a civil action by a creditor at the
expense of the creditor.
10. If a proceeding is commenced pursuant to this section, it
must be commenced:
(a) If a probate proceeding is pending in which notice to creditors
has been given at the time of filing a proceeding under this section:
(1) As to a creditor whose claim was properly and timely filed,
allowed by the personal representative or partially allowed by the
personal representative, and accepted by the creditor pursuant to
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NRS 147.160, within 60 days after the probate court enters an order
confirming the amount of payment of the approved claim that is final
and no longer subject to reconsideration or appeal or within 1 year
after the decedent’s death, whichever is later.
(2) As to a creditor:
(I) Whose claim was rejected by th e personal
representative, partially allowed by the personal representative and
rejected by the creditor pursuant to NRS 147.160, or deemed rejected
by the personal representative pursuant to NRS 147.110;
(II) Who adjudicated the creditor’s claims in th e proper
court or by a summary adjudication; and
(III) Who obtained a favorable final judgment on its claim
from the proper court,
within 60 days after the probate court enters an order confirming
the amount of payment of the approved claim that is fi nal and no
longer subject to reconsideration or appeal or within 1 year after the
decedent’s death, whichever is later.
(b) If an action had been commenced against the decedent before
the decedent’s death, the creditor receives a judgment against the
decedent’s estate and the creditor has filed a proper and timely
creditor’s claim against the estate, within 60 days after the probate
court enters an order confirming the amount of payment of the
adjudicated claim that is final and no longer subject to reconsideration
or appeal or within 1 year after the decedent’s death, whichever is
later.
(c) As to the recovery of benefits paid for Medicaid, within 3
years after the decedent’s death.
(d) As to all other creditors, within 1 year after the decedent’s
death.
11. Unless a written notice asserting that a decedent’s probate
estate is nonexistent or insufficient to pay allowed claims and
statutory allowances has been received from the decedent’s personal
representative, the following rules apply:
(a) Payment o r delivery of assets by a financial institution,
registrar or other obligor to a nonprobate transferee in accordance
with the terms of the governing instrument controlling the transfer
releases the obligor from all claims for amounts paid or assets
delivered.
(b) A trustee receiving or controlling a nonprobate transfer is
released from liability under this section with respect to any assets
distributed to the trust’s beneficiaries. Each beneficiary to the extent
of the distribution received becomes liable for the amount of the
trustee’s liability attributable to assets received by the beneficiary.
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12. Except as otherwise provided in subsection 13,
notwithstanding any provision of this section to the contrary:
(a) A creditor has no claim against:
(1) Property transferred pursuant to a power of appointment
exercised by a decedent unless the power of appointment was actually
exercised in favor of the decedent or the decedent’s estate.
(2) Property transferred pursuant to a beneficiary designation
by a decedent which transfers money held by any of the following:
(I) An individual retirement arrangement which conforms
with or is maintained pursuant to the applicable limitations and
requirements of section 408 or 408A of the Internal Revenue Code,
26 U.S. C. §§ 408 and 408A, including, without limitation, an
inherited individual retirement arrangement;
(II) A written simplified employee pension plan which
conforms with or is maintained pursuant to the applicable limitations
and requirements of section 40 8 of the Internal Revenue Code, 26
U.S.C. § 408, including, without limitation, an inherited simplified
employee pension plan;
(III) A cash or deferred arrangement plan which is
qualified and maintained pursuant to the Internal Revenue Code,
including, without limitation, an inherited cash or deferred
arrangement plan;
(IV) A trust forming part of a stock bonus, pension or
profit-sharing plan which is qualified and maintained pursuant to
sections 401 et seq. of the Internal Revenue Code, 26 U.S.C. §§ 401
et seq.; and
(V) A trust forming part of a qualified tuition program
pursuant to chapter 353B of NRS, any applicable regulations adopted
pursuant to chapter 353B of NRS and section 529 of the Internal
Revenue Code, 26 U.S.C. § 529, unless the money is deposited after
the entry of a judgment against the purchaser or account owner or the
money will not be used by any beneficiary to attend a college or
university.
(3) Property transferred pursuant to a beneficiary designation
by a decedent which trans fers money, benefits or privileges that
accrue in any manner out of life insurance.
(4) Proceeds of any wages of the decedent which were exempt
from execution during the decedent’s lifetime pursuant to paragraph
(g) of subsection 1 of NRS 21.090.
(5) A trust, a beneficial interest of the decedent under a trust
or amount payable from a trust if the trust was created by someone
other than the decedent, except to enforce a valid assignment of the
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decedent’s beneficial interest under a trust that is not a s pendthrift
trust.
(6) An irrevocable trust or amounts payable from a trust if the
trust was properly created as a valid spendthrift trust under chapter
166 of NRS, except with respect to property transferred to the trust
by the decedent to the extent per mitted under subsections 1, 2 and 3
of NRS 166.170.
(b) A purchaser for value of property or a lender who acquires a
security interest in the property from a beneficiary of a nonprobate
transfer after the death of the owner, in good faith:
(1) Takes the property free of any claims or of liability to the
owner’s estate, creditors of the owner’s estate, persons claiming
rights as beneficiaries under the nonprobate transfer or heirs of the
owner’s estate, in absence of actual knowledge that the transfer was
improper; and
(2) Has no duty to verify sworn information relating to the
nonprobate transfer. The protection provided by this subparagraph
applies to information that relates to the ownership interest of the
beneficiary in the property and the benefici ary’s right to sell,
encumber and transfer good title to a purchaser or lender and does not
relieve a purchaser or lender from the notice imparted by instruments
of record respecting the property.
13. Nothing in this section exempts any real or personal property
from any statute of this State that authorizes the recovery of money
owed to the [Department of Health and Human Services ] Nevada
Health Authority as a result of the payment of benefits from
Medicaid.
14. As used in this section, “devise” has the meaning ascribed to
it in NRS 132.095.
Sec. 45. NRS 115.090 is hereby amended to read as follows:
115.090 Nothing in this chapter exempts any real or personal
property from any statute of this State that authorizes the recovery of
money owed to the [Department of Health and Human Services ]
Nevada Health Authority as a result of the payment of benefits from
Medicaid through the imposition or foreclosure of a lien against the
property of a recipient of Medicaid in the manner set forth in NRS
422.29302, 422.29304 and 422.29306.
Sec. 46. NRS 123.259 is hereby amended to read as follows:
123.259 1. Except as otherwise provided in subsection 2, a
court of competent jurisdiction may, upon a proper petition filed by a
spouse or the guardian of a spouse, enter a decree dividing the income
and resources of a married couple pursuant to this section if one
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spouse is an institutionalized spouse and the other spouse is a
community spouse.
2. The court shall not enter such a decree if the division is
contrary to a premarital agreement between the spouses which is
enforceable pursuant to chapter 123A of NRS.
3. Unless modified pursuant to subsection 4 or 5, the court may
divide the income and resources:
(a) Equally between the spouses; or
(b) By protecting income for the community spouse through
application of the maximum federal minimum monthly maintenance
needs allowance set forth in 42 U.S.C. § 1396r -5(d)(3)(C) and by
permitting a transfer of resources to the community spouse an amount
which does not exce ed the amount set forth in 42 U.S.C. § 1396r -
5(f)(2)(A)(ii).
4. If either spouse establishes that the community spouse needs
income greater than that otherwise provided under paragraph (b) of
subsection 3, upon finding exceptional circumstances resulting in
significant financial duress and setting forth in writing the reasons for
that finding, the court may enter an order for support against the
institutionalized spouse for the support of the community spouse in
an amount adequate to provide such addition al income as is
necessary.
5. If either spouse establishes that a transfer of resources to the
community spouse pursuant to paragraph (b) of subsection 3, in
relation to the amount of income generated by such a transfer, is
inadequate to raise the income of the community spouse to the
amount allowed under paragraph (b) of subsection 3 or an order for
support issued pursuant to subsection 4, the court may substitute an
amount of resources adequate to provide income to fund the amount
so allowed or to fund the order for support.
6. A copy of a petition for relief under subsection 4 or 5 and any
court order issued pursuant to such a petition must be served on the
Administrator of the Division of [Welfare and Supportive ] Social
Services of the Department of [Health and] Human Services when
any application for medical assistance is made by or on behalf of an
institutionalized spouse. The Administrator may intervene no later
than 45 days after receipt by the Division of [Welfare and Supportive]
Social Services of the Department of [Health and] Human Services
of an application for medical assistance and a copy of the petition and
any order entered pursuant to subsection 4 or 5, and may move to
modify the order.
7. A person may enter into a written agreement wit h his or her
spouse dividing their community income, assets and obligations into
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equal shares of separate income, assets and obligations of the spouses.
Such an agreement is effective only if one spouse is an
institutionalized spouse and the other spouse i s a community spouse
or a division of the income or resources would allow one spouse to
qualify for services under NRS 427A.250 to 427A.280, inclusive.
8. An agreement entered into or decree entered pursuant to this
section may not be binding on the Medicaid Division of [Welfare and
Supportive Services of the Department of Health and Human
Services] the Nevada Health Authority in making determinations
under the State Plan for Medicaid.
9. As used in this section, “community spouse” and
“institutionalized spouse” have the meanings respectively ascribed to
them in 42 U.S.C. § 1396r-5(h).
Sec. 47. NRS 132.390 is hereby amended to read as follows:
132.390 1. For the purposes of this title, a person is an
interested person with respect to:
(a) A judicia l proceeding, a notice of a proposed action or a
nonjudicial settlement, if the person has or claims to have an
enforceable right or interest that may be materially affected by the
outcome of that proceeding, proposed action or nonjudicial
settlement. While living, a settlor or a testator shall be deemed to have
an enforceable right with respect to any trust or will that he or she
created. For the purposes of this paragraph, a person may not claim
to have a right or interest under an estate or trust after the entry of an
order of the court declaring the right or interest invalid.
(b) An estate of a decedent, if the person:
(1) Is an heir, devisee, child, spouse, creditor, settlor or
beneficiary;
(2) Has a property right in or claim against the estate of a
decedent, including, without limitation, the Director of the
[Department of Health and Human Services ] Nevada Health
Authority in any case in which money is owed to the [Department of
Health and Human Services] Authority as a result of the payment of
benefits for Medicaid;
(3) Has priority for appointment as a personal representative;
or
(4) Is any other fiduciary representing an interested person.
(c) A trust, if the person:
(1) Is a living settlor or, if a court has appointed a guardian of
the estate of the settlor, the guardian of the estate appointed by the
court;
(2) Is the trustee, including, without limitation, each acting
cotrustee;
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(3) Holds the presently exercisable right to remove or replace
the trustee or a cotrustee;
(4) Asserts the right to serve as the trustee or as a cotrustee;
(5) Is a current beneficiary or a remainder beneficiary of that
trust;
(6) Holds a presently exercisable power of appointment that
permits the holder to designate or change the designation of a current
beneficiary or a remainder beneficiary of that trust;
(7) Holds a presently exercisable power that permits the
holder to designate, remove or otherwise change the designation of a
person who, pur suant to this paragraph, would be an interested
person;
(8) Is a creditor of the settlor who has a claim which has been
accepted by the trustee or who has asserted the trustee’s liability
therefor in a probate proceeding or in a civil action under subsection
8 or 9 of NRS 111.779; or
(9) Is a creditor of the trust who has given the trustee written
notice of its claim.
(d) A revocable trust that is the subject of a petition under NRS
164.015 relating to the validity of the trust or any trust -related
document, if the person, after the death of the settlor, under the terms
of any version of the trust documents in dispute, would be:
(1) A current beneficiary or a remainder beneficiary of that
trust; or
(2) A trustee or a successor trustee, including, without
limitation, a cotrustee.
(e) A will that, while the testator is still living, is the subject of a
petition under subsection 2 of NRS 30.040, if the person, after the
death of the testator, would be:
(1) A beneficiary of that will; or
(2) A fiduciary designated in or pursuant to the terms of that
will.
2. For the purposes of this title, the following persons are not
interested persons:
(a) With respect to a motion, petition or proceeding, any person
holding or claiming an interest or right th at is not affected by the
motion, petition or proceeding.
(b) The Director of the [Department of Health and Human
Services] Nevada Health Authority after any money owed to the
[Department] Authority has been paid in full or with respect to the
estate or t rust of a decedent who did not receive any benefits from
Medicaid.
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(c) A vexatious litigant with regard to a motion, petition or
proceeding for which the vexatious litigant has been denied standing
pursuant to NRS 155.165.
(d) As to the estate of a decedent:
(1) After a will has been admitted to probate, an heir, child or
spouse who is not a beneficiary of the will, except for the purposes of
NRS 133.110, 133.160 and 137.080.
(2) A creditor whose claim has not been accepted by the
personal representative, if the enforcement of the claim of the creditor
is barred under the provisions of chapter 11 or 147 of NRS or any
other applicable statute of limitations.
(e) As to a trust:
(1) The guardian of the person of an interested person, unless
the guardian is expressly permitted to act for the interested person
under the terms of the trust instrument;
(2) A beneficiary or creditor whose right or claim is barred by
any applicable statute of limitations, including, without limitation, the
statute of limita tions found in chapter 11 of NRS or NRS 164.021,
164.025 or 166.170;
(3) Any beneficiary of a revocable trust, except as expressly
provided in paragraph (d) of subsection 1; or
(4) Any disclaimant as to a disclaimed interest, except with
respect to the enforcement of the disclaimer.
3. As used in this section:
(a) “Current beneficiary” has the meaning ascribed to it in
NRS 165.020.
(b) “Remainder beneficiary” has the meaning ascribed to it in
NRS 165.020.
Sec. 48. NRS 146.070 is hereby amended to read as follows:
146.070 1. All or part of the estate of a decedent may be set
aside without administration by the order of the court as follows:
(a) If the value of a decedent’s estate does not exceed $100,000,
the estate may be set aside without administration by the order of the
court; or
(b) If a decedent’s will directs that all or part of the decedent’s
estate is to be distributed to the trustee of a nontestamentary trust
established by the decedent and in existence at the decedent’s death,
the portion of the estate subject to such direction may be set aside
without administration. Any portion of a decedent’s estate set aside
to the nontestamentary trust pursuant to this paragraph is subject to
creditors of the estate unless the petitioner provides proof to the court
that the trustee has published or mailed the requisite notice to such
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creditors on behalf of the nontestamentary trust and settlor pursuant
to NRS 164.025.
2. Except as otherwise provided in subsection 3, the whole estate
set aside pursuant to paragraph (a) of subsection 1 must be assigned
and set apart in the following order:
(a) To the payment of the petitioner’s attorney’s fees and costs
incurred relative to the proceeding under this section;
(b) To the payment of funeral expense s, expenses of last illness,
money owed to the [Department of Health and Human Services ]
Nevada Health Authority as a result of payment of benefits for
Medicaid and creditors, if there are any;
(c) To the payment of other creditors, if any; and
(d) Any balance remaining to the claimant or claimants entitled
thereto pursuant to a valid will of the decedent, and if there is no valid
will, pursuant to intestate succession in accordance with chapter 134
of NRS.
3. If the value of the estate does not exceed $100,000 and the
decedent is survived by a spouse or one or more minor children, the
court must set aside the estate for the benefit of the surviving spouse
or the minor child or minor children of the decedent, subject to any
reduction made pursuant to subsection 4 or 5. The court may allocate
the entire estate to the surviving spouse, the entire amount to the
minor child or minor children, or may divide the estate among the
surviving spouse and minor child or minor children.
4. As to any amount set aside to or for the benefit of the
surviving spouse or minor child or minor children of the decedent
pursuant to subsection 3, the court must set aside the estate without
the payment of creditors except as the court finds necessary to prevent
a manifest injustice.
5. To prevent an injustice to creditors when there are nonprobate
transfers that already benefit the surviving spouse or minor child or
minor children of the decedent, the court has the discretion to reduce
the amount set aside under subsection 3 to the extent that the value of
the estate, when combined with the value of nonprobate transfers, as
defined in NRS 111.721, from the decedent to or for the benefit of the
surviving spouse or minor child or minor children of the decedent
exceeds $100,000.
6. In exercising the discretion granted in this section, the court
shall consider the needs and resources of the surviving spouse and
minor child or minor children, including any assets received by or for
the benefit of the surviving spouse or minor child o r minor children
from the decedent by nonprobate transfers.
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7. For the purpose of this section, a nonprobate transfer from the
decedent to one or more trusts or custodial accounts for the benefit of
the surviving spouse or minor child or minor children s hall be
considered a transfer for the benefit of such spouse or minor child or
minor children.
8. Proceedings taken under this section must not begin until at
least 30 days after the death of the decedent and must be originated
by a petition containing:
(a) A specific description of all property in the decedent’s estate;
(b) A list of all known liens and encumbrances against estate
property at the date of the decedent’s death, with a description of any
that the petitioner believes may be unenforceable;
(c) An estimate of the value of the property, together with an
explanation of how the estimated value was determined;
(d) A statement of the debts of the decedent so far as known to
the petitioner;
(e) The names and residences of the heirs and devisees of the
decedent and the age of any who is a minor and the relationship of
the heirs and devisees to the decedent, so far as known to the
petitioner; and
(f) If the decedent left a will, a statement concerning all evidence
known to the petitioner that tends to prove that the will is valid.
9. If the petition seeks to have the estate set aside for the benefit
of the decedent’s surviving spouse or minor child or minor children
without payment to creditors, the petition must also contain:
(a) A specific description and estimated value of property passing
by one or more nonprobate transfers from the decedent to the
surviving spouse or minor child or minor children; or
(b) An allegation that the estimated value of the property sought
to be set aside, combine d with the value of all nonprobate transfers
from the decedent to the surviving spouse or minor child or minor
children who are seeking to receive property pursuant to this section,
is less than $100,000.
10. When property is distributed pursuant to an o rder granted
under this section, the court may allocate the property on a pro rata
basis or a non-pro rata basis.
11. The clerk shall set the petition for hearing and the petitioner
shall give notice of the petition and hearing in the manner provided
in NRS 155.010 to the decedent’s heirs and devisees and to the
Director of the [Department of Health and Human Services.] Nevada
Health Authority. If a complete copy of the petition is not enclosed
with the notice, the notice must include a statement setting forth to
whom the estate is being set aside.
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12. No court or clerk’s fees may be charged for the filing of any
petition in, or order of court thereon, or for any certified copy of the
petition or order in an estate not exceeding $2,500 in value.
13. At the hearing on a petition under this section, the court may
require such additional evidence as the court deems necessa ry to
make the findings required under subsection 14.
14. The order granting the petition shall include:
(a) The court’s finding as to the validity of any will presented;
(b) The court’s finding as to the value of the estate and, if relevant
for the purposes of subsection 5, the value of any property subject to
nonprobate transfers;
(c) The court’s determination of any property set aside under
subsection 2;
(d) The court’s determination of any property set aside under
subsection 3, including, without limitation, the court’s determination
as to any reduction made pursuant to subsection 4 or 5; and
(e) The name of each distributee and the property to be distributed
to the distributee.
15. As to the distribution of the share of a minor child set aside
pursuant to this section, the court may direct the manner in which the
money may be used for the benefit of the minor child as is deemed in
the court’s discretion to be in the best interests of the minor child, and
the distribution of the minor child’s share shall be made as permitted
for the minor child’s share under the terms of the decedent’s will or
to one or more of the following:
(a) A parent of such minor child, with or without the filing of any
bond;
(b) A custodian under chapter 167 of NRS; or
(c) A court -appointed guardian of the estate, with or without
bond.
16. The court, upon request of a petitioner under this section and
upon such terms and conditions the court deems advisable to protect
any interested person of the estate:
(a) May order that any asset assigned and set apart pursuant to
subsection 2 be distributed first to a designated person who resides in
this State and is otherwise qualified pursuant to NRS 139.010;
(b) May order the designated person to distribute the assets to the
person or persons entitled thereto; and
(c) Shall retain jurisdiction to enforce its orders until the
designated person demonstrates to the court, by the production of
satisfactory receipts, that all sums of money due and all the property
of the estate has been distributed to the persons entitled thereto and
all acts lawfully required have been performed.
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17. For the purposes of this section, the value of property must
be the fair market value of that property, reduced by the value of all
enforceable liens and encumbrances. Property values and the values
of liens and encumbrances must be determined as of the date of the
decedent’s death.
Sec. 49. NRS 146.080 is hereby amended to read as follows:
146.080 1. If a decedent leaves no real property, nor interest
therein, nor mortgage or lien thereon, in this State, and the gross value
of the decedent’s property in this State, over and above any amounts
due to the decedent for services in the Armed Forces of the U nited
States and the value of any motor vehicles registered to the decedent,
does not exceed the applicable amount, a person who has a right to
succeed to the property of the decedent pursuant to the laws of
succession for a decedent who died intestate or pursuant to the valid
will of a decedent who died testate, on behalf of all persons entitled
to succeed to the property claimed, or the Director of the [Department
of Health and Human Services ] Nevada Health Authority or, as
applicable, the public administ rator or a person employed or
contracted with pursuant to NRS 253.125, on behalf of the State or
others entitled to the property, may, 40 days after the death of the
decedent, without procuring letters of administration or awaiting
the probate of the will , collect any money due the decedent, receive
the property of the decedent, and have any evidences of interest,
indebtedness or right transferred to the claimant upon furnishing the
person, representative, corporation, officer or body owing the money,
having custody of the property or acting as registrar or transfer agent
of the evidences of interest, indebtedness or right, with an affidavit
showing the right of the affiant or affiants to receive the money or
property or to have the evidence transferred.
2. An affidavit made pursuant to this section must state:
(a) The affiant’s name and address, and that the affiant is entitled
by law to succeed to the property claimed;
(b) The date and place of death of the decedent;
(c) That the gross value of the de cedent’s property in this State,
except amounts due the decedent for services in the Armed Forces of
the United States or the value of any motor vehicles registered to the
decedent, does not exceed the applicable amount, and that the
property does not incl ude any real property nor interest therein, nor
mortgage or lien thereon;
(d) That at least 40 days have elapsed since the death of the
decedent, as shown in a certified copy of the certificate of death of
the decedent attached to the affidavit;
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(e) That no petition for the appointment of a personal
representative is pending or has been granted in any jurisdiction;
(f) That all debts of the decedent, including funeral and burial
expenses, and money owed to the [Department of Health and Human
Services] Nevada Health Authority as a result of the payment of
benefits for Medicaid, have been paid or provided for;
(g) A description of the personal property and the portion
claimed;
(h) That the affiant has given written notice, by personal service
or by certified mail, identifying the affiant’s claim and describing the
property claimed, to every person whose right to succeed to the
decedent’s property is equal or superior to that of the affiant, and that
at least 14 days have elapsed since the notice was served or mailed;
(i) That the affiant is personally entitled, or the [Department of
Health and Human Services] Nevada Health Authority is entitled, to
full payment or delivery of the property claimed or is entitled to
payment or delivery on behalf of and with the written authority of all
other successors who have an interest in the property;
(j) That the affiant has no knowledge of any existing claims for
personal injury or tort damages against the decedent; and
(k) That the affiant acknowledges an und erstanding that filing a
false affidavit constitutes a felony in this State.
3. If the affiant:
(a) Submits an affidavit which does not meet the requirements of
subsection 2 or which contains statements which are not entirely true,
any money or property the affiant receives is subject to all debts of
the decedent.
(b) Fails to give notice to other successors as required by
subsection 2, any money or property the affiant receives is held by
the affiant in trust for all other successors who have an interest in the
property.
4. A person who receives an affidavit containing the information
required by subsection 2 is entitled to rely upon that information, and
if the person relies in good faith, the person is immune from civil
liability for actions based on that reliance.
5. Upon receiving proof of the death of the decedent and an
affidavit containing the information required by this section:
(a) A transfer agent of any security shall change the registered
ownership of the security claimed from the deced ent to the person
claiming to succeed to ownership of that security.
(b) A governmental agency required to issue certificates of title,
ownership or registration to personal property shall issue a new
certificate of title, ownership or registration to the person claiming to
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succeed to ownership of the property. The governmental agency may
not refuse to accept an affidavit containing the information required
by this section, regardless of the form of the affidavit.
6. If any property of the estate not exc eeding the applicable
amount is located in a state which requires an order of a court for the
transfer of the property, or if the estate consists of stocks or bonds
which must be transferred by an agent outside this State, any person
qualified pursuant to the provisions of subsection 1 to have the stocks
or bonds or other property transferred may do so by obtaining a court
order directing the transfer. The person desiring the transfer must file
a petition, which may be ex parte, containing:
(a) A specific description of all the property of the decedent.
(b) A list of all the liens and mortgages of record at the date of the
decedent’s death.
(c) An estimate of the value of the property of the decedent.
(d) The names, ages of any minors and residences of t he
decedent’s heirs and devisees.
(e) A request for the court to issue an order directing the transfer
of the stocks or bonds or other property if the court finds the gross
value of the estate does not exceed the applicable amount.
(f) An attached copy o f the executed affidavit made pursuant to
subsection 2.
If the court finds that the gross value of the estate does not exceed
the applicable amount and the person requesting the transfer is
entitled to it, the court may enter an order directing the transfer.
7. As used in this section, “applicable amount” means:
(a) If the claimant is the surviving spouse of the decedent,
$100,000.
(b) For any other claimant, $25,000.
Sec. 50. NRS 147.070 is hereby amended to read as follows:
147.070 1. A claim for an amount of $250 or more filed with
the clerk must be supported by the affidavit of the claimant that:
(a) The amount is justly due (or if the claim is not yet due, that
the amount is a just demand and will be due on the ..... day of ........).
(b) No payments have been made thereon which are not credited.
(c) There are no offsets to the amount demanded to the knowledge
of the claimant or other affiant.
2. Every claim filed with the clerk must contain the mailing
address of the claimant. Any written notice mailed by a personal
representative to the claim ant at the address furnished is proper
notice.
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3. When the affidavit is made by any other person than the
claimant, the reasons why it is not made by the claimant must be set
forth in the affidavit.
4. The oath may be taken before any person authorized to
administer oaths.
5. The amount of interest must be computed and included in the
statement of the claim and the rate of interest determined.
6. Except as otherwise provided in subsection 7, the court may,
for good cause shown, allow a defective cla im or affidavit to be
corrected or amended on application made at any time before the
filing of the final account, but an amendment may not be made to
increase the amount of a claim after the time for filing a claim has
expired.
7. The court shall allow the [Department of Health and Human
Services] Nevada Health Authority to amend at any time before the
filing of the final account a claim for the payment of benefits for
Medicaid that the [Department] Authority identifies after the original
claim has been filed.
Sec. 51. NRS 147.195 is hereby amended to read as follows:
147.195 The debts and charges of the estate must be paid in the
following order:
1. Expenses of administration.
2. Funeral expenses.
3. The expenses of the last illness.
4. Family allowance.
5. Debts having preference by laws of the United States.
6. Money owed to the [Department of Health and Human
Services] Nevada Health Authority as a result of the payment of
benefits for Medicaid.
7. Wages to the extent of $600, of each employee of the
decedent, for work done or personal services rendered within 3
months before the death of the employer. If there is not sufficient
money with which to pay all such labor claims in full, the money
available must be distributed among the claimants in accordance with
the amounts of their respective claims.
8. Judgments rendered against the decedent in his or her
lifetime, and mortgages in order of their date. The preference given
to a mortgage extends only to the proceeds of the property mortgaged.
If the proceeds of that property are insufficient to pay the mortgage,
the part remaining unsatisfied must be classed with other demands
against the estate.
9. All other demands against the estate.
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Sec. 52. NRS 150.230 is hereby amended to read as follows:
150.230 1. The personal representative shall, as soon as
sufficient money is available, upon receipt of a sworn statement of
the amount due and without any formal action upon creditors’ claims,
pay the funeral expenses, the expenses of the l ast illness, the
allowance made to the family of the decedents, money owed to the
[Department of Health and Human Services ] Nevada Health
Authority as a result of payment of benefits for Medicaid and wage
claims to the extent of $600 of each employee of th e decedent for
work done or personal services rendered within 3 months before the
death of the employer, but may retain the necessary expenses of
administration.
2. The personal representative is not obliged to pay any other
debt or any devise until the payment is ordered by the court.
3. The personal representative may, before court approval or
order, pay any of the decedent’s debts amounting to $500 or less if:
(a) Claims for payment thereof have been properly filed in the
proceedings;
(b) The debts are legally due; and
(c) The estate is solvent.
In settling the account of the estate, the court shall allow any such
payment if the conditions of paragraphs (a), (b) and (c) have been
met. Otherwise, the personal representative is personally liable to any
person sustaining loss or damage as a result of the payment.
4. Funeral expenses and expenses of a last illness are debts
payable out of the estate of the decedent and must not be charged to
the community share of a surviving spouse, whether or not the
surviving spouse is financially able to pay those expenses and
whether or not the surviving spouse or any other person is also liable
therefor.
Sec. 53. NRS 159.034 is hereby amended to read as follows:
159.034 1. Except as otherwise provided in t his section, by
specific statute or as ordered by the court, a petitioner in a
guardianship proceeding shall give notice of the time and place of the
hearing on any petition filed in the guardianship proceeding to:
(a) The spouse of the protected person and all other known
relatives of the protected person who are within the second degree of
consanguinity.
(b) Any other interested person or the person’s attorney who has
filed a request for notice in the guardianship proceedings and has
served a copy of the request upon the guardian. The request for notice
must state the interest of the person filing the request and the person’s
name and address, or that of his or her attorney.
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(c) The guardian, if the petitioner is not the guardian.
(d) Any person or c are provider who is providing care for the
protected person, except that if the person or care provider is not
related to the protected person, such person or care provider must not
receive copies of any inventory or accounting.
(e) Any office of the Department of Veterans Affairs in this State
if the protected person is receiving any payments or benefits through
the Department of Veterans Affairs.
(f) The Director of the [Department of Health and Human
Services] Nevada Health Authority if the protected p erson has
received or is receiving benefits from Medicaid.
(g) Those persons entitled to notice if a proceeding were brought
in the home state of the protected person.
2. The petitioner shall give notice not later than 10 days before
the date set for the hearing:
(a) By mailing a copy of the notice by certified, registered or
ordinary first-class mail to the residence, office or post office address
of each person required to be notified pursuant to this section;
(b) By personal service; or
(c) In any other manner ordered by the court, upon a showing of
good cause.
3. Except as otherwise provided in this subsection, if none of the
persons entitled to notice of a hearing on a petition pursuant to this
section can, after due diligence, be served by cert ified mail or
personal service and this fact is proven by affidavit to the satisfaction
of the court, service of the notice must be made by publication in the
manner provided by the Nevada Rules of Civil Procedure. In all such
cases, the notice must be published not later than 10 days before the
date set for the hearing. If, after the appointment of a guardian, a
search for relatives of the protected person listed in paragraph (a) of
subsection 1 fails to find any such relative, the court may waive the
notice by publication required by this subsection.
4. For good cause shown, the court may waive the requirement
of giving notice.
5. A person entitled to notice pursuant to this section may waive
such notice. Such a waiver must be in writing and filed with the court.
6. On or before the date set for the hearing, the petitioner shall
file with the court proof of giving notice to each person entitled to
notice pursuant to this section.
Sec. 54. NRS 159.047 is hereby amended to read as follows:
159.047 1. Except as otherwise provided in NRS 159.0475,
159.0523 and 159.0525, upon the filing of a petition under NRS
159.044, the clerk shall issue a citation setting forth a time and place
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for the hearing and directing the persons or care provider re ferred to
in subsection 2 to appear and show cause why a guardian should not
be appointed for the proposed protected person.
2. A citation issued under subsection 1, together with a copy of
the petition filed under NRS 159.044, must be served upon:
(a) The proposed protected person, regardless of whether the
proposed protected person is considered to have the capacity to
understand or appreciate the contents of the citation and petition;
(b) The spouse of the proposed protected person and all other
known relatives of the proposed protected person who are:
(1) Fourteen years of age or older; and
(2) Within the second degree of consanguinity;
(c) The parents and custodian of the proposed protected person;
(d) Any person or officer of a care provider having the care,
custody or control of the proposed protected person;
(e) The proposed guardian, if the petitioner is not the proposed
guardian;
(f) Any office of the Department of Veterans Affairs in this State
if the proposed protected person is receiving any payments or benefits
through the Department of Veterans Affairs; and
(g) The Director of the [Department of Health and Human
Services] Nevada Health Authority if the proposed protected person
has received or is receiving any benefits from Medicaid.
3. A person who serves notice upon a proposed protected person
pursuant to paragraph (a) of subsection 2 shall file with the court an
affidavit stating that he or she served notice upon the proposed
protected person in accordance with the provisions of
NRS 159.0475.
Sec. 55. NRS 159.113 is hereby amended to read as follows:
159.113 1. Before taking any of the following actions, the
guardian of the estate shall petition the court for an order authorizing
the guardian to:
(a) Invest the property of the protected person pursuant to
NRS 159.117.
(b) Continue the business of the protected person pursuant to
NRS 159.119.
(c) Borrow money for the protected person pursuant to
NRS 159.121.
(d) Except as otherwise provided in NRS 159.079, enter into
contracts for the protected person or complete the performance of
contracts of the protected person pursuant to NRS 159.123.
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(e) Make gifts from the estate of the protected person or make
expenditures for the relatives of the protected person pursuant to
NRS 159.125.
(f) Sell, lease or place in trust any property of the protected person
pursuant to NRS 159.127.
(g) Exchange or partition the property of the protected person
pursuant to NRS 159.175.
(h) Release the power of the protected person as trustee, personal
representative or custodian for a minor or guardian.
(i) Exercise or release the power of the protected person as a
donee of a power of appointment.
(j) Exercise the right of the protected person to take under or
against a will.
(k) Transfer to a trust created by the protected person any
property unintentionally omitted from the trust.
(l) Submit a revocable trust or an irrevocable trust to the
jurisdiction of the court if:
(1) The protected person or the spouse of the protected person,
or both, are the grantors and sole beneficiaries of the income of the
trust; or
(2) The trust was created by the court.
(m) Pay any claim by the [Department of Health and Human
Services] Nevada Health Authority to recover benefits for Medicaid
correctly paid to or on behalf of the protected person.
2. Before taking any of the following actions, unless the
guardian has been otherwise ordered by the court to petition the court
for permission to take specified actions or make specified d ecisions
in addition to those described in subsection 1, the guardian may
petition the court for an order authorizing the guardian to:
(a) Obtain advice, instructions and approval of any other
proposed act of the guardian relating to the property of the protected
person.
(b) Take any other action which the guardian deems would be in
the best interests of the protected person.
3. The petition must be signed by the guardian and contain:
(a) The name, age, residence and address of the protected person.
(b) A concise statement as to the condition of the estate of the
protected person.
(c) A concise statement as to the advantage to the protected
person of or the necessity for the proposed action.
(d) The terms and conditions of any proposed sale, lease,
partition, trust, exchange or investment, and a specific description of
any property involved.
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4. Any of the matters set forth in subsection 1 may be
consolidated in one petition, and the court may enter one order
authorizing or directing the guardian to do one or more of those acts.
5. A petition filed pursuant to paragraphs (b) and (d) of
subsection 1 may be consolidated in and filed with the petition for the
appointment of the guardian, and if the guardian is appointed, the
court may enter additional orders authorizing the guardian to continue
the business of the protected person, enter contracts for the protected
person or complete contracts of the protected person.
Sec. 56. NRS 159A.047 is hereby amended to read as follows:
159A.047 1. Except as otherwise provided in NRS
159A.0475, 159A.049, 159A.052 and 159A.053, upon the filing of a
petition under NRS 159A.044, the clerk shall issue a citation setting
forth a time and place for the hearing and directing the persons or care
provider referred to in subsection 2 to appear and show cause why a
guardian should not be appointed for the proposed protected minor.
2. A citation issued under subsection 1, together with a copy of
the petition filed under NRS 159A.044, must be served upon:
(a) A proposed protected minor who is 14 years of age or older,
regardless of whether the proposed protected minor is considered to
have the capacity to understand or appreciate the contents of the
citation and petition;
(b) All known relatives of the proposed protected minor who are:
(1) Fourteen years of age or older; and
(2) Within the second degree of consanguinity;
(c) The parents and custodian of the proposed protected minor;
(d) Any person or officer of a care provider having the care,
custody or control of the proposed protected minor;
(e) The proposed guardian, if the petitioner is not the proposed
guardian; and
(f) The Director of the [Department of Health and Human
Services] Nevada Health Authority if the proposed protected minor
has received or is receiving any benefits from Medicaid.
3. A person who serves notice upon a proposed protected minor
pursuant to paragraph (a) of subsection 2 shall file with the court an
affidavit stating that he or she served notice upon the proposed
protected minor in accordance with the provisions of
NRS 159A.0475.
Sec. 57. NRS 159A.113 is hereby amended to read as follows:
159A.113 1. Before taking any of the following actions, the
guardian of the estate shall petition the court for an order authorizing
the guardian to:
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(a) Invest the property of the protected minor pursuant to
NRS 159A.117.
(b) Borrow money for the protected minor pursuant to
NRS 159A.121.
(c) Except as otherwise provided in NRS 159A.079, enter into
contracts for the protected minor or com plete the performance of
contracts of the protected minor pursuant to NRS 159A.123.
(d) Make gifts from the protected minor’s estate pursuant to
NRS 159A.125.
(e) Sell, lease or place in trust any property of the protected minor
pursuant to NRS 159A.127.
(f) Exchange or partition the protected minor’s property pursuant
to NRS 159A.175.
(g) Exercise or release the power of the protected minor as a
donee of a power of appointment.
(h) Exercise the right of the protected minor to take under or
against a will.
(i) Transfer to a trust created by the protected minor any property
unintentionally omitted from the trust.
(j) Submit a revocable trust or an irrevocable trust to the
jurisdiction of the court if:
(1) The protected minor is the grantor and sole beneficiary of
the income of the trust; or
(2) The trust was created by the court.
(k) Pay any claim by the [Department of Health and Human
Services] Nevada Health Authority to recover benefits for Medicaid
correctly paid to or on behalf of the protected minor.
(l) Transfer money in a protected minor’s blocked account to the
Nevada Higher Education Prepaid Tuition Trust Fund created
pursuant to NRS 353B.140.
2. Before taking any of the following actions, unless the
guardian has been otherwise ordered by the court to petition the court
for permission to take specified actions or make specified decisions
in addition to those described in subsection 1, the guardian may
petition the court for an order authorizing the guardian to:
(a) Obtain advice, instru ctions and approval of any other
proposed act of the guardian relating to the protected minor’s
property.
(b) Take any other action which the guardian deems would be in
the best interests of the protected minor.
3. The petition must be signed by the guardian and contain:
(a) The name, age, residence and address of the protected minor.
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(b) A concise statement as to the condition of the protected
minor’s estate.
(c) A concise statement as to the advantage to the protected minor
of or the necessity for the proposed action.
(d) The terms and conditions of any proposed sale, lease,
partition, trust, exchange or investment, and a specific description of
any property involved.
4. Any of the matters set forth in subsection 1 may be
consolidated in one pe tition, and the court may enter one order
authorizing or directing the guardian to do one or more of those acts.
5. A petition filed pursuant to paragraph (c) of subsection 1 may
be consolidated in and filed with the petition for the appointment of
the guardian, and if the guardian is appointed, the court may enter
additional orders authorizing the guardian to enter contracts for the
protected minor or complete contracts of the protected minor.
Sec. 58. NRS 200.5093 is hereby amended to read as follows:
200.5093 1. Any person who is described in subsection 4 and
who, in a professional or occupational capacity, knows or has
reasonable cause to believe that an older person or vulnerable person
has been abused, neglected, exploited, isolated or abandoned shall:
(a) Except as otherwise provided in subsection 2, report the
abuse, neglect, exploitation, isolation or abandonment of the older
person or vulnerable person to:
(1) The local office of the Aging and Disability Services
Division of the Department of [Health and] Human Services;
(2) A police department or sheriff’s office; or
(3) A toll-free telephone service designated by the Aging and
Disability Services Division of the Department of [Health and ]
Human Services; and
(b) Make such a report as soon as reasonably practicable but not
later than 24 hours after the person knows or has reasonable cause to
believe that the older person or vulnerable person has been abused,
neglected, exploited, isolated or abandoned.
2. If a person who is required to make a report pursuant to
subsection 1 knows or has reasonable cause to believe that the abuse,
neglect, exploitation, isolation or abandonment of the older person or
vulnerable person involves an act or omission of the Aging and
Disability Services Di vision, another division of the Department of
[Health and ] Human Services or a law enforcement agency, the
person shall make the report to an agency other than the one alleged
to have committed the act or omission.
3. Each agency, after reducing a report to writing, shall forward
a copy of the report to the Aging and Disability Services Division of
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the Department of [Health and] Human Services and the Unit for the
Investigation and Prosecution of Crimes.
4. A report must be made pursuant to subsection 1 by the
following persons:
(a) Every physician, dentist, dental hygienist, expanded function
dental assistant, chiropractic physician, naprapath, optometrist,
podiatric physician, medical examiner, resident, intern, professional
or practical nurse, physic ian assistant licensed pursuant to chapter
630 or 633 of NRS, anesthesiologist assistant, perfusionist,
psychiatrist, psychologist, marriage and family therapist, clinical
professional counselor, clinical alcohol and drug counselor, alcohol
and drug counse lor, music therapist, athletic trainer, driver of an
ambulance, paramedic, licensed dietitian, holder of a license or a
limited license issued under the provisions of chapter 653 of NRS,
behavior analyst, assistant behavior analyst, registered behavior
technician, peer recovery support specialist, as defined in NRS
433.627, peer recovery support specialist supervisor, as defined in
NRS 433.629, or other person providing medical services licensed or
certified to practice in this State, who examines, attends or treats an
older person or vulnerable person who appears to have been abused,
neglected, exploited, isolated or abandoned.
(b) Any personnel of a hospital or similar institution engaged in
the admission, examination, care or treatment of persons or an
administrator, manager or other person in charge of a hospital or
similar institution upon notification of the suspected abuse, neglect,
exploitation, isolation or abandonment of an older person or
vulnerable person by a member of the staff of the hospital.
(c) A coroner.
(d) Every person who maintains or is employed by an agency to
provide personal care services in the home.
(e) Every person who maintains or is employed by an agency to
provide nursing in the home.
(f) Every person who operates, who is e mployed by or who
contracts to provide services for an intermediary service organization
as defined in NRS 449.4304.
(g) Any employee of the Department of [Health and ] Human
Services, except the State Long -Term Care Ombudsman appointed
pursuant to NRS 427 A.125 and any of his or her advocates or
volunteers where prohibited from making such a report pursuant to
45 C.F.R. § 1321.11.
(h) Any employee of a law enforcement agency or a county’s
office for protective services or an adult or juvenile probation officer.
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- 83rd Session (2025)
(i) Any person who maintains or is employed by a facility or
establishment that provides care for older persons or vulnerable
persons.
(j) Any person who maintains, is employed by or serves as a
volunteer for an agency or service which advises pers ons regarding
the abuse, neglect, exploitation, isolation or abandonment of an older
person or vulnerable person and refers them to persons and agencies
where their requests and needs can be met.
(k) Every social worker.
(l) Any person who owns or is employed by a funeral home or
mortuary.
(m) Every person who operates or is employed by a community
health worker pool, as defined in NRS 449.0028, or with whom a
community health worker pool contracts to provide the services of a
community health worker, as defined in NRS 449.0027.
(n) Every person who is enrolled with the Medicaid Division [of
Health Care Financing and Policy] of the [Department of Health and
Human Services] Nevada Health Authority to provide doula services
to recipients of Medicaid pursuant to NRS 422.27177.
5. A report may be made by any other person.
6. If a person who is required to make a report pursuant to
subsection 1 knows or has reasonable cause to believe that an older
person or vulnerable person has died as a result of abuse, neglect,
isolation or abandonment, the person shall, as soon as reasonably
practicable, report this belief to the appropriate medical examiner or
coroner, who shall investigate the cause of death of the older person
or vulnerable person and submit t o the appropriate local law
enforcement agencies, the appropriate prosecuting attorney, the
Aging and Disability Services Division of the Department of [Health
and] Human Services and the Unit for the Investigation and
Prosecution of Crimes his or her writ ten findings. The written
findings must include the information required pursuant to the
provisions of NRS 200.5094, when possible.
7. A division, office or department which receives a report
pursuant to this section shall cause the investigation of the report to
commence within 3 working days. A copy of the final report of the
investigation conducted by a division, office or department, other
than the Aging and Disability Services Division of the Department of
[Health and] Human Services, must be forwarded within 30 days after
the completion of the report to the:
(a) Aging and Disability Services Division;
(b) Repository for Information Concerning Crimes Against Older
Persons or Vulnerable Persons created by NRS 179A.450; and
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- 83rd Session (2025)
(c) Unit for the Investigation and Prosecution of Crimes.
8. If the investigation of a report results in the belief that an older
person or vulnerable person is abused, neglected, exploited, isolated
or abandoned, the Aging and Disability Services Division of the
Department of [Health and] Human Services or the county’s office
for protective services may provide protective services to the older
person or vulnerable person if the older person or vulnerable person
is able and willing to accept them.
9. A person who knowingly and w illfully violates any of the
provisions of this section is guilty of a misdemeanor.
10. As used in this section, “Unit for the Investigation and
Prosecution of Crimes” means the Unit for the Investigation and
Prosecution of Crimes Against Older Persons or Vulnerable Persons
in the Office of the Attorney General created pursuant to
NRS 228.265.
Sec. 58.5. NRS 209.111 is hereby amended to read as follows:
209.111 1. The Board has full control of all grounds,
buildings, labor, and property of the Department, and shall:
[1.] (a) Purchase, or cause to be purchased, all commissary
supplies, materials and tools necessary for any lawful purpose carried
on at any institution or facility of the Department.
[2.] (b) Regulate the number of officers and em ployees of the
Department.
[3.] (c) Prescribe regulations for carrying on the business of the
Board and the Department.
2. The Board may elect to obtain prescription drugs for the
treatment of offenders through the purchasing agreements
negotiated by the Nevada Health Authority pursuant to paragraph
(b) of subsection 1 of NRS 422.4025. To do so, the Board must notify
the Authority in the form prescribed by the Authority.
Sec. 59. NRS 217.180 is hereby amended to read as follows:
217.180 1. Except as otherwise provided in subsection 2, in
determining whether to make an order for compensation, the
compensation officer shall award compensation unless the injury or
death of the victim was substantially attributable to a wrongful act of
the victim or substantially provoked by the victim.
2. If the case involves a victim of domestic violence, sexual
assault, facilitating sex trafficking or sex trafficking, the
compensation officer shall not consider the wrongful act, provocation
or any other behavior of t he victim that directly or indirectly
contributed to the injury or death of the victim.
3. If the applicant has received or is likely to receive an amount
on account of the applicant’s injury or the death of another from:
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- 83rd Session (2025)
(a) The person who committed the crime that caused the victim’s
injury or from anyone paying on behalf of the offender;
(b) Insurance;
(c) The employer of the victim; or
(d) Another private or public source or program of assistance,
the applicant shall report the amount received or that the applicant
is likely to receive to the compensation officer. Any of those sources
that are obligated to pay an amount after the award of compensation
shall pay the Department the amount of compensation that has been
paid to the applicant and pay the remainder of the amount due to the
applicant. The compensation officer shall deduct the amounts that the
applicant has received or is likely to receive from those sources from
the applicant’s total expenses.
4. An order for compensation may be made whether or not a
person is prosecuted or convicted of an offense arising from the act
on which the claim for compensation is based.
5. As used in this section:
(a) “Domestic violence” means an act described in NRS 33.018.
(b) “Facilitating sex traffick ing” means a violation of
NRS 201.301.
(c) “Public source or program of assistance” means:
(1) Public assistance, as defined in NRS 422A.065;
(2) Medicaid or the Children’s Health Insurance Program;
(3) Social services provided by a social service agency, as
defined in NRS 430A.080; or
[(3)] (4) Other assistance provided by a public entity.
(d) “Sex trafficking” means a violation of subsection 2 of
NRS 201.300.
(e) “Sexual assault” has the meaning ascribed to it in
NRS 200.366.
Sec. 60. NRS 218E.405 is hereby amended to read as follows:
218E.405 1. Except as otherwise provided in subsection 2, the
Interim Finance Committee may exercise the powers conferred upon
it by law only when the Legislature is not in a regular or special
session.
2. During a regular or special session, the Interim Finance
Committee may also perform the duties imposed on it by NRS
228.1111, subsection 5 of NRS 284.115, NRS 285.070, subsection 2
of NRS 321.335, NRS 322.007, subsection 2 of NRS 323.020,
NRS 323.050, s ubsection 1 of NRS 323.100, subsection 3 of NRS
341.126, NRS 341.142, paragraph (f) of subsection 1 of NRS
341.145, subsection 3 of NRS 349.073, NRS 353.220, 353.224,
353.2705 to 353.2771, inclusive, 353.288, 353.335, 353.3375,
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- 83rd Session (2025)
353C.224, 353C.226, paragraph (b) of subsection 4 of NRS 407.0762,
NRS 428.375, 433.732, 439.4905, 439.620, 439.630, 445B.830,
subsection 1 of NRS 445C.320 and NRS 538.650 [.] and section 30
of this act. In performing those duties, the Senate Standing
Committee on Finance and the Ass embly Standing Committee on
Ways and Means may meet separately and transmit the results of their
respective votes to the Chair of the Interim Finance Committee to
determine the action of the Interim Finance Committee as a whole.
3. The Chair of the Inter im Finance Committee may appoint a
subcommittee consisting of six members of the Committee to review
and make recommendations to the Committee on matters of the State
Public Works Division of the Department of Administration that
require prior approval of the Interim Finance Committee pursuant to
subsection 3 of NRS 341.126, NRS 341.142 and paragraph (f) of
subsection 1 of NRS 341.145. If the Chair appoints such a
subcommittee:
(a) The Chair shall designate one of the members of the
subcommittee to serve as the chair of the subcommittee;
(b) The subcommittee shall meet throughout the year at the times
and places specified by the call of the chair of the subcommittee; and
(c) The Director or the Director’s designee shall act as the
nonvoting recording secretary of the subcommittee.
