S.B. 439
- *SB439*
SENATE BILL NO. 439–SENATORS D. HARRIS,
SCHEIBLE AND DONATE
MARCH 27, 2023
____________
Referred to Committee on Health and Human Services
SUMMARY—Revises provisions relating to communicable
diseases. (BDR 40-987)
FISCAL NOTE: Effect on Local Government: May have Fiscal Impact.
Effect on the State: Yes.
CONTAINS UNFUNDED MANDATE (§§ 1, 15, 44)
(NOT REQUESTED BY AFFECTED LOCAL GOVERNMENT)
~
EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted.
AN ACT relating to communicable diseases; requiring certain state
and local agencies to develop policies to provide uninterrupted
services during a public health emergency to certain persons;
authorizing a person who has been convicted of certain crimes to
petition a court to vacate the judgment and seal certain records;
requiring a public or private detention facility to take certain
measures to ensure the access of prisoners to treatment for and
methods to prevent the acquisition of human immunodeficiency
virus; revising provisions governing certain crimes committed by
prisoners; requiring the board of trustees of a school district to
establish a course or unit of a course of evidence-based, factual
instruction in sexuality education; requiring certain public and
private health insurers to provide certain coverage; requiring
such an insurer to reimburse an advanced practice registered
nurse or physician assistant at the same rate as a physician for
certain services; imposing certain requirements relating to cost
sharing for prescription drugs; authorizing providers of health
care to receive credit toward requirements for continuing
education for certain training relating to the human
immunodeficiency virus; requiring certain providers of health
care to complete such training; providing that the repeal or
revision of certain crimes applies retroactively; and providing
other matters properly relating thereto.
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Legislative Counsel’s Digest:
Existing law requires the Division of Public and Behavioral Health of the 1
Department of Health and Human Services and district, county and city health 2
departments to perform certain functions relating to public health in this State, 3
including certain duties relating to the control of communicable diseases. (NRS 4
439.150-439.265, 439.340, 439.350, 439.360, 439.366, 439.367, 439.3675, 5
439.405, 439.410, 439.460, 439.470) Existing law also requires a district health 6
officer or the Chief Medical Officer to perform certain duties relating to the control 7
of communicable diseases. (Chapter 441A of NRS) Existing law prescribes certain 8
responsibilities of the Division of Health Care Financing and Policy of the 9
Department concerning the administration of the Medicaid program. (NRS 10
422.061, 422.063) Section 1 of this bill requires the Department and all district, 11
county and city boards of health to develop policies to provide uninterrupted 12
services during a public health emergency to persons who have been diagnosed 13
with the human immunodeficiency virus or persons who are at a high risk of 14
acquiring the human immunodeficiency virus. Section 2 of this bill makes a 15
conforming change to indicate the proper placement of section 1 in the Nevada 16
Revised Statutes. 17
Senate Bill No. 275 of the 2021 Legislative Session repealed certain criminal 18
offenses for which an element of the offense was having the human 19
immunodeficiency virus. (Section 24, chapter 491, Statutes of Nevada 2021, at 20
page 3199) Section 77 of this bill provides that the repeal of those offenses applies 21
retroactively to violations that occurred before the effective date of Senate Bill No. 22
275. Section 3 of this bill authorizes a person who was convicted of such an 23
offense before the effective date of Senate Bill No. 275 to petition the court in 24
which he or she was convicted for an order vacating the judgment and sealing 25
certain records relating to the conviction. Section 3: (1) requires the court to grant 26
the petition if the petition meets the relevant statutory requirements; and (2) 27
authorizes the court to issue an order to vacate the judgment and dismiss the 28
accusatory pleading if the petition is deficient with respect to the sealing of 29
the records but the petitioner otherwise satisfies the requirements for vacating the 30
judgment. Section 4 of this bill makes a conforming change to indicate the proper 31
placement of section 3 in the Nevada Revised Statutes. Sections 5-7 of this bill 32
exempt a petition filed pursuant to section 3 from certain requirements, and 33
sections 8-10 of this bill make various changes to ensure that an order issued 34
pursuant to section 3 is treated in the same manner as other similar orders for 35
certain purposes. 36
Existing law requires the Director of the Department of Corrections to establish 37
standards for the medical and dental services of each institution or facility under the 38
control of the Department. (NRS 209.381) Existing law also requires a sheriff, chief 39
of police or town marshal to arrange for the administration of medical care required 40
by prisoners while in his or her custody. (NRS 211.140) Sections 11 and 12 of this 41
bill impose certain requirements on the operators of public and private prisons, jails 42
and detention facilities to ensure the access of prisoners to treatment for human 43
immunodeficiency virus and methods of preventing the acquisition of human 44
immunodeficiency virus. 45
Existing law prohibits a prisoner from using, propelling, discharging, spreading 46
or concealing human excrement or bodily fluid with intent or under circumstances 47
where it is reasonably likely that the excrement or fluid will come in contact with 48
another person. Under most circumstances, a violation is a gross misdemeanor or a 49
category D felony, depending on the circumstances of the prisoner’s confinement. 50
However, if the prisoner knew at the time of the offense that any portion of the 51
excrement or bodily fluid contained a communicable disease that causes or is 52
reasonably likely to cause substantial bodily harm, the violation is a category A 53
felony, regardless of whether the communicable disease was transmitted. 54
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(NRS 212.189) Section 13 of this bill instead provides that such a violation is only 55
a category A felony where: (1) the prisoner knew the communicable disease was 56
likely to be transmitted by his or her conduct; and (2) the communicable disease 57
was actually transmitted as a result of the conduct. Section 78 of this bill provides 58
that the provisions of section 13 apply retroactively to violations that occurred 59
before the effective date of that section, if the person who committed the violation 60
has not been convicted before that date. 61
Existing law requires public and private health plans, including Medicaid and 62
health plans for state and local government employees, to cover an examination and 63
testing of a pregnant woman for Chlamydia trachomatis, gonorrhea, hepatitis B, 64
hepatitis C and syphilis. (NRS 287.010, 287.04335, 422.27173, 689A.0412, 65
689B.0315, 689C.1675, 695A.1856, 695B.1913, 695C.1737, 695G.1714) Sections 66
15, 16, 23, 34, 42, 47, 52, 55, 60, 65, 67 and 72 of this bill additionally require 67
such insurance plans to cover: (1) testing for, treatment of and prevention of 68
sexually transmitted diseases; and (2) condoms for covered persons who are 13 69
years of age or older. Sections 15, 16, 22, 35, 43, 48, 52, 56, 61, 66, 67 and 73 of 70
this bill require an insurer to count any amount paid by a covered person or another 71
person or entity on behalf of a covered person toward any cost sharing requirement 72
applicable to certain prescription drugs, including drugs to prevent human 73
immunodeficiency virus, treat human immunodeficiency virus or hepatitis C or 74
provide certain treatment for substance use disorder. Section 21 of this bill defines 75
the term “pharmacy benefit manager” for the purpose of provisions of law 76
governing Medicaid coverage of prescription drugs. 77
Existing law requires public and private health plans, including Medicaid and 78
health plans for state and local government employees, to cover drugs that prevent 79
the acquisition of human immunodeficiency virus and any related laboratory or 80
diagnostic procedures. (NRS 287.010, 287.04335, 422.27235, 422.4025, 81
689A.0437, 689B.0312, 689C.1671, 695A.1843, 695B.1924, 695C.1743, 82
695G.1705) Sections 26, 31, 37, 44, 51, 57, 62, 68 and 74 of this bill require such 83
insurance plans to cover all such drugs approved by the United States Food and 84
Drug Administration and all drugs approved by the Food and Drug Administration 85
for treating human immunodeficiency virus or hepatitis C without restrictions, other 86
than step therapy. Sections 24, 37, 44, 51, 57, 62, 68 and 74 of this bill require 87
such insurance plans to: (1) cover any service to test for, prevent or treat those 88
diseases provided by a provider of primary care if the service is covered when 89
provided by a specialist and certain other requirements are met; and (2) reimburse 90
an advanced practice registered nurse or a physician assistant for such services at a 91
rate equal to that provided to a physician. Sections 15, 16, 20, 26, 31, 33, 41, 46, 92
52, 54, 59, 64, 67 and 71 impose similar requirements regarding: (1) coverage of 93
certain drugs approved by the Food and Drug Administration to treat substance use 94
disorder; (2) coverage of services for the treatment of substance use disorder 95
provided by a provider of primary care; and (3) reimbursement for such services 96
provided by an advanced practice registered nurse. Sections 36, 38, 49 and 50 of 97
this bill make conforming changes to indicate that the coverage required by 98
sections 33 and 46 is in addition to certain coverage of services for the treatment of 99
substance use disorder that certain insurers are required by existing law to provide. 100
Sections 14, 25 and 39 of this bill make conforming changes to indicate the proper 101
placement of sections 20-22 and 33-35 in the Nevada Revised Statutes. Section 69 102
of this bill authorizes the Commissioner of Insurance to suspend or revoke the 103
certificate of a health maintenance organization that fails to comply with the 104
requirements of sections 64-66. The Commissioner would also be authorized to 105
take such action against any health insurer who fails to comply with the 106
requirements of sections 33-35, 37, 41-44, 46-48, 50, 54-57, 59-62, 67, 68 or 71-74 107
of this bill. (NRS 680A.200, 695C.330) 108
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Existing law requires the board of trustees of each school district to establish a 109
course or unit of a course of instruction concerning acquired immune deficiency 110
syndrome, the human reproductive system, related communicable diseases and 111
sexual responsibility which must be taught by a teacher or school nurse whose 112
qualifications have been approved by the board of trustees. (NRS 389.036) Section 113
17 of this bill instead requires the board of trustees of a school district to establish a 114
course or unit of a course of evidence-based, factual instruction in sexuality 115
education. Section 17 additionally authorizes a provider of health care or other 116
qualified person approved by the board of trustees to teach such a course. Section 117
18 of this bill requires the standards adopted by the Council to Establish Academic 118
Standards for Public Schools for instruction in health to include standards for 119
sexuality education. Section 18 also authorizes the Council to include topics related 120
to sexuality education in the standards for other courses where appropriate. 121
Existing law requires physicians, osteopathic physicians, physician assistants 122
and nurses to complete certain continuing education in order to renew their 123
licenses. (NRS 630.253, 632.343, 633.471) Sections 28-30 and 75 of this bill 124
require such a provider of health care who provides or supervises the provision of 125
emergency medical care or primary care in a hospital to complete before the first 126
renewal of their license or, for currently practicing providers, the next renewal of 127
their license, at least 2 hours of training in stigma, discrimination and unrecognized 128
bias toward persons who have acquired or are at a high risk of acquiring human 129
immunodeficiency virus. Section 27 of this bill authorizes any provider of health 130
care to use training in that subject in place of not more than 2 hours of any other 131
training that the provider is required to complete, other than continuing education 132
relating to ethics. 133
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1. Chapter 441A of NRS is hereby amended by 1
adding thereto a new section to read as follows: 2
1. The Department of Health and Human Services and all 3
district, county and city boards of health shall develop policies to 4
provide uninterrupted services during a public health emergency 5
to persons who have been diagnosed with the human 6
immunodeficiency virus or who are at a high risk of acquiring the 7
human immunodeficiency virus and who are receiving services 8
from the Department or any division thereof or the district, county 9
or city health department, as applicable. Such policies may 10
provide, without limitation, for the delivery of such services during 11
a public health emergency: 12
(a) Over the Internet; 13
(b) Using an application for a mobile device; or 14
(c) By calling or sending text messages from a telephone 15
number that is not generally blocked or identified as a source of 16
unwanted calls or messages. 17
2. As used in this section: 18
(a) “Mobile device” includes, without limitation, a smartphone 19
or a tablet computer. 20
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(b) “Public health emergency” means: 1
(1) A public health emergency or other health event 2
identified by a health authority pursuant to NRS 439.970; or 3
(2) A state of emergency or declaration of disaster 4
proclaimed pursuant to NRS 414.070 that relates to or affects 5
public health. 6
Sec. 2. NRS 441A.334 is hereby amended to read as follows: 7
441A.334 As used in this section and NRS 441A.335 and 8
441A.336, and section 1 of this act, “provider of health care” means 9
a physician, nurse or physician assistant licensed in accordance with 10
state law. 11
Sec. 3. Chapter 179 of NRS is hereby amended by adding 12
thereto a new section to read as follows: 13
1. If a person has been convicted of a violation of NRS 14
201.205 or 201.358, as those sections existed before June 6, 2021, 15
which is the effective date of repeal of those sections by section 24 16
of chapter 491, Statutes of Nevada 2021, at page 3199, the person 17
may petition the court in which he or she was convicted for an 18
order: 19
(a) Vacating the judgment; and 20
(b) Sealing all documents, papers and exhibits in the person’s 21
record, minute book entries and entries on dockets, and other 22
documents relating to the case in the custody of such other 23
agencies and officers as are named in the court’s order. 24
2. A petition filed pursuant to subsection 1 must satisfy the 25
requirements of NRS 179.245. 26
3. Except as otherwise provided in subsection 6, the court 27
shall grant a petition filed pursuant to subsection 1 if the petition 28
meets the requirements of this section. 29
4. If the court grants a petition filed pursuant to subsection 1, 30
the court shall: 31
(a) Vacate the judgment and dismiss the accusatory pleading; 32
and 33
(b) Order sealed all documents, papers and exhibits in the 34
petitioner’s record, minute book entries and entries on dockets and 35
other documents relating to the case in the custody of such other 36
agencies and officers as are named in the court’s order. 37
5. If a petition filed pursuant to subsection 1 does not satisfy 38
the requirements of NRS 179.245 or the court determines that 39
the petition is otherwise deficient with respect to the sealing of the 40
petitioner’s record, the court may enter an order to vacate the 41
judgment and dismiss the accusatory pleading if the petitioner 42
satisfies all requirements necessary for the judgment to be vacated. 43
6. If the court enters an order pursuant to subsection 5, the 44
court shall also order sealed the records of the petitioner which 45
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relate to the judgment being vacated in accordance with 1
paragraph (b) of subsection 4, regardless of whether any records 2
relating to other convictions are ineligible for sealing, either by 3
operation of law or because of a deficiency in the petition. 4
7. No fee may be charged by any court or agency of criminal 5
justice for the submission of a petition pursuant to this section. 6
Sec. 4. NRS 179.241 is hereby amended to read as follows: 7
179.241 As used in NRS 179.2405 to 179.301, inclusive, and 8
section 3 of this act, unless the context otherwise requires, the 9
words and terms defined in NRS 179.242, 179.243 and 179.244 10
have the meanings ascribed to them in those sections. 11
Sec. 5. NRS 179.245 is hereby amended to read as follows: 12
179.245 1. Except as otherwise provided in subsection 6 and 13
NRS 176.211, 176A.245, 176A.265, 176A.295, 179.247, 179.259, 14
201.354 and 453.3365 [,] and section 3 of this act, a person may 15
petition the court in which the person was convicted for the sealing 16
of all records relating to a conviction of: 17
(a) A category A felony, a crime of violence or residential 18
burglary pursuant to NRS 205.060 after 10 years from the date of 19
release from actual custody or discharge from parole or probation, 20
whichever occurs later; 21
(b) Except as otherwise provided in paragraphs (a) and (e), a 22
category B, C or D felony after 5 years from the date of release from 23
actual custody or discharge from parole or probation, whichever 24
occurs later; 25
(c) A category E felony after 2 years from the date of release 26
from actual custody or discharge from parole or probation, 27
whichever occurs later; 28
(d) Except as otherwise provided in paragraph (e), any gross 29
misdemeanor after 2 years from the date of release from actual 30
custody or discharge from probation, whichever occurs later; 31
(e) A violation of NRS 422.540 to 422.570, inclusive, a 32
violation of NRS 484C.110 or 484C.120 other than a felony, or a 33
battery which constitutes domestic violence pursuant to NRS 33.018 34
other than a felony, after 7 years from the date of release from actual 35
custody or from the date when the person is no longer under a 36
suspended sentence, whichever occurs later; 37
(f) Except as otherwise provided in paragraph (e), if the offense 38
is punished as a misdemeanor, a battery pursuant to NRS 200.481, 39
harassment pursuant to NRS 200.571, stalking pursuant to NRS 40
200.575 or a violation of a temporary or extended order for 41
protection, after 2 years from the date of release from actual custody 42
or from the date when the person is no longer under a suspended 43
sentence, whichever occurs later; or 44
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(g) Any other misdemeanor after 1 year from the date of release 1
from actual custody or from the date when the person is no longer 2
under a suspended sentence, whichever occurs later. 3
2. A petition filed pursuant to subsection 1 must: 4
(a) Be accompanied by the petitioner’s current, verified records 5
received from the Central Repository for Nevada Records of 6
Criminal History; 7
(b) If the petition references NRS 453.3365, include a certificate 8
of acknowledgment or the disposition of the proceedings for the 9
records to be sealed from all agencies of criminal justice which 10
maintain such records; 11
(c) Include a list of any other public or private agency, company, 12
official or other custodian of records that is reasonably known to the 13
petitioner to have possession of records of the conviction and to 14
whom the order to seal records, if issued, will be directed; and 15
(d) Include information that, to the best knowledge and belief of 16
the petitioner, accurately and completely identifies the records to be 17
sealed, including, without limitation, the: 18
(1) Date of birth of the petitioner; 19
(2) Specific conviction to which the records to be sealed 20
pertain; and 21
(3) Date of arrest relating to the specific conviction to which 22
the records to be sealed pertain. 23
3. Upon receiving a petition pursuant to this section, the court 24
shall notify the law enforcement agency that arrested the petitioner 25
for the crime and the prosecuting attorney, including, without 26
limitation, the Attorney General, who prosecuted the petitioner for 27
the crime. The prosecuting attorney and any person having relevant 28
evidence may testify and present evidence at any hearing on the 29
petition. 30
4. If the prosecuting agency that prosecuted the petitioner for 31
the crime stipulates to the sealing of the records, the court shall 32
apply the presumption set forth in NRS 179.2445 and seal the 33
records. If the prosecuting agency does not stipulate to the sealing of 34
the records or does not file a written objection within 30 days after 35
receiving notification pursuant to subsection 3 and the court makes 36
the findings set forth in subsection 5, the court may order the sealing 37
of the records in accordance with subsection 5 without a hearing. If 38
the court does not order the sealing of the records or the prosecuting 39
agency files a written objection, a hearing on the petition must be 40
conducted. At the hearing, unless an objecting party presents 41
evidence sufficient to rebut the presumption set forth in NRS 42
179.2445, the court shall apply the presumption and seal the records. 43
5. If the court finds that, in the period prescribed in subsection 44
1, the petitioner has not been charged with any offense for which the 45
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charges are pending or convicted of any offense, except for minor 1
moving or standing traffic violations, the court may order sealed all 2
records of the conviction which are in the custody of any agency of 3
criminal justice or any public or private agency, company, official 4
or other custodian of records in the State of Nevada, and may also 5
order all such records of the petitioner returned to the file of the 6
court where the proceeding was commenced from, including, 7
without limitation, the Federal Bureau of Investigation and all other 8
agencies of criminal justice which maintain such records and which 9
are reasonably known by either the petitioner or the court to have 10
possession of such records. 11
6. A person may not petition the court to seal records relating 12
to a conviction of: 13
(a) A crime against a child; 14
(b) A sexual offense; 15
(c) Invasion of the home with a deadly weapon pursuant to 16
NRS 205.067; 17
(d) A violation of NRS 484C.110 or 484C.120 that is punishable 18
as a felony pursuant to paragraph (c) of subsection 1 of 19
NRS 484C.400; 20
(e) A violation of NRS 484C.430; 21
(f) A homicide resulting from driving or being in actual physical 22
control of a vehicle while under the influence of intoxicating liquor 23
or a controlled substance or resulting from any other conduct 24
prohibited by NRS 484C.110, 484C.130 or 484C.430; 25
(g) A violation of NRS 488.410 that is punishable as a felony 26
pursuant to NRS 488.427; or 27
(h) A violation of NRS 488.420 or 488.425. 28
7. The provisions of paragraph (e) of subsection 1 and 29
paragraph (d) of subsection 6 must not be construed to preclude a 30
person from being able to petition the court to seal records relating 31
to a conviction for a violation of NRS 484C.110 or 484C.120 32
pursuant to this section if the person was found guilty of a violation 33
of NRS 484C.110 or 484C.120 that is punishable pursuant to: 34
(a) Paragraph (b) of subsection 1 of NRS 484C.400; or 35
(b) Paragraph (c) of subsection 1 of NRS 484C.400 but had a 36
judgment of conviction entered against him or her for a violation of 37
paragraph (b) of subsection 1 of NRS 484C.400 because the person 38
participated in the statewide sobriety and drug monitoring program 39
established pursuant to NRS 484C.392. 40
8. If the court grants a petition for the sealing of records 41
pursuant to this section, upon the request of the person whose 42
records are sealed, the court may order sealed all records of the civil 43
proceeding in which the records were sealed. 44
9. As used in this section: 45
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(a) “Crime against a child” has the meaning ascribed to it in 1
