NV
Nevada Senate Bill SB439

Nevada 2023 Regular Session

Nevada Senate Bill SB439 Compare Versions

OldNewDifferences
1-
2-
3-- 82nd Session (2023)
1+ EXEMPT
2+ (Reprinted with amendments adopted on June 3, 2023)
3+ THIRD REPRINT S.B. 439
4+
5+- *SB439_R3*
6+
47 SENATE BILL NO. 439–SENATORS D. HARRIS,
58 SCHEIBLE AND DONATE
69
10+MARCH 27, 2023
11+____________
12+
713 JOINT SPONSORS: ASSEMBLYWOMEN
8-González, Peters and Taylor
9-
10-CHAPTER..........
14+GONZÁLEZ, PETERS AND TAYLOR
15+____________
16+
17+Referred to Committee on Health and Human Services
18+
19+SUMMARY—Revises provisions relating to communicable
20+diseases. (BDR 40-987)
21+
22+FISCAL NOTE: Effect on Local Government: May have Fiscal Impact.
23+ Effect on the State: Yes.
24+
25+CONTAINS UNFUNDED MANDATE (§ 1)
26+(NOT REQUESTED BY AFFECTED LOCAL GOVERNMENT)
27+
28+~
29+
30+EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted.
31+
1132
1233 AN ACT relating to communicable diseases; requiring certain state
1334 and local agencies to develop policies to provide
14-uninterrupted services during a public health emergency to
15-certain persons; requiring a public or private detention
35+uninterrupted services during a public health emergency
36+to certain persons; requiring a public or private detention
1637 facility to take certain measures to ensure the access of
1738 prisoners to treatment for and methods to prevent the
1839 acquisition of human immunodeficiency virus; revising
19-provisions governing certain crimes committed by prisoners;
20-requiring certain public and private health insurers to provide
21-certain coverage; requiring such an insurer to reimburse an
22-advanced practice registered nurse or physician assistant at
23-the same rate as a physician for certain services; authorizing
24-providers of health care to receive credit toward requirements
25-for continuing education for certain training relating to the
26-human immunodeficiency virus; requiring certain providers
27-of health care to complete such training; providing that the
28-repeal or revision of certain crimes applies retroactively; and
29-providing other matters properly relating thereto.
40+provisions governing certain crimes committed by
41+prisoners; requiring certain public and private health
42+insurers to provide certain coverage; requiring such an
43+insurer to reimburse an advanced practice registered nurse
44+or physician assistant at the same rate as a physician for
45+certain services; authorizing providers of health care to
46+receive credit toward requirements for continuing
47+education for certain training relating to the human
48+immunodeficiency virus; requiring certain providers of
49+health care to complete such training; providing that the
50+repeal or revision of certain crimes applies retroactively;
51+and providing other matters properly relating thereto.
52+ – 2 –
53+
54+
55+- *SB439_R3*
3056 Legislative Counsel’s Digest:
31- Existing law requires the Division of Public and Behavioral Health of the
32-Department of Health and Human Services and district, county and city health
33-departments to perform certain functions relating to public health in this State,
34-including certain duties relating to the control of communicable diseases. (NRS
35-439.150-439.265, 439.340, 439.350, 439.360, 439.366, 439.367, 439.3675,
36-439.405, 439.410, 439.460, 439.470) Existing law also requires a district health
37-officer or the Chief Medical Officer to perform certain duties relating to the control
38-of communicable diseases. (Chapter 441A of NRS) Existing law prescribes certain
39-responsibilities of the Division of Health Care Financing and Policy of the
40-Department concerning the administration of the Medicaid program. (NRS
41-422.061, 422.063) Section 1 of this bill requires the Department and all district,
42-county and city boards of health to develop policies to provide uninterrupted
43-services during a public health emergency to persons who have been diagnosed
44-with the human immunodeficiency virus or persons who are at a high risk of
45-acquiring the human immunodeficiency virus. Section 2 of this bill makes a
46-conforming change to indicate the proper placement of section 1 in the Nevada
47-Revised Statutes.
48- Existing law requires the Director of the Department of Corrections to establish
49-standards for the medical and dental services of each institution or facility under the
50-control of the Department. (NRS 209.381) Existing law also requires a sheriff, chief
51-of police or town marshal to arrange for the administration of medical care required
52-by prisoners while in his or her custody. (NRS 211.140) Sections 11 and 12 of this
53- – 2 –
54-
55-
56-- 82nd Session (2023)
57-bill impose certain requirements on the operators of public and private prisons, jails
58-and detention facilities to ensure the access of prisoners to treatment for human
59-immunodeficiency virus and methods of preventing the acquisition of human
60-immunodeficiency virus.
61- Existing law prohibits a prisoner from using, propelling, discharging, spreading
62-or concealing human excrement or bodily fluid with intent or under circumstances
63-where it is reasonably likely that the excrement or fluid will come in contact with
64-another person. Under most circumstances, a violation is a gross misdemeanor, a
65-category D felony or a category B felony, depending on the circumstances of the
66-prisoner’s confinement. However, if the prisoner knew at the time of the offense
67-that any portion of the excrement or bodily fluid contained a communicable disease
68-that causes or is reasonably likely to cause substantial bodily harm, the violation is
69-a category A felony, regardless of whether the communicable disease was
70-transmitted. (NRS 212.189) Section 13 of this bill instead provides that such a
71-violation is only a category A felony where: (1) the communicable disease was
72-likely to be transmitted by his or her conduct; and (2) the communicable disease
73-was actually transmitted as a result of the conduct. Section 78 of this bill provides
74-that the provisions of section 13 apply retroactively to violations that occurred
75-before the effective date of that section, if the person who committed the violation
76-has not been convicted before that date.
77- Existing law requires public and private health plans, including Medicaid and
78-health plans for state government employees, to cover an examination and testing
79-of a pregnant woman for Chlamydia trachomatis, gonorrhea, hepatitis B, hepatitis
80-C and syphilis. (NRS 287.04335, 422.27173, 689A.0412, 689B.0315, 689C.1675,
81-695A.1856, 695B.1913, 695C.1737, 695G.1714) Sections 16, 22, 34, 42, 47, 52,
82-55, 60, 65, 67 and 72 of this bill additionally require such insurance plans to cover:
83-(1) testing for, treatment of and prevention of sexually transmitted diseases; and (2)
84-condoms for certain covered persons.
85- Existing law requires certain public and private health plans, including health
86-plans for state government employees, to cover drugs that prevent the acquisition of
87-human immunodeficiency virus and any related laboratory or diagnostic
88-procedures. (NRS 287.010, 287.04335, 689A.0437, 689B.0312, 689C.1671,
89-695A.1843, 695B.1924, 695C.1743, 695G.1705) Sections 31, 37, 44, 51, 57, 62, 68
90-and 74 of this bill require such insurance plans to cover all such drugs approved by
91-the United States Food and Drug Administration and all drugs approved by the
92-Food and Drug Administration for treating human immunodeficiency virus or
93-hepatitis C without restrictions, other than step therapy. Sections 23, 37, 44, 51, 57,
94-62, 68 and 74 of this bill require such insurance plans to: (1) cover any service to
95-test for, prevent or treat those diseases provided by a provider of primary care if the
96-service is covered when provided by a specialist and certain other requirements are
97-met; and (2) reimburse an advanced practice registered nurse or a physician
98-assistant for such services at a rate equal to that provided to a physician. Sections
99-16, 20, 31, 33, 41, 46, 52, 54, 59, 64, 67 and 71 impose similar requirements
100-regarding: (1) coverage of certain drugs approved by the Food and Drug
101-Administration to treat substance use disorder; (2) coverage of services for the
102-treatment of substance use disorder provided by a provider of primary care; and (3)
103-reimbursement for such services provided by an advanced practice registered nurse.
104-Sections 14.5-15.5 of this bill make conforming changes to exempt local
105-governmental agencies that provide health insurance to employees through a plan
106-of self-insurance from the amendatory provisions of section 44 while maintaining
107-existing requirements that apply to such insurance. Sections 36, 38, 49 and 50 of
108-this bill make conforming changes to indicate that the coverage required by
109-sections 33 and 46 is in addition to certain coverage of services for the treatment of
57+ Existing law requires the Division of Public and Behavioral Health of the 1
58+Department of Health and Human Services and district, county and city health 2
59+departments to perform certain functions relating to public health in this State, 3
60+including certain duties relating to the control of communicable diseases. (NRS 4
61+439.150-439.265, 439.340, 439.350, 439.360, 439.366, 439.367, 439.3675, 5
62+439.405, 439.410, 439.460, 439.470) Existing law also requires a district health 6
63+officer or the Chief Medical Officer to perform certain duties relating to the control 7
64+of communicable diseases. (Chapter 441A of NRS) Existing law prescribes certain 8
65+responsibilities of the Division of Health Care Financing and Policy of the 9
66+Department concerning the administration of the Medicaid program. (NRS 10
67+422.061, 422.063) Section 1 of this bill requires the Department and all district, 11
68+county and city boards of health to develop policies to provide uninterrupted 12
69+services during a public health emergency to persons who have been diagnosed 13
70+with the human immunodeficiency virus or persons who are at a high risk of 14
71+acquiring the human immunodeficiency virus. Section 2 of this bill makes a 15
72+conforming change to indicate the proper placement of section 1 in the Nevada 16
73+Revised Statutes. 17
74+ Existing law requires the Director of the Department of Corrections to establish 18
75+standards for the medical and dental services of each institution or facility under the 19
76+control of the Department. (NRS 209.381) Existing law also requires a sheriff, chief 20
77+of police or town marshal to arrange for the administration of medical care required 21
78+by prisoners while in his or her custody. (NRS 211.140) Sections 11 and 12 of this 22
79+bill impose certain requirements on the operators of public and private prisons, jails 23
80+and detention facilities to ensure the access of prisoners to treatment for human 24
81+immunodeficiency virus and methods of preventing the acquisition of human 25
82+immunodeficiency virus. 26
83+ Existing law prohibits a prisoner from using, propelling, discharging, spreading 27
84+or concealing human excrement or bodily fluid with intent or under circumstances 28
85+where it is reasonably likely that the excrement or fluid will come in contact with 29
86+another person. Under most circumstances, a violation is a gross misdemeanor, a 30
87+category D felony or a category B felony, depending on the circumstances of the 31
88+prisoner’s confinement. However, if the prisoner knew at the time of the offense 32
89+that any portion of the excrement or bodily fluid contained a communicable disease 33
90+that causes or is reasonably likely to cause substantial bodily harm, the violation is 34
91+a category A felony, regardless of whether the communicable disease was 35
92+transmitted. (NRS 212.189) Section 13 of this bill instead provides that such a 36
93+violation is only a category A felony where: (1) the communicable disease was 37
94+likely to be transmitted by his or her conduct; and (2) the communicable disease 38
95+was actually transmitted as a result of the conduct. Section 78 of this bill provides 39
96+that the provisions of section 13 apply retroactively to violations that occurred 40
97+before the effective date of that section, if the person who committed the violation 41
98+has not been convicted before that date. 42
99+ Existing law requires public and private health plans, including Medicaid and 43
100+health plans for state government employees, to cover an examination and testing 44
101+of a pregnant woman for Chlamydia trachomatis, gonorrhea, hepatitis B, hepatitis 45
102+C and syphilis. (NRS 287.04335, 422.27173, 689A.0412, 689B.0315, 689C.1675, 46
103+695A.1856, 695B.1913, 695C.1737, 695G.1714) Sections 16, 22, 34, 42, 47, 52, 47
104+55, 60, 65, 67 and 72 of this bill additionally require such insurance plans to cover: 48
105+(1) testing for, treatment of and prevention of sexually transmitted diseases; and (2) 49
106+condoms for certain covered persons. 50
107+ Existing law requires certain public and private health plans, including health 51
108+plans for state government employees, to cover drugs that prevent the acquisition of 52
109+human immunodeficiency virus and any related laboratory or diagnostic 53
110+procedures. (NRS 287.010, 287.04335, 689A.0437, 689B.0312, 689C.1671, 54
110111 – 3 –
111112
112113
113-- 82nd Session (2023)
114-substance use disorder that certain insurers are required by existing law to provide.
115-Sections 14 and 39 of this bill make conforming changes to indicate the proper
116-placement of sections 20, 22, 33 and 34 in the Nevada Revised Statutes. Section
117-69 of this bill authorizes the Commissioner of Insurance to suspend or revoke the
118-certificate of a health maintenance organization that fails to comply with the
119-requirements of section 64 or 65. The Commissioner would also be authorized to
120-take such action against any health insurer who fails to comply with the
121-requirements of sections 33, 34, 37, 41-44, 46, 47, 50, 54-57, 59-62, 67, 68 or 71-
122-74 of this bill. (NRS 680A.200, 695C.330)
123- Existing law requires the Department of Health and Human Services to develop
124-a list of preferred prescription drugs to be used for the Medicaid program. Existing
125-law requires the Department to: (1) include on that list drugs for the prevention of
126-human immunodeficiency virus; and (2) include drugs prescribed to treat the
127-human immunodeficiency virus on a list of drugs that are excluded from the
128-restrictions imposed on drugs that are on the list of preferred prescription drugs.
129-(NRS 422.4025) Section 25 of this bill requires the Medicaid program to cover a
130-prescription drug that is not on the list of preferred prescription drugs if the drug is:
131-(1) used to treat hepatitis C, used to provide medication-assisted treatment for
132-opioid use disorder, used to support safe withdrawal from substance use disorder or
133-is in the same class as a prescription drug on the list of preferred prescription drugs;
134-and (2) is unsuitable for a recipient of Medicaid for certain reasons.
135- Existing law requires physicians, osteopathic physicians, physician assistants
136-and nurses to complete certain continuing education in order to renew their
137-licenses. (NRS 630.253, 632.343, 633.471) Sections 28-30 and 75 of this bill
138-require such a provider of health care who provides or supervises the provision of
139-emergency medical care or primary care in a hospital to complete before the first
140-renewal of their license or, for currently practicing providers, the next renewal of
141-their license, at least 2 hours of training in stigma, discrimination and unrecognized
142-bias toward persons who have acquired or are at a high risk of acquiring human
143-immunodeficiency virus. Section 27 of this bill authorizes any provider of health
144-care to use training in that subject in place of not more than 2 hours of any other
145-training that the provider is required to complete, other than continuing education
146-relating to ethics.
147- Senate Bill No. 275 of the 2021 Legislative Session repealed certain criminal
148-offenses for which an element of the offense was having the human
149-immunodeficiency virus. (Section 24, chapter 491, Statutes of Nevada 2021, at
150-page 3199) Section 77 of this bill provides that the repeal of those offenses applies
151-retroactively to violations that occurred before the effective date of Senate Bill
152-No. 275.
153-
154-EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted.
114+- *SB439_R3*
115+695A.1843, 695B.1924, 695C.1743, 695G.1705) Sections 31, 37, 44, 51, 57, 62, 68 55
116+and 74 of this bill require such insurance plans to cover all such drugs approved by 56
117+the United States Food and Drug Administration and all drugs approved by the 57
118+Food and Drug Administration for treating human immunodeficiency virus or 58
119+hepatitis C without restrictions, other than step therapy. Sections 23, 37, 44, 51, 57, 59
120+62, 68 and 74 of this bill require such insurance plans to: (1) cover any service to 60
121+test for, prevent or treat those diseases provided by a provider of primary care if the 61
122+service is covered when provided by a specialist and certain other requirements are 62
123+met; and (2) reimburse an advanced practice registered nurse or a physician 63
124+assistant for such services at a rate equal to that provided to a physician. Sections 64
125+16, 20, 31, 33, 41, 46, 52, 54, 59, 64, 67 and 71 impose similar requirements 65
126+regarding: (1) coverage of certain drugs approved by the Food and Drug 66
127+Administration to treat substance use disorder; (2) coverage of services for the 67
128+treatment of substance use disorder provided by a provider of primary care; and (3) 68
129+reimbursement for such services provided by an advanced practice registered nurse. 69
130+Sections 14.5-15.5 of this bill make conforming changes to exempt local 70
131+governmental agencies that provide health insurance to employees through a plan 71
132+of self-insurance from the amendatory provisions of section 44 while maintaining 72
133+existing requirements that apply to such insurance. Sections 36, 38, 49 and 50 of 73
134+this bill make conforming changes to indicate that the coverage required by 74
135+sections 33 and 46 is in addition to certain coverage of services for the treatment of 75
136+substance use disorder that certain insurers are required by existing law to provide. 76
137+Sections 14 and 39 of this bill make conforming changes to indicate the proper 77
138+placement of sections 20, 22, 33 and 34 in the Nevada Revised Statutes. Section 78
139+69 of this bill authorizes the Commissioner of Insurance to suspend or revoke the 79
140+certificate of a health maintenance organization that fails to comply with the 80
141+requirements of section 64 or 65. The Commissioner would also be authorized to 81
142+take such action against any health insurer who fails to comply with the 82
143+requirements of sections 33, 34, 37, 41-44, 46, 47, 50, 54-57, 59-62, 67, 68 or 71-83
144+74 of this bill. (NRS 680A.200, 695C.330) 84
145+ Existing law requires the Department of Health and Human Services to develop 85
146+a list of preferred prescription drugs to be used for the Medicaid program. Existing 86
147+law requires the Department to: (1) include on that list drugs for the prevention of 87
148+human immunodeficiency virus; and (2) include drugs prescribed to treat the 88
149+human immunodeficiency virus on a list of drugs that are excluded from the 89
150+restrictions imposed on drugs that are on the list of preferred prescription drugs. 90
151+(NRS 422.4025) Section 25 of this bill requires the Medicaid program to cover a 91
152+prescription drug that is not on the list of preferred prescription drugs if the drug is: 92
153+(1) used to treat hepatitis C, used to provide medication-assisted treatment for 93
154+opioid use disorder, used to support safe withdrawal from substance use disorder or 94
155+is in the same class as a prescription drug on the list of preferred prescription drugs; 95
156+and (2) is unsuitable for a recipient of Medicaid for certain reasons. 96
157+ Existing law requires physicians, osteopathic physicians, physician assistants 97
158+and nurses to complete certain continuing education in order to renew their 98
159+licenses. (NRS 630.253, 632.343, 633.471) Sections 28-30 and 75 of this bill 99
160+require such a provider of health care who provides or supervises the provision of 100
161+emergency medical care or primary care in a hospital to complete before the first 101
162+renewal of their license or, for currently practicing providers, the next renewal of 102
163+their license, at least 2 hours of training in stigma, discrimination and unrecognized 103
164+bias toward persons who have acquired or are at a high risk of acquiring human 104
165+immunodeficiency virus. Section 27 of this bill authorizes any provider of health 105
166+care to use training in that subject in place of not more than 2 hours of any other 106
167+training that the provider is required to complete, other than continuing education 107
168+relating to ethics. 108
169+ – 4 –
170+
171+
172+- *SB439_R3*
173+ Senate Bill No. 275 of the 2021 Legislative Session repealed certain criminal 109
174+offenses for which an element of the offense was having the human 110
175+immunodeficiency virus. (Section 24, chapter 491, Statutes of Nevada 2021, at 111
176+page 3199) Section 77 of this bill provides that the repeal of those offenses applies 112
177+retroactively to violations that occurred before the effective date of Senate Bill 113
178+No. 275. 114
155179
156180
157181 THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
158182 SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
159183
160- Section 1. Chapter 441A of NRS is hereby amended by
161-adding thereto a new section to read as follows:
162- 1. The Department of Health and Human Services and all
163-district, county and city boards of health shall develop policies to
164-provide uninterrupted services during a public health emergency
165- – 4 –
166-
167-
168-- 82nd Session (2023)
169-to persons who have been diagnosed with the human
170-immunodeficiency virus or who are at a high risk of acquiring the
171-human immunodeficiency virus and who are receiving services
172-from the Department or any division thereof or the district, county
173-or city health department, as applicable. Such policies may
174-provide, without limitation, for the delivery of such services during
175-a public health emergency:
176- (a) Over the Internet;
177- (b) Using an application for a mobile device; or
178- (c) By calling or sending text messages from a telephone
179-number that is not generally blocked or identified as a source of
180-unwanted calls or messages.
181- 2. As used in this section:
182- (a) “Mobile device” includes, without limitation, a smartphone
183-or a tablet computer.
184- (b) “Public health emergency” means:
185- (1) A public health emergency or other health event
186-identified by a health authority pursuant to NRS 439.970; or
187- (2) A state of emergency or declaration of disaster
188-proclaimed pursuant to NRS 414.070 that relates to or affects
189-public health.
190- Sec. 2. NRS 441A.334 is hereby amended to read as follows:
191- 441A.334 As used in this section and NRS 441A.335 and
192-441A.336, and section 1 of this act, “provider of health care” means
193-a physician, nurse or physician assistant licensed in accordance with
194-state law.
195- Secs. 3-10. (Deleted by amendment.)
196- Sec. 11. Chapter 209 of NRS is hereby amended by adding
197-thereto a new section to read as follows:
198- 1. The Department or the operator of a private facility or
199-institution shall not enter into a contract or other agreement with
200-any person or entity to provide medical services to offenders who
201-are diagnosed with human immunodeficiency virus unless the
202-person or entity demonstrates that at least 95 percent of the
203-patients who are diagnosed with human immunodeficiency virus
204-to whom the person or entity provides medical services:
205- (a) Are offered treatment on the same day as the diagnosis;
206-and
207- (b) Are able to begin such treatment not later than 7 days after
208-diagnosis.
209- 2. Except as otherwise provided in subsection 3, an
210-institution, facility or private facility or institution shall take
211-reasonable measures to ensure the availability of:
184+ Section 1. Chapter 441A of NRS is hereby amended by 1
185+adding thereto a new section to read as follows: 2
186+ 1. The Department of Health and Human Services and all 3
187+district, county and city boards of health shall develop policies to 4
188+provide uninterrupted services during a public health emergency 5
189+to persons who have been diagnosed with the human 6
190+immunodeficiency virus or who are at a high risk of acquiring the 7
191+human immunodeficiency virus and who are receiving services 8
192+from the Department or any division thereof or the district, county 9
193+or city health department, as applicable. Such policies may 10
194+provide, without limitation, for the delivery of such services during 11
195+a public health emergency: 12
196+ (a) Over the Internet; 13
197+ (b) Using an application for a mobile device; or 14
198+ (c) By calling or sending text messages from a telephone 15
199+number that is not generally blocked or identified as a source of 16
200+unwanted calls or messages. 17
201+ 2. As used in this section: 18
202+ (a) “Mobile device” includes, without limitation, a smartphone 19
203+or a tablet computer. 20
204+ (b) “Public health emergency” means: 21
205+ (1) A public health emergency or other health event 22
206+identified by a health authority pursuant to NRS 439.970; or 23
207+ (2) A state of emergency or declaration of disaster 24
208+proclaimed pursuant to NRS 414.070 that relates to or affects 25
209+public health. 26
210+ Sec. 2. NRS 441A.334 is hereby amended to read as follows: 27
211+ 441A.334 As used in this section and NRS 441A.335 and 28
212+441A.336, and section 1 of this act, “provider of health care” means 29
213+a physician, nurse or physician assistant licensed in accordance with 30
214+state law. 31
215+ Sec. 3. (Deleted by amendment.) 32
216+ Sec. 4. (Deleted by amendment.) 33
217+ Sec. 5. (Deleted by amendment.) 34
218+ Sec. 6. (Deleted by amendment.) 35
212219 – 5 –
213220
214221
215-- 82nd Session (2023)
216- (a) Any drug prescribed for treating the human
217-immunodeficiency virus in the form recommended by the
218-prescribing practitioner to each offender who has been diagnosed
219-with human immunodeficiency virus to the same extent and under
220-the same conditions as other medical care for offenders.
221- (b) Methods of preventing the acquisition of human
222-immunodeficiency virus, including, without limitation, drugs
223-approved by the United States Food and Drug Administration for
224-that purpose, to all offenders free of charge.
225- 3. An institution, facility or private facility or institution:
226- (a) Is not required to make available a drug described in
227-subsection 2 for which a prescription is required to an offender for
228-whom such a prescription has not been issued.
229- (b) Shall take reasonable measures to make available to all
230-offenders a provider of health care who is authorized to issue a
231-prescription for a drug described in subsection 2.
232- (c) Shall not demand, request or suggest that a provider of
233-health care refrain from issuing a prescription for a drug
234-described in subsection 2 to an offender or take any other measure
235-to prevent a provider of health care from issuing such a
236-prescription.
237- 4. As used in this section, “provider of health care” has the
238-meaning ascribed to it in NRS 629.031.
239- Sec. 12. Chapter 211 of NRS is hereby amended by adding
240-thereto a new section to read as follows:
241- 1. A sheriff, chief of police or town marshal who is
242-responsible for a county, city or town jail or detention facility shall
243-not enter into a contract or other agreement with any person or
244-entity to provide medical services to prisoners who are diagnosed
245-with human immunodeficiency virus unless the person or entity
246-demonstrates that at least 95 percent of the patients who are
247-diagnosed with human immunodeficiency virus to whom the
248-person or entity provides medical services:
249- (a) Are offered treatment on the same day as the diagnosis;
250-and
251- (b) Are able to begin such treatment not later than 7 days after
252-diagnosis.
253- 2. Except as otherwise provided in subsection 3, a county, city
254-or town jail or detention facility shall take reasonable measures to
255-ensure the availability of:
256- (a) Any drug prescribed for treating the human
257-immunodeficiency virus in the form recommended by the
258-prescribing practitioner to each prisoner who has been diagnosed
222+- *SB439_R3*
223+ Sec. 7. (Deleted by amendment.) 1
224+ Sec. 8. (Deleted by amendment.) 2
225+ Sec. 9. (Deleted by amendment.) 3
226+ Sec. 10. (Deleted by amendment.) 4
227+ Sec. 11. Chapter 209 of NRS is hereby amended by adding 5
228+thereto a new section to read as follows: 6
229+ 1. The Department or the operator of a private facility or 7
230+institution shall not enter into a contract or other agreement with 8
231+any person or entity to provide medical services to offenders who 9
232+are diagnosed with human immunodeficiency virus unless the 10
233+person or entity demonstrates that at least 95 percent of the 11
234+patients who are diagnosed with human immunodeficiency virus 12
235+to whom the person or entity provides medical services: 13
236+ (a) Are offered treatment on the same day as the diagnosis; 14
237+and 15
238+ (b) Are able to begin such treatment not later than 7 days after 16
239+diagnosis. 17
240+ 2. Except as otherwise provided in subsection 3, an 18
241+institution, facility or private facility or institution shall take 19
242+reasonable measures to ensure the availability of: 20
243+ (a) Any drug prescribed for treating the human 21
244+immunodeficiency virus in the form recommended by the 22
245+prescribing practitioner to each offender who has been diagnosed 23
246+with human immunodeficiency virus to the same extent and under 24
247+the same conditions as other medical care for offenders. 25
248+ (b) Methods of preventing the acquisition of human 26
249+immunodeficiency virus, including, without limitation, drugs 27
250+approved by the United States Food and Drug Administration for 28
251+that purpose, to all offenders free of charge. 29
252+ 3. An institution, facility or private facility or institution: 30
253+ (a) Is not required to make available a drug described in 31
254+subsection 2 for which a prescription is required to an offender for 32
255+whom such a prescription has not been issued. 33
256+ (b) Shall take reasonable measures to make available to all 34
257+offenders a provider of health care who is authorized to issue a 35
258+prescription for a drug described in subsection 2. 36
259+ (c) Shall not demand, request or suggest that a provider of 37
260+health care refrain from issuing a prescription for a drug 38
261+described in subsection 2 to an offender or take any other measure 39
262+to prevent a provider of health care from issuing such a 40
263+prescription. 41
264+ 4. As used in this section, “provider of health care” has the 42
265+meaning ascribed to it in NRS 629.031. 43
259266 – 6 –
260267
261268
262-- 82nd Session (2023)
263-with human immunodeficiency virus to the same extent and under
264-the same conditions as other medical care for prisoners.
265- (b) Methods of preventing the acquisition of human
266-immunodeficiency virus, including, without limitation, drugs
267-approved by the United States Food and Drug Administration for
268-that purpose, to all prisoners free of charge.
269- 3. A county, city or town jail or detention facility:
270- (a) Is not required to make available a drug described in
271-subsection 2 for which a prescription is required to a prisoner for
272-whom such a prescription has not been issued.
273- (b) Shall take reasonable measures to make available to all
274-prisoners a provider of health care who is authorized to issue a
275-prescription for a drug described in subsection 2.
276- (c) Shall not demand, request or suggest that a provider of
277-health care refrain from issuing a prescription for a drug
278-described in subsection 2 to an offender or take any other measure
279-to prevent a provider of health care from issuing such a
280-prescription.
281- 4. As used in this section, “provider of health care” has the
282-meaning ascribed to it in NRS 629.031.
283- Sec. 13. NRS 212.189 is hereby amended to read as follows:
284- 212.189 1. Except as otherwise provided in subsection 10, a
285-prisoner who is under lawful arrest, in lawful custody or in lawful
286-confinement shall not knowingly:
287- (a) Store or stockpile any human excrement or bodily fluid;
288- (b) Sell, supply or provide any human excrement or bodily fluid
289-to any other person;
290- (c) Buy, receive or acquire any human excrement or bodily fluid
291-from any other person; or
292- (d) Use, propel, discharge, spread or conceal, or cause to be
293-used, propelled, discharged, spread or concealed, any human
294-excrement or bodily fluid:
295- (1) With the intent to have the excrement or bodily fluid
296-come into physical contact with any portion of the body of another
297-person, including, without limitation, an officer or employee of a
298-prison or law enforcement agency, whether or not such physical
299-contact actually occurs; or
300- (2) Under circumstances in which the excrement or bodily
301-fluid is reasonably likely to come into physical contact with any
302-portion of the body of another person, including, without limitation,
303-an officer or employee of a prison or law enforcement agency,
304-whether or not such physical contact actually occurs.
269+- *SB439_R3*
270+ Sec. 12. Chapter 211 of NRS is hereby amended by adding 1
271+thereto a new section to read as follows: 2
272+ 1. A sheriff, chief of police or town marshal who is 3
273+responsible for a county, city or town jail or detention facility shall 4
274+not enter into a contract or other agreement with any person or 5
275+entity to provide medical services to prisoners who are diagnosed 6
276+with human immunodeficiency virus unless the person or entity 7
277+demonstrates that at least 95 percent of the patients who are 8
278+diagnosed with human immunodeficiency virus to whom the 9
279+person or entity provides medical services: 10
280+ (a) Are offered treatment on the same day as the diagnosis; 11
281+and 12
282+ (b) Are able to begin such treatment not later than 7 days after 13
283+diagnosis. 14
284+ 2. Except as otherwise provided in subsection 3, a county, city 15
285+or town jail or detention facility shall take reasonable measures to 16
286+ensure the availability of: 17
287+ (a) Any drug prescribed for treating the human 18
288+immunodeficiency virus in the form recommended by the 19
289+prescribing practitioner to each prisoner who has been diagnosed 20
290+with human immunodeficiency virus to the same extent and under 21
291+the same conditions as other medical care for prisoners. 22
292+ (b) Methods of preventing the acquisition of human 23
293+immunodeficiency virus, including, without limitation, drugs 24
294+approved by the United States Food and Drug Administration for 25
295+that purpose, to all prisoners free of charge. 26
296+ 3. A county, city or town jail or detention facility: 27
297+ (a) Is not required to make available a drug described in 28
298+subsection 2 for which a prescription is required to a prisoner for 29
299+whom such a prescription has not been issued. 30
300+ (b) Shall take reasonable measures to make available to all 31
301+prisoners a provider of health care who is authorized to issue a 32
302+prescription for a drug described in subsection 2. 33
303+ (c) Shall not demand, request or suggest that a provider of 34
304+health care refrain from issuing a prescription for a drug 35
305+described in subsection 2 to an offender or take any other measure 36
306+to prevent a provider of health care from issuing such a 37
307+prescription. 38
308+ 4. As used in this section, “provider of health care” has the 39
309+meaning ascribed to it in NRS 629.031. 40
310+ Sec. 13. NRS 212.189 is hereby amended to read as follows: 41
311+ 212.189 1. Except as otherwise provided in subsection 10, a 42
312+prisoner who is under lawful arrest, in lawful custody or in lawful 43
313+confinement shall not knowingly: 44
314+ (a) Store or stockpile any human excrement or bodily fluid; 45
305315 – 7 –
306316
307317
308-- 82nd Session (2023)
309- 2. Except as otherwise provided in subsection 4, if a prisoner
310-who is under lawful arrest or in lawful custody violates any
311-provision of subsection 1, the prisoner is guilty of:
312- (a) For a first offense, a gross misdemeanor.