Sec. 61. NRS 239.010 is hereby amended to read as follows:
239.010 1. Except as otherwise provided in this section and
NRS 1.4683, 1.4687, 1A.110, 3.2203, 41.0397, 41.071, 49.095,
49.293, 62D.420, 62D.440, 62E.516, 62E.620, 62H.025, 62H.030,
62H.170, 62H.220, 62H.320, 75A.100, 75A.150, 76.160, 78.152,
80.113, 81.850, 82.183, 86.246, 86.54615, 87.515, 87.54 13,
87A.200, 87A.580, 87A.640, 88.3355, 88.5927, 88.6067, 88A.345,
88A.7345, 89.045, 89.251, 90.730, 91.160, 116.757, 116A.270,
116B.880, 118B.026, 119.260, 119.265, 119.267, 119.280,
119A.280, 119A.653, 119A.677, 119B.370, 119B.382, 120A.640,
120A.690, 125.130, 125B.140, 126.141, 126.161, 126.163, 126.730,
127.007, 127.057, 127.130, 127.140, 127.2817, 128.090, 130.312,
130.712, 136.050, 159.044, 159A.044, 164.041, 172.075, 172.245,
176.01334, 176.01385, 176.015, 176.0625, 176.09129, 176.156,
176A.630, 178. 39801, 178.4715, 178.5691, 178.5717, 179.495,
179A.070, 179A.165, 179D.160, 180.600, 200.3771, 200.3772,
200.5095, 200.604, 202.3662, 205.4651, 209.392, 209.3923,
209.3925, 209.419, 209.429, 209.521, 211A.140, 213.010, 213.040,
213.095, 213.131, 217.105, 2 17.110, 217.464, 217.475, 218A.350,
218E.625, 218F.150, 218G.130, 218G.240, 218G.350, 218G.615,
224.240, 226.462, 226.796, 228.270, 228.450, 228.495, 228.570,
– 73 –
- 83rd Session (2025)
231.069, 231.1285, 231.1473, 232.1369, 233.190, 237.300,
239.0105, 239.0113, 239.014, 239B.026, 2 39B.030, 239B.040,
239B.050, 239C.140, 239C.210, 239C.230, 239C.250, 239C.270,
239C.420, 240.007, 241.020, 241.030, 241.039, 242.105, 244.264,
244.335, 247.540, 247.545, 247.550, 247.560, 250.087, 250.130,
250.140, 250.145, 250.150, 268.095, 268.0978, 268. 490, 268.910,
269.174, 271A.105, 281.195, 281.805, 281A.350, 281A.680,
281A.685, 281A.750, 281A.755, 281A.780, 284.4068, 284.4086,
286.110, 286.118, 287.0438, 289.025, 289.080, 289.387, 289.830,
293.4855, 293.5002, 293.503, 293.504, 293.558, 293.5757, 293.870,
293.906, 293.908, 293.909, 293.910, 293B.135, 293D.510, 331.110,
332.061, 332.351, 333.333, 333.335, 338.070, 338.1379, 338.1593,
338.1725, 338.1727, 348.420, 349.597, 349.775, 353.205, 353A.049,
353A.085, 353A.100, 353C.240, 353D.250, 360.240, 360.24 7,
360.255, 360.755, 361.044, 361.2242, 361.610, 365.138, 366.160,
368A.180, 370.257, 370.327, 372A.080, 378.290, 378.300,
379.0075, 379.008, 379.1495, 385A.830, 385B.100, 387.626,
387.631, 388.1455, 388.259, 388.501, 388.503, 388.513, 388.750,
388A.247, 3 88A.249, 391.033, 391.035, 391.0365, 391.120,
391.925, 392.029, 392.147, 392.264, 392.271, 392.315, 392.317,
392.325, 392.327, 392.335, 392.850, 393.045, 394.167, 394.16975,
394.1698, 394.447, 394.460, 394.465, 396.1415, 396.1425, 396.143,
396.159, 396.3295, 396.405, 396.525, 396.535, 396.9685, 398A.115,
408.3885, 408.3886, 408.3888, 408.5484, 412.153, 414.280,
416.070, 422.2749, 422.305, 422A.342, 422A.350, 425.400,
427A.1236, 427A.872, 427A.940, 432.028, 432.205, 432B.175,
432B.280, 432B.290, 432B.4018, 4 32B.407, 432B.430, 432B.560,
432B.5902, 432C.140, 432C.150, 433.534, 433A.360, 439.4941,
439.4988, 439.5282, 439.840, 439.914, 439A.116, 439A.124,
439B.420, 439B.754, 439B.760, 439B.845, 440.170, 441A.195,
441A.220, 441A.230, 442.330, 442.395, 442.735, 442 .774,
445A.665, 445B.570, 445B.7773, 449.209, 449.245, 449.4315,
449A.112, 450.140, 450B.188, 450B.805, 453.164, 453.720,
458.055, 458.280, 459.050, 459.3866, 459.555, 459.7056, 459.846,
463.120, 463.15993, 463.240, 463.3403, 463.3407, 463.790,
467.1005, 4 80.535, 480.545, 480.935, 480.940, 481.063, 481.091,
481.093, 482.170, 482.368, 482.5536, 483.340, 483.363, 483.575,
483.659, 483.800, 484A.469, 484B.830, 484B.833, 484E.070,
485.316, 501.344, 503.452, 522.040, 534A.031, 561.285, 571.160,
584.655, 587.877, 598.0964, 598.098, 598A.110, 598A.420,
599B.090, 603.070, 603A.210, 604A.303, 604A.710, 604D.500,
604D.600, 612.265, 616B.012, 616B.015, 616B.315, 616B.350,
618.341, 618.425, 622.238, 622.310, 623.131, 623A.137, 624.110,
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- 83rd Session (2025)
624.265, 624.327, 625.425, 625A.18 5, 628.418, 628B.230,
628B.760, 629.043, 629.047, 629.069, 630.133, 630.2671, 630.2672,
630.2673, 630.2687, 630.30665, 630.336, 630A.327, 630A.555,
631.332, 631.368, 632.121, 632.125, 632.3415, 632.3423, 632.405,
633.283, 633.301, 633.427, 633.4715, 633.4716, 633.4717, 633.524,
634.055, 634.1303, 634.214, 634A.169, 634A.185, 634B.730,
635.111, 635.158, 636.262, 636.342, 637.085, 637.145, 637B.192,
637B.288, 638.087, 638.089, 639.183, 639.2485, 639.570, 640.075,
640.152, 640A.185, 640A.220, 640B.405, 640B.73 0, 640C.580,
640C.600, 640C.620, 640C.745, 640C.760, 640D.135, 640D.190,
640E.225, 640E.340, 641.090, 641.221, 641.2215, 641A.191,
641A.217, 641A.262, 641B.170, 641B.281, 641B.282, 641C.455,
641C.760, 641D.260, 641D.320, 642.524, 643.189, 644A.870,
645.180, 645.625, 645A.050, 645A.082, 645B.060, 645B.092,
645C.220, 645C.225, 645D.130, 645D.135, 645G.510, 645H.320,
645H.330, 647.0945, 647.0947, 648.033, 648.197, 649.065, 649.067,
652.126, 652.228, 653.900, 654.110, 656.105, 657A.510, 661.115,
665.130, 665.133, 669.275, 669.285, 669A.310, 670B.680, 671.365,
671.415, 673.450, 673.480, 675.380, 676A.340, 676A.370, 677.243,
678A.470, 678C.710, 678C.800, 679B.122, 679B.124, 679B.152,
679B.159, 679B.190, 679B.285, 679B.690, 680A.270, 681A.440,
681B.260, 681B.410, 6 81B.540, 683A.0873, 685A.077, 686A.289,
686B.170, 686C.306, 687A.060, 687A.115, 687B.404, 687C.010,
688C.230, 688C.480, 688C.490, 689A.696, 692A.117, 692C.190,
692C.3507, 692C.3536, 692C.3538, 692C.354, 692C.420, 693A.480,
693A.615, 696B.550, 696C.120, 703 .196, 704B.325, 706.1725,
706A.230, 710.159, 711.600, and section 24 of this act, sections 35,
38 and 41 of chapter 478, Statutes of Nevada 2011 and section 2 of
chapter 391, Statutes of Nevada 2013 and unless otherwise declared
by law to be confidential, all public books and public records of a
governmental entity must be open at all times during office hours to
inspection by any person, and may be fully copied or an abstract or
memorandum may be prepared from those public books and public
records. Any suc h copies, abstracts or memoranda may be used to
supply the general public with copies, abstracts or memoranda of the
records or may be used in any other way to the advantage of the
governmental entity or of the general public. This section does not
supersede or in any manner affect the federal laws governing
copyrights or enlarge, diminish or affect in any other manner the
rights of a person in any written book or record which is copyrighted
pursuant to federal law.
2. A governmental entity may not reject a book or record which
is copyrighted solely because it is copyrighted.
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- 83rd Session (2025)
3. A governmental entity that has legal custody or control of a
public book or record shall not deny a request made pursuant to
subsection 1 to inspect or copy or receive a copy of a public book or
record on the basis that the requested public book or record contains
information that is confidential if the governmental entity can redact,
delete, conceal or separate, including, without limitation,
electronically, the confidential info rmation from the information
included in the public book or record that is not otherwise
confidential.
4. If requested, a governmental entity shall provide a copy of a
public record in an electronic format by means of an electronic
medium. Nothing in this subsection requires a governmental entity to
provide a copy of a public record in an electronic format or by means
of an electronic medium if:
(a) The public record:
(1) Was not created or prepared in an electronic format; and
(2) Is not available in an electronic format; or
(b) Providing the public record in an electronic format or by
means of an electronic medium would:
(1) Give access to proprietary software; or
(2) Require the production of information that is confidential
and that cannot be redacted, deleted, concealed or separated from
information that is not otherwise confidential.
5. An officer, employee or agent of a governmental entity who
has legal custody or control of a public record:
(a) Shall not refuse to provide a copy of that public record in the
medium that is requested because the officer, employee or agent has
already prepared or would prefer to provide the copy in a different
medium.
(b) Except as otherwise provided in NRS 239.030, shall, upon
request, prepare the copy of the public record and shall not require
the person who has requested the copy to prepare the copy himself or
herself.
Sec. 62. NRS 277.0655 is hereby amended to read as follows:
277.0655 1. The Department of Education, the county school
districts of the various counties, charter schools and the Health Care
Purchasing and Compliance Division of [Public and Behavioral
Health of the Department of Health and Human Services] the Nevada
Health Authority may enter into cooperative agreements for the
provision of educational services at any hospital or other facility
which is licensed:
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- 83rd Session (2025)
(a) By the Division that provides residential treatment to children
and which operates a private school licensed pursuant to chapter 394
of NRS; or
(b) In the District of Columbia or any state or territory of the
United States that:
(1) Meets the requirements of 42 C.F.R. §§ 441.151 to
441.156, inclusive;
(2) Provides residential treatment to children; and
(3) Operates an educational program accredited by a nation al
organization and approved by the Department of Education.
2. The authorization provided by subsection 1 includes the right
to pay over money appropriated to a county school district or charter
school for the education of a child placed in such a hospital or facility.
3. As used in this section, “hospital” has the meaning ascribed
to it in NRS 449.012.
Sec. 63. Chapter 287 of NRS is hereby amended by adding
thereto the provisions set forth as sections 64, 65 and 65.5 of this act.
Sec. 64. “Authority” means the Nevada Health Authority.
Sec. 65. “Director” means the Director of the Authority.
Sec. 65.5. 1. To the extent that money and resources are
available for this purpose, on or before August 31 of each even -
numbered year, the Board shall:
(a) Compile a report concerning the cost for a retired state
employee to obtain coverage through the Program under Medicare
that is actuarially comparable to the coverage provided through the
Program but not under Medicare; and
(b) Submit the report to the Director of the Legislative Counsel
Bureau for transmittal to the Interim Finance Committee.
2. The report compiled pursuant to subsection 1 must consider,
without limitation:
(a) The cost of the lowest premium charged in this State for
coverage pursuant to Medicare Part B, 42 U.S.C. §§ 1395j et seq.;
(b) The average cost in this State to obtain a Medicare
supplemental policy that provides comparable benefits to those
provided under the applicable plan of health insurance offered
under the Program;
(c) The average cost in this State to obtain coverage of
prescription drugs under Medicare Part D, 42 U.S.C. §§ 1395w-101
et seq.; and
(d) The average cost in this State to obtain dental and vision
coverage, other than limited coverage, through a Medicare
Advantage Plan under Medicare Part C, 42 U.S.C. §§ 1395w-21 et
seq.
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3. The Board may utilize the resources of the Authority,
including, without limitation, the Office of Data Analytics of the
Authority and persons and entities with which the Authority ha s
contracted, to prepare the report required by this section.
Sec. 66. NRS 287.012 is hereby amended to read as follows:
287.012 A governing body of a county, school district,
municipal corporation, political subdivision, public corporation or
other local governmental agency of the State of Nevada that provides
coverage of prescription drugs pursuant to NRS 287.010 or any issuer
of a policy of health insurance purchased pursuant to NRS 287.010
may use the list of preferred prescription drugs developed b y the
[Department of Health and Human Services ] Nevada Health
Authority pursuant to subsection 1 of NRS 422.4025 as its formulary
and obtain prescription drugs through the purchasing agreements
negotiated by the [Department] Authority pursuant to that section by
notifying the [Department] Authority in the form prescribed by the
[Department.] Authority.
Sec. 67. NRS 287.0402 is hereby amended to read as follows:
287.0402 As used in NRS 287.0402 to 287.049, inclusive, and
sections 64, 65 and 65.5 of this act, unless the context otherwise
requires, the words and terms defined in NRS 287.0404 to 287.04064,
inclusive, and sections 64 and 65 of this act, have the meanings
ascribed to them in those sections.
Sec. 68. NRS 287.041 is hereby amended to read as follows:
287.041 1. There is hereby created within the Authority the
Board of the Public Employees’ Benefits Program. The Board
consists of 11 members appointed as follows:
(a) Two members who are professional employees of the Nevada
System of Higher Education, appointed by the Governor upon
consideration of any recommendations of organizations that represent
employees of the Nevada System of Higher Education. One such
member must reside in northern Nevada and the other member m ust
reside in southern Nevada.
(b) Two members who are retired from public employment,
appointed by the Governor upon consideration of any
recommendations of organizations that represent retired public
employees.
(c) Two members who are employees in the classified or
unclassified service of the State, [appointed by the Governor upon
consideration of any recommendations of organizations that represent
state employees.] , with one such member appointed by the Senate
Majority Leader and the other appointed b y the Speaker of the
Assembly.
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(d) One member who is employed by this State in a managerial
capacity and has substantial and demonstrated experience in risk
management, group insurance programs, health care administration
or employee benefits programs appointed by the Governor.
(e) Two members who have substantial and demonstrated
experience in risk management, group insurance programs, health
care administration or employee benefits programs appointed by the
Governor.
(f) One member who is an employee i n the classified service of
the State, appointed by the Governor from a list of nominations of
[10] at least 3 classified state employees submitted by the labor
organization representing the largest number of classified state
employees participating in the Program.
(g) The Director of the Department of Administration or a
designee of the Director approved by the Governor.
2. Of the nine persons appointed to the Board pursuant to
paragraphs (a) to (e), inclusive, of subsection 1, at least four members
must have a bachelor’s degree or a more advanced degree, or
equivalent professional experience, in business administration,
economics, medicine, accounting, actuarial science, insurance, risk
management or health care administration, and at least two members
must have education or proven experience in the management of
employees’ benefits, insurance, risk management, health care
administration or business administration.
3. Each person appointed as a member of the Board must:
(a) Except for a member appoint ed pursuant to paragraph (e) of
subsection 1, have been a participant in the Program for at least 1 year
before the person’s appointment;
(b) Except for a member appointed pursuant to paragraph (e) of
subsection 1, be a current employee of the State of Nevada or another
public employer that participates in the Program or a retired public
employee who is a participant in the Program;
(c) Not be an elected officer of the State of Nevada or any of its
political subdivisions; and
(d) Not participate in any business enterprise or investment:
(1) With any vendor or provider to the Program; or
(2) In real or personal property if the Program owns or has a
direct financial interest in that enterprise or property.
4. In making appointments pursuant to subse ction 1, the
Governor, the Senate Majority Leader and the Speaker of
the Assembly shall coordinate to ensure that the membership of the
Board is diverse and, to the extent practicable, proportionally and
equitably represents the constituencies served by the Program.
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5. Except as otherwise provided in this subsection, after the
initial terms, the term of an appointed member of the Board is 4 years
and until the member’s successor is appointed and takes office unless
the member no longer possesses the qual ifications for appointment
set forth in this section or is removed by the [Governor.] appointing
authority. If a member loses the requisite qualifications within the
last 12 months of the member’s term, the member may serve the
remainder of the member’s te rm. If the labor organization that
submitted the name of the member appointed pursuant to paragraph
(f) of subsection 1 ceases to represent the largest number of classified
state employees participating in the Program during the member’s
term, the member c ontinues to serve for the remainder of his or her
unexpired term. Members are eligible for reappointment. A vacancy
occurring in the membership of the Board must be filled in the same
manner as the original appointment.
[5.] 6. The appointed members of the Board serve at the
pleasure of the [Governor.] appointing authority.
Sec. 68.5. NRS 287.0415 is hereby amended to read as follows:
287.0415 1. A majority of the members of the Board
constitutes a quorum for the transaction of business.
2. At the beginning of each calendar year, the Board shall elect
one of its members to serve as the Chair. The Governor shall
designate one of the members of the Board to serve as the Vice Chair.
3. The Board shall meet at least once every calendar quarter and
at other times upon the call of the Chair.
4. The Board may meet in closed session:
(a) To discuss matters relating to personnel;
(b) With investment counsel to plan future investments or
establish investment objectives and policies;
(c) With legal counsel to receive advice upon claims or suits by
or against the Program;
(d) To prepare a request for a proposal or other solicitation for
bids to be released by the Board for competitive bidding; or
(e) As otherwise provided pursuant to chapter 241 of NRS.
5. Except as otherwise provided in this subsection, if the Board
causes a meeting to be transcribed by a court reporter who is certified
pursuant to chapter 656 of NRS, the Board shall post a transcript of
the meeting on it s Internet website not later than 30 days after the
meeting. The Board shall post a transcript of a closed session of
the Board on its Internet website when the Board determines that the
matters discussed no longer require confidentiality and, if applicable,
the person whose character, conduct, competence or health was
discussed in the closed session has consented to the posting.
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6. The Board may appoint such advisory committees as it deems
necessary to assist the Board in carrying out its duties pursuan t to
NRS 287.0402 to 287.049, inclusive [.] , and sections 64, 65 and 65.5
of this act.
7. As used in this section, “request for a proposal” has the
meaning ascribed to it in subsection 8 of NRS 333.020.
Sec. 69. NRS 287.0424 is hereby amended to read as follows:
287.0424 1. The [Board] Director shall [employ] appoint an
Executive Officer, subject to the approval of the Governor. The
Board shall interview qualified candidates for the position of
Executive Officer and make recommendations to the Direc tor and
the Governor concerning the appointment. The Executive Officer is
in the unclassified service of the State and serves at the pleasure of
the [Board.] Governor. The Board may delegate to the Executive
Officer the exercise or discharge of any power, duty or function
vested in or imposed upon the Board.
2. The Executive Officer must:
(a) Be a graduate of a 4 -year college or university with a degree
in business administration , health sciences or public administration
or an equivalent degree, as determined by the [Board;] Director; and
(b) Possess at least 5 years’ experience in a high -level
administrative or executive capacity in the field of health care
administration, health insurance, management of employees’
benefits or risk management, includin g, without limitation,
responsibility for a variety of administrative functions such as
[personnel, accounting, data processing ] overseeing contracts, the
development of benefits under health insurance programs or the
management and structuring of health insurance programs.
3. Except as otherwise provided in NRS 284.143, the Executive
Officer shall not pursue any other business or occupation or perform
the duties of any other office of profit during normal office hours
unless on leave approved in advance. The Executive Officer shall not
participate in any business enterprise or investment:
(a) With any vendor or provider to the Program; or
(b) In real or personal property if the Program owns or has a direct
financial interest in that enterprise or property.
4. The Executive Officer [is entitled to an annual salary fixed by
the Board.] :
(a) Serves under the supervision of the Director; and
(b) Shall, as directed by the Director and the Board, manage the
operations of the Program and assist in developi ng innovative
purchasing and contracting strategies for providing services under
a program of insurance established pursuant to NRS 287.043.
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Sec. 70. NRS 287.0425 is hereby amended to read as follows:
287.0425 1. The Executive Officer shall submit a r eport
regarding the administration and operation of the Program to the
Board , the Director of the Authority and the Director of the Office
of Finance, and to the Director of the Legislative Counsel Bureau for
transmittal to the appropriate committees of the Legislature or, if the
Legislature is not in regular session, to the Legislative Commission
and the Interim Retirement and Benefits Committee of the Legislature
created by NRS 218E.420. The report must include, without
limitation:
(a) An audited financial statement of the Program Fund for the
immediately preceding fiscal year. The statement must be prepared
by an independent certified public accountant.
(b) An audited financial statement of the Retirees’ Fund for the
immediately preceding fiscal year. The statement must be prepared
by an independent certified public accountant.
(c) A report of the utilization of the Program by participants
during the immediately preceding plan year, segregated by benefit,
administrative cost, active employees and retirees, including, without
limitation, an assessment of the actuarial accuracy of reserves.
(d) Material provided generally to participants or prospective
participants in connection with enrollment in the Program for the
current plan year, including, without limitation:
(1) Information regarding rates and the costs for participation
in the Program paid by participants on a monthly basis; and
(2) A summary of the changes in the plan design for the
current plan year from the plan design for the immediately preceding
plan year.
2. The Executive Officer shall submit a biennial report to the
Board , the Director of the Authority, and the Director of the Office
of Finance, and to the Director of the Legislative Counsel Bureau for
transmittal to the appro priate committee or committees of the
Legislature. The report must include, without limitation:
(a) An independent biennial certified actuarial valuation and
report of the State’s health and welfare benefits for current and future
state retirees, which are provided for the purpose of developing the
annual required contribution pursuant to the statements issued by the
Governmental Accounting Standards Board.
(b) A biennial review of the Program to determine whether the
Program complies with federal and s tate laws relating to taxes and
employee benefits. The review must be conducted by an attorney who
specializes in employee benefits.
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Sec. 71. NRS 287.0426 is hereby amended to read as follows:
287.0426 1. The Executive Officer may, within the limits of
legislative appropriations and other available money [,] and subject
to the approval of the Director, appoint such officers and employees
as are necessary for the administration of the Program, who are in the
unclassified service of the State and serve at the pleasure of the
Executive Officer.
2. The Director of the Department of Administration shall
appoint a Quality Control Officer for the Program. The Director shall
define the duties of the Quality Control Officer with the concurrence
of the Board. The Quality Control Officer is in the unclassified
service of the State and serves at the pleasure of the Director.
3. Each officer appointed pursuant to subsection 1 or 2 who is
placed in charge of quality control, operations, finance or information
technology must be a graduate of a 4-year college or university with
a degree that is appropriate to their respective responsibilities or
possess equivalent experience.
4. The Executive Officer may employ such staff in the classified
service of the State as are necessary for the performance of the
Executive Officer’s duties, within limits of legislative appropriations
or other available money.
Sec. 72. NRS 287.043 is hereby amended to read as follows:
287.043 1. The Board shall:
(a) Establish and carry out a program to be known as the Public
Employees’ Benefits Program which:
(1) Must include a program relating to group life, accident or
health insurance, or any combination of these; and
(2) May include:
(I) A plan that offers flexibility in benefits, and for which
the rates must be based only on the experience of the participants in
the plan and not in combination with the experience of participants in
any other plan offered under the Program; or
(II) A program to reduce taxable compensati on or other
forms of compensation other than deferred compensation,
for the benefit of all state officers and employees and other persons
who participate in the Program.
(b) Ensure that the Program is funded on an actuarially sound
basis and operated in accordance with sound insurance and business
practices. To perform that duty, the Board may use actuarial
services or other appropriate services and resources provided by the
Authority or any contractor of the Authority.
(c) Within the limits of availabl e resources, maximize the
benefits available to participants in the Program and the ability of
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such participants to access available benefits to promote the
recruitment and retention of state employees, including, without
limitation, by establishing programs to ensure the provision of high
quality customer service to assist participants in navigating the
benefits available under the Program.
2. In establishing and carrying out the Program, the Board shall:
(a) For the purpose of establishing actuarial da ta to determine
rates and coverage for active and retired state officers and employees
and their dependents, commingle the claims experience of such active
and retired officers and employees and their dependents for whom the
Program provides primary health insurance coverage into a single risk
pool.
(b) Except as otherwise provided in this paragraph, negotiate and
contract pursuant to paragraph (a) of subsection 1 of NRS 287.025
with the governing body of any county, school district, municipal
corporation, political subdivision, public corporation or other local
governmental agency of the State of Nevada that wishes to obtain
exclusive group insurance for all of its active and retired officers and
employees and their dependents, except as otherwise provided in sub-
subparagraph (III) of subparagraph (2) of paragraph (h), by
participation in the Program. The Board shall establish separate rates
and coverage for active and retired officers and employees of those
local governmental agencies and their dependents based on actuarial
reports that commingle the claims experience of such active and
retired officers and employees and their dependents for whom the
Program provides primary health insurance coverage into a single risk
pool.
(c) Except as otherwise provided in paragraph (d), provide public
notice in writing of any proposed changes in rates or coverage to each
participating public agency that may be affected by the changes.
Notice must be provided at least 30 days before the effective date of
the changes.
(d) If a proposed change is a change in the premium or
contribution charged for, or coverage of, health insurance, provide
written notice of the proposed change to all participants in the
Program. The notice must be provided at least 30 days before the date
on which a participant in the Program is required to select or change
the participant’s policy of health insurance.
(e) Purchase policies of life, accident or health insurance, or any
combination of these, or, if applicable, a program to reduce the
amount of taxable compensation pursuant to 26 U.S.C. § 125, from
any company qualified to do business in this State or provide similar
coverage through a plan of self -insurance established pursuant to
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NRS 287.0433 for the benefit of all eligible participants in the
Program.
(f) Except as otherwise provided in this title, develop and
establish other employee benefits as necessary.
(g) Investigate and approve or disapprove any contract proposed
pursuant to NRS 287.0479.
(h) Adopt such regulations and perform su ch other duties as are
necessary to carry out the provisions of NRS 287.010 to 287.245,
inclusive, and sections 64, 65 and 65.5 of this act, including, without
limitation, the establishment of:
(1) Fees for applications for participation in the Program and
for the late payment of premiums or contributions;
(2) Conditions for entry and reentry into and exit from the
Program by local governmental agencies pursuant to paragraph (a) of
subsection 1 of NRS 287.025, which:
(I) Must include a minimum period of 4 years of
participation for entry into the Program;
(II) Must include a requirement that participation of any
retired officers and employees of the local governmental agency
whose last continuous period of enrollment with the Program began
after November 30, 2008, terminates upon termination of the local
governmental agency’s contract with the Program; and
(III) May allow for the exclusion of active and retired
officers and employees of the local governmental agency who are
eligible for hea lth coverage from a health and welfare plan or trust
that arose out of collective bargaining under chapter 288 of NRS or a
trust established pursuant to 29 U.S.C. § 186;
(3) Procedures by which a group of participants in the
Program may leave the Program pursuant to NRS 287.0479 and
conditions and procedures for reentry into the Program by those
participants;
(4) Specific procedures for the determination of contested
claims;
(5) Procedures for review and notification of the termination
of coverage of persons pursuant to paragraph (b) of subsection 4 of
NRS 287.023; and
(6) Procedures for the payments that are required to be made
pursuant to paragraph (b) of subsection 4 of NRS 287.023.
3. The Board may use any services provided to state agencies
and [shall] may use the services of the Authority for procurement in
accordance with section 24 of this act or the services of the
Purchasing Division of the Department of Administration to establish
and carry out the Program.
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4. The Board may engage the services of an attorney who
specializes in health plans and health care law as necessary to assist
in carrying out the Program.
5. The Board may make recommendations to the Legislature
concerning legislation that it deems necessary and appropriate
regarding the Program.
6. A participating public agency is not liable for any obligation
of the Program other than indemnification of the Board and its
employees against liability relating to the administration of the
Program, subject to the limitations specified in NRS 41.0349.
7. As used in this section, “employee benefits” includes any
form of compensation provided to a public employee except federal
benefits, wages earned, legal holidays, deferred compensation and
benefits available pursuant to chapter 286 of NRS.
Sec. 73. NRS 287.0433 is hereby amended to read as follows:
287.0433 1. The Board may establish a plan of life, accident
or health insurance and provide for the payment of contributions into
the Program Fund, a schedule of benefits and the d isbursement of
benefits from the Program Fund. The Board may reinsure any risk or
any part of such a risk.
2. If the Board provides coverage of prescription drugs pursuant
to this section, the Board or any entity with which the Board enters
into a contract to provide such coverage may use the list of preferred
prescription drugs developed by the [Department of Health and
Human Services ] Authority pursuant to subsection 1 of NRS
422.4025 as its formulary and obtain prescription drugs through the
purchasing agreements negotiated by the [Department] Authority
pursuant to that section by notifying the [Department] Authority in
the form prescribed by the [Department.] Authority.
Sec. 74. NRS 287.04345 is hereby amended to read as follows:
287.04345 1. [The] Except when using the procurement
services of the Authority pursuant to subsection 3 of NRS 287.043
or conducting procurement under the provisions of section 24 of
this act, the Program is subject to the provisions of chapter 333 of
NRS.
2. The Board s hall act as the chief of the using agency for the
purposes of NRS 333.335 [.] and may conduct procurement under
the provisions of section 24 of this act. The Board may delegate to
the Executive Officer any or all of the duties of a purchasing officer,
as defined in NRS 333.020, or any similar duties under section 24
of this act and the regulations adopted pursuant thereto. Such
delegable duties may include, without limitation, assisting a
committee to evaluate proposals for a contract for the Program
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established pursuant to NRS 333.335 or section 24 of this act , as
applicable, in evaluating proposals.
3. If a committee to evaluate proposals for a contract for the
Program is established pursuant to NRS 333.335 [, any number of
members] or section 24 of this act, at least one member of the Board
may be appointed to the evaluation committee. If one or more
members of the Board are appointed to an evaluation committee:
(a) No action or deliberation regarding any business of the Board
other than the confidential review of the proposals pursuant to NRS
333.335 or section 24 of this act, as applicable, may be taken or
conducted by the evaluation committee.
(b) Except as otherwise provided in paragraph (a), a meeting of
the evaluation committee is not subject to chapter 241 of NRS.
4. The Board shall review the results of any evaluation of
proposals for a contract for the Program pursuant to NRS 333.335 or
section 24 of this act, as applicable, in a closed meeting.
5. The Board shall take the following a ctions only in an open
meeting:
(a) Award the contract pursuant to NRS 333.335 [;] or section 24
of this act, as applicable;
(b) Cancel the request for proposals; or
(c) Modify and reissue the request for proposals.
Sec. 75. NRS 287.048 is hereby amended to read as follows:
287.048 NRS 287.0402 to 287.047, inclusive, and sections 64,
65 and 65.5 of this act do not require any officer or employee of the
State of Nevada to accept or join the Program, or to assign the
officer’s or employee’s wages or salary in payment of premiums or
contributions for the Program.
Sec. 76. NRS 287.0485 is hereby amended to read as follows:
287.0485 No officer, employee or retiree of this State has any
inherent right to benefits provided pursuant to NRS 287.0402 t o
287.049, inclusive [.] , and sections 64, 65 and 65.5 of this act.
Sec. 77. NRS 293.5768 is hereby amended to read as follows:
293.5768 1. The following agencies are automatic voter
registration agencies:
(a) The Department of Motor Vehicles;
(b) The Department of [Health and] Human Services;
(c) The Nevada Health Authority;
(d) Any agency designated by the Director of the [Department of
Health and Human Services ] Nevada Health Authority to receive
applications for Medicaid [;] pursuant to section 86 of this act;
[(d)] (e) The Silver State Health Insurance Exchange created by
NRS 695I.200;
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[(e)] (f) Any agency that has been designated by the Governor as
an automatic voter registration agency pursuant to NRS 293.57682;
and
[(f)] (g) Any agency of an Indian tribe that has been designated
by the Governor to be an automatic voter registration agency pursuant
to NRS 293.57684.
2. If, in the normal course of business, an automatic voter
registration agency collects sufficient informatio n that demonstrates
a person is qualified to vote pursuant to NRS 293.485, including,
without limitation, proof of identity, citizenship, residence and date
of birth, the provisions of NRS 293.5768 to 293.57699, inclusive,
apply to the automatic voter regi stration agency when a person
submits any of the following:
(a) An application for the issuance or renewal of or change of
address for any type of driver’s license or identification card issued
by the Department of Motor Vehicles;
(b) An application for Medicaid through the system established
by the [Department of Health and Human Services ] Nevada Health
Authority pursuant to NRS 422.2703;
(c) An application for health insurance through the Silver State
Health Insurance Exchange; and
(d) An application for any service or assistance from an automatic
voter registration agency described in paragraph [(e) or] (f) or (g) of
subsection 1.
3. An automatic voter registration agency shall not:
(a) Request any additional information for purposes of voter
registration that is not required in the normal course of business; and
(b) Transmit any information about a person using the system
established pursuant to NRS 293.57686 if the person did not provide
the agency in the normal course of business sufficient inf ormation
that demonstrates the person is qualified to vote pursuant to NRS
293.485, including, without limitation, proof of identity, citizenship,
residence and date of birth.
Sec. 78. NRS 293.57682 is hereby amended to read as follows:
293.57682 1. The Governor may designate any agency in the
Executive Department of the State Government not described in
paragraphs (a) to [(d),] (e), inclusive, of subsection 1 of NRS
293.5768 as an automatic voter registration agency if the agency
collects in the regu lar course of business from a person applying to
the agency to receive any service or assistance sufficient information
that demonstrates a person is qualified to vote pursuant to NRS
293.485, including, without limitation, proof of identity, citizenship,
residence and date of birth.
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2. Upon the designation of an agency as an automatic voter
registration agency pursuant to subsection 1:
(a) The Governor shall notify the Secretary of State; and
(b) The Secretary of State and the automatic voter registr ation
agency shall comply with the provisions of NRS 293.57686.
Sec. 79. NRS 333.020 is hereby amended to read as follows:
333.020 As used in this chapter, unless the context otherwise
requires:
1. “Administrator” means the Administrator of the Purch asing
Division.
2. “Best value” means the greatest possible economy consistent
with grades or qualities of supplies, materials, equipment and services
that are adapted to the purposes to be served.
3. “Director” means the Director of the Department of
Administration.
4. “Invitation to bid” means a written statement which sets forth
the requirements and specifications of a contract to be awarded by
competitive selection.
5. “Proprietary information” means:
(a) Any trade secret or confidential busine ss information that is
contained in a bid or proposal submitted on a particular contract; or
(b) Any other trade secret or confidential business information
submitted in a bid or proposal and designated as proprietary by the
Administrator.
As used in this subsection, “confidential business information”
means any information relating to the amount or source of any
income, profits, losses or expenditures of a person, including data
relating to cost or price submitted in support of a bid or proposal. The
term does not include the amount of a bid or proposal.
6. “Purchasing Division” means the Purchasing Division of the
Department of Administration.
7. “Purchasing officer” means a person who is authorized by the
Administrator or a using agency to facilitate:
(a) The evaluation of bids or proposals for a contract;
(b) Any negotiations concerning a contract; or
(c) The development, review or approval of a contract.
8. “Request for proposals” means a written statement which sets
forth the requirements and specifications of a contract to be awarded
by competitive selection.
9. “Trade secret” has the meaning ascribed to it in
NRS 600A.030.
10. “Using agencies” means all officers, departments, divisions,
institutions, boards, commissions and other agencies in the Executive
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Department of the State Government which derive their support from
public money in whole or in part, whether the money is provided by
the State of Nevada, received from the Federal Government or any
branch, bureau or agen cy thereof, or derived from private or other
sources. The term does not include [the] :
(1) The Nevada Rural Housing Authority, the Housing
Division of the Department of Business and Industry, local
governments as defined in NRS 354.474, conservation dis tricts,
irrigation districts and the Nevada System of Higher Education [.] ;
or
(2) Except to the extent provided in section 24 of this act, the
Nevada Health Authority.
11. “Volunteer fire department” means a volunteer fire
department which pays premiums for industrial insurance pursuant to
the provisions of chapters 616A to 616D, inclusive, or chapter 617 of
NRS.
Sec. 80. NRS 361.585 is hereby amended to read as follows:
361.585 1. When the time allowed by law for the redemption
of a property described in a certificate has expired and no redemption
has been made, the tax receiver who issued the certificate, or his or
her successor in office, shall execute and deliver to the county
treasurer a deed of the property in trust for the use and benefit of the
State and county and any officers having fees due them.
2. The county treasurer and his or her successors in office, upon
obtaining a deed of any property in trust under the provisions of this
chapter, shall hold that property in trust until it is sold or otherwise
disposed of pursuant to the provisions of this chapter.
3. Notwithstanding the provisions of NRS 361.595 or 361.603,
at any time during the 90-day period specified in NRS 361.603, or not
later than 5 p.m. on the third business day be fore the day of the sale
by a county treasurer, as specified in the notice required by NRS
361.595, of any property held in trust by him or her by virtue of any
deed made pursuant to the provisions of this chapter, any person
specified in subsection 4 is e ntitled to have the property reconveyed
upon the receipt by the county treasurer of payment by or on behalf
of that person of an amount equal to the taxes accrued, together with
any costs, penalties and interest legally chargeable against the
property. A reconveyance may not be made after expiration of the 90-
day period specified in NRS 361.603.
4. Property may be reconveyed pursuant to subsection 3 to one
or more of the persons specified in the following categories, or to one
or more persons within a par ticular category, as their interests may
appear of record:
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(a) The owner.
(b) The beneficiary under a note and deed of trust.
(c) The mortgagee under a mortgage.
(d) The creditor under a judgment.
(e) The person to whom the property was assessed.
(f) The person holding a contract to purchase the property before
its conveyance to the county treasurer.
(g) The Director of the [Department of Health and Human
Services] Nevada Health Authority if the owner has received or is
receiving any benefits from Medicaid.
(h) The successor in interest of any person specified in this
subsection.
(i) A municipality that holds a lien against the property.
5. The provisions of this section apply to land held in trust by a
county treasurer on or after April 17, 1971.
Sec. 81. NRS 387.1225 is hereby amended to read as follows:
387.1225 1. A hospital or other facility which is licensed by
the Health Care Purchasing and Compliance Division of [Public
and Behavioral Health of the Department of Health and Human
Services] the Nevada Health Authority that provides residential
treatment to children and which operates a private school licensed
pursuant to chapter 394 of NRS may request reimbursement from the
school district or charter school in which a child is enroll ed for the
cost of providing educational services to the child if:
(a) The school district or charter school verifies that the child is a
patient or resident of the hospital or facility; and
(b) The child attends the private school for more than 7 school
days.
2. A hospital or other facility licensed i n the District of
Columbia or any state or territory of the United States that provides
residential treatment and which operates an educational program
accredited by a national organization and approved by the
Department of Education may request reimbursement from the school
district or charter school in which a child is enrolled for
the cost of providing educational services to the child if:
(a) The Department and the school district or charter school, a s
applicable, verify that the child:
(1) Is a patient or resident of the hospital or facility; and
(2) Is a resident of this State; and
(b) The child:
(1) Is admitted to the hospital or facility on an order from a
physician because the necessary treatment required for the child is not
available in this State;
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(2) Attends the accredited educational program for more than
7 school days;
(3) Is not homeschooled or enrolled in a private school; and
(4) Has been admitted to the medical facility under the order
of a physician to receive medically necessary treatment for a medical
or mental health condition with which the child has been diagnosed.
3. A h ospital or other facility that wishes to receive
reimbursement pursuant to subsection 2 shall:
(a) Notify the Department and the school district or charter school
in which the child is enrolled upon admitting the child to the
accredited educational program; and
(b) Transfer any educational records of the child to the school
district or charter school in which the child is enrolled in accordance
with any applicable regulations adopted pursuant to subsection 9.
4. Upon receiving a request for reimbursemen t pursuant to
subsection 1 or 2, the school district or charter school in which the
child is enrolled shall determine the amount of reimbursement to
which the hospital or facility is entitled by multiplying the number of
days determined pursuant to subsect ion 6 by the following, as
applicable:
(a) The daily rate of the adjusted base per pupil funding for the
school district which the child would otherwise attend. The daily rate
of the adjusted base per pupil funding for the school district which
the child would otherwise attend must be calculated by dividing the
adjusted base per pupil funding provided to the school district in
which the child is enrolled pursuant to NRS 387.1214 by 180.
(b) The daily rate of the statewide base per pupil funding amount
or adjusted base per pupil funding, as applicable, for the charter
school which the child would otherwise attend. The daily rate of the
statewide base per pupil funding amount or adjusted base per pupil
funding, as applicable, for the charter school which the child would
otherwise attend must be calculated by dividing the statewide base
per pupil funding amount or adjusted base per pupil funding, as
applicable, provided to the charter school in which the child is
enrolled pursuant to NRS 387.1214 by 180.
5. If the request for reimbursement is made pursuant to
subsection 1, the child is a pupil with a disability and the hospital or
facility is in compliance with the Individuals with Disabilities
Education Act, 20 U.S.C. §§ 1400 et seq., NRS 388.417 to 388.5243,
inclusive, and any regulations adopted pursuant thereto, the hospital
or facility is also entitled to an amount determined by increasing the
daily rate determined pursuant to subsection 4 by the statewide
multiplier for the pupil established pursuant to NRS 387.122, which
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is received by the school district or charter school where the child was
enrolled before being placed in the hospital or facility for the number
of days determined pursuant to subsection 6. The Department shall
distribute the money withh eld from the school district or charter
school to the hospital or facility.
6. For the purposes of subsections 4 and 5, the amount of
reimbursement to which the hospital or facility is entitled must be
calculated on the basis of the number of school days the child is a
patient or resident of the hospital or facility and attends the private
school or accredited educational program, as applicable, excluding
the 7 school days prescribed in paragraph (b) of subsection 1 or
subparagraph (2) of paragraph (b) of subsection 2, as applicable.
7. A hospital or other facility is not entitled to reimbursement
for days of instruction provided to a child in a year in excess of the
minimum number of days of free school required by NRS 388.090.
8. If a hospital or oth er facility requests reimbursement from a
school district or charter school for the cost of providing educational
services to a pupil with a disability pursuant to subsection 1 or 2, the
school district or charter school in which the child is enrolled shall be
deemed to be the local educational agency for the child for the
purposes of the Individuals with Disabilities Education Act, 20
U.S.C. §§ 1400 et seq., NRS 388.417 to 388.5243, inclusive, and any
regulations adopted pursuant thereto.
9. The Department shall adopt any regulations necessary to
carry out the provisions of this section, which may include, without
limitation, regulations to:
(a) Prescribe a procedure for the transfer of educational records
pursuant to subsection 3;
(b) Carry out or ensure compliance with the requirements of
subsections 4 and 5 concerning reimbursement for educational
services provided to a pupil with a disability; and
(c) Require the auditing of:
(1) A hospital or other facility that requests reimbursement;
and
(2) A school district or charter school from which
reimbursement is requested,
pursuant to this section to ensure compliance with any applicable
provisions of federal or state law.
10. The provisions of this section must not be construed to
authorize reimbursement pursuant to this section of a hospital or
facility for the cost of health care services provided to a child.
11. As used in this section:
(a) “Hospital” has the meaning ascribed to it in NRS 449.012.
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(b) “Private school” has the meaning ascribed to it in
NRS 394.103.
Sec. 82. NRS 388.1336 is hereby amended to read as follows:
388.1336 1. The board of trustees of each school district shall
post on its Internet website and include in any written inform ational
materials related to pupil safety prepared by the school district
information regarding the statewide information and referral system
concerning health, [welfare,] public assistance, human and social
services created pursuant to NRS 232.359, includ ing the number
which may be used to access the system.
2. Each public school shall, to the extent money is available,
post information regarding the statewide information and referral
system concerning health, [welfare,] public assistance, human and
social services created pursuant to NRS 232.359, including the
number which may be used to access the system, in each restroom of
the public school which is available for use by pupils.
Sec. 83. NRS 396.908 is hereby amended to read as follows:
396.908 1. The Medical Education Council of Nevada is
hereby established within the University of Nevada School of
Medicine to ensure that Nevada has an adequate, well-trained health
care workforce to meet the needs of the residents of this State. The
Medical Education Council of Nevada shall:
(a) Determine the workforce needs for the provision of health
care services in this State;
(b) Determine the number and types of positions of employment
for which money appropriated to the Medical Education Council of
Nevada may be used, including, without limitation, positions for
practitioners, other providers of health care and other personnel to
staff health care facilities and programs;
(c) Investigate and make recommendations to the University of
Nevada School of Medici ne and the Legislature on the status and
needs of practitioners, other providers of health care and other
personnel of health care facilities or programs;
(d) Determine a method for reimbursing institutions that sponsor
practitioners, other providers of h ealth care or other personnel of
health care facilities or programs;
(e) To the extent authorized by federal law, prepare and submit a
formal application to the Centers for Medicare and Medicaid Services
of the United States Department of Health and Human Services for
the purpose of receiving and dispersing federal money for graduate
medical education expenses;
(f) Distribute a portion of any money it receives for graduate
medical education expenses in a manner that:
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(1) Prepares postgraduate medical an d dental residents, as
defined by the Accreditation Council for Graduate Medical
Education, to provide inpatient, outpatient and hospital services in
various communities and in geographically diverse settings;
(2) Encourages the coordination of interdisc iplinary clinical
training by practitioners and other providers of health care to such
postgraduate medical and dental residents; and
(3) Promotes funding for accredited clinical training programs
provided by practitioners or other providers of health ca re to such
postgraduate medical and dental residents;
(g) Apply for grants, gifts and donations from public and private
sources, including the Federal Government, to carry out the
objectives of the Medical Education Council of Nevada;
(h) Initiate a coop erative agreement with the [Department of
Health and Human Services ] Nevada Health Authority to promote
the intergovernmental transfer of money for the purposes of receiving
and dispersing money to carry out the objectives of the Medical
Education Council of Nevada; and
(i) Distribute additional financial resources to training programs
for practitioners, other providers of health care or other personnel of
health care facilities or programs in the State.
2. Any gift, donation, bequest, grant or other source of money
received by the Medical Education Council of Nevada may be used
to carry out the provisions of this section.
3. As used in this section, “practitioner” has the meaning
ascribed to it in NRS 439A.0195.
Sec. 84. Chapter 422 of NRS is hereby amended by adding
thereto the provisions set forth as sections 85 to 91, inclusive, of this
act.
Sec. 85. “Authority” means the Nevada Health Authority.
Sec. 86. 1. The Authority may delegate to another state ,
local or tribal governmental agency the responsibility for making
determinations concerning eligibility for Medicaid or the
Children’s Health Insurance Program or conducting hearings
under this chapter. If the Authority makes such a delegation, the
Authority shall:
(a) Ensure compliance with the provisions of 42 C.F.R. §
431.10; and
(b) Submit a biennial report to the Governor and the Director
of the Legislative Counsel Bureau for transmittal to the Legislative
Commission which includes:
(1) The state, local or tribal governmental agencies to which
the Authority has delegated functions;
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(2) The functions delegated to each state , local or tribal
governmental agency described in subparagraph (1);
(3) Information concerning the performance of each state ,
local or t ribal governmental agency to which the Authority has
delegated a function; and
(4) A description of any corrective action required of a state,
local or tribal governmental agency to which the Authority has
delegated a function.
2. Any entity to which the Authority delegates a responsibility
pursuant to subsection 1 shall comply with the relevant provisions
of this chapter to the same extent as the Authority.
3. Any delegation to a local governmental agency pursuant to
subsection 1 must be made through an intergovernmental
agreement between the Authority and the local governmental
agency. Such an agreement must be signed by a natural person
acting as the agent of the local governmental agency who has the
legal authority to bind the local governmental ag ency to the
agreement.
4. If an intergovernmental agreement entered into pursuant to
subsection 3 delegates the responsibility for making determinations
concerning eligibility for Medicaid or the Children’s Health
Insurance Program, the agreement must in clude, without
limitation, measures to ensure compliance with applicable federal
and state requirements for making such determinations of
eligibility.
5. The Authority may seek any state or federal funding
available to provide reimbursements to an entity to which the
Authority has delegated functions pursuant to this section if the
Authority has entered into an agreement with the entity that entitles
the Authority to sufficient information to conduct regular audits of
the delegated activities to ensure compliance with relevant state and
federal requirements and the efficient use of funds. An entity to
which functions are delegated pursuant to this section shall not use
state or federal money to fund activities under a contract with a
separate entity without written approval from the Director.
Sec. 86.5. (Deleted by amendment.)
Sec. 87. 1. The Office of the Medicaid Inspector General is
hereby created within the Authority.
2. The Office shall:
(a) Establish policies and protocols to ensure the integrity of
reimbursement under Medicaid and the participation of providers
in Medicaid and the Children’s Health Insurance Program;
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(b) Review providers of services under Medicaid and the
Children’s Health Insurance Program, the enrollment of such
providers and the revalidation of such providers;
(c) Review, audit and investigate providers of services under
Medicaid and the Children’s Health Insurance Program:
(1) To ensure compliance with applicable state and federal
requirements; and
(2) Upon an a llegation of waste, fraud or abuse against a
provider;
(d) Make recommendations to the Authority regarding the
prevention and detection of fraud, waste and abuse in Medicaid and
the Children’s Health Insurance Program;
(e) Take such actions as are necess ary to maximize the ability
of the Authority to prevent and recover improper reimbursements
and other improper payments to providers; and
(f) Perform such other duties as delegated by the Director.
3. On or before October 1 of each year, the Office shall:
(a) Compile a report on the activities of the Office during the
immediately preceding fiscal year which must include, without
limitation:
(1) The number of investigations and administrative actions
initiated pursuant to this chapter during the immediately preceding
fiscal year, the subject of each such investigation or administrative
action and a description of each such investigation or
administrative action;
(2) A summary of the outcome and type of each completed
investigation or administrative action;
(3) The number of referrals for prosecution to the Medicaid
Fraud Control Unit established within the Office of the Attorney
General pursuant to NRS 228.410 and other law enforcement
agencies, the subject of each such referral and a description of each
such referral; and
(b) Submit the report to the Director, the Governor and the
Director of the Legislative Counsel Bureau for transmittal to:
(1) In odd -numbered years, the Joint Interim Standing
Committee on Health and Human Services and the Joint Interim
Standing Committee on Judiciary; and
(2) In even-numbered years, the next regular session of the
Legislature.
Sec. 88. Each application for Medicaid must include a
statement that:
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1. Any assistance paid on behalf of a recipient may be
recovered in an action filed against the estate of the recipient or the
spouse of the recipient; and
2. Any person who signs an application for Medicaid and fails
to report to the Authority or the entity to which the Authority has
delegated eligibility d eterminations pursuant to section 86 of this
act:
(a) Any required information which the recipient knew at the
time the recipient signed the application; or
(b) Within the period allowed by the Authority or delegate, as
applicable, any required informati on which the recipient obtained
after the recipient filed the application,
may be personally liable for any money incorrectly paid to the
recipient.
Sec. 89. 1. If the Authority or the entity to which the
Authority has delegated eligibility determinat ions pursuant to
section 86 of this act denies an application for the Children’s Health
Insurance Program, the Authority or delegate, as applicable, shall
provide written notice of the decision to the applicant. An applicant
who disagrees with the denial o f the application may request a
review of the case and a hearing before an impartial hearing officer
by filing a written request within 30 days after the date of the notice
of the decision at the address specified in the notice.
2. The Authority shall adopt regulations regarding the review
and hearing before an impartial hearing officer. The decision of the
hearing officer must be in writing.
3. The applicant may, at any time within 30 days after the date
on which the written decision is mailed, petition the district court of
the judicial district in which the applicant resides to review the
decision. The district court shall review the decision on the record.
The decision and record must be certified as correct and filed with
the court by the Director.
4. The review by the court must be in accordance with
NRS 422.279.
Sec. 90. Notwithstanding any other provision of this chapter,
the Authority shall not, pursuant to this chapter, deny, reduce,
discontinue or terminate benefits under Medicaid or insurance
under the Children’s Health Insurance Program in violation of any
requirement of federal law or condition to the receipt of federal
money.
Sec. 91. 1. The Authority shall provide benefits under
Medicaid or insurance under the Children’s Health Insurance
Program to a qualified person who is not a citizen or national of the
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United States who complies with the requirements established by
the Authority pursuant to federal law and this chapter for the
receipt of benefits pursuant to that program.
2. A person who is not a citizen or national of the United States
is considered “qualified” for the purposes of subsection 1 if the
person meets the requirements of 8 U.S.C. § 1641(b).
Sec. 92. NRS 422.001 is hereby amended to read as follows:
422.001 As used in this chapter, unless the context otherwise
requires, the words and terms defined in NRS 422.003 to 422.054,
inclusive, and section 85 of this act have the meanings ascribed to
them in those sections.
Sec. 93. NRS 422.040 is hereby amended to read as follows:
422.040 “Director” means the Director of the [Department.]
Authority.
Sec. 94. NRS 422.041 is hereby amended to read as follows:
422.041 “Division” means the Medicaid Division of [Health
Care Financing and Policy of] the [Department.] Authority.
Sec. 95. NRS 422.061 is hereby amended to read as follows:
422.061 The purposes of the Division are:
1. To ensure that the Medicaid provided by this State and the
insurance provided pursuant to the Children’s Health Insurance
Program in this State are provided in the manner that is most efficient
to this State.
2. To evaluate alternative methods of providing Medicaid and
providing insurance pursuant to the Children’s Health Insurance
Program [.] that promote improved health outcomes and value-
based care.
3. To review Medicaid, the Children’s Health Insurance
Program and other health programs of this State to determine the
maximum amount of money that is available from the Federal
Government for such programs.
4. To [promote access to quality health care for all residents of
this State.
5. To restrain the growth of the cost of health care in this State.]
ensure compliance with federal and state laws governing Medicaid
and the Children’s Health Insurance Program.
5. To support the participation of providers of health care in
Medicaid and the Children’s Health Insurance Program to meet the
needs of recipients of Medicaid and insurance provided pursuant to
the Children’s Health Insurance Program.
6. To promote the sustainability of Medicaid and the
Children’s Health Insurance Program by leveraging all federal
funding available for those programs and otherwise ensuring that
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the public money of this State allocated to those programs is used
efficiently and effectively.