NRS 179D.0357. 2
(b) “Sexual offense” means: 3
(1) Murder of the first degree committed in the perpetration 4
or attempted perpetration of sexual assault or of sexual abuse or 5
sexual molestation of a child less than 14 years of age pursuant to 6
paragraph (b) of subsection 1 of NRS 200.030. 7
(2) Sexual assault pursuant to NRS 200.366. 8
(3) Statutory sexual seduction pursuant to NRS 200.368, if 9
punishable as a felony. 10
(4) Battery with intent to commit sexual assault pursuant to 11
NRS 200.400. 12
(5) An offense involving the administration of a drug to 13
another person with the intent to enable or assist the commission of 14
a felony pursuant to NRS 200.405, if the felony is an offense listed 15
in this paragraph. 16
(6) An offense involving the administration of a controlled 17
substance to another person with the intent to enable or assist the 18
commission of a crime of violence, if the crime of violence is an 19
offense listed in this paragraph. 20
(7) Abuse of a child pursuant to NRS 200.508, if the abuse 21
involved sexual abuse or sexual exploitation. 22
(8) An offense involving pornography and a minor pursuant 23
to NRS 200.710 to 200.730, inclusive. 24
(9) Incest pursuant to NRS 201.180. 25
(10) Open or gross lewdness pursuant to NRS 201.210, if 26
punishable as a felony. 27
(11) Indecent or obscene exposure pursuant to NRS 201.220, 28
if punishable as a felony. 29
(12) Lewdness with a child pursuant to NRS 201.230. 30
(13) Sexual penetration of a dead human body pursuant to 31
NRS 201.450. 32
(14) Sexual conduct between certain employees of a school 33
or volunteers at a school and a pupil pursuant to NRS 201.540. 34
(15) Sexual conduct between certain employees of a college 35
or university and a student pursuant to NRS 201.550. 36
(16) Luring a child or a person with mental illness pursuant 37
to NRS 201.560, if punishable as a felony. 38
(17) An attempt to commit an offense listed in this 39
paragraph. 40
Sec. 6. NRS 179.2595 is hereby amended to read as follows: 41
179.2595 Notwithstanding the procedure established in NRS 42
179.245, 179.255 or 179.259 or section 3 of this act for the filing of 43
a petition for the sealing of records: 44
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1. If a person wishes to have more than one record sealed and 1
would otherwise need to file a petition in more than one court for 2
the sealing of the records, the person may, instead of filing a petition 3
in each court, file a petition in district court for the sealing of all 4
such records. 5
2. If a person files a petition for the sealing of records in 6
district court pursuant to subsection 1 or NRS 179.245, 179.255 or 7
179.259, the district court may order the sealing of any other records 8
in the justice or municipal courts in accordance with the provisions 9
of NRS 179.2405 to 179.301, inclusive. 10
3. A district court shall act in accordance with subsection 2 11
regardless of whether a petition filed pursuant to this section 12
includes a request for the sealing of a record in a district court. 13
Sec. 7. NRS 179.271 is hereby amended to read as follows: 14
179.271 1. Except as otherwise provided in this section [,] 15
and section 3 of this act, if an offense is decriminalized: 16
(a) Any person who was convicted of that offense before the 17
date on which the offense was decriminalized may submit a written 18
request to any court in which the person was convicted of that 19
offense for the sealing of any record of criminal history in its 20
possession and in the possession of any agency of criminal justice 21
relating to the conviction. 22
(b) Upon receipt of a request pursuant to paragraph (a), the court 23
shall, as soon as practicable, send written notice of the request to the 24
office of the prosecuting attorney that prosecuted the offense. If the 25
office of the prosecuting attorney objects to the granting of 26
the request, a written objection to the request must be filed with the 27
court within 10 judicial days after the date on which notice of the 28
request was received. If no written objection to the request is filed, 29
the court shall grant the request. If a written objection to the request 30
is filed, the court must hold a hearing on the request. At the hearing, 31
the court shall grant the request unless the prosecuting attorney 32
establishes, by clear and convincing evidence, that there is good 33
cause not to grant the request. The decision of the court to deny the 34
request is subject to appeal. 35
2. No fee may be charged by any court or agency of criminal 36
justice for the submission of a request pursuant to this section. 37
3. The provisions of this section do not apply to a traffic 38
offense. 39
4. As used in this section: 40
(a) “Decriminalized” means that an offense is no longer 41
punishable as a crime as the result of enactment of an act of the 42
Legislature or the passage of a referendum petition or initiative 43
petition pursuant to Article 19 of the Nevada Constitution. 44
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(b) “Traffic offense” means a violation of any state or local law 1
or ordinance governing the operation of a motor vehicle upon any 2
highway within this State. 3
Sec. 8. NRS 179.275 is hereby amended to read as follows: 4
179.275 Where the court orders the sealing of a record 5
pursuant to NRS 34.970, 174.034, 176.211, 176A.245, 176A.265, 6
176A.295, 179.245, 179.247, 179.255, 179.259, 179.2595, 179.271, 7
201.354 or 453.3365, or section 3 of this act, a copy of the order 8
must be sent to: 9
1. The Central Repository for Nevada Records of Criminal 10
History; and 11
2. Each agency of criminal justice and each public or private 12
company, agency, official or other custodian of records named in 13
the order, and that person shall seal the records in his or her custody 14
which relate to the matters contained in the order, shall advise the 15
court of compliance and shall then seal the order. 16
Sec. 9. NRS 179.285 is hereby amended to read as follows: 17
179.285 Except as otherwise provided in NRS 179.301: 18
1. If the court orders a record sealed pursuant to NRS 34.970, 19
174.034, 176.211, 176A.245, 176A.265, 176A.295, 179.245, 20
179.247, 179.255, 179.259, 179.2595, 179.271, 201.354 or 21
453.3365 [:] or section 3 of this act: 22
(a) All proceedings recounted in the record are deemed never to 23
have occurred, and the person to whom the order pertains may 24
properly answer accordingly to any inquiry, including, without 25
limitation, an inquiry relating to an application for employment, 26
concerning the arrest, conviction, dismissal or acquittal and the 27
events and proceedings relating to the arrest, conviction, dismissal 28
or acquittal. 29
(b) The person is immediately restored to the following civil 30
rights if the person’s civil rights previously have not been restored: 31
(1) The right to vote; 32
(2) The right to hold office; and 33
(3) The right to serve on a jury. 34
2. Upon the sealing of the person’s records, a person who is 35
restored to his or her civil rights pursuant to subsection 1 must be 36
given: 37
(a) An official document which demonstrates that the person has 38
been restored to the civil rights set forth in paragraph (b) of 39
subsection 1; and 40
(b) A written notice informing the person that he or she has not 41
been restored to the right to bear arms, unless the person has 42
received a pardon and the pardon does not restrict his or her right to 43
bear arms. 44
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3. A person who has had his or her records sealed in this State 1
or any other state and whose official documentation of the 2
restoration of civil rights is lost, damaged or destroyed may file a 3
written request with a court of competent jurisdiction to restore his 4
or her civil rights pursuant to this section. Upon verification that the 5
person has had his or her records sealed, the court shall issue an 6
order restoring the person to the civil rights to vote, to hold office 7
and to serve on a jury. A person must not be required to pay a fee to 8
receive such an order. 9
4. A person who has had his or her records sealed in this State 10
or any other state may present official documentation that the person 11
has been restored to his or her civil rights or a court order restoring 12
civil rights as proof that the person has been restored to the right to 13
vote, to hold office and to serve as a juror. 14
Sec. 10. NRS 179.295 is hereby amended to read as follows: 15
179.295 1. The person who is the subject of the records that 16
are sealed pursuant to NRS 34.970, 174.034, 176.211, 176A.245, 17
176A.265, 176A.295, 179.245, 179.247, 179.255, 179.259, 18
179.2595, 179.271, 201.354 or 453.3365 or section 3 of this act 19
may petition the court that ordered the records sealed to permit 20
inspection of the records by a person named in the petition, and the 21
court may order such inspection. Except as otherwise provided in 22
this section, subsection 9 of NRS 179.255 and NRS 179.259 and 23
179.301, the court may not order the inspection of the records under 24
any other circumstances. 25
2. If a person has been arrested, the charges have been 26
dismissed and the records of the arrest have been sealed, the court 27
may order the inspection of the records by a prosecuting attorney 28
upon a showing that as a result of newly discovered evidence, the 29
person has been arrested for the same or a similar offense and that 30
there is sufficient evidence reasonably to conclude that the person 31
will stand trial for the offense. 32
3. The court may, upon the application of a prosecuting 33
attorney or an attorney representing a defendant in a criminal action, 34
order an inspection of such records for the purpose of obtaining 35
information relating to persons who were involved in the incident 36
recorded. 37
4. This section does not prohibit a court from considering a 38
proceeding for which records have been sealed pursuant to NRS 39
174.034, 176.211, 176A.245, 176A.265, 176A.295, 179.245, 40
179.247, 179.255, 179.259, 179.2595, 179.271, 201.354 or 41
453.3365 or section 3 of this act in determining whether to grant a 42
petition pursuant to NRS 176.211, 176A.245, 176A.265, 176A.295, 43
179.245, 179.255, 179.259, 179.2595 or 453.3365 for a conviction 44
of another offense. 45
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Sec. 11. Chapter 209 of NRS is hereby amended by adding 1
thereto a new section to read as follows: 2
1. The Department or the operator of a private facility or 3
institution shall not enter into a contract or other agreement with 4
any person or entity to provide medical services to offenders who 5
are diagnosed with human immunodeficiency virus unless the 6
person or entity demonstrates that at least 95 percent of the 7
patients who are diagnosed with human immunodeficiency virus 8
to whom the person or entity provides medical services: 9
(a) Are offered treatment on the same day as the diagnosis; 10
and 11
(b) Are able to begin such treatment not later than 7 days after 12
diagnosis. 13
2. Except as otherwise provided in subsection 3, an 14
institution, facility or private facility or institution shall take 15
reasonable measures to ensure the availability of: 16
(a) Any drug prescribed for treating the human 17
immunodeficiency virus in the form recommended by the 18
prescribing practitioner to each offender who has been diagnosed 19
with human immunodeficiency virus to the same extent and under 20
the same conditions as other medical care for offenders. 21
(b) Methods of preventing the acquisition of human 22
immunodeficiency virus, including, without limitation, drugs 23
approved by the United States Food and Drug Administration for 24
that purpose and condoms, to all offenders free of charge. 25
3. An institution, facility or private facility or institution: 26
(a) Is not required to make available a drug described in 27
subsection 2 for which a prescription is required to an offender for 28
whom such a prescription has not been issued. 29
(b) Shall take reasonable measures to make available to all 30
offenders a provider of health care who is authorized to issue a 31
prescription for a drug described in subsection 2. 32
(c) Shall not demand, request or suggest that a provider of 33
health care refrain from issuing a prescription for a drug 34
described in subsection 2 to an offender or take any other measure 35
to prevent a provider of health care from issuing such a 36
prescription. 37
4. As used in this section, “provider of health care” has the 38
meaning ascribed to it in NRS 629.031. 39
Sec. 12. Chapter 211 of NRS is hereby amended by adding 40
thereto a new section to read as follows: 41
1. A sheriff, chief of police or town marshal who is 42
responsible for a county, city or town jail or detention facility shall 43
not enter into a contract or other agreement with any person or 44
entity to provide medical services to prisoners who are diagnosed 45
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with human immunodeficiency virus unless the person or entity 1
demonstrates that at least 95 percent of the patients who are 2
diagnosed with human immunodeficiency virus to whom the 3
person or entity provides medical services: 4
(a) Are offered treatment on the same day as the diagnosis; 5
and 6
(b) Are able to begin such treatment not later than 7 days after 7
diagnosis. 8
2. Except as otherwise provided in subsection 3, a county, city 9
or town jail or detention facility shall take reasonable measures to 10
ensure the availability of: 11
(a) Any drug prescribed for treating the human 12
immunodeficiency virus in the form recommended by the 13
prescribing practitioner to each prisoner who has been diagnosed 14
with human immunodeficiency virus to the same extent and under 15
the same conditions as other medical care for prisoners. 16
(b) Methods of preventing the acquisition of human 17
immunodeficiency virus, including, without limitation, drugs 18
approved by the United States Food and Drug Administration for 19
that purpose and condoms, to all prisoners free of charge. 20
3. A county, city or town jail or detention facility: 21
(a) Is not required to make available a drug described in 22
subsection 2 for which a prescription is required to a prisoner for 23
whom such a prescription has not been issued. 24
(b) Shall take reasonable measures to make available to all 25
prisoners a provider of health care who is authorized to issue a 26
prescription for a drug described in subsection 2. 27
(c) Shall not demand, request or suggest that a provider of 28
health care refrain from issuing a prescription for a drug 29
described in subsection 2 to an offender or take any other measure 30
to prevent a provider of health care from issuing such a 31
prescription. 32
4. As used in this section, “provider of health care” has the 33
meaning ascribed to it in NRS 629.031. 34
Sec. 13. NRS 212.189 is hereby amended to read as follows: 35
212.189 1. Except as otherwise provided in subsection 10, a 36
prisoner who is under lawful arrest, in lawful custody or in lawful 37
confinement shall not knowingly: 38
(a) Store or stockpile any human excrement or bodily fluid; 39
(b) Sell, supply or provide any human excrement or bodily fluid 40
to any other person; 41
(c) Buy, receive or acquire any human excrement or bodily fluid 42
from any other person; or 43
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(d) Use, propel, discharge, spread or conceal, or cause to be 1
used, propelled, discharged, spread or concealed, any human 2
excrement or bodily fluid: 3
(1) With the intent to have the excrement or bodily fluid 4
come into physical contact with any portion of the body of another 5
person, including, without limitation, an officer or employee of a 6
prison or law enforcement agency, whether or not such physical 7
contact actually occurs; or 8
(2) Under circumstances in which the excrement or bodily 9
fluid is reasonably likely to come into physical contact with any 10
portion of the body of another person, including, without limitation, 11
an officer or employee of a prison or law enforcement agency, 12
whether or not such physical contact actually occurs. 13
2. Except as otherwise provided in subsection 4, if a prisoner 14
who is under lawful arrest or in lawful custody violates any 15
provision of subsection 1, the prisoner is guilty of: 16
(a) For a first offense, a gross misdemeanor. 17
(b) For a second offense or any subsequent offense, a category 18
D felony and shall be punished as provided in NRS 193.130. 19
3. Except as otherwise provided in subsection 4, if a prisoner 20
who is in lawful confinement, other than residential confinement, 21
violates any provision of subsection 1, the prisoner is guilty of a 22
category B felony and shall be punished by imprisonment in the 23
state prison for a minimum term of not less than 2 years and a 24
maximum term of not more than 10 years, and may be further 25
punished by a fine of not more than $10,000. 26
4. If a prisoner who is under lawful arrest, in lawful custody or 27
in lawful confinement violates any provision of paragraph (d) of 28
subsection 1 and, at the time of the offense, the prisoner knew that 29
any portion of the excrement or bodily fluid involved in the offense 30
contained a communicable disease that causes or is reasonably 31
likely to cause substantial bodily harm [, whether or not] and is 32
likely to be transmitted as a result of the offense and the 33
communicable disease was transmitted to a victim as a result of the 34
offense, the prisoner is guilty of a category A felony and shall be 35
punished by imprisonment in the state prison: 36
(a) For life with the possibility of parole, with eligibility for 37
parole beginning when a minimum of 10 years has been served; or 38
(b) For a definite term of 25 years, with eligibility for parole 39
beginning when a minimum of 10 years has been served, 40
and may be further punished by a fine of not more than $50,000. 41
5. A sentence imposed upon a prisoner pursuant to subsection 42
2, 3 or 4: 43
(a) Is not subject to suspension or the granting of probation; and 44
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(b) Must run consecutively after the prisoner has served any 1
sentences imposed upon the prisoner for the offense or offenses for 2
which the prisoner was under lawful arrest, in lawful custody or in 3
lawful confinement when the prisoner violated the provisions of 4
subsection 1. 5
6. In addition to any other penalty, the court shall order a 6
prisoner who violates any provision of paragraph (d) of subsection 1 7
to reimburse the appropriate person or governmental body for the 8
cost of any examinations or testing: 9
(a) Conducted pursuant to paragraphs (a) and (b) of subsection 10
8; or 11
(b) Paid for pursuant to subparagraph (2) of paragraph (c) of 12
subsection 8. 13
7. The warden, sheriff, administrator or other person 14
responsible for administering a prison shall immediately and fully 15
investigate any act described in subsection 1 that is reported or 16
suspected to have been committed in the prison. 17
8. If there is probable cause to believe that an act described in 18
paragraph (d) of subsection 1 has been committed in a prison: 19
(a) Each prisoner believed to have committed the act or to have 20
been the bodily source of any portion of the excrement or bodily 21
fluid involved in the act shall submit to any appropriate 22
examinations and testing to determine whether each such prisoner 23
has any communicable disease. 24
(b) If possible, a sample of the excrement or bodily fluid 25
involved in the act must be recovered and tested to determine 26
whether any communicable disease is present in the excrement or 27
bodily fluid. 28
(c) If the excrement or bodily fluid involved in the act came into 29
physical contact with any portion of the body of an officer or 30
employee of a prison or law enforcement agency: 31
(1) The results of any examinations or testing conducted 32
pursuant to paragraphs (a) and (b) must be provided to each such 33
officer, employee or other person; and 34
(2) For each such officer or employee: 35
(I) Of a prison, the person or governmental body 36
operating the prison where the act was committed shall pay for any 37
appropriate examinations and testing requested by the officer or 38
employee to determine whether a communicable disease was 39
transmitted to the officer or employee as a result of the act; and 40
(II) Of any law enforcement agency, the law enforcement 41
agency that employs the officer or employee shall pay for any 42
appropriate examinations and testing requested by the officer or 43
employee to determine whether a communicable disease was 44
transmitted to the officer or employee as a result of the act. 45
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- *SB439*
(d) The results of the investigation conducted pursuant to 1
subsection 7 and the results of any examinations or testing 2
conducted pursuant to paragraphs (a) and (b) must be submitted to 3
the district attorney of the county in which the act was committed or 4
to the Office of the Attorney General for possible prosecution of 5
each prisoner who committed the act. 6
9. If a prisoner is charged with committing an act described in 7
paragraph (d) of subsection 1 and a victim or an intended victim of 8
the act was an officer or employee of a prison or law enforcement 9
agency, the prosecuting attorney shall not dismiss the charge in 10
exchange for a plea of guilty, guilty but mentally ill or nolo 11
contendere to a lesser charge or for any other reason unless the 12
prosecuting attorney knows or it is obvious that the charge is not 13
supported by probable cause or cannot be proved at the time of trial. 14
10. The provisions of this section do not apply to a prisoner 15
who is in residential confinement or to a prisoner who commits an 16
act described in subsection 1 if the act: 17
(a) Is otherwise lawful and is authorized by the warden, sheriff, 18
administrator or other person responsible for administering the 19
prison, or his or her designee, and the prisoner performs the act in 20
accordance with the directions or instructions given to the prisoner 21
by that person; 22
(b) Involves the discharge of human excrement or bodily fluid 23
directly from the body of the prisoner and the discharge is the direct 24
result of a temporary or permanent injury, disease or medical 25
condition afflicting the prisoner that prevents the prisoner from 26
having physical control over the discharge of his or her own 27
excrement or bodily fluid; or 28
(c) Constitutes voluntary sexual conduct with another person in 29
violation of the provisions of NRS 212.187. 30
Sec. 14. NRS 232.320 is hereby amended to read as follows: 31
232.320 1. The Director: 32
(a) Shall appoint, with the consent of the Governor, 33
administrators of the divisions of the Department, who are 34
respectively designated as follows: 35
(1) The Administrator of the Aging and Disability Services 36
Division; 37
(2) The Administrator of the Division of Welfare and 38
Supportive Services; 39
(3) The Administrator of the Division of Child and Family 40
Services; 41
(4) The Administrator of the Division of Health Care 42
Financing and Policy; and 43
(5) The Administrator of the Division of Public and 44
Behavioral Health. 45
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(b) Shall administer, through the divisions of the Department, 1
the provisions of chapters 63, 424, 425, 427A, 432A to 442, 2
inclusive, 446 to 450, inclusive, 458A and 656A of NRS, NRS 3
127.220 to 127.310, inclusive, 422.001 to 422.410, inclusive, and 4
sections 20, 21 and 22 of this act, 422.580, 432.010 to 432.133, 5
inclusive, 432B.6201 to 432B.626, inclusive, 444.002 to 444.430, 6
inclusive, and 445A.010 to 445A.055, inclusive, and all other 7
provisions of law relating to the functions of the divisions of the 8
Department, but is not responsible for the clinical activities of the 9
Division of Public and Behavioral Health or the professional line 10
activities of the other divisions. 11
(c) Shall administer any state program for persons with 12
developmental disabilities established pursuant to the 13
Developmental Disabilities Assistance and Bill of Rights Act of 14
2000, 42 U.S.C. §§ 15001 et seq. 15
(d) Shall, after considering advice from agencies of local 16
governments and nonprofit organizations which provide social 17
services, adopt a master plan for the provision of human services in 18
this State. The Director shall revise the plan biennially and deliver a 19
copy of the plan to the Governor and the Legislature at the 20