313- (b) For a second offense or any subsequent offense, a category
314-D felony and shall be punished as provided in NRS 193.130.
315- 3. Except as otherwise provided in subsection 4, if a prisoner
316-who is in lawful confinement, other than residential confinement,
317-violates any provision of subsection 1, the prisoner is guilty of a
318-category B felony and shall be punished by imprisonment in the
319-state prison for a minimum term of not less than 2 years and a
320-maximum term of not more than 10 years, and may be further
321-punished by a fine of not more than $10,000.
322- 4. If a prisoner who is under lawful arrest, in lawful custody or
323-in lawful confinement violates any provision of paragraph (d) of
324-subsection 1 and, at the time of the offense, the prisoner knew that
325-any portion of the excrement or bodily fluid involved in the offense
326-contained a communicable disease that causes or is reasonably
327-likely to cause substantial bodily harm, [whether or not] the
328-communicable disease is likely to be transmitted as a result of the
329-offense and the communicable disease was actually transmitted to a
330-victim as a result of the offense, the prisoner is guilty of a category
331-A felony and shall be punished by imprisonment in the state prison:
332- (a) For life with the possibility of parole, with eligibility for
333-parole beginning when a minimum of 10 years has been served; or
334- (b) For a definite term of 25 years, with eligibility for parole
335-beginning when a minimum of 10 years has been served,
336- and may be further punished by a fine of not more than $50,000.
337- 5. A sentence imposed upon a prisoner pursuant to subsection
338-2, 3 or 4:
339- (a) Is not subject to suspension or the granting of probation; and
340- (b) Must run consecutively after the prisoner has served any
341-sentences imposed upon the prisoner for the offense or offenses for
342-which the prisoner was under lawful arrest, in lawful custody or in
343-lawful confinement when the prisoner violated the provisions of
344-subsection 1.
345- 6. In addition to any other penalty, the court shall order a
346-prisoner who violates any provision of paragraph (d) of subsection 1
347-to reimburse the appropriate person or governmental body for the
348-cost of any examinations or testing:
349- (a) Conducted pursuant to paragraphs (a) and (b) of subsection
350-8; or
318+- *SB439_R3*
319+ (b) Sell, supply or provide any human excrement or bodily fluid 1
320+to any other person; 2
321+ (c) Buy, receive or acquire any human excrement or bodily fluid 3
322+from any other person; or 4
323+ (d) Use, propel, discharge, spread or conceal, or cause to be 5
324+used, propelled, discharged, spread or concealed, any human 6
325+excrement or bodily fluid: 7
326+ (1) With the intent to have the excrement or bodily fluid 8
327+come into physical contact with any portion of the body of another 9
328+person, including, without limitation, an officer or employee of a 10
329+prison or law enforcement agency, whether or not such physical 11
330+contact actually occurs; or 12
331+ (2) Under circumstances in which the excrement or bodily 13
332+fluid is reasonably likely to come into physical contact with any 14
333+portion of the body of another person, including, without limitation, 15
334+an officer or employee of a prison or law enforcement agency, 16
335+whether or not such physical contact actually occurs. 17
336+ 2. Except as otherwise provided in subsection 4, if a prisoner 18
337+who is under lawful arrest or in lawful custody violates any 19
338+provision of subsection 1, the prisoner is guilty of: 20
339+ (a) For a first offense, a gross misdemeanor. 21
340+ (b) For a second offense or any subsequent offense, a category 22
341+D felony and shall be punished as provided in NRS 193.130. 23
342+ 3. Except as otherwise provided in subsection 4, if a prisoner 24
343+who is in lawful confinement, other than residential confinement, 25
344+violates any provision of subsection 1, the prisoner is guilty of a 26
345+category B felony and shall be punished by imprisonment in the 27
346+state prison for a minimum term of not less than 2 years and a 28
347+maximum term of not more than 10 years, and may be further 29
348+punished by a fine of not more than $10,000. 30
349+ 4. If a prisoner who is under lawful arrest, in lawful custody or 31
350+in lawful confinement violates any provision of paragraph (d) of 32
351+subsection 1 and, at the time of the offense, the prisoner knew that 33
352+any portion of the excrement or bodily fluid involved in the offense 34
353+contained a communicable disease that causes or is reasonably 35
354+likely to cause substantial bodily harm, [whether or not] the 36
355+communicable disease is likely to be transmitted as a result of the 37
356+offense and the communicable disease was actually transmitted to a 38
357+victim as a result of the offense, the prisoner is guilty of a category 39
358+A felony and shall be punished by imprisonment in the state prison: 40
359+ (a) For life with the possibility of parole, with eligibility for 41
360+parole beginning when a minimum of 10 years has been served; or 42
361+ (b) For a definite term of 25 years, with eligibility for parole 43
362+beginning when a minimum of 10 years has been served, 44
363+ and may be further punished by a fine of not more than $50,000. 45
351364 – 8 –
352365
353366
354-- 82nd Session (2023)
355- (b) Paid for pursuant to subparagraph (2) of paragraph (c) of
356-subsection 8.
357- 7. The warden, sheriff, administrator or other person
358-responsible for administering a prison shall immediately and fully
359-investigate any act described in subsection 1 that is reported or
360-suspected to have been committed in the prison.
361- 8. If there is probable cause to believe that an act described in
362-paragraph (d) of subsection 1 has been committed in a prison:
363- (a) Each prisoner believed to have committed the act or to have
364-been the bodily source of any portion of the excrement or bodily
365-fluid involved in the act shall submit to any appropriate
366-examinations and testing to determine whether each such prisoner
367-has any communicable disease.
368- (b) If possible, a sample of the excrement or bodily fluid
369-involved in the act must be recovered and tested to determine
370-whether any communicable disease is present in the excrement or
371-bodily fluid.
372- (c) If the excrement or bodily fluid involved in the act came into
373-physical contact with any portion of the body of an officer or
374-employee of a prison or law enforcement agency:
375- (1) The results of any examinations or testing conducted
376-pursuant to paragraphs (a) and (b) must be provided to each such
377-officer, employee or other person; and
378- (2) For each such officer or employee:
379- (I) Of a prison, the person or governmental body
380-operating the prison where the act was committed shall pay for any
381-appropriate examinations and testing requested by the officer or
382-employee to determine whether a communicable disease was
383-transmitted to the officer or employee as a result of the act; and
384- (II) Of any law enforcement agency, the law enforcement
385-agency that employs the officer or employee shall pay for any
386-appropriate examinations and testing requested by the officer or
387-employee to determine whether a communicable disease was
388-transmitted to the officer or employee as a result of the act.
389- (d) The results of the investigation conducted pursuant to
390-subsection 7 and the results of any examinations or testing
391-conducted pursuant to paragraphs (a) and (b) must be submitted to
392-the district attorney of the county in which the act was committed or
393-to the Office of the Attorney General for possible prosecution of
394-each prisoner who committed the act.
395- 9. If a prisoner is charged with committing an act described in
396-paragraph (d) of subsection 1 and a victim or an intended victim of
397-the act was an officer or employee of a prison or law enforcement
367+- *SB439_R3*
368+ 5. A sentence imposed upon a prisoner pursuant to subsection 1
369+2, 3 or 4: 2
370+ (a) Is not subject to suspension or the granting of probation; and 3
371+ (b) Must run consecutively after the prisoner has served any 4
372+sentences imposed upon the prisoner for the offense or offenses for 5
373+which the prisoner was under lawful arrest, in lawful custody or in 6
374+lawful confinement when the prisoner violated the provisions of 7
375+subsection 1. 8
376+ 6. In addition to any other penalty, the court shall order a 9
377+prisoner who violates any provision of paragraph (d) of subsection 1 10
378+to reimburse the appropriate person or governmental body for the 11
379+cost of any examinations or testing: 12
380+ (a) Conducted pursuant to paragraphs (a) and (b) of subsection 13
381+8; or 14
382+ (b) Paid for pursuant to subparagraph (2) of paragraph (c) of 15
383+subsection 8. 16
384+ 7. The warden, sheriff, administrator or other person 17
385+responsible for administering a prison shall immediately and fully 18
386+investigate any act described in subsection 1 that is reported or 19
387+suspected to have been committed in the prison. 20
388+ 8. If there is probable cause to believe that an act described in 21
389+paragraph (d) of subsection 1 has been committed in a prison: 22
390+ (a) Each prisoner believed to have committed the act or to have 23
391+been the bodily source of any portion of the excrement or bodily 24
392+fluid involved in the act shall submit to any appropriate 25
393+examinations and testing to determine whether each such prisoner 26
394+has any communicable disease. 27
395+ (b) If possible, a sample of the excrement or bodily fluid 28
396+involved in the act must be recovered and tested to determine 29
397+whether any communicable disease is present in the excrement or 30
398+bodily fluid. 31
399+ (c) If the excrement or bodily fluid involved in the act came into 32
400+physical contact with any portion of the body of an officer or 33
401+employee of a prison or law enforcement agency: 34
402+ (1) The results of any examinations or testing conducted 35
403+pursuant to paragraphs (a) and (b) must be provided to each such 36
404+officer, employee or other person; and 37
405+ (2) For each such officer or employee: 38
406+ (I) Of a prison, the person or governmental body 39
407+operating the prison where the act was committed shall pay for any 40
408+appropriate examinations and testing requested by the officer or 41
409+employee to determine whether a communicable disease was 42
410+transmitted to the officer or employee as a result of the act; and 43
411+ (II) Of any law enforcement agency, the law enforcement 44
412+agency that employs the officer or employee shall pay for any 45
398413 – 9 –
399414
400415
401-- 82nd Session (2023)
402-agency, the prosecuting attorney shall not dismiss the charge in
403-exchange for a plea of guilty, guilty but mentally ill or nolo
404-contendere to a lesser charge or for any other reason unless the
405-prosecuting attorney knows or it is obvious that the charge is not
406-supported by probable cause or cannot be proved at the time of trial.
407- 10. The provisions of this section do not apply to a prisoner
408-who is in residential confinement or to a prisoner who commits an
409-act described in subsection 1 if the act:
410- (a) Is otherwise lawful and is authorized by the warden, sheriff,
411-administrator or other person responsible for administering the
412-prison, or his or her designee, and the prisoner performs the act in
413-accordance with the directions or instructions given to the prisoner
414-by that person;
415- (b) Involves the discharge of human excrement or bodily fluid
416-directly from the body of the prisoner and the discharge is the direct
417-result of a temporary or permanent injury, disease or medical
418-condition afflicting the prisoner that prevents the prisoner from
419-having physical control over the discharge of his or her own
420-excrement or bodily fluid; or
421- (c) Constitutes voluntary sexual conduct with another person in
422-violation of the provisions of NRS 212.187.
423- Sec. 14. NRS 232.320 is hereby amended to read as follows:
424- 232.320 1. The Director:
425- (a) Shall appoint, with the consent of the Governor,
426-administrators of the divisions of the Department, who are
427-respectively designated as follows:
428- (1) The Administrator of the Aging and Disability Services
429-Division;
430- (2) The Administrator of the Division of Welfare and
431-Supportive Services;
432- (3) The Administrator of the Division of Child and Family
433-Services;
434- (4) The Administrator of the Division of Health Care
435-Financing and Policy; and
436- (5) The Administrator of the Division of Public and
437-Behavioral Health.
438- (b) Shall administer, through the divisions of the Department,
439-the provisions of chapters 63, 424, 425, 427A, 432A to 442,
440-inclusive, 446 to 450, inclusive, 458A and 656A of NRS, NRS
441-127.220 to 127.310, inclusive, 422.001 to 422.410, inclusive, and
442-section 20 of this act, 422.580, 432.010 to 432.133, inclusive,
443-432B.6201 to 432B.626, inclusive, 444.002 to 444.430, inclusive,
444-and 445A.010 to 445A.055, inclusive, and all other provisions of
416+- *SB439_R3*
417+appropriate examinations and testing requested by the officer or 1
418+employee to determine whether a communicable disease was 2
419+transmitted to the officer or employee as a result of the act. 3
420+ (d) The results of the investigation conducted pursuant to 4
421+subsection 7 and the results of any examinations or testing 5
422+conducted pursuant to paragraphs (a) and (b) must be submitted to 6
423+the district attorney of the county in which the act was committed or 7
424+to the Office of the Attorney General for possible prosecution of 8
425+each prisoner who committed the act. 9
426+ 9. If a prisoner is charged with committing an act described in 10
427+paragraph (d) of subsection 1 and a victim or an intended victim of 11
428+the act was an officer or employee of a prison or law enforcement 12
429+agency, the prosecuting attorney shall not dismiss the charge in 13
430+exchange for a plea of guilty, guilty but mentally ill or nolo 14
431+contendere to a lesser charge or for any other reason unless the 15
432+prosecuting attorney knows or it is obvious that the charge is not 16
433+supported by probable cause or cannot be proved at the time of trial. 17
434+ 10. The provisions of this section do not apply to a prisoner 18
435+who is in residential confinement or to a prisoner who commits an 19
436+act described in subsection 1 if the act: 20
437+ (a) Is otherwise lawful and is authorized by the warden, sheriff, 21
438+administrator or other person responsible for administering the 22
439+prison, or his or her designee, and the prisoner performs the act in 23
440+accordance with the directions or instructions given to the prisoner 24
441+by that person; 25
442+ (b) Involves the discharge of human excrement or bodily fluid 26
443+directly from the body of the prisoner and the discharge is the direct 27
444+result of a temporary or permanent injury, disease or medical 28
445+condition afflicting the prisoner that prevents the prisoner from 29
446+having physical control over the discharge of his or her own 30
447+excrement or bodily fluid; or 31
448+ (c) Constitutes voluntary sexual conduct with another person in 32
449+violation of the provisions of NRS 212.187. 33
450+ Sec. 14. NRS 232.320 is hereby amended to read as follows: 34
451+ 232.320 1. The Director: 35
452+ (a) Shall appoint, with the consent of the Governor, 36
453+administrators of the divisions of the Department, who are 37
454+respectively designated as follows: 38
455+ (1) The Administrator of the Aging and Disability Services 39
456+Division; 40
457+ (2) The Administrator of the Division of Welfare and 41
458+Supportive Services; 42
459+ (3) The Administrator of the Division of Child and Family 43
460+Services; 44
445461 – 10 –
446462
447463
448-- 82nd Session (2023)
449-law relating to the functions of the divisions of the Department, but
450-is not responsible for the clinical activities of the Division of Public
451-and Behavioral Health or the professional line activities of the other
452-divisions.
453- (c) Shall administer any state program for persons with
454-developmental disabilities established pursuant to the
455-Developmental Disabilities Assistance and Bill of Rights Act of
456-2000, 42 U.S.C. §§ 15001 et seq.
457- (d) Shall, after considering advice from agencies of local
458-governments and nonprofit organizations which provide social
459-services, adopt a master plan for the provision of human services in
460-this State. The Director shall revise the plan biennially and deliver a
461-copy of the plan to the Governor and the Legislature at the
462-beginning of each regular session. The plan must:
463- (1) Identify and assess the plans and programs of the
464-Department for the provision of human services, and any
465-duplication of those services by federal, state and local agencies;
466- (2) Set forth priorities for the provision of those services;
467- (3) Provide for communication and the coordination of those
468-services among nonprofit organizations, agencies of local
469-government, the State and the Federal Government;
470- (4) Identify the sources of funding for services provided by
471-the Department and the allocation of that funding;
472- (5) Set forth sufficient information to assist the Department
473-in providing those services and in the planning and budgeting for the
474-future provision of those services; and
475- (6) Contain any other information necessary for the
476-Department to communicate effectively with the Federal
477-Government concerning demographic trends, formulas for the
478-distribution of federal money and any need for the modification of
479-programs administered by the Department.
480- (e) May, by regulation, require nonprofit organizations and state
481-and local governmental agencies to provide information regarding
482-the programs of those organizations and agencies, excluding
483-detailed information relating to their budgets and payrolls, which the
484-Director deems necessary for the performance of the duties imposed
485-upon him or her pursuant to this section.
486- (f) Has such other powers and duties as are provided by law.
487- 2. Notwithstanding any other provision of law, the Director, or
488-the Director’s designee, is responsible for appointing and removing
489-subordinate officers and employees of the Department.
464+- *SB439_R3*
465+ (4) The Administrator of the Division of Health Care 1
466+Financing and Policy; and 2
467+ (5) The Administrator of the Division of Public and 3
468+Behavioral Health. 4
469+ (b) Shall administer, through the divisions of the Department, 5
470+the provisions of chapters 63, 424, 425, 427A, 432A to 442, 6
471+inclusive, 446 to 450, inclusive, 458A and 656A of NRS, NRS 7
472+127.220 to 127.310, inclusive, 422.001 to 422.410, inclusive, and 8
473+section 20 of this act, 422.580, 432.010 to 432.133, inclusive, 9
474+432B.6201 to 432B.626, inclusive, 444.002 to 444.430, inclusive, 10
475+and 445A.010 to 445A.055, inclusive, and all other provisions of 11
476+law relating to the functions of the divisions of the Department, but 12
477+is not responsible for the clinical activities of the Division of Public 13
478+and Behavioral Health or the professional line activities of the other 14
479+divisions. 15
480+ (c) Shall administer any state program for persons with 16
481+developmental disabilities established pursuant to the 17
482+Developmental Disabilities Assistance and Bill of Rights Act of 18
483+2000, 42 U.S.C. §§ 15001 et seq. 19
484+ (d) Shall, after considering advice from agencies of local 20
485+governments and nonprofit organizations which provide social 21
486+services, adopt a master plan for the provision of human services in 22
487+this State. The Director shall revise the plan biennially and deliver a 23
488+copy of the plan to the Governor and the Legislature at the 24
489+beginning of each regular session. The plan must: 25
490+ (1) Identify and assess the plans and programs of the 26
491+Department for the provision of human services, and any 27
492+duplication of those services by federal, state and local agencies; 28
493+ (2) Set forth priorities for the provision of those services; 29
494+ (3) Provide for communication and the coordination of those 30
495+services among nonprofit organizations, agencies of local 31
496+government, the State and the Federal Government; 32
497+ (4) Identify the sources of funding for services provided by 33
498+the Department and the allocation of that funding; 34
499+ (5) Set forth sufficient information to assist the Department 35
500+in providing those services and in the planning and budgeting for the 36
501+future provision of those services; and 37
502+ (6) Contain any other information necessary for the 38
503+Department to communicate effectively with the Federal 39
504+Government concerning demographic trends, formulas for the 40
505+distribution of federal money and any need for the modification of 41
506+programs administered by the Department. 42
507+ (e) May, by regulation, require nonprofit organizations and state 43
508+and local governmental agencies to provide information regarding 44
509+the programs of those organizations and agencies, excluding 45
490510 – 11 –
491511
492512
493-- 82nd Session (2023)
494- Sec. 14.5. Chapter 287 of NRS is hereby amended by adding
495-thereto a new section to read as follows:
496- 1. The governing body of any county, school district,
497-municipal corporation, political subdivision, public corporation or
498-other local governmental agency of the State of Nevada that
499-provides health insurance through a plan of self-insurance shall
500-provide coverage for:
501- (a) Drugs approved by the United States Food and Drug
502-Administration for preventing the acquisition of human
503-immunodeficiency virus;
504- (b) Laboratory testing that is necessary for therapy that uses
505-such a drug; and
506- (c) The services described in NRS 639.28085, when provided
507-by a pharmacist who participates in the network plan of the
508-governing body.
509- 2. The governing body of any county, school district,
510-municipal corporation, political subdivision, public corporation or
511-other local governmental agency of the State of Nevada that
512-provides health insurance through a plan of self-insurance shall
513-reimburse a pharmacist who participates in the network plan of
514-the governing body for the services described in NRS 639.28085 at
515-a rate equal to the rate of reimbursement provided to a physician,
516-physician assistant or advanced practice registered nurse for
517-similar services.
518- 3. The governing body of any county, school district,
519-municipal corporation, political subdivision, public corporation or
520-other local governmental agency of the State of Nevada that
521-provides health insurance through a plan of self-insurance may
522-subject the benefits required by subsection 1 to reasonable medical
523-management techniques.
524- 4. The governing body of any county, school district,
525-municipal corporation, political subdivision, public corporation or
526-other local governmental agency of the State of Nevada that
527-provides health insurance through a plan of self-insurance shall
528-ensure that the benefits required by subsection 1 are made
529-available to an insured through a provider of health care who
530-participates in the network plan of the governing body.
531- 5. A plan of self-insurance described in subsection 1 that is
532-delivered, issued for delivery or renewed on or after January 1,
533-2024, has the legal effect of including the coverage required by
534-subsection 1, and any provision of the plan that conflicts with the
535-provisions of this section is void.
536- 6. As used in this section:
513+- *SB439_R3*
514+detailed information relating to their budgets and payrolls, which the 1
515+Director deems necessary for the performance of the duties imposed 2
516+upon him or her pursuant to this section. 3
517+ (f) Has such other powers and duties as are provided by law. 4
518+ 2. Notwithstanding any other provision of law, the Director, or 5
519+the Director’s designee, is responsible for appointing and removing 6
520+subordinate officers and employees of the Department. 7
521+ Sec. 14.5. Chapter 287 of NRS is hereby amended by adding 8
522+thereto a new section to read as follows: 9
523+ 1. The governing body of any county, school district, 10
524+municipal corporation, political subdivision, public corporation or 11
525+other local governmental agency of the State of Nevada that 12
526+provides health insurance through a plan of self-insurance shall 13
527+provide coverage for: 14
528+ (a) Drugs approved by the United States Food and Drug 15
529+Administration for preventing the acquisition of human 16
530+immunodeficiency virus; 17
531+ (b) Laboratory testing that is necessary for therapy that uses 18
532+such a drug; and 19
533+ (c) The services described in NRS 639.28085, when provided 20
534+by a pharmacist who participates in the network plan of the 21
535+governing body. 22
536+ 2. The governing body of any county, school district, 23
537+municipal corporation, political subdivision, public corporation or 24
538+other local governmental agency of the State of Nevada that 25
539+provides health insurance through a plan of self-insurance shall 26
540+reimburse a pharmacist who participates in the network plan of 27
541+the governing body for the services described in NRS 639.28085 at 28
542+a rate equal to the rate of reimbursement provided to a physician, 29
543+physician assistant or advanced practice registered nurse for 30
544+similar services. 31
545+ 3. The governing body of any county, school district, 32
546+municipal corporation, political subdivision, public corporation or 33
547+other local governmental agency of the State of Nevada that 34
548+provides health insurance through a plan of self-insurance may 35
549+subject the benefits required by subsection 1 to reasonable medical 36
550+management techniques. 37
551+ 4. The governing body of any county, school district, 38
552+municipal corporation, political subdivision, public corporation or 39
553+other local governmental agency of the State of Nevada that 40
554+provides health insurance through a plan of self-insurance shall 41
555+ensure that the benefits required by subsection 1 are made 42
556+available to an insured through a provider of health care who 43
557+participates in the network plan of the governing body. 44
537558 – 12 –
538559
539560
540-- 82nd Session (2023)
541- (a) “Medical management technique” means a practice which
542-is used to control the cost or use of health care services or
543-prescription drugs. The term includes, without limitation, the use
544-of step therapy, prior authorization and categorizing drugs and
545-devices based on cost, type or method of administration.
546- (b) “Network plan” means a plan of self-insurance provided
547-by the governing body of a local governmental agency under
548-which the financing and delivery of medical care, including items
549-and services paid for as medical care, are provided, in whole or in
550-part, through a defined set of providers under contract with the
551-governing body. The term does not include an arrangement for the
552-financing of premiums.
553- (c) “Provider of health care” has the meaning ascribed to it in
554-NRS 629.031.
555- Sec. 15. NRS 287.010 is hereby amended to read as follows:
556- 287.010 1. The governing body of any county, school
557-district, municipal corporation, political subdivision, public
558-corporation or other local governmental agency of the State of
559-Nevada may:
560- (a) Adopt and carry into effect a system of group life, accident
561-or health insurance, or any combination thereof, for the benefit of its
562-officers and employees, and the dependents of officers and
563-employees who elect to accept the insurance and who, where
564-necessary, have authorized the governing body to make deductions
565-from their compensation for the payment of premiums on the
566-insurance.
567- (b) Purchase group policies of life, accident or health insurance,
568-or any combination thereof, for the benefit of such officers and
569-employees, and the dependents of such officers and employees, as
570-have authorized the purchase, from insurance companies authorized
571-to transact the business of such insurance in the State of Nevada,
572-and, where necessary, deduct from the compensation of officers and
573-employees the premiums upon insurance and pay the deductions
574-upon the premiums.
575- (c) Provide group life, accident or health coverage through a
576-self-insurance reserve fund and, where necessary, deduct
577-contributions to the maintenance of the fund from the compensation
578-of officers and employees and pay the deductions into the fund. The
579-money accumulated for this purpose through deductions from the
580-compensation of officers and employees and contributions of the
581-governing body must be maintained as an internal service fund as
582-defined by NRS 354.543. The money must be deposited in a state or
583-national bank or credit union authorized to transact business in the
561+- *SB439_R3*
562+ 5. A plan of self-insurance described in subsection 1 that is 1
563+delivered, issued for delivery or renewed on or after January 1, 2
564+2024, has the legal effect of including the coverage required by 3
565+subsection 1, and any provision of the plan that conflicts with the 4
566+provisions of this section is void. 5
567+ 6. As used in this section: 6
568+ (a) “Medical management technique” means a practice which 7
569+is used to control the cost or use of health care services or 8
570+prescription drugs. The term includes, without limitation, the use 9
571+of step therapy, prior authorization and categorizing drugs and 10
572+devices based on cost, type or method of administration. 11
573+ (b) “Network plan” means a plan of self-insurance provided 12
574+by the governing body of a local governmental agency under 13
575+which the financing and delivery of medical care, including items 14
576+and services paid for as medical care, are provided, in whole or in 15
577+part, through a defined set of providers under contract with the 16
578+governing body. The term does not include an arrangement for the 17
579+financing of premiums. 18
580+ (c) “Provider of health care” has the meaning ascribed to it in 19
581+NRS 629.031. 20
582+ Sec. 15. NRS 287.010 is hereby amended to read as follows: 21
583+ 287.010 1. The governing body of any county, school 22
584+district, municipal corporation, political subdivision, public 23
585+corporation or other local governmental agency of the State of 24
586+Nevada may: 25
587+ (a) Adopt and carry into effect a system of group life, accident 26
588+or health insurance, or any combination thereof, for the benefit of its 27
589+officers and employees, and the dependents of officers and 28
590+employees who elect to accept the insurance and who, where 29
591+necessary, have authorized the governing body to make deductions 30
592+from their compensation for the payment of premiums on the 31
593+insurance. 32
594+ (b) Purchase group policies of life, accident or health insurance, 33
595+or any combination thereof, for the benefit of such officers and 34
596+employees, and the dependents of such officers and employees, as 35
597+have authorized the purchase, from insurance companies authorized 36
598+to transact the business of such insurance in the State of Nevada, 37
599+and, where necessary, deduct from the compensation of officers and 38
600+employees the premiums upon insurance and pay the deductions 39
601+upon the premiums. 40
602+ (c) Provide group life, accident or health coverage through a 41
603+self-insurance reserve fund and, where necessary, deduct 42
604+contributions to the maintenance of the fund from the compensation 43
605+of officers and employees and pay the deductions into the fund. The 44
606+money accumulated for this purpose through deductions from the 45
584607 – 13 –
585608
586609
587-- 82nd Session (2023)
588-State of Nevada. Any independent administrator of a fund created
589-under this section is subject to the licensing requirements of chapter
590-683A of NRS, and must be a resident of this State. Any contract
591-with an independent administrator must be approved by the
592-Commissioner of Insurance as to the reasonableness of
593-administrative charges in relation to contributions collected and
594-benefits provided. The provisions of NRS 686A.135, 687B.352,
595-687B.408, 687B.723, 687B.725, 689B.030 to 689B.031, inclusive,
596-689B.0313 to 689B.050, inclusive, 689B.265, 689B.287 and
597-689B.500 apply to coverage provided pursuant to this paragraph,
598-except that the provisions of NRS 689B.0378, 689B.03785 and
599-689B.500 only apply to coverage for active officers and employees
600-of the governing body, or the dependents of such officers and
601-employees.
602- (d) Defray part or all of the cost of maintenance of a self-
603-insurance fund or of the premiums upon insurance. The money for
604-contributions must be budgeted for in accordance with the laws
605-governing the county, school district, municipal corporation,
606-political subdivision, public corporation or other local governmental
607-agency of the State of Nevada.
608- 2. If a school district offers group insurance to its officers and
609-employees pursuant to this section, members of the board of trustees
610-of the school district must not be excluded from participating in the
611-group insurance. If the amount of the deductions from compensation
612-required to pay for the group insurance exceeds the compensation to
613-which a trustee is entitled, the difference must be paid by the trustee.
614- 3. In any county in which a legal services organization exists,
615-the governing body of the county, or of any school district,
616-municipal corporation, political subdivision, public corporation or
617-other local governmental agency of the State of Nevada in the
618-county, may enter into a contract with the legal services
619-organization pursuant to which the officers and employees of the
620-legal services organization, and the dependents of those officers and
621-employees, are eligible for any life, accident or health insurance
622-provided pursuant to this section to the officers and employees, and
623-the dependents of the officers and employees, of the county, school
624-district, municipal corporation, political subdivision, public
625-corporation or other local governmental agency.