Sec. 96. NRS 422.063 is hereby amended to read as follows:
422.063 1. The Director shall adopt each state plan required
by the Federal Government, either directly or as a condition to the
receipt of federal money, for the administration of [any public
assistance] Medicaid, the Children’s Health Insurance Program or
any other program for which the Division is responsible. Such a plan
must set forth, regarding the particular program to which the plan
applies:
(a) The requirements for eligibility;
(b) The nature and amounts of grants and other assistance which
may be provided;
(c) The conditions imposed; and
(d) Such other provisions relating to the development and
administration of the program as the Director deems necessary.
2. In developing and revising such a p lan, the Director shall
consider, among other things:
(a) The amount of money available from the Federal
Government;
(b) The conditions attached to the acceptance of that money; and
(c) The limitations of legislative appropriations and
authorizations,
for the particular program to which the plan applies.
3. The Division shall comply with each state plan adopted
pursuant to this section.
Sec. 97. NRS 422.065 is hereby amended to read as follows:
422.065 1. Notwithstanding any other provision of s tate [or
local] law, [a person or governmental entity that provides a state or
local public benefit:] the Authority:
(a) Shall comply with the provisions of 8 U.S.C. § 1621 regarding
the eligibility of a person who is not a citizen or national of the United
States for [such a benefit.] benefits under Medicaid or the Children’s
Health Insurance Program.
(b) Is not required to pay any costs or other expenses relating to
the provision of [such] a benefit [after July 1, 1997,] under Medicaid
or the Children’s Health Insurance Program to a person who is not
a citizen or national of the United States who, pursuant to 8 U.S.C. §
1621, is not eligible for the benefit.
2. Compliance with the provisions of 8 U.S.C. § 1621 must not
be construed to constitute any form of discrimination, distinction or
restriction made, or any other action taken, on the basis of national
origin.
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[3. As used in this section, “state or local public benefit” has the
meaning ascribed to it in 8 U.S.C. § 1621.]
Sec. 98. NRS 422.151 is hereby amended to read as follows:
422.151 1. The Medical Care Advisory Committee is hereby
created within the Division.
2. The function of the Medical Care Advisory Committee is to:
(a) Advise the Division regarding the provision of services for the
health and medical care of [welfare] recipients [.] of Medicaid and
insurance through the Children’s Health Insurance Program.
(b) Participate, and increase the participation of [welfare]
recipients [,] of Medicaid and insurance through the Children’s
Health Insurance Program, in the development of policy and the
administration of programs by the Division.
Sec. 99. NRS 422.185 is hereby amended to read as follows:
422.185 1. A reinves tment advisory committee is hereby
established in each county whose population is 700,000 or more.
2. A reinvestment advisory committee consists of the following
members:
(a) The Administrator, who serves as a voting member;
(b) The following voting members, appointed by the Director:
(1) The director of a social services agency of the county;
(2) A representative of the government of the county;
(3) Two members who represent the government of different
cities whose population is 100,000 or more that are located in the
county;
(4) Two members who represent nonprofit organizations that
work with recipients of Medicaid who reside in the county and
receive health care services through managed care; and
(5) One member who represents the Division of [Welfare and
Supportive] Social Services of the Department [;] of Human
Services; and
(c) Other persons that the Director deems necessary or
appropriate to serve as nonvoting members.
3. The members appointed to a reinvestment advisory
committee pursuant to paragraphs (b) and (c) of subsection 2 serve at
the pleasure of the Director.
4. The members of a reinvestment advisory committee serve
without compensation and are not entitled to the per diem allowance
and travel expenses provided for state officers and employees
generally.
5. Any member of a reinvestment advisory committee who is a
public employee must be granted administrative leave from his or her
duties to engage in the business of the committee without loss of his
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or her regular compensation. Such leave does not reduce the amount
of the member’s other accrued leave.
Sec. 100. NRS 422.205 is hereby amended to read as follows:
422.205 1. A reinvestment advisory committee shall:
(a) Solicit and review reports from the Division and Medicaid
managed care organizations concerning the reinvestment of funds by
those Medicaid managed care organizations in the communities
served by the Medicaid managed care organizations.
(b) Report to the Division and Medicaid managed care
organizations concerning initiatives of local governments in the
county to address homelessness, housing issues and social
determinants of health.
(c) Make recommendations based on the reports reviewed
pursuant to paragraph (a) to the Division and Medicaid managed care
organizations concerning the reinvestment of funds by those
Medicaid managed care organizations in the communities served by
the Medicaid managed care organizations. Those recommendations
must include, without limitation, recommendations for the use of such
funds for the purposes of:
(1) Developing innovative partnerships with community
development organizations and providers of housing services; and
(2) Supporting the initiatives of local governments in the
county to address homelessness, housing issues and social
determinants of health.
2. On or before December 31 of each year, a reinvestment
advisory committee shall:
(a) Compile a report concerning:
(1) The uses of funds reinvested by Medicaid managed care
organizations in the communities served by those Medicaid managed
care organizations, including, without limitation, efforts to address
homelessness, disparities in health care and social determinants of
health; and
(2) The activities of the reinvestment advisory committee
during the c alendar year, including, without limitation, the
recommendations made by the reinvestment advisory committee
pursuant to paragraph (c) of subsection 1.
(b) Submit the report to:
(1) The Director of the Legislative Counsel Bureau for
transmittal to:
(I) In odd -numbered years, the Joint Interim Standing
Committee on Health and Human Services; and
(II) In even-numbered years, the next regular session of the
Legislature.
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(2) The Director of the [Department.] Authority.
3. As used in this section, “Medicaid managed care
organization” means a managed care organization that provides
health care services to recipients of Medicaid who reside in the county
for which a reinvestment advisory committee is established.
Sec. 101. NRS 422.2354 is hereby amended to read as follows:
422.2354 The Administrator must:
1. Be appointed on the basis of his or her training, education,
experience and interest in the financing of programs for public health,
including, without limitation, the financing of Me dicaid. In
appointing the Administrator, the Director shall, to the extent
practicable, give preference to a person who has a degree in a field of
public administration, public health, business administration or a
related field.
2. Have not less than 3 y ears of demonstrated successful
experience in the financing of health care or other public programs,
and not less than 1 year of experience relating to Medicaid, or any
equivalent combination of training and experience.
3. Possess qualities of leadership in the fields of health care and
the financing of health care.
Sec. 102. NRS 422.2356 is hereby amended to read as follows:
422.2356 The Administrator:
1. Shall serve as the Executive Officer of the Division [.] under
the supervision of the Director.
2. Shall establish policies for the administration of the programs
of the Division [,] in a manner that ensures compliance with state
and federal law and shall administer all activities and services of the
Division in accordance with those policies and any regulations of the
[Administrator,] Director, subject to [administrative] supervision by
the Director.
3. Shall oversee the operations of Medicaid and the Children’s
Health Insurance Program, including, without limitation, the
administration of benefits, the reimbursement of providers and the
oversight and administration of the system for delivering benefits
under Medicaid and the Children’s Health Insurance Program.
4. Is responsible for the management of the Division.
Sec. 103. NRS 422.2357 is hereby amended to read as follows:
422.2357 The Administrator and the Division shall administer
the provisions of this chapter, subject to [administrative] supervision
by the Director.
Sec. 104. NRS 422.2364 is hereby amended to read as follows:
422.2364 The Administrator:
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1. May , subject to the approval of the Director, establish,
consolidate and abolish sections within the Division [.] as necessary
to operate the programs for which the Division is responsible more
efficiently and effectively.
2. Shall organize the Division to comply with the requirements
of this chapter and with the standards required by federal legislation,
subject to approval by the Director.
3. Shall appoint the heads of the sections of the Division.
4. May employ such assistants and employees as may be
necessary for the efficient operation of the Division.
5. Shall set standards of service.
Sec. 105. NRS 422.2366 is hereby amended to read as follows:
422.2366 1. The [Administrator] Director or a designated
representative may administer oaths and take testimony thereunder
and issue subpoenas requiring the attendance of witnesses before the
[Division] Authority at a designated time and place and the
production of books, papers and records relative to:
(a) Eligibility or continued eligibility to provide medical care,
remedial care or other services pursuant to the State Plan for Medicaid
or the Children’s Health Insurance Program;
(b) Verification of treatment and payments to a provider of
medical care, remedial care or other services pursuant to the State
Plan for Medicaid or the Children’s Health Insurance Program; and
(c) Recovery of Medicaid benefits paid on behalf of a recipient of
medical care, remedial care or other serv ices pursuant to the State
Plan for Medicaid or the Children’s Health Insurance Program.
2. The Director or a representative designated by the Director
may administer oaths and take testimony thereunder and issue
subpoenas requiring the attendance of wit nesses before the
Authority at a designated time and place and the production of
books, papers and records relative to verification of treatment and
payments to a provider of medical care, remedial care or other
services pursuant to the State Plan for Medicaid.
3. If a witness fails to appear or refuses to give testimony or to
produce books, papers and records as required by the subpoena, the
district court of the county in which the investigation is being
conducted may compel the attendance of the witnes s, the giving of
testimony and the production of books, papers and records as required
by the subpoena.
Sec. 106. NRS 422.2368 is hereby amended to read as follows:
422.2368 The [Administrator] Director may adopt such
regulations as are necessary for the administration of this chapter.
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Sec. 107. NRS 422.23685 is hereby amended to read as
follows:
422.23685 1. The [Administrator] Director shall include in
the regulations adopted pursuant to NRS 422.2368 a provision
prohibiting the State from:
(a) Denying, limiting or seeking reimbursement from an insured
for care related to an organ transplant because the insured is a person
with a disability;
(b) Denying a person with a disability eligibility or continued
eligibility to enroll or renew coverage to avoid providing coverage in
accordance with this section;
(c) Reducing or limiting the reimbursement of or otherwise
penalizing a provider of medical or related services because the
provider of medical or related services acted in accordance with NRS
460.160; or
(d) Providing monetary or nonmonetary incentives for a provider
of medical or related services to induce the provider of medical or
related services to provide care to an insured in a manner inconsistent
with NRS 460.160.
2. As used in this section:
(a) “Disability” has the meaning ascribed to it in 42 U.S.C. §
12102(1).
(b) “Provider of medical or related services” has the meaning
ascribed to it in NRS 460.160.
Sec. 108. NRS 422.2369 is hereby amended to read as follows:
422.2369 1. Before [adopting, amending or repealing ] the
Director adopts, amends or repeals any regulation for the
administration of a program of public assistance or any other program
for which the Division is responsible, the [Administrator] Director or
his or her delegate must give at least 30 days’ notice of the intended
action.
2. The notice of intent to act upon a regulation must:
(a) Include a statement of the need for and purpose of the
proposed regulation, and either the terms or substance of the proposed
regulation or a description of the subjects and issues involved, and of
the time when, the place where and the manner in which interested
persons may present their views thereon.
(b) Include a statement identifying the entities that may be
financially aff ected by the proposed regulation and the potential
financial impact, if any, upon local government.
(c) State each address at which the text of the proposed regulation
may be inspected and copied.
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(d) Be mailed to all persons who have requested in writin g that
they be placed upon a mailing list, which must be kept by the
[Administrator] Director or his or her delegate for that purpose.
3. All interested persons must be afforded a reasonable
opportunity to submit data, views or arguments upon a proposed
regulation, orally or in writing. The [Administrator] Director or his
or her delegate shall consider fully all oral and written submissions
relating to the proposed regulation.
4. The [Administrator] Director or his or her delegate shall
keep, retain and make available for public inspection written minutes
and an audio recording or transcript of each public hearing held
pursuant to this section in the manner provided in NRS 241.035. A
copy of the minutes or audio recordings must be made available to a
member of the public upon request at no charge pursuant to
NRS 241.035.
5. An objection to any regulation on the ground of
noncompliance with the procedural requirements of this section may
not be made more than 2 years after its effective date.
Sec. 109. NRS 422.2372 is hereby amended to read as follows:
422.2372 The Administrator shall:
1. Supply the Director with material on which to base proposed
legislation.
2. Cooperate with the Federal Government and state
governments for the more effective attainment of the purposes of this
chapter.
3. Coordinate the activities of the Division with other agencies,
both public and private, with related or similar activities.
4. Keep a complete and accurate record of all proceedings,
record and file all bonds and contracts, and assume responsibility for
the custody and preservation of all papers and documents pertaining
to the [office of the Administrator.] Division.
5. Inform the public in regard to the activities and operation of
the Division, and provi de other information which will acquaint the
public with the financing of Medicaid programs.
6. Conduct studies into the causes of the social problems with
which the Division is concerned.
7. Invoke any legal, equitable or special procedures for the
enforcement of orders issued by the [Administrator] Director or the
enforcement of the provisions of this chapter.
8. Exclude from participation in Medicaid any provider of
health care that fails to comply with the requirements of state law.
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9. Exercise any other powers that are necessary and proper for
the standardization of state work, to expedite business and to promote
the efficiency of the service provided by the Division.
Sec. 110. NRS 422.2372 is hereby amended to read as follows:
422.2372 The Administrator shall:
1. Supply the Director with material on which to base proposed
legislation.
2. Cooperate with the Federal Government and state
governments for the more effective attainment of the purposes of this
chapter.
3. Coordinate the activities of the Division with other agencies,
both public and private, with related or similar activities.
4. Keep a complete and accurate record of all proceedings,
record and file all bonds and contracts, and assume responsibility for
the custody and preservation of all papers and documents pertaining
to the Division.
5. Inform the public in regard to the activities and operation of
the Division, and provide other information which will acquaint the
public with the financing of Medicaid programs.
6. Conduct studies into the causes of the social problems with
which the Division is concerned.
7. Invoke any legal, equitable or special procedures for the
enforcement of orders issued by the Director or the enforcement of
the provisions of this chapter.
8. Exclude from participation in Medicaid any provider of health
care that fails to comply with the requirements of state law [.
9. Exclude from participation in Medicaid any provider of health
care that fails to comply with the requirements of ] , includi ng,
without limitation, NRS 695K.230.
[10.] 9. Exercise any other powers that are necessary and proper
for the standardization of state work, to expedite business and to
promote the efficiency of the service provided by the Division.
Sec. 111. NRS 422.2374 is hereby amended to read as follows:
422.2374 1. The [Administrator] Director or his or her
delegate shall:
(a) Promptly comply with a request from the Unit for access to
and free copies of any records or other information in the possession
of the Division regarding a provider;
(b) Refer to the Unit all cases in which the [Administrator]
Director or his or her delegate suspects that a provider has
committed an offense pursuant to NRS 422.540 to 422.570, inclusive;
and
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(c) Suspend or exclude a provider who the [Administrator]
Director or his or her delegate determines has committed an offense
pursuant to NRS 422.540 to 422.570, inclusive, from participation as
a provider or an employee of a provider, for a minimum of 3 years. A
criminal action need not be brought against the provider before
suspension or exclusion pursuant to this subsection.
2. As used in this section:
(a) “Provider” means a person who has applied to participate or
who participates in the State Plan for Medicaid as the prov ider of
goods or services.
(b) “Unit” means the Medicaid Fraud Control Unit established in
the Office of the Attorney General pursuant to NRS 228.410.
Sec. 112. NRS 422.240 is hereby amended to read as follows:
422.240 1. Money to carry out the provisions of this chapter,
including, without limitation, any federal money allotted to the State
of Nevada pursuant to the State Plan for Medicaid, the Children’s
Health Insurance Program or any other program for which the
[Division] Director is responsible must, except as otherwise provided
in NRS 422.3755 to 422.379, inclusive, and 439.630, be provided by
appropriation by the Legislature from the State General Fund.
2. Disbursements for the purposes of this chapter must, except
as otherwise provided in NRS 422.3755 to 422.379, inclusive, and
439.630, be made upon claims duly filed and allowed in the same
manner as other money in the State Treasury is disbursed.
Sec. 113. NRS 422.242 is hereby amended to read as follows:
422.242 1. Any gifts or grants of money which the Division is
authorized to accept must be deposited in the State Treasury to the
credit of the Gift and Cooperative Account of the Medicaid Division
[of Health Care Financing and Policy] which is hereby created in the
[Department of Health and Human Services’ ] Nevada Health
Authority Gift Fund.
2. Money in the Account must be used for health care purposes
only and expended in accordance with the terms of the gift or grant.
3. All claims must be approved by the [Administrator] Director
or his or her delegate before they are paid.
Sec. 114. NRS 422.260 is hereby amended to read as follows:
422.260 1. The State of Nevada assents to the purposes of the
Act of Congress of the United States entitled the “Social Security
Act,” approved August 14, 1935, and assents to such additional
federal legislation as is not inconsistent with the purposes of this
chapter . [and NRS 432.010 to 432.085, inclusive.]
2. The State of Nevada further accepts, with the approval of the
Governor, the appropriations of money by Congress in pursuance of
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the provisions of the Social Security Act that relate to Medicaid and
the Children’s Health Insurance Program and authorizes the receipt
of such money into the State Treasury for the use of the [Department]
Authority in accordance with this chapter [, NRS 432.010 to 432.085,
inclusive,] and the conditions imposed by the Social Security Act.
3. The State of Nevada may accept, with the approval of the
Governor, any additional funds which may become or are made
available for extension of programs and services administered by the
[Department] Authority under the provisions of the Social Security
Act. Such money must be deposited in the State Treasury for the use
of the [Department] Authority in accordance with this chapter [,
NRS 432.010 to 432.085, inclusive,] and the conditions and purposes
under which granted by the Federal Government.
Sec. 115. NRS 422.265 is hereby amended to read as follows:
422.265 If Congress passes any law increasing the participation
of the Federal Government in any program for which the [Division]
Authority is responsible, whether relating to eligibility for assistance
or otherwise:
1. The Director may accept, with the approval of the Governor,
the increased benefits of such congressional legislation; and
2. The [Administrator] Director may adopt any regulations
required by the Federal Government as a condition of acceptance.
Sec. 116. NRS 422.267 is hereby amended to read as follows:
422.267 1. The Director shall have the power to sign and
execute, in the name of the State, by “The [Department of Health and
Human Services,” ] Nevada Health Authority” any contract or
agreement with the Federal Government or its agencies.
2. Any contract that obligates this State to expend federal
funding provided under Title XIX of the Social Security Act must
be signed by the Director. Any contract that obligates this State to
spend such money which does not mee t the requirements of this
subsection is void.
Sec. 117. NRS 422.270 is hereby amended to read as follows:
422.270 The [Department] Authority shall:
1. Administer Medicaid and the Children’s Health Insurance
Program.
2. Act as the single state agency of the State of Nevada and its
political subdivisions in the administration of any federal money
granted to the State of Nevada to aid in the furtherance of Medicaid
and the Children’s Health Insurance Program.
3. Cooperate with the Federal Govern ment in adopting state
plans, in all matters of mutual concern, including adoption of methods
of administration found by the Federal Government to be necessary
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for the efficient operation of Medicaid and the Children’s Health
Insurance Program and in increasing the efficiency of Medicaid and
the Children’s Health Insurance Program by prompt and judicious use
of new federal grants which will assist the [Department] Authority in
carrying out the provisions of this chapter.
4. Observe and study the changing nature and extent of needs
for Medicaid and the Children’s Health Insurance Program and
develop through tests and demonstrations effective ways of meeting
those needs and employ or contract for personnel and services
supported by legislative appropriations from the State General Fund
or money from federal or other sources.
5. Enter into reciprocal agreements with other states relative to
Medicaid and institutional care, when deemed necessary or
convenient by the Director.
Sec. 118. NRS 422.273 is hereby amended to read as follows:
422.273 1. For any Medicaid managed care program
established in the State of Nevada, the [Department] Authority shall
contract only with a health maintenance organization that has:
(a) Negotiated in good faith with a federally-qualified health
center to provide health care services for the health maintenance
organization;
(b) Negotiated in good faith with the University Medical Center
of Southern Nevada to provide inpatient and ambulatory services to
recipients of Medicaid; and
(c) Negotiated in good faith with the University of Nevada School
of Medicine to provide health care services to recipients of Medicaid.
Nothing in this section shall be construed as exempting a federally-
qualified health center, the Unive rsity Medical Center of Southern
Nevada or the University of Nevada School of Medicine from the
requirements for contracting with the health maintenance
organization.
2. During the development and implementation of any Medicaid
managed care program, the [Department] Authority shall cooperate
with the University of Nevada School of Medicine by assisting in the
provision of an adequate and diverse group of patients upon which
the school may base its educational programs.
3. The University of Nevada School of Medicine may establish
a nonprofit organization to assist in any research necessary for the
development of a Medicaid managed care program, receive and
accept gifts, grants and donations to support such a program and assist
in establishing educational services about the program for recipients
of Medicaid.
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4. For the purpose of contracting with a Medicaid managed care
program pursuant to this section, a health maintenance organization
is exempt from the provisions of NRS 695C.123.
5. The provisions o f this section apply to any managed care
organization, including a health maintenance organization, that
provides health care services to recipients of Medicaid under the State
Plan for Medicaid or the Children’s Health Insurance Program
pursuant to a cont ract with the Division. Such a managed care
organization or health maintenance organization is not required to
establish a system for conducting external reviews of adverse
determinations in accordance with chapter 695B, 695C or 695G of
NRS. This subsectio n does not exempt such a managed care
organization or health maintenance organization for services
provided pursuant to any other contract.
6. The Authority shall:
(a) Include on an Internet website maintained by the Authority
the information required b y 42 C.F.R. § 438.520(a)(3) to allow
recipients of Medicaid to compare available plans offered by health
maintenance organizations that have contracted with the Authority
pursuant to this section. The Authority may take such additional
measures as are nece ssary to facilitate the comparison of such
plans.
(b) Develop and implement a beneficiary support system for
recipients of health services under Medicaid through managed care
in accordance with 42 C.F.R. § 438.71.
7. As used in this section, unless the context otherwise requires:
(a) “Federally-qualified health center” has the meaning ascribed
to it in 42 U.S.C. § 1396d(l)(2)(B).
(b) “Health maintenance organization” has the meaning ascribed
to it in NRS 695C.030.
(c) “Managed care organization” has the meaning ascribed to it in
NRS 695G.050.
Sec. 119. NRS 422.308 is hereby amended to read as follows:
422.308 As a part of the health and [welfare] public assistance
programs of this State, the Division may:
1. Conduct a family planning service, or contract for the
provision of a family planning service, in any county of the State.
Such service may include the dispensing of information and the
distribution of literature on birth control and family planning
methods.
2. Establish a policy of referral of [welfare] recipients of public
assistance for birth control.
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Sec. 120. NRS 422.309 is hereby amended to read as follows:
422.309 1. As part of the health and [welfare] public
assistance programs of this State, the Division or any other division
designated by the Director may provide prenatal care to pregnant
women who are indigent, or may contract for the provision of that
care, at public or nonprofit hospitals in this State.
2. The Division or any other division designated by the Director
shall provide to each person licensed to engage in social work
pursuant to chapter 641B of NRS, each applicant for Medicaid and
any other interested person, information concerning the prenatal care
available pursuant to this section.
3. The Division or any oth er division designated by the
[Department] Authority shall adopt regulations setting forth criteria
of eligibility and rates of payment for prenatal care provided pursuant
to the provisions of this section, and such other provisions relating to
the development and administration of the Program for Prenatal Care
as the Director or the Administrator, as applicable, deems necessary.
Sec. 120.5. NRS 422.4025 is hereby amended to read as
follows:
422.4025 1. The [Department] Authority shall:
(a) By regulation, develop a list of preferred prescription drugs to
be used for the Medicaid program and the Children’s Health
Insurance Program, and each public or nonprofit health benefit plan
that elects to use the list of preferred prescription drugs as its
formulary pursuant to NRS 287.012, 287.0433 or 687B.407; and
(b) Negotiate and enter into agreements to purchase the drugs
included on the list of preferred prescription drugs on behalf of the
health benefit plans described in paragraph (a) and the Department
of Corrections, if the Board of State Prison Commissioners elects
pursuant to NRS 209.111 to participate in such agreements, or enter
into a contract pursuant to NRS 422.4053 with a pharmacy benefit
manager, health maintenance organization or one or m ore public or
private entities in this State, the District of Columbia or other states
or territories of the United States, as appropriate, to negotiate such
agreements.
2. The [Department] Authority shall, by regulation, establish a
list of prescription drugs which must be excluded from any
restrictions that are imposed by the Medicaid program on drugs that
are on the list of preferred prescription drugs established pursuant to
subsection 1. The list established pursuant to this subsection must
include, without limitation:
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(a) Prescription drugs that are prescribed for the treatment of the
human immunodeficiency virus, including, without limitation,
antiretroviral medications;
(b) Antirejection medications for organ transplants;
(c) Antihemophilic medications; and
(d) Any prescription drug which the Board identifies as
appropriate for exclusion from any restrictions that are imposed by
the Medicaid program on drugs that are on the list of preferred
prescription drugs.
3. The regulations must provide that the Board makes the final
determination of:
(a) Whether a class of therapeutic prescription drugs is included
on the list of preferred prescription drugs and is excluded from any
restrictions that are imposed by the Medicaid program on drugs that
are on the list of preferred prescription drugs;
(b) Which therapeutically equivalent prescription drugs will be
reviewed for inclusion on the list of preferred prescription drugs and
for exclusion from any restrictions that are imposed by the Medicaid
program on drugs that are on the list of preferred prescription drugs;
and
(c) Which prescription drugs should be excluded from any
restrictions that are imposed by the Medicaid program on drugs that
are on the list of preferred prescription drugs base d on continuity of
care concerning a specific diagnosis, condition, class of therapeutic
prescription drugs or medical specialty.
4. The list of preferred prescription drugs established pursuant
to subsection 1 must include, without limitation:
(a) Any prescription drug determined by the Board to be essential
for treating sickle cell disease and its variants; and
(b) Prescription drugs to prevent the acquisition of human
immunodeficiency virus.
5. The regulations must provide that each new pharmaceuti cal
product and each existing pharmaceutical product for which there is
new clinical evidence supporting its inclusion on the list of preferred
prescription drugs must be made available pursuant to the Medicaid
program with prior authorization until the Board reviews the product
or the evidence.
6. The Medicaid program must cover a prescription drug that is
not included on the list of preferred prescription drugs as if the drug
were included on that list if:
(a) The drug is:
(1) Used to treat hepatitis C;
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(2) Used to provide medication -assisted treatment for opioid
use disorder;
(3) Used to support safe withdrawal from substance use
disorder; or
(4) In the same class as a drug on the list of preferred
prescription drugs; and
(b) All preferred prescription drugs within the same class as the
drug are unsuitable for a recipient of Medicaid because:
(1) The recipient is allergic to all preferred prescription drugs
within the same class as the drug;
(2) All preferred prescription drugs within the same class as
the drug are contraindicated for the recipient or are likely to interact
in a harmful manner with another drug that the recipient is taking;
(3) The recipient has a history of adverse reactions to all
preferred prescription drugs within the same class as the drug; or
(4) The drug has a unique indication that is supported by peer-
reviewed clinical evidence or approved by the United States Food and
Drug Administration.
7. The Medicaid program must automatically cover any typical
or atypic al antipsychotic medication or anticonvulsant medication
that is not on the list of preferred prescription drugs upon the
demonstrated therapeutic failure of one drug on that list to adequately
treat the condition of a recipient of Medicaid.
8. On or bef ore February 1 of each year, the [Department]
Authority shall:
(a) Compile a report concerning the agreements negotiated
pursuant to paragraph (b) of subsection 1 and contracts entered into
pursuant to NRS 422.4053 which must include, without limitation,
the financial effects of obtaining prescription drugs through those
agreements and contracts, in total and aggregated separately for
agreements negotiated by the [Department,] Authority, contracts with
a pharmacy benefit manager, contracts with a health ma intenance
organization and contracts with public and private entities from this
State, the District of Columbia and other states and territories of the
United States; and
(b) Post the report on an Internet website maintained by the
[Department] Authority and submit the report to the Director of the
Legislative Counsel Bureau for transmittal to:
(1) In odd-numbered years, the Legislature; or
(2) In even-numbered years, the Legislative Commission.
Sec. 121. NRS 422.410 is hereby amended to read as follows:
422.410 [1.] Unless a different penalty is provided pursuant to
NRS 422.361 to 422.369, inclusive, or 422.450 to 422.590, inclusive,
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a person who knowingly and designedly, by any false pretense, false
or misleading statement, impersonation, mis representation, or
concealment, transfer, disposal or assignment of money or property
obtains or attempts to obtain [monetary or any other public assistance,
or] money, property, medical or remedial care or any other service
provided pursuant to Medicaid or the Children’s Health Insurance
Program, having a value of $100 or more, whether by one act or a
series of acts, with the intent to cheat, defraud or defeat the purposes
of this chapter or to enable a person to meet or appear to meet any
requirements of eligibility prescribed by state law or by rule or
regulation adopted by the [Department] Authority for [a grant or an
increase in a grant of any type of public assistance ] Medicaid or the
Children’s Health Insurance Program is guilty of a category E
felony and shall be punished as provided in NRS 193.130. In addition
to any other penalty, the court shall order the person to pay restitution.
[2. For the purposes of subsection 1, whenever a recipient of
Temporary Assistance for Needy Families pursuant to the provisions
of chapter 422A of NRS receives an overpayment of benefits for the
third time and the overpayments have resulted from a false statement
or representation by the recipient or from the failure of the recipient
to notify the Division of Welfare and Supportive Services of the
Department of a change in circumstances which would affect the
amount of assistance the recipient receives, a rebuttable presumption
arises that the payment was fraudulently received.
3. For the purposes of this section:
(a) “Public assistance” includes any money, property, medical or
remedial care or any other service provided pursuant to a state plan.
(b) “Temporary Assistance for Needy Families” has the meaning
ascribed to it in NRS 422A.080.]
Sec. 122. NRS 422A.030 is hereby amended to read as follows:
422A.030 “Division” means the Division of [Welfare and
Supportive] Social Services of the Department.
Sec. 123. NRS 422A.065 is hereby amended to read as follows:
422A.065 [1.] “Public assistance” includes:
[(a)] 1. State Supplementary Assistance;
[(b)] 2. Temporary Assistance for Needy Families;
[(c) Medicaid;
(d)] 3. Supplemental Nutrition Assistance;
[(e)] 4. Low-Income Home Energy Assistance;
[(f)] 5. The Program for Child Care and Development; and
[(g)] 6. Benefits provided pursuant to any other public [welfare]
assistance program administered by the Division pursuant to such
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additional federal legislation as is not inconsistent with the purposes
of this chapter . [; and
(h) Benefits provided pursuant to any other public welfare
program administered by the Division of Health Care Financing and
Policy pursuant to chapter 422 of NRS.
2. The term does not include the Children’s Health Insurance
Program.]
Sec. 124. NRS 422A.155 is hereby amended to read as follows:
422A.155 1. The Administrator must:
(a) Be selected on the basis of his or her training, experience,
capacity and interest in public [welfare services.] assistance.
(b) Have not less than 3 years of demonstrated successful
experience in the administration of a public agency, with
responsibility for general direction of programs of the public agency
and determination of policies for the implementation of programs of
the public agency, or any equivalent combination of training and
experience.
(c) Possess qualities of leadership.
2. In appointing the Administrator, the Director shall, to the
extent practicable, give preference to a person who has a degree in a
field of social science, public administration, business administration
or a related field.
Sec. 125. NRS 422A.180 is hereby amended to read as follows:
422A.180 1. The Administrator or a representative designated
by the Administrator may administer oaths and take testimony
thereunder and issue subpoenas requiring the attendance of witnesses
before the Division at a designated time and place and the production
of books, papers and records relative to eligibility or continued
eligibility for public assistance.
2. [The Director or a representative designated by the Director
may administer oaths and take testimony thereunder and issue
subpoenas requiring the attendance of witnesses before the
Department at a designated time and place and the production of
books, papers and records relative to verification of treatment and
payments to a provider of medical care, remedial care or other
services pursuant to the State Plan for Medicaid.
3.] If a witness fails to appear or refuses to give testimony or to
produce books, papers and records as required by a subpoena issued
pursuant to this section, the district court of the county in which the
investigation is being conducted may compel the attendance of the
witness, the giving of testimony and the production of books, papers
and records as required by the subpoena.
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Sec. 126. NRS 422A.195 is hereby amended to read as follows:
422A.195 The Administrator shall:
1. Supply the Director with material on which to base proposed
legislation.
2. Cooperate with the Federal Government and state
governments for the more effective attainment of the purposes of this
chapter.
3. Coordinate the activities of the Division with other agencies,
both public and private, with related or similar activities.
4. Keep a com plete and accurate record of all proceedings,
record and file all bonds and contracts, and assume responsibility for
the custody and preservation of all papers and documents pertaining
to the office of the Administrator.
5. Inform the public in regard to the activities and operation of
the Division, and provide other information which will acquaint the
public with problems relating to [welfare.] public assistance.
6. Conduct studies into the causes of the social problems with
which the Division is concerned.
7. Provide leadership in the community in order that all
[welfare] public assistance activities are pointed toward the single
goal of improving the public welfare.
8. Invoke any legal, equitable or special procedures for the
enforcement of his or her orders or the enforcement of the provisions
of this chapter.
9. Exercise any other powers that are necessary and proper for
the standardization of state work, to expedite business, to ensure fair
consideration of applications for aid and to promote the efficiency of
the service provided by the Division.
Sec. 127. NRS 422A.232 is hereby amended to read as follows:
422A.232 1. Any gifts or grants of money which the Division
is authorized to accept must be deposited in the State Treasury to the
credit of the Division of [Welfare and Supportive] Social Services’
Gift and Cooperative Account in the Department of [Health and ]
Human Services’ Gift Fund.
2. Money in the Account must be used for [welfare] public
assistance purposes only and expended in accordance with the terms
of the gift or grant.
3. All claims must be approved by the Administrator before they
are paid.
Sec. 128. NRS 422A.338 is hereby amended to read as follows:
422A.338 The Department shall:
1. Administer all public [welfare] assistance programs of this
State, including:
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(a) State Supplementary Assistance;
(b) Temporary Assistance for Needy Families;
(c) [Medicaid;
(d)] Supplemental Nutrition Assistance;
[(e)] (d) Low-Income Home Energy Assistance;
[(f)] (e) The Program for Child Care and Development;
[(g)] (f) The Program for the Enforcement of Child Support;
[(h) The Children’s Health Insurance Program;] and
[(i)] (g) Other [welfare] public assistance activities and social
services provided for by the laws of this State [.] , except for
Medicaid and the Children’s Health Insurance Program.
2. Act as the single state agency of the State of Nevada and its
political subdivisions in the administration of any federal money
granted to the State of Nevada to aid in the furtherance of any of the
services and activities set forth in subsection 1.
3. Cooperate with the Federal Government in adopting state
plans, in all matters of mutual concern, including adoption of methods
of administration found by the Federal Gov ernment to be necessary
for the efficient operation of [welfare] public assistance programs,
and in increasing the efficiency of [welfare] public assistance
programs by prompt and judicious use of new federal grants which
will assist the Department in carrying out the provisions of this
chapter.
4. Observe and study the changing nature and extent of [welfare]
public assistance needs and develop through tests and
demonstrations effective ways of meeting those needs and employ or
contract for personnel and services supported by legislative
appropriations from the State General Fund or money from federal or
other sources.
5. Enter into reciprocal agreements with other states relative to
public assistance, [welfare] social services and institutional care ,
when deemed necessary or convenient by the Director.
6. Make such agreements with the Federal Government as may
be necessary to carry out the Supplemental Security Income Program.
Sec. 129. NRS 422A.342 is hereby amended to read as follows:
422A.342 1. To restrict the use or disclosure of any
information concerning applicants for and recipients of public
assistance [or assistance pursuant to the Children’s Health Insurance
Program] to purposes directly connected to the administration of this
chapter, and to provide safeguards therefor, under the applicable
provisions of the Social Security Act, the Division shall establish and
enforce reasonable regulations governing the custody, use and
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preservation of any records, files and communications filed wi th the
Division.
2. If, pursuant to a specific statute or a regulation of the Division,
names and addresses of, or information concerning, applicants for and
recipients of assistance [, including, without limitation, assistance
pursuant to the Children’s Health Insurance Program,] are furnished
to or held by any other agency or department of government, such
agency or department of government is bound by the regulations of
the Division prohibiting the publication of lists and records thereof or
their use for purposes not directly connected with the administration
of this chapter.
3. Except for purposes directly connected with the
administration of this chapter, no person may publish, disclose or use,
or permit or cause to be published, disclosed or used, any confidential
information pertaining to a recipient of assistance [, including,
without limitation, a recipient of assistance pursuant to the Children’s
Health Insurance Program,] under the provisions of this chapter.
Sec. 130. NRS 422A.372 is hereby amended to read as follows:
422A.372 1. The Department shall provide public assistance
pursuant to:
(a) The program established to provide Temporary Assistance for
Needy Families; or
(b) [Medicaid; or
(c)] Any program for which a grant has been prov ided to this
State pursuant to 42 U.S.C. §§ 1397 et seq.,
to a qualified person who is not a citizen or national of the United
States who complies with the requirements established by the
Department pursuant to federal law and this chapter for the receipt of
benefits pursuant to that program.
2. A person who is not a citizen or national of the United States
is considered “qualified” for the purposes of subsection 1 if the person
meets the requirements of 8 U.S.C. § 1641(b).
Sec. 131. NRS 422A.376 is hereby amended to read as follows:
422A.376 1. Except as otherwise provided in this section, the
Department shall, to the extent that it is not prohibited by federal law,
recover from a recipient of public assistance, the estate of the
recipient or a person who signed the application for public assistance
on behalf of the recipient an amount not to exceed the amount of
public assistance incorrectly paid to the recipient, if the person who
signed the application:
(a) Failed to report any required informa tion to the Department
that the person knew at the time the person signed the application;
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(b) Refused to provide financial information regarding the
recipient’s income and assets, including, without limitation,
information regarding any transfers or assi gnments of income or
assets;
(c) Concealed information regarding the existence, transfer or
disposition of the recipient’s income and assets with the intent of
enabling a recipient to meet any eligibility requirement for public
assistance;
(d) Made any f alse representation regarding the recipient’s
income and assets, including, without limitation, any information
regarding any transfers or assignments of income or assets; or
(e) Failed to report to the Department within the period allowed
by the Department any required information that the person obtained
after the person filed the application.
2. Except as otherwise provided in this section, a recipient of
incorrectly paid public assistance or a person who signed the
application for public benefits on behalf of the recipient shall
reimburse the Department or appropriate state agency for the value of
the incorrectly paid public assistance.
3. The Director or a person designated by the Director may, to
the extent that it is not prohibited by federal law , determine the
amount of, and settle, adjust, compromise or deny a claim against a
recipient of public assistance, the estate of the recipient or a person
who signed the application for public assistance on behalf of the
recipient.
4. The Director may, to the extent that it is not prohibited by
federal law, waive the repayment of public assistance incorrectly paid
to a recipient if the incorrect payment was not the result of an
intentional misrepresentation or omission by the recipient and if
repayment w ould cause an undue hardship to the recipient. The
Director shall, by regulation, establish the terms and conditions of
such a waiver, including, without limitation, the circumstances that
constitute undue hardship.
[5. As used in this section, “public assistance” does not include
Medicaid.]
Sec. 132. NRS 422A.575 is hereby amended to read as follows:
422A.575 1. If the plan for personal responsibility signed by
the head of a household pursuant to NRS 422A.535 includes a
provision providing for the payment of [transitional] child care
assistance to the head of the household, the Division may provide
[transitional] child care assistance to the head of the household if the
household becomes ineligible for benefits for one or more of the
reasons described in 42 U.S.C. § 608(a)(11). The Division shall not
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provide [transitional] child care assistance pursuant to this section for
more than 12 consecutive months.
2. As used in this section, [“transitional] “child care assistance”
means [:
(a) Assistance] assistance provided by the Division to low -
income families to pay for the costs of child care . [; or
(b) Medicaid provided pursuant to the plan administered by the
Department pursuant to NRS 422.063.]
Sec. 133. NRS 422A.700 is hereby amended to read as follows:
422A.700 1. Unless a different penalty is provided pursuant to
NRS 422.361 to 422.369, inclusive, or 422.450 to 422.590, inclusive,
a person who knowingly and designedly, by any false pretense, false
or misleading statement, impersonation or misrepresentation, obtains
or attempts to obtain monetary or any other public assistance [, or
money, property, medic al or remedial care or any other service
provided pursuant to the Children’s Health Insurance Program, ]
having a value of $100 or more, whether by one act or a series of acts,
with the intent to cheat, defraud or defeat the purposes of this chapter
or to enable a person to meet or appear to meet any requirements of
eligibility prescribed by state law or by rule or regulation adopted
by the Department for a grant or increase in a grant of any type of
public assistance is guilty of a category E felony and sha ll be
punished as provided in NRS 193.130. In addition to any other
penalty, the court shall order the person to pay restitution.
2. For the purposes of subsection 1, whenever a recipient of
Temporary Assistance for Needy Families pursuant to the provisions
of this chapter receives an overpayment of benefits for the third time
and the overpayments have resulted from a false statement or
representation by the recipient or from the failure of the recipient to
notify the Division of a change in circumstances which would affect
the amount of assistance the recipient receives, a rebuttable
presumption arises that the payment was fraudulently received.
[3. For the purposes of subsection 1, “public assistance”
includes any money, property, medical or remedial care or any other
service provided pursuant to a state plan.]
Sec. 134. NRS 424.042 is hereby amended to read as follows:
424.042 1. The Division shall periodically review the
placement of children in specialized foster homes by each agency
which provides child welfare services to determine whether children
are being appropriately placed in such foster homes and are receiving
the care and services that they need. Such a review may include,
without limitation, an examination of:
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(a) Demographics of children who are placed in specialized foster
homes;
(b) Information from clinical evaluations of children who are
placed in specialized foster homes;
(c) Relevant information submitted to the [Department of Health
and Human Services] Nevada Health Authority pursuant to the State
Plan for Medicaid;
(d) Case files maintained by the agency which provides child
welfare services for children who are placed in specialized foster
homes; and
(e) Any other information determined to be relevant by the
Division.
2. If, after conducting a review pursuant to subsection 1, the
Division determines that an agency which provides child welfare
services is inappropriately placing children in specialized foster
homes or that children placed in such foster homes are not rece iving
the care and services that they need, the Administrator of the Division
shall require the agency which provides child welfare services to take
corrective action. If an agency fails to take the corrective action
required by the Administrator, the Divi sion may require the agency
which provides child welfare services to develop a corrective action
plan pursuant to NRS 432B.2155.
Sec. 135. NRS 428.090 is hereby amended to read as follows:
428.090 1. When a nonresident or any other person who meets
the uniform standards of eligibility prescribed by the board of county
commissioners or by NRS 439B.310, if applicable, falls sick in the
county, not having money or property to pay the person’s board,
nursing or medical aid, the board of county commission ers of the
proper county shall, on complaint being made, give or order to be
given such assistance to the poor person as is in accordance with the
policies and standards established and approved by the board of
county commissioners and within the limits of money which may be
lawfully appropriated for this purpose pursuant to NRS 428.050,
428.285 and 450.425.
2. If the sick person dies, the board of county commissioners
shall give or order to be given to the person a decent burial or
cremation.
3. Except as otherwise provided in NRS 422.382, the board of
county commissioners shall make such allowance for the person’s
board, nursing, medical aid, burial or cremation as the board deems
just and equitable, and order it paid out of the county treasury.
4. The responsibility of the board of county commissioners to
provide medical aid or any other type of remedial aid under this
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section is relieved to the extent provided in NRS 422.382 and to the
extent of the amount of money or the value of services provided by:
(a) The [Department of Health and Human Services ] Nevada
Health Authority to or for such persons for medical care or any type
of remedial care under the State Plan for Medicaid; and
(b) The Fund for Hospital Care to Indigent Persons under the
provisions of NRS 428.115 to 428.255, inclusive.
Sec. 136. NRS 428.206 is hereby amended to read as follows:
428.206 1. The Board of Trustees of the Fund for Hospital
Care to Indigent Persons may enter into an agreement with the
Medicaid Division of [Health Care Financing and Policy of the
Department of Health and Human Services ] the Nevada Health
Authority whereby:
(a) The Board agrees to transfer an agreed upon amount of money
each year from the Fund to the Division;
(b) The Division agrees to use the money so transferred to:
(1) Include in the State Plan for Medicaid an enhanced rate of
reimbursement for hospital care provided to recipients of Medicaid or
to make supplemental payments to the hospital for the provision of
such hospital care through increased federal financial participation;
(2) Offset any decrease in savings generated by any
component of the upper payment limit program established under the
State Plan for Medicaid that results from providing supplemental
payments to hospitals from the Fund pursuant to subparagraph (1);
and
(3) Satisfy any portion of the obligation of a county to pay the
nonfederal share of expenditures pursuant to NRS 422.272;
(c) The Division agrees to return any money transferred to the
Division pursuant to the agreement if the Federal Government does
not approve the enhanced rate of reimbursement or supplemental
payments included in the State Plan;
(d) The Board agrees to continue to transfer not less than the same
amount of money as the previous year if the S tate Plan is approved
by the Federal Government until the Board has requested the Division
to exclude the enhanced rate of reimbursement or supplemental
payments from the State Plan and the Federal Government approves
the State Plan without such enhanced rates or supplemental payments;
and
(e) The Division agrees to exclude the enhanced rate of
reimbursement or supplemental payments from the State Plan when
it is next submitted to the Federal Government for approval if so
requested by the Board.
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2. Any m oney transferred from the Fund to the Division
pursuant to this section must not be used to replace or supplant
funding available from other sources for the same purpose.
3. As used in this section, “upper payment limit program” means
a program providing for supplemental payments, not to exceed a limit
calculated in the manner prescribed in the State Plan for Medicaid, to
hospitals owned or operated by a governmental entity other than this
State or an agency of this State.
Sec. 137. NRS 428.285 is hereby amended to read as follows:
428.285 1. The board of county commissioners of each county
shall establish a tax rate of at least 6 cents on each $100 of assessed
valuation for the purposes of the tax imposed pursuant to subsection
2. A board of county commissioners may increase the rate to not more
than 10 cents on each $100 of assessed valuation.
2. In addition to the levies provided in NRS 428.050 and
428.185 and any tax levied pursuant to NRS 450.425, the board of
county commissioners shall levy a tax ad valorem at a rate necessary
to produce revenue in an amount equal to an amount calculated by
multiplying the assessed valuation of all taxable property in the
county by the tax rate established pursuant to subsection 1, and
subtracting from the produ ct the amount of unencumbered money
remaining in the fund on May 1 of the current fiscal year.
3. For each fiscal year beginning on or after July 1, 1989, the
board of county commissioners of each county shall remit to the State
Controller from the money in the fund an amount of money
equivalent to the amount collected from 1 cent on each $100 of
assessed valuation of all taxable property in the county for credit to
the Intergovernmental Transfer Account in the State General Fund.
4. For each fiscal yea r beginning on or after July 1, 2013, in a
county whose population is less than 100,000, the board of county
commissioners shall, pursuant to an interlocal agreement with the
State, remit to the State Controller an amount of money determined
by the Directo r of the [Department of Health and Human Services ]
Nevada Health Authority to be adequate for the State Plan for
Medicaid to include the payment of the nonfederal share of
expenditures set forth in NRS 422.272. In such a county, the amount
of money that the board of county commissioners may be required to
remit, as determined by the Director pursuant to this subsection, must
not exceed an amount of money equivalent to the amount collected
from 8 cents on each $100 of assessed valuation of all taxable
property in the county.
5. Not later than January 1, 2014, and not later than January 1 of
each year thereafter, the board of county commissioners of each
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county shall remit to the State Controller an amount equal to the
amount collected by the board of county commissioners pursuant to
NRS 439B.340 for the previous fiscal year for credit to the Fund for
Hospital Care to Indigent Persons created by NRS 428.175.
6. The tax so levied and its proceeds must be excluded in
computing the maximum amount of money whic h the county is
permitted to receive from taxes ad valorem and the highest
permissible rate of such taxes.
Sec. 138. NRS 428.295 is hereby amended to read as follows:
428.295 1. For each fiscal year the board of county
commissioners shall, in the preparation of its final budget, allocate
money for assistance to indigents pursuant to this chapter.
2. In a county whose population is less than 700,000, the amount
allocated must be calculated by multiplying the amount allocated for
that purpose for the previous fiscal year by 104.5 percent.
3. In a county whose population is 100,000 or more, the board
of county commissioners may allocate money from its fund for
medical assistance to indigent persons to make an intergovernmental
transfer of money to the Medicaid Division of [Health Care Financing
and Policy of the Department of Health and Human Services ] the
Nevada Health Authority in accordance with the regulations adopted
pursuant to NRS 422.390 and for any or all of the following purposes:
(a) If an upper payment limit program is established in the State
Plan for Medicaid, to provide supplemental payments to any public
hospital located in the county that is eligible for supplemental
payments under the program.
(b) If authorized under any other supplemental payment program
administered by the Centers for Medicare and Medicaid Services of
the United States Department of Health and Human Services, to:
(1) Provide an enhanced rate of reimbursement to any public
hospital located in the county for the hospital care provided to
recipients of Medicaid; or
(2) Make supplemental payments to any public hospital
located in the county for the provision of such hospital care through
increased federal financial participation.
4. When, during any fiscal year, the amount of money expended
by the county for any program of medical assistance for those persons
eligible pursuant to this chapter exceeds the amount allocated for that
purpose in its budget, the board of county commissioners shall, to the
extent that m oney is available in the fund, pay claims against the
county from the fund for that purpose.
5. In a county whose population is 700,000 or more, the board
of county commissioners may by resolution allocate money from the
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fund in any fiscal year, in an amount not to exceed the equivalent of
the amount collected from 2 cents on each $100 of assessed valuation
of all taxable property in the county, to make grants to any public
hospital located in the county. Such a grant may be used by a hospital
only to:
(a) Construct or acquire capital assets, including, without
limitation, land, improvements to land and major items of equipment;
and
(b) Renovate existing facilities of the hospital. Money granted for
the renovation of facilities must not be used for the normal, recurring
maintenance of the facilities.
6. As used in this section, “upper payment limit program” means
a program providing for supplemental payments, not to exceed a limit
calculated in the manner prescribed in the State Plan for Medicaid, to
hospitals owned or operated by a governmental entity other than this
State or an agency of the State.
Sec. 139. NRS 432B.220 is hereby amended to read as follows:
432B.220 1. Any person who is described in subsection 4 and
who, in his or her professional or occupational capacity, knows or has
reasonable cause to believe that a child has been abused or neglected
shall:
(a) Except as otherwise provided in subsection 2, report the abuse
or neglect of the child to an agency which provides child welfare
services or to a law enforcement agency; and
(b) Make such a report as soon as reasonably practicable but not
later than 24 hours after the person knows or has reasonable cause to
believe that the child has been abused or neglected.
2. If a pers on who is required to make a report pursuant to
subsection 1 knows or has reasonable cause to believe that the abuse
or neglect of the child involves an act or omission of:
(a) A person directly responsible or serving as a volunteer for or
an employee of a public or private home, institution or facility where
the child is receiving child care outside of the home for a portion of
the day, the person shall make the report to a law enforcement agency.
(b) An agency which provides child welfare services or a law
enforcement agency, the person shall make the report to an agency
other than the one alleged to have committed the act or omission, and
the investigation of the abuse or neglect of the child must be made by
an agency other than the one alleged to have committed the act or
omission.
3. Any person who is described in paragraph (a) of subsection 4
who delivers or provides medical services to a newborn infant and
who, in his or her professional or occupational capacity, knows or has
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reasonable cause to believe that the newborn infant has been affected
by a fetal alcohol spectrum disorder or prenatal substance use
disorder or has withdrawal symptoms resulting from prenatal
substance exposure shall, as soon as reasonably practicable but not
later than 24 hours after the person knows or has reasonable cause to
believe that the newborn infant is so affected or has such symptoms,
notify an agency which provides child welfare services of the
condition of the infant and refer each person who is responsible for
the welfare of the infant to an agency which provides child welfare
services for appropriate counseling, training or other services. A
notification and referral to an agency which provides child welfare
services pursuant to this subsection shall not be constr ued to require
prosecution for any illegal action.
4. A report must be made pursuant to subsection 1 by the
following persons:
(a) A person providing services licensed or certified in this State
pursuant to, without limitation, chapter 450B, 630, 630A, 631, 632,
633, 634, 634A, 634B, 635, 636, 637, 637B, 639, 640, 640A, 640B,
640C, 640D, 640E, 641, 641A, 641B, 641C, 641D or 653 of NRS or
practicing as an emergency medical technician, advanced emergency
medical technician or paramedic in this State under the Recognition
of Emergency Medical Services Personnel Licensure Interstate
Compact ratified by NRS 450B.145.