beginning of each regular session. The plan must: 21
(1) Identify and assess the plans and programs of the 22
Department for the provision of human services, and any 23
duplication of those services by federal, state and local agencies; 24
(2) Set forth priorities for the provision of those services; 25
(3) Provide for communication and the coordination of those 26
services among nonprofit organizations, agencies of local 27
government, the State and the Federal Government; 28
(4) Identify the sources of funding for services provided by 29
the Department and the allocation of that funding; 30
(5) Set forth sufficient information to assist the Department 31
in providing those services and in the planning and budgeting for the 32
future provision of those services; and 33
(6) Contain any other information necessary for the 34
Department to communicate effectively with the Federal 35
Government concerning demographic trends, formulas for the 36
distribution of federal money and any need for the modification of 37
programs administered by the Department. 38
(e) May, by regulation, require nonprofit organizations and state 39
and local governmental agencies to provide information regarding 40
the programs of those organizations and agencies, excluding 41
detailed information relating to their budgets and payrolls, which the 42
Director deems necessary for the performance of the duties imposed 43
upon him or her pursuant to this section. 44
(f) Has such other powers and duties as are provided by law. 45
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2. Notwithstanding any other provision of law, the Director, or 1
the Director’s designee, is responsible for appointing and removing 2
subordinate officers and employees of the Department. 3
Sec. 15. NRS 287.010 is hereby amended to read as follows: 4
287.010 1. The governing body of any county, school 5
district, municipal corporation, political subdivision, public 6
corporation or other local governmental agency of the State of 7
Nevada may: 8
(a) Adopt and carry into effect a system of group life, accident 9
or health insurance, or any combination thereof, for the benefit of its 10
officers and employees, and the dependents of officers and 11
employees who elect to accept the insurance and who, where 12
necessary, have authorized the governing body to make deductions 13
from their compensation for the payment of premiums on the 14
insurance. 15
(b) Purchase group policies of life, accident or health insurance, 16
or any combination thereof, for the benefit of such officers and 17
employees, and the dependents of such officers and employees, as 18
have authorized the purchase, from insurance companies authorized 19
to transact the business of such insurance in the State of Nevada, 20
and, where necessary, deduct from the compensation of officers and 21
employees the premiums upon insurance and pay the deductions 22
upon the premiums. 23
(c) Provide group life, accident or health coverage through a 24
self-insurance reserve fund and, where necessary, deduct 25
contributions to the maintenance of the fund from the compensation 26
of officers and employees and pay the deductions into the fund. The 27
money accumulated for this purpose through deductions from the 28
compensation of officers and employees and contributions of the 29
governing body must be maintained as an internal service fund as 30
defined by NRS 354.543. The money must be deposited in a state or 31
national bank or credit union authorized to transact business in the 32
State of Nevada. Any independent administrator of a fund created 33
under this section is subject to the licensing requirements of chapter 34
683A of NRS, and must be a resident of this State. Any contract 35
with an independent administrator must be approved by the 36
Commissioner of Insurance as to the reasonableness of 37
administrative charges in relation to contributions collected and 38
benefits provided. The provisions of NRS 686A.135, 687B.352, 39
687B.408, 687B.723, 687B.725, 689B.030 to 689B.050, inclusive, 40
and sections 42, 43 and 44 of this act, 689B.265, 689B.287 and 41
689B.500 apply to coverage provided pursuant to this paragraph, 42
except that the provisions of NRS 689B.0378, 689B.03785 and 43
689B.500 only apply to coverage for active officers and employees 44
– 20 –
- *SB439*
of the governing body, or the dependents of such officers and 1
employees. 2
(d) Defray part or all of the cost of maintenance of a self-3
insurance fund or of the premiums upon insurance. The money for 4
contributions must be budgeted for in accordance with the laws 5
governing the county, school district, municipal corporation, 6
political subdivision, public corporation or other local governmental 7
agency of the State of Nevada. 8
2. If a school district offers group insurance to its officers and 9
employees pursuant to this section, members of the board of trustees 10
of the school district must not be excluded from participating in the 11
group insurance. If the amount of the deductions from compensation 12
required to pay for the group insurance exceeds the compensation to 13
which a trustee is entitled, the difference must be paid by the trustee. 14
3. In any county in which a legal services organization exists, 15
the governing body of the county, or of any school district, 16
municipal corporation, political subdivision, public corporation or 17
other local governmental agency of the State of Nevada in the 18
county, may enter into a contract with the legal services 19
organization pursuant to which the officers and employees of the 20
legal services organization, and the dependents of those officers and 21
employees, are eligible for any life, accident or health insurance 22
provided pursuant to this section to the officers and employees, and 23
the dependents of the officers and employees, of the county, school 24
district, municipal corporation, political subdivision, public 25
corporation or other local governmental agency. 26
4. If a contract is entered into pursuant to subsection 3, the 27
officers and employees of the legal services organization: 28
(a) Shall be deemed, solely for the purposes of this section, to be 29
officers and employees of the county, school district, municipal 30
corporation, political subdivision, public corporation or other local 31
governmental agency with which the legal services organization has 32
contracted; and 33
(b) Must be required by the contract to pay the premiums or 34
contributions for all insurance which they elect to accept or of which 35
they authorize the purchase. 36
5. A contract that is entered into pursuant to subsection 3: 37
(a) Must be submitted to the Commissioner of Insurance for 38
approval not less than 30 days before the date on which the contract 39
is to become effective. 40
(b) Does not become effective unless approved by the 41
Commissioner. 42
(c) Shall be deemed to be approved if not disapproved by the 43
Commissioner within 30 days after its submission. 44
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6. As used in this section, “legal services organization” means 1
an organization that operates a program for legal aid and receives 2
money pursuant to NRS 19.031. 3
Sec. 16. NRS 287.04335 is hereby amended to read as 4
follows: 5
287.04335 If the Board provides health insurance through a 6
plan of self-insurance, it shall comply with the provisions of NRS 7
686A.135, 687B.352, 687B.409, 687B.723, 687B.725, 689B.0353, 8
689B.255, 695C.1723, 695G.150, 695G.155, 695G.160, 695G.162, 9
695G.1635, 695G.164, 695G.1645, 695G.1665, 695G.167, 10
695G.1675, 695G.170 to 695G.174, inclusive, and sections 71 and 11
72 of this act, 695G.176, 695G.177, 695G.200 to 695G.230, 12
inclusive, 695G.241 to 695G.310, inclusive, and 695G.405 [,] and 13
section 73 of this act in the same manner as an insurer that is 14
licensed pursuant to title 57 of NRS is required to comply with those 15
provisions. 16
Sec. 17. NRS 389.036 is hereby amended to read as follows: 17
389.036 1. The board of trustees of a school district shall 18
[establish] : 19
(a) Establish a course or unit of a course of [: 20
(a) Factual] evidence-based, factual instruction [concerning the 21
human immunodeficiency virus; and 22
(b) Instruction on the human reproductive system, related 23
communicable diseases and sexual responsibility. 24
2.] in sexuality education. The course of instruction must 25
comply with the standards of content and performance for a 26
course of study in health established by the Council to Establish 27
Academic Standards for Public Schools pursuant to NRS 389.520 28
and must be appropriate for the ages of the pupils who receive the 29
instruction. The course must include, without limitation, 30
instruction concerning: 31
(1) Reproductive and sexual anatomy and physiology, 32
including, without limitation, biological, psychosocial and 33
emotional changes that accompany maturation; 34
(2) Puberty, pregnancy, parenting, body image and gender 35
stereotypes; 36
(3) The human immunodeficiency virus and other sexually 37
transmitted infections and related communicable diseases; 38
(4) The benefits, potential side effects and proper use of 39
methods approved by the United States Food and Drug 40
Administration for preventing pregnancy and sexually transmitted 41
infections; 42
(5) The ways in which the use of alcohol and drugs affect 43
responsible decision making; 44
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(6) The impact of media and peers on the thoughts, feelings 1
and behaviors of pupils related to sexuality; 2
(7) How to identify, prevent and respond to domestic 3
violence, sexual abuse and sexual assault, including, without 4
limitation, medical and legal resources and counseling for 5
survivors of such crimes; 6
(8) Statutes related to age of consent and statutory rape, 7
including, without limitation, NRS 200.366, 200.727, 201.230, 8
201.540 and 201.550, and preventing statutory rape; 9
(9) Statutes related to the transmission and possession of 10
sexually explicit images, including, without limitation, NRS 11
200.604, 200.727, 200.730 and 200.780, and avoiding participation 12
in such acts and exploitation of others through the creation and 13
transmission of such images over the Internet or in any other 14
manner; and 15
(10) The manner in which to locate and access reproductive 16
health services, including, without limitation, obtaining 17
contraceptives, barrier methods, cancer screenings and testing for 18
and the treatment of sexually transmitted infections; and 19
(b) Periodically revise the content of the course or unit of a 20
course of instruction established pursuant to paragraph (a) as 21
necessary to ensure that the content is current, appropriate for the 22
ages of the pupils and, as applicable, medically accurate. 23
2. The course or unit of a course established pursuant to 24
subsection 1 must: 25
(a) Use instructional methods and materials that promote the 26
inclusion and acceptance of pupils regardless of race, gender, 27
gender identity or expression, religion, sexual orientation, ethnic 28
or cultural background or disability; 29
(b) Promote the development of skills, including, without 30
limitation, setting goals that are needed to make responsible 31
decisions about sexuality and sexual behavior throughout life; 32
(c) Be designed to provide equally meaningful instruction to 33
pupils regardless of their level of sexual experience or whether 34
they are currently engaging in sexual activity; 35
(d) Emphasize that abstaining from sexual activity is the only 36
way to ensure the avoidance of pregnancy and sexually 37
transmitted infections; 38
(e) Emphasize the use of interpersonal skills to develop healthy 39
relationships, including, without limitation, friendships, marriage 40
and romantic and familial relationships; and 41
(f) Involve the parents or guardians of pupils in the instruction 42
provided and encourage pupils to communicate with their families 43
concerning issues relating to sexuality. 44
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3. Each board of trustees shall appoint an advisory committee 1
consisting of: 2
(a) Five parents of children who attend schools in the district; 3
and 4
(b) Four representatives, one from each of four of the following 5
professions or occupations: 6
(1) Medicine or nursing; 7
(2) Counseling; 8
(3) Religion; 9
(4) Pupils who attend schools in the district; or 10
(5) Teaching. 11
[ This] 12
4. The advisory committee appointed pursuant to subsection 3 13
shall advise the district concerning the content of and materials to be 14
used in a course or unit of a course of instruction established 15
pursuant to this section, and the recommended ages of the pupils to 16
whom the course or unit is offered. The final decision on these 17
matters must be that of the board of trustees. 18
[3.] 5. The subjects of the [courses] course or unit of a course 19
of instruction may be taught only by a teacher , [or] school nurse 20
[whose qualifications have] , provider of health care or other 21
person who has been [previously] approved by the board of 22
trustees. The board of trustees may approve a person for the 23
purposes of this subsection if it determines that the person has 24
demonstrated competency in the applicable subject and the use of 25
the required instructional materials. 26
[4.] 6. The parent or guardian of each pupil to whom a course 27
or unit of a course of instruction established pursuant to this 28
section is offered must first be furnished written notice that the 29
course or unit of a course will be offered. The notice must be given 30
in the usual manner used by the local district to transmit written 31
material to parents, and must contain a form for the signature of the 32
parent or guardian of the pupil consenting to the pupil’s attendance. 33
Upon receipt of the written consent of the parent or guardian, the 34
pupil may attend the course [.] or unit of a course. If the written 35
consent of the parent or guardian is not received, the pupil must be 36
excused from such attendance without any penalty as to credits or 37
academic standing. Any course or unit of a course offered pursuant 38
to this section is not a requirement for graduation. 39
[5.] 7. All instructional materials to be used in a course or unit 40
of a course of instruction established pursuant to this section must 41
be available for inspection by parents or guardians of pupils at 42
reasonable times and locations before the course is taught, and 43
appropriate written notice of the availability of the material must be 44
furnished to all parents and guardians. 45
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8. As used in this section, “provider of health care” has the 1
meaning ascribed to it in NRS 629.031. 2
Sec. 18. NRS 389.520 is hereby amended to read as follows: 3
389.520 1. The Council shall: 4
(a) Establish standards of content and performance, including, 5
without limitation, a prescription of the resulting level of 6
achievement, for the grade levels set forth in subsection 5, based 7
upon the content of each course, that is expected of pupils for the 8
following courses of study: 9
(1) English language arts; 10
(2) Mathematics; 11
(3) Science; 12
(4) Social studies, which includes only the subjects of 13
history, geography, economics, civics, financial literacy and 14
multicultural education; 15
(5) The arts; 16
(6) Computer education and technology, which includes 17
computer science and computational thinking; 18
(7) Health; 19
(8) Physical education; and 20
(9) A foreign or world language. 21
(b) Establish a schedule for the periodic review and, if 22
necessary, revision of the standards of content and performance. The 23
review must include, without limitation, the review required 24
pursuant to NRS 390.115 of the results of pupils on the 25
examinations administered pursuant to NRS 390.105. 26
(c) Assign priorities to the standards of content and performance 27
relative to importance and degree of emphasis and revise the 28
standards, if necessary, based upon the priorities. 29
2. The standards for computer education and technology must 30
include a policy for the ethical, safe and secure use of computers 31
and other electronic devices. The policy must include, without 32
limitation: 33
(a) The ethical use of computers and other electronic devices, 34
including, without limitation: 35
(1) Rules of conduct for the acceptable use of the Internet 36
and other electronic devices; and 37
(2) Methods to ensure the prevention of: 38
(I) Cyber-bullying; 39
(II) Plagiarism; and 40
(III) The theft of information or data in an electronic 41
form; 42
(b) The safe use of computers and other electronic devices, 43
including, without limitation, methods to: 44
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(1) Avoid cyber-bullying and other unwanted electronic 1
communication, including, without limitation, communication with 2
on-line predators; 3
(2) Recognize when an on-line electronic communication is 4
dangerous or potentially dangerous; and 5
(3) Report a dangerous or potentially dangerous on-line 6
electronic communication to the appropriate school personnel; 7
(c) The secure use of computers and other electronic devices, 8
including, without limitation: 9
(1) Methods to maintain the security of personal identifying 10
information and financial information, including, without limitation, 11
identifying unsolicited electronic communication which is sent for 12
the purpose of obtaining such personal and financial information for 13
an unlawful purpose; 14
(2) The necessity for secure passwords or other unique 15
identifiers; 16
(3) The effects of a computer contaminant; 17
(4) Methods to identify unsolicited commercial material; and 18
(5) The dangers associated with social networking Internet 19
sites; and 20
(d) A designation of the level of detail of instruction as 21
appropriate for the grade level of pupils who receive the instruction. 22
3. The standards for social studies must include multicultural 23
education, including, without limitation, information relating to 24
contributions made by men and women from various racial and 25
ethnic backgrounds. The Council shall consult with members of the 26
community who represent the racial and ethnic diversity of this 27
State in developing such standards. 28
4. The standards for health must include [mental] : 29
(a) Mental health and the relationship between mental health 30
and physical health. 31
(b) Standards for sexuality education. The standards for other 32
courses may include topics relating to sexuality education where 33
appropriate. 34
5. The Council shall establish standards of content and 35
performance for each grade level in kindergarten and grades 1 to 8, 36
inclusive, for English language arts and mathematics. The Council 37
shall establish standards of content and performance for the grade 38
levels selected by the Council for the other courses of study 39
prescribed in subsection 1. 40
6. The Council shall forward to the State Board the standards 41
of content and performance established by the Council for each 42
course of study. The State Board shall: 43
(a) Adopt the standards for each course of study, as submitted 44
by the Council; or 45
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(b) If the State Board objects to the standards for a course of 1
study or a particular grade level for a course of study, return those 2
standards to the Council with a written explanation setting forth the 3
reason for the objection. 4
7. If the State Board returns to the Council the standards of 5
content and performance for a course of study or a grade level, the 6
Council shall: 7
(a) Consider the objection provided by the State Board and 8
determine whether to revise the standards based upon the objection; 9
and 10
(b) Return the standards or the revised standards, as applicable, 11
to the State Board. 12
The State Board shall adopt the standards of content and 13
performance or the revised standards, as applicable. 14
8. The Council shall work in cooperation with the State Board 15
to prescribe the examinations required by NRS 390.105. 16
9. As used in this section: 17
(a) “Computer contaminant” has the meaning ascribed to it in 18
NRS 205.4737. 19
(b) “Cyber-bullying” has the meaning ascribed to it in 20
NRS 388.123. 21
(c) “Electronic communication” has the meaning ascribed to it 22
in NRS 388.124. 23
Sec. 19. Chapter 422 of NRS is hereby amended by adding 24
thereto the provisions set forth as sections 20 and 21 of this act. 25
Sec. 20. 1. The Director shall include in the State Plan for 26
Medicaid a requirement that the State pay the nonfederal share of 27
expenses for any service for the treatment of substance use 28
disorder provided by a provider of primary care if the service is 29
included in the State Plan when provided by a specialist and: 30
(a) The service is within the scope of practice of the provider of 31
primary care; or 32
(b) The provider of primary care is capable of providing the 33
service safely and effectively in consultation with a specialist and 34
the provider engages in such consultation. 35
2. As used in this section, “primary care” means the practice 36
of family medicine, pediatrics, internal medicine, obstetrics and 37
gynecology and midwifery. 38
Sec. 21. When calculating the amount of the contribution by 39
a recipient of Medicaid towards a deductible, copayment, 40
coinsurance or any other cost-sharing requirement for 41
prescription drugs, the Department or any pharmacy benefit 42
manager or health maintenance organization that manages 43
pharmacy benefits for the Department pursuant to NRS 422.4053 44
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must include the amount paid by the recipient or another person 1
or entity on behalf of the recipient for a prescription drug: 2
1. That has no generic equivalent; 3
2. For which the Department, pharmacy benefit manager or 4
health maintenance organization has imposed a requirement for 5
prior authorization or a step therapy protocol pursuant to 6
NRS 422.403; 7
3. Which is only covered under the State Plan for Medicaid 8
after the recipient: 9
(a) Obtains an exception to a general policy of the 10
Department, pharmacy benefit manager or health maintenance 11
organization; or 12
(b) Wins an appeal of such a policy; or 13
4. That is prescribed to: 14
(a) Prevent the acquisition of human immunodeficiency virus; 15
(b) Treat human immunodeficiency virus or hepatitis C; 16
(c) Provide medication-assisted treatment for opioid use 17
disorder; or 18
(d) Support safe withdrawal from substance use disorder. 19
Sec. 22. NRS 422.27173 is hereby amended to read as 20
follows: 21
422.27173 The Director shall include in the State Plan for 22
Medicaid a requirement that the State must pay the nonfederal share 23
of expenditures incurred for : 24
1. Testing for and the treatment and prevention of sexually 25
transmitted diseases, including, without limitation, Chlamydia 26
trachomatis, gonorrhea, syphilis, human immunodeficiency virus 27
and hepatitis B and C, for all recipients of Medicaid, regardless of 28
age. Services covered pursuant to this section must include, 29
without limitation, the examination of a pregnant woman for the 30
discovery of: 31
[1.] (a) Chlamydia trachomatis, gonorrhea, hepatitis B and 32
hepatitis C in accordance with NRS 442.013. 33
[2.] (b) Syphilis in accordance with NRS 442.010. 34
2. Condoms for recipients of Medicaid who are 13 years of 35
age or older. 36
Sec. 23. NRS 422.27235 is hereby amended to read as 37
follows: 38
422.27235 1. The Director shall include in the State Plan for 39
Medicaid a requirement that the State pay the nonfederal share of 40
expenditures incurred for: 41
[1.] (a) Any laboratory testing that is necessary for therapy that 42
uses a drug approved by the United States Food and Drug 43
Administration for preventing the acquisition of human 44
immunodeficiency virus . [; and] 45
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[2.] (b) The services of a pharmacist described in NRS 1
639.28085. The State must provide reimbursement for such services 2
at a rate equal to the rate of reimbursement provided to a physician, 3
physician assistant or advanced practice registered nurse for similar 4
services. 5
(c) Any service to test for, prevent or treat human 6
immunodeficiency virus or hepatitis C provided by a provider of 7
primary care if the service is covered when provided by a specialist 8
and: 9
(1) The service is within the scope of practice of the 10
provider of primary care; or 11
(2) The provider of primary care is capable of providing the 12
service safely and effectively in consultation with a specialist and 13