626- 4. If a contract is entered into pursuant to subsection 3, the
627-officers and employees of the legal services organization:
628- (a) Shall be deemed, solely for the purposes of this section, to be
629-officers and employees of the county, school district, municipal
630-corporation, political subdivision, public corporation or other local
610+- *SB439_R3*
611+compensation of officers and employees and contributions of the 1
612+governing body must be maintained as an internal service fund as 2
613+defined by NRS 354.543. The money must be deposited in a state or 3
614+national bank or credit union authorized to transact business in the 4
615+State of Nevada. Any independent administrator of a fund created 5
616+under this section is subject to the licensing requirements of chapter 6
617+683A of NRS, and must be a resident of this State. Any contract 7
618+with an independent administrator must be approved by the 8
619+Commissioner of Insurance as to the reasonableness of 9
620+administrative charges in relation to contributions collected and 10
621+benefits provided. The provisions of NRS 686A.135, 687B.352, 11
622+687B.408, 687B.723, 687B.725, 689B.030 to 689B.031, inclusive, 12
623+689B.0313 to 689B.050, inclusive, 689B.265, 689B.287 and 13
624+689B.500 apply to coverage provided pursuant to this paragraph, 14
625+except that the provisions of NRS 689B.0378, 689B.03785 and 15
626+689B.500 only apply to coverage for active officers and employees 16
627+of the governing body, or the dependents of such officers and 17
628+employees. 18
629+ (d) Defray part or all of the cost of maintenance of a self-19
630+insurance fund or of the premiums upon insurance. The money for 20
631+contributions must be budgeted for in accordance with the laws 21
632+governing the county, school district, municipal corporation, 22
633+political subdivision, public corporation or other local governmental 23
634+agency of the State of Nevada. 24
635+ 2. If a school district offers group insurance to its officers and 25
636+employees pursuant to this section, members of the board of trustees 26
637+of the school district must not be excluded from participating in the 27
638+group insurance. If the amount of the deductions from compensation 28
639+required to pay for the group insurance exceeds the compensation to 29
640+which a trustee is entitled, the difference must be paid by the trustee. 30
641+ 3. In any county in which a legal services organization exists, 31
642+the governing body of the county, or of any school district, 32
643+municipal corporation, political subdivision, public corporation or 33
644+other local governmental agency of the State of Nevada in the 34
645+county, may enter into a contract with the legal services 35
646+organization pursuant to which the officers and employees of the 36
647+legal services organization, and the dependents of those officers and 37
648+employees, are eligible for any life, accident or health insurance 38
649+provided pursuant to this section to the officers and employees, and 39
650+the dependents of the officers and employees, of the county, school 40
651+district, municipal corporation, political subdivision, public 41
652+corporation or other local governmental agency. 42
653+ 4. If a contract is entered into pursuant to subsection 3, the 43
654+officers and employees of the legal services organization: 44
631655 – 14 –
632656
633657
634-- 82nd Session (2023)
635-governmental agency with which the legal services organization has
636-contracted; and
637- (b) Must be required by the contract to pay the premiums or
638-contributions for all insurance which they elect to accept or of which
639-they authorize the purchase.
640- 5. A contract that is entered into pursuant to subsection 3:
641- (a) Must be submitted to the Commissioner of Insurance for
642-approval not less than 30 days before the date on which the contract
643-is to become effective.
644- (b) Does not become effective unless approved by the
645-Commissioner.
646- (c) Shall be deemed to be approved if not disapproved by the
647-Commissioner within 30 days after its submission.
648- 6. As used in this section, “legal services organization” means
649-an organization that operates a program for legal aid and receives
650-money pursuant to NRS 19.031.
651- Sec. 15.5. NRS 287.040 is hereby amended to read as follows:
652- 287.040 The provisions of NRS 287.010 to 287.040, inclusive,
653-and section 14.5 of this act do not make it compulsory upon any
654-governing body of any county, school district, municipal
655-corporation, political subdivision, public corporation or other local
656-governmental agency of the State of Nevada, except as otherwise
657-provided in NRS 287.021 or subsection 4 of NRS 287.023 or in an
658-agreement entered into pursuant to subsection 3 of NRS 287.015, to
659-pay any premiums, contributions or other costs for group insurance,
660-a plan of benefits or medical or hospital services established
661-pursuant to NRS 287.010, 287.015, 287.020 or paragraph (b), (c) or
662-(d) of subsection 1 of NRS 287.025, for coverage under the Public
663-Employees’ Benefits Program, or to make any contributions to a
664-trust fund established pursuant to NRS 287.017, or upon any officer
665-or employee of any county, school district, municipal corporation,
666-political subdivision, public corporation or other local governmental
667-agency of this State to accept any such coverage or to assign his or
668-her wages or salary in payment of premiums or contributions
669-therefor.
670- Sec. 16. NRS 287.04335 is hereby amended to read as
671-follows:
672- 287.04335 If the Board provides health insurance through a
673-plan of self-insurance, it shall comply with the provisions of NRS
674-686A.135, 687B.352, 687B.409, 687B.723, 687B.725, 689B.0353,
675-689B.255, 695C.1723, 695G.150, 695G.155, 695G.160, 695G.162,
676-695G.1635, 695G.164, 695G.1645, 695G.1665, 695G.167,
677-695G.1675, 695G.170 to 695G.174, inclusive, and sections 71 and
658+- *SB439_R3*
659+ (a) Shall be deemed, solely for the purposes of this section, to be 1
660+officers and employees of the county, school district, municipal 2
661+corporation, political subdivision, public corporation or other local 3
662+governmental agency with which the legal services organization has 4
663+contracted; and 5
664+ (b) Must be required by the contract to pay the premiums or 6
665+contributions for all insurance which they elect to accept or of which 7
666+they authorize the purchase. 8
667+ 5. A contract that is entered into pursuant to subsection 3: 9
668+ (a) Must be submitted to the Commissioner of Insurance for 10
669+approval not less than 30 days before the date on which the contract 11
670+is to become effective. 12
671+ (b) Does not become effective unless approved by the 13
672+Commissioner. 14
673+ (c) Shall be deemed to be approved if not disapproved by the 15
674+Commissioner within 30 days after its submission. 16
675+ 6. As used in this section, “legal services organization” means 17
676+an organization that operates a program for legal aid and receives 18
677+money pursuant to NRS 19.031. 19
678+ Sec. 15.5. NRS 287.040 is hereby amended to read as follows: 20
679+ 287.040 The provisions of NRS 287.010 to 287.040, inclusive, 21
680+and section 14.5 of this act do not make it compulsory upon any 22
681+governing body of any county, school district, municipal 23
682+corporation, political subdivision, public corporation or other local 24
683+governmental agency of the State of Nevada, except as otherwise 25
684+provided in NRS 287.021 or subsection 4 of NRS 287.023 or in an 26
685+agreement entered into pursuant to subsection 3 of NRS 287.015, to 27
686+pay any premiums, contributions or other costs for group insurance, 28
687+a plan of benefits or medical or hospital services established 29
688+pursuant to NRS 287.010, 287.015, 287.020 or paragraph (b), (c) or 30
689+(d) of subsection 1 of NRS 287.025, for coverage under the Public 31
690+Employees’ Benefits Program, or to make any contributions to a 32
691+trust fund established pursuant to NRS 287.017, or upon any officer 33
692+or employee of any county, school district, municipal corporation, 34
693+political subdivision, public corporation or other local governmental 35
694+agency of this State to accept any such coverage or to assign his or 36
695+her wages or salary in payment of premiums or contributions 37
696+therefor. 38
697+ Sec. 16. NRS 287.04335 is hereby amended to read as 39
698+follows: 40
699+ 287.04335 If the Board provides health insurance through a 41
700+plan of self-insurance, it shall comply with the provisions of NRS 42
701+686A.135, 687B.352, 687B.409, 687B.723, 687B.725, 689B.0353, 43
702+689B.255, 695C.1723, 695G.150, 695G.155, 695G.160, 695G.162, 44
703+695G.1635, 695G.164, 695G.1645, 695G.1665, 695G.167, 45
678704 – 15 –
679705
680706
681-- 82nd Session (2023)
682-72 of this act, 695G.176, 695G.177, 695G.200 to 695G.230,
683-inclusive, 695G.241 to 695G.310, inclusive, and 695G.405, in the
684-same manner as an insurer that is licensed pursuant to title 57 of
685-NRS is required to comply with those provisions.
686- Secs. 17 and 18. (Deleted by amendment.)
687- Sec. 19. Chapter 422 of NRS is hereby amended by adding
688-thereto the provisions set forth as sections 20 and 21 of this act.
689- Sec. 20. 1. The Director shall include in the State Plan for
690-Medicaid a requirement that the State pay the nonfederal share of
691-expenses for any service for the treatment of substance use
692-disorder provided by a provider of primary care if the service is
693-included in the State Plan when provided by a specialist and:
694- (a) The service is within the scope of practice of the provider of
695-primary care; or
696- (b) The provider of primary care is capable of providing the
697-service safely and effectively in consultation with a specialist and
698-the provider engages in such consultation.
699- 2. As used in this section, “primary care” means the practice
700-of family medicine, pediatrics, internal medicine, obstetrics and
701-gynecology and midwifery.
702- Sec. 21. (Deleted by amendment.)
703- Sec. 22. NRS 422.27173 is hereby amended to read as
704-follows:
705- 422.27173 The Director shall include in the State Plan for
706-Medicaid a requirement that the State must pay the nonfederal share
707-of expenditures incurred for :
708- 1. Testing for and the treatment and prevention of sexually
709-transmitted diseases, including, without limitation, Chlamydia
710-trachomatis, gonorrhea, syphilis, human immunodeficiency virus
711-and hepatitis B and C, for all recipients of Medicaid, regardless of
712-age. Services covered pursuant to this section must include,
713-without limitation, the examination of a pregnant woman for the
714-discovery of:
715- [1.] (a) Chlamydia trachomatis, gonorrhea, hepatitis B and
716-hepatitis C in accordance with NRS 442.013.
717- [2.] (b) Syphilis in accordance with NRS 442.010.
718- 2. Condoms for recipients of Medicaid.
719- Sec. 23. NRS 422.27235 is hereby amended to read as
720-follows:
721- 422.27235 1. The Director shall include in the State Plan for
722-Medicaid a requirement that the State pay the nonfederal share of
723-expenditures incurred for:
707+- *SB439_R3*
708+695G.1675, 695G.170 to 695G.174, inclusive, and sections 71 and 1
709+72 of this act, 695G.176, 695G.177, 695G.200 to 695G.230, 2
710+inclusive, 695G.241 to 695G.310, inclusive, and 695G.405, in the 3
711+same manner as an insurer that is licensed pursuant to title 57 of 4
712+NRS is required to comply with those provisions. 5
713+ Sec. 17. (Deleted by amendment.) 6
714+ Sec. 18. (Deleted by amendment.) 7
715+ Sec. 19. Chapter 422 of NRS is hereby amended by adding 8
716+thereto the provisions set forth as sections 20 and 21 of this act. 9
717+ Sec. 20. 1. The Director shall include in the State Plan for 10
718+Medicaid a requirement that the State pay the nonfederal share of 11
719+expenses for any service for the treatment of substance use 12
720+disorder provided by a provider of primary care if the service is 13
721+included in the State Plan when provided by a specialist and: 14
722+ (a) The service is within the scope of practice of the provider of 15
723+primary care; or 16
724+ (b) The provider of primary care is capable of providing the 17
725+service safely and effectively in consultation with a specialist and 18
726+the provider engages in such consultation. 19
727+ 2. As used in this section, “primary care” means the practice 20
728+of family medicine, pediatrics, internal medicine, obstetrics and 21
729+gynecology and midwifery. 22
730+ Sec. 21. (Deleted by amendment.) 23
731+ Sec. 22. NRS 422.27173 is hereby amended to read as 24
732+follows: 25
733+ 422.27173 The Director shall include in the State Plan for 26
734+Medicaid a requirement that the State must pay the nonfederal share 27
735+of expenditures incurred for : 28
736+ 1. Testing for and the treatment and prevention of sexually 29
737+transmitted diseases, including, without limitation, Chlamydia 30
738+trachomatis, gonorrhea, syphilis, human immunodeficiency virus 31
739+and hepatitis B and C, for all recipients of Medicaid, regardless of 32
740+age. Services covered pursuant to this section must include, 33
741+without limitation, the examination of a pregnant woman for the 34
742+discovery of: 35
743+ [1.] (a) Chlamydia trachomatis, gonorrhea, hepatitis B and 36
744+hepatitis C in accordance with NRS 442.013. 37
745+ [2.] (b) Syphilis in accordance with NRS 442.010. 38
746+ 2. Condoms for recipients of Medicaid. 39
747+ Sec. 23. NRS 422.27235 is hereby amended to read as 40
748+follows: 41
749+ 422.27235 1. The Director shall include in the State Plan for 42
750+Medicaid a requirement that the State pay the nonfederal share of 43
751+expenditures incurred for: 44
724752 – 16 –
725753
726754
727-- 82nd Session (2023)
728- [1.] (a) Any laboratory testing that is necessary for therapy that
729-uses a drug approved by the United States Food and Drug
730-Administration for preventing the acquisition of human
731-immunodeficiency virus . [; and]
732- [2.] (b) The services of a pharmacist described in NRS
733-639.28085. The State must provide reimbursement for such services
734-at a rate equal to the rate of reimbursement provided to a physician,
735-physician assistant or advanced practice registered nurse for similar
736-services.
737- (c) Any service to test for, prevent or treat human
738-immunodeficiency virus or hepatitis C provided by a provider of
739-primary care if the service is covered when provided by a specialist
740-and:
741- (1) The service is within the scope of practice of the
742-provider of primary care; or
743- (2) The provider of primary care is capable of providing the
744-service safely and effectively in consultation with a specialist and
745-the provider engages in such consultation.
746- 2. The Director shall include in the State Plan for Medicaid a
747-requirement that the State reimburse an advanced practice
748-registered nurse or a physician assistant for any service to test for,
749-prevent or treat human immunodeficiency virus or hepatitis C at a
750-rate equal to the rate of reimbursement provided to a physician for
751-similar services.
752- 3. As used in this section, “primary care” means the practice
753-of family medicine, pediatrics, internal medicine, obstetrics and
754-gynecology and midwifery.
755- Sec. 24. (Deleted by amendment.)
756- Sec. 25. NRS 422.4025 is hereby amended to read as follows:
757- 422.4025 1. The Department shall:
758- (a) By regulation, develop a list of preferred prescription drugs
759-to be used for the Medicaid program and the Children’s Health
760-Insurance Program, and each public or nonprofit health benefit plan
761-that elects to use the list of preferred prescription drugs as its
762-formulary pursuant to NRS 287.012, 287.0433 or 687B.407; and
763- (b) Negotiate and enter into agreements to purchase the drugs
764-included on the list of preferred prescription drugs on behalf of the
765-health benefit plans described in paragraph (a) or enter into a
766-contract pursuant to NRS 422.4053 with a pharmacy benefit
767-manager, health maintenance organization or one or more public or
768-private entities in this State, the District of Columbia or other states
769-or territories of the United States, as appropriate, to negotiate such
770-agreements.
755+- *SB439_R3*
756+ [1.] (a) Any laboratory testing that is necessary for therapy that 1
757+uses a drug approved by the United States Food and Drug 2
758+Administration for preventing the acquisition of human 3
759+immunodeficiency virus . [; and] 4
760+ [2.] (b) The services of a pharmacist described in NRS 5
761+639.28085. The State must provide reimbursement for such services 6
762+at a rate equal to the rate of reimbursement provided to a physician, 7
763+physician assistant or advanced practice registered nurse for similar 8
764+services. 9
765+ (c) Any service to test for, prevent or treat human 10
766+immunodeficiency virus or hepatitis C provided by a provider of 11
767+primary care if the service is covered when provided by a specialist 12
768+and: 13
769+ (1) The service is within the scope of practice of the 14
770+provider of primary care; or 15
771+ (2) The provider of primary care is capable of providing the 16
772+service safely and effectively in consultation with a specialist and 17
773+the provider engages in such consultation. 18
774+ 2. The Director shall include in the State Plan for Medicaid a 19
775+requirement that the State reimburse an advanced practice 20
776+registered nurse or a physician assistant for any service to test for, 21
777+prevent or treat human immunodeficiency virus or hepatitis C at a 22
778+rate equal to the rate of reimbursement provided to a physician for 23
779+similar services. 24
780+ 3. As used in this section, “primary care” means the practice 25
781+of family medicine, pediatrics, internal medicine, obstetrics and 26
782+gynecology and midwifery. 27
783+ Sec. 24. (Deleted by amendment.) 28
784+ Sec. 25. NRS 422.4025 is hereby amended to read as follows: 29
785+ 422.4025 1. The Department shall: 30
786+ (a) By regulation, develop a list of preferred prescription drugs 31
787+to be used for the Medicaid program and the Children’s Health 32
788+Insurance Program, and each public or nonprofit health benefit plan 33
789+that elects to use the list of preferred prescription drugs as its 34
790+formulary pursuant to NRS 287.012, 287.0433 or 687B.407; and 35
791+ (b) Negotiate and enter into agreements to purchase the drugs 36
792+included on the list of preferred prescription drugs on behalf of the 37
793+health benefit plans described in paragraph (a) or enter into a 38
794+contract pursuant to NRS 422.4053 with a pharmacy benefit 39
795+manager, health maintenance organization or one or more public or 40
796+private entities in this State, the District of Columbia or other states 41
797+or territories of the United States, as appropriate, to negotiate such 42
798+agreements. 43
799+ 2. The Department shall, by regulation, establish a list of 44
800+prescription drugs which must be excluded from any restrictions that 45
771801 – 17 –
772802
773803
774-- 82nd Session (2023)
775- 2. The Department shall, by regulation, establish a list of
776-prescription drugs which must be excluded from any restrictions that
777-are imposed by the Medicaid program on drugs that are on the list of
778-preferred prescription drugs established pursuant to subsection 1.
779-The list established pursuant to this subsection must include,
780-without limitation:
781- (a) Prescription drugs that are prescribed for the treatment of the
782-human immunodeficiency virus, including, without limitation,
783-antiretroviral medications;
784- (b) Antirejection medications for organ transplants;
785- (c) Antihemophilic medications; and
786- (d) Any prescription drug which the Board identifies as
787-appropriate for exclusion from any restrictions that are imposed by
788-the Medicaid program on drugs that are on the list of preferred
789-prescription drugs.
790- 3. The regulations must provide that the Board makes the final
791-determination of:
792- (a) Whether a class of therapeutic prescription drugs is included
793-on the list of preferred prescription drugs and is excluded from any
794-restrictions that are imposed by the Medicaid program on drugs that
795-are on the list of preferred prescription drugs;
796- (b) Which therapeutically equivalent prescription drugs will be
797-reviewed for inclusion on the list of preferred prescription drugs and
798-for exclusion from any restrictions that are imposed by the Medicaid
799-program on drugs that are on the list of preferred prescription drugs;
800-and
801- (c) Which prescription drugs should be excluded from any
802-restrictions that are imposed by the Medicaid program on drugs that
803-are on the list of preferred prescription drugs based on continuity of
804-care concerning a specific diagnosis, condition, class of therapeutic
805-prescription drugs or medical specialty.
806- 4. The list of preferred prescription drugs established pursuant
807-to subsection 1 must include, without limitation:
808- (a) Any prescription drug determined by the Board to be
809-essential for treating sickle cell disease and its variants; and
810- (b) Prescription drugs to prevent the acquisition of human
811-immunodeficiency virus.
812- 5. The regulations must provide that each new pharmaceutical
813-product and each existing pharmaceutical product for which there is
814-new clinical evidence supporting its inclusion on the list of preferred
815-prescription drugs must be made available pursuant to the Medicaid
816-program with prior authorization until the Board reviews the product
817-or the evidence.
804+- *SB439_R3*
805+are imposed by the Medicaid program on drugs that are on the list of 1
806+preferred prescription drugs established pursuant to subsection 1. 2
807+The list established pursuant to this subsection must include, 3
808+without limitation: 4
809+ (a) Prescription drugs that are prescribed for the treatment of the 5
810+human immunodeficiency virus, including, without limitation, 6
811+antiretroviral medications; 7
812+ (b) Antirejection medications for organ transplants; 8
813+ (c) Antihemophilic medications; and 9
814+ (d) Any prescription drug which the Board identifies as 10
815+appropriate for exclusion from any restrictions that are imposed by 11
816+the Medicaid program on drugs that are on the list of preferred 12
817+prescription drugs. 13
818+ 3. The regulations must provide that the Board makes the final 14
819+determination of: 15
820+ (a) Whether a class of therapeutic prescription drugs is included 16
821+on the list of preferred prescription drugs and is excluded from any 17
822+restrictions that are imposed by the Medicaid program on drugs that 18
823+are on the list of preferred prescription drugs; 19
824+ (b) Which therapeutically equivalent prescription drugs will be 20
825+reviewed for inclusion on the list of preferred prescription drugs and 21
826+for exclusion from any restrictions that are imposed by the Medicaid 22
827+program on drugs that are on the list of preferred prescription drugs; 23
828+and 24
829+ (c) Which prescription drugs should be excluded from any 25
830+restrictions that are imposed by the Medicaid program on drugs that 26
831+are on the list of preferred prescription drugs based on continuity of 27
832+care concerning a specific diagnosis, condition, class of therapeutic 28
833+prescription drugs or medical specialty. 29
834+ 4. The list of preferred prescription drugs established pursuant 30
835+to subsection 1 must include, without limitation: 31
836+ (a) Any prescription drug determined by the Board to be 32
837+essential for treating sickle cell disease and its variants; and 33
838+ (b) Prescription drugs to prevent the acquisition of human 34
839+immunodeficiency virus. 35
840+ 5. The regulations must provide that each new pharmaceutical 36
841+product and each existing pharmaceutical product for which there is 37
842+new clinical evidence supporting its inclusion on the list of preferred 38
843+prescription drugs must be made available pursuant to the Medicaid 39
844+program with prior authorization until the Board reviews the product 40
845+or the evidence. 41
846+ 6. The Medicaid program must cover a prescription drug that 42
847+is not included on the list of preferred prescription drugs as if the 43
848+drug were included on that list if: 44
849+ (a) The drug is: 45
818850 – 18 –
819851
820852
821-- 82nd Session (2023)
822- 6. The Medicaid program must cover a prescription drug that
823-is not included on the list of preferred prescription drugs as if the
824-drug were included on that list if:
825- (a) The drug is:
826- (1) Used to treat hepatitis C;
827- (2) Used to provide medication-assisted treatment for opioid
828-use disorder;
829- (3) Used to support safe withdrawal from substance use
830-disorder; or
831- (4) In the same class as a drug on the list of preferred
832-prescription drugs; and
833- (b) All preferred prescription drugs within the same class as
834-the drug are unsuitable for a recipient of Medicaid because:
835- (1) The recipient is allergic to all preferred prescription
836-drugs within the same class as the drug;
837- (2) All preferred prescription drugs within the same class as
838-the drug are contraindicated for the recipient or are likely to
839-interact in a harmful manner with another drug that the recipient
840-is taking;
841- (3) The recipient has a history of adverse reactions to all
842-preferred prescription drugs within the same class as the drug; or
843- (4) The drug has a unique indication that is supported by
844-peer-reviewed clinical evidence or approved by the United States
845-Food and Drug Administration.
846- 7. On or before February 1 of each year, the Department shall:
847- (a) Compile a report concerning the agreements negotiated
848-pursuant to paragraph (b) of subsection 1 and contracts entered into
849-pursuant to NRS 422.4053 which must include, without limitation,
850-the financial effects of obtaining prescription drugs through those
851-agreements and contracts, in total and aggregated separately for
852-agreements negotiated by the Department, contracts with a
853-pharmacy benefit manager, contracts with a health maintenance
854-organization and contracts with public and private entities from this
855-State, the District of Columbia and other states and territories of the
856-United States; and
857- (b) Post the report on an Internet website maintained by the
858-Department and submit the report to the Director of the Legislative
859-Counsel Bureau for transmittal to:
860- (1) In odd-numbered years, the Legislature; or
861- (2) In even-numbered years, the Legislative Commission.
862- Sec. 26. NRS 608.156 is hereby amended to read as follows:
863- 608.156 1. [If] In addition to any benefits required by NRS
864-608.1555, an employer provides health benefits for his or her
853+- *SB439_R3*
854+ (1) Used to treat hepatitis C; 1
855+ (2) Used to provide medication-assisted treatment for opioid 2
856+use disorder; 3
857+ (3) Used to support safe withdrawal from substance use 4
858+disorder; or 5
859+ (4) In the same class as a drug on the list of preferred 6
860+prescription drugs; and 7
861+ (b) All preferred prescription drugs within the same class as 8
862+the drug are unsuitable for a recipient of Medicaid because: 9
863+ (1) The recipient is allergic to all preferred prescription 10
864+drugs within the same class as the drug; 11
865+ (2) All preferred prescription drugs within the same class as 12
866+the drug are contraindicated for the recipient or are likely to 13
867+interact in a harmful manner with another drug that the recipient 14
868+is taking; 15
869+ (3) The recipient has a history of adverse reactions to all 16
870+preferred prescription drugs within the same class as the drug; or 17
871+ (4) The drug has a unique indication that is supported by 18
872+peer-reviewed clinical evidence or approved by the United States 19
873+Food and Drug Administration. 20
874+ 7. On or before February 1 of each year, the Department shall: 21
875+ (a) Compile a report concerning the agreements negotiated 22
876+pursuant to paragraph (b) of subsection 1 and contracts entered into 23
877+pursuant to NRS 422.4053 which must include, without limitation, 24
878+the financial effects of obtaining prescription drugs through those 25
879+agreements and contracts, in total and aggregated separately for 26
880+agreements negotiated by the Department, contracts with a 27
881+pharmacy benefit manager, contracts with a health maintenance 28
882+organization and contracts with public and private entities from this 29
883+State, the District of Columbia and other states and territories of the 30
884+United States; and 31
885+ (b) Post the report on an Internet website maintained by the 32
886+Department and submit the report to the Director of the Legislative 33
887+Counsel Bureau for transmittal to: 34
888+ (1) In odd-numbered years, the Legislature; or 35
889+ (2) In even-numbered years, the Legislative Commission. 36
890+ Sec. 26. NRS 608.156 is hereby amended to read as follows: 37
891+ 608.156 1. [If] In addition to any benefits required by NRS 38
892+608.1555, an employer provides health benefits for his or her 39
893+employees, the employer shall provide benefits for the expenses for 40
894+the treatment of alcohol and substance use disorders. The annual 41
895+benefits provided by the employer must [consist of:] include, 42
896+without limitation: 43
865897 – 19 –
866898
867899
868-- 82nd Session (2023)
869-employees, the employer shall provide benefits for the expenses for
870-the treatment of alcohol and substance use disorders. The annual
871-benefits provided by the employer must [consist of:] include,
872-without limitation:
873- (a) Treatment for withdrawal from the physiological effects of
874-alcohol or drugs, with a maximum benefit of $1,500 per calendar
875-year.
876- (b) Treatment for a patient admitted to a facility, with a
877-maximum benefit of $9,000 per calendar year.
878- (c) Counseling for a person, group or family who is not admitted
879-to a facility, with a maximum benefit of $2,500 per calendar year.
880- 2. The maximum amount which may be paid in the lifetime of
881-the insured for any combination of the treatments listed in
882-subsection 1 is $39,000.
883- 3. Except as otherwise provided in NRS 687B.409, these
884-benefits must be paid in the same manner as benefits for any other
885-illness covered by the employer are paid.
886- 4. The employee is entitled to these benefits if treatment is
887-received in any:
888- (a) Program for the treatment of alcohol or substance use
889-disorders which is certified by the Division of Public and Behavioral
890-Health of the Department of Health and Human Services.
891- (b) Hospital or other medical facility or facility for the
892-dependent which is licensed by the Division of Public and
893-Behavioral Health of the Department of Health and Human
894-Services, is accredited by The Joint Commission or CARF
895-International and provides a program for the treatment of alcohol or
896-substance use disorders as part of its accredited activities.
897- Sec. 27. NRS 629.093 is hereby amended to read as follows:
898- 629.093 Unless a specific statute or regulation requires or
899-authorizes a greater number of hours, a provider of health care may
900-use credit earned for continuing education relating to Alzheimer’s
901-disease or the stigma, discrimination and unrecognized bias
902-toward persons who have acquired or are at a high risk of
903-acquiring human immunodeficiency virus in place of not more
904-than 2 hours each year of the continuing education that the provider
905-of health care is required to complete, other than any continuing
906-education relating to ethics that the provider of health care is
907-required to complete.
908- Sec. 28. NRS 630.253 is hereby amended to read as follows:
909- 630.253 1. The Board shall, as a prerequisite for the:
910- (a) Renewal of a license as a physician assistant; or
900+- *SB439_R3*
901+ (a) Treatment for withdrawal from the physiological effects of 1
902+alcohol or drugs, with a maximum benefit of $1,500 per calendar 2
903+year. 3
904+ (b) Treatment for a patient admitted to a facility, with a 4
905+maximum benefit of $9,000 per calendar year. 5
906+ (c) Counseling for a person, group or family who is not admitted 6
907+to a facility, with a maximum benefit of $2,500 per calendar year. 7
908+ 2. The maximum amount which may be paid in the lifetime of 8
909+the insured for any combination of the treatments listed in 9
910+subsection 1 is $39,000. 10
911+ 3. Except as otherwise provided in NRS 687B.409, these 11
912+benefits must be paid in the same manner as benefits for any other 12
913+illness covered by the employer are paid. 13
914+ 4. The employee is entitled to these benefits if treatment is 14
915+received in any: 15
916+ (a) Program for the treatment of alcohol or substance use 16
917+disorders which is certified by the Division of Public and Behavioral 17
918+Health of the Department of Health and Human Services. 18
919+ (b) Hospital or other medical facility or facility for the 19
920+dependent which is licensed by the Division of Public and 20
921+Behavioral Health of the Department of Health and Human 21
922+Services, is accredited by The Joint Commission or CARF 22
923+International and provides a program for the treatment of alcohol or 23
924+substance use disorders as part of its accredited activities. 24
925+ Sec. 27. NRS 629.093 is hereby amended to read as follows: 25
926+ 629.093 Unless a specific statute or regulation requires or 26
927+authorizes a greater number of hours, a provider of health care may 27
928+use credit earned for continuing education relating to Alzheimer’s 28
929+disease or the stigma, discrimination and unrecognized bias 29
930+toward persons who have acquired or are at a high risk of 30
931+acquiring human immunodeficiency virus in place of not more 31
932+than 2 hours each year of the continuing education that the provider 32
933+of health care is required to complete, other than any continuing 33
934+education relating to ethics that the provider of health care is 34
935+required to complete. 35
936+ Sec. 28. NRS 630.253 is hereby amended to read as follows: 36
937+ 630.253 1. The Board shall, as a prerequisite for the: 37
938+ (a) Renewal of a license as a physician assistant; or 38
939+ (b) Biennial registration of the holder of a license to practice 39
940+medicine, 40
941+ require each holder to submit evidence of compliance with the 41
942+requirements for continuing education as set forth in regulations 42
943+adopted by the Board. 43
944+ 2. These requirements: 44
911945 – 20 –
912946
913947
914-- 82nd Session (2023)
915- (b) Biennial registration of the holder of a license to practice
916-medicine,
917- require each holder to submit evidence of compliance with the
918-requirements for continuing education as set forth in regulations
919-adopted by the Board.
920- 2. These requirements:
921- (a) May provide for the completion of one or more courses of
922-instruction relating to risk management in the performance of
923-medical services.