(b) Any personnel of a medical facility licensed pursuant to
chapter 449 of NRS who are engaged in the admission, examination,
care or treatment of persons or an administrator, manager or other
person in charge of such a medical facility upon notification of
suspected abuse or neglect of a child by a member of the staff of the
medical facility.
(c) A coroner.
(d) A member of the clergy, practiti oner of Christian Science or
religious healer, unless the person has acquired the knowledge of the
abuse or neglect from the offender during a confession.
(e) A person employed by a public school or private school and
any person who serves as a volunteer at such a school.
(f) Any person who maintains or is employed by a facility or
establishment that provides care for children, children’s camp or
other public or private facility, institution or agency furnishing care
to a child.
(g) Any person licensed p ursuant to chapter 424 of NRS to
conduct a foster home.
(h) Any officer or employee of a law enforcement agency or an
adult or juvenile probation officer.
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(i) Except as otherwise provided in NRS 432B.225, an attorney.
(j) Any person who maintains, is em ployed by or serves as a
volunteer for an agency or service which advises persons regarding
abuse or neglect of a child and refers them to persons and agencies
where their requests and needs can be met.
(k) Any person who is employed by or serves as a volunteer for a
youth shelter. As used in this paragraph, “youth shelter” has the
meaning ascribed to it in NRS 244.427.
(l) Any adult person who is employed by an entity that provides
organized activities for children, including, without limitation, a
person who is employed by a school district or public school.
(m) Any person who is enrolled with the Medicaid Division of
[Health Care Financing and Policy of the Department of Health and
Human Services ] the Nevada Health Authority to provide doula
services to recipients of Medicaid pursuant to NRS 422.27177.
(n) A peer recovery support specialist, as defined in NRS
433.627, or peer recovery support specialist supervisor, as defined in
NRS 433.629.
5. A report may be made by any other person.
6. If a p erson who is required to make a report pursuant to
subsection 1 knows or has reasonable cause to believe that a child has
died as a result of abuse or neglect, the person shall, as soon as
reasonably practicable, report this belief to an agency which provides
child welfare services or a law enforcement agency. If such a report
is made to a law enforcement agency, the law enforcement agency
shall notify an agency which provides child welfare services and the
appropriate medical examiner or coroner of the report. If such a report
is made to an agency which provides child welfare services, the
agency which provides child welfare services shall notify the
appropriate medical examiner or coroner of the report. The medical
examiner or coroner who is notified of a report pursuant to this
subsection shall investigate the report and submit his or her written
findings to the appropriate agency which provides child welfare
services, the appropriate district attorney and a law enforcement
agency. The written findings mus t include, if obtainable, the
information required pursuant to the provisions of subsection 2 of
NRS 432B.230.
7. The agency, board, bureau, commission, department, division
or political subdivision of the State responsible for the licensure,
certification or endorsement of a person who is described in
subsection 4 and who is required in his or her professional or
occupational capacity to be licensed, certified or endorsed in this
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State shall, at the time of initial licensure, certification or
endorsement:
(a) Inform the person, in writing or by electronic communication,
of his or her duty as a mandatory reporter pursuant to this section;
(b) Obtain a written acknowledgment or electronic record from
the person that he or she has been informed of his or her duty pursuant
to this section; and
(c) Maintain a copy of the written acknowledgment or electronic
record for as long as the person is licensed, certified or endorsed in
this State.
8. The employer of a person who is described in subsection 4
and who is not required in his or her professional or occupational
capacity to be licensed, certified or endorsed in this State must, upon
initial employment of the person:
(a) Inform the person, in writing or by electronic communication,
of his or her duty as a mandatory reporter pursuant to this section;
(b) Obtain a written acknowledgment or electronic record from
the person that he or she has been informed of his or her duty pursuant
to this section; and
(c) Maintain a copy of the written acknowledgment or electronic
record for as long as the person is employed by the employer.
9. Before a person may serve as a volunteer at a public school or
private school, the school must:
(a) Inform the person, in writing or by electronic communication,
of his or her duty as a mandatory reporter pursuant to this section and
NRS 392.303;
(b) Obtain a written acknowledgment or electronic record from
the person that he or she has been informed of his or her duty pursuant
to this section and NRS 392.303; and
(c) Maintain a copy of the written acknowledgment or electronic
record for as long as the person serves as a volunteer at the school.
10. The provisions of subsection 8 do not apply to the employer
of a person practicing as an emergency medical technician, advanced
emergency medical technician or paramedic in this State under the
Recognition of Emergency Medical Services Personnel Licensure
Interstate Compact ratified by NRS 450B.145.
11. As used in this section:
(a) “Private school” has the meaning ascribed to it in
NRS 394.103.
(b) “Public school” has the meaning ascribed to it in
NRS 385.007.
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Sec. 140. NRS 439.005 is hereby amended to read as follows:
439.005 As used in this chapter, unless the context requires
otherwise:
1. “Administrator” means the Administrator of the Division.
2. “Authority” means the Nevada Health Authority.
3. “Department” means the Department of [Health and] Human
Services.
[3.] 4. “Director” means the Director of the Department.
[4.] 5. “Division” means the Division of Public and Behavioral
Health of the Department.
[5.] 6. “Health authority” means the officers and agents of the
Division or the officers and agents of the local boards of health.
[6.] 7. “Health Care Purchasing and Compliance Division”
means the Health Care Purchasing and Compliance Division of the
Authority.
8. “Individually identifiable health information” has the
meaning ascribed to it in 45 C.F.R. § 160.103.
Sec. 141. NRS 439.010 is hereby amended to read as follows:
439.010 Except as otherwise provided in NRS 439.258, 439.271
to 439.2794, inclusive, 439.5102 to 439.5108, inclusive, [and]
439.581 to 439.597, inclusive, and 439.800 to 439.918, inclusive, the
provisions of this chapter must be administered by the Administrator
and the Division, subject to administrative supervision by the
Director.
Sec. 142. NRS 439.015 is hereby amended to read as follows:
439.015 The Department, through the Division, may accept and
direct the disbursement of money appropriated by any Act of
Congress and apportioned or allocated to the State of Nevada for
health purposes [.] under the jurisdiction of the Division. This
federal money must be deposited in the State Treas ury for credit to
the State Division of Public and Behavioral Health Federal Account
within the State General Fund.
Sec. 143. NRS 439.150 is hereby amended to read as follows:
439.150 1. The State Board of Health is hereby declared to be
supreme in al l nonadministrative health matters. It has general
supervision over all matters, except for administrative matters and as
otherwise provided in NRS 439.950 to 439.983, inclusive, relating to
the preservation of the health and lives of citizens of this Stat e and
over the work of the Chief Medical Officer and all district, county
and city health departments, boards of health and health officers.
2. The Department is hereby designated as the agency of this
State to cooperate with the federal authorities in the administration of
those parts of the Social Security Act which relate to the general
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promotion of public health. It may receive and expend all money
made available to the Division by the Federal Government, the State
of Nevada or its political subdivisions, or from any other source, for
the purposes provided in this chapter. In developing and revising any
state plan in connection with federal assistance for health programs,
the Department shall consider, without limitation, the amount of
money available from the Federal Government for those programs,
the conditions attached to the acceptance of that money and the
limitations of legislative appropriations for those programs.
3. Except as otherwise provided in NRS 576.128, the State
Board of Health may set reasonable fees for the:
(a) Licensing, registering, certifying, inspecting or granting of
permits for any facility, establishment or service regulated by the
Division [;] or the Health Care Purchasing and Compliance
Division;
(b) Programs and services of the Division [;] and the Health Care
Purchasing and Compliance Division;
(c) Review of plans; and
(d) Certification and licensing of personnel.
Fees set pursuant to this subsection must be calculated to produce
for that period the revenue from the fees projected in the budget
approved for the Division or the Health Care Purchasing and
Compliance Division, as applicable, by the Legislature.
Sec. 144. NRS 439.155 is hereby amended to read as follows:
439.155 1. For the purposes of [this chapter, ] NRS 439.010
to 439.255, inclusive, 439.259 to 439.265, inclusive, 439.280 to
439.580, inclusive, 439.600, 439.620, 439.630 and 439.942 to
439.994, in clusive, the Department through the Division may
cooperate, financially or otherwise, and execute contracts or
agreements with the Federal Government, any federal department or
agency, any other state department or agency, a county, a city, a
public district or any political subdivision of this State, a public or
private corporation, an individual or a group of individuals. Such a
contract or agreement may include provisions whereby the Division
will provide staff, services or other resources, or any combin ation
thereof, without payment, to further the purposes of the contract or
agreement. If the contract or agreement includes a provision whereby
the Division is paid for the provision of staff, services or other
resources, the payment will be reimbursed dir ectly to the Division’s
budget. Cooperation pursuant to this section does not of itself relieve
any person, department, agency or political subdivision of any
responsibility or liability existing under any provision of law.
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2. If the Administrator or the Administrator’s designee enters
into a contract or agreement pursuant to subsection 1 with a private
nonprofit corporation, the contract or agreement may allow:
(a) The Division to enter and inspect any premises which are
related to services provided und er the contract or agreement and to
inspect any records which are related to services provided under the
contract or agreement to ensure the welfare of any consumer served
by the private nonprofit corporation under the contract or agreement;
(b) The Division and the private nonprofit corporation to share
confidential information concerning any consumer served by the
private nonprofit corporation under the contract or agreement; and
(c) The private nonprofit corporation to assign rights and
obligations of the private nonprofit corporation under the contract or
agreement to the Division.
3. The State, the Department and the Division do not waive any
immunity from liability or limitation on liability provided by law by
entering into a contract or agreement pursuant to this section and any
such contract or agreement must include a provision to that effect.
Sec. 145. NRS 439.160 is hereby amended to read as follows:
439.160 1. The Division is charged with:
(a) The thorough and efficient execution of the provisions of [this
chapter] NRS 439.010 to 439.255, inclusive, 439.259 to 439.265,
inclusive, 439.280 to 439.580, inclusive, 439.600, 439.620, 439.630
and 439.942 to 439.994, inclusive, in every part of the State; and
(b) Supervisory power over local health officers,
to the end that all of the requirements of [this chapter ] NRS
439.010 to 439.255, inclusive, 439.259 to 439.265, inclusive,
439.280 to 439.580, inclusive, 439.600, 439.620, 439.630 and
439.942 to 439.994, inclusive, shall be uniformly complied with.
2. The Division shall have authority to investigate cases of
irregularity or violation of the law, and all local health officers shall
aid the Division, upon request, in such investigations.
Sec. 146. NRS 439.258 is hereby amended to read as follows:
439.258 1. The Health Care Purchasing and Compliance
Division shall evaluate, certify and monitor programs for the
treatment of persons who commit domestic violence in accordance
with the regulations adopted pursuant to subsection 2.
2. The [Division] State Board of Health shall adopt regulations
[governing] :
(a) Governing the evaluation, certification and monitoring of
programs for the treatment of persons who commit domestic violence
[.] ; and
(b) Imposing fees for the certification of such programs.
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3. The regulations adopted pursuant to subsection 2 must
include, without limitation, provisions:
(a) Requiring that a program:
(1) Include a module specific to victim safety; and
(2) Be based on:
(I) Evidence-based practices; and
(II) The assessment of a program participant by a
supervisor of treatment or provider of treatment; and
(b) Allowing a program that is located in another state to become
certified in this State to provide treatment to persons who:
(1) Reside in this State; and
(2) Are ordered by a court in this State to participate in a
program for the treatment of persons who commit domestic violence.
Sec. 147. NRS 439.272 is hereby amended to read as follows:
439.272 1. The Director of the Authority shall appoint a State
Dental Health Officer, who may serve in the unclassified service of
the State or as a contractor for the [Department.] Authority. The State
Dental Health Officer must:
(a) Be a resident of this State;
(b) Have satisfied the educational requirements for and may, but
is not required to, satisfy any other requirements for the issuance of
an unrestricted license to practice dentistry pursuant to chapter 631 of
NRS; and
(c) Be appointed on the basis of his or her education, training and
experience and his or her interest in public dental health and related
programs.
2. The State Dental Health Officer shall:
(a) Determine the needs of the residents of this State for public
dental health;
(b) Provide the Advisory Committee , [and] the Department and
the Authority with advice regarding public dental health;
(c) Make recommendations to the Advisory Committee, the
Department , the Authority and the Legislature regarding programs
in this State for public dental health;
(d) Work collaboratively with the State Public Health Dental
Hygienist; and
(e) Seek such information and advice from the Advisory
Committee or from any dental education program in this State,
including any such programs of the Nevada S ystem of Higher
Education, as necessary to carry out his or her duties.
Sec. 148. NRS 439.279 is hereby amended to read as follows:
439.279 1. The [Department] Director of the Authority shall
appoint a State Public Health Dental Hygienist, who may serve in the
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unclassified service of the State or as a contractor for the
[Department.] Authority. The State Public Health Dental Hygienist:
(a) Must be a resident of this State;
(b) May, but is not required to, hold a current license to practice
dental hygiene issued pursuant to chapter 631 of NRS with a special
endorsement issued pursuant to NRS 631.287; and
(c) Must be appointed on the basis of his or her education, training
and experience and his or her interest in public health dental hygiene
and related programs.
2. The State Public Health Dental Hygienist:
(a) Shall work collaboratively with the State Dental Health
Officer in carrying out his or her duties; and
(b) May:
(1) Provide advice and make recommendations to the
Advisory Committee , [and] the Department and the Authority
regarding programs in this State for public health dental hygiene; and
(2) If he or she holds a license to practice dental hygiene
issued pursuant to chap ter 631 of NRS with a special endorsement
issued pursuant to NRS 631.287, perform any acts authorized
pursuant to NRS 631.287.
3. The [Department] Authority may solicit and accept gifts and
grants to pay the costs associated with the position of State Public
Health Dental Hygienist.
Sec. 149. NRS 439.2791 is hereby amended to read as follows:
439.2791 There is hereby established within the [Department]
Authority the State Program for Oral Health to increase public
knowledge and raise public awarenes s of the importance of oral
health and to educate the residents of this State on matters relating to
oral health, including, without limitation:
1. Proper oral hygiene;
2. The factors that increase the risk of a person developing oral
diseases; and
3. The prevention and treatment of oral diseases.
Sec. 150. NRS 439.2792 is hereby amended to read as follows:
439.2792 1. There is hereby created within the [Department]
Authority the Advisory Committee on the State Program for Oral
Health to advise a nd make recommendations to the [Department]
Authority concerning the Program.
2. The Director of the Authority shall appoint to the Advisory
Committee 13 members, including, without limitation, one or more
persons who are representatives of:
(a) Public health care professionals and educators;
(b) Providers of oral health care;
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(c) Persons knowledgeable in promoting and educating the public
on oral health issues; and
(d) National dental and other oral health organizations and their
local or state chapters.
3. After the initial terms, the members of the Advisory
Committee serve terms of 2 years commencing on July 1. A member
may be reappointed.
4. Members of the Advisory Committee serve without
compensation, except that each member is entitled, while engaged in
the business of the Advisory Committee, to the per diem allowance
and travel expenses provided for state officers and employees
generally.
5. Any member of the Advisory Committee who is a public
employee must be granted administrative leave from his or her duties
to engage in the business of the Advisory Committee without loss of
his or her regular compensation. Such leave does not reduce the
amount of the member’s other accrued leave.
6. A majority of the members of the Advisory Committee
constitutes a quorum for the transaction of business, and a majority
of a quorum present at any meeting is sufficient for any official action
taken by the Advisory Committee.
7. The Advisory Committee shall:
(a) At its first meeting and annually thereafter, elect a Chair from
among its members;
(b) Meet at the call of the Director [,] of the Authority, the Chair
or a majority of its members as necessary and within the budget of
the Advisory Committee; and
(c) On or before July 1 of each year, submit a written report to the
Director of the Authority summarizing the activities of the Advisory
Committee and any recommendations of the Advisory Committee.
Sec. 151. NRS 439.2793 is hereby amended to read as follows:
439.2793 To carry out the provisions of NRS 439.271 to
439.2794, inclusive, the [Department] Authority shall, with advice
and recommendations of the Advisory Committee:
1. Establish a solid scientific database of the most current
information on the importance of oral health, using information
obtained through surveillance, epidemiology and research related to
oral health;
2. Provide educational materials and information on research
concerning matters relating to oral health to health care professionals,
providers of oral health care and the public, including, without
limitation, materials and information concerning programs and
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services available to the public and strategies for the prevention of
oral diseases;
3. Coordinate the establishment of regional coalitions to support
the efforts of the Program;
4. Increase public awareness about the prevention, detection and
treatment of oral diseases among state and local governmental
officials who are responsible for matters relating to oral health, health
care professionals, providers of oral health care and policymakers;
5. Coordinate state and local programs and services to ensure
that the public has adequate access to dental services;
6. Work with other governmental agencies, national health
organizations and their local and state chapters, community and
business leaders, community organizations and providers of oral
health care to:
(a) Coordinate the work of the Program with the work of those
agencies, organizations and persons; and
(b) Maximize the resources of state and local governments in the
efforts to educate the public about the importance of oral health,
including, without limitation, the prevention and detection of oral
diseases and proper oral hygiene;
7. Develop and carry out public awareness and media campaigns
in each county, targeting groups of persons who are considered at risk
for developing oral diseases;
8. Evaluate the need to improve the quality and accessibility of
dental services that exist in communities in this State; and
9. Develop and coordinate, in cooperation with the Department
of Education, recommendations for dental programs to encourage
proper oral hygiene by children.
Sec. 152. NRS 439.2794 is hereby amended to read as follows:
439.2794 1. The [Department] Authority may:
(a) Enter into contracts for any services necessary to carry out or
assist the [Department] Authority in carrying out the provisions of
NRS 439.271 to 439.2794, inclusive, with public or private entities
that have the appropriate expertise to provide such services;
(b) Apply for and accept any gift, donation, bequest, grant or
other source of money to carry out the provisions of NRS 439.271 to
439.2794, inclusive;
(c) Apply for any waiver from the Federal Government that may
be necessary to maximize the amount of money this State may obtain
from the Federal Government to carry out the provisions of NRS
439.271 to 439.2794, inclusive; and
(d) Adopt regulations as necessary to carry out and administer the
Program.
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2. Any money that is accepted b y the [Department] Authority
pursuant to subsection 1 must be deposited in the State Treasury and
accounted for separately in the State General Fund.
3. The Director of the Authority shall administer the account
created pursuant to subsection 2. Money in the account does not lapse
to the State General Fund at the end of the fiscal year. The interest
and income earned on the money in the account must be credited to
the account. Any claims against the account must be paid as other
claims against the State are paid.
Sec. 153. NRS 439.4905 is hereby amended to read as follows:
439.4905 1. Unless an exemption is approved pursuant to
subsection 3, each county shall pay an assessment to the Division, in
an amount determined by the Division, for the costs of services
provided in that county by the Division or by the Chief Medical
Officer, including, without limitation, services provided pursuant to
this chapter and chapters 441A [, 444, 446] and 583 of NRS and the
regulations adopted pursuant to those chapters, regardless of whether
the county has a local health authority.
2. Each county shall pay the assessment to the Division in
quarterly installments that are due on the first day of the first month
of each calendar quarter.
3. A county may submit a propo sal to the Governor for the
county to carry out the services that would otherwise be provided by
the Division or the Chief Medical Officer pursuant to this chapter and
chapters 441A [, 444, 446 ] and 583 of NRS and the regulations
adopted pursuant to those chapters. If the Governor approves
the proposal, the Governor shall submit a recommendation to the
Interim Finance Committee to exempt the county from the assessment
required pursuant to subsection 1. The Interim Finance Committee,
upon receiving the reco mmendation from the Governor, shall
consider the proposal and determine whether to approve the
exemption. In considering whether to approve the exemption,
the Interim Finance Committee shall consider, among other things,
the best interests of the State, t he effect of the exemption and the
intent of the Legislature in requiring the assessment to be paid by each
county.
4. An exemption that is approved by the Interim Finance
Committee pursuant to subsection 3 must not become effective until
at least 6 months after that approval.
5. A county that receives approval pursuant to subsection 3 to
carry out the services that would otherwise be provided by the
Division or the Chief Medical Officer pursuant to this chapter and
chapters 441A [, 444, 446 ] and 58 3 of NRS and the regulations
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adopted pursuant to those chapters shall carry out those services in
the manner set forth in those chapters and regulations.
6. The Division may adopt such regulations as necessary to carry
out the provisions of this section.
Sec. 154. NRS 439.580 is hereby amended to read as follows:
439.580 1. Any local health officer or a deputy of a local
health officer who neglects or fails to enforce the provisions of this
chapter in his or her jurisdiction, or neglects or refuses to perform any
of the duties imposed upon him or her by this chapter or by the
instructions and directions of the Division shall be punished by a fine
of not more than $250.
2. Except as otherwise provided in NRS 439.589, each person
who violates any of t he provisions of this chapter or refuses or
neglects to obey any lawful order, rule or regulation of the:
(a) State Board of Health or violates any rule or regulation
approved by the State Board of Health pursuant to NRS 439.350,
439.366, 439.410 and 439.460; or
(b) Director of the Authority adopted pursuant to NRS 439.581
to 439.597, inclusive,
is guilty of a misdemeanor.
Sec. 155. NRS 439.587 is hereby amended to read as follows:
439.587 1. The Director of the Authority is the state authority
for health information technology.
2. The Director of the Authority may establish or contract with
one or more health information exchanges to be responsible for
compiling statewide master indexes of patients, health care providers
and payers. The Director of the Authority may by regulation
prescribe the requirements for such a health information exchange,
including, without limitation, the procedure by which any patient,
health care provider or payer master index created pursuant to any
contract is transferred to the State upon termination of the contract.
3. The Director of the Authority may enter into contracts, apply
for and accept available gifts, grants and donations, and adopt such
regulations as are necessary to carry out the provisions of NRS
439.581 to 439.597, inclusive.
Sec. 156. 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 of the Authority 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
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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 of the Authority 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, or the regu lations adopted
pursuant thereto or any applicable federal or state law.
4. When the Director of the Authority 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 authority,
jurisdiction and reasons for the action to be taken. A health
information exchange that wishes to contest the action of the Director
of the Authority must file an appeal with the Director [.] of the
Authority.
5. The Director of the Authority shall adopt regulations
establishing the manner in which a person may file a complaint with
the Director of the Authority regarding a violation of the provisions
of this section.
6. The Director of the Authority may impose an administrative
fine against a health information exchange which operates in this
State without holding a certification in an amount established by the
Director of the Authority by regulation. The Director of the Authority
shall afford a health information exchange so fined an opportunity for
a hearing pursuant to the provisions of NRS 233B.121.
7. The Director of the Authority may adopt such regulations as
he or she determines are necessary to carry out the provisions of this
section.
Sec. 157. NRS 439.589 is hereby amended to read as follows:
439.589 1. The Director [,] of the Authority, 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 electronic 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:
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(I) The use of networks and technologies that allow
patients to ac cess 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 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 he alth 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 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 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, se curing 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
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(c) Be based on nationally 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 transmittal 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 retrieve 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 requirements necessary to comply with all
applicable federal laws relating to electronic health records, heal th-
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 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, the Authority and the divisions
thereof, other state and local governmental entities, 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 any other r egulations
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 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 health care provi der may apply to the [Department]
Authority for a waiver from the provisions of subsection 4 on the
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basis that the health care provider does not have the infrastructure
necessary to comply with those provisions, including, without
limitation, because the h ealth care provider does not have access to
the Internet. The [Department] Authority shall grant a waiver if it
determines that:
(a) The 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 health care provider to continue to
operate.
7. The provisions of subsection 4 do not apply to the Department
of Corrections.
8. A violation of the provisions of this section or any regulations
adopted pursuant thereto is not a misdemeanor.
9. As used in this section:
(a) “Pharmacy benefit manager” has the meaning ascribed to it in
NRS 683A.174.
(b) “Third party” means any insurer, governmental entity or other
organization providing health coverage or benefits in accordance with
state or federal law.
Sec. 158. NRS 439.5895 is hereby amended to read as follows:
439.5895 1. The [Department] Authority 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] Authority determines that the licensed
provider or insurer is not in compliance with the requirements of
subsection 4 of NRS 439.589; and
(b) The licensed provider or insurer:
(1) Is not exempt from those requirements pursuant to
subsection 5 of NRS 439.589; and
(2) Has not received a waiver of those requirements pursuant
to subsection 6 of NRS 439.589.
2. If the [Department] Authority 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 of NRS 439.589, th e [Department] Authority 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 practice an occupation or
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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 provider of health care, as defined in NRS 629.031, who
is licensed pursuant to title 54 of NRS; or
(4) Any person licensed pursuant to title 57 of NRS.
(c) “Regulatory body” means any governmental entity that issues
a license.
Sec. 159. NRS 439.590 is hereby amended to read as follows:
439.590 1. Except as otherwise authorized by the Health
Insurance Portability and Accountability Act of 1996, Public Law
104-191, a person shall not use, release or publish:
(a) Individually identifiable health information from an electronic
health record or a health information exchange for a purpose
unrelated to the treatment, care, well -being or billing of the person
who is the subject of the information; or
(b) Any information contained in an electronic health record or
retained by or retrieved from a health information exchange for a
marketing purpose.
2. Individually identifiable health information obtained from an
electronic health record or a health information exchange concerning
health care services received by a child without the consent of a parent
or guardian of the child must not be disclosed to the parent or
guardian of the child without the consent of the c hild which is
obtained in the manner established pursuant to NRS 439.589.
3. A person who accesses an electronic health record or a health
information exchange without authority to do so is guilty of a
misdemeanor and liable for any damages to any person that result
from the unauthorized access.
4. The Director of the Authority shall adopt regulations
establishing the manner in which a person may file a complaint with
the Director of the Authority regarding a violation of the provisions
of this section. The Director of the Authority shall also post on the
Internet website of the [Department] Authority and publish in any
other manner the Director of the Authority deems necessary and
appropriate information concerning the manner in which to file a
complaint with the Director of the Authority and the manner in which
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to file a complaint of a violation of the Health Insurance Portability
and Accountability Act of 1996, Public Law 104-191.
Sec. 160. NRS 439.591 is hereby amended to read as follows:
439.591 1. Except as otherwise provided in subsection 2 of
NRS 439.597, a patient must not be required to participate in a health
information exchange. Before a patient’s health care records may be
retrieved from a health information exchange, the patient must be
fully informed and affirmatively consent, in the manner prescribed by
the Director [.] of the Authority. It is the public policy of this State
that, except as otherwise provided in NRS 439.597, a patient’s health
care records must not be retrieved from a health information
exchange unless the patient provides such affirmative consent.
2. A patient must be notified in the manner prescribed by the
Director of the A uthority of any breach of the confidentiality of
electronic health records of the patient or a health information
exchange.
3. A patient who consents to the retrieval of his or her electronic
health record from a health information exchange may at any ti me
request that a health care provider access and provide the patient with
his or her electronic health record in accordance with the provisions
of 45 C.F.R. § 164.524.
Sec. 161. NRS 439.803 is hereby amended to read as follows:
439.803 “Health facility” means:
1. Any facility licensed by the Health Care Purchasing and
Compliance Division pursuant to chapter 449 of NRS; and
2. A home operated by a provider of community -based living
arrangement services, as defined in NRS 449.0026.
Sec. 162. NRS 439.835 is hereby amended to read as follows:
439.835 1. Except as otherwise provided in subsection 2:
(a) A person who is employed by a health facility shall, within 24
hours after becoming aware of a sentinel event that occurred at the
health facility, notify the patient safety officer of the facility of the
sentinel event; and
(b) The patient safety officer shall, within 13 days after receiving
notification pursuant to paragraph (a), report the date, the time and a
brief description of the sentinel event to:
(1) The Health Care Purchasing and Compliance Division;
and
(2) The representative designated pursuant to NRS 439.855, if
that person is different from the patient safety officer.
2. If the patient safety officer of a health facility person ally
discovers or becomes aware, in the absence of notification by another
employee, of a sentinel event that occurred at the health facility, the
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patient safety officer shall, within 14 days after discovering or
becoming aware of the sentinel event, report the date, time and brief
description of the sentinel event to:
(a) The Health Care Purchasing and Compliance Division; and
(b) The representative designated pursuant to NRS 439.855, if
that person is different from the patient safety officer.
3. The State Board of Health shall prescribe the manner in which
reports of sentinel events must be made pursuant to this section.
Sec. 163. NRS 439.840 is hereby amended to read as follows:
439.840 1. The Health Care Purchasing and Compliance
Division shall:
(a) Collect and maintain reports received pursuant to NRS
439.835 and 439.843 and any additional information requested by the
Health Care Purchasing and Compliance Division pursuant to
NRS 439.841;
(b) Ensure that such reports, and any additional documents
created from such reports, are protected adequately from fire, theft,
loss, destruction and other hazards and from unauthorized access;
(c) Annually prepare a report of sentinel events reported pursuant
to NRS 439.835 by a health facility, including, without limitation, the
type of event, the number of events, the rate of occurrence of events,
and the health facility which reported the event, and provide the
report for inclusion on the Internet website maintained by the
Authority pursuant to NRS 439A.270; and
(d) Annually prepare a summary of the reports received pursuant
to NRS 439.835 and provide a summary for inclusion on the Internet
website maintained by the Authority pursuant to NRS 439A.270. The
Health Care Purchasing and Compliance Division shall maintain
the confidentiality of the patient, the provider of health care or other
member of the staff of the health facility identified in the reports
submitted pursuant to NRS 439.835 when preparing the annual
summary pursuant to this paragraph.
2. Except as otherwise provided in this section and NRS
239.0115, reports received pursuant to NRS 439.835 and subsection
1 of NRS 439.843 and any additional information requested by the
Health Care Purchasing and Compliance Division pursuant to NRS
439.841 are confidential, not subject to subpoena or discovery and
not subject to inspection by the general public.
3. The report prepared pursuant to paragraph (c) of subsection 1
must provide to the public information concerning each health facility
which [provided medical services and care in ] reported a sentinel
event during the immediately preceding calendar year and must:
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(a) Be presented in a manner that allows a person to view and
compare the information for the health facilities;
(b) Be readily accessible and understandable by a member of the
general public;
(c) Use standard statistical methodology, including without
limitation, risk-adjusted methodology when applicable, and include
the description of the methodology and data limitations contained in
the report;
(d) Not identify a patient, provider of health care or other member
of the staff of the health facility; and
(e) Not be reported for a health facility if reporting the data would
risk identifying a patient.
Sec. 164. NRS 439.841 is hereby amended to read as follows:
439.841 1. Upon receipt of a report pursuant to NRS 439.835,
the Health Care Purchasing and Compliance Division may, as often
as deemed necessary by the Administrator of the Health Care
Purchasing and Compliance Division to protect the health and safety
of the public, request additional information regarding the sentinel
event or conduct an audit or investigation of the health facility.
2. A health facility shall provide to the Health Care Purchasing
and Compliance Division any information requested in furtherance
of a request for information, an audit or an investigation pursuant to
this section.
3. If the Health Care Purchasing and Compliance Division
conducts an audit or investigation pursuant to this section, the Health
Care Purchasing and Compliance Division shall, within 30 days
after completing such an audit or investigation, report its findings to
the State Board of Health.
4. A health facility which is audited or investigated pursuant to
this section shal l pay to the Health Care Purchasing and
Compliance Division the actual cost of conducting the audit or
investigation.
Sec. 165. NRS 439.843 is hereby amended to read as follows:
439.843 1. On or before March 1 of each year, each health
facility shall provide to the Health Care Purchasing and
Compliance Division, in the form prescribed by the State Board of
Health, a summary of the reports submitted by the health facility
pursuant to NRS 439.835 during the immediately preceding calendar
year. The summary must include, without limitation:
(a) The total number and types of sentinel events reported by the
health facility, if any;
(b) For a medical facility:
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(1) A copy of the most current patient safety plan established
pursuant to NRS 439.865; and
(2) A summary of the membership and activities of the patient
safety committee established pursuant to NRS 439.875; and
(c) Any other information required by the State Board of Health
concerning the reports submitted by the health facility pursuant to
NRS 439.835.
2. On or before June 1 of each year, the Health Care
Purchasing and Compliance Division shall submit to the State Board
of Health an annual summary of the reports and information received
by the Health Care Purchasing and Compliance Division pursuant
to this section. The annual summary must include, without limitation,
a compilation of the information submitted pursuant to subsection 1
and any other pertinent information deemed necessary by the State
Board of Health concerning the reports submitted by the health
facility pursuant to NRS 439.835. The Health Care Purchasing and
Compliance Division shall maintain the confidentiality of the patient,
the provider of health care or other member of the staff of the health
facility identified in the reports submitted pursuant to NRS 439.835
and any other identifying information of a person requested by the
State Board of Health concerning those reports when preparing the
annual summary pursuant to this section.
3. The [Department] Authority shall post on the Internet website
maintained pursuant to NRS 439A.270 or any other website
maintained by the [Department] Authority a copy of the most current
patient safety plan submitted by each health facility pursuant to
subsection 1.
Sec. 166. NRS 439.845 is hereby amended to read as follows:
439.845 1. The Health Care Purchasing and Compliance
Division shall analyze and report trends regarding sentinel events.
2. When the Health Care Purchasing and Compliance
Division receives notice from a health facility that the health facility
has taken corrective action to remedy the causes or contributing
factors, or both, of a sentinel event, the Health Care Purchasing and
Compliance Division shall:
(a) Make a record of the information;
(b) Ensure that the information is released in a manner so as not
to reveal the identity of a specific patient, provider of health care or
member of the staff of the facility; and
(c) At least quarterly, report its findings regarding the analysis of
trends of sentinel events on the Internet website maintained by the
Authority pursuant to NRS 439A.270.
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Sec. 167. NRS 439.847 is hereby amended to read as follows:
439.847 1. Each medical facility and facility for skilled
nursing which provided medical services and care to an average of
25 or more patients during each business day in the immediately
preceding calendar year shall, within 120 days after becoming
eligible, participate in the secure, Internet-based surveillance system
established by the Division of Healthcare Qua lity Promotion of the
Centers for Disease Control and Prevention of the United States
Department of Health and Human Services that integrates patient and
health care personnel safety surveillance systems. As part of that
participation, the medical facility or facility for skilled nursing shall
provide, at a minimum, the information required by the Health Care
Purchasing and Compliance Division pursuant to this subsection.
The Health Care Purchasing and Compliance Division shall by
regulation prescribe the i nformation which must be provided by a
medical facility or facility for skilled nursing, including, without
limitation, information relating to infections and procedures.
2. Each medical facility or facility for skilled nursing which
provided medical services and care to an average of less than 25
patients during each business day in the immediately preceding
calendar year may participate in the secure, Internet -based
surveillance system established by the Division of Healthcare Quality
Promotion of the Centers for Disease Control and Prevention of the
United States Department of Health and Human Services that
integrates patient and health care personnel safety surveillance
systems.
3. A medical facility or facility for skilled nursing that
participates in the secure, Internet -based surveillance system
established by the Division of Healthcare Quality Promotion shall:
(a) Authorize the Health Care Purchasing and Compliance
Division to access all information submitted to the system by:
(1) A medical facility, on or after October 15, 2010; and
(2) A facility for skilled nursing, on or after January 1, 2012;
and
(b) Provide consent for the Health Care Purchasing and
Compliance Division to prepare and post reports pursuant to
paragraph (b) of subsection 4, including without limitation,
permission to identify the medical facility or facility for skilled
nursing that is the subject of each report:
(1) For a medical facility, on or after October 15, 2010; and
(2) For a facility for skilled nursing, on or after January 1,
2012.
4. The Health Care Purchasing and Compliance Division:
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(a) Shall analyze the information submitted to the system by
medical facilities and facilities for skilled nursing pursuant to this
section and recommend regulations and legislation relating to the
reporting required pursuant to NRS 439.800 to 439.890, inclusive.
(b) Shall annually prepare a report of the information submitted
to the system by eac h medical facility and each facility for skilled
nursing pursuant to this section and provide the reports for inclusion
on the Internet website maintained by the Authority pursuant to NRS
439A.270. The information must be reported in a manner that allows
a person to compare the information for the medical facilities and for
the facilities for skilled nursing and expressed as a total number and
a rate of occurrence.
(c) Shall enter into an agreement with the Division of Healthcare
Quality Promotion to carry out the provisions of this section.
5. As used in this section, “facility for skilled nursing” has the
meaning ascribed to it in NRS 449.0039.
Sec. 168. NRS 439.856 is hereby amended to read as follows:
439.856 1. A medical facility shall:
(a) Provide to each patient of the medical facility, upon admission
of the patient, the general and facility-specific information relating to
facility-acquired infections required by subsection 2.
(b) Post in publicly accessible areas of the medical facility
information on reporting facility -acquired infections, including,
without limitation, the contact information for making reports to the
Health Care Purchasing and Compliance Division. Such
information may be added to other required notices concerning the
making of reports to the Health Care Purchasing and Compliance
Division.
2. The information provided to each patient pursuant to
paragraph (a) of subsection 1 must include, without limitation:
(a) The measures used by the medical facility for preventing
infections, including facility-acquired infections;
(b) Information on determining whether a patient had an infection
upon admission to the medical facility, risk factors for acquiring
infections and determining whether an infection has been acquired;
(c) Information on preventing facility-acquired infections;
(d) Instructions for reporting facility -acquired infections,
including, without limitation, the contact information for making
reports to the Health Care Purchasing and Compliance Division;
and
(e) Any other information that the medical facility deems
necessary.
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Sec. 169. NRS 439.873 is hereby amended to read as follows:
439.873 1. A medical facility shall designate an officer or
employee of the facility to serve as the infection control officer of the
medical facility.
2. The person who is designated as the infection control officer
of a medical facility:
(a) Shall serve on the patient safety committee.
(b) Shall monitor the occurrences of infections at the medical
facility to determine the number and severity of infections.
(c) Shall report to the patient safety committee concerning the
number and severity of infections at the medical facility.
(d) Shall take such action as he or she determines is necessary to
prevent and control infections alleged to have occurred at the medical
facility.
(e) Shall carry out the provisions of the infection control program
adopted pursuant to NRS 439.865 and ensure compliance with the
program.
3. If a medical facility has 175 or more beds, the person who is
designated as the infection control officer of the medical facility must
be certified as an infection preventionist by the Certification Board of
Infection Control and Epidemiology, Inc., or a successor
organization. A person may serve as the certified infection
preventionist for more than one medical facility if the facilities have
common ownership.
4. A medical facility that designates an infection control officer
who is not a certified infection preventionist must ensure that the
person has successf ully completed a nationally recognized basic
training program in infection control, which may include, without
limitation, the program offered by the Association for Professionals
in Infection Control and Epidemiology, Inc., or a successor
organization. A medical facility shall ensure that an infection control
officer completes at least 4 hours of continuing education each year
on topics relating to current practices in infection control and
prevention.
5. A medical facility shall ensure that it maintains a ratio of at
least one employee who has the training described in subsection 4 for
every 100 occupied beds. The number of beds must be determined
based upon the most recent annual calendar-year average reported by
the medical facility to the Director of the Authority pursuant to NRS
449.490 and the regulations adopted pursuant thereto.
6. A medical facility shall maintain records concerning the
certification and training required by this section.
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7. The Health Care Purchasing and Compliance Division shall
provide education and technical assistance relating to infection
control and prevention in medical facilities.
Sec. 170. NRS 439.875 is hereby amended to read as follows:
439.875 1. A medical facility shall establish a patient safety
committee.
2. Except as otherwise provided in subsection 3:
(a) A patient safety committee established pursuant to subsection
1 must be composed of:
(1) The infection control officer of the medical facility.
(2) The patient safety officer of the medical facility, if he or
she is not designated as the infection control officer of the medical
facility.
(3) At least three providers of health care who treat patients at
the medical facility, including, without limitation, at least one
member of the medical, nursing and pharmaceutical staff of the
medical facility.
(4) One member of the executive or governing body of the
medical facility.
(b) A patient safety committee shall meet at least once each
month.
3. The Administrator of the Health Care Purchasing and
Compliance Division shall adopt regulations prescribing the
composition and frequency of meetings of patient safety committees
at medical facilities having fewer than 25 employees and contractors.
4. A patient safety committee shall:
(a) Receive re ports from the patient safety officer pursuant to
NRS 439.870.
(b) Evaluate actions of the patient safety officer in connection
with all reports of sentinel events alleged to have occurred at the
medical facility.
(c) Review and evaluate the quality of m easures carried out by
the medical facility to improve the safety of patients who receive
treatment at the medical facility.
(d) Review and evaluate the quality of measures carried out by
the medical facility to prevent and control infections at the medic al
facility.
(e) Make recommendations to the executive or governing body of
the medical facility to reduce the number and severity of sentinel
events and infections that occur at the medical facility.
(f) At least once each calendar quarter, report to the executive or
governing body of the medical facility regarding:
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(1) The number of sentinel events that occurred at the medical
facility during the preceding calendar quarter;
(2) The number and severity of infections that occurred at the
medical facility during the preceding calendar quarter; and
(3) Any recommendations to reduce the number and severity
of sentinel events and infections that occur at the medical facility.
(g) Adopt patient safety checklists and patient safety policies as
required by NRS 439.877, review the checklists and policies annually
and revise the checklists and policies as the patient safety committee
determines necessary.
5. The proceedings and records of a patient safety committee are
subject to the same privilege and pr otection from discovery as the
proceedings and records described in NRS 49.265.
Sec. 171. NRS 439.885 is hereby amended to read as follows:
439.885 1. If a health facility:
(a) Commits a violation of any provision of NRS 439.800 to
439.890, inclusive, or for any violation for which an administrative
sanction pursuant to NRS 449.163 would otherwise be applicable;
and
(b) Of its own volition, reports the violation to the Administrator
[,] of the Health Care Purchasing and Compliance Division,
such a violation must not be used as the basis for imposing an
administrative sanction pursuant to NRS 449.163.
2. If a health facility commits a violation of any provision of
NRS 439.800 to 439.890, inclusive, and does not, of its own volition,
report the violation to the Administrator [,] of the Health Care
Purchasing and Compliance Division, the Health Care Purchasing
and Compliance Division may, in accordance with the provisions of
subsection 3, impose an administrative sanction:
(a) For failure to report a sentinel event, in an amount not to
exceed $100 per day for each day after the date on which the sentinel
event was required to be reported pursuant to NRS 439.835;
(b) For failure to adopt and implement a patient safety plan
pursuant to NRS 439.865, in an amount not to exceed $1,000 for each
month in which a patient safety plan was not in effect; and
(c) For failure to establish a patient safety committee or failure of
such a committee to meet pursuant to the requirements of NRS
439.875, in an amount not to exceed $2,000 for each violation of that
section.
3. Before the Health Care Purchasing and Compliance
Division imposes an administrative sanction pursuant to subsection
2, the Health Care Purchasing and Compliance Division shall
provide the health facility with reasonable notice. The notice must
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contain the legal authority, jurisdiction and reasons for the action to
be taken. If a health facility wants to contest the action, the facility
may file an appeal pursuant to the regulations of the State Board of
Health adopted pursuant to NRS 449.165 and 449.170. Upon
receiving notice of an appeal, the Health Care Purchasing and
Compliance Division shall hold a hearing in accordance with those
regulations.
4. An administrative sanction collected p ursuant to this section
must be accounted for separately and used by the Health Care
Purchasing and Compliance Division to provide training and
education to employees of the Health Care Purchasing and
Compliance Division, employees of health facilities and members of
the general public regarding issues relating to the provision of quality
and safe health care.
Sec. 172. NRS 439.908 is hereby amended to read as follows:
439.908 1. The Patient Protection Commission is hereby
created within the [Office of the Director. ] Consumer Health
Division of the Authority. The Commission consists of:
(a) The following 12 voting members appointed by the Director
of the Authority, subject to the approval of the Governor:
(1) Two members who are persons with expertise and
experience in advocating on behalf of patients.
(2) One member who is a provider of health care who operates
a for-profit business to provide health care.
(3) One member who is a registered nurse who practices
primarily at a nonprofit hospital.
(4) One member who is a physician or registered nurse who
practices primarily at a federally-qualified health center, as defined in
42 U.S.C. § 1396d(l)(2)(B).
(5) One member who is a pharmacist at a pharmacy not
affiliated with any chain of pharmacies or a person who has expertise
and experience in advocating on behalf of patients.
(6) One member who represents a nonprofit public hospital
that is located in the county of this State that spends the largest
amount of money on hospital care for i ndigent persons pursuant to
chapter 428 of NRS.
(7) One member who represents the private nonprofit health
insurer with the highest percentage of insureds in this State who are
adversely impacted by social determinants of health.
(8) One member who has expertise and experience in
advocating for persons who are not covered by a policy of health
insurance.
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(9) One member who has expertise and experience in
advocating for persons with special health care needs and has
education and experience in health care.
(10) One member who is an employee or a consultant of the
[Department] Authority with expertise in health information
technology and patient access to medical records.
(11) One member who is a representative of the general
public.
(b) The Direc tor of the [Department,] Authority, the
Commissioner of Insurance, the Executive Director of the Silver State
Health Insurance Exchange and the Executive Officer of the Public
Employees’ Benefits Program or his or her designee as ex officio,
nonvoting members.
2. The [Governor] Director of the Authority shall:
(a) Appoint two of the voting members of the Commission
described in paragraph (a) of subsection 1 from a list of persons
nominated by the Majority Leader of the Senate;
(b) Appoint two of the vot ing members of the Commission
described in paragraph (a) of subsection 1 from a list of persons
nominated by the Speaker of the Assembly; and
(c) Ensure that the members appointed by the [Governor]
Director of the Authority to the Commission reflect the geographic
diversity of this State.
3. Members of the Commission serve:
(a) At the pleasure of the [Governor;] Director of the Authority;
and
(b) Without compensation or per diem but are entitled to receive
reimbursement for travel expenses in the same amount provided for
state officers and employees generally.
4. After the initial terms, the term of each voting member is 2
years, except that the [Governor] Director of the Authority may
remove a voting member at any time and for any reason. A member
may be reappointed.
5. If a vacancy occurs during the term of a voting member, the
[Governor] Director of the Authority shall appoint a person similarly
qualified to replace that member for the remainder of the unexpired
term.
6. The [Governor] Director of the Authority shall annually
designate a voting member to serve as the Chair of the Commission.
7. A majority of the voting members of the Commission
constitutes a quorum for the transaction of business, and a majority
of the members of a quorum pres ent at any meeting is sufficient for
any official action taken by the Commission.
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8. The members of the Commission shall comply with the
requirements of NRS 281A.420 applicable to public officers
generally.
Sec. 173. NRS 439.914 is hereby amended to read as follows:
439.914 1. The [Governor] Director of the Authority shall ,
subject to the approval of the Governor, appoint the Executive
Director of the Commission within the [Office of the Governor. ]
Authority. The Executive Director:
(a) Must have experience in health care or health insurance;
(b) Is in the unclassified service of the State; and
(c) Serves at the pleasure of the [Governor.] Director of the
Authority.
2. The Executive Director shall:
(a) Perform the administrative duties of the Commission and such
other duties as are directed by the Commission [;] and the Director
of the Authority or his or her designee; and
(b) To the extent that money is available for this purpose, appoint
employees to assist the Executive Director in carrying out the duties
prescribed in paragraph (a). Such employees serve at the pleasure of
the Executive Director and are in the unclassified service of the State.
3. The Executive Director may request any information
maintained by a state agency that is necessary for the performance of
his or her duties, including, without limitation, information that is
otherwise declared confidential by law. Except as otherwise provided
in NRS 598A.110, to the extent authorized by the Health Insurance
Portability and Accountability Act of 1996, Public Law 104-191, and
the regulations adopted pursuant thereto, an agency from which such
information is requested shall provide the information to the
Executive Director.
4. The Executive Director:
(a) Shall maintain any information obtained pursuant to
subsection 3 under the same conditions as the information is
maintained by the agency that provided the information; and
(b) Except as otherwise provided in this paragraph, shall not
disclose any confidential information obtained pursuant to subsection
3 to any other person or entity, including, without limitation, the
Commission or a member thereof. The Executive Director may
disclose or publish aggregated information in a manner that does not
reveal the identity of any person.
Sec. 174. NRS 439.916 is hereby amended to read as follows:
439.916 1. The Commission shall systematically review
issues related to the health care needs of residents of this State and
the quality, accessibility and affordability of health care, including,
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without limitation, prescription drugs, in this State. The review must
include, without limitation:
(a) Comprehensively examining the system for regulating health
care in this State, including, without limitation, the licensing and
regulation of health care facilities and providers of health care and the
role of professional licensing boards, commissions and other bodies
established to regulate or evaluate policies related to health care.
(b) Identifying gaps and duplication in the roles of su ch boards,
commissions and other bodies.
(c) Examining the cost of health care and the primary factors
impacting those costs.
(d) Examining disparities in the quality and cost of health care
between different groups, including, without limitation, minori ty
groups and other distinct populations in this State.
(e) Reviewing the adequacy and types of providers of health care
who participate in networks established by health carriers in this State
and the geographic distribution of the providers of health ca re who
participate in each such network.
(f) Reviewing the availability of health benefit plans, as defined
in NRS 687B.470, in this State.
(g) Reviewing the effect of any changes to Medicaid, including,
without limitation, the expansion of Medicaid pursuant to the Patient
Protection and Affordable Care Act, Public Law 111-148, on the cost
and availability of health care and health insurance in this State.
(h) If a data dashboard is established pursuant to NRS 439.245,
using the data dashboard to rev iew access by different groups and
populations in this State to services provided through telehealth and
evaluating policies to make such access more equitable.
(i) Reviewing proposed and enacted legislation, regulations and
other changes to state and loc al policy related to health care in this
State.
(j) Researching possible changes to state or local policy in this
State that may improve the quality, accessibility or affordability of
health care in this State, including, without limitation:
(1) The use of purchasing pools to decrease the cost of health
care;
(2) Increasing transparency concerning the cost or provision
of health care;
(3) Regulatory measures designed to increase the accessibility
and the quality of health care, regardless of geograph ic location or
ability to pay;
(4) Facilitating access to data concerning insurance claims for
medical services to assist in the development of public policies;
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(5) Resolving problems relating to the billing of patients for
medical services;
(6) Leveraging the expenditure of money by the Medicaid
program and reimbursement rates under Medicaid to increase the
quality and accessibility of health care for low-income persons; and
(7) Increasing access to health care for uninsured populations
in this State, including, without limitation, retirees and children.
(k) Monitoring and evaluating proposed and enacted federal
legislation and regulations and other proposed and actual changes to
federal health care policy to determine the impact of such changes on
the cost of health care in this State.
(l) Evaluating the degree to which the role, structure and duties of
the Commission facilitate the oversight of the provision of health care
in this State by the Commission and allow the Commission to perform
activities necessary to promote the health care needs of residents of
this State.
(m) Making recommendations to the Governor, the Legislature,
the Department of [Health and] Human Services, the Authority, local
health authorities and any other person or governm ental entity to
increase the quality, accessibility and affordability of health care in
this State, including, without limitation, recommendations
concerning the items described in this subsection.
2. The Commission may request that any state or local
governmental entity submit not more than two reports each year
containing or analyzing information that is not confidential by law
concerning the cost of health care, consolidation among entities that
provide or pay for health care or other issues related to access to
health care. To the extent that a governmental entity from which such
a report is requested has the resources to compile the report and the
disclosure of the information requested is authorized by the Health
Insurance Portability and Accountabil ity Act of 1996, Public Law
104-191, the governmental entity shall provide the report to the
Executive Director of the Commission and submit a copy of the report
to the Attorney General.
3. If a data dashboard is established pursuant to NRS 439.245,
the Commission shall make available on an Internet website
maintained by the Commission a hyperlink to the data dashboard.
4. As used in this section:
(a) “Health carrier” has the meaning ascribed to it in
NRS 687B.625.
(b) “Network” has the meaning ascribed to it in NRS 687B.640.
(c) “Telehealth” has the meaning ascribed to it in NRS 629.515.
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Sec. 175. NRS 439.918 is hereby amended to read as follows:
439.918 1. In addition to conducting the review described in
NRS 439.916, the Commission shall:
(a) Attempt to identify and facilitate collaboration between
existing state governmental entities that study or address issues
relating to the quality, accessibility and affordability of health care in
this State, including, without limitation, the regional behavioral
health policy boards created by NRS 433.429;
(b) Attempt to coordinate with such entities to reduce any
duplication of efforts among and between those entities and the
Commission;
(c) Establish, submit to the Director of the Authority and annually
update a plan to increase access by patients to their medical records
and provide for the interoperability of medical records between
providers of health care in accordance with the requirements of the
Health Insurance Portability and Accountability Act of 1996, Public
Law 104-191, and any other applicable federal law or regulations;
and
(d) Make recommendations to the Director of the Authority and
the Legislature concerning:
(1) The analysis and use of data to improve access to and the
quality of health care in this State, including, without limitation, using
data to establish priorities for addressing health care needs; and
(2) Ensuring that data concerning health care in this State is
publicly available and transparent.