the provider engages in such consultation. 14
2. The Director shall include in the State Plan for Medicaid a 15
requirement that the State reimburse an advanced practice 16
registered nurse or a physician assistant for any service to test for, 17
prevent or treat human immunodeficiency virus or hepatitis C at a 18
rate equal to the rate of reimbursement provided to a physician for 19
similar services. 20
3. As used in this section, “primary care” means the practice 21
of family medicine, pediatrics, internal medicine, obstetrics and 22
gynecology and midwifery. 23
Sec. 24. NRS 422.401 is hereby amended to read as follows: 24
422.401 As used in NRS 422.401 to 422.406, inclusive, and 25
section 21 of this act, unless the context otherwise requires, the 26
words and terms defined in NRS 422.4015 to 422.4024, inclusive, 27
and section 21 of this act have the meanings ascribed to them in 28
those sections. 29
Sec. 25. NRS 422.4025 is hereby amended to read as follows: 30
422.4025 1. The Department shall: 31
(a) By regulation, develop a list of preferred prescription drugs 32
to be used for the Medicaid program and the Children’s Health 33
Insurance Program, and each public or nonprofit health benefit plan 34
that elects to use the list of preferred prescription drugs as its 35
formulary pursuant to NRS 287.012, 287.0433 or 687B.407; and 36
(b) Negotiate and enter into agreements to purchase the drugs 37
included on the list of preferred prescription drugs on behalf of the 38
health benefit plans described in paragraph (a) or enter into a 39
contract pursuant to NRS 422.4053 with a pharmacy benefit 40
manager, health maintenance organization or one or more public or 41
private entities in this State, the District of Columbia or other states 42
or territories of the United States, as appropriate, to negotiate such 43
agreements. 44
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2. The Department shall, by regulation, establish a list of 1
prescription drugs which must be excluded from any restrictions that 2
are imposed by the Medicaid program on drugs that are on the list of 3
preferred prescription drugs established pursuant to subsection 1. 4
The list established pursuant to this subsection must include, 5
without limitation: 6
(a) Prescription drugs that are prescribed for the treatment of the 7
human immunodeficiency virus, including, without limitation, 8
antiretroviral medications; 9
(b) Antirejection medications for organ transplants; 10
(c) Antihemophilic medications; [and] 11
(d) Any prescription drug described in paragraph (b) of 12
subsection 4; and 13
(e) Any prescription drug which the Board identifies as 14
appropriate for exclusion from any restrictions that are imposed by 15
the Medicaid program on drugs that are on the list of preferred 16
prescription drugs. 17
3. The regulations must provide that the Board makes the final 18
determination of: 19
(a) Whether a class of therapeutic prescription drugs is included 20
on the list of preferred prescription drugs and is excluded from any 21
restrictions that are imposed by the Medicaid program on drugs that 22
are on the list of preferred prescription drugs; 23
(b) Which therapeutically equivalent prescription drugs will be 24
reviewed for inclusion on the list of preferred prescription drugs and 25
for exclusion from any restrictions that are imposed by the Medicaid 26
program on drugs that are on the list of preferred prescription drugs; 27
and 28
(c) Which prescription drugs should be excluded from any 29
restrictions that are imposed by the Medicaid program on drugs that 30
are on the list of preferred prescription drugs based on continuity of 31
care concerning a specific diagnosis, condition, class of therapeutic 32
prescription drugs or medical specialty. 33
4. The list of preferred prescription drugs established pursuant 34
to subsection 1 must include, without limitation: 35
(a) Any prescription drug determined by the Board to be 36
essential for treating sickle cell disease and its variants; and 37
(b) [Prescription] All prescription drugs approved by the United 38
States Food and Drug Administration to [prevent] : 39
(1) Prevent the acquisition of human immunodeficiency 40
virus [.] or hepatitis C or treat those diseases. 41
(2) Provide medication-assisted treatment for opioid use 42
disorder, including, without limitation, buprenorphine, methadone 43
and naltrexone. 44
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(3) Support safe withdrawal from substance use disorder, 1
including, without limitation, lofexidine. 2
5. The regulations must provide that each new pharmaceutical 3
product and each existing pharmaceutical product for which there is 4
new clinical evidence supporting its inclusion on the list of preferred 5
prescription drugs must be made available pursuant to the Medicaid 6
program with prior authorization until the Board reviews the product 7
or the evidence. 8
6. On or before February 1 of each year, the Department shall: 9
(a) Compile a report concerning the agreements negotiated 10
pursuant to paragraph (b) of subsection 1 and contracts entered into 11
pursuant to NRS 422.4053 which must include, without limitation, 12
the financial effects of obtaining prescription drugs through those 13
agreements and contracts, in total and aggregated separately for 14
agreements negotiated by the Department, contracts with a 15
pharmacy benefit manager, contracts with a health maintenance 16
organization and contracts with public and private entities from this 17
State, the District of Columbia and other states and territories of the 18
United States; and 19
(b) Post the report on an Internet website maintained by the 20
Department and submit the report to the Director of the Legislative 21
Counsel Bureau for transmittal to: 22
(1) In odd-numbered years, the Legislature; or 23
(2) In even-numbered years, the Legislative Commission. 24
Sec. 26. NRS 608.156 is hereby amended to read as follows: 25
608.156 1. [If] In addition to any benefits required by NRS 26
608.1555, an employer provides health benefits for his or her 27
employees, the employer shall provide benefits for the expenses for 28
the treatment of alcohol and substance use disorders. The annual 29
benefits provided by the employer must [consist of:] include, 30
without limitation: 31
(a) Treatment for withdrawal from the physiological effects of 32
alcohol or drugs, with a maximum benefit of $1,500 per calendar 33
year. 34
(b) Treatment for a patient admitted to a facility, with a 35
maximum benefit of $9,000 per calendar year. 36
(c) Counseling for a person, group or family who is not admitted 37
to a facility, with a maximum benefit of $2,500 per calendar year. 38
2. The maximum amount which may be paid in the lifetime of 39
the insured for any combination of the treatments listed in 40
subsection 1 is $39,000. 41
3. Except as otherwise provided in NRS 687B.409, these 42
benefits must be paid in the same manner as benefits for any other 43
illness covered by the employer are paid. 44
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4. The employee is entitled to these benefits if treatment is 1
received in any: 2
(a) Program for the treatment of alcohol or substance use 3
disorders which is certified by the Division of Public and Behavioral 4
Health of the Department of Health and Human Services. 5
(b) Hospital or other medical facility or facility for the 6
dependent which is licensed by the Division of Public and 7
Behavioral Health of the Department of Health and Human 8
Services, is accredited by The Joint Commission or CARF 9
International and provides a program for the treatment of alcohol or 10
substance use disorders as part of its accredited activities. 11
Sec. 27. NRS 629.093 is hereby amended to read as follows: 12
629.093 Unless a specific statute or regulation requires or 13
authorizes a greater number of hours, a provider of health care may 14
use credit earned for continuing education relating to Alzheimer’s 15
disease or the stigma, discrimination and unrecognized bias 16
toward persons who have acquired or are at a high risk of 17
acquiring human immunodeficiency virus in place of not more 18
than 2 hours each year of the continuing education that the provider 19
of health care is required to complete, other than any continuing 20
education relating to ethics that the provider of health care is 21
required to complete. 22
Sec. 28. NRS 630.253 is hereby amended to read as follows: 23
630.253 1. The Board shall, as a prerequisite for the: 24
(a) Renewal of a license as a physician assistant; or 25
(b) Biennial registration of the holder of a license to practice 26
medicine, 27
require each holder to submit evidence of compliance with the 28
requirements for continuing education as set forth in regulations 29
adopted by the Board. 30
2. These requirements: 31
(a) May provide for the completion of one or more courses of 32
instruction relating to risk management in the performance of 33
medical services. 34
(b) Must provide for the completion of a course of instruction, 35
within 2 years after initial licensure, relating to the medical 36
consequences of an act of terrorism that involves the use of a 37
weapon of mass destruction. The course must provide at least 4 38
hours of instruction that includes instruction in the following 39
subjects: 40
(1) An overview of acts of terrorism and weapons of mass 41
destruction; 42
(2) Personal protective equipment required for acts of 43
terrorism; 44
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(3) Common symptoms and methods of treatment associated 1
with exposure to, or injuries caused by, chemical, biological, 2
radioactive and nuclear agents; 3
(4) Syndromic surveillance and reporting procedures for acts 4
of terrorism that involve biological agents; and 5
(5) An overview of the information available on, and the use 6
of, the Health Alert Network. 7
(c) Must provide for the completion by a holder of a license to 8
practice medicine of a course of instruction within 2 years after 9
initial licensure that provides at least 2 hours of instruction on 10
evidence-based suicide prevention and awareness as described in 11
subsection 6. 12
(d) Must provide for the completion of at least 2 hours of 13
training in the screening, brief intervention and referral to treatment 14
approach to substance use disorder within 2 years after initial 15
licensure. 16
(e) Must provide for the biennial completion by each 17
psychiatrist and each physician assistant practicing under the 18
supervision of a psychiatrist of one or more courses of instruction 19
that provide at least 2 hours of instruction relating to cultural 20
competency and diversity, equity and inclusion. Such instruction: 21
(1) May include the training provided pursuant to NRS 22
449.103, where applicable. 23
(2) Must be based upon a range of research from diverse 24
sources. 25
(3) Must address persons of different cultural backgrounds, 26
including, without limitation: 27
(I) Persons from various gender, racial and ethnic 28
backgrounds; 29
(II) Persons from various religious backgrounds; 30
(III) Lesbian, gay, bisexual, transgender and questioning 31
persons; 32
(IV) Children and senior citizens; 33
(V) Veterans; 34
(VI) Persons with a mental illness; 35
(VII) Persons with an intellectual disability, 36
developmental disability or physical disability; and 37
(VIII) Persons who are part of any other population that a 38
psychiatrist or a physician assistant practicing under the supervision 39
of a psychiatrist may need to better understand, as determined by the 40
Board. 41
(f) Must allow the holder of a license to receive credit toward 42
the total amount of continuing education required by the Board for 43
the completion of a course of instruction relating to genetic 44
counseling and genetic testing. 45
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(g) Must provide for the completion by a physician or 1
physician assistant who provides or supervises the provision of 2
emergency medical services in a hospital or primary care of at 3
least 2 hours of training in the stigma, discrimination and 4
unrecognized bias toward persons who have acquired or are at a 5
high risk of acquiring human immunodeficiency virus within 2 6
years after beginning to provide or supervise the provision of such 7
services or care. 8
3. The Board may determine whether to include in a program 9
of continuing education courses of instruction relating to the 10
medical consequences of an act of terrorism that involves the use of 11
a weapon of mass destruction in addition to the course of instruction 12
required by paragraph (b) of subsection 2. 13
4. The Board shall encourage each holder of a license who 14
treats or cares for persons who are more than 60 years of age to 15
receive, as a portion of their continuing education, education in 16
geriatrics and gerontology, including such topics as: 17
(a) The skills and knowledge that the licensee needs to address 18
aging issues; 19
(b) Approaches to providing health care to older persons, 20
including both didactic and clinical approaches; 21
(c) The biological, behavioral, social and emotional aspects of 22
the aging process; and 23
(d) The importance of maintenance of function and 24
independence for older persons. 25
5. The Board shall encourage each holder of a license to 26
practice medicine to receive, as a portion of his or her continuing 27
education, training concerning methods for educating patients about 28
how to effectively manage medications, including, without 29
limitation, the ability of the patient to request to have the symptom 30
or purpose for which a drug is prescribed included on the label 31
attached to the container of the drug. 32
6. The Board shall require each holder of a license to practice 33
medicine to receive as a portion of his or her continuing education at 34
least 2 hours of instruction every 4 years on evidence-based suicide 35
prevention and awareness, which may include, without limitation, 36
instruction concerning: 37
(a) The skills and knowledge that the licensee needs to detect 38
behaviors that may lead to suicide, including, without limitation, 39
post-traumatic stress disorder; 40
(b) Approaches to engaging other professionals in suicide 41
intervention; and 42
(c) The detection of suicidal thoughts and ideations and the 43
prevention of suicide. 44
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7. The Board shall encourage each holder of a license to 1
practice medicine or as a physician assistant to receive, as a portion 2
of his or her continuing education, training and education in the 3
diagnosis of rare diseases, including, without limitation: 4
(a) Recognizing the symptoms of pediatric cancer; and 5
(b) Interpreting family history to determine whether such 6
symptoms indicate a normal childhood illness or a condition that 7
requires additional examination. 8
8. A holder of a license to practice medicine may not substitute 9
the continuing education credits relating to suicide prevention and 10
awareness required by this section for the purposes of satisfying an 11
equivalent requirement for continuing education in ethics. 12
9. Except as otherwise provided in NRS 630.2535, a holder of 13
a license to practice medicine may substitute not more than 2 hours 14
of continuing education credits in pain management, care for 15
persons with an addictive disorder or the screening, brief 16
intervention and referral to treatment approach to substance use 17
disorder for the purposes of satisfying an equivalent requirement for 18
continuing education in ethics. 19
10. As used in this section: 20
(a) “Act of terrorism” has the meaning ascribed to it in 21
NRS 202.4415. 22
(b) “Biological agent” has the meaning ascribed to it in 23
NRS 202.442. 24
(c) “Chemical agent” has the meaning ascribed to it in 25
NRS 202.4425. 26
(d) “Primary care” means the practice of family medicine, 27
pediatrics, internal medicine, obstetrics and gynecology and 28
midwifery. 29
(e) “Radioactive agent” has the meaning ascribed to it in 30
NRS 202.4437. 31
[(e)] (f) “Weapon of mass destruction” has the meaning 32
ascribed to it in NRS 202.4445. 33
Sec. 29. NRS 632.343 is hereby amended to read as follows: 34
632.343 1. The Board shall not renew any license issued 35
under this chapter until the licensee has submitted proof satisfactory 36
to the Board of completion, during the 2-year period before renewal 37
of the license, of 30 hours in a program of continuing education 38
approved by the Board in accordance with regulations adopted by 39
the Board. Except as otherwise provided in subsection 3, the 40
licensee is exempt from this provision for the first biennial period 41
after graduation from: 42
(a) An accredited school of professional nursing; 43
(b) An accredited school of practical nursing; 44
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(c) An approved school of professional nursing in the process of 1
obtaining accreditation; or 2
(d) An approved school of practical nursing in the process of 3
obtaining accreditation. 4
2. The Board shall review all courses offered to nurses for the 5
completion of the requirement set forth in subsection 1. The Board 6
may approve nursing and other courses which are directly related to 7
the practice of nursing as well as others which bear a reasonable 8
relationship to current developments in the field of nursing or any 9
special area of practice in which a licensee engages. These may 10
include academic studies, workshops, extension studies, home study 11
and other courses. 12
3. The program of continuing education required by subsection 13
1 must include: 14
(a) For a person licensed as an advanced practice registered 15
nurse: 16
(1) A course of instruction to be completed within 2 years 17
after initial licensure that provides at least 2 hours of instruction on 18
suicide prevention and awareness as described in subsection 6. 19
(2) The ability to receive credit toward the total amount of 20
continuing education required by subsection 1 for the completion of 21
a course of instruction relating to genetic counseling and genetic 22
testing. 23
(b) For each person licensed pursuant to this chapter, a course of 24
instruction, to be completed within 2 years after initial licensure, 25
relating to the medical consequences of an act of terrorism that 26
involves the use of a weapon of mass destruction. The course must 27
provide at least 4 hours of instruction that includes instruction in the 28
following subjects: 29
(1) An overview of acts of terrorism and weapons of mass 30
destruction; 31
(2) Personal protective equipment required for acts of 32
terrorism; 33
(3) Common symptoms and methods of treatment associated 34
with exposure to, or injuries caused by, chemical, biological, 35
radioactive and nuclear agents; 36
(4) Syndromic surveillance and reporting procedures for acts 37
of terrorism that involve biological agents; and 38
(5) An overview of the information available on, and the use 39
of, the Health Alert Network. 40
(c) For each person licensed pursuant to this chapter, one or 41
more courses of instruction that provide at least 2 hours of 42
instruction relating to cultural competency and diversity, equity and 43
inclusion to be completed biennially. Such instruction: 44
– 36 –
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(1) May include the training provided pursuant to NRS 1
449.103, where applicable. 2
(2) Must be based upon a range of research from diverse 3
sources. 4
(3) Must address persons of different cultural backgrounds, 5
including, without limitation: 6
(I) Persons from various gender, racial and ethnic 7
backgrounds; 8
(II) Persons from various religious backgrounds; 9
(III) Lesbian, gay, bisexual, transgender and questioning 10
persons; 11
(IV) Children and senior citizens; 12
(V) Veterans; 13
(VI) Persons with a mental illness; 14
(VII) Persons with an intellectual disability, 15
developmental disability or physical disability; and 16
(VIII) Persons who are part of any other population that a 17
person licensed pursuant to this chapter may need to better 18
understand, as determined by the Board. 19
(d) For a person licensed as an advanced practice registered 20
nurse, at least 2 hours of training in the screening, brief intervention 21
and referral to treatment approach to substance use disorder to be 22
completed within 2 years after initial licensure. 23
(e) For each person licensed pursuant to this chapter who 24
provides or supervises the provision of emergency medical services 25
in a hospital or primary care, at least 2 hours of training in the 26
stigma, discrimination and unrecognized bias toward persons who 27
have acquired or are at a high risk of acquiring human 28
immunodeficiency virus to be completed within 2 years after 29
beginning to provide or supervise the provision of such services or 30
care. 31
4. The Board may determine whether to include in a program 32
of continuing education courses of instruction relating to the 33
medical consequences of an act of terrorism that involves the use of 34
a weapon of mass destruction in addition to the course of instruction 35
required by paragraph (b) of subsection 3. 36
5. The Board shall encourage each licensee who treats or cares 37
for persons who are more than 60 years of age to receive, as a 38
portion of their continuing education, education in geriatrics and 39
gerontology, including such topics as: 40
(a) The skills and knowledge that the licensee needs to address 41
aging issues; 42
(b) Approaches to providing health care to older persons, 43
including both didactic and clinical approaches; 44
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(c) The biological, behavioral, social and emotional aspects of 1
the aging process; and 2
(d) The importance of maintenance of function and 3
independence for older persons. 4
6. The Board shall require each person licensed as an advanced 5
practice registered nurse to receive as a portion of his or her 6
continuing education at least 2 hours of instruction every 4 years on 7
evidence-based suicide prevention and awareness or another course 8
of instruction on suicide prevention and awareness that is approved 9
by the Board which the Board has determined to be effective and 10
appropriate. 11
7. The Board shall encourage each person licensed as an 12
advanced practice registered nurse to receive, as a portion of his or 13
her continuing education, training and education in the diagnosis of 14
rare diseases, including, without limitation: 15
(a) Recognizing the symptoms of pediatric cancer; and 16
(b) Interpreting family history to determine whether such 17
symptoms indicate a normal childhood illness or a condition that 18
requires additional examination. 19
8. As used in this section: 20
(a) “Act of terrorism” has the meaning ascribed to it in 21
NRS 202.4415. 22
(b) “Biological agent” has the meaning ascribed to it in 23
NRS 202.442. 24
(c) “Chemical agent” has the meaning ascribed to it in 25
NRS 202.4425. 26
(d) “Primary care” means the practice of family medicine, 27
pediatrics, internal medicine, obstetrics and gynecology and 28
midwifery. 29
(e) “Radioactive agent” has the meaning ascribed to it in 30
NRS 202.4437. 31
[(e)] (f) “Weapon of mass destruction” has the meaning 32
ascribed to it in NRS 202.4445. 33
Sec. 30. NRS 633.471 is hereby amended to read as follows: 34
633.471 1. Except as otherwise provided in subsection [14] 35
15 and NRS 633.491, every holder of a license, except a physician 36
assistant, issued under this chapter, except a temporary or a special 37
license, may renew the license on or before January 1 of each 38
calendar year after its issuance by: 39
(a) Applying for renewal on forms provided by the Board; 40
(b) Paying the annual license renewal fee specified in this 41
chapter; 42
(c) Submitting a list of all actions filed or claims submitted to 43
arbitration or mediation for malpractice or negligence against the 44
holder during the previous year; 45
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(d) Subject to subsection [13,] 14, submitting evidence to the 1
Board that in the year preceding the application for renewal the 2
holder has attended courses or programs of continuing education 3
approved by the Board in accordance with regulations adopted by 4
the Board totaling a number of hours established by the Board 5
which must not be less than 35 hours nor more than that set in the 6
requirements for continuing medical education of the American 7
Osteopathic Association; and 8
(e) Submitting all information required to complete the renewal. 9
2. The Secretary of the Board shall notify each licensee of the 10