924- (b) Must provide for the completion of a course of instruction,
925-within 2 years after initial licensure, relating to the medical
926-consequences of an act of terrorism that involves the use of a
927-weapon of mass destruction. The course must provide at least 4
928-hours of instruction that includes instruction in the following
929-subjects:
930- (1) An overview of acts of terrorism and weapons of mass
931-destruction;
932- (2) Personal protective equipment required for acts of
933-terrorism;
934- (3) Common symptoms and methods of treatment associated
935-with exposure to, or injuries caused by, chemical, biological,
936-radioactive and nuclear agents;
937- (4) Syndromic surveillance and reporting procedures for acts
938-of terrorism that involve biological agents; and
939- (5) An overview of the information available on, and the use
940-of, the Health Alert Network.
941- (c) Must provide for the completion by a holder of a license to
942-practice medicine of a course of instruction within 2 years after
943-initial licensure that provides at least 2 hours of instruction on
944-evidence-based suicide prevention and awareness as described in
945-subsection 6.
946- (d) Must provide for the completion of at least 2 hours of
947-training in the screening, brief intervention and referral to treatment
948-approach to substance use disorder within 2 years after initial
949-licensure.
950- (e) Must provide for the biennial completion by each
951-psychiatrist and each physician assistant practicing under the
952-supervision of a psychiatrist of one or more courses of instruction
953-that provide at least 2 hours of instruction relating to cultural
954-competency and diversity, equity and inclusion. Such instruction:
955- (1) May include the training provided pursuant to NRS
956-449.103, where applicable.
948+- *SB439_R3*
949+ (a) May provide for the completion of one or more courses of 1
950+instruction relating to risk management in the performance of 2
951+medical services. 3
952+ (b) Must provide for the completion of a course of instruction, 4
953+within 2 years after initial licensure, relating to the medical 5
954+consequences of an act of terrorism that involves the use of a 6
955+weapon of mass destruction. The course must provide at least 4 7
956+hours of instruction that includes instruction in the following 8
957+subjects: 9
958+ (1) An overview of acts of terrorism and weapons of mass 10
959+destruction; 11
960+ (2) Personal protective equipment required for acts of 12
961+terrorism; 13
962+ (3) Common symptoms and methods of treatment associated 14
963+with exposure to, or injuries caused by, chemical, biological, 15
964+radioactive and nuclear agents; 16
965+ (4) Syndromic surveillance and reporting procedures for acts 17
966+of terrorism that involve biological agents; and 18
967+ (5) An overview of the information available on, and the use 19
968+of, the Health Alert Network. 20
969+ (c) Must provide for the completion by a holder of a license to 21
970+practice medicine of a course of instruction within 2 years after 22
971+initial licensure that provides at least 2 hours of instruction on 23
972+evidence-based suicide prevention and awareness as described in 24
973+subsection 6. 25
974+ (d) Must provide for the completion of at least 2 hours of 26
975+training in the screening, brief intervention and referral to treatment 27
976+approach to substance use disorder within 2 years after initial 28
977+licensure. 29
978+ (e) Must provide for the biennial completion by each 30
979+psychiatrist and each physician assistant practicing under the 31
980+supervision of a psychiatrist of one or more courses of instruction 32
981+that provide at least 2 hours of instruction relating to cultural 33
982+competency and diversity, equity and inclusion. Such instruction: 34
983+ (1) May include the training provided pursuant to NRS 35
984+449.103, where applicable. 36
985+ (2) Must be based upon a range of research from diverse 37
986+sources. 38
987+ (3) Must address persons of different cultural backgrounds, 39
988+including, without limitation: 40
989+ (I) Persons from various gender, racial and ethnic 41
990+backgrounds; 42
991+ (II) Persons from various religious backgrounds; 43
992+ (III) Lesbian, gay, bisexual, transgender and questioning 44
993+persons; 45
957994 – 21 –
958995
959996
960-- 82nd Session (2023)
961- (2) Must be based upon a range of research from diverse
962-sources.
963- (3) Must address persons of different cultural backgrounds,
964-including, without limitation:
965- (I) Persons from various gender, racial and ethnic
966-backgrounds;
967- (II) Persons from various religious backgrounds;
968- (III) Lesbian, gay, bisexual, transgender and questioning
969-persons;
970- (IV) Children and senior citizens;
971- (V) Veterans;
972- (VI) Persons with a mental illness;
973- (VII) Persons with an intellectual disability,
974-developmental disability or physical disability; and
975- (VIII) Persons who are part of any other population that a
976-psychiatrist or a physician assistant practicing under the supervision
977-of a psychiatrist may need to better understand, as determined by the
978-Board.
979- (f) Must allow the holder of a license to receive credit toward
980-the total amount of continuing education required by the Board for
981-the completion of a course of instruction relating to genetic
982-counseling and genetic testing.
983- (g) Must provide for the completion by a physician or
984-physician assistant who provides or supervises the provision of
985-emergency medical services in a hospital or primary care of at
986-least 2 hours of training in the stigma, discrimination and
987-unrecognized bias toward persons who have acquired or are at a
988-high risk of acquiring human immunodeficiency virus within 2
989-years after beginning to provide or supervise the provision of such
990-services or care.
991- 3. The Board may determine whether to include in a program
992-of continuing education courses of instruction relating to the
993-medical consequences of an act of terrorism that involves the use of
994-a weapon of mass destruction in addition to the course of instruction
995-required by paragraph (b) of subsection 2.
996- 4. The Board shall encourage each holder of a license who
997-treats or cares for persons who are more than 60 years of age to
998-receive, as a portion of their continuing education, education in
999-geriatrics and gerontology, including such topics as:
1000- (a) The skills and knowledge that the licensee needs to address
1001-aging issues;
1002- (b) Approaches to providing health care to older persons,
1003-including both didactic and clinical approaches;
997+- *SB439_R3*
998+ (IV) Children and senior citizens; 1
999+ (V) Veterans; 2
1000+ (VI) Persons with a mental illness; 3
1001+ (VII) Persons with an intellectual disability, 4
1002+developmental disability or physical disability; and 5
1003+ (VIII) Persons who are part of any other population that a 6
1004+psychiatrist or a physician assistant practicing under the supervision 7
1005+of a psychiatrist may need to better understand, as determined by the 8
1006+Board. 9
1007+ (f) Must allow the holder of a license to receive credit toward 10
1008+the total amount of continuing education required by the Board for 11
1009+the completion of a course of instruction relating to genetic 12
1010+counseling and genetic testing. 13
1011+ (g) Must provide for the completion by a physician or 14
1012+physician assistant who provides or supervises the provision of 15
1013+emergency medical services in a hospital or primary care of at 16
1014+least 2 hours of training in the stigma, discrimination and 17
1015+unrecognized bias toward persons who have acquired or are at a 18
1016+high risk of acquiring human immunodeficiency virus within 2 19
1017+years after beginning to provide or supervise the provision of such 20
1018+services or care. 21
1019+ 3. The Board may determine whether to include in a program 22
1020+of continuing education courses of instruction relating to the 23
1021+medical consequences of an act of terrorism that involves the use of 24
1022+a weapon of mass destruction in addition to the course of instruction 25
1023+required by paragraph (b) of subsection 2. 26
1024+ 4. The Board shall encourage each holder of a license who 27
1025+treats or cares for persons who are more than 60 years of age to 28
1026+receive, as a portion of their continuing education, education in 29
1027+geriatrics and gerontology, including such topics as: 30
1028+ (a) The skills and knowledge that the licensee needs to address 31
1029+aging issues; 32
1030+ (b) Approaches to providing health care to older persons, 33
1031+including both didactic and clinical approaches; 34
1032+ (c) The biological, behavioral, social and emotional aspects of 35
1033+the aging process; and 36
1034+ (d) The importance of maintenance of function and 37
1035+independence for older persons. 38
1036+ 5. The Board shall encourage each holder of a license to 39
1037+practice medicine to receive, as a portion of his or her continuing 40
1038+education, training concerning methods for educating patients about 41
1039+how to effectively manage medications, including, without 42
1040+limitation, the ability of the patient to request to have the symptom 43
1041+or purpose for which a drug is prescribed included on the label 44
1042+attached to the container of the drug. 45
10041043 – 22 –
10051044
10061045
1007-- 82nd Session (2023)
1008- (c) The biological, behavioral, social and emotional aspects of
1009-the aging process; and
1010- (d) The importance of maintenance of function and
1011-independence for older persons.
1012- 5. The Board shall encourage each holder of a license to
1013-practice medicine to receive, as a portion of his or her continuing
1014-education, training concerning methods for educating patients about
1015-how to effectively manage medications, including, without
1016-limitation, the ability of the patient to request to have the symptom
1017-or purpose for which a drug is prescribed included on the label
1018-attached to the container of the drug.
1019- 6. The Board shall require each holder of a license to practice
1020-medicine to receive as a portion of his or her continuing education at
1021-least 2 hours of instruction every 4 years on evidence-based suicide
1022-prevention and awareness, which may include, without limitation,
1023-instruction concerning:
1024- (a) The skills and knowledge that the licensee needs to detect
1025-behaviors that may lead to suicide, including, without limitation,
1026-post-traumatic stress disorder;
1027- (b) Approaches to engaging other professionals in suicide
1028-intervention; and
1029- (c) The detection of suicidal thoughts and ideations and the
1030-prevention of suicide.
1031- 7. The Board shall encourage each holder of a license to
1032-practice medicine or as a physician assistant to receive, as a portion
1033-of his or her continuing education, training and education in the
1034-diagnosis of rare diseases, including, without limitation:
1035- (a) Recognizing the symptoms of pediatric cancer; and
1036- (b) Interpreting family history to determine whether such
1037-symptoms indicate a normal childhood illness or a condition that
1038-requires additional examination.
1039- 8. A holder of a license to practice medicine may not substitute
1040-the continuing education credits relating to suicide prevention and
1041-awareness required by this section for the purposes of satisfying an
1042-equivalent requirement for continuing education in ethics.
1043- 9. Except as otherwise provided in NRS 630.2535, a holder of
1044-a license to practice medicine may substitute not more than 2 hours
1045-of continuing education credits in pain management, care for
1046-persons with an addictive disorder or the screening, brief
1047-intervention and referral to treatment approach to substance use
1048-disorder for the purposes of satisfying an equivalent requirement for
1049-continuing education in ethics.
1050- 10. As used in this section:
1046+- *SB439_R3*
1047+ 6. The Board shall require each holder of a license to practice 1
1048+medicine to receive as a portion of his or her continuing education at 2
1049+least 2 hours of instruction every 4 years on evidence-based suicide 3
1050+prevention and awareness, which may include, without limitation, 4
1051+instruction concerning: 5
1052+ (a) The skills and knowledge that the licensee needs to detect 6
1053+behaviors that may lead to suicide, including, without limitation, 7
1054+post-traumatic stress disorder; 8
1055+ (b) Approaches to engaging other professionals in suicide 9
1056+intervention; and 10
1057+ (c) The detection of suicidal thoughts and ideations and the 11
1058+prevention of suicide. 12
1059+ 7. The Board shall encourage each holder of a license to 13
1060+practice medicine or as a physician assistant to receive, as a portion 14
1061+of his or her continuing education, training and education in the 15
1062+diagnosis of rare diseases, including, without limitation: 16
1063+ (a) Recognizing the symptoms of pediatric cancer; and 17
1064+ (b) Interpreting family history to determine whether such 18
1065+symptoms indicate a normal childhood illness or a condition that 19
1066+requires additional examination. 20
1067+ 8. A holder of a license to practice medicine may not substitute 21
1068+the continuing education credits relating to suicide prevention and 22
1069+awareness required by this section for the purposes of satisfying an 23
1070+equivalent requirement for continuing education in ethics. 24
1071+ 9. Except as otherwise provided in NRS 630.2535, a holder of 25
1072+a license to practice medicine may substitute not more than 2 hours 26
1073+of continuing education credits in pain management, care for 27
1074+persons with an addictive disorder or the screening, brief 28
1075+intervention and referral to treatment approach to substance use 29
1076+disorder for the purposes of satisfying an equivalent requirement for 30
1077+continuing education in ethics. 31
1078+ 10. As used in this section: 32
1079+ (a) “Act of terrorism” has the meaning ascribed to it in 33
1080+NRS 202.4415. 34
1081+ (b) “Biological agent” has the meaning ascribed to it in 35
1082+NRS 202.442. 36
1083+ (c) “Chemical agent” has the meaning ascribed to it in 37
1084+NRS 202.4425. 38
1085+ (d) “Primary care” means the practice of family medicine, 39
1086+pediatrics, internal medicine, obstetrics and gynecology and 40
1087+midwifery. 41
1088+ (e) “Radioactive agent” has the meaning ascribed to it in 42
1089+NRS 202.4437. 43
1090+ [(e)] (f) “Weapon of mass destruction” has the meaning 44
1091+ascribed to it in NRS 202.4445. 45
10511092 – 23 –
10521093
10531094
1054-- 82nd Session (2023)
1055- (a) “Act of terrorism” has the meaning ascribed to it in
1056-NRS 202.4415.
1057- (b) “Biological agent” has the meaning ascribed to it in
1058-NRS 202.442.
1059- (c) “Chemical agent” has the meaning ascribed to it in
1060-NRS 202.4425.
1061- (d) “Primary care” means the practice of family medicine,
1062-pediatrics, internal medicine, obstetrics and gynecology and
1063-midwifery.
1064- (e) “Radioactive agent” has the meaning ascribed to it in
1065-NRS 202.4437.
1066- [(e)] (f) “Weapon of mass destruction” has the meaning
1067-ascribed to it in NRS 202.4445.
1068- Sec. 29. NRS 632.343 is hereby amended to read as follows:
1069- 632.343 1. The Board shall not renew any license issued
1070-under this chapter until the licensee has submitted proof satisfactory
1071-to the Board of completion, during the 2-year period before renewal
1072-of the license, of 30 hours in a program of continuing education
1073-approved by the Board in accordance with regulations adopted by
1074-the Board. Except as otherwise provided in subsection 3, the
1075-licensee is exempt from this provision for the first biennial period
1076-after graduation from:
1077- (a) An accredited school of professional nursing;
1078- (b) An accredited school of practical nursing;
1079- (c) An approved school of professional nursing in the process of
1080-obtaining accreditation; or
1081- (d) An approved school of practical nursing in the process of
1082-obtaining accreditation.
1083- 2. The Board shall review all courses offered to nurses for the
1084-completion of the requirement set forth in subsection 1. The Board
1085-may approve nursing and other courses which are directly related to
1086-the practice of nursing as well as others which bear a reasonable
1087-relationship to current developments in the field of nursing or any
1088-special area of practice in which a licensee engages. These may
1089-include academic studies, workshops, extension studies, home study
1090-and other courses.
1091- 3. The program of continuing education required by subsection
1092-1 must include:
1093- (a) For a person licensed as an advanced practice registered
1094-nurse:
1095- (1) A course of instruction to be completed within 2 years
1096-after initial licensure that provides at least 2 hours of instruction on
1097-suicide prevention and awareness as described in subsection 6.
1095+- *SB439_R3*
1096+ Sec. 29. NRS 632.343 is hereby amended to read as follows: 1
1097+ 632.343 1. The Board shall not renew any license issued 2
1098+under this chapter until the licensee has submitted proof satisfactory 3
1099+to the Board of completion, during the 2-year period before renewal 4
1100+of the license, of 30 hours in a program of continuing education 5
1101+approved by the Board in accordance with regulations adopted by 6
1102+the Board. Except as otherwise provided in subsection 3, the 7
1103+licensee is exempt from this provision for the first biennial period 8
1104+after graduation from: 9
1105+ (a) An accredited school of professional nursing; 10
1106+ (b) An accredited school of practical nursing; 11
1107+ (c) An approved school of professional nursing in the process of 12
1108+obtaining accreditation; or 13
1109+ (d) An approved school of practical nursing in the process of 14
1110+obtaining accreditation. 15
1111+ 2. The Board shall review all courses offered to nurses for the 16
1112+completion of the requirement set forth in subsection 1. The Board 17
1113+may approve nursing and other courses which are directly related to 18
1114+the practice of nursing as well as others which bear a reasonable 19
1115+relationship to current developments in the field of nursing or any 20
1116+special area of practice in which a licensee engages. These may 21
1117+include academic studies, workshops, extension studies, home study 22
1118+and other courses. 23
1119+ 3. The program of continuing education required by subsection 24
1120+1 must include: 25
1121+ (a) For a person licensed as an advanced practice registered 26
1122+nurse: 27
1123+ (1) A course of instruction to be completed within 2 years 28
1124+after initial licensure that provides at least 2 hours of instruction on 29
1125+suicide prevention and awareness as described in subsection 6. 30
1126+ (2) The ability to receive credit toward the total amount of 31
1127+continuing education required by subsection 1 for the completion of 32
1128+a course of instruction relating to genetic counseling and genetic 33
1129+testing. 34
1130+ (b) For each person licensed pursuant to this chapter, a course of 35
1131+instruction, to be completed within 2 years after initial licensure, 36
1132+relating to the medical consequences of an act of terrorism that 37
1133+involves the use of a weapon of mass destruction. The course must 38
1134+provide at least 4 hours of instruction that includes instruction in the 39
1135+following subjects: 40
1136+ (1) An overview of acts of terrorism and weapons of mass 41
1137+destruction; 42
1138+ (2) Personal protective equipment required for acts of 43
1139+terrorism; 44
10981140 – 24 –
10991141
11001142
1101-- 82nd Session (2023)
1102- (2) The ability to receive credit toward the total amount of
1103-continuing education required by subsection 1 for the completion of
1104-a course of instruction relating to genetic counseling and genetic
1105-testing.
1106- (b) For each person licensed pursuant to this chapter, a course of
1107-instruction, to be completed within 2 years after initial licensure,
1108-relating to the medical consequences of an act of terrorism that
1109-involves the use of a weapon of mass destruction. The course must
1110-provide at least 4 hours of instruction that includes instruction in the
1111-following subjects:
1112- (1) An overview of acts of terrorism and weapons of mass
1113-destruction;
1114- (2) Personal protective equipment required for acts of
1115-terrorism;
1116- (3) Common symptoms and methods of treatment associated
1117-with exposure to, or injuries caused by, chemical, biological,
1118-radioactive and nuclear agents;
1119- (4) Syndromic surveillance and reporting procedures for acts
1120-of terrorism that involve biological agents; and
1121- (5) An overview of the information available on, and the use
1122-of, the Health Alert Network.
1123- (c) For each person licensed pursuant to this chapter, one or
1124-more courses of instruction that provide at least 2 hours of
1125-instruction relating to cultural competency and diversity, equity and
1126-inclusion to be completed biennially. Such instruction:
1127- (1) May include the training provided pursuant to NRS
1128-449.103, where applicable.
1129- (2) Must be based upon a range of research from diverse
1130-sources.
1131- (3) Must address persons of different cultural backgrounds,
1132-including, without limitation:
1133- (I) Persons from various gender, racial and ethnic
1134-backgrounds;
1135- (II) Persons from various religious backgrounds;
1136- (III) Lesbian, gay, bisexual, transgender and questioning
1137-persons;
1138- (IV) Children and senior citizens;
1139- (V) Veterans;
1140- (VI) Persons with a mental illness;
1141- (VII) Persons with an intellectual disability,
1142-developmental disability or physical disability; and
1143+- *SB439_R3*
1144+ (3) Common symptoms and methods of treatment associated 1
1145+with exposure to, or injuries caused by, chemical, biological, 2
1146+radioactive and nuclear agents; 3
1147+ (4) Syndromic surveillance and reporting procedures for acts 4
1148+of terrorism that involve biological agents; and 5
1149+ (5) An overview of the information available on, and the use 6
1150+of, the Health Alert Network. 7
1151+ (c) For each person licensed pursuant to this chapter, one or 8
1152+more courses of instruction that provide at least 2 hours of 9
1153+instruction relating to cultural competency and diversity, equity and 10
1154+inclusion to be completed biennially. Such instruction: 11
1155+ (1) May include the training provided pursuant to NRS 12
1156+449.103, where applicable. 13
1157+ (2) Must be based upon a range of research from diverse 14
1158+sources. 15
1159+ (3) Must address persons of different cultural backgrounds, 16
1160+including, without limitation: 17
1161+ (I) Persons from various gender, racial and ethnic 18
1162+backgrounds; 19
1163+ (II) Persons from various religious backgrounds; 20
1164+ (III) Lesbian, gay, bisexual, transgender and questioning 21
1165+persons; 22
1166+ (IV) Children and senior citizens; 23
1167+ (V) Veterans; 24
1168+ (VI) Persons with a mental illness; 25
1169+ (VII) Persons with an intellectual disability, 26
1170+developmental disability or physical disability; and 27
1171+ (VIII) Persons who are part of any other population that a 28
1172+person licensed pursuant to this chapter may need to better 29
1173+understand, as determined by the Board. 30
1174+ (d) For a person licensed as an advanced practice registered 31
1175+nurse, at least 2 hours of training in the screening, brief intervention 32
1176+and referral to treatment approach to substance use disorder to be 33
1177+completed within 2 years after initial licensure. 34
1178+ (e) For each person licensed pursuant to this chapter who 35
1179+provides or supervises the provision of emergency medical services 36
1180+in a hospital or primary care, at least 2 hours of training in the 37
1181+stigma, discrimination and unrecognized bias toward persons who 38
1182+have acquired or are at a high risk of acquiring human 39
1183+immunodeficiency virus to be completed within 2 years after 40
1184+beginning to provide or supervise the provision of such services or 41
1185+care. 42
1186+ 4. The Board may determine whether to include in a program 43
1187+of continuing education courses of instruction relating to the 44
1188+medical consequences of an act of terrorism that involves the use of 45
11431189 – 25 –
11441190
11451191
1146-- 82nd Session (2023)
1147- (VIII) Persons who are part of any other population that a
1148-person licensed pursuant to this chapter may need to better
1149-understand, as determined by the Board.
1150- (d) For a person licensed as an advanced practice registered
1151-nurse, at least 2 hours of training in the screening, brief intervention
1152-and referral to treatment approach to substance use disorder to be
1153-completed within 2 years after initial licensure.
1154- (e) For each person licensed pursuant to this chapter who
1155-provides or supervises the provision of emergency medical services
1156-in a hospital or primary care, at least 2 hours of training in the
1157-stigma, discrimination and unrecognized bias toward persons who
1158-have acquired or are at a high risk of acquiring human
1159-immunodeficiency virus to be completed within 2 years after
1160-beginning to provide or supervise the provision of such services or
1161-care.
1162- 4. The Board may determine whether to include in a program
1163-of continuing education courses of instruction relating to the
1164-medical consequences of an act of terrorism that involves the use of
1165-a weapon of mass destruction in addition to the course of instruction
1166-required by paragraph (b) of subsection 3.
1167- 5. The Board shall encourage each licensee who treats or cares
1168-for persons who are more than 60 years of age to receive, as a
1169-portion of their continuing education, education in geriatrics and
1170-gerontology, including such topics as:
1171- (a) The skills and knowledge that the licensee needs to address
1172-aging issues;
1173- (b) Approaches to providing health care to older persons,
1174-including both didactic and clinical approaches;
1175- (c) The biological, behavioral, social and emotional aspects of
1176-the aging process; and
1177- (d) The importance of maintenance of function and
1178-independence for older persons.
1179- 6. The Board shall require each person licensed as an advanced
1180-practice registered nurse to receive as a portion of his or her
1181-continuing education at least 2 hours of instruction every 4 years on
1182-evidence-based suicide prevention and awareness or another course
1183-of instruction on suicide prevention and awareness that is approved
1184-by the Board which the Board has determined to be effective and
1185-appropriate.
1186- 7. The Board shall encourage each person licensed as an
1187-advanced practice registered nurse to receive, as a portion of his or
1188-her continuing education, training and education in the diagnosis of
1189-rare diseases, including, without limitation:
1192+- *SB439_R3*
1193+a weapon of mass destruction in addition to the course of instruction 1
1194+required by paragraph (b) of subsection 3. 2
1195+ 5. The Board shall encourage each licensee who treats or cares 3
1196+for persons who are more than 60 years of age to receive, as a 4
1197+portion of their continuing education, education in geriatrics and 5
1198+gerontology, including such topics as: 6
1199+ (a) The skills and knowledge that the licensee needs to address 7
1200+aging issues; 8
1201+ (b) Approaches to providing health care to older persons, 9
1202+including both didactic and clinical approaches; 10
1203+ (c) The biological, behavioral, social and emotional aspects of 11
1204+the aging process; and 12
1205+ (d) The importance of maintenance of function and 13
1206+independence for older persons. 14
1207+ 6. The Board shall require each person licensed as an advanced 15
1208+practice registered nurse to receive as a portion of his or her 16
1209+continuing education at least 2 hours of instruction every 4 years on 17
1210+evidence-based suicide prevention and awareness or another course 18
1211+of instruction on suicide prevention and awareness that is approved 19
1212+by the Board which the Board has determined to be effective and 20
1213+appropriate. 21
1214+ 7. The Board shall encourage each person licensed as an 22
1215+advanced practice registered nurse to receive, as a portion of his or 23
1216+her continuing education, training and education in the diagnosis of 24
1217+rare diseases, including, without limitation: 25
1218+ (a) Recognizing the symptoms of pediatric cancer; and 26
1219+ (b) Interpreting family history to determine whether such 27
1220+symptoms indicate a normal childhood illness or a condition that 28
1221+requires additional examination. 29
1222+ 8. As used in this section: 30
1223+ (a) “Act of terrorism” has the meaning ascribed to it in 31
1224+NRS 202.4415. 32
1225+ (b) “Biological agent” has the meaning ascribed to it in 33
1226+NRS 202.442. 34
1227+ (c) “Chemical agent” has the meaning ascribed to it in 35
1228+NRS 202.4425. 36
1229+ (d) “Primary care” means the practice of family medicine, 37
1230+pediatrics, internal medicine, obstetrics and gynecology and 38
1231+midwifery. 39
1232+ (e) “Radioactive agent” has the meaning ascribed to it in 40
1233+NRS 202.4437. 41
1234+ [(e)] (f) “Weapon of mass destruction” has the meaning 42
1235+ascribed to it in NRS 202.4445. 43
11901236 – 26 –
11911237
11921238
1193-- 82nd Session (2023)
1194- (a) Recognizing the symptoms of pediatric cancer; and
1195- (b) Interpreting family history to determine whether such
1196-symptoms indicate a normal childhood illness or a condition that
1197-requires additional examination.
1198- 8. As used in this section:
1199- (a) “Act of terrorism” has the meaning ascribed to it in
1200-NRS 202.4415.
1201- (b) “Biological agent” has the meaning ascribed to it in
1202-NRS 202.442.
1203- (c) “Chemical agent” has the meaning ascribed to it in
1204-NRS 202.4425.
1205- (d) “Primary care” means the practice of family medicine,
1206-pediatrics, internal medicine, obstetrics and gynecology and
1207-midwifery.
1208- (e) “Radioactive agent” has the meaning ascribed to it in
1209-NRS 202.4437.
1210- [(e)] (f) “Weapon of mass destruction” has the meaning
1211-ascribed to it in NRS 202.4445.
1212- Sec. 30. NRS 633.471 is hereby amended to read as follows:
1213- 633.471 1. Except as otherwise provided in subsection [14]
1214-15 and NRS 633.491, every holder of a license, except a physician
1215-assistant, issued under this chapter, except a temporary or a special
1216-license, may renew the license on or before January 1 of each
1217-calendar year after its issuance by:
1218- (a) Applying for renewal on forms provided by the Board;
1219- (b) Paying the annual license renewal fee specified in this
1220-chapter;
1221- (c) Submitting a list of all actions filed or claims submitted to
1222-arbitration or mediation for malpractice or negligence against the
1223-holder during the previous year;
1224- (d) Subject to subsection [13,] 14, submitting evidence to the
1225-Board that in the year preceding the application for renewal the
1226-holder has attended courses or programs of continuing education
1227-approved by the Board in accordance with regulations adopted by
1228-the Board totaling a number of hours established by the Board
1229-which must not be less than 35 hours nor more than that set in the
1230-requirements for continuing medical education of the American
1231-Osteopathic Association; and
1232- (e) Submitting all information required to complete the renewal.
1233- 2. The Secretary of the Board shall notify each licensee of the
1234-requirements for renewal not less than 30 days before the date of
1235-renewal.
1239+- *SB439_R3*
1240+ Sec. 30. NRS 633.471 is hereby amended to read as follows: 1
1241+ 633.471 1. Except as otherwise provided in subsection [14] 2
1242+15 and NRS 633.491, every holder of a license, except a physician 3
1243+assistant, issued under this chapter, except a temporary or a special 4
1244+license, may renew the license on or before January 1 of each 5
1245+calendar year after its issuance by: 6
1246+ (a) Applying for renewal on forms provided by the Board; 7
1247+ (b) Paying the annual license renewal fee specified in this 8
1248+chapter; 9
1249+ (c) Submitting a list of all actions filed or claims submitted to 10
1250+arbitration or mediation for malpractice or negligence against the 11
1251+holder during the previous year; 12
1252+ (d) Subject to subsection [13,] 14, submitting evidence to the 13
1253+Board that in the year preceding the application for renewal the 14
1254+holder has attended courses or programs of continuing education 15
1255+approved by the Board in accordance with regulations adopted by 16
1256+the Board totaling a number of hours established by the Board 17
1257+which must not be less than 35 hours nor more than that set in the 18
1258+requirements for continuing medical education of the American 19
1259+Osteopathic Association; and 20
1260+ (e) Submitting all information required to complete the renewal. 21
1261+ 2. The Secretary of the Board shall notify each licensee of the 22
1262+requirements for renewal not less than 30 days before the date of 23
1263+renewal. 24
1264+ 3. The Board shall request submission of verified evidence of 25
1265+completion of the required number of hours of continuing medical 26
1266+education annually from no fewer than one-third of the applicants 27
1267+for renewal of a license to practice osteopathic medicine or a license 28
1268+to practice as a physician assistant. Subject to subsection [13,] 14, 29
1269+upon a request from the Board, an applicant for renewal of a license 30
1270+to practice osteopathic medicine or a license to practice as a 31
1271+physician assistant shall submit verified evidence satisfactory to the 32
1272+Board that in the year preceding the application for renewal the 33
1273+applicant attended courses or programs of continuing medical 34
1274+education approved by the Board totaling the number of hours 35
1275+established by the Board. 36
1276+ 4. The Board shall require each holder of a license to practice 37
1277+osteopathic medicine to complete a course of instruction within 2 38
1278+years after initial licensure that provides at least 2 hours of 39
1279+instruction on evidence-based suicide prevention and awareness as 40
1280+described in subsection 9. 41
1281+ 5. The Board shall encourage each holder of a license to 42
1282+practice osteopathic medicine to receive, as a portion of his or her 43
1283+continuing education, training concerning methods for educating 44
1284+patients about how to effectively manage medications, including, 45
12361285 – 27 –
12371286
12381287
1239-- 82nd Session (2023)
1240- 3. The Board shall request submission of verified evidence of
1241-completion of the required number of hours of continuing medical
1242-education annually from no fewer than one-third of the applicants
1243-for renewal of a license to practice osteopathic medicine or a license
1244-to practice as a physician assistant. Subject to subsection [13,] 14,
1245-upon a request from the Board, an applicant for renewal of a license
1246-to practice osteopathic medicine or a license to practice as a
1247-physician assistant shall submit verified evidence satisfactory to the
1248-Board that in the year preceding the application for renewal the
1249-applicant attended courses or programs of continuing medical
1250-education approved by the Board totaling the number of hours
1251-established by the Board.