2. On or befo re January 1 and July 1 of each year, the
Commission shall:
(a) Compile a report describing the meetings of the Commission
and the activities of the Commission during the immediately
preceding 6 months. The report must include, without limitation, a
description of any issues identified as negatively impacting the
quality, accessibility or affordability of health care in this State and
any recommendations for legislation, regulations or other changes to
policy or budgets to address those issues.
(b) Submit the report to the Governor and the Director of the
Legislative Counsel Bureau for transmittal to:
(1) In January of odd-numbered years, the next regular session
of the Legislature.
(2) In all other cases, to the Joint Interim Standing Committee
on Health and Human Services.
3. Upon receiving a report pursuant to subsection 2, the
Governor shall post the report on an Internet website maintained by
the Governor.
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4. The Commission may prepare and publish additional reports
on specific topics at the direction of the Chair.
Sec. 175.3. NRS 439.942 is hereby amended to read as follows:
439.942 1. The Division may establish a secure Internet
website which makes certain information available for the Authority
or a website client to conduct an investi gation into the background
and personal history of a person that is required pursuant to the
provisions of this chapter or chapter 62B, 63, 424, 427A, 432, 432A,
432B, 433, 433B, 435 or 449 of NRS.
2. To become a website client, a person or governmental entity
must:
(a) Create an account on the Internet website;
(b) Comply with NRS 439.942 to 439.948, inclusive, and any
regulations adopted pursuant thereto governing use of the Internet
website; and
(c) Designate a website client administrator who is re sponsible
for:
(1) Determining the persons who are authorized to use the
Internet website;
(2) Providing the Division with the names of the persons who
are authorized to use the Internet website;
(3) Ensuring that only those authorized persons have access to
the Internet website; and
(4) Notifying the Division of any change in the persons who
are authorized to use the Internet website.
3. Authorized employees of the Division and of the Department
of Public Safety may be designated to serve as adm inistrators of the
Internet website with access to all the data and information on the
Internet website.
4. Except as otherwise provided in this section and NRS
239.0115, information collected, maintained, stored, backed up or on
file on the Internet website is confidential, not subject to subpoena or
discovery and is not subject to inspection by the general public.
5. The Division shall ensure that any information collected,
maintained and stored on the Internet website is protected adequately
from fir e, theft, loss, destruction, other hazards and unauthorized
access, and is backed -up in a manner that ensures proper
confidentiality and security.
6. The Internet website must be maintained in accordance with
any requirements of the Office of the Chief Information Officer
within the Office of the Governor established for use of the equipment
or services of the Office pursuant to NRS 242.181.
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Sec. 175.6. NRS 439.947 is hereby amended to read as follows:
439.947 1. When establishing permissions for a website client
to access information on the Internet website established pursuant to
NRS 439.942, the Division shall determine the information necessary
for the website client to conduct an investigation into the background
and personal history of a person and limit access to the website client
to only the information necessary for that website client.
2. Information regarding a person whose background and
personal history is investigated must not be shared with any other
website client.
3. A person who is authorized to use the Internet website by the
website client administrator pursuant to NRS 439.942 may be given
permission to access any information deemed necessary pursuant to
subsection 1.
4. The Authority or any division thereof may access
information on the Internet website established pursuant to NRS
439.942 without restriction , without becoming a website client
pursuant to NRS 439.942 and without paying any fee imposed
pursuant to NRS 439.948.
Sec. 176. Chapter 439A of NRS is hereby amended by adding
thereto a new section to read as follows:
“Authority” means the Nevada Health Authority.
Sec. 177. NRS 439A.010 is hereby amended to read as follows:
439A.010 As used in this chapter, unless the context otherwise
requires, the words and term s defined in NRS 439A.012 to
439A.0195, inclusive, and section 176 of this act have the meanings
ascribed to them in those sections.
Sec. 178. NRS 439A.100 is hereby amended to read as follows:
439A.100 1. Except as otherwise provided in this section, in a
county whose population is less than 100,000, or in an incorporated
city or unincorporated town whose population is less than 25,000 that
is located in a county whose population is 100,000 or more, no person
may undertake any proposed expenditure for new construction by or
on behalf of a health facility in excess of the greater of $2,000,000 or
such an amount as the [Department] Authority may specify by
regulation, which under generally accepted accounting principles
consistently applied is a capital expenditure, without first applying
for and obtaining the written approval of the Director. The Health
Care Purchasing and Compliance Division of [Public and
Behavioral Health of the Department] the Authority shall not issue a
new license or alter an existing license for such a project unless the
Director has issued such an approval.
2. The provisions of subsection 1 do not apply to:
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(a) Any capital expenditure for:
(1) The acquisition of land;
(2) The construction of a facility for parking;
(3) The maintenance of a health facility;
(4) The renovation of a health facility to comply with
standards for safety, licensure, certification or accreditation;
(5) The installation of a system to conserve energy;
(6) The installation of a system for data processing or
communication; or
(7) Any other project which, in the opinion of the Director,
does not relate directly to the provision of any health service;
(b) Any project for the development of a health facility that has
received legislative approval and authorization; or
(c) A project for the construction of a hospital in an
unincorporated town if:
(1) The population of the unincorporated town is more than
24,000;
(2) No other hospital exists in the town;
(3) No other hospital has been a pproved for construction or
qualified for an exemption from approval for construction in the town
pursuant to this section; and
(4) The unincorporated town is at least a 45-minute drive from
the nearest center for the treatment of trauma that is [licensed]
approved by the Administrator of the Division of Public and
Behavioral Health of the Department [.] pursuant to
NRS 450B.236.
Upon determining that a project satisfies the requirements for an
exemption pursuant to this subsection, the Director shall issue a
certificate which states that the project is exempt from the
requirements of this section.
3. In reviewing an application for approval, the Director shall:
(a) Comparatively assess applications for similar projects
affecting the same geographic area; and
(b) Base his or her decision on criteria established by the Director
by regulation. The criteria must include:
(1) The need for and the appropriateness of the project in the
area to be served;
(2) The financial feasibility of the project;
(3) The effect of the project on the cost of health care; and
(4) The extent to which the project is consistent with the
purposes set forth in NRS 439A.020 and the priorities set forth in
NRS 439A.081, including, without limitation:
(I) The impact of the project on other health care facilities;
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(II) The need for any equipment that the project proposes
to add, the manner in which such equipment will improve the quality
of health care and any protocols provided in the project for avoiding
repetitive testing;
(III) The impact of the project on disparate health
outcomes for different populations in the area that will be served b y
the project;
(IV) The manner in which the project will expand, promote
or enhance the capacity to provide primary health care in the area that
will be served by the project;
(V) Any plan by the applicant to collect and analyze data
concerning the effect of the project on health care quality and patient
outcomes in the area served by the project;
(VI) Any plan by the applicant for controlling the spread
of infectious diseases; and
(VII) The manner in which the applicant will coordinate
with and support existing health facilities and practitioners, including,
without limitation, mental health facilities, programs for the treatment
and prevention of substance use disorders and providers of nursing
services.
4. The Department may by regulation re quire additional
approval for a proposed change to a project which has previously
been approved if the proposal would result in a change in the location
of the project or a substantial increase in the cost of the project.
5. The decision of the Director is a final decision for the
purposes of judicial review.
6. As used in this section, “hospital” has the meaning ascribed
to it in NRS 449.012.
Sec. 179. NRS 439A.102 is hereby amended to read as follows:
439A.102 1. Except as otherwise provided in this section, no
person may close a hospital in a county whose population is 100,000
or more or convert a hospital in such a county into a different type of
health facility without first applying for and obtaining the wr itten
approval of the Director or the designee of the Director. The Health
Care Purchasing and Compliance Division of [Public and
Behavioral Health of the Department] the Authority shall not issue a
new license or alter an existing license for conversion t o a different
type of health facility unless the Director or the designee of the
Director has issued such an approval.
2. The Director may adopt regulations which prescribe the
process to apply for written approval pursuant to this section.
3. An applicant must provide any information requested by the
Director or the designee of the Director for consideration of an
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application, which must include, without limitation, information
related to:
(a) The location of the hospital;
(b) The ownership structure of the hospital;
(c) Whether the closure or conversion is likely to benefit any
other health facility in the same geographic area as the hospital in
which any person with an ownership interest in the hospital also has
an ownership interest;
(d) An explanation of the need for the closure or conversion;
(e) Data regarding the population served by the hospital in the 24
months immediately preceding the application; and
(f) The manner in which and the locations where the population
served by the hospital w ill be able to obtain the health services that
were provided by the hospital during the 24 months following the
closure or conversion of the hospital.
4. The Director or the designee of the Director shall not approve
an application submitted pursuant to subsection 1 without considering
the information required to be submitted pursuant to subsection 3.
5. The decision of the Director or the designee of the Director
pursuant to this section is a final decision for the purposes of judicial
review.
6. The provisions of this section do not apply to any person who
ceases to operate hospitals in this State.
Sec. 180. NRS 439A.220 is hereby amended to read as follows:
439A.220 1. The [Department] Authority shall establish and
maintain a program to increase public awareness of health care
information concerning the hospitals in this State. The program must
be designed to assist consumers with comparing the quality of care
provided by the hospitals 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) Inpatients and outpatients of each hospital in this State as
reported in the forms submitted pursuant to NRS 449.485;
(b) The quality of care provided by each hospital in this State as
determined by applying measures of quality endorsed by the entities
described in subparagraph (1) of paragraph (b) of subsection 1 of
NRS 439A.230, expressed as a number of events and rate of
occurrence, if su ch measures can be applied to the information
reported in the forms submitted pursuant to NRS 449.485;
(c) How consistently each hospital follows recognized practices
to prevent the infection of patients, to speed the recovery of patients
and to avoid medical complications of patients;
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(d) For each hospital, the total number of patients discharged, the
average length of stay and the average billed charges, reported by
diagnosis-related groups for inpatients and for the 50 medical
treatments for outpatients that the [Department] Authority determines
are most useful for consumers;
(e) The total number of patients discharged from the hospital and
the total number of potentially preventable readmissions, 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;
(f) To the extent that money is available for that purpose, for each
hospital, the name of e ach physician who performed a surgical
procedure in the hospital and the total number of surgical procedures
performed by the physician, reported by diagnosis-related group if the
information is available and by principal diagnosis, principal surgical
procedure and secondary surgical procedure; and
(g) Any other information relating to the charges imposed and the
quality of the services provided by the hospitals in this State which
the [Department] Authority determines is:
(1) Useful to consumers;
(2) Nationally recognized; and
(3) Reported in a standard and reliable manner.
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 thir d-party health care
plans.
Sec. 181. NRS 439A.230 is hereby amended to read as follows:
439A.230 1. The [Department] Authority shall, by regulation:
(a) Prescribe the information that each hospital in this State must
submit to the [Department] Authority for the program established
pursuant to NRS 439A.220.
(b) Prescribe the measures of quality for hospitals that are
required pursuant to paragraph (b) of subsection 2 of NRS 439A.220.
In adopting the regulations, the [Department] Authority shall:
(1) Use the measures of quality endorsed by the Agency for
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 hospitals; and
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(3) Take into consideration the financial burden placed on the
hospitals to comply with the regulations.
The measures prescribed pursuant to this paragraph must report
health outcomes of hospitals, which do not necessarily correlate with
the inpatient diagnosis-related groups or the outpatient treatments that
are posted on the Internet website pursuant to NRS 439A.270.
(c) Prescribe the manner in which a hospital must determine
whether the readmission of a patient must be reported pursuant to
NRS 439A.220 as a potentially preventable readmission and the form
for submission of such information.
(d) Require each hospital to:
(1) Provide the information prescribed in paragraphs (a), (b)
and (c) in the format required by the [Department;] Authority; and
(2) Report the information separately for inpatients and
outpatients.
2. The information required pursuant to this section and NRS
439A.220 must be submitted to the [Department] Authority not later
than 45 days after the last day of each calendar month.
3. If a hospital fails to submit the information required pursuant
to this section or NRS 439A.220 or submits information that is
incomplete or inaccurate, the [Department] Authority shall send a
notice of such failure to the hospital and to the Health Ca re
Purchasing and Compliance Division of [Public and Behavioral
Health of the Department.] the Authority.
Sec. 182. NRS 439A.240 is hereby amended to read as follows:
439A.240 1. The [Department] Authority shall establish and
maintain a program to inc rease public awareness of health care
information concerning the surgical centers for ambulatory patients
in this State. The program must be designed to assist consumers with
comparing the quality of care provided by the surgical centers for
ambulatory patients 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) The charges imposed on outpatients by each surgical center
for ambulatory patien ts in this State as reported in the forms
submitted pursuant to NRS 439A.250;
(b) The quality of care provided by each surgical center for
ambulatory patients in this State as determined by applying uniform
measures of quality prescribed by the [Department] Authority
pursuant to NRS 439A.250;
(c) How consistently each surgical center for ambulatory patients
follows recognized practices to prevent the infection of patients, to
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speed the recovery of patients and to avoid medical complications of
patients;
(d) For each surgical center for ambulatory patients, the total
number of patients discharged and the average billed charges,
reported for 50 medical treatments for outpatients that the
[Department] Authority determines are most useful for consumers;
(e) To the extent that money is available for that purpose, for each
surgical center for ambulatory patients, the 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 the physician, reported by type of medical treatment,
principal diagnosis and, if the information is available, by principal
surgical procedure and secondary surgical procedure; and
(f) Any other information relating to the charges imposed and the
quality of the services provided by the surgical centers for ambulatory
patients in this State which the [Department] Authority determines is:
(1) Useful to consumers;
(2) Nationally recognized; and
(3) Reported in a standard and reliable manner.
Sec. 183. NRS 439A.250 is hereby amended to read as follows:
439A.250 1. The [Department] Authority shall, by regulation:
(a) Prescribe the information that each surgical center for
ambulatory patients in this State must submit to the [Department]
Authority for the program as set forth in NRS 439A.240 and the form
for submission of such information.
(b) Prescribe the measures of quality for surgical centers for
ambulatory patients that are required pursuant to paragraph (b) of
subsection 2 of NRS 439A.240. In adopting the regulations, the
[Department] Authority shall:
(1) Use measures of quality which are substantially similar to
those required pursuant to subparagraph (1) of paragraph (b) of
subsection 1 of NRS 439A.230;
(2) Prescribe a reasonable number of measures of quality
which must not be unduly burdensome on the surgical centers for
ambulatory patients; and
(3) Take into consideration the financial burden placed on the
surgical centers for ambulatory patients to comply with the
regulations.
The measures prescribed pursuant to this paragraph must report
health outcomes of surgical centers for ambulatory patients, which do
not necessarily correlate with the outpatient treatments posted on the
Internet website pursuant to NRS 439A.270.
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(c) Require each surgical center for ambulatory patients to
provide the information prescribed in paragraphs (a) and (b) in the
format required by the [Department.] Authority.
(d) Prescribe which surgical centers for ambulatory patients in
this State must participate in the program established pursuant to
NRS 439A.240.
2. The information required pursuant to this section and NRS
439A.240 must be submitted to the [Department] Authority not later
than 45 days after the last day of each calendar month.
3. If a surgical center for ambulatory patients fails to submit the
information required pursuant to this section or NRS 439A.240 or
submits information that is incomplete or inaccurate, the
[Department] Authority shall send a notice of s uch failure to the
surgical center for ambulatory patients and to the Health Care
Purchasing and Compliance Division of [Public and Behavioral
Health of the Department.] the Authority.
Sec. 184. NRS 439A.260 is hereby amended to read as follows:
439A.260 1. The [Department] Authority shall collect and
maintain all information that it receives from the hospitals and
surgical centers for ambulatory patients in this State pursuant to NRS
439A.220 to 439A.250, inclusive. Upon request, the [Department]
Authority 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] Authority 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.
Sec. 185. NRS 439A.270 is hereby amended to read as follows:
439A.270 1. The [Department] Authority shall establish and
maintain 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 in this State as
required by the programs established pursuant to NRS 439A.220 and
439A.240. The information must:
(a) Include, for each hospital in this State, the:
(1) Total number of patients discharged, the average
length of stay and the average billed charges, reported for the
diagnosis-related groups for inpatients and the 50 medical treatments
for outpatients that the [Department] Authority determines are most
useful for consumers;
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(2) Total number of potentially prevent able readmissions
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 inpatients
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 hospi tal, reported for the most
frequent surgical procedures that the [Department] Authority
determines are most useful for consumers if the information is
available;
(b) Include, for each surgical center for ambulatory patients in
this State, the:
(1) Total number of patients discharged and the average billed
charges, reported for 50 medical treatments for outpatients that the
[Department] Authority 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] Authority determines are
most useful for consumers;
(c) Be presented in a manner that allows a person 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) 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) Be presented in a manner that allows a person to view and
compare the information separately for:
(1) The inpatients and outpatients of each hospital; and
(2) The outpatients of each surgical center for ambu latory
patients;
(f) Be readily accessible and understandable by a member of the
general public;
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(g) Include the annual summary of reports of sentinel events
prepared for each health facility pursuant to paragraph (c) of
subsection 1 of NRS 439.840;
(h) Include the annual summary of reports of sentinel events
prepared pursuant to paragraph (d) of subsection 1 of NRS 439.840;
(i) Include the reports of information prepared for each medical
facility pursuant to paragraph (b) of subsection 4 of NRS 439.847;
(j) Include a link to electronic copies of all reports, summaries,
compilations and supplementary reports required by NRS 449.450 to
449.530, inclusive;
(k) 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] Authority 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 i nformation is
publicly available;
(5) The operating margin of the hospital;
(6) The ratio of the cost of providing care to patients 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) 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 in this State which the [Department]
Authority determines is:
(1) Useful to consumers;
(2) Nationally recognized; and
(3) Reported in a standard and reliable manner.
2. The [Department] Authority 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 for inpatients and outpatients which is
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contained on the Internet website is expressed as a total number and
as a rate, and must be 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;
(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 is not a guarantee by the [Department]
Authority or its employees as to the charges imposed by the hospitals
in this State or the quality of the services provided by the hospitals in
this State, including, without limitation, an explanation that the actual
amount charged to a person by a particular hospital may not be the
same charge as posted on the website for that hospital;
(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 o f 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. 186. NRS 439A.280 is hereby amended to read as follows:
439A.280 1. On or before July 1 of each odd -numbered year,
the [Department] Authority shall make a determination of whether
sufficient money is available and authorized for expenditure to fund
one or more components of the programs and other duties of the
[Department] Authority relating to NRS 439A.200 to 439A.290,
inclusive.
2. The [Department] Authority shall temporarily suspend any
components of the program or duties of the [Department,] Authority,
other than those set forth in NRS 439A.240 and 439A.250, for which
it determines pursuant to subsection 1 that sufficient money is not
available.
3. The [Department] Authority may accept any gift, donation,
bequest, grant or other source of money for the purpose of carrying
out the provisions of NRS 439A.200 to 439A.290, inclusive.
Sec. 187. NRS 439A.290 is hereby amended to read as follows:
439A.290 1. In carrying out the provisions of NRS 439A.200
to 439A.290, inclusive, the [Department:] Authority:
(a) Shall work in consultation with a quality improvement
organization of the Centers for Medicare and Medicaid Services of
the United States Department of Health and Human Services; and
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(b) May contract with the Nevada System of Higher Education or
any appropriate, independent and qualified person or entity to analyze
the information collected and maintained by the [Department]
Authority pursuant to NRS 439A.200 to 439A.290, inclusive. Such a
contractor may release or publish or otherwise use information made
available to it pursuant to the contract if the [Department] Authority
determines that the information is accurate and the contractor
complies with the regulations adopted pursuant to subsection 2.
2. The [Department] Authority shall adopt regulations for the
review and release of information collected and maintained by the
[Department] Authority pursuant to NRS 439A.200 to 439A.290,
inclusive. The regulations must require, without limitation, the
[Department] Authority to review each request for information if the
request is for purposes other than research.
3. The [Department] Authority shall, on or before July 1 of each
year, submit to the Joint Interim Standing Committee on Health and
Human Services a report concerning each request that is made
pursuant to subsection 2 and the determination of the [Department]
Authority with regard to each request.
Sec. 188. NRS 439A.300 is hereby amended to read as follows:
439A.300 1. Except as provided in subsection 2, the
Department or the Authority, as applicable, may apply to any court
of competent jurisdiction to enjoin any person, state agency or local
governmental agency which has engaged in or is about to engage in
any act which violates any provision of this chapter or the regulations
adopted pursuant thereto. Such injunction may be issued without
proof of actual damage sustained by any person.
2. The Department or the Authority, as applicable, shall not
seek injunctive relief under this section if it has imposed a civil
penalty for the same violation.
Sec. 189. NRS 439A.310 is hereby amended to read as follows:
439A.310 1. Except as otherwise provided in subsec tion 2,
any person who violates any of the provisions of this chapter is liable
to the State for a civil penalty of:
(a) Where the provision violated governs the licensing of a
project which is required to be approved pursuant to NRS 439A.100
or 439A.102, not more than 10 percent of the proposed expenditure
for the project.
(b) Where any other provision is violated, not more than $20,000
for each violation.
2. The Department or the Authority shall not impose a penalty
under this section if it applies for injunctive relief to prevent the same
violation.
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Sec. 190. Chapter 439B of NRS is hereby amended by adding
thereto the provisions set forth as sections 191 and 192 of this act.
Sec. 191. “Authority” means the Nevada Health Authority.
Sec. 192. “Office” means the Office of Data Analytics of the
Authority.
Sec. 193. NRS 439B.010 is hereby amended to read as follows:
439B.010 As used in this chapter, unless the context otherwise
requires, the words and terms defined in NRS 439B.030 to 439B.150,
inclusive, and section 191 of this act have the meanings ascribed to
them in those sections.
Sec. 194. NRS 439B.110 is hereby amended to read as follows:
439B.110 “Hospital” means any facility licensed as a medical,
surgical or obstetrical hospital, o r as any combination of medical,
surgical or obstetrical hospital, by the Health Care Purchasing and
Compliance Division of [Public and Behavioral Health of the
Department.] the Authority.
Sec. 195. NRS 439B.410 is hereby amended to read as follows:
439B.410 1. Except as otherwise provided in subsection 4,
each hospital in this State has an obligation to provide emergency
services and care, including care provided by physicians and nurses,
and to admit a patient where appropriate, regardless of the fin ancial
status of the patient.
2. Except as otherwise provided in subsection 4, it is unlawful
for a hospital or a physician working in a hospital emergency room
to:
(a) Refuse to accept or treat a patient in need of emergency
services and care; or
(b) Except when medically necessary in the judgment of the
attending physician:
(1) Transfer a patient to another hospital or health facility
unless, as documented in the patient’s records:
(I) A determination has been made that the patient is
medically fit for transfer;
(II) Consent to the transfer has been given by the receiving
physician, hospital or health facility;
(III) The patient has been provided with an explanation of
the need for the transfer; and
(IV) Consent to the transfer has been given by the patient
or the patient’s legal representative; or
(2) Provide a patient with orders for testing at another hospital
or health facility when the hospital from which the orders are issued
is capable of providing that testing.
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3. A physician, hospital or other health facility which treats a
patient as a result of a violation of subsection 2 by a hospital or a
physician working in the hospital is entitled to recover from that
hospital an amount equal to three times the charges for the treatment
provided that was billed by the physician, hospital or other health
facility which provided the treatment, plus reasonable attorney’s fees
and costs.
4. This section does not prohibit the transfer of a patient from
one hospital to another:
(a) When the patient is covered by an insurance policy or other
contractual arrangement which provides for payment at the receiving
hospital;
(b) After the county responsible for payment for the care of an
indigent patient has exhausted the money which may be appropriated
for that purpose pursuant to NRS 428.050, 428.285 and 450.425; or
(c) When the hospital cannot provide the services needed by the
patient.
No transfer may be made pursuant to this subsection until the
patient’s condition has been stabilized to a d egree that allows the
transfer without an additional risk to the patient.
5. As used in this section:
(a) “Emergency services and care” means medical screening,
examination and evaluation by a physician or, to the extent permitted
by a specific statute, by a person under the supervision of a physician,
to determine if an emergency medical condition or active labor exists
and, if it does, the care, treatment and surgery by a physician
necessary to relieve or eliminate the emergency medical condition or
active labor, within the capability of the hospital. As used in this
paragraph:
(1) “Active labor” means, in relation to childbirth, labor that
occurs when:
(I) There is inadequate time before delivery to transfer the
patient safely to another hospital; or
(II) A transfer may pose a threat to the health and safety of
the patient or the unborn child.
(2) “Emergency medical condition” means the presence of
acute symptoms of sufficient severity, including severe pain, such
that the absence of immediate medical attention could reasonably be
expected to result in:
(I) Placing the health of the patient in serious jeopardy;
(II) Serious impairment of bodily functions; or
(III) Serious dysfunction of any bodily organ or part.
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(b) “Medically fit” means that the condition of the patient has
been sufficiently stabilized so that the patient may be safely
transported to another hospital, or is such that, in the determination
of the attending physician, the transfer of the patient constitutes an
acceptable risk. Such a determination must be based upon the
condition of the patient, the expected benefits, if any, to the patient
resulting from the transfer and whether the risks to the patient’s health
are outweighed by the expected benefits, and must be documented in
the patient’s records before the transfer.
6. If an allegation of a violation of the provisions of subsection
2 is made against a hospital licensed pursuant to the provisions of
chapter 449 of NRS, the Health Care Purchasing and Compliance
Division of [Public and Behavioral Health of the Department ] the
Authority shall conduct an investigation of the alleged violation.
Such a violation, in addition to any criminal penalties that may be
imposed, constitutes grounds for the denial, suspension or revocation
of such a license, or for the imposition of any sanction prescribed by
NRS 449.163.
7. If an allegation of a violation of the provisions of subsection
2 is made against:
(a) A physician licensed to practice medicine pursuant to the
provisions of chapter 630 of NRS, the Board of Medical Examiners
shall conduct an investigation of the alleged violation. Such a
violation, in addition to any criminal penalties that may be imposed,
constitutes grounds for initiating disciplinary action or denying
licensure pursuant to the provisions of subsection 3 of
NRS 630.3065.
(b) An osteopathic physician licensed to practice osteopathic
medicine pursuant to the provisions of chapter 633 of NRS, the State
Board of Osteopathic Medicine shall conduct an investigation of the
alleged violation. Such a violation, in addition to any criminal
penalties that may be imposed, constitutes grounds for initiating
disciplinary action pursuant to the provisions of subsection 1 of
NRS 633.131.
Sec. 196. NRS 439B.618 is hereby amended to read as follows:
439B.618 “Third party” means:
1. An insurer, as that term is defined in NRS 679B.540;
2. A health benefit plan, as that term is defined in NRS
687B.470, for employees which provides coverage for prescription
drugs;
3. The Public Employees’ Benefits Program established
pursuant to subsection 1 of NRS 287.043;
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4. A governing body of a county, school district, municipal
corporation, political subdivision, public corporation or other local
governmental agency that pr ovides health coverage to employees
through a self-insurance reserve fund pursuant to NRS 287.010;
5. The [Department,] Authority, with regard to Medicaid and the
Children’s Health Insurance Program; and
6. Any other insurer or organization providing c overage of
prescription drugs in accordance with state or federal law.
Sec. 197. NRS 439B.630 is hereby amended to read as follows:
439B.630 1. On or before February 1 of each year, the
[Department] Authority shall compile:
(a) A list of prescription drugs that the [Department] Authority
determines to be essential for treating diabetes in this State and the
wholesale acquisition cost of each such drug on the list. The list must
include, without limitation, all forms of insuli n and biguanides
marketed for sale in this State.
(b) A list of prescription drugs described in paragraph (a) that
have been subject to an increase in the wholesale acquisition cost of
a percentage equal to or greater than:
(1) The percentage increase i n the Consumer Price Index,
Medical Care Component during the immediately preceding calendar
year; or
(2) Twice the percentage increase in the Consumer Price
Index, Medical Care Component during the immediately preceding 2
calendar years.
(c) A list of prescription drugs [with] that:
(1) Except as otherwise provided in subsection 2, have a
wholesale acquisition cost exceeding $40 for a course of therapy [that
have] ; or
(2) Have been subject to an increase in the wholesale
acquisition cost of a percentage equal to or greater than:
[(1)] (I) Ten percent during the immediately preceding
calendar year; or
[(2)] (II) Twenty percent during the immediately preceding 2
calendar years.
2. To the extent that money is available to include such drugs
in the reporting conducted pursuant to NRS 439B.635 to 439B.645,
inclusive, the Authority may include on the list compiled pursuant
to paragraph (c) of subsection 1 prescription drugs that meet the
criteria prescribed in subparagraph (2) of that paragraph but have
a wholesale acquisition cost that does not exceed $40 for a course
of therapy. The Authority shall prioritize for inclusion the
prescription drugs for which the benefit to the public of reporting
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pursuant to NRS 439B.635 to 439B.645, inclusive, would be the
greatest, as determined by the Authority.
3. As used in this section, “course of therapy” means:
(a) Except as otherwise provided in paragraph (b), the
recommended daily dosage of a prescription drug, as set forth on the
label for the prescripti on drug approved by the United States Food
and Drug Administration, for 30 days.
(b) If the normal course of treatment using a prescription drug is
less than 30 days, the recommended daily dosage of a prescription
drug, as set forth on the label for the p rescription drug approved by
the United States Food and Drug Administration, for the duration of
the recommended course of treatment.
Sec. 198. NRS 439B.650 is hereby amended to read as follows:
439B.650 On or before June 1 of each year, the [Department]
Authority shall:
1. Analyze the information submitted pursuant to NRS
439B.635 to 439B.645, inclusive, and compile a report on the price
of prescription drugs. The report:
(a) Must include, without limitation, a separate analysis of the
information reported by manufacturers, pharmacy benefit managers
and wholesalers, the reasons for any increases in the prices of
prescription drugs in this State and the effect of those prices on overall
spending on prescription drugs, insurance premiums and cost-sharing
in this State; and
(b) May include, without limitation, opportunities for persons and
entities in this State to lower the cost of prescription drugs while
maintaining access to such drugs.
2. Present the findings in the report at a public hearing.
Sec. 199. NRS 439B.680 is hereby amended to read as follows:
439B.680 The [Department] Authority and its members,
officers and employees are not liable civilly or criminally for any act,
omission, error or technical problem that results in:
1. The failure to provide to consumers information regarding a
pharmacy, prescription drug or nonprofit organization, including,
without limitation, the information made available on the
[Department’s] Authority’s Internet website pursuant to NRS
439B.670; or
2. The providing to consumers of incorrect information
regarding a pharmacy, prescription drug or nonprofit organization,
including, without limitation, the information made available on the
[Department’s] Authority’s Internet website pursuant to
NRS 439B.670.
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Sec. 200. NRS 439B.695 is hereby amended to read as follows:
439B.695 1. If a pharmacy that is licensed under the
provisions of chapter 639 of NRS and is located within the State of
Nevada fails to provide to the [Department] Authority the
information required to be provided pursuant to NRS 439B.655 or
fails to provide such information on a timely basis, and the failure
was not caused by excusable neglect, technical problems or other
extenuating circumstances, the [Department] Authority may impose
against the pharmacy an administrative penalty of not more than $500
for each day of such failure.
2. If a manufacturer fails to provide to the [Department]
Authority the information required by NRS 439B.635, 439B.640 or
439B.660, a pharmacy benefi t manager fails to provide to the
[Department] Authority the information required by NRS 439B.645,
a wholesaler fails to provide to the [Department] Authority the
information required by NRS 439B.642 or a nonprofit organization
fails to post or provide to the [Department,] Authority, as applicable,
the information required by NRS 439B.665 or a manufacturer,
pharmacy benefit manager, wholesaler or nonprofit organization fails
to post or provide, as applicable, such information on a timely basis,
and the failure was not caused by excusable neglect, technical
problems or other extenuating circumstances, the [Department]
Authority may impose against the manufacturer, pharmacy benefit
manager, wholesaler or nonprofit organization, as applicable, an
administrative penalty of not more than $5,000 for each day of such
failure.
3. If a pharmaceutical sales representative fails to comply with
the requirements of NRS 439B.660, the [Department] Authority may
impose against the pharmaceutical sales representative an
administrative penalty of not more than $500 for each day of such
failure.
4. Any money collected as administrative penalties pursuant to
this section must be a ccounted for separately and used by the
[Department:] Authority:
(a) For purposes relating to improvement of transparency
concerning the costs of prescription drugs, including, without
limitation, carrying out and administering the provisions of NRS
439B.600 to 439B.695, inclusive, and 439B.800 to 439B.875,
inclusive [;] , and section 192 of this act; and
(b) To establish and carry out programs to:
(1) Educate patients concerning ways to reduce the cost of
health care and prescription drugs; and
(2) Provide education concerning chronic diseases.
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Sec. 201. NRS 439B.800 is hereby amended to read as follows:
439B.800 As used in NRS 439B.800 to 439B.875, inclusive,
and section 192 of this act, unless the context otherwise requires, the
words and terms defined in NRS 439B.805 to 439B.830, inclusive,
and section 192 of this act have the meanings ascribed to them in
those sections.
Sec. 202. NRS 439B.835 is hereby amended to read as follows:
439B.835 1. The [Department] Office shall, to the extent that
federal money is available for this purpose, establish an all -payer
claims database of information relating to health insurance claims
resulting from medical, dental or pharmacy benefits provided in this
State.
2. If the [Department] Office establishes an all -payer claims
database pursuant to subsection 1, the [Department] Office shall:
(a) Establish a secure process for uploading data to the database
pursuant to NRS 439B.840. When establishin g that process, the
[Department] Office shall consider the time and cost incurred to
upload data to the database.
(b) Establish and carry out a process to review the data submitted
to the database to:
(1) Ensure the accuracy of the data and the consistency of
records; and
(2) Identify and remove duplicate records.
3. If the [Department] Office establishes an all -payer claims
database pursuant to subsection 1, the [Department:] Office:
(a) Shall adopt regulations to establish an advisory committee to
make recommendations to the [Department] Office concerning the
collection, analysis and reporting of data in the all -payer claims
database, secure access to such data and the release of such data
pursuant to NRS 439B.800 to 439B.875, inclusive [.] , and section
192 of this act.
(b) May adopt regulations to establish any other advisory
committee if necessary to assist the [Department] Office in carrying
out the provisions of NRS 439B.800 to 439B.875, inclusive [.] , and
section 192 of this act.
4. The membership of any advisory committee established
pursuant to subsection 3 must include, without limitation,
representatives of providers of health care, health facilities, health
authorities, as defined in NR S 439.005, health maintenance
organizations, private insurers, nonprofit organizations that represent
consumers of health care services and each of the two entities that
submit data concerning the largest number of claims to the database.
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Sec. 203. NRS 439B.870 is hereby amended to read as follows:
439B.870 1. No person or entity providing information to the
[Department,] Office, including, without limitation, data submitted to
the all -payer claims database, if established pursuant to NRS
439B.835, in accordance with NRS 439B.800 to 439B.875, inclusive,
and section 192 of this act, may be held liable in a civil or criminal
action for disclosing confidential information unless the person or
entity has done so in bad faith or with malicious purpose.
2. The [Department] Office and its members, officers and
employees are not liable in any civil or criminal action for any
damages resulting from any act, omission, error or technical problem
that causes incorrect information from the all -payer claims database
to be provided to any person or entity.
Sec. 204. NRS 439B.875 is hereby amended to read as follows:
439B.875 If the all -payer claims database is established
pursuant to NRS 439B.835:
1. The [Department] Office shall adopt regulations that
prescribe:
(a) The data that must be submitted to the all -payer claims
database pursuant to NRS 439B.840, the format for submitting such
data and the date by which such data must be submitted. Those
regulations must align with applicable nationally and regionally
recognized standards for all-payer claims databases, where applicable
and to the extent that those standards do not conflict with each other
or the provisions of NRS 439B.800 to 439B.875, inclusive [.] , and
section 192 of this act.
(b) The privacy and security of data maintained in the all -payer
claims database and the procedure for releasing data from the all -
payer claims database pursuant to subsection 3 of NRS 439B.855,
which must ensure compliance with subsection 2 of NRS 439B.845.
(c) The use of data released from the all -payer claims database,
including, without limitation, requirements concerning the reporting
and publication of information from the database.
(d) Administrative penalties to be assessed against any person or
entity who violates any provision of NRS 439B.800 to 439B.875,
inclusive, and section 192 of this act, or the regulations adopted
pursuant thereto. Any penalties for the failure to comply with the
requirements of NRS 439B.840 or the regulations adopted pursuant
to th is section concerning the submission of data to the all -payer
claims database must not exceed $5,000 for each day of such failure.
2. The [Department] Office may adopt:
(a) Regulations that require entities that provide health coverage
in this State, in addition to the entities required by NRS 439B.840 but
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not including entities exempt from reporting pursuant to subsection 1
of that section, to upload data to the all-payer claims database; and
(b) Any other regulations necessary to carry out the provisions of
NRS 439B.800 to 439B.875, inclusive [.] , and section 192 of this
act.
3. The [Department] Office may:
(a) Enter into any contract or agreement necessary to carry out the
provisions of NRS 439B.800 to 439B.875, inclusive [;] , and section
192 of this act; and
(b) Accept any gifts, grants and donations for the purpose of
carrying out the provisions of NRS 439B.800 to 439B.875, inclusive
[.] , and section 192 of this act.
4. Any contract or agreement entered into pursuant to paragraph
(a) of subsection 3 must:
(a) Prohibit the contractor from collecting data containing direct
patient identifiers or using data for any purpose not specified by the
contract; and
(b) Require the contractor to:
(1) Obtain certification by the HITRUST Alliance o r its
successor organization and maintain such certification for the term of
the contract;
(2) Comply with the requirements of subsection 2 of NRS
439B.845 to the same extent as the [Department;] Office; and
(3) Comply with any applicable standards pre scribed by the
National Institute of Standards and Technology of the United States
Department of Commerce.
5. Any money collected as administrative penalties under the
regulations adopted pursuant to this section must be accounted for
separately and used by the [Department] Office to:
(a) Carry out the provisions of NRS 439B.600 to 439B.695,
inclusive, and 439B.800 to 439B.875, inclusive [;] , and section 192
of this act; and
(b) Establish and carry out programs to educate patients
concerning ways to r educe the cost of health care and prescription
drugs.
Sec. 205. NRS 441A.220 is hereby amended to read as follows:
441A.220 All information of a personal nature about any person
provided by any other person reporting a case or suspected case of a
communicable disease, drug overdose or attempted suicide, or by any
person who has a communicable disease, has suffered a drug
overdose or has attempted suicide, or as determined by investigation
of the health authority, is confidential medical information and must
not be disclosed to any person under any circumstances, including
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pursuant to any subpoena, search warrant or discovery proceeding,
except:
1. As otherwise provided in NRS 439.597.
2. For statistical purposes, provided that the identity of the
person is not discernible from the information disclosed.
3. In a prosecution for a violation of this chapter.
4. In a proceeding for an injunction brought pursuant to this
chapter.
5. In reporting the actual or suspected abuse or neglect of a child
or elderly person.
6. To any person who has a medical need to know the
information for his or her own protection or for the well -being of a
patient or dependent person, as determined by the health authority in
accordance with regulations of the Board.
7. If the person who is the subject of the information consents in
writing to the disclosure.
8. Pursuant to NRS 629.069.
9. If the disclosure is made to the [Department of Health and
Human Services ] Nevada Health Authority and the person about
whom the disclosure is made has been diagnosed with the human
immunodeficiency virus and is a recipient of or an applicant for
Medicaid.
10. To a firefighter, police officer or person providing
emergency medical services if the Board has determined that the
information relates to a communicable disease significantly related to
that occupation. The information must be disclosed in the manner
prescribed by the Board.
11. If the disclosure is authorized or required by NRS 239.0115
or another specific statute.
Sec. 206. NRS 444.003 is hereby amended to read as follows:
444.003 As used in this chapter, unless the context otherwise
requires, “health authority” means the officers and agents of the
[Division] Nevada Health Authority or the officers and agents of the
local boards of health.
Sec. 207. NRS 444.160 is hereby amended to read as follows:
444.160 Every construction or labor camp must have convenient
and suitable toilet facilities or portable facilities for temporarily
holding sewage that is treated with chemicals which must be kept in
a clean and sanitary state. The toilet facilities and portable facilities
must conform to the provisions of the Uniform Plumbing Code of the
International Association of Plumbing and Mechanical Officials, as
adopted by t he [Division,] Nevada Health Authority, and all
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applicable administrative regulations which pertain to the disposal of
sewage.
Sec. 208. NRS 444.270 is hereby amended to read as follows:
444.270 1. Every children’s camp must have suitable toilets
and disposal systems or portable facilities for temporarily holding
sewage that is treated with chemicals which conform to the provisions
of the Uniform Plumbing Code of the International Association of
Plumbing and Mechanical Officials, as adopted by the [Division,]
Nevada Health Authority, and all applicable administrative
regulations which pertain to the disposal of sewage.
2. A children’s camp must provide one toilet or portable facility
for every 15 persons or fraction thereof in the camp population.
Sec. 209. NRS 444.310 is hereby amended to read as follows:
444.310 Nothing in NRS 444.220 to 444.320, inclusive, shall be
interpreted to limit the powers and duties of the Division of Public
and Behavioral Health of the Department of Human Services
prescribed by NRS 439.170 and 439.570.
Sec. 210. NRS 444.330 is hereby amended to read as follows:
444.330 1. The [Division] Nevada Health Authority has
supervision over the sanitation, healthfulness, cleanliness and safety,
as it pertains to the foregoi ng matters, of the following state
institutions:
(a) Institutions and facilities of the Department of Corrections.
(b) Northern Nevada Adult Mental Health Services.
(c) Nevada Youth Training Center, Caliente Youth Center and
any other state facility for the detention of children that is operated
pursuant to title 5 of NRS.
(d) Nevada System of Higher Education.
2. The State Board of Health may adopt regulations pertaining
thereto as are necessary to promote properly the sanitation,
healthfulness, cleanliness and, as it pertains to the foregoing matters,
the safety of those institutions.
3. The Chief Medical Officer or an authorized agent of the
Officer shall inspect those institutions at least once each calendar year
and whenever he or she deems an i nspection necessary to carry out
the provisions of this section. The inspection of any state facility for
the detention of children that is operated pursuant to title 5 of NRS
must include, without limitation, an inspection of all areas where food
is prepared and served, bathrooms, areas used for sleeping, common
areas and areas located outdoors that are used by children at the
facility.
4. The Chief Medical Officer shall publish reports of the
inspections of any state facility for the detention of childr en that is
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operated pursuant to title 5 of NRS and may publish reports of the
inspections of other state institutions.
5. All persons charged with the duty of maintenance and
operation of the institutions named in this section shall operate the
institutions in conformity with the regulations adopted by the State
Board of Health pursuant to subsection 2.
6. The Chief Medical Officer or an authorized agent of the
Officer may, in carrying out the provisions of this section, enter upon
any part of the premises of any of the institutions named in this
section over which he or she has jurisdiction, to determine the
sanitary conditions of the institutions and to determine whether the
provisions of this section and the regulations of the State Board of
Health pertaining thereto are being violated.
Sec. 211. NRS 444.420 is hereby amended to read as follows:
444.420 The State Public Works Board shall:
1. Review all proposed adoptions of the Uniform Plumbing
Code by any city or county and any proposed changes to the Uniform
Plumbing Code, and advise such city or county on whether or not
such change is deemed warranted by geographic, topographic or
climatic conditions.
2. Submit a copy of the Uniform Plumbing Code adopted by any
city or county to the [Division.] Nevada Health Authority.
Sec. 212. NRS 446.050 is hereby amended to read as follows:
446.050 “Health authority” means the officers and agents of the
[Division of Public and Behavioral Health of the Dep artment of
Health and Human Services, ] Nevada Health Authority or the
officers and agents of the local boards of health.
Sec. 213. NRS 446.057 is hereby amended to read as follows:
446.057 “Potentially hazardous food” has the meaning ascribed
to it in subpart 1-201 of the 1999 edition of the Food Code published
by the Food and Drug Administration of the United States
Department of Health and Human Services, unless the
[Administrator] Director of the [Division of Public and Behavioral
Health of the Department of Health and Human Services ] Nevada
Health Authority has adopted a later edition of the Food Code for this
purpose.
Sec. 214. NRS 446.841 is hereby amended to read as follows:
446.841 A food establishment engaged in the cutting and
packaging of meat, poultry or fish for retail sale may use sawdust on
the floors in that area of such establishment not visited by the public
if:
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1. Such sawdust is treated in a manner approved by the [Division
of Public and Behavioral Health of the Department of Health and
Human Services;] Nevada Health Authority; and
2. The floors are cleaned and fresh sawdust is used daily.
Sec. 215. NRS 446.842 is hereby amended to read as follows:
446.842 1. Except as otherwise provided in subsection 5, each
food establishment in which alcoholic beverages are sold by the drink
for consumption on the premises shall post at least one sign that meets
the requirements of this section in a location con spicuous to the
patrons of the establishment. The conspicuous location described in
this subsection may include, without limitation, a women’s restroom
that is located within the establishment.
2. Each sign required by subsection 1 must be not less than 8 1/2
by 11 inches in size and must contain a notice in boldface type that is
clearly legible and, except as otherwise provided in paragraph (a) of
subsection 4, in substantially the following form:
HEALTH WARNING
Drinking wine, beer and other alcoholic b everages during
pregnancy can cause birth defects.
¡ADVERTENCIA!
El consumo de vino, cerveza y otras bebidas alcohólicas
durante el embarazo puede causar defectos físicos y/o mentales
en el feto.
3. The letters in the words “HEALTH WARNING” and
“¡ADVERTENCIA!” in the sign must be written in not less than 40-
point type, and the letters in all other words in the sign must be written
in not less than 30-point type.
4. The [Division of Public and Behavioral Health of the
Department of Health and Human Ser vices] Nevada Health
Authority may:
(a) Provide by regulation for one or more alternative forms for the
language of the warning to be included on the signs required by
subsection 1 to increase the effectiveness of the signs. Each
alternative form must con tain substantially the same message as is
stated in subsection 2.
(b) Solicit and accept the donation of signs that satisfy the
requirements of this section from a nonprofit organization or any
other source. To the extent that such signs are donated, the [Division
of Public and Behavioral Health ] Nevada Health Authority shall
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distribute the signs upon request to food establishments that are
required to post the signs.
5. A food establishment is not required to post the sign otherwise
required by this section if the food establishment provides to its
patrons a food or drink menu that contains a notice, in boldface type
that is clearly legible and not less than the size of the type used for
the items on the menu, in substantially the same form and langua ge
as is set forth in subsection 2 or authorized pursuant to paragraph (a)
of subsection 4.
6. As used in this section, “alcoholic beverage” means:
(a) Beer, ale, porter, stout and other similar fermented beverages,
including, without limitation, sake and similar products, of any name
or description containing one-half of 1 percent or more of alcohol by
volume, brewed or produced from malt, wholly or in part, or from
any substitute therefor.
(b) Any beverage obtained by the fermentation of the natural
content of fruits or other agricultural products containing sugar, of
one-half of 1 percent or more of alcohol by volume.
(c) Any distilled spirits commonly referred to as ethyl alcohol,
ethanol or spirits of wine in any form, including, without limitatio n,
all dilutions and mixtures thereof from whatever process produced.
Sec. 216. NRS 446.872 is hereby amended to read as follows:
446.872 Any person who knowingly sells any flesh of any
diseased animal or any container containing shellfish, if the container
does not have an approved stamp authorized by the [Division of
Public and Behavioral Health of the Department of Health and
Human Services, ] Nevada Health Authority, is guilty of a gross
misdemeanor.
Sec. 217. NRS 449.0032 is hereby amended to read as follows:
449.0032 “Division” means the Health Care Purchasing and
Compliance Division of [Public and Behavioral Health of the
Department of Health and Human Services. ] the Nevada Health
Authority.
Sec. 218. NRS 449.040 is hereby amended to read as follows:
449.040 Any person, state or local government or agency
thereof desiring a license under the provisions of NRS 449.029 to
449.2428, inclusive, must file with the Division an application on a
form prescribed, prepared and furnished by the Division, containing:
1. The name of the applicant and, if a natural person, whether
the applicant has attained the age of 21 years.
2. The type of facility to be operated.
3. The location of the facility.
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4. In specific terms, the nature of services and type of care to be
offered, as defined in the regulations.
5. The number of beds authorized by the Director of the
[Department of Health and Human Services ] Nevada Health
Authority or, if such authorization is not required, the number of beds
the facility will contain.
6. The name of the person in charge of the facility.
7. Such other information as may be required by the Division for
the proper administration and enforcement of NRS 449.029 to
449.2428, inclusive.
8. Evidence satisfactory to the Div ision that the applicant is of
reputable and responsible character. If the applicant is a firm,
association, organization, partnership, business trust, corporation or
company, similar evidence must be submitted as to the members
thereof and the person in charge of the facility for which application
is made. If the applicant is a political subdivision of the State or other
governmental agency, similar evidence must be submitted as to the
person in charge of the institution for which application is made.
9. Evidence satisfactory to the Division of the ability of the
applicant to comply with the provisions of NRS 449.029 to 449.2428,
inclusive, and the standards and regulations adopted by the Board.
10. Evidence satisfactory to the Division that the facilit y
conforms to the zoning regulations of the local government within
which the facility will be operated or that the applicant has applied
for an appropriate reclassification, variance, permit for special use or
other exception for the facility.
Sec. 219. NRS 449.065 is hereby amended to read as follows:
449.065 1. Except as otherwise provided in subsections 6 and
7 and NRS 449.067, each facility for intermediate care, facility for
skilled nursing, residential facility for groups, home for individual
residential care, agency to provide personal care services in the home
and agency to provide nursing in the home shall, when applying for a
license or renewing a license, file with the Administrator of the
Health Care Purchasing and Compliance Division of [Public and
Behavioral] the Nevada Health Authority a surety bond:
(a) If the facility, agency, organization or home employs less than
7 employees, in the amount of $5,000;
(b) If the facility, agency, organization or home employs at least
7 but not more than 25 employees, in the amount of $25,000; or
(c) If the facility, agency, organization or home employs more
than 25 employees, in the amount of $50,000.
2. A bond filed pursuant to this section must be executed by the
facility, agency, organization o r home as principal and by a surety
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company as surety. The bond must be payable to the Aging and
Disability Services Division of the Department of [Health and ]
Human Services and must be conditioned to provide indemnification
to an older patient who the Attorney for the Rights of Older Persons
and Persons with a Physical Disability, an Intellectual Disability or a
Related Condition determines has suffered property damage as a
result of any act or failure to act by the facility, agency, organization
or home to protect the property of the older patient.
3. Except when a surety is released, the surety bond must cover
the period of the initial license to operate or the period of the renewal,
as appropriate.
4. A surety on any bond filed pursuant to this section may be
released after the surety gives 30 days’ written notice to the
Administrator of the Health Care Purchasing and Compliance
Division of [Public and Behavioral Health, ] the Nevada Health
Authority, but the release does not discharge or otherwise affect any
claim filed by an older patient for property damaged as a result of any
act or failure to act by the facility, agency, organization or home to
protect the property of the older patient alleged to hav e occurred
while the bond was in effect.
5. A license is suspended by operation of law when the facility,
agency, organization or home is no longer covered by a surety bond
as required by this section or by a substitute for the surety bond
pursuant to NR S 449.067. The Administrator of the Health Care
Purchasing and Compliance Division of [Public and Behavioral] the
Nevada Health Authority shall give the facility, agency, organization
or home at least 20 days’ written notice before the release of the
surety or the substitute for the surety, to the effect that the license will
be suspended by operation of law until another surety bond or
substitute for the surety bond is filed in the same manner and amount
as the bond or substitute being terminated.
6. The Administrator of the Health Care Purchasing and
Compliance Division of [Public and Behavioral] the Nevada Health
Authority may exempt a residential facility for groups or a home for
individual residential care from the requirement of filing a surety
bond pursuant to this section if the Administrator determines that the
requirement would result in undue hardship to the residential facility
for groups or home for individual residential care.
7. The requirement of filing a surety bond set forth in this section
does not apply to a facility for intermediate care, facility for skilled
nursing, residential facility for groups, home for individual residential
care, agency to provide personal care services in the home or agency
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to provide nursing in the home that is operated and maintained by the
State of Nevada or an agency thereof.