requirements for renewal not less than 30 days before the date of 11
renewal. 12
3. The Board shall request submission of verified evidence of 13
completion of the required number of hours of continuing medical 14
education annually from no fewer than one-third of the applicants 15
for renewal of a license to practice osteopathic medicine or a license 16
to practice as a physician assistant. Subject to subsection [13,] 14, 17
upon a request from the Board, an applicant for renewal of a license 18
to practice osteopathic medicine or a license to practice as a 19
physician assistant shall submit verified evidence satisfactory to the 20
Board that in the year preceding the application for renewal the 21
applicant attended courses or programs of continuing medical 22
education approved by the Board totaling the number of hours 23
established by the Board. 24
4. The Board shall require each holder of a license to practice 25
osteopathic medicine to complete a course of instruction within 2 26
years after initial licensure that provides at least 2 hours of 27
instruction on evidence-based suicide prevention and awareness as 28
described in subsection 9. 29
5. The Board shall encourage each holder of a license to 30
practice osteopathic medicine to receive, as a portion of his or her 31
continuing education, training concerning methods for educating 32
patients about how to effectively manage medications, including, 33
without limitation, the ability of the patient to request to have the 34
symptom or purpose for which a drug is prescribed included on the 35
label attached to the container of the drug. 36
6. The Board shall encourage each holder of a license to 37
practice osteopathic medicine or as a physician assistant to receive, 38
as a portion of his or her continuing education, training and 39
education in the diagnosis of rare diseases, including, without 40
limitation: 41
(a) Recognizing the symptoms of pediatric cancer; and 42
(b) Interpreting family history to determine whether such 43
symptoms indicate a normal childhood illness or a condition that 44
requires additional examination. 45
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7. The Board shall require, as part of the continuing education 1
requirements approved by the Board, the biennial completion by a 2
holder of a license to practice osteopathic medicine of at least 2 3
hours of continuing education credits in ethics, pain management, 4
care of persons with addictive disorders or the screening, brief 5
intervention and referral to treatment approach to substance use 6
disorder. 7
8. The continuing education requirements approved by the 8
Board must allow the holder of a license as an osteopathic physician 9
or physician assistant to receive credit toward the total amount of 10
continuing education required by the Board for the completion of a 11
course of instruction relating to genetic counseling and genetic 12
testing. 13
9. The Board shall require each holder of a license to practice 14
osteopathic medicine to receive as a portion of his or her continuing 15
education at least 2 hours of instruction every 4 years on evidence-16
based suicide prevention and awareness which may include, without 17
limitation, instruction concerning: 18
(a) The skills and knowledge that the licensee needs to detect 19
behaviors that may lead to suicide, including, without limitation, 20
post-traumatic stress disorder; 21
(b) Approaches to engaging other professionals in suicide 22
intervention; and 23
(c) The detection of suicidal thoughts and ideations and the 24
prevention of suicide. 25
10. A holder of a license to practice osteopathic medicine may 26
not substitute the continuing education credits relating to suicide 27
prevention and awareness required by this section for the purposes 28
of satisfying an equivalent requirement for continuing education in 29
ethics. 30
11. The Board shall require each holder of a license to practice 31
osteopathic medicine to complete at least 2 hours of training in the 32
screening, brief intervention and referral to treatment approach to 33
substance use disorder within 2 years after initial licensure. 34
12. The Board shall require each psychiatrist or a physician 35
assistant practicing under the supervision of a psychiatrist to 36
biennially complete one or more courses of instruction that provide 37
at least 2 hours of instruction relating to cultural competency and 38
diversity, equity and inclusion. Such instruction: 39
(a) May include the training provided pursuant to NRS 449.103, 40
where applicable. 41
(b) Must be based upon a range of research from diverse 42
sources. 43
(c) Must address persons of different cultural backgrounds, 44
including, without limitation: 45
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(1) Persons from various gender, racial and ethnic 1
backgrounds; 2
(2) Persons from various religious backgrounds; 3
(3) Lesbian, gay, bisexual, transgender and questioning 4
persons; 5
(4) Children and senior citizens; 6
(5) Veterans; 7
(6) Persons with a mental illness; 8
(7) Persons with an intellectual disability, developmental 9
disability or physical disability; and 10
(8) Persons who are part of any other population that a 11
psychiatrist or physician assistant practicing under the supervision 12
of a psychiatrist may need to better understand, as determined by the 13
Board. 14
13. The Board shall require each holder of a license to 15
practice osteopathic medicine or as a physician assistant who 16
provides or supervises the provision of emergency medical services 17
in a hospital or primary care to complete at least 2 hours of 18
training in the stigma, discrimination and unrecognized bias 19
toward persons who have acquired or are at a high risk of 20
acquiring human immunodeficiency virus within 2 years after 21
beginning to provide or supervise the provision of such services or 22
care. 23
14. The Board shall not require a physician assistant to receive 24
or maintain certification by the National Commission on 25
Certification of Physician Assistants, or its successor organization, 26
or by any other nationally recognized organization for the 27
accreditation of physician assistants to satisfy any continuing 28
education requirement pursuant to paragraph (d) of subsection 1 and 29
subsection 3. 30
[14.] 15. Members of the Armed Forces of the United States 31
and the United States Public Health Service are exempt from 32
payment of the annual license renewal fee during their active duty 33
status. 34
16. As used in this section, “primary care” means the practice 35
of family medicine, pediatrics, internal medicine, obstetrics and 36
gynecology and midwifery. 37
Sec. 31. NRS 687B.225 is hereby amended to read as follows: 38
687B.225 1. Except as otherwise provided in NRS 39
689A.0405, 689A.0412, 689A.0413, 689A.0437, 689A.044, 40
689A.0445, 689B.031, 689B.0312, 689B.0313, 689B.0315, 41
689B.0317, 689B.0374, 689C.1671, 689C.1675, 695A.1843, 42
695A.1856, 695B.1912, 695B.1913, 695B.1914, 695B.1924, 43
695B.1925, 695B.1942, 695C.1713, 695C.1735, 695C.1737, 44
695C.1743, 695C.1745, 695C.1751, 695G.170, 695G.1705, 45
– 41 –
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695G.171, 695G.1714 and 695G.177, and sections 33, 41, 46, 54, 1
59, 64 and 71 of this act, any contract for group, blanket or 2
individual health insurance or any contract by a nonprofit hospital, 3
medical or dental service corporation or organization for dental care 4
which provides for payment of a certain part of medical or dental 5
care may require the insured or member to obtain prior authorization 6
for that care from the insurer or organization. The insurer or 7
organization shall: 8
(a) File its procedure for obtaining approval of care pursuant to 9
this section for approval by the Commissioner; and 10
(b) Respond to any request for approval by the insured or 11
member pursuant to this section within 20 days after it receives the 12
request. 13
2. The procedure for prior authorization may not discriminate 14
among persons licensed to provide the covered care. 15
Sec. 32. Chapter 689A of NRS is hereby amended by adding 16
thereto the provisions set forth as sections 33, 34 and 35 of this act. 17
Sec. 33. 1. An insurer that offers or issues a policy of 18
health insurance shall include in the policy coverage for: 19
(a) All drugs approved by the United States Food and Drug 20
Administration to: 21
(1) Provide medication-assisted treatment for opioid use 22
disorder, including, without limitation, buprenorphine, methadone 23
and naltrexone. 24
(2) Support safe withdrawal from substance use disorder, 25
including, without limitation, lofexidine. 26
(b) Any service for the treatment of substance use disorder 27
provided by a provider of primary care if the service is covered 28
when provided by a specialist and: 29
(1) The service is within the scope of practice of the 30
provider of primary care; or 31
(2) The provider of primary care is capable of providing the 32
service safely and effectively in consultation with a specialist and 33
the provider engages in such consultation. 34
2. An insurer shall provide the coverage required by 35
paragraph (a) of subsection 1 regardless of whether the drug is 36
included in the formulary of the insurer. 37
3. An insurer shall not: 38
(a) Subject the benefits required by paragraph (a) of 39
subsection 1 to medical management techniques, other than step 40
therapy; 41
(b) Limit the covered amount of a drug described in paragraph 42
(a) of subsection 1; or 43
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(c) Refuse to cover a drug described in paragraph (a) of 1
subsection 1 because the drug is dispensed by a pharmacy through 2
mail order service. 3
4. An insurer shall ensure that the benefits required by 4
subsection 1 are made available to an insured through a provider 5
of health care who participates in the network plan of the insurer. 6
5. A policy of health insurance subject to the provisions of 7
this chapter that is delivered, issued for delivery or renewed on or 8
after January 1, 2024, has the legal effect of including the 9
coverage required by subsection 1, and any provision of the policy 10
that conflicts with the provisions of this section is void. 11
6. As used in this section: 12
(a) “Medical management technique” means a practice which 13
is used to control the cost or use of health care services or 14
prescription drugs. The term includes, without limitation, the use 15
of step therapy, prior authorization and categorizing drugs and 16
devices based on cost, type or method of administration. 17
(b) “Network plan” means a policy of health insurance offered 18
by an insurer under which the financing and delivery of medical 19
care, including items and services paid for as medical care, are 20
provided, in whole or in part, through a defined set of providers 21
under contract with the insurer. The term does not include an 22
arrangement for the financing of premiums. 23
(c) “Primary care” means the practice of family medicine, 24
pediatrics, internal medicine, obstetrics and gynecology and 25
midwifery. 26
(d) “Provider of health care” has the meaning ascribed to it in 27
NRS 629.031. 28
Sec. 34. 1. An insurer that offers or issues a policy of 29
health insurance shall include in the policy: 30
(a) Coverage of testing for and the treatment and prevention of 31
sexually transmitted diseases, including, without limitation, 32
Chlamydia trachomatis, gonorrhea, syphilis, human 33
immunodeficiency virus and hepatitis B and C, for all insureds, 34
regardless of age. Such coverage must include, without limitation, 35
the coverage required by NRS 689A.0412 and 689A.0437. 36
(b) Unrestricted coverage of condoms for insureds who are 13 37
years of age or older. 38
2. A policy of health insurance subject to the provisions of 39
this chapter that is delivered, issued for delivery or renewed on or 40
after January 1, 2024, has the legal effect of including the 41
coverage required by subsection 1, and any provision of the policy 42
that conflicts with the provisions of this section is void. 43
Sec. 35. 1. A policy of health insurance which provides 44
coverage for prescription drugs must provide that, when 45
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- *SB439*
calculating the amount of the contribution by an insured towards 1
a deductible, copayment, coinsurance or any other cost-sharing 2
requirement for prescription drugs, the insurer or any pharmacy 3
benefit manager that manages pharmacy benefits for the insurer 4
must include the amount paid by the insured or another person or 5
entity on behalf of the insured for a prescription drug: 6
(a) That has no generic equivalent; 7
(b) For which the insurer or pharmacy benefit manager has 8
imposed a requirement for prior authorization or a step therapy 9
protocol; 10
(c) Which is only covered under the policy of health insurance 11
after the insured: 12
(1) Obtains an exception to a general policy of the insurer 13
or pharmacy benefit manager; or 14
(2) Wins an appeal of such a policy; or 15
(d) That is prescribed to: 16
(1) Prevent the acquisition of human immunodeficiency 17
virus; 18
(2) Treat human immunodeficiency virus or hepatitis C; 19
(3) Provide medication-assisted treatment for opioid use 20
disorder; or 21
(4) Support safe withdrawal from substance use disorder. 22
2. A policy of health insurance subject to the provisions of 23
this chapter that is delivered, issued for delivery or renewed on or 24
after January 1, 2024, has the legal effect of including the 25
provisions required by subsection 1, and any provision of the 26
policy that conflicts with the provisions of this section is void. 27
3. As used in this section, “pharmacy benefit manager” has 28
the meaning ascribed to it in NRS 683A.174. 29
Sec. 36. NRS 689A.030 is hereby amended to read as follows: 30
689A.030 A policy of health insurance must not be delivered 31
or issued for delivery to any person in this State unless it otherwise 32
complies with this Code, and complies with the following: 33
1. The entire money and other considerations for the policy 34
must be expressed therein. 35
2. The time when the insurance takes effect and terminates 36
must be expressed therein. 37
3. It must purport to insure only one person, except that a 38
policy may insure, originally or by subsequent amendment, upon the 39
application of an adult member of a family, who shall be deemed the 40
policyholder, any two or more eligible members of that family, 41
including the husband, wife, domestic partner as defined in NRS 42
122A.030, dependent children, from the time of birth, adoption or 43
placement for the purpose of adoption as provided in NRS 44
689A.043, or any child on or before the last day of the month in 45
– 44 –
- *SB439*
which the child attains 26 years of age, and any other person 1
dependent upon the policyholder. 2
4. The style, arrangement and overall appearance of the policy 3
must not give undue prominence to any portion of the text, and 4
every printed portion of the text of the policy and of any 5
endorsements or attached papers must be plainly printed in light-6
faced type of a style in general use, the size of which must be 7
uniform and not less than 10 points with a lowercase unspaced 8
alphabet length not less than 120 points. “Text” includes all printed 9
matter except the name and address of the insurer, the name or the 10
title of the policy, the brief description, if any, and captions and 11
subcaptions. 12
5. The exceptions and reductions of indemnity must be set 13
forth in the policy and, other than those contained in NRS 689A.050 14
to 689A.290, inclusive, must be printed, at the insurer’s option, with 15
the benefit provision to which they apply or under an appropriate 16
caption such as “Exceptions” or “Exceptions and Reductions,” 17
except that if an exception or reduction specifically applies only to a 18
particular benefit of the policy, a statement of that exception or 19
reduction must be included with the benefit provision to which it 20
applies. 21
6. Each such form, including riders and endorsements, must be 22
identified by a number in the lower left-hand corner of the first page 23
thereof. 24
7. The policy must not contain any provision purporting to 25
make any portion of the charter, rules, constitution or bylaws of the 26
insurer a part of the policy unless that portion is set forth in full in 27
the policy, except in the case of the incorporation of or reference to 28
a statement of rates or classification of risks, or short-rate table filed 29
with the Commissioner. 30
8. The policy must provide benefits for expense arising from 31
care at home or health supportive services if that care or service was 32
prescribed by a physician and would have been covered by the 33
policy if performed in a medical facility or facility for the dependent 34
as defined in chapter 449 of NRS. 35
9. [The] Except as otherwise provided in this subsection, the 36
policy must provide [, at the option of the applicant,] benefits for 37
expenses incurred for the treatment of alcohol or substance use 38
disorder . [, unless] Except for the benefits required by section 34 39
of this act, such benefits must be provided: 40
(a) At the option of the applicant; and 41
(b) Unless the policy provides coverage only for a specified 42
disease or provides for the payment of a specific amount of money 43
if the insured is hospitalized or receiving health care in his or her 44
home. 45
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10. The policy must provide benefits for expense arising from 1
hospice care. 2
Sec. 37. NRS 689A.0437 is hereby amended to read as 3
follows: 4
689A.0437 1. An insurer that offers or issues a policy of 5
health insurance shall include in the policy coverage for: 6
(a) [Drugs] All drugs approved by the United States Food and 7
Drug Administration for preventing the acquisition of human 8
immunodeficiency virus [;] or treating human immunodeficiency 9
virus or hepatitis C in the form recommended by the prescribing 10
practitioner, regardless of whether the drug is included in the 11
formulary of the insurer; 12
(b) Laboratory testing that is necessary for therapy that uses 13
[such] a drug [;] to prevent the acquisition of human 14
immunodeficiency virus; 15
(c) Any service to test for, prevent or treat human 16
immunodeficiency virus or hepatitis C provided by a provider of 17
primary care if the service is covered when provided by a specialist 18
and: 19
(1) The service is within the scope of practice of the 20
provider of primary care; or 21
(2) The provider of primary care is capable of providing the 22
service safely and effectively in consultation with a specialist and 23
the provider engages in such consultation; and 24
[(c)] (d) The services described in NRS 639.28085, when 25
provided by a pharmacist who participates in the network plan of the 26
insurer. 27
2. An insurer that offers or issues a policy of health insurance 28
shall reimburse [a] : 29
(a) A pharmacist who participates in the network plan of the 30
insurer for the services described in NRS 639.28085 at a rate equal 31
to the rate of reimbursement provided to a physician, physician 32
assistant or advanced practice registered nurse for similar services. 33
(b) An advanced practice registered nurse or a physician 34
assistant who participates in the network plan of the insurer for 35
any service to test for, prevent or treat human immunodeficiency 36
virus or hepatitis C at a rate equal to the rate of reimbursement 37
provided to a physician for similar services. 38
3. An insurer [may subject] shall not: 39
(a) Subject the benefits required by subsection 1 to [reasonable] 40
medical management techniques [.] , other than step therapy; 41
(b) Limit the covered amount of a drug described in paragraph 42
(a) of subsection 1; 43
– 46 –
- *SB439*
(c) Refuse to cover a drug described in paragraph (a) of 1
subsection 1 because the drug is dispensed by a pharmacy through 2
mail order service; or 3
(d) Prohibit or restrict access to any service or drug to treat 4
human immunodeficiency virus or hepatitis C on the same day on 5
which the insured is diagnosed. 6
4. An insurer shall ensure that the benefits required by 7
subsection 1 are made available to an insured through a provider of 8
health care who participates in the network plan of the insurer. 9
5. A policy of health insurance subject to the provisions of this 10
chapter that is delivered, issued for delivery or renewed on or after 11
[October] January 1, [2021,] 2024, has the legal effect of including 12
the coverage required by subsection 1, and any provision of the 13
policy that conflicts with the provisions of this section is void. 14
6. As used in this section: 15
(a) “Medical management technique” means a practice which is 16
used to control the cost or use of health care services or prescription 17
drugs. The term includes, without limitation, the use of step therapy, 18
prior authorization and categorizing drugs and devices based on 19
cost, type or method of administration. 20
(b) “Network plan” means a policy of health insurance offered 21
by an insurer under which the financing and delivery of medical 22
care, including items and services paid for as medical care, are 23
provided, in whole or in part, through a defined set of providers 24
under contract with the insurer. The term does not include an 25
arrangement for the financing of premiums. 26
(c) “Primary care” means the practice of family medicine, 27
pediatrics, internal medicine, obstetrics and gynecology and 28
midwifery. 29
(d) “Provider of health care” has the meaning ascribed to it in 30
NRS 629.031. 31
Sec. 38. NRS 689A.046 is hereby amended to read as follows: 32
689A.046 1. [The] In addition to the benefits required by 33
section 33 of this act, the benefits provided by a policy for health 34
insurance for treatment of alcohol or substance use disorder must 35
[consist of:] include, without limitation: 36
(a) Treatment for withdrawal from the physiological effect of 37
alcohol or drugs, with a minimum benefit of $1,500 per calendar 38
year. 39
(b) Treatment for a patient admitted to a facility, with a 40
minimum benefit of $9,000 per calendar year. 41
(c) Counseling for a person, group or family who is not admitted 42
to a facility, with a minimum benefit of $2,500 per calendar year. 43
– 47 –
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2. Except as otherwise provided in NRS 687B.409, these 1
benefits must be paid in the same manner as benefits for any other 2
illness covered by a similar policy are paid. 3
3. The insured person is entitled to these benefits if treatment is 4
received in any: 5
(a) Facility for the treatment of alcohol or substance use disorder 6
which is certified by the Division of Public and Behavioral Health 7
of the Department of Health and Human Services. 8
(b) Hospital or other medical facility or facility for the 9
dependent which is licensed by the Division of Public and 10
Behavioral Health of the Department of Health and Human 11
Services, accredited by The Joint Commission or CARF 12
International and provides a program for the treatment of alcohol or 13
substance use disorder as part of its accredited activities. 14
Sec. 39. NRS 689A.330 is hereby amended to read as follows: 15
689A.330 If any policy is issued by a domestic insurer for 16
delivery to a person residing in another state, and if the insurance 17
commissioner or corresponding public officer of that other state has 18
informed the Commissioner that the policy is not subject to approval 19
or disapproval by that officer, the Commissioner may by ruling 20
require that the policy meet the standards set forth in NRS 689A.030 21
to 689A.320, inclusive [.] , and sections 33, 34 and 35 of this act. 22
Sec. 40. Chapter 689B of NRS is hereby amended by adding 23
thereto the provisions set forth as sections 41, 42 and 43 of this act. 24
Sec. 41. 1. An insurer that offers or issues a policy of 25
group health insurance shall include in the policy coverage for: 26
(a) All drugs approved by the United States Food and Drug 27
Administration to: 28
(1) Provide medication-assisted treatment for opioid use 29
disorder, including, without limitation, buprenorphine, methadone 30
and naltrexone. 31
(2) Support safe withdrawal from substance use disorder, 32
including, without limitation, lofexidine. 33
(b) Any service for the treatment of substance use disorder 34
provided by a provider of primary care if the service is covered 35
when provided by a specialist and: 36
(1) The service is within the scope of practice of the 37
provider of primary care; or 38
(2) The provider of primary care is capable of providing the 39