1252- 4. The Board shall require each holder of a license to practice
1253-osteopathic medicine to complete a course of instruction within 2
1254-years after initial licensure that provides at least 2 hours of
1255-instruction on evidence-based suicide prevention and awareness as
1256-described in subsection 9.
1257- 5. The Board shall encourage each holder of a license to
1258-practice osteopathic medicine to receive, as a portion of his or her
1259-continuing education, training concerning methods for educating
1260-patients about how to effectively manage medications, including,
1261-without limitation, the ability of the patient to request to have the
1262-symptom or purpose for which a drug is prescribed included on the
1263-label attached to the container of the drug.
1264- 6. The Board shall encourage each holder of a license to
1265-practice osteopathic medicine or as a physician assistant to receive,
1266-as a portion of his or her continuing education, training and
1267-education in the diagnosis of rare diseases, including, without
1268-limitation:
1269- (a) Recognizing the symptoms of pediatric cancer; and
1270- (b) Interpreting family history to determine whether such
1271-symptoms indicate a normal childhood illness or a condition that
1272-requires additional examination.
1273- 7. The Board shall require, as part of the continuing education
1274-requirements approved by the Board, the biennial completion by a
1275-holder of a license to practice osteopathic medicine of at least 2
1276-hours of continuing education credits in ethics, pain management,
1277-care of persons with addictive disorders or the screening, brief
1278-intervention and referral to treatment approach to substance use
1279-disorder.
1280- 8. The continuing education requirements approved by the
1281-Board must allow the holder of a license as an osteopathic physician
1282-or physician assistant to receive credit toward the total amount of
1288+- *SB439_R3*
1289+without limitation, the ability of the patient to request to have the 1
1290+symptom or purpose for which a drug is prescribed included on the 2
1291+label attached to the container of the drug. 3
1292+ 6. The Board shall encourage each holder of a license to 4
1293+practice osteopathic medicine or as a physician assistant to receive, 5
1294+as a portion of his or her continuing education, training and 6
1295+education in the diagnosis of rare diseases, including, without 7
1296+limitation: 8
1297+ (a) Recognizing the symptoms of pediatric cancer; and 9
1298+ (b) Interpreting family history to determine whether such 10
1299+symptoms indicate a normal childhood illness or a condition that 11
1300+requires additional examination. 12
1301+ 7. The Board shall require, as part of the continuing education 13
1302+requirements approved by the Board, the biennial completion by a 14
1303+holder of a license to practice osteopathic medicine of at least 2 15
1304+hours of continuing education credits in ethics, pain management, 16
1305+care of persons with addictive disorders or the screening, brief 17
1306+intervention and referral to treatment approach to substance use 18
1307+disorder. 19
1308+ 8. The continuing education requirements approved by the 20
1309+Board must allow the holder of a license as an osteopathic physician 21
1310+or physician assistant to receive credit toward the total amount of 22
1311+continuing education required by the Board for the completion of a 23
1312+course of instruction relating to genetic counseling and genetic 24
1313+testing. 25
1314+ 9. The Board shall require each holder of a license to practice 26
1315+osteopathic medicine to receive as a portion of his or her continuing 27
1316+education at least 2 hours of instruction every 4 years on evidence-28
1317+based suicide prevention and awareness which may include, without 29
1318+limitation, instruction concerning: 30
1319+ (a) The skills and knowledge that the licensee needs to detect 31
1320+behaviors that may lead to suicide, including, without limitation, 32
1321+post-traumatic stress disorder; 33
1322+ (b) Approaches to engaging other professionals in suicide 34
1323+intervention; and 35
1324+ (c) The detection of suicidal thoughts and ideations and the 36
1325+prevention of suicide. 37
1326+ 10. A holder of a license to practice osteopathic medicine may 38
1327+not substitute the continuing education credits relating to suicide 39
1328+prevention and awareness required by this section for the purposes 40
1329+of satisfying an equivalent requirement for continuing education in 41
1330+ethics. 42
1331+ 11. The Board shall require each holder of a license to practice 43
1332+osteopathic medicine to complete at least 2 hours of training in the 44
12831333 – 28 –
12841334
12851335
1286-- 82nd Session (2023)
1287-continuing education required by the Board for the completion of a
1288-course of instruction relating to genetic counseling and genetic
1289-testing.
1290- 9. The Board shall require each holder of a license to practice
1291-osteopathic medicine to receive as a portion of his or her continuing
1292-education at least 2 hours of instruction every 4 years on evidence-
1293-based suicide prevention and awareness which may include, without
1294-limitation, instruction concerning:
1295- (a) The skills and knowledge that the licensee needs to detect
1296-behaviors that may lead to suicide, including, without limitation,
1297-post-traumatic stress disorder;
1298- (b) Approaches to engaging other professionals in suicide
1299-intervention; and
1300- (c) The detection of suicidal thoughts and ideations and the
1301-prevention of suicide.
1302- 10. A holder of a license to practice osteopathic medicine may
1303-not substitute the continuing education credits relating to suicide
1304-prevention and awareness required by this section for the purposes
1305-of satisfying an equivalent requirement for continuing education in
1306-ethics.
1307- 11. The Board shall require each holder of a license to practice
1308-osteopathic medicine to complete at least 2 hours of training in the
1309-screening, brief intervention and referral to treatment approach to
1310-substance use disorder within 2 years after initial licensure.
1311- 12. The Board shall require each psychiatrist or a physician
1312-assistant practicing under the supervision of a psychiatrist to
1313-biennially complete one or more courses of instruction that provide
1314-at least 2 hours of instruction relating to cultural competency and
1315-diversity, equity and inclusion. Such instruction:
1316- (a) May include the training provided pursuant to NRS 449.103,
1317-where applicable.
1318- (b) Must be based upon a range of research from diverse
1319-sources.
1320- (c) Must address persons of different cultural backgrounds,
1321-including, without limitation:
1322- (1) Persons from various gender, racial and ethnic
1323-backgrounds;
1324- (2) Persons from various religious backgrounds;
1325- (3) Lesbian, gay, bisexual, transgender and questioning
1326-persons;
1327- (4) Children and senior citizens;
1328- (5) Veterans;
1329- (6) Persons with a mental illness;
1336+- *SB439_R3*
1337+screening, brief intervention and referral to treatment approach to 1
1338+substance use disorder within 2 years after initial licensure. 2
1339+ 12. The Board shall require each psychiatrist or a physician 3
1340+assistant practicing under the supervision of a psychiatrist to 4
1341+biennially complete one or more courses of instruction that provide 5
1342+at least 2 hours of instruction relating to cultural competency and 6
1343+diversity, equity and inclusion. Such instruction: 7
1344+ (a) May include the training provided pursuant to NRS 449.103, 8
1345+where applicable. 9
1346+ (b) Must be based upon a range of research from diverse 10
1347+sources. 11
1348+ (c) Must address persons of different cultural backgrounds, 12
1349+including, without limitation: 13
1350+ (1) Persons from various gender, racial and ethnic 14
1351+backgrounds; 15
1352+ (2) Persons from various religious backgrounds; 16
1353+ (3) Lesbian, gay, bisexual, transgender and questioning 17
1354+persons; 18
1355+ (4) Children and senior citizens; 19
1356+ (5) Veterans; 20
1357+ (6) Persons with a mental illness; 21
1358+ (7) Persons with an intellectual disability, developmental 22
1359+disability or physical disability; and 23
1360+ (8) Persons who are part of any other population that a 24
1361+psychiatrist or physician assistant practicing under the supervision 25
1362+of a psychiatrist may need to better understand, as determined by the 26
1363+Board. 27
1364+ 13. The Board shall require each holder of a license to 28
1365+practice osteopathic medicine or as a physician assistant who 29
1366+provides or supervises the provision of emergency medical services 30
1367+in a hospital or primary care to complete at least 2 hours of 31
1368+training in the stigma, discrimination and unrecognized bias 32
1369+toward persons who have acquired or are at a high risk of 33
1370+acquiring human immunodeficiency virus within 2 years after 34
1371+beginning to provide or supervise the provision of such services or 35
1372+care. 36
1373+ 14. The Board shall not require a physician assistant to receive 37
1374+or maintain certification by the National Commission on 38
1375+Certification of Physician Assistants, or its successor organization, 39
1376+or by any other nationally recognized organization for the 40
1377+accreditation of physician assistants to satisfy any continuing 41
1378+education requirement pursuant to paragraph (d) of subsection 1 and 42
1379+subsection 3. 43
1380+ [14.] 15. Members of the Armed Forces of the United States 44
1381+and the United States Public Health Service are exempt from 45
13301382 – 29 –
13311383
13321384
1333-- 82nd Session (2023)
1334- (7) Persons with an intellectual disability, developmental
1335-disability or physical disability; and
1336- (8) Persons who are part of any other population that a
1337-psychiatrist or physician assistant practicing under the supervision
1338-of a psychiatrist may need to better understand, as determined by the
1339-Board.
1340- 13. The Board shall require each holder of a license to
1341-practice osteopathic medicine or as a physician assistant who
1342-provides or supervises the provision of emergency medical services
1343-in a hospital or primary care to complete at least 2 hours of
1344-training in the stigma, discrimination and unrecognized bias
1345-toward persons who have acquired or are at a high risk of
1346-acquiring human immunodeficiency virus within 2 years after
1347-beginning to provide or supervise the provision of such services or
1348-care.
1349- 14. The Board shall not require a physician assistant to receive
1350-or maintain certification by the National Commission on
1351-Certification of Physician Assistants, or its successor organization,
1352-or by any other nationally recognized organization for the
1353-accreditation of physician assistants to satisfy any continuing
1354-education requirement pursuant to paragraph (d) of subsection 1 and
1355-subsection 3.
1356- [14.] 15. Members of the Armed Forces of the United States
1357-and the United States Public Health Service are exempt from
1358-payment of the annual license renewal fee during their active duty
1359-status.
1360- 16. As used in this section, “primary care” means the practice
1361-of family medicine, pediatrics, internal medicine, obstetrics and
1362-gynecology and midwifery.
1363- Sec. 31. NRS 687B.225 is hereby amended to read as follows:
1364- 687B.225 1. Except as otherwise provided in NRS
1365-689A.0405, 689A.0412, 689A.0413, 689A.0437, 689A.044,
1366-689A.0445, 689B.031, 689B.0312, 689B.0313, 689B.0315,
1367-689B.0317, 689B.0374, 689C.1671, 689C.1675, 695A.1843,
1368-695A.1856, 695B.1912, 695B.1913, 695B.1914, 695B.1924,
1369-695B.1925, 695B.1942, 695C.1713, 695C.1735, 695C.1737,
1370-695C.1743, 695C.1745, 695C.1751, 695G.170, 695G.1705,
1371-695G.171, 695G.1714 and 695G.177, and sections 33, 41, 46, 54,
1372-59, 64 and 71 of this act, any contract for group, blanket or
1373-individual health insurance or any contract by a nonprofit hospital,
1374-medical or dental service corporation or organization for dental care
1375-which provides for payment of a certain part of medical or dental
1376-care may require the insured or member to obtain prior authorization
1385+- *SB439_R3*
1386+payment of the annual license renewal fee during their active duty 1
1387+status. 2
1388+ 16. As used in this section, “primary care” means the practice 3
1389+of family medicine, pediatrics, internal medicine, obstetrics and 4
1390+gynecology and midwifery. 5
1391+ Sec. 31. NRS 687B.225 is hereby amended to read as follows: 6
1392+ 687B.225 1. Except as otherwise provided in NRS 7
1393+689A.0405, 689A.0412, 689A.0413, 689A.0437, 689A.044, 8
1394+689A.0445, 689B.031, 689B.0312, 689B.0313, 689B.0315, 9
1395+689B.0317, 689B.0374, 689C.1671, 689C.1675, 695A.1843, 10
1396+695A.1856, 695B.1912, 695B.1913, 695B.1914, 695B.1924, 11
1397+695B.1925, 695B.1942, 695C.1713, 695C.1735, 695C.1737, 12
1398+695C.1743, 695C.1745, 695C.1751, 695G.170, 695G.1705, 13
1399+695G.171, 695G.1714 and 695G.177, and sections 33, 41, 46, 54, 14
1400+59, 64 and 71 of this act, any contract for group, blanket or 15
1401+individual health insurance or any contract by a nonprofit hospital, 16
1402+medical or dental service corporation or organization for dental care 17
1403+which provides for payment of a certain part of medical or dental 18
1404+care may require the insured or member to obtain prior authorization 19
1405+for that care from the insurer or organization. The insurer or 20
1406+organization shall: 21
1407+ (a) File its procedure for obtaining approval of care pursuant to 22
1408+this section for approval by the Commissioner; and 23
1409+ (b) Respond to any request for approval by the insured or 24
1410+member pursuant to this section within 20 days after it receives the 25
1411+request. 26
1412+ 2. The procedure for prior authorization may not discriminate 27
1413+among persons licensed to provide the covered care. 28
1414+ Sec. 32. Chapter 689A of NRS is hereby amended by adding 29
1415+thereto the provisions set forth as sections 33, 34 and 35 of this act. 30
1416+ Sec. 33. 1. An insurer that offers or issues a policy of 31
1417+health insurance shall include in the policy coverage for: 32
1418+ (a) All drugs approved by the United States Food and Drug 33
1419+Administration to: 34
1420+ (1) Provide medication-assisted treatment for opioid use 35
1421+disorder, including, without limitation, buprenorphine, methadone 36
1422+and naltrexone. 37
1423+ (2) Support safe withdrawal from substance use disorder, 38
1424+including, without limitation, lofexidine. 39
1425+ (b) Any service for the treatment of substance use disorder 40
1426+provided by a provider of primary care if the service is covered 41
1427+when provided by a specialist and: 42
1428+ (1) The service is within the scope of practice of the 43
1429+provider of primary care; or 44
13771430 – 30 –
13781431
13791432
1380-- 82nd Session (2023)
1381-for that care from the insurer or organization. The insurer or
1382-organization shall:
1383- (a) File its procedure for obtaining approval of care pursuant to
1384-this section for approval by the Commissioner; and
1385- (b) Respond to any request for approval by the insured or
1386-member pursuant to this section within 20 days after it receives the
1387-request.
1388- 2. The procedure for prior authorization may not discriminate
1389-among persons licensed to provide the covered care.
1390- Sec. 32. Chapter 689A of NRS is hereby amended by adding
1391-thereto the provisions set forth as sections 33, 34 and 35 of this act.
1392- Sec. 33. 1. An insurer that offers or issues a policy of
1393-health insurance shall include in the policy coverage for:
1394- (a) All drugs approved by the United States Food and Drug
1395-Administration to:
1396- (1) Provide medication-assisted treatment for opioid use
1397-disorder, including, without limitation, buprenorphine, methadone
1398-and naltrexone.
1399- (2) Support safe withdrawal from substance use disorder,
1400-including, without limitation, lofexidine.
1401- (b) Any service for the treatment of substance use disorder
1402-provided by a provider of primary care if the service is covered
1403-when provided by a specialist and:
1404- (1) The service is within the scope of practice of the
1405-provider of primary care; or
1406- (2) The provider of primary care is capable of providing the
1407-service safely and effectively in consultation with a specialist and
1408-the provider engages in such consultation.
1409- 2. An insurer shall provide the coverage required by
1410-paragraph (a) of subsection 1 regardless of whether the drug is
1411-included in the formulary of the insurer.
1412- 3. An insurer shall not:
1413- (a) Subject the benefits required by paragraph (a) of
1414-subsection 1 to medical management techniques, other than step
1415-therapy;
1416- (b) Limit the covered amount of a drug described in paragraph
1417-(a) of subsection 1; or
1418- (c) Refuse to cover a drug described in paragraph (a) of
1419-subsection 1 because the drug is dispensed by a pharmacy through
1420-mail order service.
1421- 4. An insurer shall ensure that the benefits required by
1422-subsection 1 are made available to an insured through a provider
1423-of health care who participates in the network plan of the insurer.
1433+- *SB439_R3*
1434+ (2) The provider of primary care is capable of providing the 1
1435+service safely and effectively in consultation with a specialist and 2
1436+the provider engages in such consultation. 3
1437+ 2. An insurer shall provide the coverage required by 4
1438+paragraph (a) of subsection 1 regardless of whether the drug is 5
1439+included in the formulary of the insurer. 6
1440+ 3. An insurer shall not: 7
1441+ (a) Subject the benefits required by paragraph (a) of 8
1442+subsection 1 to medical management techniques, other than step 9
1443+therapy; 10
1444+ (b) Limit the covered amount of a drug described in paragraph 11
1445+(a) of subsection 1; or 12
1446+ (c) Refuse to cover a drug described in paragraph (a) of 13
1447+subsection 1 because the drug is dispensed by a pharmacy through 14
1448+mail order service. 15
1449+ 4. An insurer shall ensure that the benefits required by 16
1450+subsection 1 are made available to an insured through a provider 17
1451+of health care who participates in the network plan of the insurer. 18
1452+ 5. A policy of health insurance subject to the provisions of 19
1453+this chapter that is delivered, issued for delivery or renewed on or 20
1454+after January 1, 2024, has the legal effect of including the 21
1455+coverage required by subsection 1, and any provision of the policy 22
1456+that conflicts with the provisions of this section is void. 23
1457+ 6. As used in this section: 24
1458+ (a) “Medical management technique” means a practice which 25
1459+is used to control the cost or use of health care services or 26
1460+prescription drugs. The term includes, without limitation, the use 27
1461+of step therapy, prior authorization and categorizing drugs and 28
1462+devices based on cost, type or method of administration. 29
1463+ (b) “Network plan” means a policy of health insurance offered 30
1464+by an insurer under which the financing and delivery of medical 31
1465+care, including items and services paid for as medical care, are 32
1466+provided, in whole or in part, through a defined set of providers 33
1467+under contract with the insurer. The term does not include an 34
1468+arrangement for the financing of premiums. 35
1469+ (c) “Primary care” means the practice of family medicine, 36
1470+pediatrics, internal medicine, obstetrics and gynecology and 37
1471+midwifery. 38
1472+ (d) “Provider of health care” has the meaning ascribed to it in 39
1473+NRS 629.031. 40
1474+ Sec. 34. 1. An insurer that offers or issues a policy of 41
1475+health insurance shall include in the policy: 42
1476+ (a) Coverage of testing for and the treatment and prevention of 43
1477+sexually transmitted diseases, including, without limitation, 44
1478+Chlamydia trachomatis, gonorrhea, syphilis, human 45
14241479 – 31 –
14251480
14261481
1427-- 82nd Session (2023)
1428- 5. A policy of health insurance subject to the provisions of
1429-this chapter that is delivered, issued for delivery or renewed on or
1430-after January 1, 2024, has the legal effect of including the
1431-coverage required by subsection 1, and any provision of the policy
1432-that conflicts with the provisions of this section is void.
1433- 6. As used in this section:
1434- (a) “Medical management technique” means a practice which
1435-is used to control the cost or use of health care services or
1436-prescription drugs. The term includes, without limitation, the use
1437-of step therapy, prior authorization and categorizing drugs and
1438-devices based on cost, type or method of administration.
1439- (b) “Network plan” means a policy of health insurance offered
1440-by an insurer under which the financing and delivery of medical
1441-care, including items and services paid for as medical care, are
1442-provided, in whole or in part, through a defined set of providers
1443-under contract with the insurer. The term does not include an
1444-arrangement for the financing of premiums.
1445- (c) “Primary care” means the practice of family medicine,
1446-pediatrics, internal medicine, obstetrics and gynecology and
1447-midwifery.
1448- (d) “Provider of health care” has the meaning ascribed to it in
1449-NRS 629.031.
1450- Sec. 34. 1. An insurer that offers or issues a policy of
1451-health insurance shall include in the policy:
1452- (a) Coverage of testing for and the treatment and prevention of
1453-sexually transmitted diseases, including, without limitation,
1454-Chlamydia trachomatis, gonorrhea, syphilis, human
1455-immunodeficiency virus and hepatitis B and C, for all insureds,
1456-regardless of age. Such coverage must include, without limitation,
1457-the coverage required by NRS 689A.0412 and 689A.0437.
1458- (b) Unrestricted coverage of condoms for insureds who are 13
1459-years of age or older.
1460- 2. A policy of health insurance subject to the provisions of
1461-this chapter that is delivered, issued for delivery or renewed on or
1462-after January 1, 2024, has the legal effect of including the
1463-coverage required by subsection 1, and any provision of the policy
1464-that conflicts with the provisions of this section is void.
1465- Sec. 35. (Deleted by amendment.)
1466- Sec. 36. NRS 689A.030 is hereby amended to read as follows:
1467- 689A.030 A policy of health insurance must not be delivered
1468-or issued for delivery to any person in this State unless it otherwise
1469-complies with this Code, and complies with the following:
1482+- *SB439_R3*
1483+immunodeficiency virus and hepatitis B and C, for all insureds, 1
1484+regardless of age. Such coverage must include, without limitation, 2
1485+the coverage required by NRS 689A.0412 and 689A.0437. 3
1486+ (b) Unrestricted coverage of condoms for insureds who are 13 4
1487+years of age or older. 5
1488+ 2. A policy of health insurance subject to the provisions of 6
1489+this chapter that is delivered, issued for delivery or renewed on or 7
1490+after January 1, 2024, has the legal effect of including the 8
1491+coverage required by subsection 1, and any provision of the policy 9
1492+that conflicts with the provisions of this section is void. 10
1493+ Sec. 35. (Deleted by amendment.) 11
1494+ Sec. 36. NRS 689A.030 is hereby amended to read as follows: 12
1495+ 689A.030 A policy of health insurance must not be delivered 13
1496+or issued for delivery to any person in this State unless it otherwise 14
1497+complies with this Code, and complies with the following: 15
1498+ 1. The entire money and other considerations for the policy 16
1499+must be expressed therein. 17
1500+ 2. The time when the insurance takes effect and terminates 18
1501+must be expressed therein. 19
1502+ 3. It must purport to insure only one person, except that a 20
1503+policy may insure, originally or by subsequent amendment, upon the 21
1504+application of an adult member of a family, who shall be deemed the 22
1505+policyholder, any two or more eligible members of that family, 23
1506+including the husband, wife, domestic partner as defined in NRS 24
1507+122A.030, dependent children, from the time of birth, adoption or 25
1508+placement for the purpose of adoption as provided in NRS 26
1509+689A.043, or any child on or before the last day of the month in 27
1510+which the child attains 26 years of age, and any other person 28
1511+dependent upon the policyholder. 29
1512+ 4. The style, arrangement and overall appearance of the policy 30
1513+must not give undue prominence to any portion of the text, and 31
1514+every printed portion of the text of the policy and of any 32
1515+endorsements or attached papers must be plainly printed in light-33
1516+faced type of a style in general use, the size of which must be 34
1517+uniform and not less than 10 points with a lowercase unspaced 35
1518+alphabet length not less than 120 points. “Text” includes all printed 36
1519+matter except the name and address of the insurer, the name or the 37
1520+title of the policy, the brief description, if any, and captions and 38
1521+subcaptions. 39
1522+ 5. The exceptions and reductions of indemnity must be set 40
1523+forth in the policy and, other than those contained in NRS 689A.050 41
1524+to 689A.290, inclusive, must be printed, at the insurer’s option, with 42
1525+the benefit provision to which they apply or under an appropriate 43
1526+caption such as “Exceptions” or “Exceptions and Reductions,” 44
1527+except that if an exception or reduction specifically applies only to a 45
14701528 – 32 –
14711529
14721530
1473-- 82nd Session (2023)
1474- 1. The entire money and other considerations for the policy
1475-must be expressed therein.
1476- 2. The time when the insurance takes effect and terminates
1477-must be expressed therein.
1478- 3. It must purport to insure only one person, except that a
1479-policy may insure, originally or by subsequent amendment, upon the
1480-application of an adult member of a family, who shall be deemed the
1481-policyholder, any two or more eligible members of that family,
1482-including the husband, wife, domestic partner as defined in NRS
1483-122A.030, dependent children, from the time of birth, adoption or
1484-placement for the purpose of adoption as provided in NRS
1485-689A.043, or any child on or before the last day of the month in
1486-which the child attains 26 years of age, and any other person
1487-dependent upon the policyholder.
1488- 4. The style, arrangement and overall appearance of the policy
1489-must not give undue prominence to any portion of the text, and
1490-every printed portion of the text of the policy and of any
1491-endorsements or attached papers must be plainly printed in light-
1492-faced type of a style in general use, the size of which must be
1493-uniform and not less than 10 points with a lowercase unspaced
1494-alphabet length not less than 120 points. “Text” includes all printed
1495-matter except the name and address of the insurer, the name or the
1496-title of the policy, the brief description, if any, and captions and
1497-subcaptions.
1498- 5. The exceptions and reductions of indemnity must be set
1499-forth in the policy and, other than those contained in NRS 689A.050
1500-to 689A.290, inclusive, must be printed, at the insurer’s option, with
1501-the benefit provision to which they apply or under an appropriate
1502-caption such as “Exceptions” or “Exceptions and Reductions,”
1503-except that if an exception or reduction specifically applies only to a
1504-particular benefit of the policy, a statement of that exception or
1505-reduction must be included with the benefit provision to which it
1506-applies.
1507- 6. Each such form, including riders and endorsements, must be
1508-identified by a number in the lower left-hand corner of the first page
1509-thereof.
1510- 7. The policy must not contain any provision purporting to
1511-make any portion of the charter, rules, constitution or bylaws of the
1512-insurer a part of the policy unless that portion is set forth in full in
1513-the policy, except in the case of the incorporation of or reference to
1514-a statement of rates or classification of risks, or short-rate table filed
1515-with the Commissioner.
1531+- *SB439_R3*
1532+particular benefit of the policy, a statement of that exception or 1
1533+reduction must be included with the benefit provision to which it 2
1534+applies. 3
1535+ 6. Each such form, including riders and endorsements, must be 4
1536+identified by a number in the lower left-hand corner of the first page 5
1537+thereof. 6
1538+ 7. The policy must not contain any provision purporting to 7
1539+make any portion of the charter, rules, constitution or bylaws of the 8
1540+insurer a part of the policy unless that portion is set forth in full in 9
1541+the policy, except in the case of the incorporation of or reference to 10
1542+a statement of rates or classification of risks, or short-rate table filed 11
1543+with the Commissioner. 12
1544+ 8. The policy must provide benefits for expense arising from 13
1545+care at home or health supportive services if that care or service was 14
1546+prescribed by a physician and would have been covered by the 15
1547+policy if performed in a medical facility or facility for the dependent 16
1548+as defined in chapter 449 of NRS. 17
1549+ 9. [The] Except as otherwise provided in this subsection, the 18
1550+policy must provide [, at the option of the applicant,] benefits for 19
1551+expenses incurred for the treatment of alcohol or substance use 20
1552+disorder . [, unless] Except for the benefits required by section 34 21
1553+of this act, such benefits must be provided: 22
1554+ (a) At the option of the applicant; and 23
1555+ (b) Unless the policy provides coverage only for a specified 24
1556+disease or provides for the payment of a specific amount of money 25
1557+if the insured is hospitalized or receiving health care in his or her 26
1558+home. 27
1559+ 10. The policy must provide benefits for expense arising from 28
1560+hospice care. 29
1561+ Sec. 37. NRS 689A.0437 is hereby amended to read as 30
1562+follows: 31
1563+ 689A.0437 1. An insurer that offers or issues a policy of 32
1564+health insurance shall include in the policy coverage for: 33
1565+ (a) [Drugs] All drugs approved by the United States Food and 34
1566+Drug Administration for preventing the acquisition of human 35
1567+immunodeficiency virus [;] or treating human immunodeficiency 36
1568+virus or hepatitis C in the form recommended by the prescribing 37
1569+practitioner, regardless of whether the drug is included in the 38
1570+formulary of the insurer; 39
1571+ (b) Laboratory testing that is necessary for therapy that uses 40
1572+[such] a drug [;] to prevent the acquisition of human 41
1573+immunodeficiency virus; 42
1574+ (c) Any service to test for, prevent or treat human 43
1575+immunodeficiency virus or hepatitis C provided by a provider of 44
15161576 – 33 –
15171577
15181578
1519-- 82nd Session (2023)
1520- 8. The policy must provide benefits for expense arising from
1521-care at home or health supportive services if that care or service was
1522-prescribed by a physician and would have been covered by the
1523-policy if performed in a medical facility or facility for the dependent
1524-as defined in chapter 449 of NRS.
1525- 9. [The] Except as otherwise provided in this subsection, the
1526-policy must provide [, at the option of the applicant,] benefits for
1527-expenses incurred for the treatment of alcohol or substance use
1528-disorder . [, unless] Except for the benefits required by section 34
1529-of this act, such benefits must be provided:
1530- (a) At the option of the applicant; and
1531- (b) Unless the policy provides coverage only for a specified
1532-disease or provides for the payment of a specific amount of money
1533-if the insured is hospitalized or receiving health care in his or her
1534-home.
1535- 10. The policy must provide benefits for expense arising from
1536-hospice care.
1537- Sec. 37. NRS 689A.0437 is hereby amended to read as
1538-follows:
1539- 689A.0437 1. An insurer that offers or issues a policy of
1540-health insurance shall include in the policy coverage for:
1541- (a) [Drugs] All drugs approved by the United States Food and
1542-Drug Administration for preventing the acquisition of human
1543-immunodeficiency virus [;] or treating human immunodeficiency
1544-virus or hepatitis C in the form recommended by the prescribing
1545-practitioner, regardless of whether the drug is included in the
1546-formulary of the insurer;
1547- (b) Laboratory testing that is necessary for therapy that uses
1548-[such] a drug [;] to prevent the acquisition of human
1549-immunodeficiency virus;
1550- (c) Any service to test for, prevent or treat human
1551-immunodeficiency virus or hepatitis C provided by a provider of
1552-primary care if the service is covered when provided by a specialist
1553-and:
1554- (1) The service is within the scope of practice of the
1555-provider of primary care; or
1556- (2) The provider of primary care is capable of providing the
1557-service safely and effectively in consultation with a specialist and
1558-the provider engages in such consultation; and
1559- [(c)] (d) The services described in NRS 639.28085, when
1560-provided by a pharmacist who participates in the network plan of the
1561-insurer.