8. As used in this section, “older patient” means a patient who is
60 years of age or older.
Sec. 220. NRS 449.067 is hereby amended to read as follows:
449.067 1. As a substitute for the surety bond required
pursuant to NRS 449.065, a facility for intermediate care, a facility
for skilled nursing, a residential facility for groups, a home for
individual residential care, an agency to provide personal care
services in the home and an agency to provide nursing in the home
may deposit with any bank or trust company authorized to do business
in this State, upon approval from the Administrator of the Health
Care Purchasing and Compliance Division of [Public and
Behavioral Health:] the Nevada Health Authority:
(a) An obligation of a bank, savings and loan association, savings
bank, thrift company or credit union licensed to do business in this
State;
(b) Bills, bonds, notes, debentures or other obligations of the
United States or any agency or instrumentality thereof, or guaranteed
by the United States; or
(c) Any obligation of this State or any city, county, town,
township, school district or other instrumentality of this State, or
guaranteed by this State, in an aggrega te amount, based upon
principal amount or market value, whichever is lower.
2. The obligations of a bank, savings and loan association,
savings bank, thrift company or credit union must be held to secure
the same obligation as would the surety bond requi red by NRS
449.065. With the approval of the Administrator of the Health Care
Purchasing and Compliance Division of [Public and Behavioral
Health,] the Nevada Health Authority, the depositor may substitute
other suitable obligations for those deposited, which must be assigned
to the Aging and Disability Services Division of the Department of
[Health and] Human Services and are negotiable only upon approval
by the Administrator of the Aging and Disability Services Division.
3. Any interest or dividends earned on the deposit accrue to the
account of the depositor.
4. The deposit must be an amount at least equal to the surety
bond required by NRS 449.065 and must state that the amount may
not be withdrawn except by direct and sole order of the Administrator
of the Aging and Disability Services Division.
Sec. 221. NRS 449.103 is hereby amended to read as follows:
449.103 1. Except as otherwise provided in subsection 3, to
enable an agent or employee of a medical facility, facility for the
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dependent or fa cility which is otherwise required by regulations
adopted by the Board pursuant to NRS 449.0303 to be licensed who
is described in subsection 2 to more effectively treat patients or care
for residents, as applicable, the Board shall, by regulation, require
such a facility to conduct training relating specifically to cultural
competency for any agent or employee of the facility who is described
in subsection 2 so that such an agent or employee may better
understand patients or residents who have different cu ltural
backgrounds, including, without limitation, patients or residents who
are:
(a) From various racial and ethnic backgrounds;
(b) From various religious backgrounds;
(c) Persons with various sexual orientations and gender identities
or expressions;
(d) Children and senior citizens;
(e) Persons with a mental or physical disability; and
(f) Part of any other population that such an agent or employee
may need to better understand, as determined by the Board.
The Board shall set forth by regulation the frequency with which
a medical facility, facility for the dependent or other facility is
required to provide such training relating to cultural competency.
2. Except as otherwise provided in subsection 3, the
requirements of subsection 1 apply to any agent or employee of a
medical facility, facility for the dependent or facility which is
otherwise required by regulations adopted by the Board pursuant to
NRS 449.0303 to be licensed who:
(a) Provides clinical, administrative or support services and has
direct patient contact at least once each week on average as a part of
his or her regular job duties; or
(b) Oversees an agent or employee described in paragraph (a).
3. A medical facility, facility for the dependent or other facility
is not required t o provide training relating specifically to cultural
competency to an agent or employee who is described in subsection
2 and who has successfully completed a course or program in cultural
competency as part of the continuing education requirements for the
agent or employee to renew his or her professional license,
registration or certificate, as applicable.
4. Except as otherwise provided in subsection 6, the training
relating specifically to cultural competency conducted by a medical
facility, facility f or the dependent or facility which is otherwise
required by regulations adopted by the Board pursuant to NRS
449.0303 to be licensed pursuant to subsection 1 must be provided
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through a course or program that is approved by the [Department of
Health and Human Services.] Nevada Health Authority.
5. The Office of Minority Health and Equity of the Department
of [Health and] Human Services shall:
(a) Establish and maintain a list of the courses and programs that
are approved for training relating to cultural competency pursuant to
subsection 4. The Office shall make the most current list available on
the Internet website of the Office.
(b) Ensure that the list established and maintained pursuant to
paragraph (a) is distributed to each medical facility, facili ty for the
dependent or other facility which is required to conduct training
relating specifically to cultural competency pursuant to subsection 1.
6. A medical facility, facility for the dependent or other facility
which is required to conduct training specifically relating to cultural
competency may apply to the [Department of Health and Human
Services] Nevada Health Authority to provide a course or program
on cultural competency that is not approved by the [Department]
Authority pursuant to subsection 4. Any such request must be
approved or denied by the [Department] Authority not later than 10
business days after the receipt of the application.
7. On or before October 1 of each year, the [Department of
Health and Human Service s] Nevada Health Authority shall report
the average length of time within which the [Department] Authority
approved a course of program or training relating to cultural
competency in the immediately preceding year pursuant to subsection
4 or 6, as applicable, to the Director of the Legislative Counsel Bureau
for transmittal to the Joint Interim Standing Committee on Health and
Human Services and the Joint Interim Standing Committee on
Commerce and Labor.
8. As used in this section:
(a) “Direct patient contact” means direct contact with a patient or
resident of a medical facility, facility for the dependent or facility
which is otherwise required by regulations adopted by the Board
pursuant to NRS 449.0303 to be licensed which is in person or using
telephone, electronic mail, telehealth or other electronic means,
except that the term does not include incidental contact.
(b) “Telehealth” has the meaning ascribed to it in NRS 629.515.
Sec. 222. NRS 449.132 is hereby amended to read as follows:
449.132 Every 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 may be inspected at any
time, with or without notice, as often as is necessary by:
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1. The Health Care Purchasing and Compliance Division of
[Public and Behavioral ] the Nevada Health Authority to ensure
compliance with all applicable regulations and standards; and
2. Any person designated by the Aging and Disability Services
Division of the Department of [Health and ] Human Services to
investigate complaints made against the facility.
Sec. 223. NRS 449.167 is hereby amended to read as follows:
449.167 1. If the Div ision receives notification from the
[Department of Health and Human Services ] Nevada Health
Authority pursuant to NRS 439.5895 that a medical facility licensed
pursuant to this chapter is not in compliance with the requirements of
subsection 4 of NRS 439.589, the Division may, after notice and the
opportunity for a hearing in accordance with the provisions of this
chapter, require corrective action or impose an administrative penalty
in the amount prescribed by NRS 449.163.
2. The Division shall not suspend or revoke a license for failure
to comply with the requirements of subsection 4 of NRS 439.589.
Sec. 224. NRS 449.2488 is hereby amended to read as follows:
449.2488 1. The [Department of Health and Human Services]
Nevada Health Authority shall develop a brochure and website to
assist persons who are 55 years of age or older in determining the
appropriate level of care and type of housing that they require to meet
their individual needs. The brochure and website must include,
without limitation:
(a) The various types of housing and levels of care that are
available to persons who are 55 years of age or older, including,
without limitation, residential facilities for groups, facilities for
intermediate care and facilities for skilled nursing, distinguishing the
varying degree of services that are offered by the different types of
facilities;
(b) Whether individual facilities accept payment through
Medicaid or Medicare for the level of care and type of housing that
the facilities provide;
(c) The manner in which a person may obtain information
concerning whether the facility has ever been found to have violated
the provisions of this chapter; and
(d) Such other information as the [Department] Nevada Health
Authority deems to be beneficial to persons who are 55 years of age
or older in determining the appropriate level of care and type of
housing that they require to meet their individual needs.
2. As used in this section:
(a) “Medicaid” has the meaning ascribed to it in NRS 439B.120.
(b) “Medicare” has the meaning ascribed to it in NRS 439B.130.
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Sec. 225. NRS 449.260 is hereby amended to read as follows:
449.260 As used in NRS 449.250 to 449.430, inclusive:
1. “Authority” means the Nevada Health Authority, acting
through its appropriate divisions.
2. “Community mental health center” means a facility providing
services for the prevention or diagnosis of mental illness, or care and
treatment of patients with mental illness, or rehabilitation of such
persons, which services are provided principally for persons residing
in a particular community in or near which the facility is situated.
[2.] 3. “Construction” includes the construction of new
buildings, modernization, expansion, remodeling and alteration of
existing buildings, and initial equipment of such buildings, including
medical transportation facilities, and includes architects’ fees, but
excludes the cost of off -site improvements and, except with respect
to public health centers, the cost of the acquisition of the land.
[3.] 4. “Facility for persons with intellectual disabilities” means
a facility specially designed for the diagnosis, treatment, education,
training or custodial care of persons with intellectual disabilities,
including facilities for training specialists and shelt ered workshops
for persons with intellectual disabilities, but only if such workshops
are part of facilities which provide or will provide comprehensive
services for persons with intellectual disabilities.
[4.] 5. “Federal Act” means 42 U.S.C. §§ 291 to 291o-l,
inclusive, and 300k to 300t, inclusive, and any other federal law
providing for or applicable to the provision of assistance for health
facilities.
[5.] 6. “Federal agency” means the federal department, agency
or official designated by law, regulation or delegation of authority to
administer the Federal Act.
[6.] 7. “Health facility” includes a public health center, hospital,
facility for hospice care, facility for persons with intellectual
disabilities, community mental health center, and other facility to
provide diagnosis, treatment, care, rehabilitation, training or related
services to persons with physical or mental impairments, including
diagnostic or diagnostic and treatment centers, rehabilitation facilities
and nursing homes, as those terms are defined in the Federal Act, and
such other facilities for which federal aid may be authorized under
the Federal Act, but, except for facilities for persons with intellectual
disabilities, does not include any facility furnishing primarily
domiciliary care.
[7.] 8. “Nonprofit health facility” means any health facility
owned and operated by a corporation or association, no part of the net
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earnings of which inures or may lawfully inure to the benefit of any
private shareholder or natural person.
[8.] 9. “Public health center” means a publicly owned facility
for the provision of public health services, including related facilities
such as laboratories, clinics and administrative offices operated in
connection with public health centers.
[9. “State Department” means the Department of Health and
Human Services, acting through its appropriate divisions.]
Sec. 226. NRS 449.270 is hereby amended to read as follows:
449.270 The [State Department] Authority shall constitute the
sole agency of the State for the purpose of:
1. Inventorying existing health facilities, surveying the need for
construction of health facilities, and developing programs of health
facilities construction as provided in NRS 449.250 to 449.430,
inclusive.
2. Developing and administering state plans for the construction
of public and other nonprofit health facilities as provided in NRS
449.250 to 449.430, inclusive.
3. Developing and administering any other plan or program
providing assistance to health facilities for which funds may be
available to this state under the Federal Act.
Sec. 227. NRS 449.280 is hereby amended to read as follows:
449.280 In carrying out the purposes of NRS 449.250 to
449.430, inclusive, the [State Department] Authority is authorized
and directed:
1. To require such reports, make such inspections and
investigations, and prescribe such regulations as it deems necessary.
2. To provide such methods of administration, appoint all
necessary officers and other personnel and take such other action as
may be necessary to comply with the requirements of NRS 449.250
to 449.430, inclusive, the Federal Act and the regulations thereunder.
3. To procure in its discretion the temporary or intermittent
services of experts or consultants, by contract, when such services are
to be performed on a part -time or fee -for-service basis and do not
involve the performance of administrative duties.
4. To the extent that it considers desirable to effectuate the
purposes of NRS 449.250 to 449.430, inclusive, to enter into
agreements for the utilization of the facilities and services of other
departments, agencies and institutions, public or private.
5. To accept on behalf of the State and to deposit with the State
Treasurer in appropriate accounts in the [Department of Health and
Human Services’] Nevada Health Authority Gift Fund any grant, gift
or contribution made to assist in meeting the cost of carrying out the
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purposes of NRS 449.250 to 449.430, inclusive, and to expend the
same for such purposes.
6. To do all other things on behalf of the State necessary or
advisable to obtain the maximum benefits available under the Federal
Act.
7. All claims must be approved by the Health Officer before they
are paid.
Sec. 228. NRS 449.300 is hereby amended to read as follows:
449.300 The [State Department ] Authority is authorized and
directed to inventory existing health facilities, including public,
nonprofit, and proprietary health facilities, to survey the need for
construction of health facilities, and, on the ba sis of such inventory
and survey, to develop programs for the construction of such public
and other nonprofit health facilities as will, in conjunction with
existing facilities, afford the necessary physical facilities for
furnishing adequate health facili ty services to all the people of the
State.
Sec. 229. NRS 449.320 is hereby amended to read as follows:
449.320 1. The [State Department] Authority may apply to the
federal agency for federal money to assist in carrying out the surveys,
planning and construction activities provided for in NRS 449.250 to
449.430, inclusive.
2. The money must be deposited in the State Treasury and must
be available to the [State Department] Authority for expenditure for
carrying out the purposes of NRS 449.250 to 449.430, inclusive.
Sec. 230. NRS 449.340 is hereby amended to read as follows:
449.340 1. The [State Department ] Authority may, by
regulation, establish standards for the maintenance and operation of
health facilities, which supersede all local ordinances and regulations
inconsistent therewith.
2. A copy of the regulations, giving the date that they take effect,
must be issued in pamphlet form.
3. Any health facility that applies for and accepts federal aid for
construction under a state plan does so on the condition that the health
facility qualify under the minimum standards for maintenance and
operation adopted and enforced by the [State Department.] Authority.
4. Any person, partnership, association or corporation
establishing, conducting, managing or operating any health facility
within the meaning of NRS 449.250 to 449.430, inclusive, who
violates any of the provisions of this section or regu lations lawfully
adopted thereunder is guilty of a misdemeanor.
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Sec. 231. NRS 449.345 is hereby amended to read as follows:
449.345 Before the [State Department ] Authority may adopt
any regulation concerning the construction, maintenance, operation
or safety of a building, structure or other property in this State, the
[State Department ] Authority shall consult with the Deputy
Administrator of the Public Works - Compliance and Code
Enforcement Section for the purposes of subsection 9 of
NRS 341.100.
Sec. 232. NRS 449.360 is hereby amended to read as follows:
449.360 1. Applications for health facility construction
projects for which federal funds are required must be submitted to the
appropriate health systems agency and the [State Department. ]
Authority. They may be submitted by the State or any political
subdivision thereof or by any public or nonprofit agency authorized
to construct and operate a health facility.
2. Each application for a construction project must conform to
federal and state requirements and must be submitted in the manner
and form prescribed by the [State Department.] Authority.
Sec. 233. NRS 449.370 is hereby amended to read as follows:
449.370 1. The [State Department] Authority shall afford to
every applicant for assi stance for a construction project an
opportunity for a fair hearing before the [State Department] Authority
upon 10 days’ written notice to the applicant.
2. If the [State Department, ] Authority, after affording
reasonable opportunity for development and presentation of
applications in the order of relative need, finds that an application is
in conformity with the state plan, the [State Department] Authority
shall approve the application and shall recommend and forward it to
the federal agency.
3. The [State Department] Authority shall consider and forward
applications in the order of relative need set forth in the state plan.
Sec. 234. NRS 449.380 is hereby amended to read as follows:
449.380 From time to time, the [State Department] Authority
shall inspect each construction project approved by the federal agency
and, if the inspection so warrants, the [State Department] Authority
shall certify to the federal agency that work has been performed upon
the project, or that purchases have been made, in accordance with the
approved plans and specifications, and that payment of an installment
of federal funds is due to the applicant.
Sec. 235. NRS 449.390 is hereby amended to read as follows:
449.390 1. The [State Department ] Authority is hereby
authorized to receive federal funds in behalf of, and transmit them to,
applicants.
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2. There is hereby established a nonreverting trust fund
designated as the Health Facilities Assistance Fund. Money received
from the Federal Government for a construction project approved by
the federal agency shall be transmitted to the State Treasurer to be
deposited in the State Treasury to the credit of the Health Facilities
Assistance Fund, and shall be used solely for payments due applicants
for work performed, purchases made or other approved expenditures
in carrying out approved projects or plans, except that any moneys in
such Fund which become available under the Federal Act and
regulations for expenditure i n administering an approved state plan
may be expended for that purpose.
3. The [State Department ] Authority shall establish and
maintain such accounts and fiscal controls of moneys deposited in
and disbursed from the Health Facilities Assistance Fund as may be
required by the Federal Act and regulations promulgated thereunder.
Sec. 236. NRS 449.400 is hereby amended to read as follows:
449.400 1. In order to provide state assistance for construction
projects for publicly owned hospitals, hospitals for the chronically ill
and impaired, facilities for persons with intellectual disabilities,
community mental health facilities, diagnostic or diagnostic and
treatment centers, rehabilitation facilities, nursing homes and other
facilities financed in part b y federal funds in accordance with NRS
449.250 to 449.430, inclusive, and to promote maximum utilization
of federal funds available for such projects, there is hereby created in
the State Treasury a nonreverting trust fund to be known as the State
Public Health Facilities Construction Assistance Fund. Money for the
Fund may be provided from time to time by legislative appropriation.
2. The State Public Health Facilities Construction Assistance
Fund must be administered by the [State Department] Authority in
accordance with the purposes and provisions of NRS 449.250 to
449.430, inclusive.
Sec. 237. NRS 449.410 is hereby amended to read as follows:
449.410 1. Money in the State Public Health Facilities
Construction Assistance Fund must be used to supple ment money
from the Federal Government and money provided by the sponsor of
a project for approved projects for the construction of publicly owned
hospitals, hospitals for the chronically ill or impaired, facilities for
persons with intellectual disabiliti es, community mental health
facilities, diagnostic or diagnostic and treatment centers,
rehabilitation facilities, nursing homes and other facilities financed in
part by federal funds pursuant to NRS 449.250 to 449.430, inclusive,
and for no other purpose or purposes.
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2. Applications for state assistance for construction projects
must be submitted to the [State Department ] Authority for
consideration in the manner prescribed in NRS 449.250 to 449.430,
inclusive, for applications for federal assistance.
3. No project is entitled to receive state assistance unless it is
entitled to receive federal assistance.
Sec. 238. NRS 449.420 is hereby amended to read as follows:
449.420 Money in the State Public Health Facilities
Construction Assistance Fund must be allocated and paid to
construction projects on the basis of relative need in accordance with
the need identified in the state health plan and in accordance with a
ratio between state money and federal money determined by the
[State Department.] Authority. In no event may the amount of state
assistance made available or paid out for a project exceed the amount
supplied by the sponsor of the project.
Sec. 239. NRS 449.4313 is hereby amended to read as follows:
449.4313 1. An applicant for the issuance or renewal of a
certificate to operate an intermediary service organization must
submit to the Division the statement prescribed by the Division of
[Welfare and Supportive ] Social Services of the Department of
Human Services pursuant to NRS 425.520. The statement must be
completed and signed by the applicant.
2. The Division shall include the statement required pursuant to
subsection 1 in:
(a) The application or any other forms that must be submitted for
the issuance or renewal of the certificate; or
(b) A separate form prescribed by the Division.
3. A certificate as an intermediary service organization may not
be issued or renewed by the Division if the applicant:
(a) Fails to submit the statement required pursuant to su bsection
1; or
(b) Indicates on the statement submitted pursuant to subsection 1
that the applicant is subject to a court order for the support of a child
and is not in compliance with the order or a plan approved by the
district attorney or other public agency enforcing the order for the
repayment of the amount owed pursuant to the order.
4. If an applicant indicates on the statement submitted pursuant
to subsection 1 that the applicant is subject to a court order for the
support of a child and is not i n compliance with the order or a plan
approved by the district attorney or other public agency enforcing the
order for the repayment of the amount owed pursuant to the order, the
Division shall advise the applicant to contact the district attorney or
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other public agency enforcing the order to determine the actions that
the applicant may take to satisfy the arrearage.
Sec. 240. NRS 449.450 is hereby amended to read as follows:
449.450 As used in NRS 449.450 to 449.530, inclusive, unless
the context otherwise requires:
1. “Admitted health insurer” means an insurer authorized to
transact health insurance in this State under a certificate of authority
issued by the Commissioner of Insurance.
2. [“Department” means the Department of Health and Human
Services.] “Authority” means the Nevada Health Authority.
3. “Director” means the Director of the [Department.]
Authority.
4. “Institution” means any person, place, building or agency
which maintains and operates facilities for the diagnosis, care and
treatment of human illness and provides beds for inpatient care. The
term includes but is not limited to hospitals, convalescent care
facilities, nursing care facilities, detoxification centers and all
specialized medical health care facilities.
Sec. 241. NRS 449.460 is hereby amended to read as follows:
449.460 The Director may:
1. Adopt regulations respecting the exercise of the powers
conferred by NRS 449.450 to 449.530, inclusive.
2. Hold public hearings, conduct investigations and require the
filing of information relating to any matter affecting the cost of
services in all institutions subject to the provisions of NRS 449.450
to 449.530, inclusive, and may subpoena witnesses, financial papers,
records and documents in connection therewith. An o rder requiring
the filing of information or a subpoena issued pursuant to this
subsection must state the purpose for which it is issued. The Director
may also administer oaths in any hearing or investigation.
3. Exercise, subject to the limitations and r estrictions imposed
in NRS 449.450 to 449.530, inclusive, all other powers which are
reasonably necessary to carry out the expressed objects of those
sections.
4. Delegate to any of the divisions of the [Department]
Authority the authority to carry out the provisions of NRS 449.450 to
449.530, inclusive.
Sec. 242. NRS 449.485 is hereby amended to read as follows:
449.485 1. Each hospital 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.] Authority. Any
form prescribed by the Director must be a form that is commonly used
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nationwide by hospitals, if applicable, and comply with federal laws
and regulations.
2. Each hospital in this State shall, on a monthly basis, report to
the [Department] Authority 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 in this State.
4. Except as otherwise provided in subsection 5, each hospital in
this State shall provide the information required pursuant to
subsection 2 in an electronic form specified by the [Department.]
Authority.
5. The Director may exempt a hospital from the requirements of
subsection 4 if requiring the hospital to comply with the requirements
would cause the hospital financial hardship.
6. The [Department] Authority shall use the information
submitted pursuant to this section for the program established
pursuant to NRS 439A.220 to increase public awareness of health
care information concerning the hospitals in this State.
Sec. 243. NRS 449.490 is hereby amended to read as follows:
449.490 1. Every institution which is subject to the provisions
of NRS 449.450 to 449.530, inclusive, shall file with the
[Department] Authority the following financial statements or reports
in a form and at intervals specified by the Director but at least
annually:
(a) A balance sheet detailing the assets, liabilities and net worth
of the institution for its fiscal year; and
(b) A statement of income and expenses for the fiscal year.
2. Each hospital with 100 or more beds shall file with the
[Department,] Authority, in a form and at intervals specified by the
Director but at least annually, a capital improvement report which
includes, without limitation, any major service line that the hospital
has added or is in the process of adding since the previous report was
filed, any major expansion of the existing facilities of the hospital that
has been completed or is in the process of being completed since the
previous report was filed, and any major piece of equipment that
the hospital has acquired or is in th e process of acquiring since the
previous report was filed.
3. In addition to the information required to be filed pursuant to
subsections 1 and 2, each hospital with 100 or more beds shall file
with the [Department,] Authority, in a form and at intervals specified
by the Director but at least annually:
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(a) The expenses that the hospital has incurred for providing
community benefits and the in -kind services that the hospital has
provided to the community in which it is located. These expenses
must be rep orted as the total amount expended for community
benefits and in-kind services and reported as a percentage of the total
net revenues of the hospital. For the purposes of this paragraph,
“community benefits” includes, without limitation, goods, services
and resources provided by a hospital to a community to address the
specific needs and concerns of that community, services provided by
a hospital to the uninsured and underserved persons in that
community, training programs for employees in a community and
health care services provided in areas of a community that have a
critical shortage of such services, for which the hospital does not
receive full reimbursement.
(b) A statement of its policies and procedures for providing
discounted services to, or reducing charges for services provided to,
persons without health insurance that are in addition to any reduction
or discount required to be provided pursuant to
NRS 439B.260.
(c) A list of the services which the hospital purchased from its
corporate home office.
(d) A report of the cost to the hospital of providing services to
patients covered by Medicare.
(e) Financial information from the consolidated corporation, if
the hospital is owned by such a corporation and if that information is
publicly available, including, without limitation, the annual report of
the consolidated corporation.
(f) A statement of its policies regarding patients’ account
receivables, including, without limitation, the manner in which a
hospital collects or makes payment arrangement s for patients’
account receivables, the factors that initiate collections and the
method by which unpaid account receivables are collected.
4. A complete current charge master must be available at each
hospital during normal business hours for review by the Director, any
payor that has a contract with the hospital to pay for services provided
by the hospital, any payor that has received a bill from the hospital
and any state agency that is authorized to review such information.
The complete and current c harge master must be made available to
the [Department,] Authority, at the request of the Director, in an
electronic format specified by the [Department.] Authority. The
[Department] Authority may use the electronic copy of the charge
master to review and analyze the data contained in the charge master
and, except as otherwise provided in NRS 439A.200 to 439A.290,
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inclusive, shall not release or publish the information contained in the
charge master.
5. The Director shall require the certification of spec ified
financial reports by an independent certified public accountant and
may require attestations from responsible officers of the institution
that the reports are, to the best of their knowledge and belief, accurate
and complete to the extent that the ce rtifications and attestations are
not required by federal law.
6. The Director shall require:
(a) The filing of all reports by specified dates, and may adopt
regulations which assess penalties for failure to file as required; and
(b) The submission of a final annual report not later than 6 months
after the close of the fiscal year,
and may grant extensions to institutions which can show that the
required information is not available on the required reporting date.
7. All reports, except privileged m edical information, filed
under any provisions of NRS 449.450 to 449.530, inclusive:
(a) Are open to public inspection;
(b) Must be in a form which is readily understandable by a
member of the general public;
(c) Must, as soon as practicable after those reports become
available, be posted on the Internet website maintained by the
Authority pursuant to NRS 439A.270; and
(d) Must be available for examination at the office of the
[Department] Authority during regular business hours.
Sec. 244. 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] Authority’s operations and
activities for the preceding fiscal year.
2. The report prepared pursuant to subsection 1 must [include:]
include, for the immediately preceding fiscal year:
(a) Copies of all reports, summaries, compilat ions and
supplementary reports required by NRS 449.450 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] Authority required or performed during the
previous year;
(c) An analysis of the trends in the costs, expenses and profits of
hospitals in this State;
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(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 in formation 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 and 439A.240 to increase public awareness of
health care information concerning the hospitals and surgical centers
for ambulatory patients in this State, including, without limitation, the
information that was posted in the preceding fiscal year on the
Internet website maintained by the Authority for those programs
pursuant to NRS 439A.270.
3. The Joint Interim Standing Committee on Health and Human
Services shall develop a comprehensive plan 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 r eview of the capital improvement reports submitted by
hospitals pursuant to subsection 2 of NRS 449.490.
Sec. 245. NRS 449A.017 is hereby amended to read as follows:
449A.017 “Division” means the Health Care Purchasing and
Compliance Division of [Public and Behavioral Health of the
Department of Health and Human Services. ] the Nevada Health
Authority.
Sec. 246. NRS 449A.186 is hereby amended to read as follows:
449A.186 1. Except as otherwise provided in this section, a
person other than the patient or the representative of the patient who
has requested the installation and use of an electronic communication
device pursuant to NRS 449A.182 shall not intentionally:
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(a) Obstruct, tamper with or destroy the electronic
communication device or any recording made by the electronic
communication device; or
(b) View or listen to any images or sounds which are displayed,
broadcast or recorded by the electronic communication device.
2. The following persons may view or listen to the images or
sounds which are displayed, broadcast or recorded by an electronic
communication device installed and used pursuant to NRS 449A.182
or temporarily disable or turn off such a device:
(a) A representative of a law enforcement agency who is
conducting an investigation;
(b) A representative of the Aging and Disability Services
Division [or the Division of Public and Behavioral Health ] of the
Department of [Health and ] Human Services or the Health Care
Purchasing and Compliance Division of the Nevada Health
Authority who is conducting an investigation;
(c) The State Long-Term Care Ombudsman; and
(d) An attorney who is representing the patient or a roommate of
the patient and acting within the scope of that representation.
3. A patient or the representative of the patient who has
requested the installation and use of an electronic communication
device pursuant to NRS 449A.182 may authorize a person other than
a person described in subsection 2 to view or listen to the images or
sounds which are displayed, broadcast or recorded by the electronic
communication device. Any such authorization must be made in
writing. The patient or representative, as applicable, may provide a
copy of the authorization to the facility and the roommate of the
patient or the representative of the roommate, if any.
4. A person who temporarily disables or turns off an electronic
communication device pursuant to subsection 2 shall ensure that the
functions of the electronic communication device are appropriately
enabled or turned back on befo re exiting the living quarters of the
patient.
5. A facility for skilled nursing shall not deny admission to or
discharge a patient from the facility or otherwise discriminate or
retaliate against a patient because of a decision to request the
installation and use of an electronic communication device in the
living quarters of the patient pursuant to NRS 449A.182.
Sec. 247. NRS 449A.280 is hereby amended to read as follows:
449A.280 A contract between a resident and a residential
facility for groups for the delivery of services to the resident must:
1. Be entitled “Service Delivery Contract for Residential
Facility for Groups”;
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2. Be printed in at least 12 point type; and
3. Include, without limitation, the following information in the
body of the contract or in a supporting document or attachment:
(a) The name, physical address and mailing address, if different,
of the residential facility for groups;
(b) The name and mailing address of every person, partnership,
association or corporation which establishes, conducts, manages or
operates the residential facility for groups;
(c) The name and address of at least one person who is authorized
to accept service on behalf of the parties described in paragraph (b);
(d) A telephone number or the address of the Internet website of:
(1) The Division that the resident or a representative of the
resident may use to verify the status of the license of the residential
facility for groups; and
(2) Each licensing board or other regulatory body that has
issued a license to a provider of health care or other person required
to be licensed who provides services to residents at the residential
facility for groups that the resident or a representative of the resident
may use to verify the status of the licen se of the provider of health
care or other person;
(e) The duration of the contract;
(f) The manner in which the contract may be modified, amended
or terminated;
(g) The base rate to be paid by the resident and a description of
the services to be provided as part of the base rate;
(h) A fee schedule outlining the cost of any additional services;
(i) Any additional fee to be paid by the resident pursuant to the
fee schedule and a description of any additional services to be
provided as part of that fee, either directly by the residential facility
for groups or by a third-party provider of services under contract with
the facility;
(j) A statement affirming the freedom of the resident to receive
services from a provider of services with whom the residential facility
for groups does not have a contractual arrangement, which may also
disclaim liability on the part of the residential facility for groups for
any such services;
(k) The procedures and requirements for billing and payment
under the contract;
(l) A statement detailing the criteria and procedures for
admission, management of risk and termination of residency;
(m) The obligations of the resident in order to maintain residency
and receive services, including, without limitation, compliance with
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the annual physical examination and assessment required by
NRS 449.1845;
(n) A description of the process of the residential facility for
groups for resolving the complaints of residents and contact
information for the Aging and Disability Services Divisi on [and the
Division of Public and Behavioral Health ] of the Department of
[Health and] Human Services [;] and the Health Care Purchasing
and Compliance Division of the Nevada Health Authority;
(o) The name and mailing address of any representative of the
resident, if applicable; and
(p) Contact information for:
(1) The State Long -Term Care Ombudsman appointed
pursuant to NRS 427A.125;
(2) The Nevada Disability Advocacy and Law Center, or its
successor organization; or
(3) Other resources for legal aid or mental health assistance,
as appropriate.
Sec. 248. NRS 450.750 is hereby amended to read as follows:
450.750 For the purposes of NRS 422.380 to 422.390, inclusive,
if a hospital district created pursuant to NRS 450.550 to 450.750,
inclusive, includes territory within more than one county, the board
of county commissioners of the county in which the hospital is
located shall be deemed to be the local government responsible for
transferring payments of money to the [Department] Nevada Health
Authority for treatment of patients pursuant to the provisions of NRS
422.380 to 422.390, inclusive.
Sec. 249. NRS 450B.215 is hereby amended to read as follows:
450B.215 1. If the health authority receives notification from
the [Department of Health and Human Services ] Nevada Health
Authority pursuant to NRS 439.5895 that the holder of a permit to
operate an ambulance, air ambulance or vehicle of a fire -fighting
agency is not in compliance with the requirements of subsection 4 of
NRS 439.589, the health authority may, after notice and the
opportunity for a hearing in accordance with the provisions of this
chapter, require corrective action or impose an administrative penalty
in an amount established by regulation of the board.
2. The health authority shall not suspend or revoke a permit for
failure to comply with the requirements of subsection 4 of
NRS 439.589.
Sec. 250. NRS 451.587 is hereby amended to read as follows:
451.587 1. Each nontransplant anatomical donation
organization that procures a human body or part in this State shall:
(a) Be certified by the Division;
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(b) Follow the standards and guidelines established by the State
Board of Health pursuant to subsection 2; and
(c) Report to the Division, in a manner and frequency prescribed
by the State Board of Health, the number and disposition of human
bodies or parts procured by the nontransplant anatomi cal donation
organization.
2. The State Board of Health shall:
(a) Adopt regulations that establish standards and guidelines for
nontransplant anatomical donation organizations which must be
substantially based upon federal laws and regulations relating to the
procurement of human bodies and parts, NRS 451.500 to 451.598,
inclusive, and the best standards and practices in the industry; and
(b) Adopt any regulations necessary to carry out the provisions of
this section, including, without limitation, regulations that establish a
fee for an application for the issuance or renewal of a certification as
a nontransplant anatomical donation organization.
3. Before adopting or amending any regulation pursuant to
subsection 2, the State Board of Health shall s eek input from each
procurement organization and nontransplant anatomical donation
organization in this State.
4. The Division shall:
(a) Collect and analyze information from each nontransplant
anatomical donation organization in this State on the numbe r and
disposition of human bodies and parts procured by the nontransplant
anatomical donation organization and make such information
available to the Governor and the Legislature upon request; and
(b) Monitor all nontransplant anatomical donation organiza tions
in this State for compliance with federal and state laws and
regulations.
5. A person who engages in the activity of a nontransplant
anatomical donation organization without being certified by the
Division pursuant to this section or who violates the standards and
guidelines adopted by the State Board of Health pursuant to
subsection 2 is guilty of a category C felony and shall be punished as
provided in NRS 193.130, or by a fine of not more than $50,000, or
by both fine and the punishment provided in NRS 193.130.
6. As used in this section:
(a) “Division” means the Health Care Purchasing and
Compliance Division of [Public and Behavioral Health of the
Department of Health and Human Services. ] the Nevada Health
Authority.
(b) “Nontransplant anato mical donation organization” means a
person who engages in the recovery, screening, testing, processing,
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storage or distribution of human bodies or parts for a purpose other
than transplantation, including, without limitation, education,
research or the advancement of medical, dental or mortuary science.
Sec. 251. NRS 453.038 is hereby amended to read as follows:
453.038 “Chart order” means an order entered on the chart of a
patient:
1. In a hospital, facility for intermediate care or facility for
skilled nursing which is licensed as such by the Health Care
Purchasing and Compliance Division of [Public and Behavioral
Health of the Department;] the Nevada Health Authority; or
2. Under emergency treatment in a hospital by a physician,
advanced practice registered nurse, certified registered nurse
anesthetist, dentist or podiatric physician, or on the written or oral
order of a physician, physician assistant or anesthesiologist assistant
licensed pursuant to chapter 630 or 633 of NRS, advanced practice
registered nurse, certified registered nurse anesthetist, dentist or
podiatric physician authorizing the administration of a drug to the
patient.
Sec. 252. NRS 453.316 is hereby amended to read as follows:
453.316 1. A person who opens or maintains any place for the
purpose of unlawfully selling, giving away or using any controlled
substance is guilty of a category C felony and shall be punished as
provided in NRS 193.130.
2. If a person convicted of violating this section has previously
been convicted of violating this section, or if, in the case of a first
conviction of violating this section, the person has been convicted of
an offense under the laws of the United States or any state, territory
or district which, if committed in this State, would amount to a felony
under this section, the person is guilty of a category B felony and shall
be punished by imprisonment in the state prison for a minimum term
of not less than 1 year and a maximum term of not more than 6 years,
and may be further punished by a fine of not more than $10,000.
3. This section does not apply to:
(a) Any rehabilitation clinic established [or licensed ] by the
Division of Public and Behavioral Health of the Department [.] or
licensed by the Health Care Purchasing and Compliance Division
of the Nevada Health Authority.
(b) Any cannabis consumption lounge, as defined in NRS
678A.087, whose activities are confined to those authorized in title
56 of NRS.
(c) Any person who opens or maintains any public place in which
a person is a uthorized to consume cannabis, as defined in NRS
678A.085, or cannabis products, as defined in NRS 678A.120,
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pursuant to regulations adopted by the Cannabis Compliance Board
pursuant to NRS 678B.645, and whose activities are confined to those
authorized by such regulations.
Sec. 253. NRS 453.411 is hereby amended to read as follows:
453.411 1. It is unlawful for a person knowingly to use or be
under the influence of a controlled substance except in accordance
with a lawfully issued prescription.
2. It is unlawful for a person knowingly to use or be under the
influence of a controlled substance except when administered to
the person at a rehabilitation clinic established [or licensed] by the
Division of Public and Behavioral Health of the Department [,] or
licensed by the Health Care Purchasing and Compliance Division
of the Nevada Health Authority, or a hospital certified by the
Department.
3. Unless a greater penalty is provided in NRS 212.160, a person
who violates this section shall be punished for a misdemeanor.
Sec. 254. NRS 454.0041 is hereby amended to read as follows:
454.0041 “Chart order” means an order entered on the chart of
a patient:
1. In a hospital, facility for intermediate care or facility for
skilled nursing which is licensed as such by the Health Care
Purchasing and Compliance Division of [Public and Behavioral
Health of the Department of Health and Human Services; ] the
Nevada Health Authority; or
2. Under emergency treatment in a hospital by a practitioner or
on the written or oral order of a practitioner authorizing the
administration of a drug to the patient.
Sec. 255. NRS 483.800 is hereby amended to read as follows:
483.800 1. The following sources shall submit, within 30 days
after learning such information, to the Department the name, address,
birth date, social security number, visual acuity and any other
information which may be required by regulation of the Department,
of persons who are blind or night -blind or whose vision is severely
impaired and shall designate whether the person is blind, night-blind
or has severely impaired vision:
(a) Hospitals, medical clinics and similar institutions which treat
persons who ar e blind, night -blind or whose vision is severely
impaired; and
(b) Agencies of the State and political subdivisions which provide
special tax consideration for blindness.
2. When any source described in subsection 1 learns that vision
has been restored to any person whose name appears in the registry
established pursuant to subsection 3, the fact of restoration of vision
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must be reported to the registry within 30 days after learning of that
fact.
3. The Department may establish a registry for the purpo ses of
this section and adopt regulations governing reports to and operation
of the registry.
4. The Department shall maintain a file of the names, addresses,
birth dates and social security numbers of persons who are blind or
night-blind or whose vision is severely impaired.
5. Except as otherwise provided in NRS 239.0115, all
information learned by the Department pursuant to this section is
confidential and any person who, without the consent of the person
concerned, reveals that information for purpo ses other than those
specified in this section, or other than for administration of the
Program for Supplemental Security Income, including State
Supplementary Assistance pursuant to chapter [422 or] 422A of NRS,
or services to persons who are blind pursua nt to NRS 426.517 to
426.610, inclusive, is guilty of a misdemeanor.
Sec. 256. NRS 608.156 is hereby amended to read as follows:
608.156 1. In addition to any benefits required by NRS
608.1555, if an employer provides health benefits for his or her
employees, the employer shall provide benefits for the expenses for
the treatment of alcohol and substance use disorders. The annual
benefits provided by the employer must include, without limitation:
(a) Treatment for withdrawal from the physiological effe cts of
alcohol or drugs, with a maximum benefit of $1,500 per calendar
year.
(b) Treatment for a patient admitted to a facility, with a maximum
benefit of $9,000 per calendar year.
(c) Counseling for a person, group or family who is not admitted
to a facility, with a maximum benefit of $2,500 per calendar year.
2. The maximum amount which may be paid in the lifetime of
the insured for any combination of the treatments listed in subsection
1 is $39,000.
3. Except as otherwise provided in NRS 687B.409, these
benefits must be paid in the same manner as benefits for any other
illness covered by the employer are paid.
4. The employee is entitled to these benefits if treatment is
received in any:
(a) Program for the treatment of alcohol or substance use
disorders which is certified by the Division of Public and Behavioral
Health of the Department of [Health and] Human Services.
(b) Hospital or other medical facility or facility for the dependent
which is licensed by the Health Care Purchasing and Complian ce
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Division of [Public and Behavioral Health of the Department of
Health and Human Services, ] the Nevada Health Authority, is
accredited by The Joint Commission or CARF International and
provides a program for the treatment of alcohol or substance use
disorders as part of its accredited activities.
Sec. 257. NRS 608.630 is hereby amended to read as follows:
608.630 1. As soon as practicable after the appointment of the
members of a home care employment standards board pursuant to
NRS 608.610, the Director shall fix a date for the first meeting of the
board. If a home care employment standards board is established
upon the petition of 50 or more home care employees pursuant to
NRS 608.610, the first meeting of the board must be held not later
than 60 days after the date of the meeting described in
NRS 608.620.
2. Before the first meeting of a home care employment standards
board, the Director and the Labor Commissioner shall conduct a
preliminary investigation into the wages and working conditions of
home care employees in this State and the compliance of home care
employers with applicable federal, state and local laws. The Director
and the Labor Commissioner shall coordinate with the Aging and
Disability Services Division of the Department, the Medicaid
Division of [Health Care Financing and Policy of ] the [Department]
Nevada Health Authority and the Health Care Purchasing and
Compliance Division of [Public and Behavioral Health of the
Department] the Nevada Health Authority as necessary to complete
the investigation.
3. The Director and the Labor Commissioner shall present the
results of the preliminary investigation conducted pursuant to
subsection 2 to the home care employment standards board at the first
meeting of the board.
4. As used in this section, “Department” means the Department
of [Health and] Human Services.
Sec. 258. NRS 612.167 is hereby amended to read as follows:
612.167 “Hospital” means an institution which has been
licensed, certified or approved by the Health Care Purchasing and
Compliance Division of [Public and Behavioral Health of the
Department of Health and Human Services. ] the Nevada Health
Authority.
Sec. 259. NRS 618.7317 is hereby amended to read as follows:
618.7317 1. The Division shall, in consultation with the
Health Care Purchasing and Compliance Division of [Public and
Behavioral Health of the Department of Health and Human Services,]
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the Nevada Health Authority, define by regulation the term “unit”
for the purposes of NRS 618.7301 to 618.7318, inclusive.
2. In addition to the regulations adopted pursuant to subsection
1, the Division shall adopt regulations that:
(a) Prescribe minimum requirements for the procedures for
assessing and responding to situations that create the potentia l for
workplace violence included in the plan adopted pursuant to
paragraph (b) of subsection 1 of NRS 618.7312.
(b) Prescribe minimum requirements for the engineering controls,
work practice controls and other appropriate measures to prevent and
mitigate the risk of workplace violence carried out pursuant to
NRS 618.7315.
(c) Prescribe the required contents of a record of workplace
violence maintained pursuant to NRS 618.7316.
Sec. 260. NRS 618.7318 is hereby amended to read as follows:
618.7318 1. A medical facility shall submit to the Division the
most current annual summary of workplace injuries and illnesses
compiled pursuant to 29 C.F.R. § 1904.32.
2. The Division shall make available on an Internet website
maintained by the Division a copy of the most recent:
(a) Annual summary submitted by each medical facility in this
State pursuant to subsection 1;
(b) Reports prepared by the Health Care Purchasing and
Compliance Division of [Public and Behavioral Health of the
Department of Health and H uman Services ] the Nevada Health
Authority pursuant to NRS 439.840 and 439.845; and
(c) Sentinel Event Data Summary published by The Joint
Commission or its successor organization or, if that summary ceases
to be published, a similar report selected by the Division.
Sec. 261. NRS 622.315 is hereby amended to read as follows:
622.315 1. Any regulatory body may share information in its
possession relating to public health concerns with any other
regulatory body and with the Division of Public and Behavi oral
Health of the Department of [Health and] Human Services [,] or the
Health Care Purchasing and Compliance Division of the Nevada
Health Authority, if the confidentiality of the information is
otherwise maintained in accordance with the terms and conditions
required by law.
2. Any regulatory body may conduct a joint investigation with
the Division of Public and Behavioral Health or the Health Care
Purchasing and Compliance Division if either of them so requests
and the regulatory body and the Div ision of Public and Behavioral
Health or the Health Care Purchasing and Compliance Division,
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as applicable, agree that each of them will benefit from conducting a
joint investigation.
Sec. 262. NRS 622A.120 is hereby amended to read as follows:
622A.120 1. The following regulatory bodies are exempted
from the provisions of this chapter:
(a) State Contractors’ Board.
(b) Real Estate Commission, Real Estate Administrator and Real
Estate Division of the Department of Business and Industry.
(c) Commission of Appraisers of Real Estate.
(d) Commissioner of Mortgage Lending and Division of
Mortgage Lending of the Department of Business and Industry.
(e) Commissioner of Financial Institutions and Division of
Financial Institutions of the Department of Business and Industry.
(f) State Board of Health [and] , Division of Public and
Behavioral Health of the Department of [Health and] Human Services
[.] and Health Care Purchasing and Compliance Division of the
Nevada Health Authority.
2. Any regulatory body which is exempted from the provisions
of this chapter pursuant to subsection 1 may elect by regulation to
follow the provisions of this chapter or any portion thereof.
Sec. 263. 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 recognized 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. Health care records:
(a) Must, except as otherwise provided in subsections 5 and 6 of
NRS 439.589, be created, maintained, transmitted and exchanged
electronically as required by subsection 4 of NRS 439.589; and
(b) May be created, authenticated and stored in a health
information exchange which meets the requirements of NRS 439.581
to 439.597, inclusive, and the regulations adopted pursuant thereto.
2. 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.
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3. 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. If a provider of health care fails to deliver the written
statement to the patient pursuant to subsection 3, the provider of
health care shall deliver to the patient the written statement described
in subsection 3 when the provider of health care next performs health
care services for the patient.
5. In addition to delivering a written statement p ursuant to
subsection 3 or 4, a provider of health care may deliver such a written
statement to a patient at any other time.
6. A written statement delivered to a patient pursuant to this
section may be included with other written information delivered t o
the patient by a provider of health care.
7. 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 health 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. If a health care licensing board receives notification from the
[Department of Health and Human Services ] Nevada Health
Authority pursuant to NRS 439.5895 that a provider of health care to
which the health care licensing board has issued a license is not in
compliance with the requirements of subsec tion 4 of NRS 439.589,
the health care licensing board may, after notice and the 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 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
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(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.] Health Care Purchasing
and Compliance Division of the Nevada Health Authority.
(b) “License” has the meaning ascribed to it in NRS 439.5895.
Sec. 264. NRS 629.079 is hereby amended to read as follows:
629.079 1. If a health care licensing board determines that a
complaint received by the health care licensing board concerns a
matter within the jurisdiction of another health care licensing board ,
the health care licensing board which received the complaint shall:
(a) Except as otherwise provided in paragraph (b), refer the
complaint to the other health care licensing board within 5 days after
making the determination; and
(b) If the health care licensing board also determines t hat the
complaint concerns an emergency situation, immediately refer the
complaint to the other health care licensing board.
2. If a health care licensing board determines that a complaint
received by the health care licensing board concerns a public health
emergency or other health event that is an immediate threat to the
health and safety of the public in a health care facility or the office of
a provider of health care, the health care licensing board shall
immediately notify the appropriate health authority for the purposes
of NRS 439.970.
3. A health care licensing board may refer a complaint pursuant
to subsection 1 or provide notification pursuant to subsection 2 orally,
electronically or in writing.
4. The provisions of subsections 1 and 2 apply to any complaint
received by a health care licensing board, including, without
limitation:
(a) A complaint which concerns a person who or entity which is
licensed, certified or otherwise regulated by the health care licensing
board that received the complaint and by another health care licensing
board; and
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(b) A complaint which concerns a person who or entity which is
licensed, certified or otherwise regulated solely by another health care
licensing board.
5. The provisions of this section do not p revent a health care
licensing board from acting upon a complaint which concerns a
matter within the jurisdiction of the health care licensing board
regardless of whether the health care licensing board refers the
complaint pursuant to subsection 1 or prov ides notification based
upon the complaint pursuant to subsection 2.
6. A health care licensing board or an officer or employee of the
health care licensing board is immune from any civil liability for any
decision or action taken in good faith and without malicious intent in
carrying out the provisions of this section.
7. As used in this section:
(a) “Health care facility” means any facility licensed pursuant to
chapter 449 of NRS.
(b) “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,
[640D, 640E,] 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 Health Care Purchasing and Compliance Division
of the Nevada Health Authority.
Sec. 265. NRS 629.250 is hereby amended to read as follows:
629.250 1. A health care licensing board shall not disqualify a
person from licensure or subject any person to discipline solely:
(a) For providing or assisting in the provision of reproductive
health care services; or
(b) As a consequence of any judgment, discipline or other
sanction threatened or imposed under the laws of the District of
Columbia or any state or territory of the United States for providing
or assisting in the provision of reproductive health care services,
if the reproductive health care services as provided would have
been lawful and consistent with standards for the practice of th e
relevant profession in this State.
2. 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,
[640D, 640E,] 641, 641A, 641B, 641C or 641D of NRS.
(2) The Division of Public and Behavioral Health of the
Department of [Health and] Human Services.
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(3) The Health Care Purchasing and Compliance Division
of the Nevada Health Authority.
(b) “Reproductive health care services” means medical, surgical,
counseling or referral services relating to the human reproductive
system, including, without limitation, services relating to pregnancy,
contraception, the termination of pregnancy or any procedure or care
found by a compe tent medical professional to be appropriate based
upon the wishes of a patient and in accordance with the laws of this
State.
Sec. 266. NRS 629.260 is hereby amended to read as follows:
629.260 1. A health care facility shall not provide a patient
with human reproductive material for assisted reproduction except in
accordance with any written agreement entered into between:
(a) The health care facility and the patient; and
(b) The health care facility and the donor.
2. A health care facility that violates the provisions of this
section is subject to a civil penalty of not more than $10,000 for each
violation. This penalty must be recovered in a civil action, brought in
the name of the State of Nevada by the Attorney General. In such an
action, the Attorney General may recover reasonable attorney’s fees
and costs. If a civil penalty is imposed against a health care facility
for violating the provisions of this section, the Attorney General shall,
within 30 days after the imposition of the civil penalty, notify:
(a) The Health Care Purchasing and Compliance Division of
[Public and Behavioral Health of the Department of Health and
Human Services,] the Nevada Health Authority, if the violation was
committed by a medical facility or medical laboratory.
(b) The occupational licensing board responsible for licensing the
provider of health care who oversees an unlicensed health care
facility, if the violation was committed by a health care facility that
is not a medical facility or medical laboratory.
3. As used in this section:
(a) “Assisted reproduction” has the meaning ascribed to it in
NRS 126.510.
(b) “Health care facility” means a medical facility, sperm bank,
laboratory, clinic or office of a provider of health care that provides
services relating to assisted reproduction.
(c) “Human reproductive material” means a gamete or human
organism at any stage of development from fertilized ovum to
embryo.
(d) “Medical facility” has the meaning ascribed to it in
NRS 449.0151.
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(e) “Medical laboratory” has the meaning ascribed to it in
NRS 652.060.
(f) “Provider of health care” has the meaning ascribed to it in
NRS 200.975.
Sec. 267. NRS 630.133 is hereby amended to read as follows:
630.133 1. The Board shall immediately notify the Health
Care Purchasing and Compliance Division of [Public and
Behavioral Health of the Department of Health and Human Services]
the Nevada Health Authority if the Board identifies a sentinel event
which is required to be reported by a medical facility pursuant to
NRS 439.835.
2. Except as otherwise provided in NRS 239.0115, any
information provided to the Health Care Purchasing and
Compliance Division [of Public and Behavioral Health ] pursuant to
this section relati ng to the identification of a sentinel event is
confidential, not subject to subpoena or discovery and not subject to
inspection by the general public.