service safely and effectively in consultation with a specialist and 40
the provider engages in such consultation. 41
2. An insurer shall provide the coverage required by 42
paragraph (a) of subsection 1 regardless of whether the drug is 43
included in the formulary of the insurer. 44
3. An insurer shall not: 45
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- *SB439*
(a) Subject the benefits required by paragraph (a) of 1
subsection 1 to medical management techniques, other than step 2
therapy; 3
(b) Limit the covered amount of a drug described in paragraph 4
(a) of subsection 1; or 5
(c) Refuse to cover a drug described in paragraph (a) of 6
subsection 1 because the drug is dispensed by a pharmacy through 7
mail order service. 8
4. An insurer shall ensure that the benefits required by 9
subsection 1 are made available to an insured through a provider 10
of health care who participates in the network plan of the insurer. 11
5. A policy of group health insurance subject to the 12
provisions of this chapter that is delivered, issued for delivery or 13
renewed on or after January 1, 2024, has the legal effect of 14
including the coverage required by subsection 1, and any 15
provision of the policy that conflicts with the provisions of this 16
section is void. 17
6. As used in this section: 18
(a) “Medical management technique” means a practice which 19
is used to control the cost or use of health care services or 20
prescription drugs. The term includes, without limitation, the use 21
of step therapy, prior authorization and categorizing drugs and 22
devices based on cost, type or method of administration. 23
(b) “Network plan” means a policy of group health insurance 24
offered by an insurer under which the financing and delivery of 25
medical care, including items and services paid for as medical 26
care, are provided, in whole or in part, through a defined set of 27
providers under contract with the insurer. The term does not 28
include an arrangement for the financing of premiums. 29
(c) “Primary care” means the practice of family medicine, 30
pediatrics, internal medicine, obstetrics and gynecology and 31
midwifery. 32
(d) “Provider of health care” has the meaning ascribed to it in 33
NRS 629.031. 34
Sec. 42. 1. An insurer that offers or issues a policy of 35
group health insurance shall include in the policy: 36
(a) Coverage of testing for and the treatment of and prevention 37
of sexually transmitted diseases, including, without limitation, 38
Chlamydia trachomatis, gonorrhea, syphilis, human 39
immunodeficiency virus and hepatitis B and C, for all insureds, 40
regardless of age. Such coverage must include, without limitation, 41
the coverage required by NRS 689B.0312 and 689B.0315. 42
(b) Unrestricted coverage of condoms for insureds who are 13 43
years of age or older. 44
– 49 –
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2. A policy of group health insurance subject to the 1
provisions of this chapter that is delivered, issued for delivery or 2
renewed on or after January 1, 2024, has the legal effect of 3
including the coverage required by subsection 1, and any 4
provision of the policy that conflicts with the provisions of this 5
section is void. 6
Sec. 43. 1. A policy of group health insurance which 7
provides coverage for prescription drugs must provide that, when 8
calculating the amount of the contribution by an insured towards 9
a deductible, copayment, coinsurance or any other cost-sharing 10
requirement for prescription drugs, the insurer or any pharmacy 11
benefit manager that manages pharmacy benefits for the insurer 12
must include the amount paid by the insured or another person or 13
entity on behalf of the insured for a prescription drug: 14
(a) That has no generic equivalent; 15
(b) For which the insurer or pharmacy benefit manager has 16
imposed a requirement for prior authorization or a step therapy 17
protocol; 18
(c) Which is only covered under the policy of group health 19
insurance after the insured: 20
(1) Obtains an exception to a general policy of the insurer 21
or pharmacy benefit manager; or 22
(2) Wins an appeal of such a policy; or 23
(d) That is prescribed to: 24
(1) Prevent the acquisition of human immunodeficiency 25
virus; 26
(2) Treat human immunodeficiency virus or hepatitis C; 27
(3) Provide medication-assisted treatment for opioid use 28
disorder; or 29
(4) Support safe withdrawal from substance use disorder. 30
2. A policy of group health insurance subject to the 31
provisions of this chapter that is delivered, issued for delivery or 32
renewed on or after January 1, 2024, has the legal effect of 33
including the provisions required by subsection 1, and any 34
provision of the policy that conflicts with the provisions of this 35
section is void. 36
3. As used in this section, “pharmacy benefit manager” has 37
the meaning ascribed to it in NRS 683A.174. 38
Sec. 44. NRS 689B.0312 is hereby amended to read as 39
follows: 40
689B.0312 1. An insurer that offers or issues a policy of 41
group health insurance shall include in the policy coverage for: 42
(a) [Drugs] All drugs approved by the United States Food and 43
Drug Administration for preventing the acquisition of human 44
immunodeficiency virus [;] or treating human immunodeficiency 45
– 50 –
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virus or hepatitis C in the form recommended by the prescribing 1
practitioner, regardless of whether the drug is included in the 2
formulary of the insurer; 3
(b) Laboratory testing that is necessary for therapy that uses 4
[such] a drug [;] to prevent the acquisition of human 5
immunodeficiency virus; 6
(c) Any service to test for, prevent or treat human 7
immunodeficiency virus or hepatitis C provided by a provider of 8
primary care if the service is covered when provided by a specialist 9
and: 10
(1) The service is within the scope of practice of the 11
provider of primary care; or 12
(2) The provider of primary care is capable of providing the 13
service safely and effectively in consultation with a specialist and 14
the provider engages in such consultation; and 15
[(c)] (d) The services described in NRS 639.28085, when 16
provided by a pharmacist who participates in the network plan of the 17
insurer. 18
2. An insurer that offers or issues a policy of group health 19
insurance shall reimburse [a] : 20
(a) A pharmacist who participates in the network plan of the 21
insurer for the services described in NRS 639.28085 at a rate equal 22
to the rate of reimbursement provided to a physician, physician 23
assistant or advanced practice registered nurse for similar services. 24
(b) An advanced practice registered nurse or a physician 25
assistant who participates in the network plan of the insurer for 26
any service to test for, prevent or treat human immunodeficiency 27
virus or hepatitis C at a rate equal to the rate of reimbursement 28
provided to a physician for similar services. 29
3. An insurer [may subject] shall not: 30
(a) Subject the benefits required by subsection 1 to [reasonable] 31
medical management techniques [.] , other than step therapy; 32
(b) Limit the covered amount of a drug described in paragraph 33
(a) of subsection 1; 34
(c) Refuse to cover a drug described in paragraph (a) of 35
subsection 1 because the drug is dispensed by a pharmacy through 36
mail order service; or 37
(d) Prohibit or restrict access to any service or drug to treat 38
human immunodeficiency virus or hepatitis C on the same day on 39
which the insured is diagnosed. 40
4. An insurer shall ensure that the benefits required by 41
subsection 1 are made available to an insured through a provider of 42
health care who participates in the network plan of the insurer. 43
5. A policy of group health insurance subject to the provisions 44
of this chapter that is delivered, issued for delivery or renewed on or 45
– 51 –
- *SB439*
after [October] January 1, [2021,] 2024, has the legal effect of 1
including the coverage required by subsection 1, and any provision 2
of the policy that conflicts with the provisions of this section is void. 3
6. As used in this section: 4
(a) “Medical management technique” means a practice which is 5
used to control the cost or use of health care services or prescription 6
drugs. The term includes, without limitation, the use of step therapy, 7
prior authorization and categorizing drugs and devices based on 8
cost, type or method of administration. 9
(b) “Network plan” means a policy of group health insurance 10
offered by an insurer under which the financing and delivery of 11
medical care, including items and services paid for as medical care, 12
are provided, in whole or in part, through a defined set of providers 13
under contract with the insurer. The term does not include an 14
arrangement for the financing of premiums. 15
(c) “Primary care” means the practice of family medicine, 16
pediatrics, internal medicine, obstetrics and gynecology and 17
midwifery. 18
(d) “Provider of health care” has the meaning ascribed to it in 19
NRS 629.031. 20
Sec. 45. Chapter 689C of NRS is hereby amended by adding 21
thereto the provisions set forth as sections 46, 47 and 48 of this act. 22
Sec. 46. 1. A carrier that offers or issues a health benefit 23
plan shall include in the plan coverage for: 24
(a) All drugs approved by the United States Food and Drug 25
Administration to: 26
(1) Provide medication-assisted treatment for opioid use 27
disorder, including, without limitation, buprenorphine, methadone 28
and naltrexone. 29
(2) Support safe withdrawal from substance use disorder, 30
including, without limitation, lofexidine. 31
(b) Any service for the treatment of substance use disorder 32
provided by a provider of primary care if the service is covered 33
when provided by a specialist and: 34
(1) The service is within the scope of practice of the 35
provider of primary care; or 36
(2) The provider of primary care is capable of providing the 37
service safely and effectively in consultation with a specialist and 38
the provider engages in such consultation. 39
2. A carrier shall provide the coverage required by paragraph 40
(a) of subsection 1 regardless of whether the drug is included in 41
the formulary of the carrier. 42
3. A carrier shall not: 43
– 52 –
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(a) Subject the benefits required by paragraph (a) of 1
subsection 1 to medical management techniques, other than step 2
therapy; 3
(b) Limit the covered amount of a drug described in paragraph 4
(a) of subsection 1; or 5
(c) Refuse to cover a drug described in paragraph (a) of 6
subsection 1 because the drug is dispensed by a pharmacy through 7
mail order service. 8
4. A carrier shall ensure that the benefits required by 9
subsection 1 are made available to an insured through a provider 10
of health care who participates in the network plan of the carrier. 11
5. A health benefit plan subject to the provisions of this 12
chapter that is delivered, issued for delivery or renewed on or after 13
January 1, 2024, has the legal effect of including the coverage 14
required by subsection 1, and any provision of the plan that 15
conflicts with the provisions of this section is void. 16
6. As used in this section: 17
(a) “Medical management technique” means a practice which 18
is used to control the cost or use of health care services or 19
prescription drugs. The term includes, without limitation, the use 20
of step therapy, prior authorization and categorizing drugs and 21
devices based on cost, type or method of administration. 22
(b) “Network plan” means a health benefit plan offered by a 23
carrier under which the financing and delivery of medical care, 24
including items and services paid for as medical care, are 25
provided, in whole or in part, through a defined set of providers 26
under contract with the carrier. The term does not include an 27
arrangement for the financing of premiums. 28
(c) “Primary care” means the practice of family medicine, 29
pediatrics, internal medicine, obstetrics and gynecology and 30
midwifery. 31
(d) “Provider of health care” has the meaning ascribed to it in 32
NRS 629.031. 33
Sec. 47. 1. A carrier that offers or issues a health benefit 34
plan shall include in the plan: 35
(a) Coverage of testing for and the treatment and prevention of 36
sexually transmitted diseases, including, without limitation, 37
Chlamydia trachomatis, gonorrhea, syphilis, human 38
immunodeficiency virus and hepatitis B and C, for all insureds, 39
regardless of age. Such coverage must include, without limitation, 40
the coverage required by NRS 689C.1671 and 689C.1675. 41
(b) Unrestricted coverage of condoms for insureds who are 13 42
years of age or older. 43
2. A health benefit plan subject to the provisions of this 44
chapter that is delivered, issued for delivery or renewed on or after 45
– 53 –
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January 1, 2024, has the legal effect of including the coverage 1
required by subsection 1, and any provision of the plan that 2
conflicts with the provisions of this section is void. 3
Sec. 48. 1. A health benefit plan which provides coverage 4
for prescription drugs must provide that, when calculating the 5
amount of the contribution by an insured towards a deductible, 6
copayment, coinsurance or any other cost-sharing requirement for 7
prescription drugs, the carrier or any pharmacy benefit manager 8
that manages pharmacy benefits for the carrier must include the 9
amount paid by the insured or another person or entity on behalf 10
of the insured for a prescription drug: 11
(a) That has no generic equivalent; 12
(b) For which the carrier or pharmacy benefit manager has 13
imposed a requirement for prior authorization or a step therapy 14
protocol; 15
(c) Which is only covered under the health benefit plan after 16
the insured: 17
(1) Obtains an exception to a general policy of the carrier 18
or pharmacy benefit manager; or 19
(2) Wins an appeal of such a policy; or 20
(d) That is prescribed to: 21
(1) Prevent the acquisition of human immunodeficiency 22
virus; 23
(2) Treat human immunodeficiency virus or hepatitis C; 24
(3) Provide medication-assisted treatment for opioid use 25
disorder; or 26
(4) Support safe withdrawal from substance use disorder. 27
2. A health benefit plan subject to the provisions of this 28
chapter that is delivered, issued for delivery or renewed on or after 29
January 1, 2024, has the legal effect of including the provisions 30
required by subsection 1, and any provision of the plan that 31
conflicts with the provisions of this section is void. 32
3. As used in this section, “pharmacy benefit manager” has 33
the meaning ascribed to it in NRS 683A.174. 34
Sec. 49. NRS 689C.166 is hereby amended to read as follows: 35
689C.166 Each group health insurance policy must contain in 36
substance a provision for benefits payable for expenses incurred for 37
the treatment of alcohol or substance use disorder, as provided in 38
NRS 689C.167 [.] and section 46 of this act. 39
Sec. 50. NRS 689C.167 is hereby amended to read as follows: 40
689C.167 1. [The] In addition to the benefits required by 41
section 46 of this act, the benefits provided by a group policy for 42
health insurance, as required by NRS 689C.166, for the treatment of 43
alcohol or substance use disorders must [consist of:] include, 44
without limitation: 45
– 54 –
- *SB439*
(a) Treatment for withdrawal from the physiological effects of 1
alcohol or drugs, with a minimum benefit of $1,500 per calendar 2
year. 3
(b) Treatment for a patient admitted to a facility, with a 4
minimum benefit of $9,000 per calendar year. 5
(c) Counseling for a person, group or family who is not admitted 6
to a facility, with a minimum benefit of $2,500 per calendar year. 7
2. Except as otherwise provided in NRS 687B.409, these 8
benefits must be paid in the same manner as benefits for any other 9
illness covered by a similar policy are paid. 10
3. The insured person is entitled to these benefits if treatment is 11
received in any: 12
(a) Facility for the treatment of alcohol or substance use 13
disorders which is certified by the Division of Public and Behavioral 14
Health of the Department of Health and Human Services. 15
(b) Hospital or other medical facility or facility for the 16
dependent which is licensed by the Division of Public and 17
Behavioral Health of the Department of Health and Human 18
Services, is accredited by The Joint Commission or CARF 19
International and provides a program for the treatment of alcohol or 20
substance use disorders as part of its accredited activities. 21
Sec. 51. NRS 689C.1671 is hereby amended to read as 22
follows: 23
689C.1671 1. A carrier that offers or issues a health benefit 24
plan shall include in the plan coverage for: 25
(a) [Drugs] All drugs approved by the United States Food and 26
Drug Administration for preventing the acquisition of human 27
immunodeficiency virus [;] or treating human immunodeficiency 28
virus or hepatitis C in the form recommended by the prescribing 29
practitioner, regardless of whether the drug is included in the 30
formulary of the carrier; 31
(b) Laboratory testing that is necessary for therapy that uses 32
[such] a drug [;] to prevent the acquisition of human 33
immunodeficiency virus; 34
(c) Any service to test for, prevent or treat human 35
immunodeficiency virus or hepatitis C provided by a provider of 36
primary care if the service is covered when provided by a specialist 37
and: 38
(1) The service is within the scope of practice of the 39
provider of primary care; or 40
(2) The provider of primary care is capable of providing the 41
service safely and effectively in consultation with a specialist and 42
the provider engages in such consultation; and 43
– 55 –
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[(c)] (d) The services described in NRS 639.28085, when 1
provided by a pharmacist who participates in the health benefit plan 2
of the carrier. 3
2. A carrier that offers or issues a health benefit plan shall 4
reimburse [a] : 5
(a) A pharmacist who participates in the health benefit plan of 6
the carrier for the services described in NRS 639.28085 at a rate 7
equal to the rate of reimbursement provided to a physician, 8
physician assistant or advanced practice registered nurse for similar 9
services. 10
(b) An advanced practice registered nurse or a physician 11
assistant who participates in the network plan of the carrier for 12
any service to test for, prevent or treat human immunodeficiency 13
virus or hepatitis C at a rate equal to the rate of reimbursement 14
provided to a physician for similar services. 15
3. A carrier [may subject] shall not: 16
(a) Subject the benefits required by subsection 1 to [reasonable] 17
medical management techniques [.] , other than step therapy; 18
(b) Limit the covered amount of a drug described in paragraph 19
(a) of subsection 1; 20
(c) Refuse to cover a drug described in paragraph (a) of 21
subsection 1 because the drug is dispensed by a pharmacy through 22
mail order service; or 23
(d) Prohibit or restrict access to any service or drug to treat 24
human immunodeficiency virus or hepatitis C on the same day on 25
which the insured is diagnosed. 26
4. A carrier shall ensure that the benefits required by 27
subsection 1 are made available to an insured through a provider of 28
health care who participates in the network plan of the carrier. 29
5. A health benefit plan subject to the provisions of this chapter 30
that is delivered, issued for delivery or renewed on or after 31
[October] January 1, [2021,] 2024, has the legal effect of including 32
the coverage required by subsection 1, and any provision of the plan 33
that conflicts with the provisions of this section is void. 34
6. As used in this section: 35
(a) “Medical management technique” means a practice which is 36
used to control the cost or use of health care services or prescription 37
drugs. The term includes, without limitation, the use of step therapy, 38
prior authorization and categorizing drugs and devices based on 39
cost, type or method of administration. 40
(b) “Network plan” means a health benefit plan offered by a 41
carrier under which the financing and delivery of medical care, 42
including items and services paid for as medical care, are provided, 43
in whole or in part, through a defined set of providers under contract 44
– 56 –
- *SB439*
with the carrier. The term does not include an arrangement for the 1
financing of premiums. 2
(c) “Primary care” means the practice of family medicine, 3
pediatrics, internal medicine, obstetrics and gynecology and 4
midwifery. 5
(d) “Provider of health care” has the meaning ascribed to it in 6
NRS 629.031. 7
Sec. 52. NRS 689C.425 is hereby amended to read as follows: 8
689C.425 A voluntary purchasing group and any contract 9
issued to such a group pursuant to NRS 689C.360 to 689C.600, 10
inclusive, are subject to the provisions of NRS 689C.015 to 11
689C.355, inclusive, and sections 46, 47 and 48 of this act to the 12
extent applicable and not in conflict with the express provisions of 13
NRS 687B.408 and 689C.360 to 689C.600, inclusive. 14
Sec. 53. Chapter 695A of NRS is hereby amended by adding 15
thereto the provisions set forth as sections 54, 55 and 56 of this act. 16
Sec. 54. 1. A society that offers or issues a benefit contract 17
shall include in the contract coverage for: 18
(a) All drugs approved by the United States Food and Drug 19
Administration to: 20
(1) Provide medication-assisted treatment for opioid use 21
disorder, including, without limitation, buprenorphine, methadone 22
and naltrexone. 23
(2) Support safe withdrawal from substance use disorder, 24
including, without limitation, lofexidine. 25
(b) Any service for the treatment of substance use disorder 26
provided by a provider of primary care if the service is covered 27
when provided by a specialist and: 28
(1) The service is within the scope of practice of the 29
provider of primary care; or 30
(2) The provider of primary care is capable of providing the 31
service safely and effectively in consultation with a specialist and 32
the provider engages in such consultation. 33
2. A society shall provide the coverage required by paragraph 34
(a) of subsection 1 regardless of whether the drug is included in 35
the formulary of the society. 36
3. A society shall not: 37
(a) Subject the benefits required by paragraph (a) of 38
subsection 1 to medical management techniques, other than step 39
therapy; 40
(b) Limit the covered amount of a drug described in paragraph 41
(a) of subsection 1; or 42
(c) Refuse to cover a drug described in paragraph (a) of 43
subsection 1 because the drug is dispensed by a pharmacy through 44
mail order service. 45
– 57 –
- *SB439*
4. A society shall ensure that the benefits required by 1
subsection 1 are made available to an insured through a provider 2
of health care who participates in the network plan of the society. 3
5. A benefit contract subject to the provisions of this chapter 4
that is delivered, issued for delivery or renewed on or after 5
January 1, 2024, has the legal effect of including the coverage 6
required by subsection 1, and any provision of the contract that 7
conflicts with the provisions of this section is void. 8
6. As used in this section: 9
(a) “Medical management technique” means a practice which 10
is used to control the cost or use of health care services or 11
prescription drugs. The term includes, without limitation, the use 12
of step therapy, prior authorization and categorizing drugs and 13
devices based on cost, type or method of administration. 14
(b) “Network plan” means a benefit contract offered by a 15
society under which the financing and delivery of medical care, 16
including items and services paid for as medical care, are 17
provided, in whole or in part, through a defined set of providers 18
under contract with the society. The term does not include an 19
arrangement for the financing of premiums. 20
(c) “Primary care” means the practice of family medicine, 21
pediatrics, internal medicine, obstetrics and gynecology and 22
midwifery. 23
(d) “Provider of health care” has the meaning ascribed to it in 24
NRS 629.031. 25
Sec. 55. 1. A society that offers or issues a benefit contract 26
shall include in the contract: 27
(a) Coverage of testing for and the treatment and prevention of 28
sexually transmitted diseases, including, without limitation, 29
Chlamydia trachomatis, gonorrhea, syphilis, human 30
immunodeficiency virus and hepatitis B and C, for all insureds, 31
regardless of age. Such coverage must include, without limitation, 32
the coverage required by NRS 695A.1843 and 695A.1856. 33
(b) Unrestricted coverage of condoms for insureds who are 13 34
years of age or older. 35