1579+- *SB439_R3*
1580+primary care if the service is covered when provided by a specialist 1
1581+and: 2
1582+ (1) The service is within the scope of practice of the 3
1583+provider of primary care; or 4
1584+ (2) The provider of primary care is capable of providing the 5
1585+service safely and effectively in consultation with a specialist and 6
1586+the provider engages in such consultation; and 7
1587+ [(c)] (d) The services described in NRS 639.28085, when 8
1588+provided by a pharmacist who participates in the network plan of the 9
1589+insurer. 10
1590+ 2. An insurer that offers or issues a policy of health insurance 11
1591+shall reimburse [a] : 12
1592+ (a) A pharmacist who participates in the network plan of the 13
1593+insurer for the services described in NRS 639.28085 at a rate equal 14
1594+to the rate of reimbursement provided to a physician, physician 15
1595+assistant or advanced practice registered nurse for similar services. 16
1596+ (b) An advanced practice registered nurse or a physician 17
1597+assistant who participates in the network plan of the insurer for 18
1598+any service to test for, prevent or treat human immunodeficiency 19
1599+virus or hepatitis C at a rate equal to the rate of reimbursement 20
1600+provided to a physician for similar services. 21
1601+ 3. An insurer [may subject] shall not: 22
1602+ (a) Subject the benefits required by subsection 1 to [reasonable] 23
1603+medical management techniques [.] , other than step therapy; 24
1604+ (b) Limit the covered amount of a drug described in paragraph 25
1605+(a) of subsection 1; 26
1606+ (c) Refuse to cover a drug described in paragraph (a) of 27
1607+subsection 1 because the drug is dispensed by a pharmacy through 28
1608+mail order service; or 29
1609+ (d) Prohibit or restrict access to any service or drug to treat 30
1610+human immunodeficiency virus or hepatitis C on the same day on 31
1611+which the insured is diagnosed. 32
1612+ 4. An insurer shall ensure that the benefits required by 33
1613+subsection 1 are made available to an insured through a provider of 34
1614+health care who participates in the network plan of the insurer. 35
1615+ 5. A policy of health insurance subject to the provisions of this 36
1616+chapter that is delivered, issued for delivery or renewed on or after 37
1617+[October] January 1, [2021,] 2024, has the legal effect of including 38
1618+the coverage required by subsection 1, and any provision of the 39
1619+policy that conflicts with the provisions of this section is void. 40
1620+ 6. As used in this section: 41
1621+ (a) “Medical management technique” means a practice which is 42
1622+used to control the cost or use of health care services or prescription 43
1623+drugs. The term includes, without limitation, the use of step therapy, 44
15621624 – 34 –
15631625
15641626
1565-- 82nd Session (2023)
1566- 2. An insurer that offers or issues a policy of health insurance
1567-shall reimburse [a] :
1568- (a) A pharmacist who participates in the network plan of the
1569-insurer for the services described in NRS 639.28085 at a rate equal
1570-to the rate of reimbursement provided to a physician, physician
1571-assistant or advanced practice registered nurse for similar services.
1572- (b) An advanced practice registered nurse or a physician
1573-assistant who participates in the network plan of the insurer for
1574-any service to test for, prevent or treat human immunodeficiency
1575-virus or hepatitis C at a rate equal to the rate of reimbursement
1576-provided to a physician for similar services.
1577- 3. An insurer [may subject] shall not:
1578- (a) Subject the benefits required by subsection 1 to [reasonable]
1579-medical management techniques [.] , other than step therapy;
1580- (b) Limit the covered amount of a drug described in paragraph
1581-(a) of subsection 1;
1582- (c) Refuse to cover a drug described in paragraph (a) of
1583-subsection 1 because the drug is dispensed by a pharmacy through
1584-mail order service; or
1585- (d) Prohibit or restrict access to any service or drug to treat
1586-human immunodeficiency virus or hepatitis C on the same day on
1587-which the insured is diagnosed.
1588- 4. An insurer shall ensure that the benefits required by
1589-subsection 1 are made available to an insured through a provider of
1590-health care who participates in the network plan of the insurer.
1591- 5. A policy of health insurance subject to the provisions of this
1592-chapter that is delivered, issued for delivery or renewed on or after
1593-[October] January 1, [2021,] 2024, has the legal effect of including
1594-the coverage required by subsection 1, and any provision of the
1595-policy that conflicts with the provisions of this section is void.
1596- 6. As used in this section:
1597- (a) “Medical management technique” means a practice which is
1598-used to control the cost or use of health care services or prescription
1599-drugs. The term includes, without limitation, the use of step therapy,
1600-prior authorization and categorizing drugs and devices based on
1601-cost, type or method of administration.
1602- (b) “Network plan” means a policy of health insurance offered
1603-by an insurer under which the financing and delivery of medical
1604-care, including items and services paid for as medical care, are
1605-provided, in whole or in part, through a defined set of providers
1606-under contract with the insurer. The term does not include an
1607-arrangement for the financing of premiums.
1627+- *SB439_R3*
1628+prior authorization and categorizing drugs and devices based on 1
1629+cost, type or method of administration. 2
1630+ (b) “Network plan” means a policy of health insurance offered 3
1631+by an insurer under which the financing and delivery of medical 4
1632+care, including items and services paid for as medical care, are 5
1633+provided, in whole or in part, through a defined set of providers 6
1634+under contract with the insurer. The term does not include an 7
1635+arrangement for the financing of premiums. 8
1636+ (c) “Primary care” means the practice of family medicine, 9
1637+pediatrics, internal medicine, obstetrics and gynecology and 10
1638+midwifery. 11
1639+ (d) “Provider of health care” has the meaning ascribed to it in 12
1640+NRS 629.031. 13
1641+ Sec. 38. NRS 689A.046 is hereby amended to read as follows: 14
1642+ 689A.046 1. [The] In addition to the benefits required by 15
1643+section 33 of this act, the benefits provided by a policy for health 16
1644+insurance for treatment of alcohol or substance use disorder must 17
1645+[consist of:] include, without limitation: 18
1646+ (a) Treatment for withdrawal from the physiological effect of 19
1647+alcohol or drugs, with a minimum benefit of $1,500 per calendar 20
1648+year. 21
1649+ (b) Treatment for a patient admitted to a facility, with a 22
1650+minimum benefit of $9,000 per calendar year. 23
1651+ (c) Counseling for a person, group or family who is not admitted 24
1652+to a facility, with a minimum benefit of $2,500 per calendar year. 25
1653+ 2. Except as otherwise provided in NRS 687B.409, these 26
1654+benefits must be paid in the same manner as benefits for any other 27
1655+illness covered by a similar policy are paid. 28
1656+ 3. The insured person is entitled to these benefits if treatment is 29
1657+received in any: 30
1658+ (a) Facility for the treatment of alcohol or substance use disorder 31
1659+which is certified by the Division of Public and Behavioral Health 32
1660+of the Department of Health and Human Services. 33
1661+ (b) Hospital or other medical facility or facility for the 34
1662+dependent which is licensed by the Division of Public and 35
1663+Behavioral Health of the Department of Health and Human 36
1664+Services, accredited by The Joint Commission or CARF 37
1665+International and provides a program for the treatment of alcohol or 38
1666+substance use disorder as part of its accredited activities. 39
1667+ Sec. 39. NRS 689A.330 is hereby amended to read as follows: 40
1668+ 689A.330 If any policy is issued by a domestic insurer for 41
1669+delivery to a person residing in another state, and if the insurance 42
1670+commissioner or corresponding public officer of that other state has 43
1671+informed the Commissioner that the policy is not subject to approval 44
1672+or disapproval by that officer, the Commissioner may by ruling 45
16081673 – 35 –
16091674
16101675
1611-- 82nd Session (2023)
1612- (c) “Primary care” means the practice of family medicine,
1613-pediatrics, internal medicine, obstetrics and gynecology and
1614-midwifery.
1615- (d) “Provider of health care” has the meaning ascribed to it in
1616-NRS 629.031.
1617- Sec. 38. NRS 689A.046 is hereby amended to read as follows:
1618- 689A.046 1. [The] In addition to the benefits required by
1619-section 33 of this act, the benefits provided by a policy for health
1620-insurance for treatment of alcohol or substance use disorder must
1621-[consist of:] include, without limitation:
1622- (a) Treatment for withdrawal from the physiological effect of
1623-alcohol or drugs, with a minimum benefit of $1,500 per calendar
1624-year.
1625- (b) Treatment for a patient admitted to a facility, with a
1626-minimum benefit of $9,000 per calendar year.
1627- (c) Counseling for a person, group or family who is not admitted
1628-to a facility, with a minimum benefit of $2,500 per calendar year.
1629- 2. Except as otherwise provided in NRS 687B.409, these
1630-benefits must be paid in the same manner as benefits for any other
1631-illness covered by a similar policy are paid.
1632- 3. The insured person is entitled to these benefits if treatment is
1633-received in any:
1634- (a) Facility for the treatment of alcohol or substance use disorder
1635-which is certified by the Division of Public and Behavioral Health
1636-of the Department of Health and Human Services.
1637- (b) Hospital or other medical facility or facility for the
1638-dependent which is licensed by the Division of Public and
1639-Behavioral Health of the Department of Health and Human
1640-Services, accredited by The Joint Commission or CARF
1641-International and provides a program for the treatment of alcohol or
1642-substance use disorder as part of its accredited activities.
1643- Sec. 39. NRS 689A.330 is hereby amended to read as follows:
1644- 689A.330 If any policy is issued by a domestic insurer for
1645-delivery to a person residing in another state, and if the insurance
1646-commissioner or corresponding public officer of that other state has
1647-informed the Commissioner that the policy is not subject to approval
1648-or disapproval by that officer, the Commissioner may by ruling
1649-require that the policy meet the standards set forth in NRS 689A.030
1650-to 689A.320, inclusive [.] , and sections 33 and 34 of this act.
1651- Sec. 40. Chapter 689B of NRS is hereby amended by adding
1652-thereto the provisions set forth as sections 41, 42 and 43 of this act.
1653- Sec. 41. 1. An insurer that offers or issues a policy of
1654-group health insurance shall include in the policy coverage for:
1676+- *SB439_R3*
1677+require that the policy meet the standards set forth in NRS 689A.030 1
1678+to 689A.320, inclusive [.] , and sections 33 and 34 of this act. 2
1679+ Sec. 40. Chapter 689B of NRS is hereby amended by adding 3
1680+thereto the provisions set forth as sections 41, 42 and 43 of this act. 4
1681+ Sec. 41. 1. An insurer that offers or issues a policy of 5
1682+group health insurance shall include in the policy coverage for: 6
1683+ (a) All drugs approved by the United States Food and Drug 7
1684+Administration to: 8
1685+ (1) Provide medication-assisted treatment for opioid use 9
1686+disorder, including, without limitation, buprenorphine, methadone 10
1687+and naltrexone. 11
1688+ (2) Support safe withdrawal from substance use disorder, 12
1689+including, without limitation, lofexidine. 13
1690+ (b) Any service for the treatment of substance use disorder 14
1691+provided by a provider of primary care if the service is covered 15
1692+when provided by a specialist and: 16
1693+ (1) The service is within the scope of practice of the 17
1694+provider of primary care; or 18
1695+ (2) The provider of primary care is capable of providing the 19
1696+service safely and effectively in consultation with a specialist and 20
1697+the provider engages in such consultation. 21
1698+ 2. An insurer shall provide the coverage required by 22
1699+paragraph (a) of subsection 1 regardless of whether the drug is 23
1700+included in the formulary of the insurer. 24
1701+ 3. An insurer shall not: 25
1702+ (a) Subject the benefits required by paragraph (a) of 26
1703+subsection 1 to medical management techniques, other than step 27
1704+therapy; 28
1705+ (b) Limit the covered amount of a drug described in paragraph 29
1706+(a) of subsection 1; or 30
1707+ (c) Refuse to cover a drug described in paragraph (a) of 31
1708+subsection 1 because the drug is dispensed by a pharmacy through 32
1709+mail order service. 33
1710+ 4. An insurer shall ensure that the benefits required by 34
1711+subsection 1 are made available to an insured through a provider 35
1712+of health care who participates in the network plan of the insurer. 36
1713+ 5. A policy of group health insurance subject to the 37
1714+provisions of this chapter that is delivered, issued for delivery or 38
1715+renewed on or after January 1, 2024, has the legal effect of 39
1716+including the coverage required by subsection 1, and any 40
1717+provision of the policy that conflicts with the provisions of this 41
1718+section is void. 42
1719+ 6. As used in this section: 43
1720+ (a) “Medical management technique” means a practice which 44
1721+is used to control the cost or use of health care services or 45
16551722 – 36 –
16561723
16571724
1658-- 82nd Session (2023)
1659- (a) All drugs approved by the United States Food and Drug
1660-Administration to:
1661- (1) Provide medication-assisted treatment for opioid use
1662-disorder, including, without limitation, buprenorphine, methadone
1663-and naltrexone.
1664- (2) Support safe withdrawal from substance use disorder,
1665-including, without limitation, lofexidine.
1666- (b) Any service for the treatment of substance use disorder
1667-provided by a provider of primary care if the service is covered
1668-when provided by a specialist and:
1669- (1) The service is within the scope of practice of the
1670-provider of primary care; or
1671- (2) The provider of primary care is capable of providing the
1672-service safely and effectively in consultation with a specialist and
1673-the provider engages in such consultation.
1674- 2. An insurer shall provide the coverage required by
1675-paragraph (a) of subsection 1 regardless of whether the drug is
1676-included in the formulary of the insurer.
1677- 3. An insurer shall not:
1678- (a) Subject the benefits required by paragraph (a) of
1679-subsection 1 to medical management techniques, other than step
1680-therapy;
1681- (b) Limit the covered amount of a drug described in paragraph
1682-(a) of subsection 1; or
1683- (c) Refuse to cover a drug described in paragraph (a) of
1684-subsection 1 because the drug is dispensed by a pharmacy through
1685-mail order service.
1686- 4. An insurer shall ensure that the benefits required by
1687-subsection 1 are made available to an insured through a provider
1688-of health care who participates in the network plan of the insurer.
1689- 5. A policy of group health insurance subject to the
1690-provisions of this chapter that is delivered, issued for delivery or
1691-renewed on or after January 1, 2024, has the legal effect of
1692-including the coverage required by subsection 1, and any
1693-provision of the policy that conflicts with the provisions of this
1694-section is void.
1695- 6. As used in this section:
1696- (a) “Medical management technique” means a practice which
1697-is used to control the cost or use of health care services or
1698-prescription drugs. The term includes, without limitation, the use
1699-of step therapy, prior authorization and categorizing drugs and
1700-devices based on cost, type or method of administration.
1725+- *SB439_R3*
1726+prescription drugs. The term includes, without limitation, the use 1
1727+of step therapy, prior authorization and categorizing drugs and 2
1728+devices based on cost, type or method of administration. 3
1729+ (b) “Network plan” means a policy of group health insurance 4
1730+offered by an insurer under which the financing and delivery of 5
1731+medical care, including items and services paid for as medical 6
1732+care, are provided, in whole or in part, through a defined set of 7
1733+providers under contract with the insurer. The term does not 8
1734+include an arrangement for the financing of premiums. 9
1735+ (c) “Primary care” means the practice of family medicine, 10
1736+pediatrics, internal medicine, obstetrics and gynecology and 11
1737+midwifery. 12
1738+ (d) “Provider of health care” has the meaning ascribed to it in 13
1739+NRS 629.031. 14
1740+ Sec. 42. 1. An insurer that offers or issues a policy of 15
1741+group health insurance shall include in the policy: 16
1742+ (a) Coverage of testing for and the treatment of and prevention 17
1743+of sexually transmitted diseases, including, without limitation, 18
1744+Chlamydia trachomatis, gonorrhea, syphilis, human 19
1745+immunodeficiency virus and hepatitis B and C, for all insureds, 20
1746+regardless of age. Such coverage must include, without limitation, 21
1747+the coverage required by NRS 689B.0312 and 689B.0315. 22
1748+ (b) Unrestricted coverage of condoms for insureds who are 13 23
1749+years of age or older. 24
1750+ 2. A policy of group health insurance subject to the 25
1751+provisions of this chapter that is delivered, issued for delivery or 26
1752+renewed on or after January 1, 2024, has the legal effect of 27
1753+including the coverage required by subsection 1, and any 28
1754+provision of the policy that conflicts with the provisions of this 29
1755+section is void. 30
1756+ Sec. 43. (Deleted by amendment.) 31
1757+ Sec. 44. NRS 689B.0312 is hereby amended to read as 32
1758+follows: 33
1759+ 689B.0312 1. An insurer that offers or issues a policy of 34
1760+group health insurance shall include in the policy coverage for: 35
1761+ (a) [Drugs] All drugs approved by the United States Food and 36
1762+Drug Administration for preventing the acquisition of human 37
1763+immunodeficiency virus [;] or treating human immunodeficiency 38
1764+virus or hepatitis C in the form recommended by the prescribing 39
1765+practitioner, regardless of whether the drug is included in the 40
1766+formulary of the insurer; 41
1767+ (b) Laboratory testing that is necessary for therapy that uses 42
1768+[such] a drug [;] to prevent the acquisition of human 43
1769+immunodeficiency virus; 44
17011770 – 37 –
17021771
17031772
1704-- 82nd Session (2023)
1705- (b) “Network plan” means a policy of group health insurance
1706-offered by an insurer under which the financing and delivery of
1707-medical care, including items and services paid for as medical
1708-care, are provided, in whole or in part, through a defined set of
1709-providers under contract with the insurer. The term does not
1710-include an arrangement for the financing of premiums.
1711- (c) “Primary care” means the practice of family medicine,
1712-pediatrics, internal medicine, obstetrics and gynecology and
1713-midwifery.
1714- (d) “Provider of health care” has the meaning ascribed to it in
1715-NRS 629.031.
1716- Sec. 42. 1. An insurer that offers or issues a policy of
1717-group health insurance shall include in the policy:
1718- (a) Coverage of testing for and the treatment of and prevention
1719-of sexually transmitted diseases, including, without limitation,
1720-Chlamydia trachomatis, gonorrhea, syphilis, human
1721-immunodeficiency virus and hepatitis B and C, for all insureds,
1722-regardless of age. Such coverage must include, without limitation,
1723-the coverage required by NRS 689B.0312 and 689B.0315.
1724- (b) Unrestricted coverage of condoms for insureds who are 13
1725-years of age or older.
1726- 2. A policy of group health insurance subject to the
1727-provisions of this chapter that is delivered, issued for delivery or
1728-renewed on or after January 1, 2024, has the legal effect of
1729-including the coverage required by subsection 1, and any
1730-provision of the policy that conflicts with the provisions of this
1731-section is void.
1732- Sec. 43. (Deleted by amendment.)
1733- Sec. 44. NRS 689B.0312 is hereby amended to read as
1734-follows:
1735- 689B.0312 1. An insurer that offers or issues a policy of
1736-group health insurance shall include in the policy coverage for:
1737- (a) [Drugs] All drugs approved by the United States Food and
1738-Drug Administration for preventing the acquisition of human
1739-immunodeficiency virus [;] or treating human immunodeficiency
1740-virus or hepatitis C in the form recommended by the prescribing
1741-practitioner, regardless of whether the drug is included in the
1742-formulary of the insurer;
1743- (b) Laboratory testing that is necessary for therapy that uses
1744-[such] a drug [;] to prevent the acquisition of human
1745-immunodeficiency virus;
1746- (c) Any service to test for, prevent or treat human
1747-immunodeficiency virus or hepatitis C provided by a provider of
1773+- *SB439_R3*
1774+ (c) Any service to test for, prevent or treat human 1
1775+immunodeficiency virus or hepatitis C provided by a provider of 2
1776+primary care if the service is covered when provided by a specialist 3
1777+and: 4
1778+ (1) The service is within the scope of practice of the 5
1779+provider of primary care; or 6
1780+ (2) The provider of primary care is capable of providing the 7
1781+service safely and effectively in consultation with a specialist and 8
1782+the provider engages in such consultation; and 9
1783+ [(c)] (d) The services described in NRS 639.28085, when 10
1784+provided by a pharmacist who participates in the network plan of the 11
1785+insurer. 12
1786+ 2. An insurer that offers or issues a policy of group health 13
1787+insurance shall reimburse [a] : 14
1788+ (a) A pharmacist who participates in the network plan of the 15
1789+insurer for the services described in NRS 639.28085 at a rate equal 16
1790+to the rate of reimbursement provided to a physician, physician 17
1791+assistant or advanced practice registered nurse for similar services. 18
1792+ (b) An advanced practice registered nurse or a physician 19
1793+assistant who participates in the network plan of the insurer for 20
1794+any service to test for, prevent or treat human immunodeficiency 21
1795+virus or hepatitis C at a rate equal to the rate of reimbursement 22
1796+provided to a physician for similar services. 23
1797+ 3. An insurer [may subject] shall not: 24
1798+ (a) Subject the benefits required by subsection 1 to [reasonable] 25
1799+medical management techniques [.] , other than step therapy; 26
1800+ (b) Limit the covered amount of a drug described in paragraph 27
1801+(a) of subsection 1; 28
1802+ (c) Refuse to cover a drug described in paragraph (a) of 29
1803+subsection 1 because the drug is dispensed by a pharmacy through 30
1804+mail order service; or 31
1805+ (d) Prohibit or restrict access to any service or drug to treat 32
1806+human immunodeficiency virus or hepatitis C on the same day on 33
1807+which the insured is diagnosed. 34
1808+ 4. An insurer shall ensure that the benefits required by 35
1809+subsection 1 are made available to an insured through a provider of 36
1810+health care who participates in the network plan of the insurer. 37
1811+ 5. A policy of group health insurance subject to the provisions 38
1812+of this chapter that is delivered, issued for delivery or renewed on or 39
1813+after [October] January 1, [2021,] 2024, has the legal effect of 40
1814+including the coverage required by subsection 1, and any provision 41
1815+of the policy that conflicts with the provisions of this section is void. 42
1816+ 6. As used in this section: 43
1817+ (a) “Medical management technique” means a practice which is 44
1818+used to control the cost or use of health care services or prescription 45
17481819 – 38 –
17491820
17501821
1751-- 82nd Session (2023)
1752-primary care if the service is covered when provided by a specialist
1753-and:
1754- (1) The service is within the scope of practice of the
1755-provider of primary care; or
1756- (2) The provider of primary care is capable of providing the
1757-service safely and effectively in consultation with a specialist and
1758-the provider engages in such consultation; and
1759- [(c)] (d) The services described in NRS 639.28085, when
1760-provided by a pharmacist who participates in the network plan of the
1761-insurer.
1762- 2. An insurer that offers or issues a policy of group health
1763-insurance shall reimburse [a] :
1764- (a) A pharmacist who participates in the network plan of the
1765-insurer for the services described in NRS 639.28085 at a rate equal
1766-to the rate of reimbursement provided to a physician, physician
1767-assistant or advanced practice registered nurse for similar services.
1768- (b) An advanced practice registered nurse or a physician
1769-assistant who participates in the network plan of the insurer for
1770-any service to test for, prevent or treat human immunodeficiency
1771-virus or hepatitis C at a rate equal to the rate of reimbursement
1772-provided to a physician for similar services.
1773- 3. An insurer [may subject] shall not:
1774- (a) Subject the benefits required by subsection 1 to [reasonable]
1775-medical management techniques [.] , other than step therapy;
1776- (b) Limit the covered amount of a drug described in paragraph
1777-(a) of subsection 1;
1778- (c) Refuse to cover a drug described in paragraph (a) of
1779-subsection 1 because the drug is dispensed by a pharmacy through
1780-mail order service; or
1781- (d) Prohibit or restrict access to any service or drug to treat
1782-human immunodeficiency virus or hepatitis C on the same day on
1783-which the insured is diagnosed.
1784- 4. An insurer shall ensure that the benefits required by
1785-subsection 1 are made available to an insured through a provider of
1786-health care who participates in the network plan of the insurer.
1787- 5. A policy of group health insurance subject to the provisions
1788-of this chapter that is delivered, issued for delivery or renewed on or
1789-after [October] January 1, [2021,] 2024, has the legal effect of
1790-including the coverage required by subsection 1, and any provision
1791-of the policy that conflicts with the provisions of this section is void.
1792- 6. As used in this section:
1793- (a) “Medical management technique” means a practice which is
1794-used to control the cost or use of health care services or prescription
1822+- *SB439_R3*
1823+drugs. The term includes, without limitation, the use of step therapy, 1
1824+prior authorization and categorizing drugs and devices based on 2
1825+cost, type or method of administration. 3
1826+ (b) “Network plan” means a policy of group health insurance 4
1827+offered by an insurer under which the financing and delivery of 5
1828+medical care, including items and services paid for as medical care, 6
1829+are provided, in whole or in part, through a defined set of providers 7
1830+under contract with the insurer. The term does not include an 8
1831+arrangement for the financing of premiums. 9
1832+ (c) “Primary care” means the practice of family medicine, 10
1833+pediatrics, internal medicine, obstetrics and gynecology and 11
1834+midwifery. 12
1835+ (d) “Provider of health care” has the meaning ascribed to it in 13
1836+NRS 629.031. 14
1837+ Sec. 45. Chapter 689C of NRS is hereby amended by adding 15
1838+thereto the provisions set forth as sections 46, 47 and 48 of this act. 16
1839+ Sec. 46. 1. A carrier that offers or issues a health benefit 17
1840+plan shall include in the plan coverage for: 18
1841+ (a) All drugs approved by the United States Food and Drug 19
1842+Administration to: 20
1843+ (1) Provide medication-assisted treatment for opioid use 21
1844+disorder, including, without limitation, buprenorphine, methadone 22
1845+and naltrexone. 23
1846+ (2) Support safe withdrawal from substance use disorder, 24
1847+including, without limitation, lofexidine. 25
1848+ (b) Any service for the treatment of substance use disorder 26
1849+provided by a provider of primary care if the service is covered 27
1850+when provided by a specialist and: 28
1851+ (1) The service is within the scope of practice of the 29
1852+provider of primary care; or 30
1853+ (2) The provider of primary care is capable of providing the 31
1854+service safely and effectively in consultation with a specialist and 32
1855+the provider engages in such consultation. 33
1856+ 2. A carrier shall provide the coverage required by paragraph 34
1857+(a) of subsection 1 regardless of whether the drug is included in 35
1858+the formulary of the carrier. 36
1859+ 3. A carrier shall not: 37
1860+ (a) Subject the benefits required by paragraph (a) of 38
1861+subsection 1 to medical management techniques, other than step 39
1862+therapy; 40
1863+ (b) Limit the covered amount of a drug described in paragraph 41
1864+(a) of subsection 1; or 42
1865+ (c) Refuse to cover a drug described in paragraph (a) of 43
1866+subsection 1 because the drug is dispensed by a pharmacy through 44
1867+mail order service. 45
17951868 – 39 –
17961869
17971870
1798-- 82nd Session (2023)
1799-drugs. The term includes, without limitation, the use of step therapy,
1800-prior authorization and categorizing drugs and devices based on
1801-cost, type or method of administration.
1802- (b) “Network plan” means a policy of group health insurance
1803-offered by an insurer under which the financing and delivery of
1804-medical care, including items and services paid for as medical care,
1805-are provided, in whole or in part, through a defined set of providers
1806-under contract with the insurer. The term does not include an
1807-arrangement for the financing of premiums.
1808- (c) “Primary care” means the practice of family medicine,
1809-pediatrics, internal medicine, obstetrics and gynecology and
1810-midwifery.
1811- (d) “Provider of health care” has the meaning ascribed to it in
1812-NRS 629.031.
1813- Sec. 45. Chapter 689C of NRS is hereby amended by adding
1814-thereto the provisions set forth as sections 46, 47 and 48 of this act.
1815- Sec. 46. 1. A carrier that offers or issues a health benefit
1816-plan shall include in the plan coverage for:
1817- (a) All drugs approved by the United States Food and Drug
1818-Administration to:
1819- (1) Provide medication-assisted treatment for opioid use
1820-disorder, including, without limitation, buprenorphine, methadone
1821-and naltrexone.
1822- (2) Support safe withdrawal from substance use disorder,
1823-including, without limitation, lofexidine.
1824- (b) Any service for the treatment of substance use disorder
1825-provided by a provider of primary care if the service is covered
1826-when provided by a specialist and:
1827- (1) The service is within the scope of practice of the
1828-provider of primary care; or
1829- (2) The provider of primary care is capable of providing the
1830-service safely and effectively in consultation with a specialist and
1831-the provider engages in such consultation.
1832- 2. A carrier shall provide the coverage required by paragraph
1833-(a) of subsection 1 regardless of whether the drug is included in
1834-the formulary of the carrier.
1835- 3. A carrier shall not:
1836- (a) Subject the benefits required by paragraph (a) of
1837-subsection 1 to medical management techniques, other than step
1838-therapy;
1839- (b) Limit the covered amount of a drug described in paragraph
1840-(a) of subsection 1; or
1871+- *SB439_R3*
1872+ 4. A carrier shall ensure that the benefits required by 1
1873+subsection 1 are made available to an insured through a provider 2
1874+of health care who participates in the network plan of the carrier. 3
1875+ 5. A health benefit plan subject to the provisions of this 4
1876+chapter that is delivered, issued for delivery or renewed on or after 5
1877+January 1, 2024, has the legal effect of including the coverage 6
1878+required by subsection 1, and any provision of the plan that 7
1879+conflicts with the provisions of this section is void. 8
1880+ 6. As used in this section: 9
1881+ (a) “Medical management technique” means a practice which 10
1882+is used to control the cost or use of health care services or 11
1883+prescription drugs. The term includes, without limitation, the use 12
1884+of step therapy, prior authorization and categorizing drugs and 13
1885+devices based on cost, type or method of administration. 14
1886+ (b) “Network plan” means a health benefit plan offered by a 15
1887+carrier under which the financing and delivery of medical care, 16
1888+including items and services paid for as medical care, are 17
1889+provided, in whole or in part, through a defined set of providers 18
1890+under contract with the carrier. The term does not include an 19
1891+arrangement for the financing of premiums. 20
1892+ (c) “Primary care” means the practice of family medicine, 21
1893+pediatrics, internal medicine, obstetrics and gynecology and 22
1894+midwifery. 23
1895+ (d) “Provider of health care” has the meaning ascribed to it in 24
1896+NRS 629.031. 25
1897+ Sec. 47. 1. A carrier that offers or issues a health benefit 26
1898+plan shall include in the plan: 27
1899+ (a) Coverage of testing for and the treatment and prevention of 28
1900+sexually transmitted diseases, including, without limitation, 29
1901+Chlamydia trachomatis, gonorrhea, syphilis, human 30
1902+immunodeficiency virus and hepatitis B and C, for all insureds, 31
1903+regardless of age. Such coverage must include, without limitation, 32
1904+the coverage required by NRS 689C.1671 and 689C.1675. 33
1905+ (b) Unrestricted coverage of condoms for insureds who are 13 34
1906+years of age or older. 35
1907+ 2. A health benefit plan subject to the provisions of this 36
1908+chapter that is delivered, issued for delivery or renewed on or after 37
1909+January 1, 2024, has the legal effect of including the coverage 38
1910+required by subsection 1, and any provision of the plan that 39
1911+conflicts with the provisions of this section is void. 40
1912+ Sec. 48. (Deleted by amendment.) 41
1913+ Sec. 49. NRS 689C.166 is hereby amended to read as follows: 42
1914+ 689C.166 Each group health insurance policy must contain in 43
1915+substance a provision for benefits payable for expenses incurred for 44
18411916 – 40 –
18421917
18431918
1844-- 82nd Session (2023)
1845- (c) Refuse to cover a drug described in paragraph (a) of
1846-subsection 1 because the drug is dispensed by a pharmacy through
1847-mail order service.
1848- 4. A carrier shall ensure that the benefits required by
1849-subsection 1 are made available to an insured through a provider
1850-of health care who participates in the network plan of the carrier.
1851- 5. A health benefit plan subject to the provisions of this
1852-chapter that is delivered, issued for delivery or renewed on or after
1853-January 1, 2024, has the legal effect of including the coverage
1854-required by subsection 1, and any provision of the plan that
1855-conflicts with the provisions of this section is void.
1856- 6. As used in this section:
1857- (a) “Medical management technique” means a practice which
1858-is used to control the cost or use of health care services or
1859-prescription drugs. The term includes, without limitation, the use
1860-of step therapy, prior authorization and categorizing drugs and
1861-devices based on cost, type or method of administration.