Sec. 268. NRS 630.307 is hereby amended to read as follows:
630.307 1. Except as otherwise provided in subsection 2, any
person may file with the Board a complaint against a physician,
perfusionist, physician assistant, anesthesiologist assistant or
practitioner of respiratory care on a form provided by the Board. The
form may be submitted in writing or electronically. If a complaint is
submitted anonymously, the Board may accept the complaint but may
refuse to consider the complaint if the lack of the identity of the
complainant makes processing the complaint impossible or unfair to
the person who is the subject of the complaint.
2. Any licensee, medical school or medical facility that becomes
aware that a person practicing medicine, perfusion or respiratory care
in this State has, is or is about to become engaged in conduct which
constitutes grounds f or initiating disciplinary action shall file a
written complaint with the Board within 30 days after becoming
aware of the conduct.
3. Except as otherwise provided in subsection 4, any hospital,
clinic or other medical facility licensed in this State, or medical
society, shall report to the Board any change in the privileges of a
physician, perfusionist, physician assistant, anesthesiologist assistant
or practitioner of respiratory care to practice while the physician,
perfusionist, physician assistant, a nesthesiologist assistant or
practitioner of respiratory care is under investigation and the outcome
of any disciplinary action taken by that facility or society against the
physician, perfusionist, physician assistant, anesthesiologist assistant
or practitioner of respiratory care concerning the care of a patient or
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the competency of the physician, perfusionist, physician assistant,
anesthesiologist assistant or practitioner of respiratory care within 30
days after the change in privileges is made or disci plinary action is
taken.
4. A hospital, clinic or other medical facility licensed in this
State, or medical society, shall report to the Board within 5 days after
a change in the privileges of a physician, perfusionist, physician
assistant, anesthesiologist assistant or practitioner of respiratory care
to practice that is based on:
(a) An investigation of the mental, medical or psychological
competency of the physician, perfusionist, physician assistant,
anesthesiologist assistant or practitioner of respiratory care; or
(b) Suspected or alleged substance abuse in any form by the
physician, perfusionist, physician assistant, anesthesiologist assistant
or practitioner of respiratory care.
5. The Board shall report any failure to comply with subsection
3 or 4 by a hospital, clinic or other medical facility licensed in this
State to t he Health Care Purchasing and Compliance Division of
[Public and Behavioral Health of the Department of Health and
Human Services.] the Nevada Health Authority. If, after a hearing,
the Health Care Purchasing and Compliance Division [of Public
and Behavioral Health] determines that any such facility or society
failed to comply with the requirements of subsection 3 or 4, the
Division may impose an administrative fine of not more than $10,000
against the facility or society for each such failure to report. If the
administrative fine is not paid when due, the fine must be recovered
in a civil action brought by the Attorney General on behalf of the
Division.
6. The clerk of every court shall report to the Board any finding,
judgment or other determination of t he court that a physician,
perfusionist, physician assistant, anesthesiologist assistant or
practitioner of respiratory care:
(a) Is mentally ill;
(b) Is mentally incompetent;
(c) Has been convicted of a felony or any law governing
controlled substances or dangerous drugs;
(d) Is guilty of abuse or fraud under any state or federal program
providing medical assistance; or
(e) Is liable for damages for malpractice or negligence,
within 45 days after such a finding, judgment or determination is
made.
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7. The Board shall retain all complaints filed with the Board
pursuant to this section for at least 10 years, including, without
limitation, any complaints not acted upon.
Sec. 269. NRS 630.415 is hereby amended to read as follows:
630.415 1. A physician or any agent or employee thereof shall
not retaliate or discriminate unfairly against:
(a) An employee of the physician or a person acting on behalf of
the employee who in good faith:
(1) Reports to the Board of Medical Examiners information
relating to the conduct of the physician which may constitute grounds
for initiating disciplinary action against the physician or which
otherwise raises a reasonable question regarding the competence of
the physician to practice medicine with reasonable skill and safety to
patients; or
(2) Reports a sentinel event to the Health Care Purchasing
and Compliance Division of [Public and Behavioral Health of the
Department of Health and Human Services ] the Nevada Health
Authority pursuant to NRS 439.835;
(b) A registered nurse, licensed practical nurse, nursing assistant
or medication aide - certified who is employed by or contracts to
provide nursing services for the physician and who:
(1) In good faith, reports to the physician, the Board of
Medical Examiners, the State Board of Nursing, the Legislature or
any committee thereof or any other governmental entity:
(I) Any information concerning the willful conduct of
another registered nurse, licensed practical nurse, nursing assistant or
medication aide - certified which violates any provision of chapter
632 of NRS or which is required to be reported to the State Board of
Nursing;
(II) Any concerns regarding patients who may be exposed
to a substantial risk of harm as a result of the failure of the physician
or any agent or employee thereof to comply with minimum
professional or accreditation standards or applicable statutory or
regulatory requirements; or
(III) Any other concerns regarding the physician, the
agents and employees thereof or any situation that reasonably could
result in harm to patients; or
(2) Refuses to engage in conduct that would violate the duty
of the registered nurse, licensed practical nurse, nursing assistant or
medication aide - certified to protect patients from actual or potential
harm, including, without limitation, conduct which would violate any
provision of chapter 632 of NRS or which would subject the
registered nurse, licensed practical nurse, nursing assistant or
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medication aide - certified to disciplinary action by the State Board
of Nursing; or
(c) An employee of the physician, a person acting on behalf of the
employee or a registered nurse, licensed practical nurse, nursing
assistant or medication aide - certified who is employed by or
contracts to provide nursing se rvices for the physician and who
cooperates or otherwise participates in an investigation or proceeding
conducted by the Board of Medical Examiners or another
governmental entity relating to conduct described in paragraph (a)
or (b).
2. A physician or a ny agent or employee thereof shall not
retaliate or discriminate unfairly against an employee of the physician
or a registered nurse, licensed practical nurse, nursing assistant or
medication aide - certificate who is employed by or contracts to
provide nu rsing services for the physician because the employee,
registered nurse, licensed practical nurse, nursing assistant or
medication aide - certified has taken an action described in
subsection 1.
3. A physician or any agent or employee thereof shall not
prohibit, restrict or attempt to prohibit or restrict by contract, policy,
procedure or any other manner the right of an employee of the
physician or a registered nurse, licensed practical nurse, nursing
assistant or medication aide - certified who is empl oyed by or
contracts to provide nursing services for the physician to take an
action described in subsection 1.
4. As used in this section:
(a) “Good faith” means honesty in fact in the reporting of the
information or in the cooperation of the investigation concerned.
(b) “Retaliate or discriminate”:
(1) Includes, without limitation, any of the following actions
if taken solely because the employee, registered nurse, licensed
practical nurse, nursing assistant or medication aide - certified took
an action described in subsection 1:
(I) Frequent or undesirable changes in the location where
the person works;
(II) Frequent or undesirable transfers or reassignments;
(III) The issuance of letters of reprimand, letters of
admonition or evaluations of poor performance;
(IV) A demotion;
(V) A reduction in pay;
(VI) The denial of a promotion;
(VII) A suspension;
(VIII) A dismissal;
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(IX) A transfer; or
(X) Frequent changes in working hours or workdays.
(2) Does not include an action described in sub-subparagraphs
(I) to (X), inclusive, of subparagraph (1) if the action is taken in the
normal course of employment or as a form of discipline.
Sec. 270. NRS 632.121 is hereby amended to read as follows:
632.121 1. The Board shall immediately notify the Health
Care Purchasing and Compliance Division of [Public and
Behavioral Health of the Department of Health and Human Services]
the Nevada Health Authority if the Board identifies a sentinel event
which is required to be repor ted by a medical facility pursuant to
NRS 439.835.
2. Except as otherwise provided in NRS 239.0115, any
information provided to the Health Care Purchasing and
Compliance Division [of Public and Behavioral Health ] pursuant to
this section relating to the identification of a sentinel event is
confidential, not subject to subpoena or discovery and not subject to
inspection by the general public.
Sec. 271. NRS 632.127 is hereby amended to read as follows:
632.127 1. The Board shall supply the Health Care
Purchasing and Compliance Division of [Public and Behavioral
Health of the Department of Health and Human Services] the Nevada
Health Authority upon request with a list of each training program
approved by the Board.
2. The Board shall share with each state agency which regulates
medical facilities and facilities for the dependent any information the
Board receives concerning disciplinary action taken against nursing
assistants or medication aides - certified who work in the facilities.
Sec. 272. NRS 633.283 is hereby amended to read as follows:
633.283 1. The Board shall immediately notify the Health
Care Purchasing and Compliance Division of [Public and
Behavioral Health of the Department of Health and Human Services]
the Nevada Health Authority if the Board identifies a sentinel event
which is required to be reported by a medical facility pursuant to
NRS 439.835.
2. Except as otherwise provided in NRS 239.0115, any
information provided to the Health Care Purchasing and
Compliance Division [of Public and Behavioral Health ] pursuant to
this section relating to the identification of a sentinel event is
confidential, not subject to subpoena or discovery and not subject to
inspection by the general public.
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Sec. 273. NRS 633.524 is hereby amended to read as follows:
633.524 1. The Board shall require each holder of a license to
practice osteopathic medicine issued pursuant to this chapter to
submit to the Board, on a form provided by the Board, a nd in the
format required by the Board by regulation, a report stating t he
number and type of surgeries requiring conscious sedation, deep
sedation or general anesthesia performed by the holder of the license
at his or her office or any other facility, exc luding any surgical care
performed:
(a) At a medical facility as that term is defined in NRS 449.0151;
or
(b) Outside of this State.
2. In addition to the report required pursuant to subsection 1, the
Board shall require each holder of a license to pr actice osteopathic
medicine to submit a report to the Board concerning the occurrence
of any sentinel event arising from any surgery described in subsection
1. The report must be submitted in the manner prescribed by the
Board which must be substantially similar to the manner prescribed
by the State Board of Health for reporting information pursuant to
NRS 439.835.
3. Each holder of a license to practice osteopathic medicine shall
submit the reports required pursuant to subsections 1 and 2:
(a) At the time the holder of the license renews his or her license;
and
(b) Whether or not the holder of the license performed any
surgery described in subsection 1. Failure to submit a report or
knowingly or willfully filing false information in a report constitutes
grounds for initiating disciplinary action pursuant to NRS 633.511.
4. In addition to the reports required pursuant to subsections 1
and 2, the Board shall require each holder of a license to practice
osteopathic medicine to submit a report to the Boar d concerning the
occurrence of any sentinel event arising from any surgery described
in subsection 1 within 14 days after the occurrence of the sentinel
event. The report must be submitted in the manner prescribed by the
Board.
5. The Board shall:
(a) Collect and maintain reports received pursuant to subsections
1, 2 and 4;
(b) Ensure that the reports, and any additional documents created
from the reports, are protected adequately from fire, theft, loss,
destruction and other hazards, and from unauthorized access; and
(c) Submit to the Health Care Purchasing and Compliance
Division of [Public and Behavioral] the Nevada Health Authority a
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copy of the report submitted pursuant to subsection 1. The Division
shall maintain the confidentiality of such reports in accordance with
subsection 6.
6. Except as otherwise provided in NRS 239.0115, a report
received pursuant to subsection 1, 2 or 4 is confidential, not subject
to subpoena or discovery, and not subject to inspection by the general
public.
7. The provisions of this section do not apply to surgical care
requiring only the administration of oral medication to a patient to
relieve the patient’s anxiety or pain, if the medication is not given in
a dosage that is sufficient to induce in a patient a controlled state of
depressed consciousness or unconsciousness similar to general
anesthesia, deep sedation or conscious sedation.
8. In addition to any other remedy or penalty, if a holder of a
license to practice osteopathic medicine fails to submit a report or
knowingly or willfully files false information in a report submitted
pursuant to this section, the Board may, after providing the holder of
a license to practice osteopathic medicine with notice and opportunity
for a hearing, impose against the holder of a license an administrative
penalty for each such violation. The Board shall establish by
regulation a sliding scale based on the severity of the violation to
determine the amount of the administrative penalty to be imposed
against the holder of the license to practice osteopathic medicine. The
regulations must include standards for determining the severity of the
violation and may provide for a more severe penalty for multiple
violations.
9. As used in this section:
(a) “Conscious sedation” has the meaning ascribed to it in
NRS 449.436.
(b) “Deep sedation” has the meaning ascribed to it in
NRS 449.437.
(c) “General anesthesia” has the meaning ascribed to it in
NRS 449.438.
(d) “Sentinel event” has the meaning ascribed to it in
NRS 439.830.
Sec. 274. NRS 633.533 is hereby amended to read as follows:
633.533 1. Except as otherwise provided in subsection 2, any
person may file with the Board a complaint against an osteopathic
physician, physician assistant or anesthesiologist assistant on a form
provided by the Board. The form may be submitted in writing or
electronically. If a complaint is submitted anonymously, the Board
may accept the complaint but may refuse to consider the complaint if
the lack of the identity of the complainant mak es processing the
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complaint impossible or unfair to the person who is the subject of the
complaint.
2. Any licensee, medical school or medical facility that becomes
aware that a person practicing osteopathic medicine or practicing as
a physician assistant or anesthesiologist assistant in this State has, is
or is about to become engaged in conduct which constitutes grounds
for initiating disciplinary action shall file a written complaint with the
Board within 30 days after becoming aware of the conduct.
3. Except as otherwise provided in subsection 4, any hospital,
clinic or other medical facility licensed in this State, or medical
society, shall file a written report with the Board of any change in the
privileges of an osteopathic physician, phys ician assistant or
anesthesiologist assistant to practice while the osteopathic physician,
physician assistant or anesthesiologist assistant is under investigation,
and the outcome of any disciplinary action taken by the facility or
society against the ost eopathic physician, physician assistant or
anesthesiologist assistant concerning the care of a patient or the
competency of the osteopathic physician, physician assistant or
anesthesiologist assistant, within 30 days after the change in
privileges is made or disciplinary action is taken.
4. A hospital, clinic or other medical facility licensed in this
State, or medical society, shall report to the Board within 5 days after
a change in the privileges of an osteopathic physician, physician
assistant or anesthesiologist assistant that is based on:
(a) An investigation of the mental, medical or psychological
competency of the osteopathic physician, physician assistant or
anesthesiologist assistant; or
(b) A suspected or alleged substance use disorder in any form by
the osteopathic physician, physician assistant or anesthesiologist
assistant.
5. The Board shall report any failure to comply with subsection
3 or 4 by a hospital, clinic or other medical facility licensed in this
State to the Health Care Purchas ing and Compliance Division of
[Public and Behavioral Health of the Department of Health and
Human Services.] the Nevada Health Authority. If, after a hearing,
the Division determines that any such facility or society failed to
comply with the requirements of subsection 3 or 4, the Division may
impose an administrative fine of not more than $10,000 against the
facility or society for each such failure to report. If the administrative
fine is not paid when due, the fine must be recovered in a civil action
brought by the Attorney General on behalf of the Division.
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6. The clerk of every court shall report to the Board any finding,
judgment or other determination of the court that an osteopathic
physician, physician assistant or anesthesiologist assistant:
(a) Is mentally ill;
(b) Is mentally incompetent;
(c) Has been convicted of a felony or any law governing
controlled substances or dangerous drugs;
(d) Is guilty of abuse or fraud under any state or federal program
providing medical assistance; or
(e) Is liable for damages for malpractice or negligence,
within 45 days after the finding, judgment or determination.
Sec. 275. NRS 633.750 is hereby amended to read as follows:
633.750 1. An osteopathic physician or any agent or employee
thereof shall not retaliate or discriminate unfairly against:
(a) An employee of the osteopathic physician or a person acting
on behalf of the employee who in good faith:
(1) Reports to the State Board of Osteopathic Medicine
information relating to the conduct of the osteopathic physician which
may constitute grounds for initiating disciplinary action against the
osteopathic physician or which otherwise raises a reasonable question
regarding the competence of the osteopathic physician to practice
medicine with reasonable skill and safety to patients; or
(2) Reports a sentinel event to the Health Care Purchasing
and Compliance Division of [Public and Behavioral Health of the
Department of Health and Human Services ] the Nevada Health
Authority pursuant to NRS 439.835;
(b) A registered nurse, licensed practical nurse, nursing assistant
or medication aide - certified who is employed by or contracts to
provide nursing services for the osteopathic physician and who:
(1) In good faith, reports to the osteopathic physician, the State
Board of Osteopathic Medicine, the State Board of Nursing, the
Legislature or any committee thereof or any other governmental
entity:
(I) Any information concerning the willful conduct of
another registered nurse, licensed practical nurse, nursing assistant or
medication aide - certified which violates any provision of chapter
632 of NRS or which is required to be reported to the State Board of
Nursing;
(II) Any concerns regarding patients who may be exposed
to a substantial risk of harm as a result of the failure of the osteopathic
physician or any agent or employee thereof to comply with minimum
professional or accreditation standards or applicable statutory or
regulatory requirements; or
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(III) Any other concerns regarding the osteop athic
physician, the agents and employees thereof or any situation that
reasonably could result in harm to patients; or
(2) Refuses to engage in conduct that would violate the duty
of the registered nurse, licensed practical nurse, nursing assistant or
medication aide - certified to protect patients from actual or potential
harm, including, without limitation, conduct which would violate any
provision of chapter 632 of NRS or which would subject the
registered nurse, licensed practical nurse, nursing ass istant or
medication aide - certified to disciplinary action by the State Board
of Nursing; or
(c) An employee of the osteopathic physician, a person acting on
behalf of the employee or a registered nurse, licensed practical nurse,
nursing assistant or me dication aide - certified who is employed by
or contracts to provide nursing services for the osteopathic physician
and who cooperates or otherwise participates in an investigation or
proceeding conducted by the State Board of Osteopathic Medicine or
another governmental entity relating to conduct described in
paragraph (a) or (b).
2. An osteopathic physician or any agent or employee thereof
shall not retaliate or discriminate unfairly against an employee of the
osteopathic physician or a registered nurse , licensed practical nurse,
nursing assistant or medication aide - certified who is employed by
or contracts to provide nursing services for the osteopathic physician
because the employee, registered nurse, licensed practical nurse,
nursing assistant or me dication aide - certified has taken an action
described in subsection 1.
3. An osteopathic physician or any agent or employee thereof
shall not prohibit, restrict or attempt to prohibit or restrict by contract,
policy, procedure or any other manner the right of an employee of the
osteopathic physician or a registered nurse, licensed practical nurse,
nursing assistant or medication aide - certified who is employed by
or contracts to provide nursing services for the osteopathic physician
to take an action described in subsection 1.
4. As used in this section:
(a) “Good faith” means honesty in fact in the reporting of the
information or in the cooperation in the investigation concerned.
(b) “Retaliate or discriminate”:
(1) Includes, without limitation, any of the following actions
if taken solely because the employee, registered nurse, licensed
practical nurse, nursing assistant or medication aide - certified took
an action described in subsection 1:
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(I) Frequent or undesirable changes in the location where
the person works;
(II) Frequent or undesirable transfers or reassignments;
(III) The issuance of letters of reprimand, letters of
admonition or evaluations of poor performance;
(IV) A demotion;
(V) A reduction in pay;
(VI) The denial of a promotion;
(VII) A suspension;
(VIII) A dismissal;
(IX) A transfer; or
(X) Frequent changes in working hours or workdays.
(2) Does not include an action described in sub-subparagraphs
(I) to (X), inclusive, of subparagraph (1) if the act ion is taken in the
normal course of employment or as a form of discipline.
Sec. 276. NRS 634B.040 is hereby amended to read as follows:
634B.040 “Division” means the Health Care Purchasing and
Compliance Division of [Public and Behavioral Health of the
Department of Health and Human Services. ] the Nevada Health
Authority.
Sec. 277. NRS 639.004 is hereby amended to read as follows:
639.004 “Chart order” means an order entered on the chart of a
patient in a hospital, recovery center, facility for intermediate care or
facility for skilled nursing which is licensed as such by the Health
Care Purchasing and Compliance Division of [Public and
Behavioral Health of the Department of Health and Human Services]
the Nevada Health Authority or on the chart of a patient under
emergency treatment in a hospital by a practitioner or on the written
or oral order of a practitioner authorizing the administration of a drug
to the patient.
Sec. 278. NRS 639.0144 is hereby amended to read as follows:
639.0144 “Recovery center” means any public or private facility
that provides only short-term care, not to exceed 72 hours, to a person
recovering from surgery, which is licensed as such by the Health
Care Purchasing and Compliance Division of [Public and
Behavioral Health of the Department of Health and Human Services.]
the Nevada Health Authority.
Sec. 279. NRS 639.2327 is hereby amended to read as follows:
639.2327 A facility for intermediate care or facility for skilled
nursing which is licensed as such by the Health Care Purchasing
and Compliance Division of [Public and Behavioral Health of the
Department of Health and Human Services ] the Nevada Health
Authority and is registered with the Board pursuant to this chapter
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may maintain a stock of drugs for emergency treatment of inpatients,
subject to the following conditions:
1. The Board shall by regulation determine the specific drugs
and the quantities thereof which may be maintained.
2. The emergency stock of drugs must be maintained at all times
in a solid, sealed container and the seal must remain intact except
when the drugs are needed for emergency treatment of a patient in the
facility. The sealed container must be stored at all times in a locked
compartment on the premises of the facility.
3. All drugs delivered to a facility must be signed for by the
nurse or other person in charge. An inventory of the stock of drugs
must be appended to the sealed container. Immediately after the drugs
are needed, the physician or registered nurse who breaks the seal shall
enter on the inventory sheet the following information:
(a) The date and time the sealed container is opened;
(b) The name of the patient for whom the drugs are to be used;
(c) The name of the patient’s physician or the physician who
directs the administration of the drugs, if different;
(d) An itemization of the drugs removed; and
(e) The signature of the person who opened the sealed container.
4. When the drugs have been removed and the information
required by subsection 3 has been entered on the inventory, the
physician or registered nurse shall immediately replace the container
in a locked compartment and shall notify the pharmaceutical
consultant, as soon as it is practical to do so, that the container has
been opened.
5. The sealed container and its contents at all times remain the
responsibility of the pharmaceutical consultant. Upon being notified
that the sealed container has been opened, or on the next business day
if notification is not received during business hours, but in no event
more than 48 hours following receipt of the notification, the
pharmaceutical consultant shall:
(a) Examine the inventory sheet;
(b) Replace the drugs removed;
(c) Secure a written prescription for the drugs replaced, if one is
required by law;
(d) Enter the name and quantity of the drugs so replaced on the
inventory sheet, together with the date and time of replacement;
(e) Reseal the container; and
(f) Sign the inventory sheet.
6. No person other than a licensed physician or registered nurse
may open the container or remove any drugs from the container.
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7. The Board, its agents and inspectors may at all times have
access to the premises of the facility to determine compliance with
this section.
Sec. 280. NRS 639.23275 is hereby amended to read as
follows:
639.23275 1. Except as otherwise provided in NRS 453.256,
no pharmacy may deliver a controlled substance or dangerous drug
for a specific patient to a hospital, recovery center, facility for
intermediate care or facility for skilled nursing which is licensed as
such by the Health Care Purchasing and Compliance Division of
[Public and Behavioral Health of the Department of Health and
Human Services] the Nevada Health Authority which does not have
a pharmacy on the premises except pursuant to a prescription given:
(a) Directly from the prescribing practitioner to a pharmacist;
(b) Indirectly by means of an order signed by the prescribing
practitioner; or
(c) By an oral order transmitted by an agent of the prescribing
practitioner.
2. If an order for entry on a chart is given by a prescribing
practitioner, the chart order must be signed by the practitioner who
authorized the administration of the drug within 48 hours after the
order is given by that practitioner.
Sec. 281. Chapter 640D of NRS is hereby amended by adding
thereto a new section to read as follows:
“Division” means the Health Care Purchasing and Compliance
Division of the Nevada Health Authority.
Sec. 282. NRS 640D.020 is hereby amended to read as follows:
640D.020 As used in this chapter, unless the context otherwise
requires, the words and terms defined in NRS 640D.030 to 640D.070,
inclusive, and section 281 of this act have the meanings ascribed to
them in those sections.
Sec. 283. NRS 640D.060 is hereby amended to read as follows:
640D.060 “Music therapy” means the clinical use of music
interventions by a licensee to accomplish individualized goals within
a therapeutic relationship by a credentialed professional who has
completed a music therapy program approved by th e [Board.]
Division. The term does not include:
1. The practice of psychology or medicine;
2. The psychological assessment or treatment of couples or
families;
3. The prescribing of drugs or electroconvulsive therapy;
4. The medical treatment of physical disease, injury or
deformity;
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5. The diagnosis or psychological treatment of a psychotic
disorder;
6. The use of projective techniques in the assessment of
personality;
7. The use of psychological, neuropsychological, psychometric
assessment or clinical tests designed to identify or classify abnormal
or pathological human behavior or to determine intelligence,
personality, aptitude, interests or addictions;
8. The use of individually administered intelligence tests,
academic achievement tests or neuropsychological tests;
9. The use of psychotherapy to treat the concomitants of organic
illness;
10. The diagnosis of any physical or mental disorder; or
11. The evaluation of the effects of medical and psychotropic
drugs.
Sec. 284. NRS 640D.090 is hereby amended to read as follows:
640D.090 1. The Board may adopt such regulations as it
deems necessary to carry out the provisions of this chapter. The
regulations may include, without limitation, additional:
(a) Standards of training for music therapists;
(b) Requirements for continuing education for music therapists;
and
(c) Standards of practice for music therapists.
2. The [Board] Division shall:
(a) Enforce the provisions of this chapter and any regulations
adopted pursuant thereto, to the extent that money is available for that
purpose; and
(b) Maintain a list of:
(1) Applicants for a license;
(2) Licensees; and
(3) Persons whose licenses have been revoked or suspended
by the [Board.] Division.
3. The [Board] Division shall, upon request and payment of any
fee, provide a copy of a list maintained pursuant to paragraph (b) of
subsection 2. A fee charged for providing the copy must not exceed
the actual cost incurred by the [Board] Division to make the copy.
4. The [Board] Division may accept gifts, grants, donations and
contributions from any source to assist in carrying out the provisions
of this chapter.
Sec. 285. NRS 640D.100 is hereby amended to read as follows:
640D.100 1. The Board may establish a Music Therapy
Advisory Group consisting of persons familiar with the practice of
music therapy to provide the Board and the Division with expertise
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and assistance in carrying out [its] their duties pursuant to this
chapter. If a Music Therapy Advisory Group is established, the Board
must:
(a) Determine the number of members;
(b) Appoint the members;
(c) Establish the terms of the members; and
(d) Determine the duties of the Music Therapy Advisory Group.
2. Members of a Music Therapy Advisory Group established
pursuant to subsection 1 serve without compensation.
Sec. 286. NRS 640D.110 is hereby amended to read as follows:
640D.110 1. The [Board] Division shall issue a license to
practice music therapy to an applicant who:
(a) Is at least 18 years of age;
(b) Is of good moral character; and
(c) Submits to the [Board:] Division:
(1) A completed application on a form provided by the
[Board;] Division;
(2) Proof that the applicant has successfully completed an
academic program approved by the American Music Therapy
Association or its successor organization with a bachelor’s degree or
higher degree in music therapy;
(3) A fee in the amount of $200 or such other amount as
prescribed by regulation by the Board;
(4) A co mplete set of fingerprints and written permission
authorizing the [Board] Division to forward the fingerprints to the
Central Repository for Nevada Records of Criminal History for
submission to the Federal Bureau of Investigation for its report; and
(5) Proof that the applicant has passed the examination for
board certification offered by the Certification Board for Music
Therapists or its successor organization or is certified as a music
therapist by that Board or its successor organization.
2. Any increase in the fees imposed pursuant to this section must
not exceed the amount necessary for the [Board] Division to carry out
the provisions of this chapter.
Sec. 287. NRS 640D.120 is hereby amended to read as follows:
640D.120 1. In addition to any other requirements set forth in
this chapter, an applicant for the issuance or renewal of a license as a
music therapist shall:
(a) Include the social security number of the applicant in the
application submitted to the [Board.] Division.
(b) Submit to t he [Board] Division the statement prescribed by
the Division of [Welfare and Supportive ] Social Services of
the Department of [Health and ] Human Services pursuant to
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NRS 425.520. The statement must be completed and signed by the
applicant.
2. The [Board] Division shall include the statement required
pursuant to subsection 1 in:
(a) The application or any other forms that must be submitted for
the issuance or renewal of the license; or
(b) A separate form prescribed by the [Board.] Division.
3. A lic ense may not be issued or renewed by the [Board]
Division if the applicant:
(a) Fails to submit the statement required pursuant to subsection
1; or
(b) Indicates on the statement submitted pursuant to subsection 1
that the applicant is subject to a court order for the support of a child
and is not in compliance with the order or a plan approved by the
district attorney or other public agency enforcing the order for the
repayment of the amount owed pursuant to the order.
4. If an applicant indicates on the statement submitted pursuant
to subsection 1 that the applicant is subject to a court order for the
support of a child and is not in compliance with the order or a plan
approved by the district attorney or other public agency enforcing the
order for the repayment of the amount owed pursuant to the order, the
[Board] Division shall advise the applicant to contact the district
attorney or other public agency enforcing the order to determine the
actions that the applicant may take to satisfy the arrearage.
Sec. 288. NRS 640D.130 is hereby amended to read as follows:
640D.130 1. Each license to practice music therapy expires 3
years after the date on which it is issued and may be renewed if,
before the license expires, the l icensee submits to the [Board:]
Division.
(a) A completed application for renewal on a form prescribed by
the [Board;] Division;
(b) Proof that the applicant has continuously maintained for the
previous 3 years his or her certification with and is currently certified
as a music therapist by the Certification Board for Music Therapists
or its successor organization;
(c) Proof that the applicant has completed not less than 100 units
of continuing education approved by the Certification Board for
Music Therapists or its successor organization; and
(d) A fee in the amount of $200 or such other amount as
prescribed by regulation by the Board.
2. Any increase in the fees imposed pursuant to this section must
not exceed the amount necessary for the [Board] Division to carry out
the provisions of this chapter.
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Sec. 289. NRS 640D.135 is hereby amended to read as follows:
640D.135 1. The [Board] Division may:
(a) Make the data request developed by the Director of the
Department of [Health and ] Human Services pursuant to NRS
439A.116 available to applicants for the renewal of a license pursuant
to this chapter through a link on the electronic application for the
renewal of a license; and
(b) Request each applicant to complete and electronically submit
the data request to the Director.
2. The information provided by an applicant for the renewal of
a license pursuant to subsection 1 is confidential and, except as
required by subsection 1, must not be disclosed to any person or
entity.
3. An applicant for the renewal of a license is not required to
complete a data request pursuant to subsection 1 and is not subject to
disciplinary action, including, without limitation, refusal to renew the
license, for failure to do so.
Sec. 290. NRS 640D.140 is hereby amended to read as follows:
640D.140 1. A license that is not renewed on or before the date
on which it expires is delinquent. The [Board] Division shall, within
30 days after the license becomes delinquent, send a notice to the
licensee by certified mail, return receipt requested, to the address of
the licensee as indicated in the records of the [Board.] Division.
2. A licensee may renew a delinquent license within 60 days
after the license becomes delinquent by complying with the
requirements of NRS 640D.130.
3. A license expires 60 days after it becomes delinquent if it is
not renewed within that period.
Sec. 291. NRS 640D.160 is hereby amended to read as follows:
640D.160 1. If any member of the Board or a Music Therapy
Advisory Group or an officer or employee of the Division becomes
aware of any ground for initiating disciplinary action against a
licensee, the member , officer or employee must file a written
complaint with the [Board.] Division.
2. As soon as practicable after receiving a complaint, the
[Board] Division shall:
(a) Forward the complaint to the Certification Board for Music
Therapists or its successor organization for investigation of the
complaint and request a written report of the findings of such
investigation; or
(b) To the extent money is available to do so, conduct an
investigation of the complaint to determine whether the allegations in
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the complaint merit the initiation of disciplinary proceedings against
the licensee.
3. The [Board] Division shall retain a copy of each complaint
filed with the [Board] Division pursuant to this section for at least 10
years, including, without limitation, any complaint that is not acted
upon.
Sec. 292. NRS 640D.170 is hereby amended to read as follows:
640D.170 The [Board] Division may refuse to grant or may
suspend or revoke a license to practice music therapy for any of the
following reasons:
1. Submitting false, fraudulent or misleading information to the
[Board] Division or any agency of this Stat e, any other state, a
territory or possession of the United States, the District of Columbia
or the Federal Government.
2. Violating any provision of this chapter or any regulation
adopted pursuant thereto.
3. Conviction of a felony relating to the pra ctice of music
therapy or of any offense involving moral turpitude, the record of
conviction being conclusive evidence thereof.
4. Having an alcohol or other substance use disorder.
5. Impersonating a licensed music therapist or allowing another
person to use his or her license.
6. Using fraud or deception in applying for a license to practice
music therapy.
7. Failing to comply with the “Code of Professional Practice” of
the Certification Board for Music Therapists or its successor
organization or committing any other unethical practices contrary to
the interest of the public as determined by the [Board.] Division.
8. Negligence, fraud or deception in connection with the music
therapy services a licensee is authorized to provide pursuant to this
chapter.
Sec. 293. NRS 640D.180 is hereby amended to read as follows:
640D.180 1. If, after an investigation conducted by the
[Board] Division or receiving the findings from an investigation of a
complaint from the Certification Board for Music Therapists or its
successor organization, and after notice and a hearing as required by
law, the [Board] Division finds one or more grounds for taking
disciplinary action, the [Board] Division may:
(a) Place the licensee on probation for a specified period or until
further order of the [Board;] Division;
(b) Administer to the applicant or licensee a public reprimand;
(c) Refuse to renew the license of the licensee;
(d) Suspend or revoke the license of the licensee;
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(e) Impose an administrative fine of not more than $500 for each
violation; or
(f) Take any combination of actions set forth in paragraphs (a) to
(e), inclusive.
2. The order of the [Board] Division may include such other
terms, provisions or conditions as the [Board] Division deems
appropriate.
3. The order of the [Board] Division and the findings of fact and
conclusions of law supporting that order are public records.
4. The [Board] Division shall not issue a private reprimand.
Sec. 294. NRS 640D.190 is hereby amended to read as follows:
640D.190 1. Except as otherwise provided in this section and
NRS 239.0115, a complaint filed with the [Board,] Division, all
documents and other information filed with the complaint and all
documents and other information returned from the Certification
Board for Music Therapists or its successor organization as a result
of an investigation conducted to determine whether to initiate
disciplinary action against a person are confidential, unless the person
submits a written statement to the [Board] Division requesting that
such documents and information be made public records.
2. The charging documents filed with the [Board] Division to
initiate disciplinary action pursuant to chapter 622A of NRS and all
documents and information considered by the [Board] Division when
determining whether to impose discipline are public records.
3. An order that imposes discipline and the findings of fact and
conclusions of law supporting that order are public records.
4. The provisions of this section do not prohibit the [Board]
Division from communicating or cooperating with or providing any
documents or other information to any other licensing bo ard or any
other agency that is investigating a person, including, without
limitation, a law enforcement agency.
Sec. 295. NRS 640D.200 is hereby amended to read as follows:
640D.200 1. If the [Board] Division receives a copy of a court
order issued p ursuant to NRS 425.540 that provides for the
suspension of all professional, occupational and recreational licenses,
certificates and permits issued to a person who is the holder of a
license as a music therapist, the [Board] Division shall deem the
license issued to that person to be suspended at the end of the 30th
day after the date on which the court order was issued unless the
[Board] Division receives a letter issued to the holder of the license
by the district attorney or other public agency pursuant to NRS
425.550 stating that the holder of the license has complied with the
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subpoena or warrant or has satisfied the arrearage pursuant to
NRS 425.560.
2. The [Board] Division shall reinstate a license as a music
therapist that has been suspended by a district court pursuant to NRS
425.540 if the [Board] Division receives a letter issued by the district
attorney or other public agency pursuant to NRS 425.550 to the
person whose license was suspended stating that the person whose
license was suspended has complied with the subpoena or warrant or
has satisfied the arrearage pursuant to NRS 425.560.
Sec. 296. NRS 640D.210 is hereby amended to read as follows:
640D.210 1. If the [Board] Division determines that a person
has violated or is about to violate any provision of this chapter or a
regulation adopted pursuant thereto, the [Board] Division may bring
an action in a court of competent jurisdiction to enjoin the person
from engaging in or continuing the violation.
2. An injunction:
(a) May be issued without proof of actual damage sustained by
any person.
(b) Does not prohibit the criminal prosecution and punishment of
the person who commits the violation.
Sec. 297. NRS 640D.220 is hereby amended to read as follows:
640D.220 1. A person who is not licensed to practice music
therapy pursuant to this chapter, or a person whose license to practice
music therapy has expired or has been suspended or revoked by the
[Board,] Division, shall not:
(a) Provide music therapy services;
(b) Use in connection with his or her name the words or letters
“MT,” “music therapist,” “licensed, board-certified music therapist,”
“MT-BC,” “Music Therapist - Board Certified,” “MT - BC/L” or
“Licensed Music Therapist - Board Certified” or any other letters,
words or insignia indicating or implying that he or she is licensed to
practice music therapy, or in any other way, orally, or in writing or
print, or by sign, directly or by implication, use the words “music
therapy” or represent himself or herself as licensed or qualified to
engage in the practice of music therapy; or
(c) List or cause to have listed in any directory, including, without
limitation, a telephone directory, his or her name or the name of his
or her company under the heading “Music Therapy” or “Music
Therapist” or any other term that indicates or implies that he or she is
licensed or qualified to practice music therapy.
2. A person who violates the provisions of this section is guilty
of a misdemeanor.
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Sec. 298. Chapter 640E of NRS is hereby amended by adding
thereto a new section to read as follows:
“Division” means the Health Care Purchasing and Compliance
Division of the Nevada Health Authority.
Sec. 299. NRS 640E.020 is hereby amended to read as follows:
640E.020 As used in this chapter, unless the context otherwise
requires, the words and terms defined in NRS 640E.030 to 640E.080,
inclusive, and section 298 of this act have the meanings ascribed to
them in those sections.
Sec. 300. NRS 640E.100 is hereby amended to read as follows:
640E.100 1. The [Board] Division shall make and keep a
complete record of all its proceedings pursuant to this chapter,
including, without limitation:
(a) A file of all applications for licenses pursuant to this chapter,
together with the action of the [Board] Division upon each
application;
(b) A register of all licensed dietitians in this State; and
(c) Documentation of any disciplinary action taken by the [Board]
Division against a licensee.
2. The [Board] Division shall maintain in its main office a public
docket or other record in which it shall record, from time to time as
made, the rulings or decisions upon all complaints filed with the
[Board] Division and all investigations instituted by it, upon or in
connection with which any hearing has been held or in which the
licensee charged has made no defense.
Sec. 301. NRS 640E.110 is hereby amended to read as follows:
640E.110 1. The Board may:
(a) Adopt regulations establishing reasonable standards:
(1) For the denial, renewal, suspension and revocation of, and
the placement of conditions, limitations and restrictions upon, a
license to engage in the practice of dietetics.
(2) Of professional conduct for the practice of dietetics.
(b) Investigate and determine the eligibility of an applicant for a
license pursuant to this chapter.
(c) Carry out and enforce the provisions of this chapter and the
regulations adopted pursuant thereto.
2. The Board shall adopt regulations establishing reasonable:
(a) Qualifications for the issuance of a license pursuant to this
chapter.
(b) Standards for the continuing profe ssional competence of
licensees. The [Board] Division may evaluate licensees periodically
for compliance with those standards.
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3. The Board shall adopt regulations establishing a schedule of
reasonable fees and charges for:
(a) Investigating licensees and applicants for a license pursuant to
this chapter;
(b) Evaluating the professional competence of licensees;
(c) Conducting hearings pursuant to this chapter;
(d) Duplicating and verifying records of the [Board;] Division;
and
(e) Surveying, evaluating and approving schools and courses of
dietetics,
and may collect the fees established pursuant to this subsection.
4. The Board may adopt such other regulations as it determines
necessary to carry out the provisions of this chapter relating to the
practice of dietetics.
Sec. 302. NRS 640E.120 is hereby amended to read as follows:
640E.120 The [Board] Division may:
1. Accept gifts or grants of money to pay for the costs of
administering the provisions of this chapter.
2. Enter into contracts with other public agencies and accept
payment from those agencies to pay the expenses incurred by the
[Board] Division in carrying out the provisions of this chapter relating
to the practice of dietetics.
Sec. 303. NRS 640E.130 is hereby amended to read as follows:
640E.130 1. The Board may establish a Dietitian Advisory
Group consisting of persons familiar with the practice of dietetics to
provide the Board and the Division with expertise and assistance in
carrying out [its] their duties pursuant to this chapter. If a Dietitian
Advisory Group is established, the Board shall:
(a) Determine the number of members;
(b) Appoint the members;
(c) Establish the terms of the members; and
(d) Determine the duties of the Dietitian Advisory Group.
2. Members of a Dietitian Advisory Group established pursuant
to subsection 1 serve without compensation.
Sec. 304. NRS 640E.150 is hereby amended to read as follows:
640E.150 1. An applicant for a license to engage in the
practice of dietetics in this State must submit to the [Board] Division
a completed application on a form prescribed by the [Board.]
Division. The application must include evidence that the applicant is
a registered dietitian in good standing.
2. Each applicant must remit the applicable fee required
pursuant to this chapter with the application for a license to engage in
the practice of dietetics in this State.
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3. Each applicant shall submit to the Central Repository for
Nevada Records of Criminal History two complete sets of
fingerprints for submission to the Federal Bureau of Investigation for
its report. The Central Repository for Nevada Records of Criminal
History shall determine whether the applicant has been convicted of
a crime listed in paragraph (a) of subsection 1 of NRS 449.174 and
immediately inform the [Board] Division of whether the applicant has
been convicted of such a crime.
Sec. 305. NRS 640E.180 is hereby amended to read as follows:
640E.180 1. Upon application and payment of the applicable
fee required pursuant to this chapter, the [Board] Division may grant
a provisional license to engage in the practice of dietetics in this State
to an app licant who provides evidence to the [Board] Division that
the applicant is eligible to take, but has not successfully completed,
the Registration Examination for Dietitians administered by the
Commission on Dietetic Registration, or its successor organization.
2. A provisional license is valid for 1 year after the date of
issuance. A provisional license may be renewed for not more than 6
months if the applicant submits evidence satisfactory to the [Board]
Division for the failure of the applicant to obtain a license to engage
in the practice of dietetics during the time the applicant held the
provisional license.
3. A person who holds a provisional license may engage in the
practice of dietetics only under the supervision of a licensed dietitian.
Sec. 306. NRS 640E.190 is hereby amended to read as follows:
640E.190 1. Upon application and payment of the applicable
fee required pursuant to this chapter, the [Board] Division may grant
a temporary license to engage in the practice of dietetics in this State
to a person who holds a corresponding license in another jurisdiction
if:
(a) The corresponding license is in good standing; and
(b) The requirements for licensure in the other jurisdiction are
substantially equal to the requirements for licensure in this State.
2. A temporary license may be issued for the limited purpose of
authorizing the licensee to treat patients in this State.
3. A temporary license is valid for the 10-day period designated
on the license.
Sec. 307. NRS 640E.200 is hereby amended to read as follows:
640E.200 1. In addition to any other requirements set forth in
this chapter:
(a) An applicant for the issuance of a license to engage in the
practice of dietetics in this State shall include the social security
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number of the applicant in the application submitted to the [Board.]
Division.
(b) An applicant for the issuance or renewal of a license to engage
in the practice of dietetics in this State shall submit to the [Board]
Division the statement prescribed by the Division of [Welfare and
Supportive] Social Services of the Department of [Health and ]
Human Services pursuant to NRS 425.520. The statement must be
completed and signed by the applicant.
2. The [Board] Division shall include the statement required
pursuant to subsection 1 in:
(a) The application or any other forms that must be submitted for
the issuance or renewal of the license; or
(b) A separate form prescribed by the [Board.] Division.
3. A license to enga ge in the practice of dietetics may not be
issued or renewed by the [Board] Division if the applicant:
(a) Fails to submit the statement required pursuant to subsection
1; or
(b) Indicates on the statement submitted pursuant to subsection 1
that the applicant is subject to a court order for the support of a child
and is not in compliance with the order or a plan approved by the
district attorney or other public agency enforcing the order for the
repayment of the amount owed pursuant to the order.
4. If an applicant indicates on the statement submitted pursuant
to subsection 1 that the applicant is subject to a court order for the
support of a child and is not in compliance with the order or a plan
approved by the district attorney or other public agency enforcing the
order for the repayment of the amount owed pursuant to the order, the
[Board] Division shall advise the applicant to contact the district
attorney or other public agency enforcing the order to determine the
actions that the applicant may take to satisfy the arrearage.
Sec. 308. NRS 640E.220 is hereby amended to read as follows:
640E.220 1. A license to engage in the practice of dietetics
expires 2 years after the date of issuance.
2. The [Board] Division may renew a license if the applicant:
(a) Submits a completed written application and the appropriate
fee required pursuant to this chapter;
(b) Submits documentation of completion of such continuing
training and education as required by regulations adopted by the
Board;
(c) Has not committed any act which is grounds for disciplinary
action, unless the [Board] Division determines that sufficient
restitution has been made or the act was not substantially related to
the practice of dietetics;
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(d) Submits information that the creden tials of the applicant are
in good standing; and
(e) Submits all other information required to complete the
renewal.
Sec. 309. NRS 640E.225 is hereby amended to read as follows:
640E.225 1. The [Board] Division may:
(a) Make the data request developed by the Director of the
Department of [Health and ] Human Services pursuant to NRS
439A.116 available to applicants for the renewal of a license pursuant
to this chapter through a link on the electronic application for the
renewal of a license; and
(b) Request each applicant to complete and electronically submit
the data request to the Director.
2. The information provided by an applicant for the renewal of
a license pursuant to subsection 1 is confidential and, except as
required by subsection 1, must not be disclosed to any person or
entity.
3. An applicant for the renewal of a license is not required to
complete a data request pursuant to subsection 1 and is not subject to
disciplinary action, including, without limitation, refusal to renew the
license, for failure to do so.
Sec. 310. NRS 640E.230 is hereby amended to read as follows:
640E.230 The [Board] Division shall act upon an application for
a license submitted pursuant to this chapter without unnecessary
delay. If an applicant is found qualified, the applicant must be issued
a license to engage in the practice of dietetics.
Sec. 311. NRS 640E.240 is hereby amended to read as follows:
640E.240 1. The Board shall adopt regulations establishing
reasonable fees for:
(a) The issuance of a license;
(b) The issuance of a provisional license;
(c) The issuance of a temporary license;
(d) The renewal of a license;
(e) The reinstatement of a license which has been suspended or
revoked; and
(f) Changing the name on a license.
2. The fees established pursuant to subsection 1 must be set in
such an amount as to reimburse the [Board] Division for the cost of
carrying out the provisions of this chapter, except that no such fee
may exceed $250.
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Sec. 312. NRS 640E.250 is hereby amended to read as follows:
640E.250 1. Any licensee whose license is revoked by the
[Board] Division may apply for reinstatement of the license pursuant
to regulations adopted by the Board.
2. The [Board] Division may reinstate the license upon
compliance by the licensee with all requirements for reinstatement
established by regulations adopted by the Board and payment of the
applicable fee required pursuant to this chapter.
Sec. 313. NRS 640E.270 is hereby amended to read as follows:
640E.270 1. The [Board] Division may deny, refuse to renew,
revoke or suspend any license applied for or issued pursuant to this
chapter, or take such other disciplinary action against a licensee as
authorized by regulations adopted by the Board, upon determining
that the licensee:
(a) Is guilty of fraud or deceit in procuring or attempting to
procure a license pursuant to this chapter.
(b) Is guilty of any offense:
(1) Involving moral turpitude; or
(2) Relating to the qualifications, functio ns or duties of a
licensee.
(c) Uses any controlled substance, dangerous drug as defined in
chapter 454 of NRS, or intoxicating liquor to an extent or in a manner
which is dangerous or injurious to any other person or which impairs
his or her ability to conduct the practice authorized by the license.
(d) Is guilty of unprofessional conduct, which includes, without
limitation:
(1) Impersonating another licensed dietitian.
(2) Permitting or allowing another person to use his or her
license to engage in the practice of dietetics.
(3) Repeated malpractice, which may be evidenced by claims
of malpractice settled against the licensee.
(4) Physical, verbal or psychological abuse of a patient.
(5) Conviction for the use or unlawful possession of a
controlled substance or dangerous drug as defined in chapter 454 of
NRS.
(e) Has willfully or repeatedly violated any provision of this
chapter.
(f) Is guilty of aiding or abetting any person in violating any
provision of this chapter.
(g) Has been discipline d in another state in connection with the
practice of dietetics or has committed an act in another state which
would constitute a violation of this chapter.
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(h) Has engaged in conduct likely to deceive, defraud or endanger
a patient or the general public.
(i) Has willfully failed to comply with a regulation [,] of the
Board or a subpoena or order of the [Board.] Division.
2. In addition to any criminal or civil penalty that may be
imposed pursuant to this chapter, the [Board] Division may assess
against and collect from a licensee all costs incurred by the [Board]
Division in connection with any disciplinary action taken against the
licensee, including, without limitation, costs for investigators and
stenographers, attorney’s fees and other costs of the hearing.
3. For the purposes of this section, a plea or verdict of guilty or
guilty but mentally ill or a plea of nolo contendere constitutes a
conviction of an offense. The [Board] Division may take disciplinary
action pending the appeal of a conviction.
Sec. 314. NRS 640E.280 is hereby amended to read as follows:
640E.280 1. If the [Board] Division receives a copy of a court
order issued pursuant to NRS 425.540 that provides for the
suspension of all professional, occupational and recreational licenses,
certificates and permits issued to a person who is the holder of a
license issued pursuant to this chapter, the [Board] Division shall
deem the license issued to that person to be suspended at the end of
the 30th day after the date on which the court order was issued unless
the [Board] Division receives a letter issued to the holder of the
license by the district attorney or other public agency pursuant to NRS
425.550 stating that the holder of the license has complied with the
subpoena or warrant or has satisfied the arrearage pursuant to
NRS 425.560.
2. The [Board] Division shall reinstate a license issued pursuant
to this chapter that has been suspended by a district court pursuant to
NRS 425.540 if:
(a) The [Board] Division receives a letter issued by the district
attorney or other public agency pursuant to NRS 425.550 to the
person whose license was suspended stating that the person whose
license was suspended has complied with the subpoena or warrant or
has satisfied the arrearage pursuant to NRS 425.560; and
(b) The person whose license was suspended pays the appropriate
fee required pursuant to this chapter.
Sec. 315. NRS 640E.290 is hereby amended to read as follows:
640E.290 1. If any member of the Board or a Dietitian
Advisory Group established pursuant to NRS 640E.130 or an officer
or employee of the Division becomes aware of any ground for
initiating disciplinary action against a licensee, the member , officer
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or employee shall file an administrative complaint with the [Board.]
Division.
2. As soon as practical after receiving an administrative
complaint, the [Board] Division shall:
(a) Notify the licensee in writing of the charges against him or
her, accompanying the notice with a copy of the administrative
complaint; and
(b) Forward a copy of the complaint to the Commission on
Dietetic Registration, or its successor organizat ion, for investigation
of the complaint and request a written report of the findings of the
investigation or, to the extent money is available to do so, conduct an
investigation of the complaint to determine whether the allegations in
the complaint merit the initiation of disciplinary proceedings against
the licensee.
3. Written notice to the licensee may be served by delivering it
personally to the licensee, or by mailing it by registered or certified
mail to the last known residential address of the licensee.
4. If the licensee, after receiving a copy of the administrative
complaint pursuant to subsection 1, submits a written request, the
[Board] Division shall furnish the licensee with a copy of each
communication, report and affidavit in the possession of the [Board]
Division which relates to the matter in question.
5. If, after an investigation conducted by the [Board] Division or
receiving the findings from an investigation of the complaint from the
Commission on Dietetic Registration, or its successor organization,
the [Board] Division determines that the administrative complaint is
valid, the [Board] Division shall hold a hearing on the charges at such
time and place as the [Board] Division prescribes. If the [Board]
Division receives a report pursuant to subsection 5 of NRS 228.420,
the hearing must be held within 30 days after receiving the report. If
requested by the licensee, the hearing must be held within the county
in which the licensee resides.