2. A benefit contract subject to the provisions of this chapter 36
that is delivered, issued for delivery or renewed on or after 37
January 1, 2024, has the legal effect of including the coverage 38
required by subsection 1, and any provision of the contract that 39
conflicts with the provisions of this section is void. 40
Sec. 56. 1. A benefit contract which provides coverage for 41
prescription drugs must provide that, when calculating the amount 42
of the contribution by an insured towards a deductible, copayment, 43
coinsurance or any other cost-sharing requirement for 44
prescription drugs, the society or any pharmacy benefit manager 45
– 58 –
- *SB439*
that manages pharmacy benefits for the society must include the 1
amount paid by the insured or another person or entity on behalf 2
of the insured for a prescription drug: 3
(a) That has no generic equivalent; 4
(b) For which the society or pharmacy benefit manager has 5
imposed a requirement for prior authorization or a step therapy 6
protocol; 7
(c) Which is only covered under the benefit contract after the 8
insured: 9
(1) Obtains an exception to a general policy of the society 10
or pharmacy benefit manager; or 11
(2) Wins an appeal of such a policy; or 12
(d) That is prescribed to: 13
(1) Prevent the acquisition of human immunodeficiency 14
virus; 15
(2) Treat human immunodeficiency virus or hepatitis C; 16
(3) Provide medication-assisted treatment for opioid use 17
disorder; or 18
(4) Support safe withdrawal from substance use disorder. 19
2. A benefit contract subject to the provisions of this chapter 20
that is delivered, issued for delivery or renewed on or after 21
January 1, 2024, has the legal effect of including the provisions 22
required by subsection 1, and any provision of the contract that 23
conflicts with the provisions of this section is void. 24
3. As used in this section, “pharmacy benefit manager” has 25
the meaning ascribed to it in NRS 683A.174. 26
Sec. 57. NRS 695A.1843 is hereby amended to read as 27
follows: 28
695A.1843 1. A society that offers or issues a benefit 29
contract shall include in the benefit coverage for: 30
(a) [Drugs] All approved by the United States Food and Drug 31
Administration for preventing the acquisition of human 32
immunodeficiency virus [;] or treating human immunodeficiency 33
virus or hepatitis C in the form recommended by the prescribing 34
practitioner, regardless of whether the drug is included in the 35
formulary of the society; 36
(b) Laboratory testing that is necessary for therapy that uses 37
[such] a drug [;] to prevent the acquisition of human 38
immunodeficiency virus; 39
(c) Any service to test for, prevent or treat human 40
immunodeficiency virus or hepatitis C provided by a provider of 41
primary care if the service is covered when provided by a specialist 42
and: 43
(1) The service is within the scope of practice of the 44
provider of primary care; or 45
– 59 –
- *SB439*
(2) The provider of primary care is capable of providing the 1
service safely and effectively in consultation with a specialist and 2
the provider engages in such consultation; and 3
[(c)] (d) The services described in NRS 639.28085, when 4
provided by a pharmacist who participates in the network plan of the 5
society. 6
2. A society that offers or issues a benefit contract shall 7
reimburse [a] : 8
(a) A pharmacist who participates in the network plan of the 9
society for the services described in NRS 639.28085 at a rate equal 10
to the rate of reimbursement provided to a physician, physician 11
assistant or advanced practice registered nurse for similar services. 12
(b) An advanced practice registered nurse or a physician 13
assistant who participates in the network plan of the society for 14
any service to test for, prevent or treat human immunodeficiency 15
virus or hepatitis C at a rate equal to the rate of reimbursement 16
provided to a physician for similar services. 17
3. A society [may subject] shall not: 18
(a) Subject the benefits required by subsection 1 to [reasonable] 19
medical management techniques [.] , other than step therapy; 20
(b) Limit the covered amount of a drug described in paragraph 21
(a) of subsection 1; 22
(c) Refuse to cover a drug described in paragraph (a) of 23
subsection 1 because the drug is dispensed by a pharmacy through 24
mail order service; or 25
(d) Prohibit or restrict access to any service or drug to treat 26
human immunodeficiency virus or hepatitis C on the same day on 27
which the insured is diagnosed. 28
4. A society shall ensure that the benefits required by 29
subsection 1 are made available to an insured through a provider of 30
health care who participates in the network plan of the society. 31
5. A benefit contract subject to the provisions of this chapter 32
that is delivered, issued for delivery or renewed on or after 33
[October] January 1, [2021,] 2024, has the legal effect of including 34
the coverage required by subsection 1, and any provision of the plan 35
that conflicts with the provisions of this section is void. 36
6. As used in this section: 37
(a) “Medical management technique” means a practice which is 38
used to control the cost or use of health care services or prescription 39
drugs. The term includes, without limitation, the use of step therapy, 40
prior authorization and categorizing drugs and devices based on 41
cost, type or method of administration. 42
(b) “Network plan” means a benefit contract offered by a society 43
under which the financing and delivery of medical care, including 44
items and services paid for as medical care, are provided, in whole 45
– 60 –
- *SB439*
or in part, through a defined set of providers under contract with the 1
society. The term does not include an arrangement for the financing 2
of premiums. 3
(c) “Primary care” means the practice of family medicine, 4
pediatrics, internal medicine, obstetrics and gynecology and 5
midwifery. 6
(d) “Provider of health care” has the meaning ascribed to it in 7
NRS 629.031. 8
Sec. 58. Chapter 695B of NRS is hereby amended by adding 9
thereto the provisions set forth as sections 59, 60 and 61 of this act. 10
Sec. 59. 1. A hospital or medical services corporation that 11
offers or issues a policy of health insurance shall include in the 12
policy coverage for: 13
(a) All drugs approved by the United States Food and Drug 14
Administration to: 15
(1) Provide medication-assisted treatment for opioid use 16
disorder, including, without limitation, buprenorphine, methadone 17
and naltrexone. 18
(2) Support safe withdrawal from substance use disorder, 19
including, without limitation, lofexidine. 20
(b) Any service for the treatment of substance use disorder 21
provided by a provider of primary care if the service is covered 22
when provided by a specialist and: 23
(1) The service is within the scope of practice of the 24
provider of primary care; or 25
(2) The provider of primary care is capable of providing the 26
service safely and effectively in consultation with a specialist and 27
the provider engages in such consultation. 28
2. A hospital or medical services corporation shall provide the 29
coverage required by paragraph (a) of subsection 1 regardless of 30
whether the drug is included in the formulary of the hospital or 31
medical services corporation. 32
3. A hospital or medical services corporation shall not: 33
(a) Subject the benefits required by paragraph (a) of 34
subsection 1 to medical management techniques, other than step 35
therapy; 36
(b) Limit the covered amount of a drug described in paragraph 37
(a) of subsection 1; or 38
(c) Refuse to cover a drug described in paragraph (a) of 39
subsection 1 because the drug is dispensed by a pharmacy through 40
mail order service. 41
4. A hospital or medical services corporation shall ensure 42
that the benefits required by subsection 1 are made available to an 43
insured through a provider of health care who participates in the 44
network plan of the hospital or medical services corporation. 45
– 61 –
- *SB439*
5. A policy of health insurance subject to the provisions of 1
this chapter that is delivered, issued for delivery or renewed on or 2
after January 1, 2024, has the legal effect of including the 3
coverage required by subsection 1, and any provision of the policy 4
that conflicts with the provisions of this section is void. 5
6. As used in this section: 6
(a) “Medical management technique” means a practice which 7
is used to control the cost or use of health care services or 8
prescription drugs. The term includes, without limitation, the use 9
of step therapy, prior authorization and categorizing drugs and 10
devices based on cost, type or method of administration. 11
(b) “Network plan” means a policy of health insurance offered 12
by a hospital or medical services corporation under which the 13
financing and delivery of medical care, including items and 14
services paid for as medical care, are provided, in whole or in part, 15
through a defined set of providers under contract with the hospital 16
or medical services corporation. The term does not include an 17
arrangement for the financing of premiums. 18
(c) “Primary care” means the practice of family medicine, 19
pediatrics, internal medicine, obstetrics and gynecology and 20
midwifery. 21
(d) “Provider of health care” has the meaning ascribed to it in 22
NRS 629.031. 23
Sec. 60. 1. A hospital or medical services corporation that 24
offers or issues a policy of health insurance shall include in the 25
policy: 26
(a) Coverage of testing for and the treatment and prevention of 27
sexually transmitted diseases, including, without limitation, 28
Chlamydia trachomatis, gonorrhea, syphilis, human 29
immunodeficiency virus and hepatitis B and C, for all insureds, 30
regardless of age. Such coverage must include, without limitation, 31
the coverage required by NRS 695B.1913 and 695B.1924. 32
(b) Unrestricted coverage of condoms for insureds who are 13 33
years of age or older. 34
2. A policy of health insurance subject to the provisions of 35
this chapter that is delivered, issued for delivery or renewed on or 36
after January 1, 2024, has the legal effect of including the 37
coverage required by subsection 1, and any provision of the policy 38
that conflicts with the provisions of this section is void. 39
Sec. 61. 1. A policy of health insurance which provides 40
coverage for prescription drugs must provide that, when 41
calculating the amount of the contribution by an insured towards 42
a deductible, copayment, coinsurance or any other cost-sharing 43
requirement for prescription drugs, the hospital or medical 44
services corporation or any pharmacy benefit manager that 45
– 62 –
- *SB439*
manages pharmacy benefits for the hospital or medical services 1
corporation must include the amount paid by the insured or 2
another person or entity on behalf of the insured for a prescription 3
drug: 4
(a) That has no generic equivalent; 5
(b) For which the hospital or medical services corporation or 6
pharmacy benefit manager has imposed a requirement for prior 7
authorization or a step therapy protocol; or 8
(c) Which is only covered under the policy of health insurance 9
after the insured: 10
(1) Obtains an exception to a general policy of the hospital 11
or medical services corporation or pharmacy benefit manager; or 12
(2) Wins an appeal of such a policy; or 13
(d) That is prescribed to: 14
(1) Prevent the acquisition of human immunodeficiency 15
virus; 16
(2) Treat human immunodeficiency virus or hepatitis C; 17
(3) Provide medication-assisted treatment for opioid use 18
disorder; or 19
(4) Support safe withdrawal from substance use disorder. 20
2. A policy of health insurance subject to the provisions of 21
this chapter that is delivered, issued for delivery or renewed on or 22
after January 1, 2024, has the legal effect of including the 23
provisions required by subsection 1, and any provision of the 24
policy that conflicts with the provisions of this section is void. 25
3. As used in this section, “pharmacy benefit manager” has 26
the meaning ascribed to it in NRS 683A.174. 27
Sec. 62. NRS 695B.1924 is hereby amended to read as 28
follows: 29
695B.1924 1. A hospital or medical services corporation that 30
offers or issues a policy of health insurance shall include in the 31
policy coverage for: 32
(a) [Drugs] All drugs approved by the United States Food and 33
Drug Administration for preventing the acquisition of human 34
immunodeficiency virus [;] or treating human immunodeficiency 35
virus or hepatitis C in the form recommended by the prescribing 36
practitioner, regardless of whether the drug is included in the 37
formulary of the hospital or medical services organization; 38
(b) Laboratory testing that is necessary for therapy using [such] 39
a drug [;] to prevent the acquisition of human immunodeficiency 40
virus; 41
(c) Any service to test for, prevent or treat human 42
immunodeficiency virus or hepatitis C provided by a provider of 43
primary care if the service is covered when provided by a specialist 44
and: 45
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(1) The service is within the scope of practice of the 1
provider of primary care; or 2
(2) The provider of primary care is capable of providing the 3
service safely and effectively in consultation with a specialist and 4
the provider engages in such consultation; and 5
[(c)] (d) The services described in NRS 639.28085, when 6
provided by a pharmacist who participates in the network plan of the 7
hospital or medical services corporation. 8
2. A hospital or medical services corporation that offers or 9
issues a policy of health insurance shall reimburse [a] : 10
(a) A pharmacist who participates in the network plan of the 11
hospital or medical services corporation for the services described in 12
NRS 639.28085 at a rate equal to the rate of reimbursement 13
provided to a physician, physician assistant or advanced practice 14
registered nurse for similar services. 15
(b) An advanced practice registered nurse or a physician 16
assistant who participates in the network plan of the hospital or 17
medical services corporation for any service to test for, prevent or 18
treat human immunodeficiency virus or hepatitis C at a rate equal 19
to the rate of reimbursement provided to a physician for similar 20
services. 21
3. A hospital or medical services corporation [may subject] 22
shall not: 23
(a) Subject the benefits required by subsection 1 to [reasonable] 24
medical management techniques [.] , other than step therapy; 25
(b) Limit the covered amount of a drug described in paragraph 26
(a) of subsection 1; 27
(c) Refuse to cover a drug described in paragraph (a) of 28
subsection 1 because the drug is dispensed by a pharmacy through 29
mail order service; or 30
(d) Prohibit or restrict access to any service or drug to treat 31
human immunodeficiency virus or hepatitis C on the same day on 32
which the insured is diagnosed. 33
4. A hospital or medical services corporation shall ensure that 34
the benefits required by subsection 1 are made available to an 35
insured through a provider of health care who participates in the 36
network plan of the hospital or medical services corporation. 37
5. A policy of health insurance subject to the provisions of this 38
chapter that is delivered, issued for delivery or renewed on or after 39
[October] January 1, [2021,] 2024, has the legal effect of including 40
the coverage required by subsection 1, and any provision of the 41
policy that conflicts with the provisions of this section is void. 42
6. As used in this section: 43
(a) “Medical management technique” means a practice which is 44
used to control the cost or use of health care services or prescription 45
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drugs. The term includes, without limitation, the use of step therapy, 1
prior authorization and categorizing drugs and devices based on 2
cost, type or method of administration. 3
(b) “Network plan” means a policy of health insurance offered 4
by a hospital or medical services corporation under which the 5
financing and delivery of medical care, including items and services 6
paid for as medical care, are provided, in whole or in part, through a 7
defined set of providers under contract with the hospital or medical 8
services corporation. The term does not include an arrangement for 9
the financing of premiums. 10
(c) “Primary care” means the practice of family medicine, 11
pediatrics, internal medicine, obstetrics and gynecology and 12
midwifery. 13
(d) “Provider of health care” has the meaning ascribed to it in 14
NRS 629.031. 15
Sec. 63. Chapter 695C of NRS is hereby amended by adding 16
thereto the provisions set forth as sections 64, 65 and 66 of this act. 17
Sec. 64. 1. A health maintenance organization that offers 18
or issues a health care plan shall include in the plan coverage for: 19
(a) All drugs approved by the United States Food and Drug 20
Administration to: 21
(1) Provide medication-assisted treatment for opioid use 22
disorder, including, without limitation, buprenorphine, methadone 23
and naltrexone. 24
(2) Support safe withdrawal from substance use disorder, 25
including, without limitation, lofexidine. 26
(b) Any service for the treatment of substance use disorder 27
provided by a provider of primary care if the service is covered 28
when provided by a specialist and: 29
(1) The service is within the scope of practice of the 30
provider of primary care; or 31
(2) The provider of primary care is capable of providing the 32
service safely and effectively in consultation with a specialist and 33
the provider engages in such consultation. 34
2. A health maintenance organization shall provide the 35
coverage required by paragraph (a) of subsection 1 regardless of 36
whether the drug is included in the formulary of the health 37
maintenance organization. 38
3. A health maintenance organization shall not: 39
(a) Subject the benefits required by paragraph (a) of 40
subsection 1 to medical management techniques, other than step 41
therapy; 42
(b) Limit the covered amount of a drug described in paragraph 43
(a) of subsection 1; or 44
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(c) Refuse to cover a drug described in paragraph (a) of 1
subsection 1 because the drug is dispensed by a pharmacy through 2
mail order service. 3
4. A health maintenance organization shall ensure that the 4
benefits required by subsection 1 are made available to an enrollee 5
through a provider of health care who participates in the network 6
plan of the health maintenance organization. 7
5. A health care plan subject to the provisions of this chapter 8
that is delivered, issued for delivery or renewed on or after 9
January 1, 2024, has the legal effect of including the coverage 10
required by subsection 1, and any provision of the plan that 11
conflicts with the provisions of this section is void. 12
6. As used in this section: 13
(a) “Medical management technique” means a practice which 14
is used to control the cost or use of health care services or 15
prescription drugs. The term includes, without limitation, the use 16
of step therapy, prior authorization and categorizing drugs and 17
devices based on cost, type or method of administration. 18
(b) “Network plan” means a health care plan offered by a 19
health maintenance organization under which the financing and 20
delivery of medical care, including items and services paid for as 21
medical care, are provided, in whole or in part, through a defined 22
set of providers under contract with the health maintenance 23
organization. The term does not include an arrangement for the 24
financing of premiums. 25
(c) “Primary care” means the practice of family medicine, 26
pediatrics, internal medicine, obstetrics and gynecology and 27
midwifery. 28
(d) “Provider of health care” has the meaning ascribed to it in 29
NRS 629.031. 30
Sec. 65. 1. A health maintenance organization that offers 31
or issues a health care plan shall include in the plan: 32
(a) Coverage of testing for and the treatment and prevention of 33
sexually transmitted diseases, including, without limitation, 34
Chlamydia trachomatis, gonorrhea, syphilis, human 35
immunodeficiency virus and hepatitis B and C, for all enrollees, 36
regardless of age. Such coverage must include, without limitation, 37
the coverage required by NRS 695C.1737 and 695C.1743. 38
(b) Unrestricted coverage of condoms for enrollees who are 13 39
years of age or older. 40
2. A health care plan subject to the provisions of this chapter 41
that is delivered, issued for delivery or renewed on or after 42
January 1, 2024, has the legal effect of including the coverage 43
required by subsection 1, and any provision of the plan that 44
conflicts with the provisions of this section is void. 45
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Sec. 66. 1. A health care plan which provides coverage for 1
prescription drugs must provide that, when calculating the amount 2
of the contribution by an enrollee towards a deductible, 3
copayment, coinsurance or any other cost-sharing requirement for 4
prescription drugs, the health maintenance organization or any 5
pharmacy benefit manager that manages pharmacy benefits for 6
the health maintenance organization must include the amount 7
paid by the enrollee or another person or entity on behalf of the 8
enrollee for a prescription drug: 9
(a) That has no generic equivalent; 10
(b) For which the health maintenance organization or 11
pharmacy benefit manager has imposed a requirement for prior 12
authorization or a step therapy protocol; 13
(c) Which is only covered under the health care plan after the 14
enrollee: 15
(1) Obtains an exception to a general policy of the health 16
maintenance organization or pharmacy benefit manager; or 17
(2) Wins an appeal of such a policy; or 18
(d) That is prescribed to: 19
(1) Prevent the acquisition of human immunodeficiency 20
virus; 21
(2) Treat human immunodeficiency virus or hepatitis C; 22
(3) Provide medication-assisted treatment for opioid use 23
disorder; or 24
(4) Support safe withdrawal from substance use disorder. 25
2. A health care plan subject to the provisions of this chapter 26
that is delivered, issued for delivery or renewed on or after 27
January 1, 2024, has the legal effect of including the provisions 28
required by subsection 1, and any provision of the plan that 29
conflicts with the provisions of this section is void. 30
3. As used in this section, “pharmacy benefit manager” has 31
the meaning ascribed to it in NRS 683A.174. 32
Sec. 67. NRS 695C.050 is hereby amended to read as follows: 33
695C.050 1. Except as otherwise provided in this chapter or 34
in specific provisions of this title, the provisions of this title are not 35
applicable to any health maintenance organization granted a 36
certificate of authority under this chapter. This provision does not 37
apply to an insurer licensed and regulated pursuant to this title 38
except with respect to its activities as a health maintenance 39
organization authorized and regulated pursuant to this chapter. 40
2. Solicitation of enrollees by a health maintenance 41
organization granted a certificate of authority, or its representatives, 42
must not be construed to violate any provision of law relating to 43
solicitation or advertising by practitioners of a healing art. 44
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3. Any health maintenance organization authorized under this 1
chapter shall not be deemed to be practicing medicine and is exempt 2
from the provisions of chapter 630 of NRS. 3
4. The provisions of NRS 695C.110, 695C.125, 695C.1691, 4
695C.1693, 695C.170, 695C.1703, 695C.1705, 695C.1709 to 5
695C.173, inclusive, 695C.1733, 695C.17335, 695C.1734, 6
695C.1751, 695C.1755, 695C.1759, 695C.176 to 695C.200, 7
inclusive, and 695C.265 do not apply to a health maintenance 8
organization that provides health care services through managed 9
care to recipients of Medicaid under the State Plan for Medicaid or 10
insurance pursuant to the Children’s Health Insurance Program 11
pursuant to a contract with the Division of Health Care Financing 12
and Policy of the Department of Health and Human Services. This 13
subsection does not exempt a health maintenance organization from 14
any provision of this chapter for services provided pursuant to any 15
other contract. 16
5. The provisions of NRS 695C.1694 to 695C.1698, inclusive, 17
695C.1701, 695C.1708, 695C.1728, 695C.1731, 695C.17333, 18
695C.17345, 695C.17347, 695C.1735, 695C.1737, 695C.1743, 19
695C.1745 and 695C.1757 and sections 64, 65 and 66 of this act 20
apply to a health maintenance organization that provides health care 21
services through managed care to recipients of Medicaid under the 22