1862- (b) “Network plan” means a health benefit plan offered by a
1863-carrier under which the financing and delivery of medical care,
1864-including items and services paid for as medical care, are
1865-provided, in whole or in part, through a defined set of providers
1866-under contract with the carrier. The term does not include an
1867-arrangement for the financing of premiums.
1868- (c) “Primary care” means the practice of family medicine,
1869-pediatrics, internal medicine, obstetrics and gynecology and
1870-midwifery.
1871- (d) “Provider of health care” has the meaning ascribed to it in
1872-NRS 629.031.
1873- Sec. 47. 1. A carrier that offers or issues a health benefit
1874-plan shall include in the plan:
1875- (a) Coverage of testing for and the treatment and prevention of
1876-sexually transmitted diseases, including, without limitation,
1877-Chlamydia trachomatis, gonorrhea, syphilis, human
1878-immunodeficiency virus and hepatitis B and C, for all insureds,
1879-regardless of age. Such coverage must include, without limitation,
1880-the coverage required by NRS 689C.1671 and 689C.1675.
1881- (b) Unrestricted coverage of condoms for insureds who are 13
1882-years of age or older.
1883- 2. A health benefit plan subject to the provisions of this
1884-chapter that is delivered, issued for delivery or renewed on or after
1885-January 1, 2024, has the legal effect of including the coverage
1886-required by subsection 1, and any provision of the plan that
1887-conflicts with the provisions of this section is void.
1919+- *SB439_R3*
1920+the treatment of alcohol or substance use disorder, as provided in 1
1921+NRS 689C.167 [.] and section 46 of this act. 2
1922+ Sec. 50. NRS 689C.167 is hereby amended to read as follows: 3
1923+ 689C.167 1. [The] In addition to the benefits required by 4
1924+section 46 of this act, the benefits provided by a group policy for 5
1925+health insurance, as required by NRS 689C.166, for the treatment of 6
1926+alcohol or substance use disorders must [consist of:] include, 7
1927+without limitation: 8
1928+ (a) Treatment for withdrawal from the physiological effects of 9
1929+alcohol or drugs, with a minimum benefit of $1,500 per calendar 10
1930+year. 11
1931+ (b) Treatment for a patient admitted to a facility, with a 12
1932+minimum benefit of $9,000 per calendar year. 13
1933+ (c) Counseling for a person, group or family who is not admitted 14
1934+to a facility, with a minimum benefit of $2,500 per calendar year. 15
1935+ 2. Except as otherwise provided in NRS 687B.409, these 16
1936+benefits must be paid in the same manner as benefits for any other 17
1937+illness covered by a similar policy are paid. 18
1938+ 3. The insured person is entitled to these benefits if treatment is 19
1939+received in any: 20
1940+ (a) Facility for the treatment of alcohol or substance use 21
1941+disorders which is certified by the Division of Public and Behavioral 22
1942+Health of the Department of Health and Human Services. 23
1943+ (b) Hospital or other medical facility or facility for the 24
1944+dependent which is licensed by the Division of Public and 25
1945+Behavioral Health of the Department of Health and Human 26
1946+Services, is accredited by The Joint Commission or CARF 27
1947+International and provides a program for the treatment of alcohol or 28
1948+substance use disorders as part of its accredited activities. 29
1949+ Sec. 51. NRS 689C.1671 is hereby amended to read as 30
1950+follows: 31
1951+ 689C.1671 1. A carrier that offers or issues a health benefit 32
1952+plan shall include in the plan coverage for: 33
1953+ (a) [Drugs] All drugs approved by the United States Food and 34
1954+Drug Administration for preventing the acquisition of human 35
1955+immunodeficiency virus [;] or treating human immunodeficiency 36
1956+virus or hepatitis C in the form recommended by the prescribing 37
1957+practitioner, regardless of whether the drug is included in the 38
1958+formulary of the carrier; 39
1959+ (b) Laboratory testing that is necessary for therapy that uses 40
1960+[such] a drug [;] to prevent the acquisition of human 41
1961+immunodeficiency virus; 42
1962+ (c) Any service to test for, prevent or treat human 43
1963+immunodeficiency virus or hepatitis C provided by a provider of 44
18881964 – 41 –
18891965
18901966
1891-- 82nd Session (2023)
1892- Sec. 48. (Deleted by amendment.)
1893- Sec. 49. NRS 689C.166 is hereby amended to read as follows:
1894- 689C.166 Each group health insurance policy must contain in
1895-substance a provision for benefits payable for expenses incurred for
1896-the treatment of alcohol or substance use disorder, as provided in
1897-NRS 689C.167 [.] and section 46 of this act.
1898- Sec. 50. NRS 689C.167 is hereby amended to read as follows:
1899- 689C.167 1. [The] In addition to the benefits required by
1900-section 46 of this act, the benefits provided by a group policy for
1901-health insurance, as required by NRS 689C.166, for the treatment of
1902-alcohol or substance use disorders must [consist of:] include,
1903-without limitation:
1904- (a) Treatment for withdrawal from the physiological effects of
1905-alcohol or drugs, with a minimum benefit of $1,500 per calendar
1906-year.
1907- (b) Treatment for a patient admitted to a facility, with a
1908-minimum benefit of $9,000 per calendar year.
1909- (c) Counseling for a person, group or family who is not admitted
1910-to a facility, with a minimum benefit of $2,500 per calendar year.
1911- 2. Except as otherwise provided in NRS 687B.409, these
1912-benefits must be paid in the same manner as benefits for any other
1913-illness covered by a similar policy are paid.
1914- 3. The insured person is entitled to these benefits if treatment is
1915-received in any:
1916- (a) Facility for the treatment of alcohol or substance use
1917-disorders which is certified by the Division of Public and Behavioral
1918-Health of the Department of Health and Human Services.
1919- (b) Hospital or other medical facility or facility for the
1920-dependent which is licensed by the Division of Public and
1921-Behavioral Health of the Department of Health and Human
1922-Services, is accredited by The Joint Commission or CARF
1923-International and provides a program for the treatment of alcohol or
1924-substance use disorders as part of its accredited activities.
1925- Sec. 51. NRS 689C.1671 is hereby amended to read as
1926-follows:
1927- 689C.1671 1. A carrier that offers or issues a health benefit
1928-plan shall include in the plan coverage for:
1929- (a) [Drugs] All drugs approved by the United States Food and
1930-Drug Administration for preventing the acquisition of human
1931-immunodeficiency virus [;] or treating human immunodeficiency
1932-virus or hepatitis C in the form recommended by the prescribing
1933-practitioner, regardless of whether the drug is included in the
1934-formulary of the carrier;
1967+- *SB439_R3*
1968+primary care if the service is covered when provided by a specialist 1
1969+and: 2
1970+ (1) The service is within the scope of practice of the 3
1971+provider of primary care; or 4
1972+ (2) The provider of primary care is capable of providing the 5
1973+service safely and effectively in consultation with a specialist and 6
1974+the provider engages in such consultation; and 7
1975+ [(c)] (d) The services described in NRS 639.28085, when 8
1976+provided by a pharmacist who participates in the health benefit plan 9
1977+of the carrier. 10
1978+ 2. A carrier that offers or issues a health benefit plan shall 11
1979+reimburse [a] : 12
1980+ (a) A pharmacist who participates in the health benefit plan of 13
1981+the carrier for the services described in NRS 639.28085 at a rate 14
1982+equal to the rate of reimbursement provided to a physician, 15
1983+physician assistant or advanced practice registered nurse for similar 16
1984+services. 17
1985+ (b) An advanced practice registered nurse or a physician 18
1986+assistant who participates in the network plan of the carrier for 19
1987+any service to test for, prevent or treat human immunodeficiency 20
1988+virus or hepatitis C at a rate equal to the rate of reimbursement 21
1989+provided to a physician for similar services. 22
1990+ 3. A carrier [may subject] shall not: 23
1991+ (a) Subject the benefits required by subsection 1 to [reasonable] 24
1992+medical management techniques [.] , other than step therapy; 25
1993+ (b) Limit the covered amount of a drug described in paragraph 26
1994+(a) of subsection 1; 27
1995+ (c) Refuse to cover a drug described in paragraph (a) of 28
1996+subsection 1 because the drug is dispensed by a pharmacy through 29
1997+mail order service; or 30
1998+ (d) Prohibit or restrict access to any service or drug to treat 31
1999+human immunodeficiency virus or hepatitis C on the same day on 32
2000+which the insured is diagnosed. 33
2001+ 4. A carrier shall ensure that the benefits required by 34
2002+subsection 1 are made available to an insured through a provider of 35
2003+health care who participates in the network plan of the carrier. 36
2004+ 5. A health benefit plan subject to the provisions of this chapter 37
2005+that is delivered, issued for delivery or renewed on or after 38
2006+[October] January 1, [2021,] 2024, has the legal effect of including 39
2007+the coverage required by subsection 1, and any provision of the plan 40
2008+that conflicts with the provisions of this section is void. 41
2009+ 6. As used in this section: 42
2010+ (a) “Medical management technique” means a practice which is 43
2011+used to control the cost or use of health care services or prescription 44
2012+drugs. The term includes, without limitation, the use of step therapy, 45
19352013 – 42 –
19362014
19372015
1938-- 82nd Session (2023)
1939- (b) Laboratory testing that is necessary for therapy that uses
1940-[such] a drug [;] to prevent the acquisition of human
1941-immunodeficiency virus;
1942- (c) Any service to test for, prevent or treat human
1943-immunodeficiency virus or hepatitis C provided by a provider of
1944-primary care if the service is covered when provided by a specialist
1945-and:
1946- (1) The service is within the scope of practice of the
1947-provider of primary care; or
1948- (2) The provider of primary care is capable of providing the
1949-service safely and effectively in consultation with a specialist and
1950-the provider engages in such consultation; and
1951- [(c)] (d) The services described in NRS 639.28085, when
1952-provided by a pharmacist who participates in the health benefit plan
1953-of the carrier.
1954- 2. A carrier that offers or issues a health benefit plan shall
1955-reimburse [a] :
1956- (a) A pharmacist who participates in the health benefit plan of
1957-the carrier for the services described in NRS 639.28085 at a rate
1958-equal to the rate of reimbursement provided to a physician,
1959-physician assistant or advanced practice registered nurse for similar
1960-services.
1961- (b) An advanced practice registered nurse or a physician
1962-assistant who participates in the network plan of the carrier for
1963-any service to test for, prevent or treat human immunodeficiency
1964-virus or hepatitis C at a rate equal to the rate of reimbursement
1965-provided to a physician for similar services.
1966- 3. A carrier [may subject] shall not:
1967- (a) Subject the benefits required by subsection 1 to [reasonable]
1968-medical management techniques [.] , other than step therapy;
1969- (b) Limit the covered amount of a drug described in paragraph
1970-(a) of subsection 1;
1971- (c) Refuse to cover a drug described in paragraph (a) of
1972-subsection 1 because the drug is dispensed by a pharmacy through
1973-mail order service; or
1974- (d) Prohibit or restrict access to any service or drug to treat
1975-human immunodeficiency virus or hepatitis C on the same day on
1976-which the insured is diagnosed.
1977- 4. A carrier shall ensure that the benefits required by
1978-subsection 1 are made available to an insured through a provider of
1979-health care who participates in the network plan of the carrier.
1980- 5. A health benefit plan subject to the provisions of this chapter
1981-that is delivered, issued for delivery or renewed on or after
2016+- *SB439_R3*
2017+prior authorization and categorizing drugs and devices based on 1
2018+cost, type or method of administration. 2
2019+ (b) “Network plan” means a health benefit plan offered by a 3
2020+carrier under which the financing and delivery of medical care, 4
2021+including items and services paid for as medical care, are provided, 5
2022+in whole or in part, through a defined set of providers under contract 6
2023+with the carrier. The term does not include an arrangement for the 7
2024+financing of premiums. 8
2025+ (c) “Primary care” means the practice of family medicine, 9
2026+pediatrics, internal medicine, obstetrics and gynecology and 10
2027+midwifery. 11
2028+ (d) “Provider of health care” has the meaning ascribed to it in 12
2029+NRS 629.031. 13
2030+ Sec. 52. NRS 689C.425 is hereby amended to read as follows: 14
2031+ 689C.425 A voluntary purchasing group and any contract 15
2032+issued to such a group pursuant to NRS 689C.360 to 689C.600, 16
2033+inclusive, are subject to the provisions of NRS 689C.015 to 17
2034+689C.355, inclusive, and sections 46 and 47 of this act to the extent 18
2035+applicable and not in conflict with the express provisions of NRS 19
2036+687B.408 and 689C.360 to 689C.600, inclusive. 20
2037+ Sec. 53. Chapter 695A of NRS is hereby amended by adding 21
2038+thereto the provisions set forth as sections 54, 55 and 56 of this act. 22
2039+ Sec. 54. 1. A society that offers or issues a benefit contract 23
2040+shall include in the contract coverage for: 24
2041+ (a) All drugs approved by the United States Food and Drug 25
2042+Administration to: 26
2043+ (1) Provide medication-assisted treatment for opioid use 27
2044+disorder, including, without limitation, buprenorphine, methadone 28
2045+and naltrexone. 29
2046+ (2) Support safe withdrawal from substance use disorder, 30
2047+including, without limitation, lofexidine. 31
2048+ (b) Any service for the treatment of substance use disorder 32
2049+provided by a provider of primary care if the service is covered 33
2050+when provided by a specialist and: 34
2051+ (1) The service is within the scope of practice of the 35
2052+provider of primary care; or 36
2053+ (2) The provider of primary care is capable of providing the 37
2054+service safely and effectively in consultation with a specialist and 38
2055+the provider engages in such consultation. 39
2056+ 2. A society shall provide the coverage required by paragraph 40
2057+(a) of subsection 1 regardless of whether the drug is included in 41
2058+the formulary of the society. 42
2059+ 3. A society shall not: 43
19822060 – 43 –
19832061
19842062
1985-- 82nd Session (2023)
1986-[October] January 1, [2021,] 2024, has the legal effect of including
1987-the coverage required by subsection 1, and any provision of the plan
1988-that conflicts with the provisions of this section is void.
1989- 6. As used in this section:
1990- (a) “Medical management technique” means a practice which is
1991-used to control the cost or use of health care services or prescription
1992-drugs. The term includes, without limitation, the use of step therapy,
1993-prior authorization and categorizing drugs and devices based on
1994-cost, type or method of administration.
1995- (b) “Network plan” means a health benefit plan offered by a
1996-carrier under which the financing and delivery of medical care,
1997-including items and services paid for as medical care, are provided,
1998-in whole or in part, through a defined set of providers under contract
1999-with the carrier. The term does not include an arrangement for the
2000-financing of premiums.
2001- (c) “Primary care” means the practice of family medicine,
2002-pediatrics, internal medicine, obstetrics and gynecology and
2003-midwifery.
2004- (d) “Provider of health care” has the meaning ascribed to it in
2005-NRS 629.031.
2006- Sec. 52. NRS 689C.425 is hereby amended to read as follows:
2007- 689C.425 A voluntary purchasing group and any contract
2008-issued to such a group pursuant to NRS 689C.360 to 689C.600,
2009-inclusive, are subject to the provisions of NRS 689C.015 to
2010-689C.355, inclusive, and sections 46 and 47 of this act to the extent
2011-applicable and not in conflict with the express provisions of NRS
2012-687B.408 and 689C.360 to 689C.600, inclusive.
2013- Sec. 53. Chapter 695A of NRS is hereby amended by adding
2014-thereto the provisions set forth as sections 54, 55 and 56 of this act.
2015- Sec. 54. 1. A society that offers or issues a benefit contract
2016-shall include in the contract coverage for:
2017- (a) All drugs approved by the United States Food and Drug
2018-Administration to:
2019- (1) Provide medication-assisted treatment for opioid use
2020-disorder, including, without limitation, buprenorphine, methadone
2021-and naltrexone.
2022- (2) Support safe withdrawal from substance use disorder,
2023-including, without limitation, lofexidine.
2024- (b) Any service for the treatment of substance use disorder
2025-provided by a provider of primary care if the service is covered
2026-when provided by a specialist and:
2027- (1) The service is within the scope of practice of the
2028-provider of primary care; or
2063+- *SB439_R3*
2064+ (a) Subject the benefits required by paragraph (a) of 1
2065+subsection 1 to medical management techniques, other than step 2
2066+therapy; 3
2067+ (b) Limit the covered amount of a drug described in paragraph 4
2068+(a) of subsection 1; or 5
2069+ (c) Refuse to cover a drug described in paragraph (a) of 6
2070+subsection 1 because the drug is dispensed by a pharmacy through 7
2071+mail order service. 8
2072+ 4. A society shall ensure that the benefits required by 9
2073+subsection 1 are made available to an insured through a provider 10
2074+of health care who participates in the network plan of the society. 11
2075+ 5. A benefit contract subject to the provisions of this chapter 12
2076+that is delivered, issued for delivery or renewed on or after 13
2077+January 1, 2024, has the legal effect of including the coverage 14
2078+required by subsection 1, and any provision of the contract that 15
2079+conflicts with the provisions of this section is void. 16
2080+ 6. As used in this section: 17
2081+ (a) “Medical management technique” means a practice which 18
2082+is used to control the cost or use of health care services or 19
2083+prescription drugs. The term includes, without limitation, the use 20
2084+of step therapy, prior authorization and categorizing drugs and 21
2085+devices based on cost, type or method of administration. 22
2086+ (b) “Network plan” means a benefit contract offered by a 23
2087+society under which the financing and delivery of medical care, 24
2088+including items and services paid for as medical care, are 25
2089+provided, in whole or in part, through a defined set of providers 26
2090+under contract with the society. The term does not include an 27
2091+arrangement for the financing of premiums. 28
2092+ (c) “Primary care” means the practice of family medicine, 29
2093+pediatrics, internal medicine, obstetrics and gynecology and 30
2094+midwifery. 31
2095+ (d) “Provider of health care” has the meaning ascribed to it in 32
2096+NRS 629.031. 33
2097+ Sec. 55. 1. A society that offers or issues a benefit contract 34
2098+shall include in the contract: 35
2099+ (a) Coverage of testing for and the treatment and prevention of 36
2100+sexually transmitted diseases, including, without limitation, 37
2101+Chlamydia trachomatis, gonorrhea, syphilis, human 38
2102+immunodeficiency virus and hepatitis B and C, for all insureds, 39
2103+regardless of age. Such coverage must include, without limitation, 40
2104+the coverage required by NRS 695A.1843 and 695A.1856. 41
2105+ (b) Unrestricted coverage of condoms for insureds who are 13 42
2106+years of age or older. 43
2107+ 2. A benefit contract subject to the provisions of this chapter 44
2108+that is delivered, issued for delivery or renewed on or after 45
20292109 – 44 –
20302110
20312111
2032-- 82nd Session (2023)
2033- (2) The provider of primary care is capable of providing the
2034-service safely and effectively in consultation with a specialist and
2035-the provider engages in such consultation.
2036- 2. A society shall provide the coverage required by paragraph
2037-(a) of subsection 1 regardless of whether the drug is included in
2038-the formulary of the society.
2039- 3. A society shall not:
2040- (a) Subject the benefits required by paragraph (a) of
2041-subsection 1 to medical management techniques, other than step
2042-therapy;
2043- (b) Limit the covered amount of a drug described in paragraph
2044-(a) of subsection 1; or
2045- (c) Refuse to cover a drug described in paragraph (a) of
2046-subsection 1 because the drug is dispensed by a pharmacy through
2047-mail order service.
2048- 4. A society shall ensure that the benefits required by
2049-subsection 1 are made available to an insured through a provider
2050-of health care who participates in the network plan of the society.
2051- 5. A benefit contract subject to the provisions of this chapter
2052-that is delivered, issued for delivery or renewed on or after
2053-January 1, 2024, has the legal effect of including the coverage
2054-required by subsection 1, and any provision of the contract that
2055-conflicts with the provisions of this section is void.
2056- 6. As used in this section:
2057- (a) “Medical management technique” means a practice which
2058-is used to control the cost or use of health care services or
2059-prescription drugs. The term includes, without limitation, the use
2060-of step therapy, prior authorization and categorizing drugs and
2061-devices based on cost, type or method of administration.
2062- (b) “Network plan” means a benefit contract offered by a
2063-society under which the financing and delivery of medical care,
2064-including items and services paid for as medical care, are
2065-provided, in whole or in part, through a defined set of providers
2066-under contract with the society. The term does not include an
2067-arrangement for the financing of premiums.
2068- (c) “Primary care” means the practice of family medicine,
2069-pediatrics, internal medicine, obstetrics and gynecology and
2070-midwifery.
2071- (d) “Provider of health care” has the meaning ascribed to it in
2072-NRS 629.031.
2073- Sec. 55. 1. A society that offers or issues a benefit contract
2074-shall include in the contract:
2112+- *SB439_R3*
2113+January 1, 2024, has the legal effect of including the coverage 1
2114+required by subsection 1, and any provision of the contract that 2
2115+conflicts with the provisions of this section is void. 3
2116+ Sec. 56. (Deleted by amendment.) 4
2117+ Sec. 57. NRS 695A.1843 is hereby amended to read as 5
2118+follows: 6
2119+ 695A.1843 1. A society that offers or issues a benefit 7
2120+contract shall include in the benefit coverage for: 8
2121+ (a) [Drugs] All approved by the United States Food and Drug 9
2122+Administration for preventing the acquisition of human 10
2123+immunodeficiency virus [;] or treating human immunodeficiency 11
2124+virus or hepatitis C in the form recommended by the prescribing 12
2125+practitioner, regardless of whether the drug is included in the 13
2126+formulary of the society; 14
2127+ (b) Laboratory testing that is necessary for therapy that uses 15
2128+[such] a drug [;] to prevent the acquisition of human 16
2129+immunodeficiency virus; 17
2130+ (c) Any service to test for, prevent or treat human 18
2131+immunodeficiency virus or hepatitis C provided by a provider of 19
2132+primary care if the service is covered when provided by a specialist 20
2133+and: 21
2134+ (1) The service is within the scope of practice of the 22
2135+provider of primary care; or 23
2136+ (2) The provider of primary care is capable of providing the 24
2137+service safely and effectively in consultation with a specialist and 25
2138+the provider engages in such consultation; and 26
2139+ [(c)] (d) The services described in NRS 639.28085, when 27
2140+provided by a pharmacist who participates in the network plan of the 28
2141+society. 29
2142+ 2. A society that offers or issues a benefit contract shall 30
2143+reimburse [a] : 31
2144+ (a) A pharmacist who participates in the network plan of the 32
2145+society for the services described in NRS 639.28085 at a rate equal 33
2146+to the rate of reimbursement provided to a physician, physician 34
2147+assistant or advanced practice registered nurse for similar services. 35
2148+ (b) An advanced practice registered nurse or a physician 36
2149+assistant who participates in the network plan of the society for 37
2150+any service to test for, prevent or treat human immunodeficiency 38
2151+virus or hepatitis C at a rate equal to the rate of reimbursement 39
2152+provided to a physician for similar services. 40
2153+ 3. A society [may subject] shall not: 41
2154+ (a) Subject the benefits required by subsection 1 to [reasonable] 42
2155+medical management techniques [.] , other than step therapy; 43
2156+ (b) Limit the covered amount of a drug described in paragraph 44
2157+(a) of subsection 1; 45
20752158 – 45 –
20762159
20772160
2078-- 82nd Session (2023)
2079- (a) Coverage of testing for and the treatment and prevention of
2080-sexually transmitted diseases, including, without limitation,
2081-Chlamydia trachomatis, gonorrhea, syphilis, human
2082-immunodeficiency virus and hepatitis B and C, for all insureds,
2083-regardless of age. Such coverage must include, without limitation,
2084-the coverage required by NRS 695A.1843 and 695A.1856.
2085- (b) Unrestricted coverage of condoms for insureds who are 13
2086-years of age or older.
2087- 2. A benefit contract subject to the provisions of this chapter
2088-that is delivered, issued for delivery or renewed on or after
2089-January 1, 2024, has the legal effect of including the coverage
2090-required by subsection 1, and any provision of the contract that
2091-conflicts with the provisions of this section is void.
2092- Sec. 56. (Deleted by amendment.)
2093- Sec. 57. NRS 695A.1843 is hereby amended to read as
2094-follows:
2095- 695A.1843 1. A society that offers or issues a benefit
2096-contract shall include in the benefit coverage for:
2097- (a) [Drugs] All approved by the United States Food and Drug
2098-Administration for preventing the acquisition of human
2099-immunodeficiency virus [;] or treating human immunodeficiency
2100-virus or hepatitis C in the form recommended by the prescribing
2101-practitioner, regardless of whether the drug is included in the
2102-formulary of the society;
2103- (b) Laboratory testing that is necessary for therapy that uses
2104-[such] a drug [;] to prevent the acquisition of human
2105-immunodeficiency virus;
2106- (c) Any service to test for, prevent or treat human
2107-immunodeficiency virus or hepatitis C provided by a provider of
2108-primary care if the service is covered when provided by a specialist
2109-and:
2110- (1) The service is within the scope of practice of the
2111-provider of primary care; or
2112- (2) The provider of primary care is capable of providing the
2113-service safely and effectively in consultation with a specialist and
2114-the provider engages in such consultation; and
2115- [(c)] (d) The services described in NRS 639.28085, when
2116-provided by a pharmacist who participates in the network plan of the
2117-society.
2118- 2. A society that offers or issues a benefit contract shall
2119-reimburse [a] :
2120- (a) A pharmacist who participates in the network plan of the
2121-society for the services described in NRS 639.28085 at a rate equal
2161+- *SB439_R3*
2162+ (c) Refuse to cover a drug described in paragraph (a) of 1
2163+subsection 1 because the drug is dispensed by a pharmacy through 2
2164+mail order service; or 3
2165+ (d) Prohibit or restrict access to any service or drug to treat 4
2166+human immunodeficiency virus or hepatitis C on the same day on 5
2167+which the insured is diagnosed. 6
2168+ 4. A society shall ensure that the benefits required by 7
2169+subsection 1 are made available to an insured through a provider of 8
2170+health care who participates in the network plan of the society. 9
2171+ 5. A benefit contract subject to the provisions of this chapter 10
2172+that is delivered, issued for delivery or renewed on or after 11
2173+[October] January 1, [2021,] 2024, has the legal effect of including 12
2174+the coverage required by subsection 1, and any provision of the plan 13
2175+that conflicts with the provisions of this section is void. 14
2176+ 6. As used in this section: 15
2177+ (a) “Medical management technique” means a practice which is 16
2178+used to control the cost or use of health care services or prescription 17
2179+drugs. The term includes, without limitation, the use of step therapy, 18
2180+prior authorization and categorizing drugs and devices based on 19
2181+cost, type or method of administration. 20
2182+ (b) “Network plan” means a benefit contract offered by a society 21
2183+under which the financing and delivery of medical care, including 22
2184+items and services paid for as medical care, are provided, in whole 23
2185+or in part, through a defined set of providers under contract with the 24
2186+society. The term does not include an arrangement for the financing 25
2187+of premiums. 26
2188+ (c) “Primary care” means the practice of family medicine, 27
2189+pediatrics, internal medicine, obstetrics and gynecology and 28
2190+midwifery. 29
2191+ (d) “Provider of health care” has the meaning ascribed to it in 30
2192+NRS 629.031. 31
2193+ Sec. 58. Chapter 695B of NRS is hereby amended by adding 32
2194+thereto the provisions set forth as sections 59, 60 and 61 of this act. 33
2195+ Sec. 59. 1. A hospital or medical services corporation that 34
2196+offers or issues a policy of health insurance shall include in the 35
2197+policy coverage for: 36
2198+ (a) All drugs approved by the United States Food and Drug 37
2199+Administration to: 38
2200+ (1) Provide medication-assisted treatment for opioid use 39
2201+disorder, including, without limitation, buprenorphine, methadone 40
2202+and naltrexone. 41
2203+ (2) Support safe withdrawal from substance use disorder, 42
2204+including, without limitation, lofexidine. 43
21222205 – 46 –
21232206
21242207
2125-- 82nd Session (2023)
2126-to the rate of reimbursement provided to a physician, physician
2127-assistant or advanced practice registered nurse for similar services.
2128- (b) An advanced practice registered nurse or a physician
2129-assistant who participates in the network plan of the society for
2130-any service to test for, prevent or treat human immunodeficiency
2131-virus or hepatitis C at a rate equal to the rate of reimbursement
2132-provided to a physician for similar services.
2133- 3. A society [may subject] shall not:
2134- (a) Subject the benefits required by subsection 1 to [reasonable]
2135-medical management techniques [.] , other than step therapy;
2136- (b) Limit the covered amount of a drug described in paragraph
2137-(a) of subsection 1;
2138- (c) Refuse to cover a drug described in paragraph (a) of
2139-subsection 1 because the drug is dispensed by a pharmacy through
2140-mail order service; or
2141- (d) Prohibit or restrict access to any service or drug to treat
2142-human immunodeficiency virus or hepatitis C on the same day on
2143-which the insured is diagnosed.
2144- 4. A society shall ensure that the benefits required by
2145-subsection 1 are made available to an insured through a provider of
2146-health care who participates in the network plan of the society.
2147- 5. A benefit contract subject to the provisions of this chapter
2148-that is delivered, issued for delivery or renewed on or after
2149-[October] January 1, [2021,] 2024, has the legal effect of including
2150-the coverage required by subsection 1, and any provision of the plan
2151-that conflicts with the provisions of this section is void.
2152- 6. As used in this section:
2153- (a) “Medical management technique” means a practice which is
2154-used to control the cost or use of health care services or prescription
2155-drugs. The term includes, without limitation, the use of step therapy,
2156-prior authorization and categorizing drugs and devices based on
2157-cost, type or method of administration.
2158- (b) “Network plan” means a benefit contract offered by a society
2159-under which the financing and delivery of medical care, including
2160-items and services paid for as medical care, are provided, in whole
2161-or in part, through a defined set of providers under contract with the
2162-society. The term does not include an arrangement for the financing
2163-of premiums.
2164- (c) “Primary care” means the practice of family medicine,
2165-pediatrics, internal medicine, obstetrics and gynecology and
2166-midwifery.
2167- (d) “Provider of health care” has the meaning ascribed to it in
2168-NRS 629.031.