Sec. 316. NRS 640E.300 is hereby amended to read as follows:
640E.300 The [Board] Division may delegate its authority to
conduct hearings pursuant to NRS 640E.290 concerning t he
discipline of a licensee to a hearing officer. The hearing officer has
the powers of the [Board] Division in connection with such hearings,
and shall report to the [Board] Division his or her findings of fact and
conclusions of law within 30 days after the final hearing on the
matter. The [Board] Division may take action based upon the report
of the hearing officer, refer the matter to the hearing officer for further
hearings or conduct its own hearings on the matter.
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Sec. 317. NRS 640E.310 is hereby amended to read as follows:
640E.310 The [Board] Division may:
1. Issue subpoenas for the attendance of witnesses and the
production of books, papers and documents; and
2. Administer oaths when taking testimony in any matter
relating to the duties of the [Board.] Division.
Sec. 318. NRS 640E.320 is hereby amended to read as follows:
640E.320 1. The district court in and for the county in which
any hearing is held by the [Board] Division may compel the
attendance of witnesses, the giving of testimony and the production
of books, papers and documents as required by any subpoena issued
by the [Board.] Division.
2. In case of the refusal of any witness to attend or testify or
produce any books, papers or documents required by a subpoena, the
[Board] Division may report to the district court in and for the county
in which the hearing is pending, by petition setting forth:
(a) That due notice has been given of the time and place of
attendance of the witness or the production of books, papers or
documents;
(b) That the witness has been subpoenaed in the manner
prescribed by this chapter; and
(c) That the witness has failed and refused to attend or produce
the books, papers or documents required by the subpoena before the
[Board] Division in the cause or proceeding named in the subpoena,
or has refused to answer questions propounded to him or her in the
course of the hearing,
and ask an order of the court compelling the witness to attend and
testify or produce the books, papers or documents before the [Board.]
Division.
3. The court, upon petition of the [Board,] Division, shall enter
an order directing the witness to appear before the court at a time and
place to be fixed by the court in the order, the time to be not more
than 10 days after the date of the order, to show cause why the witness
has not attended or testified o r produced the books, papers or
documents before the [Board.] Division. A certified copy of the order
must be served upon the witness.
4. If it appears to the court that the subpoena was regularly
issued by the [Board,] Division, the court shall enter an order that the
witness appear before the [Board] Division at the time and place fixed
in the order and testify or produce the required books, papers or
documents. Upon failure to obey the order, the witness must be dealt
with as for contempt of court.
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Sec. 319. NRS 640E.330 is hereby amended to read as follows:
640E.330 1. The [Board] Division shall render a decision on
any administrative complaint within 60 days after the final hearing
thereon. For the purposes of this subsect ion, the final hearing on a
matter delegated to a hearing officer pursuant to NRS 640E.300 is the
final hearing conducted by the hearing officer unless the Board
conducts a hearing with regard to the administrative complaint.
2. The [Board] Division shall notify the licensee of its decision
in writing by certified mail, return receipt requested. The decision of
the [Board] Division becomes effective on the date the licensee
receives the notice or on the date the [Board] Division receives a
notice from the United States Postal Service stating that the licensee
refused to accept delivery or could not be located.
Sec. 320. NRS 640E.340 is hereby amended to read as follows:
640E.340 1. Except as otherwise provided in this section and
NRS 239.0115, any records or information obtained during the course
of an investigation by the [Board] Division and any record of the
investigation are confidential.
2. Any complaint or other document filed by the [Board]
Division to initiate disciplinary action and all docu ments and
information considered by the [Board] Division when determining
whether to impose disciplinary action are public records.
3. This section does not prevent or prohibit the [Board] Division
from communicating or cooperating with another licensing board or
any agency that is investigating a licensee, including a law
enforcement agency.
Sec. 321. NRS 640E.350 is hereby amended to read as follows:
640E.350 If the [Board,] Division, based on evidence
satisfactory to it, believes that any person has violated or is about to
violate any provision of this chapter, the terms of any license, or any
order, decision, demand or requirement, or any part thereof, the
[Board] Division may bring a n action, in the name of the [Board,]
Division, in the district court in and for the county in which the person
resides, against the person to enjoin the person from continuing the
violation or engaging in any act that constitutes such a violation. The
court may enter an order or judgment granting such injunctive relief
as it determines proper, but no such injunctive relief may be granted
without at least 5 days’ notice to the opposite party.
Sec. 322. NRS 640E.360 is hereby amended to read as follows:
640E.360 If a person is not licensed to engage in the practice of
dietetics pursuant to this chapter, or if a person’s license to engage in
the practice of dietetics has been suspended or revoked by the
[Board,] Division, the person shall not:
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1. Engage in the practice of dietetics;
2. Use in connection with his or her name the words or letters
“L.D.,” “licensed dietitian” or any other letters, words or insignia
indicating or implying that he or she is licensed to engage in the
practice of dietetics, or in any other way, orally, or in writing or print,
or by sign, directly or by implication, use the word “dietetics” or
represent himself or herself as licensed or qualified to engage in the
practice of dietetics in this State; or
3. List or cause to have listed in any directory, including,
without limitation, a telephone directory, his or her name or the name
of his or her company under the heading “Dietitian” or any other term
that indicates or implies that he or she is licensed or qualified to
engage in the practice of dietetics in this State.
Sec. 323. NRS 640E.370 is hereby amended to read as follows:
640E.370 1. A person who violates any provision of this
chapter or any regulation adopted pursuant thereto is guilty of a
misdemeanor.
2. In addit ion to any criminal penalty that may be imposed
pursuant to subsection 1, the [Board] Division may, after notice and
hearing, impose a civil penalty of not more than $100 for each such
violation. For the purposes of this subsection, each day on which a
violation occurs constitutes a separate offense, except that the
aggregate civil penalty that may be imposed against a person pursuant
to this subsection may not exceed $10,000.
Sec. 324. NRS 644A.880 is hereby amended to read as follows:
644A.880 1. If the Board determines that a complaint filed
with the Board concerns a matter within the jurisdiction of another
licensing board, the Board shall refer the complaint to the other
licensing board within 5 days after making the determination.
2. The Board m ay refer a complaint pursuant to subsection 1
orally, electronically or in writing.
3. The provisions of subsection 1 apply to any complaint filed
with the Board, including, without limitation:
(a) A complaint which concerns a person who or entity which is
licensed, certified or otherwise regulated by the Board or by another
licensing board; and
(b) A complaint which concerns a person who or entity which is
licensed, certified or otherwise regulated solely by another licensing
board.
4. The provisions of this section do not prevent the Board from
acting upon a complaint which concerns a matter within the
jurisdiction of the Board regardless of whether the Board refers the
complaint pursuant to subsection 1.
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5. The Board or an officer or employee of the Board is immune
from any civil liability for any decision or action taken in good faith
and without malicious intent in carrying out the provisions of this
section.
6. As used in this section, “licensing board” means:
(a) A board created pursuant to chapter 630, 630A, 631, 632, 633,
634, 634A, 635, 636, 637, 637B, 639, 640, 640A, 640B, 640C,
[640D, 640E,] 641, 641A, 641B, 641C, 641D, 643 or 654 of NRS;
[and]
(b) The Division of Public and Behavioral Health of the
Department of [Health and] Human Services [.] ; and
(c) The Health Care Purchasing and Compliance Division of
the Nevada Health Authority.
Sec. 325. NRS 652.035 is hereby amended to read as follows:
652.035 “Division” means the Health Care Purchasing and
Compliance Division of [Public and Behavioral Health of the
Department of Health and Human Services. ] the Nevada Health
Authority.
Sec. 326. NRS 652.075 is hereby amended to read as follows:
652.075 1. In addition to any other requirements set forth in
this chapter:
(a) An applicant for the issuance of a license or certificate issued
pursuant to NRS 652.125 shall include the social security number of
the applicant in the application submitted to the [Board.] Health Care
Purchasing and Compliance Division.
(b) An applicant for the issuance or renewal of a license or
certificate issued pursuant to NRS 652.125 shall submit to the [Board]
Health Care Purchasing and Compliance Division the statement
prescribed by the Division of [Welfare and Supportive ] Social
Services of the Department of [Health and] Human Services pursuant
to NRS 425.520. The statement must be completed and signed by the
applicant.
2. The [Board] Health Care Purchasing and Compliance
Division shall include the statement required pursuant to subsection
1 in:
(a) The application or any other forms that must be submitted for
the issuance or renewal of the license or certificate; or
(b) A separate form prescribed by the [Board.] Division.
3. A license or certificate may not be issued or renewed by the
[Board] Health Care Purchasing and Compliance Division pursuant
to NRS 652.125 if the applicant:
(a) Fails to submit the statement required pursuant to subsection
1; or
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(b) Indicates on the statement submitted pursuant to subsection 1
that the applicant is subject to a court order for the support of a child
and is not in compliance with the order or a plan approved by the
district attorney or other public agency enforcing the order for the
repayment of the amount owed pursuant to the order.
4. If an applicant indicates on the statement submitted pursuant
to subsection 1 that the applicant is subject to a court order for the
support of a child and is not in compliance with the order or a plan
approved by the district attorney or other public agency enforcing the
order for the repayment of the amount owed pursuant to the order, the
[Board] Health Care Purchasing and Compliance Division shall
advise the applicant to contact the district attorney or other public
agency enforcing the order to determine the actions that the applicant
may take to satisfy the arrearage.
Sec. 327. NRS 652.223 is hereby amended to read as follows:
652.223 1. If the [Board] Division receives a copy of a court
order issued pursuant t o NRS 425.540 that provides for the
suspension of all professional, occupational and recreational licenses,
certificates and permits issued to a person who is the holder of a
license or certificate issued pursuant to NRS 652.125, the [Board]
Division shall deem the license or certificate issued to that person to
be suspended at the end of the 30th day after the date on which the
court order was issued unless the [Board] Division receives a letter
issued to the holder of the license or certificate by the district attorney
or other public agency pursuant to NRS 425.550 stating that the
holder of the license or certificate has complied with the subpoena or
warrant or has satisfied the arrearage pursuant to NRS 425.560.
2. The [Board] Division shall reinstate a license or certificate
issued pursuant to NRS 652.125 that has been suspended by a district
court pursuant to NRS 425.540 if the [Board] Division receives a
letter issued by the district attorney or other public agency pursuant
to NRS 425.550 to the pers on whose license or certificate was
suspended stating that the person whose license or certificate was
suspended has complied with the subpoena or warrant or has satisfied
the arrearage pursuant to NRS 425.560.
Sec. 328. NRS 654.185 is hereby amended to read as follows:
654.185 1. If the Board determines that a complaint filed with
the Board concerns a matter within the jurisdiction of another
licensing board, the Board shall refer the complaint to the other
licensing board within 5 days after making the determination.
2. The Board may refer a complaint pursuant to subsection 1
orally, electronically or in writing.
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3. The provisions of subsection 1 apply to any complaint filed
with the Board, including, without limitation:
(a) A complaint which concerns a person who or entity which is
licensed, certified or otherwise regulated by the Board or by another
licensing board; and
(b) A complaint which concerns a person who or entity which is
licensed, certified or otherwise regulated solely by another l icensing
board.
4. The provisions of this section do not prevent the Board from
acting upon a complaint which concerns a matter within the
jurisdiction of the Board regardless of whether the Board refers the
complaint pursuant to subsection 1.
5. The Board or an officer or employee of the Board is immune
from any civil liability for any decision or action taken in good faith
and without malicious intent in carrying out the provisions in this
section.
6. As used in this section, “licensing board” means:
(a) A board created pursuant to chapter 630, 630A, 631, 632, 633,
634, 634A, 635, 636, 637, 637B, 639, 640, 640A, 640B, 640C,
[640D, 640E,] 641, 641A, 641B, 641C, 641D, 643 or 644A of NRS;
[and]
(b) The Division of Public and Behavioral Health of the
Department of [Health and] Human Services [.] ; and
(c) The Health Care Purchasing and Compliance Division of
the Nevada Health Authority.
Sec. 329. NRS 680A.225 is hereby amended to read as follows:
680A.225 1. If the Commissioner receives notification from
the [Department of Health and Human Services ] Nevada Health
Authority pursuant to NRS 439.5895 that an insurer is not in
compliance with the requirements of subsection 4 of NRS 439.589,
the Commissioner may, after notice and the opportunity for a hearing
in accordance with the provisions of this title, require corrective
action or impose an administrative fine in the amount prescribed by
NRS 680A.200.
2. The Commissioner shall not suspend or revoke the certificate
of authority of an insurer for failure to comply with the requirements
of subsection 4 of NRS 439.589.
Sec. 330. NRS 683A.0891 is hereby amended to read as
follows:
683A.0891 1. If the Commissioner receives notification from
the [Department of Health and Human Services ] Nevada Health
Authority pursuant to NRS 439.5895 that an administrator is not in
compliance with the requirements of subsection 4 of NRS 439.589,
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the Commissioner may, after notice and the opportunity for a hearing
in accordance with the provisions of this chapter, require corrective
action or impose an administrative fine in the amount prescribed by
NRS 683A.461.
2. The Commissioner shall not suspend or revoke the certificate
of registration of an administrator for failure to comply with the
requirements of subsection 4 of NRS 439.589.
Sec. 331. NRS 683A.1785 is hereby amended to read as
follows:
683A.1785 1. A pharmacy benefit manager shall not:
(a) Discriminate against a covered entity, a contract pharmacy or
a 340B drug in the amount of reimbursement for any item or service
or the procedures for obtaining such reimbursement;
(b) Assess any fee, chargeback, clawback or adjustment against a
covered entity or contract pharmacy on the basis that the covered
entity or contract pharmacy dispenses a 340B drug or otherwise limit
the ability of a covered entity or contract pharmacy to receive the full
benefit of purchasing the 340B drug at or below the ceiling price, as
calculated pursuant to 42 U.S.C. § 256b(a)(1);
(c) Exclude a covered entity or contract pharmacy from any
network because the covered entity or contract pharmacy dispenses a
340B drug;
(d) Restrict the ability of a person to receive a 340B drug,
including, without limitation, by imposing a copayment, coinsurance,
deductible or other cost -sharing obligation on the drug that is
different from a similar drug on the basis that the drug is a 340B drug;
(e) Restrict the methods by which a covered entity or contract
pharmacy may dispense or deliver a 340B drug or the entity through
which a covered entity may dispense or deliver such a drug in a
manner that does not apply to drugs that are not 340B drugs; or
(f) Prohibit a covered entity or contract pharmacy from
purchasing a 340B drug or interfere with the ability of a covered
entity or contract pharmacy to purchase a 340B drug.
2. This section does not:
(a) Apply to a pharmacy benefit manager that has entered into a
contract with the [Department of Health and Human Services ]
Nevada Health Authority pursuant to NRS 422.4053 when the
pharmacy benefit manager is managing prescription drug benefits
under Medicaid, including, without limitation, where such benefits
are delivered through a Medicaid managed care organization.
(b) Prohibit the [Department o f Health and Human Services, ]
Nevada Health Authority, the Medicaid Division of [Health Care
Financing and Policy of the Department of Health and Human
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Services] the Nevada Health Authority or a Medicaid managed care
organization from taking such actions as are necessary to:
(1) Prevent duplicate discounts or rebates where prohibited by
42 U.S.C. § 256b(a)(5)(A); or
(2) Ensure the financial stability of the Medicaid program,
including, without limitation, by including or enforcing provisions in
any contract with a pharmacy benefit manager entered into pursuant
to NRS 422.4053.
3. As used in this section:
(a) “340B drug” means a prescription drug that is purchased by a
covered entity under the 340B Program.
(b) “340B Program” means the drug pricing program established
by the United States Secretary of Health and Human Services
pursuant to section 340B of the Public Health Service Act, 42 U.S.C.
§ 256b, as amended.
(c) “Contract pharmacy” means a pharmacy that enters into a
contract with a covered en tity to dispense 340B drugs and provide
related pharmacy services to the patients of the covered entity.
(d) “Covered entity” has the meaning ascribed to it in 42 U.S.C.
§ 256b(a)(4).
(e) “Medicaid managed care organization” has the meaning
ascribed to it in 42 U.S.C. § 1396b(m).
(f) “Network” means a defined set of providers of health care who
are under contract with a pharmacy benefit manager or third party to
provide health care services to covered persons.
Sec. 332. NRS 686A.315 is hereby amended to read as follows:
686A.315 1. If a hospital submits to an insurer the form
prescribed by the Director of the [Department of Health and Human
Services] Nevada Health Authority 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 essential
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 i s licensed to practice one of the health
professions regulated by title 54 of NRS submits to an insurer the
form commonly referred to as the “HCFA-1500” for a patient who is
not covered by any governmental program which offers insurance
coverage for health care, the form must be accompanied by a
statement that reads substantially as follows:
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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. 333. NRS 687B.407 is hereby amended to read as follows:
687B.407 1. A nonprofit health benefit plan may use the list
of preferred prescription drugs developed by the [Department of
Health and Human Services ] Nevada Health Authority pursuant to
subsection 1 o f NRS 422.4025 as its formulary and obtain
prescription drugs through the purchasing agreements negotiated by
the [Department] Authority pursuant to that section by notifying the
[Department] Authority in the form prescribed by the [Department.]
Authority.
2. As used in this section “health benefit plan” has the meaning
ascribed to it in NRS 422.4021.
Sec. 334. NRS 687B.805 is hereby amended to read as follows:
687B.805 1. A health carrier shall not:
(a) Discriminate against a covered entity, a contract pharmacy or
a 340B drug in the amount of reimbursement for any item or service
or the procedures for obtaining such reimbursement;
(b) Assess any fee, chargeback, clawback or adjustment against a
covered entity or contract pharmacy on the basis t hat the covered
entity or contract pharmacy dispenses a 340B drug or otherwise limit
the ability of a covered entity or contract pharmacy to receive the full
benefit of purchasing the 340B drug at or below the ceiling price, as
calculated pursuant to 42 U.S.C. § 256b(a)(1);
(c) Exclude a covered entity or contract pharmacy from any
network because the covered entity or contract pharmacy dispenses a
340B drug;
(d) Restrict the ability of a person to receive a 340B drug,
including, without limitation, by imposing a copayment, coinsurance,
deductible or other cost -sharing obligation on the drug that is
different from a similar drug on the basis that the drug is a 340B drug;
(e) Restrict the methods by which a covered entity or contract
pharmacy may dispense or deliver a 340B drug or the entity through
which a covered entity may dispense or deliver such a drug in a
manner that does not apply to drugs that are not 340B drugs; or
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(f) Prohibit a covered entity or contract pharmacy from
purchasing a 340B drug or interfere with the ability of a covered
entity or contract pharmacy to purchase a 340B drug.
2. This section does not prohibit the [Department of Health and
Human Services,] Nevada Health Authority, the Medicaid Division
of [Health Care Financing and Po licy of the Department of Health
and Human Services ] the Nevada Health Authority or a Medicaid
managed care organization from taking such actions as are necessary
to:
(a) Prevent duplicate discounts or rebates where prohibited by 42
U.S.C. § 256b(a)(5)(A); or
(b) Ensure the financial stability of the Medicaid program,
including, without limitation, by including or enforcing provisions in
any relevant contract.
3. As used in this section:
(a) “340B drug” means a prescription drug that is purchased by a
covered entity under the 340B Program.
(b) “340B Program” means the drug pricing program established
by the United States Secretary of Health and Human Services
pursuant to section 340B of the Public Health Service Act, 42 U.S.C.
§ 256b, as amended.
(c) “Contract pharmacy” means a pharmacy that enters into a
contract with a covered entity to dispense 340B drugs and provide
related pharmacy services to the patients of the covered entity.
(d) “Covered entity” has the meaning ascribed to it in 42 U.S.C.
§ 256b(a)(4).
(e) “Medicaid managed care organization” has the meaning
ascribed to it in 42 U.S.C. § 1396b(m).
Sec. 335. NRS 689A.046 is hereby amended to read as follows:
689A.046 1. In addition to the benefits required by NRS
689A.0459, the benefits provided by a policy for health insurance for
treatment of alcohol or substance use disorder must include, without
limitation:
(a) Treatment for withdrawal from the physiological effect of
alcohol or drugs, with a minimum benefit of $1,500 per calendar year.
(b) Treatment for a patient admitted to a facility, with a minimum
benefit of $9,000 per calendar year.
(c) Counseling for a person, group or family who is not admitted
to a facility, with a minimum benefit of $2,500 per calendar year.
2. Except as otherwise provided in NRS 687B.409, these
benefits must be paid in the same manner as benefits for any other
illness covered by a similar policy are paid.
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3. The insured person is entitled to these benefits if treatment is
received in any:
(a) Facility for the treatment of alcohol or substance use disorder
which is certified by the Division of Public and Behavioral Health of
the Department of [Health and] Human Services.
(b) Hospital or other medical facility or facility for the dependent
which is licensed by the Health Care Purchasing and Compliance
Division of [Public and Behavioral Health of the Department of
Health and Human Services, ] the Nevada Health Authority,
accredited by The Joi nt Commission or CARF International and
provides a program for the treatment of alcohol or substance use
disorder as part of its accredited activities.
Sec. 336. NRS 689A.405 is hereby amended to read as follows:
689A.405 1. An insurer that offers or issues a policy of health
insurance which provides coverage for prescription drugs shall
include with any summary, certificate or evidence of that coverage
provided to an insured, notice of whether a formulary is used and, if
so, of the opportunity to secu re information regarding the formulary
from the insurer pursuant to subsection 2. The notice required by this
subsection must:
(a) Be in a language that is easily understood and in a format that
is easy to understand;
(b) Include an explanation of what a formulary is; and
(c) If a formulary is used, include:
(1) An explanation of:
(I) How often the contents of the formulary are reviewed;
and
(II) The procedure and criteria for determining which
prescription drugs are included in and excluded from the formulary;
and
(2) The telephone number of the insurer for making a request
for information regarding the formulary pursuant to subsection 2.
2. If an insurer offers or issues a policy of health insurance
which provides coverage for prescription d rugs and a formulary is
used, the insurer shall:
(a) Provide to any insured or participating provider of health care,
upon request:
(1) Information regarding whether a specific drug is included
in the formulary.
(2) Access to the most current list of prescription drugs in the
formulary, organized by major therapeutic category, with an
indication of whether any listed drugs are preferred over other listed
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drugs. If more than one formulary is maintained, the insurer shall
notify the requester that a choice of formulary lists is available.
(b) Notify each person who requests information regarding the
formulary, that the inclusion of a drug in the formulary does not
guarantee that a provider of health care will prescribe that drug for a
particular medical condition.
(c) During each period for open enrollment, publish on an Internet
website that is operated by the insurer and accessible to the public or
include in any enrollment materials distributed by the insurer a notice
of all prescription drugs that:
(1) Are included on the most recent list of drugs that are
essential for treating diabetes in this State compiled by the
[Department of Health and Human Services ] Nevada Health
Authority pursuant to paragraph (a) of subsection 1 of NRS
439B.630; and
(2) Have been removed or will be removed from the formulary
during the current plan year or the next plan year.
(d) Update the notice required by paragraph (c) throughout the
period for open enrollment.
Sec. 337. NRS 689B.065 is hereby amended to read as follows:
689B.065 1. A policy of group health insurance issued to
replace any discontinued policy or coverage for group health
insurance must:
(a) Provide coverage for all persons who were covered under the
previous policy or coverage on the date it was discontinued; and
(b) Except as otherwise provided in subsection 2, provide benefits
which are at least as extensive as the benefits provided by the previous
policy or coverage, except that benefits may be reduced or excluded
to the extent that such a reduction or exclusion was permissible under
the terms of the previous policy or coverage,
if that replacement policy is issued within 60 days after the date on
which the previous policy or coverage was discontinued.
2. If an employer obtains a replacem ent policy pursuant to
subsection 1 to cover the employees of the employer, any benefits
provided by the previous policy or coverage may be reduced if notice
of the reduction is given to the employees of the employer pursuant
to NRS 608.1577.
3. Any insurer which issues a replacement policy pursuant to
subsection 1 may submit a written request to the insurer who provided
the previous policy or coverage for a statement of benefits which were
provided under that policy or coverage. Upon receiving such a
request, the insurer who provided the previous policy or coverage
shall give a written statement to the insurer providing the replacement
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policy which indicates what benefits were provided and what
exclusions or reductions were in effect under the previous po licy or
coverage.
4. The provisions of this section:
(a) Apply to a self-insured employer who provides health benefits
to the employees of the employer and replaces those benefits with a
policy of group health insurance.
(b) Do not apply to the Public Employees’ Benefits Program
established pursuant to NRS 287.0402 to 287.049, inclusive [.] , and
sections 64, 65 and 65.5 of this act.
Sec. 338. NRS 689C.167 is hereby amended to read as follows:
689C.167 1. In addition to the benefits required by NRS
689C.1665, the benefits provided by a group policy for health
insurance, as required by NRS 689C.166, for the treatment of alcohol
or substance use disorders must include, without limitation:
(a) Treatment for withdrawal from the physiological effects of
alcohol or drugs, with a minimum benefit of $1,500 per calendar year.
(b) Treatment for a patient admitted to a facility, with a minimum
benefit of $9,000 per calendar year.
(c) Counseling for a person, group or family who is not admitted
to a facility, with a minimum benefit of $2,500 per calendar year.
2. Except as otherwise provided in NRS 687B.409, these
benefits must be paid in the same manner as benefits for any other
illness covered by a similar policy are paid.
3. The insured person is entitled to these benefits if treatment is
received in any:
(a) Facility for the treatment of alcohol or substance use disorders
which is certified by the Division of Public and Behavioral Health of
the Department of [Health and] Human Services.
(b) Hospital or other medical facility or facility for the dependent
which is licensed by the Health Care Purchasing and Compliance
Division of [Public and Behavioral Health of the Department of
Health and Human Services, ] the Nevada Health Authority, is
accredited by The Joint Commission or CARF International and
provides a program for the treatment of alcohol or substance use
disorders as part of its accredited activities.
Sec. 339. NRS 695C.202 is hereby amended to read as follows:
695C.202 If the [Department of Health and Human Services ]
Nevada Health Authority obtains a waiver to provide the dental care
described in NRS 422.27247, a health maintenance organization that
provides health care services through managed care to recipients of
Medicaid must:
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1. Provide written notice to each such recipient who is diagnosed
with diabetes and is eligible to receive dental care pursuant to NRS
422.27247 of his or her eligibility to receive such care; and
2. Coordinate with any entity necessary to ensure that eligible
recipients of Medicaid receive the benefits prescribed by that section.
Sec. 340. NRS 695C.329 is hereby amended to read as follows:
695C.329 1. If the Commissioner receives notification from
the [Department of Health and Human Services ] Nevada Health
Authority pursuant to NRS 439.5895 that a health maintenance
organization is not in compliance with the requirements of subsection
4 of NRS 439.589, the Commissioner may, after notice and the
opportunity for a hearing in accordance with the p rovisions of this
chapter, require corrective action or impose an administrative fine in
the amount prescribed by NRS 695C.350.
2. The Commissioner shall not suspend or revoke the certificate
of authority of a health maintenance organization for failure to
comply with the requirements of subsection 4 of NRS 439.589.
Sec. 341. NRS 695G.325 is hereby amended to read as follows:
695G.325 If the [Department of Health and Human Services ]
Nevada Health Authority obtains a waiver to provide the dental care
described in NRS 422.27247, a managed care organization that
provides health care services through managed care to recipients of
Medicaid must:
1. Provide written notice to each such recipient who is diagnosed
with diabetes and is eligible to receive den tal care pursuant to NRS
422.27247 of his or her eligibility to receive such care; and
2. Coordinate with any entity necessary to ensure that eligible
recipients of Medicaid receive the benefits prescribed by that section.
Sec. 342. Chapter 695I of NRS is hereby amended by adding
thereto the provisions set forth as sections 343 and 344 of this act.
Sec. 343. “Authority” means the Nevada Health Authority.
Sec. 344. “Division” means the Consumer Health Division of
the Authority.
Sec. 345. NRS 695I.010 is hereby amended to read as follows:
695I.010 As used in this chapter, unless the context otherwise
requires, the words and terms defined in NRS 695I.020 to 695I.110,
inclusive, and sections 343 and 344 of this act have the meanings
ascribed to them in those sections.
Sec. 346. NRS 695I.200 is hereby amended to read as follows:
695I.200 The Silver State Health Insurance Exchange is hereby
established within the Division to:
1. Facilitate the purchase and sale of qualified health plans in the
individual market in Nevada;
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2. Assist qualified small employers in Nevada in facilitating the
enrollment and purchase of coverage and the application for subsidies
for small business enrollees;
3. Reduce the number of uninsured persons in Nevada;
4. Provide a transparent marketplace for health insurance and
consumer education on matters relating to health insurance; and
5. Assist residents of Nevada with access to programs, premium
assistance tax credits and cost-sharing reductions.
Sec. 347. NRS 695I.210 is hereby amended to read as follows:
695I.210 1. The [Exchange] Division shall [:] , through the
Exchange:
(a) Create and administer a health insurance exchange;
(b) Facilitate the purchase and sale of qualified health plans
consistent with established patterns of care within the State;
(c) Provide for the establishment of a program to assist qualified
small employers in Nevada in facilitating the enrollment of their
employees in qualified health plans offered in the small group market;
(d) Except as otherwise authorized by a waiver obtained pursuant
to NRS 695I.505, make only qualified health plans available to
qualified individuals and qualified small employers; and
(e) Unless the Federal Act is repealed or is held to be
unconstitutional or otherwise invalid or unlawful, perform all duties
that are required of the Exchange to implement the requirements of
the Federal Act.
2. The [Exchange] Division may [:] , through the Exchange:
(a) Enter into contracts with any person, including, without
limitation, a local government, a political subdivision of a local
government and a governmental agency, to assist in carrying out the
duties and powers of the Exchange ; [or the Board;] and
(b) Apply for and accept any gift, donation, bequest, gr ant or
other source of money to carry out the duties and powers of the
Exchange ; [or the Board.]
3. [The] Except for purchasing conducted by the Authority
pursuant to section 24 of this act, the Exchange is subject to the
provisions of chapter 333 of NRS.
Sec. 348. NRS 695I.300 is hereby amended to read as follows:
695I.300 1. The [governing authority] Board of the Exchange
is [the Board, consisting ] hereby created within the Division. The
Board consists of seven voting members and [three] one ex officio
nonvoting [members.] member.
2. Subject to the provisions of subsections 3 to 6, inclusive:
(a) The Governor shall appoint [five] two voting members of the
Board;
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(b) The Senate Majority Leader shall appoint one voting member
of the Board; [and]
(c) The Speaker of the Assembly shall appoint one voting
member of the Board [.] ;
(d) The Administrator of the Medicaid Division of the Authority
or his or her designee shall serve as a voting member;
(e) The Director of the Department of Human Services or his or
her designee shall serve as a voting member; and
(f) The Commissioner of Insurance or his or her designee shall
serve as a voting member.
3. Each appointed or designated voting member of the Board
must have:
(a) Expertise in the sale or m arketing of individual or small
employer health insurance;
(b) Expertise in health care administration, health care financing,
health information technology or health insurance;
(c) Expertise in the administration of health care delivery
systems;
(d) Experience as a consumer who would benefit from services
provided by the Exchange; or
(e) Experience as a consumer advocate, including, without
limitation, experience in consumer outreach and education for those
who would benefit from services provided by the Exchange.
4. When making an appointment pursuant to subsection 2, the
Governor, the Majority Leader and the Speaker of the Assembly shall
consider the collective expertise and experience of the voting
members of the Board and shall attempt to make each appointment so
that:
(a) The areas of expertise and experience described in subsection
3 are collectively represented by the voting members of the Board;
and
(b) The voting members of the Board represent a range and
diversity of skills, knowledge, expe rience and geographic and
stakeholder perspectives.
5. When making an appointment pursuant to subsection 2, the
Governor, the Majority Leader and the Speaker of the Assembly
shall, as vacancies on the Board occur, ensure that not more than two
voting me mbers of the Board represent any particular area of
expertise or experience described in paragraph (a), (b), (c), (d) or (e)
of subsection 3.
6. A voting member of the Board may not be a Legislator or hold
any elective office in State Government.
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7. The [following are ex officio ] Director of the Office of
Finance or his or her designee shall serve as a nonvoting [members]
member of the Board [who shall] to assist the voting members of the
Board by providing advice and expertise . [:
(a) The Director of the Department of Health and Human
Services, or his or her designee;
(b) The Director of the Department of Business and Industry, or
his or her designee; and
(c) The Director of the Office of Finance, or his or her designee.]
Sec. 349. NRS 695I.310 is hereby amended to read as follows:
695I.310 1. After the initial terms, the term of each [voting]
appointed member of the Board is 3 years.
2. [A voting ] An appointed member of the Board may be
reappointed to an additional nonconsecutive term on the Board.
3. The appointing authority who appoints a [voting] member of
the Board may remove that [voting] member if the voting member
neglects his or her duty or commits misfeasance, malfeasance or
nonfeasance in office.
4. A vacancy on the Board in the position of a voting member
must be filled in the same manner as the original appointment.
[5. Upon the expiration of his or her term of office, a voting
member of the Board may continue to serve until he or she is
reappointed or a person is appointed as a successor.]
Sec. 350. NRS 695I.320 is hereby amended to read as follows:
695I.320 1. The Board shall elect a Chair and a Vice Chair
from among its members.
2. The terms of the Chair and Vice Chair are 1 year.
3. The Chair and Vice Chair may be reelected to not more than
one [or more terms.] additional term.
4. If a vacancy occurs, the members of the Board shall elect a
replacement Chair or Vice Chair, as applicable, for the remainder of
the unexpired term.
Sec. 351. NRS 695I.370 is hereby amended to read as follows:
695I.370 1. The Board shall:
(a) Advise the Executive Director concerning the governance
and operation of the Exchange in accordance with the Federal Act;
(b) Adopt bylaws setting forth its procedures and governing it s
operations;
[(b) On or before June 30 and December 31 of each year,
submit a]
(c) Review the written fiscal and operational report described in
paragraph (a) of subsection 5 of NRS 695I.380 before the Executive
Director submits the report to the Governor and the Legislature [,
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which must include, without limitation, any recommendations
concerning the Exchange;
(c)] ;
(d) On or before December 31 of each year, prepare a report for
the public summarizing the activities of the Board and the
contributions of the Exchange to the health of the residents of Nevada
during the previous year;
[(d) Provide for an]
(e) Review the annual audit [of its functions and operations;
(e)] described in paragraph (c) of subsection 5 of
NRS 695I.380;
(f) Submit all reports required by federal law to the appropriate
federal agency and in a timely manner; and
[(f)] (g) If the Federal Act is repealed or is held unconstitutional
or otherwise invalid or unlawful, [define by regulation “qualified
health plan” for the purposes of this act.] make recommendations to
the Executive Director concerning the regulations described in
paragraph (d) of subsection 5 of NRS 695I.380.
2. The Board may:
(a) Adopt regulations to carry out the duties and powers of the
Exchange;
(b) Prepare special reports concerning the Exchange for the
Governor, the Legislature and the public; and
(c) [Contract for the services of such legal, professional, technical
and operational personnel and consultants as the execution of its
duties and po wers and the operation of the Exchange may require. ]
Make recommendations to the Executive Director concerning
entering into contracts pursuant to paragraph (b) of subsection 3 of
NRS 695I.380.
3. The Board is subject to Legislative and Executive Branch
audits.
Sec. 352. NRS 695I.380 is hereby amended to read as follows:
695I.380 1. The [Board] Director of the Authority shall ,
subject to the approval of the Governor, appoint an Executive
Director of the Exchange.
2. The Executive Director:
(a) Is in the unclassified service of the State;
(b) [Is responsible to the Board and serves] Serves at the pleasure
of the [Board;] Director of the Authority;
(c) Must have experience in the administration of health care or
health insurance; and
(d) Is responsible for the administrative matters of the Board [.]
and the operations and management of the Exchange, subject to the
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supervision of the Director of the Authority or the designee of the
Director.
3. Subject to the limits of available funding [,] and the approval
of the Director of the Authority, the Executive Director may [, in] :
(a) In accordance with chapter 284 of NRS, appoint and remove
such employees of the Exchange as are necessary for the
administration of the Exchange [.] ; and
(b) Contract for the services of such legal, professional,
technical and operational personnel and consultants as the
execution of his or her duties and powers may require.
4. Employees of the Exchange appointed pursuant to subsection
3 are in either the classif ied or unclassified service of the State, in
accordance with the historical manner of categorization.
5. The Executive Director shall:
(a) On or before June 30 and December 31 of each year,
compile and submit to the Board a written report concerning the
finances and operations of the Exchange which includes, without
limitation, any recommendations concerning the Exchange;
(b) Upon the approval of the Board, submit the report described
in paragraph (a) to the Governor and the Legislature;
(c) Provide for an annual audit of the functions and operations
of the Exchange; and
(d) If the Federal Act is repealed or held unconstitutional or
otherwise invalid or unlawful, define by regulation “qualified
health plan” for the purposes of this chapter.
Sec. 353. NRS 695I.390 is hereby amended to read as follows:
695I.390 1. The [Board] Director of the Authority and the
Director of the Department of [Health and] Human Services shall
collaborate to ensure that the Exchange coordinates with Medicaid,
the Childre n’s Health Insurance Program and any other applicable
state or local [public] social service programs to create a single point
of entry for users of the Exchange who are eligible for such programs
and to promote continuity of coverage and care.
2. As use d in this section, “Children’s Health Insurance
Program” has the meaning ascribed to it in NRS 422.021.
Sec. 354. NRS 695I.500 is hereby amended to read as follows:
695I.500 The Department of [Health and] Human Services, the
Division of Insurance of the Department of Business and Industry and
any other relevant state agency shall work with and provide support
to the Authority and the Exchange as [it carries] those entities carry
out [its] their duties and powers [,] pursuant to this chapter,
including, without limitation, entering into agreements to share
information and intergovernmental agreements with the Exchange.
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Sec. 355. NRS 695K.050 is hereby amended to read as follows:
695K.050 “Director” means the Director of the [Department of
Health and Human Services.] Nevada Health Authority.
Sec. 356. NRS 706.745 is hereby amended to read as follows:
706.745 1. The provisions of NRS 706.386 and 706.421 do
not apply to:
(a) Ambulances;
(b) Hearses; or
(c) Common motor carriers or contract motor c arriers that are
providing transportation services pursuant to a contract with the
[Department of Health and Human Services ] Nevada Health
Authority entered into pursuant to NRS 422.27495.
2. A common motor carrier that enters into an agreement for the
purchase of its service by an incorporated city, county or regional
transportation commission is not required to obtain a certificate of
public convenience and necessity to operate a system of public transit
consisting of:
(a) Regular routes and fixed schedules;
(b) Nonemergency medical transportation of persons to facilitate
their participation in jobs and day training services as defined in NRS
435.176 if the transportation is available upon request and without
regard to regular routes or fixed schedules;
(c) Nonmedical transportation of persons with disabilities
without regard to regular routes or fixed schedules; or
(d) In a county whose population is less than 100,000 or an
incorporated city within such a county, nonmedical transportation of
persons if the transportation is available by reservation 1 day in
advance of the transportation and without regard to regular routes or
fixed schedules.
3. Under any agreement for a system of public transit that
provides for the transportation of passengers th at is described in
subsection 2:
(a) The public entity shall provide for any required safety
inspections; or
(b) If the public entity is unable to do so, the Authority shall
provide for any required safety inspections.
4. In addition to the requirement s of subsection 3, under an
agreement for a system of public transit that provides for the
transportation of passengers that is described in:
(a) Paragraph (a) of subsection 2, the public entity shall establish
the routes and fares.
(b) Paragraph (c) or (d) of subsection 2, the common motor
carrier:
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(1) May provide transportation to any passenger who can
board a vehicle with minimal assistance from the operator of the
vehicle.
(2) Except as otherwise provided in NRS 706.248, shall not
offer medical assistance as part of its transportation service.
5. In a county whose population:
(a) Is less than 700,000, a nonprofit carrier of elderly persons or
persons with disabilities is not required to obtain a certificate of
public convenience and necessity to operate as a common motor
carrier of such passengers only, but such a carrier is not exempt from
inspection by the Authority to determine whether its vehicles and
their operation are safe.
(b) Is 700,000 or more, a nonprofit carrier of elderly persons or
persons with disabilities is not required to obtain a certificate of
public convenience and necessity to operate as a common motor
carrier of such passengers only, but:
(1) Only if the nonprofit carrier:
(I) Does not charge for transportation services;
(II) Provides transportation services pursuant to a contract
with the [Department of Health and Human Services] Nevada Health
Authority entered into pursuant to NRS 422.27495; or
(III) Enters into an agreement for the purchase of its
service by an incorporated city, county or regional transportation
commission; and
(2) Such a carrier is not exempt from inspection by the
Authority to determine whether its vehicles and their operation are
safe.
6. An incorporated city, county or regional transpor tation
commission is not required to obtain a certificate of public
convenience and necessity to operate a system of public
transportation.
7. Before an incorporated city or a county enters into an
agreement with a common motor carrier for a system of public transit
that provides for the transportation of passengers that is described in
paragraph (c) or (d) of subsection 2 in an area of the incorporated city
or an area of the county, it must determine that:
(a) There are no other common motor carriers of passengers who
are authorized to provide such services in that area; or
(b) Although there are other common motor carriers of
passengers who are authorized to provide such services in the area,
the common motor carriers of passengers do not wish to prov ide, or
are not capable of providing, such services.
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Sec. 357. NRS 706A.070 is hereby amended to read as follows:
706A.070 The provisions of this chapter do not apply to:
1. Common motor carriers or contract motor carriers that are
providing transpor tation services pursuant to a contract with the
[Department of Health and Human Services ] Nevada Health
Authority entered into pursuant to NRS 422.27495.
2. A person who provides a digital network or software
application service to enable persons who are interested in sharing
expenses for transportation to a destination, commonly known as
carpooling, to connect with each other, regardless of whether a fee is
charged by the person who provides the digital network or software
application service.
Sec. 358. NRS 706B.060 is hereby amended to read as follows:
706B.060 The provisions of this chapter do not apply to:
1. Common motor carriers or contract motor carriers that are
providing transportation services pursuant to a contract with the
[Department of Health and Human Services ] Nevada Health
Authority entered into pursuant to NRS 422.27495.
2. A person who provides a method to enable persons who are
interested in sharing expenses for transportation to a destination,
commonly known as carpooling, to connect with each other,
regardless of whether a fee is charged by the person who provides the
method.
Sec. 359. 1. All authority, duties and responsibilities ascribed
to:
(a) The Department of Health and Human Services in chapter 422
of NRS and NRS 43 9B.600 to 439B.695, inclusive, are hereby
transferred to the Nevada Health Authority unless expressly
transferred to a different entity by the provisions of this act.
(b) The Director of the Department of Health and Human
Services in chapter 422 of NRS are hereby transferred to the Director
of the Nevada Health Authority unless expressly transferred to a
different person or entity by the provisions of this act.
(c) The Department of Health and Human Services in NRS
439B.800 to 439B.875, inclusive, are hereby transferred to the Office
of Data Analytics of the Nevada Health Authority unless expressly
transferred to a different entity by the provisions of this act.
2. All authority, duties and responsibilities ascribed to the
Division of Health Care Financi ng and Policy of the Department of
Health and Human Services are hereby transferred to the Medicaid
Division of the Nevada Health Authority unless expressly transferred
to a different entity by the provisions of this act.
Sec. 360. All authority, duties and responsibilities ascribed to:
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1. The Department of Health and Human Services in Assembly
Bill No. 519 of this session are hereby transferred to the Health Care
Purchasing and Compliance Division of the Nevada Health
Authority.
2. The Division of Pu blic and Behavioral Health of the
Department of Health and Human Services in Assembly Bill No. 519
of this session are hereby transferred to the Health Care Purchasing
and Compliance Division of the Nevada Health Authority.
Sec. 361. Any authority, duty or responsibility to administer a
program to award grants of money to address shortages of providers
of health care in this State or to implement requirements on Medicaid
or the Children’s Health Insurance Program, which is ascribed to the
Department of Health and Human Services by a bill enacted by the
Legislature during this session and approved by the Governor, is
hereby transferred to the Health Care Purchasing and Compliance
Division of the Nevada Health Authority.
Sec. 362. Any exemption approved pursuant to subsection 3 of
NRS 439.4905 on or before June 30, 2025, from the assessment
required by subsection 1 of that section also exempts the county to
which the exemption applies from the assessment required by section
30 of this act for the duration of the current term of the exemption.
Sec. 362.5. 1. If a bill enacted by the Legislature during this
session transfers the responsibility for regulating food establishments,
cottage food operations and farm-to-fork events in counties where the
Division of Public and Behavioral Health of the Department of Health
and Human Services serves as the health authority, as prescribed in
chapter 446 of NRS, and the duty to collect an assessment for the
costs of those services pursuant to NRS 439.4905 to any entity other
than the Division, the provisions of this bill transferring those
responsibilities and duties to the Nevada Health Authority, including,
without limitation, such provisions of sections 24, 30, 34, 153, 212 to
216, inclusive, and 362 of this act, must not be given effect.
2. As used in this section:
(a) “Cottage food operation” has the meaning ascribed to it in
NRS 446.866.
(b) “Farm-to-fork event” has the meaning ascribed to it in
NRS 446.0145.
(c) “Food establishment” has the meaning ascribed to it in
NRS 446.020.
(d) “Health authority” has the meaning ascribed to it in
NRS 446.050, as that section existed on January 1, 2025.
Sec. 363. Except as otherwise provided in sections 364, 365 and
366 of this act, members of any body for whom the appointing
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authority is changed by the provisions of this act who are incumbent
on July 1, 2025, and remain qualified for their positions shall serve
the remainder of their terms. Upon the expiration of those terms, the
new appointing authority shall appoint a replacement.
Sec. 364. On July 1, 2025, unless he or she is reappointed
pursuant to this section, the member appointed to the Committee on
Domestic Violence pursuant to paragraph (b) of subsection 1 of NRS
228.470, as that section existed on June 30, 2025, shall vacate his or
her position. The Administrator of the Health Care Purchasing and
Compliance Division of the Nevada Health Authority shall appoint a
member pursuant to paragraph (b) of subsection 1 of NRS 228.470,
as amended by section 12 of this act, to serve the remainder of the
unexpired term.
Sec. 365. 1. The terms of the members of the Board of the
Public Employees’ Benefits Program appointed pursuant to
paragraph (c) of subsection 1 of NRS 287.041 who are incumbent on
June 30, 2025, expire on that date.
2. As soon as practicable on or after July 1, 2025:
(a) The Senate Majority Leader shall appoint to the Board of the
Public Employees’ Benefits Program one member described in
paragraph (c) of subsection 1 of NRS 287.041, as amended by section
68 of this act, to a term that expires on June 30, 2027.
(b) The Speaker of the Assembly shall appoint to the Board of the
Public Employees’ Benefits Program one member described in
paragraph (c) of subsection 1 of NRS 287.041, as amended by section
68 of this act, to a term that expires on June 30, 2029.
Sec. 366. 1. The terms of the appointed members of the Board
of the Silver State Health Insurance Exchange created by NRS
695I.300 who are incumbent on June 30, 2025, expire on that date.
2. As soon as practicable on or after July 1, 2025:
(a) The Governor shall appoint to the Board:
(1) One member described in paragraph (a) of subsection 2 of
NRS 695I.300, as amended by section 348 of this act, to an initial
term that expires on July 1, 2026; and
(2) One member described in paragraph (a) of subsection 2 of
NRS 695I.300, as amended by section 348 of this act, to an initial
term that expires on July 1, 2028.
(b) The Senate Majority Leader shall appoint to the Board the
member described in paragraph (b) of subsection 2 of NRS 695I.300,
as amended by section 348 of this act, to an initial term that expires
on July 1, 2027.
(c) The Speaker of the Assembly shall appoint to the Board the
member described in paragraph (c) of subsection 2 of NRS 695I.300,
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as amended by section 348 of this act, to an initial term t hat expires
on July 1, 2028.
3. Notwithstanding the provisions of NRS 695I.310, as amended
by section 349 of this act, the Governor, Senate Majority Leader or
Speaker of the Assembly may reappoint to the Board any member
who has not served a full term.
Sec. 367. The provisions of subsection 2 of NRS 422.267, as
amended by section 116 of this act, apply to any contract subject to
the requirements of that subsection entered into on or after July 1,
2025.
Sec. 367.5. 1. During the 2025 -2026 interim, th e Nevada
Health Authority and the Board of the Public Employees’ Benefits
Program shall study opportunities for the Board to enter into direct
contracts pursuant to subsection 3 of NRS 287.0434 with physicians,
surgeons, hospitals and rehabilitative facili ties for medical, surgical
and rehabilitative care and the evaluation, treatment and nursing care
of members of the Program and covered dependents.
2. On or before August 1, 2026, the Director of the Nevada
Health Authority shall submit a report of the s tudy conducted
pursuant to subsection 1 to the Director of the Legislative Counsel
Bureau for transmittal to the Joint Interim Standing Committee on
Health and Human Services.
Sec. 367.8. 1. During the 2025 -2026 interim, the Nevada
Health Authority and the Department of Health and Human Services
shall:
(a) Collaboratively study the actions necessary to transfer the
administrative functions, personnel and funding associated with
behavioral health, maternal health and public health from the
Division of Pu blic and Behavioral Health of the Department to the
Authority. The study must include, without limitation:
(1) A full inventory of programs of the Division related to
behavioral health, maternal health and public health and the money
and personnel allocated to those programs;
(2) An analysis of the statutory, regulatory and policy changes
necessary to effectuate the transfer;
(3) An analysis of the fiscal impact of the transfer, including,
without limitation, the administrative costs of the transfer; and
(4) Engagement with interested persons and entities,
including, without limitation, local boards of health and health
departments, providers of health care and nonprofit organizations that
provide services related to behavioral health, maternal healt h and
public health.
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(b) Develop a plan to carry out the transfer described in paragraph
(a). The plan must include, without limitation, recommended
milestones and metrics to measure performance.
2. On or before January 31, 2027, the Director of the Nev ada
Health Authority shall submit to the Governor and the Director of the
Legislative Counsel Bureau for transmittal to the 84th Session of the
Legislature:
(a) A report of the study conducted pursuant to paragraph (a) of
subsection 1; and
(b) The plan developed pursuant to paragraph (b) of subsection 1.
Sec. 368. The Legislative Counsel shall:
1. In preparing the reprint and supplements to the Nevada
Revised Statutes:
(a) Appropriately change any references to an officer, agency or
other entity who se name is changed or whose responsibilities are
transferred pursuant to the provisions of this act to refer to the
appropriate officer, agency or other entity; and
(b) Appropriately change the term “welfare” when used to refer
to public assistance, as de fined in NRS 422A.065, as amended by
section 123 of this act, to “public assistance.”
2. In preparing supplements to the Nevada Administrative Code:
(a) Appropriately change any references to an officer, agency or
other entity whose name is changed or w hose responsibilities are
transferred pursuant to the provisions of this act to refer to the
appropriate officer, agency or other entity; and
(b) Appropriately change the term “welfare” when used to refer
to public assistance, as defined in NRS 422A.065, as amended by
section 123 of this act, to “public assistance.”
Sec. 369. 1. Any administrative regulations adopted by an
officer or an agency whose name has been changed or whose
responsibilities have been transferred pursuant to the provisions of
this act to another officer or agency remain in force until amended by
the officer or agency to which the responsibility for the adoption of
the regulations has been transferred.
2. Any contracts or other agreements entered into by an officer
or agency whose name has been changed or whose responsibilities
have been transferred pursuant to the provisions of this act to another
officer or agency are binding upon the officer or agency to which the
responsibility for the administration of the provisions of the contract
or other agreement has been transferred. Such contracts and other
agreements may be enforced by the officer or agency to which the
responsibility for the enforcement of the provisions of the contract or
other agreement has been transferred.
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3. Any action taken by an officer or agency whose name has
been changed or whose responsibilities have been transferred
pursuant to the provisions of this act to another officer or agency
remains in effect as if taken by the officer or agency to which the
responsibility for the enforcement of such actions has been
transferred.
Sec. 370. 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. 371. NRS 422.030, 422.2362, 422A.015, 422A.035,
422A.050, 422A.3351, 422A.336 and 444.002 are hereby repealed.
Sec. 372. 1. This section and sections 1 to 109, inclusive, 111
to 354, inclusive, 356 to 359, inclusive, and 361 to 371, inclusive, of
this act become effective on July 1, 2025.
2. Section 360 of this act becomes effective on July 1, 2025, if,
and only if, Assembly Bill No. 519 of this session is enacted by the
Legislature and becomes effective.
3. Sections 110 and 355 of this act become effe ctive on
January 1, 2026.
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