State Plan for Medicaid. 23
Sec. 68. NRS 695C.1743 is hereby amended to read as 24
follows: 25
695C.1743 1. A health maintenance organization that offers 26
or issues a health care plan shall include in the plan coverage for: 27
(a) [Drugs] All drugs approved by the United States Food and 28
Drug Administration for preventing the acquisition of human 29
immunodeficiency virus [;] or treating human immunodeficiency 30
virus or hepatitis C in the form recommended by the prescribing 31
practitioner, regardless of whether the drug is included in the 32
formulary of the health maintenance organization; 33
(b) Laboratory testing that is necessary for therapy that uses 34
[such] a drug [;] to prevent the acquisition of human 35
immunodeficiency virus; 36
(c) Any service to test for, prevent or treat human 37
immunodeficiency virus or hepatitis C provided by a provider of 38
primary care if the service is covered when provided by a specialist 39
and: 40
(1) The service is within the scope of practice of the 41
provider of primary care; or 42
(2) The provider of primary care is capable of providing the 43
service safely and effectively in consultation with a specialist and 44
the provider engages in such consultation; and 45
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[(c)] (d) The services described in NRS 639.28085, when 1
provided by a pharmacist who participates in the network plan of the 2
health maintenance organization. 3
2. A health maintenance organization that offers or issues a 4
health care plan shall reimburse [a] : 5
(a) A pharmacist who participates in the network plan of the 6
health maintenance organization for the services described in NRS 7
639.28085 at a rate equal to the rate of reimbursement provided to a 8
physician, physician assistant or advanced practice registered nurse 9
for similar services. 10
(b) An advanced practice registered nurse or a physician 11
assistant who participates in the network plan of the health 12
maintenance organization for any service to test for, prevent or 13
treat human immunodeficiency virus or hepatitis C at a rate equal 14
to the rate of reimbursement provided to a physician for similar 15
services. 16
3. A health maintenance organization [may subject] shall not: 17
(a) Subject the benefits required by subsection 1 to [reasonable] 18
medical management techniques [.] , other than step therapy; 19
(b) Limit the covered amount of a drug described in paragraph 20
(a) of subsection 1; 21
(c) Refuse to cover a drug described in paragraph (a) of 22
subsection 1 because the drug is dispensed by a pharmacy through 23
mail order service; or 24
(d) Prohibit or restrict access to any service or drug to treat 25
human immunodeficiency virus or hepatitis C on the same day on 26
which the enrollee is diagnosed. 27
4. A health maintenance organization shall ensure that the 28
benefits required by subsection 1 are made available to an enrollee 29
through a provider of health care who participates in the network 30
plan of the health maintenance organization. 31
5. A health care plan subject to the provisions of this chapter 32
that is delivered, issued for delivery or renewed on or after 33
[October] January 1, [2021,] 2024, has the legal effect of including 34
the coverage required by subsection 1, and any provision of the plan 35
that conflicts with the provisions of this section is void. 36
6. As used in this section: 37
(a) “Medical management technique” means a practice which is 38
used to control the cost or use of health care services or prescription 39
drugs. The term includes, without limitation, the use of step therapy, 40
prior authorization and categorizing drugs and devices based on 41
cost, type or method of administration. 42
(b) “Network plan” means a health care plan offered by a health 43
maintenance organization under which the financing and delivery of 44
medical care, including items and services paid for as medical care, 45
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are provided, in whole or in part, through a defined set of providers 1
under contract with the health maintenance organization. The term 2
does not include an arrangement for the financing of premiums. 3
(c) “Primary care” means the practice of family medicine, 4
pediatrics, internal medicine, obstetrics and gynecology and 5
midwifery. 6
(d) “Provider of health care” has the meaning ascribed to it in 7
NRS 629.031. 8
Sec. 69. NRS 695C.330 is hereby amended to read as follows: 9
695C.330 1. The Commissioner may suspend or revoke any 10
certificate of authority issued to a health maintenance organization 11
pursuant to the provisions of this chapter if the Commissioner finds 12
that any of the following conditions exist: 13
(a) The health maintenance organization is operating 14
significantly in contravention of its basic organizational document, 15
its health care plan or in a manner contrary to that described in and 16
reasonably inferred from any other information submitted pursuant 17
to NRS 695C.060, 695C.070 and 695C.140, unless any amendments 18
to those submissions have been filed with and approved by the 19
Commissioner; 20
(b) The health maintenance organization issues evidence of 21
coverage or uses a schedule of charges for health care services 22
which do not comply with the requirements of NRS 695C.1691 to 23
695C.200, inclusive, and sections 64, 65 and 66 of this act or 24
695C.207; 25
(c) The health care plan does not furnish comprehensive health 26
care services as provided for in NRS 695C.060; 27
(d) The Commissioner certifies that the health maintenance 28
organization: 29
(1) Does not meet the requirements of subsection 1 of NRS 30
695C.080; or 31
(2) Is unable to fulfill its obligations to furnish health care 32
services as required under its health care plan; 33
(e) The health maintenance organization is no longer financially 34
responsible and may reasonably be expected to be unable to meet its 35
obligations to enrollees or prospective enrollees; 36
(f) The health maintenance organization has failed to put into 37
effect a mechanism affording the enrollees an opportunity to 38
participate in matters relating to the content of programs pursuant to 39
NRS 695C.110; 40
(g) The health maintenance organization has failed to put into 41
effect the system required by NRS 695C.260 for: 42
(1) Resolving complaints in a manner reasonably to dispose 43
of valid complaints; and 44
– 70 –
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(2) Conducting external reviews of adverse determinations 1
that comply with the provisions of NRS 695G.241 to 695G.310, 2
inclusive; 3
(h) The health maintenance organization or any person on its 4
behalf has advertised or merchandised its services in an untrue, 5
misrepresentative, misleading, deceptive or unfair manner; 6
(i) The continued operation of the health maintenance 7
organization would be hazardous to its enrollees or creditors or to 8
the general public; 9
(j) The health maintenance organization fails to provide the 10
coverage required by NRS 695C.1691; or 11
(k) The health maintenance organization has otherwise failed to 12
comply substantially with the provisions of this chapter. 13
2. A certificate of authority must be suspended or revoked only 14
after compliance with the requirements of NRS 695C.340. 15
3. If the certificate of authority of a health maintenance 16
organization is suspended, the health maintenance organization shall 17
not, during the period of that suspension, enroll any additional 18
groups or new individual contracts, unless those groups or persons 19
were contracted for before the date of suspension. 20
4. If the certificate of authority of a health maintenance 21
organization is revoked, the organization shall proceed, immediately 22
following the effective date of the order of revocation, to wind up its 23
affairs and shall conduct no further business except as may be 24
essential to the orderly conclusion of the affairs of the organization. 25
It shall engage in no further advertising or solicitation of any kind. 26
The Commissioner may, by written order, permit such further 27
operation of the organization as the Commissioner may find to be in 28
the best interest of enrollees to the end that enrollees are afforded 29
the greatest practical opportunity to obtain continuing coverage for 30
health care. 31
Sec. 70. Chapter 695G of NRS is hereby amended by adding 32
thereto the provisions set forth as sections 71, 72 and 73 of this act. 33
Sec. 71. 1. A managed care organization that offers or 34
issues a health care plan shall include in the plan coverage for: 35
(a) All drugs approved by the United States Food and Drug 36
Administration to: 37
(1) Provide medication-assisted treatment for opioid use 38
disorder, including, without limitation, buprenorphine, methadone 39
and naltrexone. 40
(2) Support safe withdrawal from substance use disorder, 41
including, without limitation, lofexidine. 42
(b) Any service for the treatment of substance use disorder 43
provided by a provider of primary care if the service is covered 44
when provided by a specialist and: 45
– 71 –
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(1) The service is within the scope of practice of the 1
provider of primary care; or 2
(2) The provider of primary care is capable of providing the 3
service safely and effectively in consultation with a specialist and 4
the provider engages in such consultation. 5
2. A managed care organization shall provide the coverage 6
required by paragraph (a) of subsection 1 regardless of whether 7
the drug is included in the formulary of the managed care 8
organization. 9
3. A managed care organization shall not: 10
(a) Subject the benefits required by paragraph (a) of 11
subsection 1 to medical management techniques, other than step 12
therapy; 13
(b) Limit the covered amount of a drug described in paragraph 14
(a) of subsection 1; or 15
(c) Refuse to cover a drug described in paragraph (a) of 16
subsection 1 because the drug is dispensed by a pharmacy through 17
mail order service. 18
4. A managed care organization shall ensure that the benefits 19
required by subsection 1 are made available to an insured through 20
a provider of health care who participates in the network plan of 21
the managed care organization. 22
5. A health care plan subject to the provisions of this chapter 23
that is delivered, issued for delivery or renewed on or after 24
January 1, 2024, has the legal effect of including the coverage 25
required by subsection 1, and any provision of the plan that 26
conflicts with the provisions of this section is void. 27
6. As used in this section: 28
(a) “Medical management technique” means a practice which 29
is used to control the cost or use of health care services or 30
prescription drugs. The term includes, without limitation, the use 31
of step therapy, prior authorization and categorizing drugs and 32
devices based on cost, type or method of administration. 33
(b) “Network plan” means a health care plan offered by a 34
managed care organization under which the financing and 35
delivery of medical care, including items and services paid for as 36
medical care, are provided, in whole or in part, through a defined 37
set of providers under contract with the managed care 38
organization. The term does not include an arrangement for the 39
financing of premiums. 40
(c) “Primary care” means the practice of family medicine, 41
pediatrics, internal medicine, obstetrics and gynecology and 42
midwifery. 43
(d) “Provider of health care” has the meaning ascribed to it in 44
NRS 629.031. 45
– 72 –
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Sec. 72. 1. A managed care organization that offers or 1
issues a health care plan shall include in the plan: 2
(a) Coverage of testing for, treatment of and prevention of 3
sexually transmitted diseases, including, without limitation, 4
Chlamydia trachomatis, gonorrhea, syphilis, human 5
immunodeficiency virus and hepatitis B and C, for all insureds, 6
regardless of age. Such coverage must include, without limitation, 7
the coverage required by NRS 695G.1705 and 695G.1714. 8
(b) Unrestricted coverage of condoms for insureds who are 13 9
years of age or older. 10
2. A health care plan subject to the provisions of this chapter 11
that is delivered, issued for delivery or renewed on or after 12
January 1, 2024, has the legal effect of including the coverage 13
required by subsection 1, and any provision of the plan that 14
conflicts with the provisions of this section is void. 15
Sec. 73. 1. A health care plan which provides coverage for 16
prescription drugs must provide that, when calculating the amount 17
of the contribution by an insured towards a deductible, copayment, 18
coinsurance or any other cost-sharing requirement for 19
prescription drugs, the managed care organization or any 20
pharmacy benefit manager that manages pharmacy benefits for 21
the managed care organization must include the amount paid by 22
the insured or another person or entity on behalf of the insured 23
for a prescription drug: 24
(a) That has no generic equivalent; 25
(b) For which the managed care organization or pharmacy 26
benefit manager has imposed a requirement for prior 27
authorization or a step therapy protocol; 28
(c) Which is only covered under the health care plan after the 29
insured: 30
(1) Obtains an exception to a general policy of the managed 31
care organization or pharmacy benefit manager; or 32
(2) Wins an appeal of such a policy; or 33
(d) That is prescribed to: 34
(1) Prevent the acquisition of human immunodeficiency 35
virus; 36
(2) Treat human immunodeficiency virus or hepatitis C; 37
(3) Provide medication-assisted treatment for opioid use 38
disorder; or 39
(4) Support safe withdrawal from substance use disorder. 40
2. A health care plan subject to the provisions of this chapter 41
that is delivered, issued for delivery or renewed on or after 42
January 1, 2024, has the legal effect of including the provisions 43
required by subsection 1, and any provision of the plan that 44
conflicts with the provisions of this section is void. 45
– 73 –
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3. As used in this section, “pharmacy benefit manager” has 1
the meaning ascribed to it in NRS 683A.174. 2
Sec. 74. NRS 695G.1705 is hereby amended to read as 3
follows: 4
695G.1705 1. A managed care organization that offers or 5
issues a health care plan shall include in the plan coverage for: 6
(a) [Drugs] All drugs approved by the United States Food and 7
Drug Administration for preventing the acquisition of human 8
immunodeficiency virus [;] or treating human immunodeficiency 9
virus or hepatitis C in the form recommended by the prescribing 10
practitioner, regardless of whether the drug is included in the 11
formulary of the managed care organization; 12
(b) Laboratory testing that is necessary for therapy that uses 13
[such] a drug [;] to prevent the acquisition of human 14
immunodeficiency virus; 15
(c) Any service to test for, prevent or treat human 16
immunodeficiency virus or hepatitis C provided by a provider of 17
primary care if the service is covered when provided by a specialist 18
and: 19
(1) The service is within the scope of practice of the 20
provider of primary care; or 21
(2) The provider of primary care is capable of providing the 22
service safely and effectively in consultation with a specialist and 23
the provider engages in such consultation; and 24
[(c)] (d) The services described in NRS 639.28085, when 25
provided by a pharmacist who participates in the network plan of the 26
managed care organization. 27
2. A managed care organization that offers or issues a health 28
care plan shall reimburse [a] : 29
(a) A pharmacist who participates in the network plan of the 30
managed care organization for the services described in NRS 31
639.28085 at a rate equal to the rate of reimbursement provided to a 32
physician, physician assistant or advanced practice registered nurse 33
for similar services. 34
(b) An advanced practice registered nurse or a physician 35
assistant who participates in the network plan of the managed care 36
organization for any service to test for, prevent or treat human 37
immunodeficiency virus or hepatitis C at a rate equal to the rate of 38
reimbursement provided to a physician for similar services. 39
3. A managed care organization [may subject] shall not: 40
(a) Subject the benefits required by subsection 1 to [reasonable] 41
medical management techniques [.] , other than step therapy; 42
(b) Limit the covered amount of a drug described in paragraph 43
(a) of subsection 1; 44
– 74 –
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(c) Refuse to cover a drug described in paragraph (a) of 1
subsection 1 because the drug is dispensed by a pharmacy through 2
mail order service; or 3
(d) Prohibit or restrict access to any service or drug to treat 4
human immunodeficiency virus or hepatitis C on the same day on 5
which the insured is diagnosed. 6
4. A managed care organization shall ensure that the benefits 7
required by subsection 1 are made available to an insured through a 8
provider of health care who participates in the network plan of the 9
managed care organization. 10
5. A health care plan subject to the provisions of this chapter 11
that is delivered, issued for delivery or renewed on or after 12
[October] January 1, [2021,] 2024, has the legal effect of including 13
the coverage required by subsection 1, and any provision of the plan 14
that conflicts with the provisions of this section is void. 15
6. As used in this section: 16
(a) “Medical management technique” means a practice which is 17
used to control the cost or use of health care services or prescription 18
drugs. The term includes, without limitation, the use of step therapy, 19
prior authorization and categorizing drugs and devices based on 20
cost, type or method of administration. 21
(b) “Network plan” means a health care plan offered by a 22
managed care organization under which the financing and delivery 23
of medical care, including items and services paid for as medical 24
care, are provided, in whole or in part, through a defined set of 25
providers under contract with the managed care organization. The 26
term does not include an arrangement for the financing of 27
premiums. 28
(c) “Primary care” means the practice of family medicine, 29
pediatrics, internal medicine, obstetrics and gynecology and 30
midwifery. 31
(d) “Provider of health care” has the meaning ascribed to it in 32
NRS 629.031. 33
Sec. 75. 1. The first application that a physician, osteopathic 34
physician or physician assistant licensed pursuant to chapter 630 or 35
633 of NRS or a nurse who provides or supervises the provision of 36
emergency medical services in a hospital or primary care and who is 37
licensed on January 1, 2024, submits to renew his or her license on 38
or after that date must include, without limitation, proof that the 39
applicant has completed at least 2 hours of training in the stigma, 40
discrimination and unrecognized bias toward persons who have 41
acquired or are at a high risk of acquiring human immunodeficiency 42
virus, as required by NRS 630.253, 632.343 and 633.471, as 43
amended by sections 28, 29 and 30 of this act, respectively, as 44
applicable. 45
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2. As used in this section, “primary care” means the practice of 1
family medicine, pediatrics, internal medicine, obstetrics and 2
gynecology and midwifery. 3
Sec. 76. The Legislature hereby finds and declares that: 4
1. In Lapinski v. State, 84 Nev. 611, 613 (1968), the Nevada 5
Supreme Court held that “the power to define crimes and penalties 6
lies exclusively in the legislature.” 7
2. The Nevada Supreme Court has further held in Tellis v. 8
State, 84 Nev. 587, 591 (1968), Sparkman v. State, 95 Nev. 76, 82 9
(1979) and State v. Dist. Ct. (Pullin), 124 Nev. 564, 567-68 (2008), 10
that the penalty for a crime is determined by the law in effect at the 11
time the offender committed the crime and not the law in effect at 12
the time the offender is sentenced unless the Legislature has 13
expressed its clear intent that a statute ameliorating the penalty 14
apply retroactively. 15
3. NRS 441A.118 states that “[t]he Legislature hereby finds 16
and declares that the spread of communicable diseases is best 17
addressed through public health measures rather than 18
criminalization.” 19
4. For those reasons, the Legislature is exercising its exclusive 20
power to define the acts which subject a person to criminal penalties 21
by: 22
(a) Retroactively applying the provisions of section 24 of 23
chapter 491, Statutes of Nevada 2021, at page 3199, which repealed 24
certain criminal offenses that were based on a person having the 25
human immunodeficiency virus, to apply to conduct that occurred 26
before those offenses were repealed; and 27
(b) Making certain offenses which were punishable as category 28
A felonies before the effective date of section 13 of this act based on 29
the potential to spread a communicable disease instead punishable 30
as category B felonies, category D felonies or gross misdemeanors. 31
Sec. 77. 1. The provisions of section 24 of chapter 491, 32
Statutes of Nevada 2021, at page 3199, apply to any violation of 33
NRS 201.205 or 201.358, as those sections existed before the 34
enactment of section 24 of chapter 491, Statutes of Nevada 2021, at 35
page 3199, if the violation occurred before, on or after June 6, 2021, 36
and the person was convicted on or after the effective date of this 37
section. 38
2. The provisions of section 3 of this act apply to any violation 39
of NRS 201.205 or 201.358, as those sections existed before the 40
enactment of section 24 of chapter 491, Statutes of Nevada 2021, at 41
page 3199, if the violation occurred before, on or after June 6, 2021, 42
regardless of when the person was convicted. 43
3. If, before June 6, 2021, a person committed a violation of a 44
NRS 201.205 or 201.358, as those sections existed before the 45
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enactment of section 24 of chapter 491, Statutes of Nevada 2021, at 1
page 3199, and the person was not charged for that violation before 2
the effective date of this section, the person must not be charged for 3
that violation. 4
4. Each court in this State shall cancel each outstanding bench 5
warrant issued by the court for a person who failed to appear in 6
court in relation to an alleged violation of NRS 201.205 or 201.358, 7
as those sections existed before the enactment of section 24 of 8
chapter 491, Statutes of Nevada 2021, at page 3199. 9
5. The Central Repository for Nevada Records of Criminal 10
History shall remove from each database or compilation of records 11
of criminal history maintained by the Central Repository all records 12
of bench warrants issued for a person who failed to appear in court 13
in relation to an alleged violation of NRS 201.205 or 201.358, as 14
those sections existed before the enactment of section 24 of chapter 15
491, Statutes of Nevada 2021, at page 3199. 16
Sec. 78. 1. The provisions of NRS 212.189, as amended by 17
section 13 of this act, apply to any violation of that section, that 18
occurred before, on or after the effective date of that section, if the 19
person was not convicted before the effective date of that section. 20
2. If a person commits a violation of a NRS 212.189 which is 21
punishable as a category A felony before the effective date of 22
section 13 of this act, and the violation is punishable as a category B 23
felony, a category D felony or a gross misdemeanor pursuant to 24
NRS 212.189, as amended by section 13 of this act, the person must 25
not be charged with or convicted of a category A felony, if the 26
violation occurs on or after the effective date of section 13 of this 27
act, and may only be charged with and convicted of a category B 28
felony, category D felony or gross misdemeanor, as applicable, on 29
or after the effective date of section 13 of this act. 30
Sec. 79. The provisions of NRS 354.599 do not apply to any 31
additional expenses of a local government that are related to the 32
provisions of this act. 33
Sec. 80. 1. This section and sections 3 to 10, inclusive, 13, 34
76, 77 and 78 of this act become effective upon passage and 35
approval. 36
2. Sections 1, 2, 11, 12, 14 to 75, inclusive, and 79 of this act 37
become effective: 38
(a) Upon passage and approval for the purpose of adopting any 39
regulations and performing any other preparatory administrative 40
tasks that are necessary to carry out the provisions of this act; and 41
(b) On January 1, 2024, for all other purposes. 42
H