2208+- *SB439_R3*
2209+ (b) Any service for the treatment of substance use disorder 1
2210+provided by a provider of primary care if the service is covered 2
2211+when provided by a specialist and: 3
2212+ (1) The service is within the scope of practice of the 4
2213+provider of primary care; or 5
2214+ (2) The provider of primary care is capable of providing the 6
2215+service safely and effectively in consultation with a specialist and 7
2216+the provider engages in such consultation. 8
2217+ 2. A hospital or medical services corporation shall provide the 9
2218+coverage required by paragraph (a) of subsection 1 regardless of 10
2219+whether the drug is included in the formulary of the hospital or 11
2220+medical services corporation. 12
2221+ 3. A hospital or medical services corporation shall not: 13
2222+ (a) Subject the benefits required by paragraph (a) of 14
2223+subsection 1 to medical management techniques, other than step 15
2224+therapy; 16
2225+ (b) Limit the covered amount of a drug described in paragraph 17
2226+(a) of subsection 1; or 18
2227+ (c) Refuse to cover a drug described in paragraph (a) of 19
2228+subsection 1 because the drug is dispensed by a pharmacy through 20
2229+mail order service. 21
2230+ 4. A hospital or medical services corporation shall ensure 22
2231+that the benefits required by subsection 1 are made available to an 23
2232+insured through a provider of health care who participates in the 24
2233+network plan of the hospital or medical services corporation. 25
2234+ 5. A policy of health insurance subject to the provisions of 26
2235+this chapter that is delivered, issued for delivery or renewed on or 27
2236+after January 1, 2024, has the legal effect of including the 28
2237+coverage required by subsection 1, and any provision of the policy 29
2238+that conflicts with the provisions of this section is void. 30
2239+ 6. As used in this section: 31
2240+ (a) “Medical management technique” means a practice which 32
2241+is used to control the cost or use of health care services or 33
2242+prescription drugs. The term includes, without limitation, the use 34
2243+of step therapy, prior authorization and categorizing drugs and 35
2244+devices based on cost, type or method of administration. 36
2245+ (b) “Network plan” means a policy of health insurance offered 37
2246+by a hospital or medical services corporation under which the 38
2247+financing and delivery of medical care, including items and 39
2248+services paid for as medical care, are provided, in whole or in part, 40
2249+through a defined set of providers under contract with the hospital 41
2250+or medical services corporation. The term does not include an 42
2251+arrangement for the financing of premiums. 43
21692252 – 47 –
21702253
21712254
2172-- 82nd Session (2023)
2173- Sec. 58. Chapter 695B of NRS is hereby amended by adding
2174-thereto the provisions set forth as sections 59, 60 and 61 of this act.
2175- Sec. 59. 1. A hospital or medical services corporation that
2176-offers or issues a policy of health insurance shall include in the
2177-policy coverage for:
2178- (a) All drugs approved by the United States Food and Drug
2179-Administration to:
2180- (1) Provide medication-assisted treatment for opioid use
2181-disorder, including, without limitation, buprenorphine, methadone
2182-and naltrexone.
2183- (2) Support safe withdrawal from substance use disorder,
2184-including, without limitation, lofexidine.
2185- (b) Any service for the treatment of substance use disorder
2186-provided by a provider of primary care if the service is covered
2187-when provided by a specialist and:
2188- (1) The service is within the scope of practice of the
2189-provider of primary care; or
2190- (2) The provider of primary care is capable of providing the
2191-service safely and effectively in consultation with a specialist and
2192-the provider engages in such consultation.
2193- 2. A hospital or medical services corporation shall provide the
2194-coverage required by paragraph (a) of subsection 1 regardless of
2195-whether the drug is included in the formulary of the hospital or
2196-medical services corporation.
2197- 3. A hospital or medical services corporation shall not:
2198- (a) Subject the benefits required by paragraph (a) of
2199-subsection 1 to medical management techniques, other than step
2200-therapy;
2201- (b) Limit the covered amount of a drug described in paragraph
2202-(a) of subsection 1; or
2203- (c) Refuse to cover a drug described in paragraph (a) of
2204-subsection 1 because the drug is dispensed by a pharmacy through
2205-mail order service.
2206- 4. A hospital or medical services corporation shall ensure
2207-that the benefits required by subsection 1 are made available to an
2208-insured through a provider of health care who participates in the
2209-network plan of the hospital or medical services corporation.
2210- 5. A policy of health insurance subject to the provisions of
2211-this chapter that is delivered, issued for delivery or renewed on or
2212-after January 1, 2024, has the legal effect of including the
2213-coverage required by subsection 1, and any provision of the policy
2214-that conflicts with the provisions of this section is void.
2215- 6. As used in this section:
2255+- *SB439_R3*
2256+ (c) “Primary care” means the practice of family medicine, 1
2257+pediatrics, internal medicine, obstetrics and gynecology and 2
2258+midwifery. 3
2259+ (d) “Provider of health care” has the meaning ascribed to it in 4
2260+NRS 629.031. 5
2261+ Sec. 60. 1. A hospital or medical services corporation that 6
2262+offers or issues a policy of health insurance shall include in the 7
2263+policy: 8
2264+ (a) Coverage of testing for and the treatment and prevention of 9
2265+sexually transmitted diseases, including, without limitation, 10
2266+Chlamydia trachomatis, gonorrhea, syphilis, human 11
2267+immunodeficiency virus and hepatitis B and C, for all insureds, 12
2268+regardless of age. Such coverage must include, without limitation, 13
2269+the coverage required by NRS 695B.1913 and 695B.1924. 14
2270+ (b) Unrestricted coverage of condoms for insureds who are 13 15
2271+years of age or older. 16
2272+ 2. A policy of health insurance subject to the provisions of 17
2273+this chapter that is delivered, issued for delivery or renewed on or 18
2274+after January 1, 2024, has the legal effect of including the 19
2275+coverage required by subsection 1, and any provision of the policy 20
2276+that conflicts with the provisions of this section is void. 21
2277+ Sec. 61. (Deleted by amendment.) 22
2278+ Sec. 62. NRS 695B.1924 is hereby amended to read as 23
2279+follows: 24
2280+ 695B.1924 1. A hospital or medical services corporation that 25
2281+offers or issues a policy of health insurance shall include in the 26
2282+policy coverage for: 27
2283+ (a) [Drugs] All drugs approved by the United States Food and 28
2284+Drug Administration for preventing the acquisition of human 29
2285+immunodeficiency virus [;] or treating human immunodeficiency 30
2286+virus or hepatitis C in the form recommended by the prescribing 31
2287+practitioner, regardless of whether the drug is included in the 32
2288+formulary of the hospital or medical services organization; 33
2289+ (b) Laboratory testing that is necessary for therapy using [such] 34
2290+a drug [;] to prevent the acquisition of human immunodeficiency 35
2291+virus; 36
2292+ (c) Any service to test for, prevent or treat human 37
2293+immunodeficiency virus or hepatitis C provided by a provider of 38
2294+primary care if the service is covered when provided by a specialist 39
2295+and: 40
2296+ (1) The service is within the scope of practice of the 41
2297+provider of primary care; or 42
2298+ (2) The provider of primary care is capable of providing the 43
2299+service safely and effectively in consultation with a specialist and 44
2300+the provider engages in such consultation; and 45
22162301 – 48 –
22172302
22182303
2219-- 82nd Session (2023)
2220- (a) “Medical management technique” means a practice which
2221-is used to control the cost or use of health care services or
2222-prescription drugs. The term includes, without limitation, the use
2223-of step therapy, prior authorization and categorizing drugs and
2224-devices based on cost, type or method of administration.
2225- (b) “Network plan” means a policy of health insurance offered
2226-by a hospital or medical services corporation under which the
2227-financing and delivery of medical care, including items and
2228-services paid for as medical care, are provided, in whole or in part,
2229-through a defined set of providers under contract with the hospital
2230-or medical services corporation. The term does not include an
2231-arrangement for the financing of premiums.
2232- (c) “Primary care” means the practice of family medicine,
2233-pediatrics, internal medicine, obstetrics and gynecology and
2234-midwifery.
2235- (d) “Provider of health care” has the meaning ascribed to it in
2236-NRS 629.031.
2237- Sec. 60. 1. A hospital or medical services corporation that
2238-offers or issues a policy of health insurance shall include in the
2239-policy:
2240- (a) Coverage of testing for and the treatment and prevention of
2241-sexually transmitted diseases, including, without limitation,
2242-Chlamydia trachomatis, gonorrhea, syphilis, human
2243-immunodeficiency virus and hepatitis B and C, for all insureds,
2244-regardless of age. Such coverage must include, without limitation,
2245-the coverage required by NRS 695B.1913 and 695B.1924.
2246- (b) Unrestricted coverage of condoms for insureds who are 13
2247-years of age or older.
2248- 2. A policy of health insurance subject to the provisions of
2249-this chapter that is delivered, issued for delivery or renewed on or
2250-after January 1, 2024, has the legal effect of including the
2251-coverage required by subsection 1, and any provision of the policy
2252-that conflicts with the provisions of this section is void.
2253- Sec. 61. (Deleted by amendment.)
2254- Sec. 62. NRS 695B.1924 is hereby amended to read as
2255-follows:
2256- 695B.1924 1. A hospital or medical services corporation that
2257-offers or issues a policy of health insurance shall include in the
2258-policy coverage for:
2259- (a) [Drugs] All drugs approved by the United States Food and
2260-Drug Administration for preventing the acquisition of human
2261-immunodeficiency virus [;] or treating human immunodeficiency
2262-virus or hepatitis C in the form recommended by the prescribing
2304+- *SB439_R3*
2305+ [(c)] (d) The services described in NRS 639.28085, when 1
2306+provided by a pharmacist who participates in the network plan of the 2
2307+hospital or medical services corporation. 3
2308+ 2. A hospital or medical services corporation that offers or 4
2309+issues a policy of health insurance shall reimburse [a] : 5
2310+ (a) A pharmacist who participates in the network plan of the 6
2311+hospital or medical services corporation for the services described in 7
2312+NRS 639.28085 at a rate equal to the rate of reimbursement 8
2313+provided to a physician, physician assistant or advanced practice 9
2314+registered nurse for similar services. 10
2315+ (b) An advanced practice registered nurse or a physician 11
2316+assistant who participates in the network plan of the hospital or 12
2317+medical services corporation for any service to test for, prevent or 13
2318+treat human immunodeficiency virus or hepatitis C at a rate equal 14
2319+to the rate of reimbursement provided to a physician for similar 15
2320+services. 16
2321+ 3. A hospital or medical services corporation [may subject] 17
2322+shall not: 18
2323+ (a) Subject the benefits required by subsection 1 to [reasonable] 19
2324+medical management techniques [.] , other than step therapy; 20
2325+ (b) Limit the covered amount of a drug described in paragraph 21
2326+(a) of subsection 1; 22
2327+ (c) Refuse to cover a drug described in paragraph (a) of 23
2328+subsection 1 because the drug is dispensed by a pharmacy through 24
2329+mail order service; or 25
2330+ (d) Prohibit or restrict access to any service or drug to treat 26
2331+human immunodeficiency virus or hepatitis C on the same day on 27
2332+which the insured is diagnosed. 28
2333+ 4. A hospital or medical services corporation shall ensure that 29
2334+the benefits required by subsection 1 are made available to an 30
2335+insured through a provider of health care who participates in the 31
2336+network plan of the hospital or medical services corporation. 32
2337+ 5. A policy of health insurance subject to the provisions of this 33
2338+chapter that is delivered, issued for delivery or renewed on or after 34
2339+[October] January 1, [2021,] 2024, has the legal effect of including 35
2340+the coverage required by subsection 1, and any provision of the 36
2341+policy that conflicts with the provisions of this section is void. 37
2342+ 6. As used in this section: 38
2343+ (a) “Medical management technique” means a practice which is 39
2344+used to control the cost or use of health care services or prescription 40
2345+drugs. The term includes, without limitation, the use of step therapy, 41
2346+prior authorization and categorizing drugs and devices based on 42
2347+cost, type or method of administration. 43
2348+ (b) “Network plan” means a policy of health insurance offered 44
2349+by a hospital or medical services corporation under which the 45
22632350 – 49 –
22642351
22652352
2266-- 82nd Session (2023)
2267-practitioner, regardless of whether the drug is included in the
2268-formulary of the hospital or medical services organization;
2269- (b) Laboratory testing that is necessary for therapy using [such]
2270-a drug [;] to prevent the acquisition of human immunodeficiency
2271-virus;
2272- (c) Any service to test for, prevent or treat human
2273-immunodeficiency virus or hepatitis C provided by a provider of
2274-primary care if the service is covered when provided by a specialist
2275-and:
2276- (1) The service is within the scope of practice of the
2277-provider of primary care; or
2278- (2) The provider of primary care is capable of providing the
2279-service safely and effectively in consultation with a specialist and
2280-the provider engages in such consultation; and
2281- [(c)] (d) The services described in NRS 639.28085, when
2282-provided by a pharmacist who participates in the network plan of the
2283-hospital or medical services corporation.
2284- 2. A hospital or medical services corporation that offers or
2285-issues a policy of health insurance shall reimburse [a] :
2286- (a) A pharmacist who participates in the network plan of the
2287-hospital or medical services corporation for the services described in
2288-NRS 639.28085 at a rate equal to the rate of reimbursement
2289-provided to a physician, physician assistant or advanced practice
2290-registered nurse for similar services.
2291- (b) An advanced practice registered nurse or a physician
2292-assistant who participates in the network plan of the hospital or
2293-medical services corporation for any service to test for, prevent or
2294-treat human immunodeficiency virus or hepatitis C at a rate equal
2295-to the rate of reimbursement provided to a physician for similar
2296-services.
2297- 3. A hospital or medical services corporation [may subject]
2298-shall not:
2299- (a) Subject the benefits required by subsection 1 to [reasonable]
2300-medical management techniques [.] , other than step therapy;
2301- (b) Limit the covered amount of a drug described in paragraph
2302-(a) of subsection 1;
2303- (c) Refuse to cover a drug described in paragraph (a) of
2304-subsection 1 because the drug is dispensed by a pharmacy through
2305-mail order service; or
2306- (d) Prohibit or restrict access to any service or drug to treat
2307-human immunodeficiency virus or hepatitis C on the same day on
2308-which the insured is diagnosed.
2353+- *SB439_R3*
2354+financing and delivery of medical care, including items and services 1
2355+paid for as medical care, are provided, in whole or in part, through a 2
2356+defined set of providers under contract with the hospital or medical 3
2357+services corporation. The term does not include an arrangement for 4
2358+the financing of premiums. 5
2359+ (c) “Primary care” means the practice of family medicine, 6
2360+pediatrics, internal medicine, obstetrics and gynecology and 7
2361+midwifery. 8
2362+ (d) “Provider of health care” has the meaning ascribed to it in 9
2363+NRS 629.031. 10
2364+ Sec. 63. Chapter 695C of NRS is hereby amended by adding 11
2365+thereto the provisions set forth as sections 64, 65 and 66 of this act. 12
2366+ Sec. 64. 1. A health maintenance organization that offers 13
2367+or issues a health care plan shall include in the plan coverage for: 14
2368+ (a) All drugs approved by the United States Food and Drug 15
2369+Administration to: 16
2370+ (1) Provide medication-assisted treatment for opioid use 17
2371+disorder, including, without limitation, buprenorphine, methadone 18
2372+and naltrexone. 19
2373+ (2) Support safe withdrawal from substance use disorder, 20
2374+including, without limitation, lofexidine. 21
2375+ (b) Any service for the treatment of substance use disorder 22
2376+provided by a provider of primary care if the service is covered 23
2377+when provided by a specialist and: 24
2378+ (1) The service is within the scope of practice of the 25
2379+provider of primary care; or 26
2380+ (2) The provider of primary care is capable of providing the 27
2381+service safely and effectively in consultation with a specialist and 28
2382+the provider engages in such consultation. 29
2383+ 2. A health maintenance organization shall provide the 30
2384+coverage required by paragraph (a) of subsection 1 regardless of 31
2385+whether the drug is included in the formulary of the health 32
2386+maintenance organization. 33
2387+ 3. A health maintenance organization shall not: 34
2388+ (a) Subject the benefits required by paragraph (a) of 35
2389+subsection 1 to medical management techniques, other than step 36
2390+therapy; 37
2391+ (b) Limit the covered amount of a drug described in paragraph 38
2392+(a) of subsection 1; or 39
2393+ (c) Refuse to cover a drug described in paragraph (a) of 40
2394+subsection 1 because the drug is dispensed by a pharmacy through 41
2395+mail order service. 42
2396+ 4. A health maintenance organization shall ensure that the 43
2397+benefits required by subsection 1 are made available to an enrollee 44
23092398 – 50 –
23102399
23112400
2312-- 82nd Session (2023)
2313- 4. A hospital or medical services corporation shall ensure that
2314-the benefits required by subsection 1 are made available to an
2315-insured through a provider of health care who participates in the
2316-network plan of the hospital or medical services corporation.
2317- 5. A policy of health insurance subject to the provisions of this
2318-chapter that is delivered, issued for delivery or renewed on or after
2319-[October] January 1, [2021,] 2024, has the legal effect of including
2320-the coverage required by subsection 1, and any provision of the
2321-policy that conflicts with the provisions of this section is void.
2322- 6. As used in this section:
2323- (a) “Medical management technique” means a practice which is
2324-used to control the cost or use of health care services or prescription
2325-drugs. The term includes, without limitation, the use of step therapy,
2326-prior authorization and categorizing drugs and devices based on
2327-cost, type or method of administration.
2328- (b) “Network plan” means a policy of health insurance offered
2329-by a hospital or medical services corporation under which the
2330-financing and delivery of medical care, including items and services
2331-paid for as medical care, are provided, in whole or in part, through a
2332-defined set of providers under contract with the hospital or medical
2333-services corporation. The term does not include an arrangement for
2334-the financing of premiums.
2335- (c) “Primary care” means the practice of family medicine,
2336-pediatrics, internal medicine, obstetrics and gynecology and
2337-midwifery.
2338- (d) “Provider of health care” has the meaning ascribed to it in
2339-NRS 629.031.
2340- Sec. 63. Chapter 695C of NRS is hereby amended by adding
2341-thereto the provisions set forth as sections 64, 65 and 66 of this act.
2342- Sec. 64. 1. A health maintenance organization that offers
2343-or issues a health care plan shall include in the plan coverage for:
2344- (a) All drugs approved by the United States Food and Drug
2345-Administration to:
2346- (1) Provide medication-assisted treatment for opioid use
2347-disorder, including, without limitation, buprenorphine, methadone
2348-and naltrexone.
2349- (2) Support safe withdrawal from substance use disorder,
2350-including, without limitation, lofexidine.
2351- (b) Any service for the treatment of substance use disorder
2352-provided by a provider of primary care if the service is covered
2353-when provided by a specialist and:
2354- (1) The service is within the scope of practice of the
2355-provider of primary care; or
2401+- *SB439_R3*
2402+through a provider of health care who participates in the network 1
2403+plan of the health maintenance organization. 2
2404+ 5. A health care plan subject to the provisions of this chapter 3
2405+that is delivered, issued for delivery or renewed on or after 4
2406+January 1, 2024, has the legal effect of including the coverage 5
2407+required by subsection 1, and any provision of the plan that 6
2408+conflicts with the provisions of this section is void. 7
2409+ 6. As used in this section: 8
2410+ (a) “Medical management technique” means a practice which 9
2411+is used to control the cost or use of health care services or 10
2412+prescription drugs. The term includes, without limitation, the use 11
2413+of step therapy, prior authorization and categorizing drugs and 12
2414+devices based on cost, type or method of administration. 13
2415+ (b) “Network plan” means a health care plan offered by a 14
2416+health maintenance organization under which the financing and 15
2417+delivery of medical care, including items and services paid for as 16
2418+medical care, are provided, in whole or in part, through a defined 17
2419+set of providers under contract with the health maintenance 18
2420+organization. The term does not include an arrangement for the 19
2421+financing of premiums. 20
2422+ (c) “Primary care” means the practice of family medicine, 21
2423+pediatrics, internal medicine, obstetrics and gynecology and 22
2424+midwifery. 23
2425+ (d) “Provider of health care” has the meaning ascribed to it in 24
2426+NRS 629.031. 25
2427+ Sec. 65. 1. A health maintenance organization that offers 26
2428+or issues a health care plan shall include in the plan: 27
2429+ (a) Coverage of testing for and the treatment and prevention of 28
2430+sexually transmitted diseases, including, without limitation, 29
2431+Chlamydia trachomatis, gonorrhea, syphilis, human 30
2432+immunodeficiency virus and hepatitis B and C, for all enrollees, 31
2433+regardless of age. Such coverage must include, without limitation, 32
2434+the coverage required by NRS 695C.1737 and 695C.1743. 33
2435+ (b) Unrestricted coverage of condoms for enrollees who are 13 34
2436+years of age or older. 35
2437+ 2. A health care plan subject to the provisions of this chapter 36
2438+that is delivered, issued for delivery or renewed on or after 37
2439+January 1, 2024, has the legal effect of including the coverage 38
2440+required by subsection 1, and any provision of the plan that 39
2441+conflicts with the provisions of this section is void. 40
2442+ Sec. 66. (Deleted by amendment.) 41
2443+ Sec. 67. NRS 695C.050 is hereby amended to read as follows: 42
2444+ 695C.050 1. Except as otherwise provided in this chapter or 43
2445+in specific provisions of this title, the provisions of this title are not 44
2446+applicable to any health maintenance organization granted a 45
23562447 – 51 –
23572448
23582449
2359-- 82nd Session (2023)
2360- (2) The provider of primary care is capable of providing the
2361-service safely and effectively in consultation with a specialist and
2362-the provider engages in such consultation.
2363- 2. A health maintenance organization shall provide the
2364-coverage required by paragraph (a) of subsection 1 regardless of
2365-whether the drug is included in the formulary of the health
2366-maintenance organization.
2367- 3. A health maintenance organization shall not:
2368- (a) Subject the benefits required by paragraph (a) of
2369-subsection 1 to medical management techniques, other than step
2370-therapy;
2371- (b) Limit the covered amount of a drug described in paragraph
2372-(a) of subsection 1; or
2373- (c) Refuse to cover a drug described in paragraph (a) of
2374-subsection 1 because the drug is dispensed by a pharmacy through
2375-mail order service.
2376- 4. A health maintenance organization shall ensure that the
2377-benefits required by subsection 1 are made available to an enrollee
2378-through a provider of health care who participates in the network
2379-plan of the health maintenance organization.
2380- 5. A health care plan subject to the provisions of this chapter
2381-that is delivered, issued for delivery or renewed on or after
2382-January 1, 2024, has the legal effect of including the coverage
2383-required by subsection 1, and any provision of the plan that
2384-conflicts with the provisions of this section is void.
2385- 6. As used in this section:
2386- (a) “Medical management technique” means a practice which
2387-is used to control the cost or use of health care services or
2388-prescription drugs. The term includes, without limitation, the use
2389-of step therapy, prior authorization and categorizing drugs and
2390-devices based on cost, type or method of administration.
2391- (b) “Network plan” means a health care plan offered by a
2392-health maintenance organization under which the financing and
2393-delivery of medical care, including items and services paid for as
2394-medical care, are provided, in whole or in part, through a defined
2395-set of providers under contract with the health maintenance
2396-organization. The term does not include an arrangement for the
2397-financing of premiums.
2398- (c) “Primary care” means the practice of family medicine,
2399-pediatrics, internal medicine, obstetrics and gynecology and
2400-midwifery.
2401- (d) “Provider of health care” has the meaning ascribed to it in
2402-NRS 629.031.
2450+- *SB439_R3*
2451+certificate of authority under this chapter. This provision does not 1
2452+apply to an insurer licensed and regulated pursuant to this title 2
2453+except with respect to its activities as a health maintenance 3
2454+organization authorized and regulated pursuant to this chapter. 4
2455+ 2. Solicitation of enrollees by a health maintenance 5
2456+organization granted a certificate of authority, or its representatives, 6
2457+must not be construed to violate any provision of law relating to 7
2458+solicitation or advertising by practitioners of a healing art. 8
2459+ 3. Any health maintenance organization authorized under this 9
2460+chapter shall not be deemed to be practicing medicine and is exempt 10
2461+from the provisions of chapter 630 of NRS. 11
2462+ 4. The provisions of NRS 695C.110, 695C.125, 695C.1691, 12
2463+695C.1693, 695C.170, 695C.1703, 695C.1705, 695C.1709 to 13
2464+695C.173, inclusive, 695C.1733, 695C.17335, 695C.1734, 14
2465+695C.1751, 695C.1755, 695C.1759, 695C.176 to 695C.200, 15
2466+inclusive, and 695C.265 do not apply to a health maintenance 16
2467+organization that provides health care services through managed 17
2468+care to recipients of Medicaid under the State Plan for Medicaid or 18
2469+insurance pursuant to the Children’s Health Insurance Program 19
2470+pursuant to a contract with the Division of Health Care Financing 20
2471+and Policy of the Department of Health and Human Services. This 21
2472+subsection does not exempt a health maintenance organization from 22
2473+any provision of this chapter for services provided pursuant to any 23
2474+other contract. 24
2475+ 5. The provisions of NRS 695C.1694 to 695C.1698, inclusive, 25
2476+695C.1701, 695C.1708, 695C.1728, 695C.1731, 695C.17333, 26
2477+695C.17345, 695C.17347, 695C.1735, 695C.1737, 695C.1743, 27
2478+695C.1745 and 695C.1757 and sections 64 and 65 of this act apply 28
2479+to a health maintenance organization that provides health care 29
2480+services through managed care to recipients of Medicaid under the 30
2481+State Plan for Medicaid. 31
2482+ Sec. 68. NRS 695C.1743 is hereby amended to read as 32
2483+follows: 33
2484+ 695C.1743 1. A health maintenance organization that offers 34
2485+or issues a health care plan shall include in the plan coverage for: 35
2486+ (a) [Drugs] All drugs approved by the United States Food and 36
2487+Drug Administration for preventing the acquisition of human 37
2488+immunodeficiency virus [;] or treating human immunodeficiency 38
2489+virus or hepatitis C in the form recommended by the prescribing 39
2490+practitioner, regardless of whether the drug is included in the 40
2491+formulary of the health maintenance organization; 41
2492+ (b) Laboratory testing that is necessary for therapy that uses 42
2493+[such] a drug [;] to prevent the acquisition of human 43
2494+immunodeficiency virus; 44
24032495 – 52 –
24042496
24052497
2406-- 82nd Session (2023)
2407- Sec. 65. 1. A health maintenance organization that offers
2408-or issues a health care plan shall include in the plan:
2409- (a) Coverage of testing for and the treatment and prevention of
2410-sexually transmitted diseases, including, without limitation,
2411-Chlamydia trachomatis, gonorrhea, syphilis, human
2412-immunodeficiency virus and hepatitis B and C, for all enrollees,
2413-regardless of age. Such coverage must include, without limitation,
2414-the coverage required by NRS 695C.1737 and 695C.1743.
2415- (b) Unrestricted coverage of condoms for enrollees who are 13
2416-years of age or older.
2417- 2. A health care plan subject to the provisions of this chapter
2418-that is delivered, issued for delivery or renewed on or after
2419-January 1, 2024, has the legal effect of including the coverage
2420-required by subsection 1, and any provision of the plan that
2421-conflicts with the provisions of this section is void.
2422- Sec. 66. (Deleted by amendment.)
2423- Sec. 67. NRS 695C.050 is hereby amended to read as follows:
2424- 695C.050 1. Except as otherwise provided in this chapter or
2425-in specific provisions of this title, the provisions of this title are not
2426-applicable to any health maintenance organization granted a
2427-certificate of authority under this chapter. This provision does not
2428-apply to an insurer licensed and regulated pursuant to this title
2429-except with respect to its activities as a health maintenance
2430-organization authorized and regulated pursuant to this chapter.
2431- 2. Solicitation of enrollees by a health maintenance
2432-organization granted a certificate of authority, or its representatives,
2433-must not be construed to violate any provision of law relating to
2434-solicitation or advertising by practitioners of a healing art.
2435- 3. Any health maintenance organization authorized under this
2436-chapter shall not be deemed to be practicing medicine and is exempt
2437-from the provisions of chapter 630 of NRS.
2438- 4. The provisions of NRS 695C.110, 695C.125, 695C.1691,
2439-695C.1693, 695C.170, 695C.1703, 695C.1705, 695C.1709 to
2440-695C.173, inclusive, 695C.1733, 695C.17335, 695C.1734,
2441-695C.1751, 695C.1755, 695C.1759, 695C.176 to 695C.200,
2442-inclusive, and 695C.265 do not apply to a health maintenance
2443-organization that provides health care services through managed
2444-care to recipients of Medicaid under the State Plan for Medicaid or
2445-insurance pursuant to the Children’s Health Insurance Program
2446-pursuant to a contract with the Division of Health Care Financing
2447-and Policy of the Department of Health and Human Services. This
2448-subsection does not exempt a health maintenance organization from
2498+- *SB439_R3*
2499+ (c) Any service to test for, prevent or treat human 1
2500+immunodeficiency virus or hepatitis C provided by a provider of 2
2501+primary care if the service is covered when provided by a specialist 3
2502+and: 4
2503+ (1) The service is within the scope of practice of the 5
2504+provider of primary care; or 6
2505+ (2) The provider of primary care is capable of providing the 7
2506+service safely and effectively in consultation with a specialist and 8
2507+the provider engages in such consultation; and 9
2508+ [(c)] (d) The services described in NRS 639.28085, when 10
2509+provided by a pharmacist who participates in the network plan of the 11
2510+health maintenance organization. 12
2511+ 2. A health maintenance organization that offers or issues a 13
2512+health care plan shall reimburse [a] : 14
2513+ (a) A pharmacist who participates in the network plan of the 15
2514+health maintenance organization for the services described in NRS 16
2515+639.28085 at a rate equal to the rate of reimbursement provided to a 17
2516+physician, physician assistant or advanced practice registered nurse 18
2517+for similar services. 19
2518+ (b) An advanced practice registered nurse or a physician 20
2519+assistant who participates in the network plan of the health 21
2520+maintenance organization for any service to test for, prevent or 22
2521+treat human immunodeficiency virus or hepatitis C at a rate equal 23
2522+to the rate of reimbursement provided to a physician for similar 24
2523+services. 25
2524+ 3. A health maintenance organization [may subject] shall not: 26
2525+ (a) Subject the benefits required by subsection 1 to [reasonable] 27
2526+medical management techniques [.] , other than step therapy; 28
2527+ (b) Limit the covered amount of a drug described in paragraph 29
2528+(a) of subsection 1; 30
2529+ (c) Refuse to cover a drug described in paragraph (a) of 31
2530+subsection 1 because the drug is dispensed by a pharmacy through 32
2531+mail order service; or 33
2532+ (d) Prohibit or restrict access to any service or drug to treat 34
2533+human immunodeficiency virus or hepatitis C on the same day on 35
2534+which the enrollee is diagnosed. 36
2535+ 4. A health maintenance organization shall ensure that the 37
2536+benefits required by subsection 1 are made available to an enrollee 38
2537+through a provider of health care who participates in the network 39
2538+plan of the health maintenance organization. 40
2539+ 5. A health care plan subject to the provisions of this chapter 41
2540+that is delivered, issued for delivery or renewed on or after 42
2541+[October] January 1, [2021,] 2024, has the legal effect of including 43
2542+the coverage required by subsection 1, and any provision of the plan 44
2543+that conflicts with the provisions of this section is void. 45
24492544 – 53 –
24502545
24512546
2452-- 82nd Session (2023)
2453-any provision of this chapter for services provided pursuant to any
2454-other contract.
2455- 5. The provisions of NRS 695C.1694 to 695C.1698, inclusive,
2456-695C.1701, 695C.1708, 695C.1728, 695C.1731, 695C.17333,
2457-695C.17345, 695C.17347, 695C.1735, 695C.1737, 695C.1743,
2458-695C.1745 and 695C.1757 and sections 64 and 65 of this act apply
2459-to a health maintenance organization that provides health care
2460-services through managed care to recipients of Medicaid under the
2461-State Plan for Medicaid.
2462- Sec. 68. NRS 695C.1743 is hereby amended to read as
2463-follows:
2464- 695C.1743 1. A health maintenance organization that offers
2465-or issues a health care plan shall include in the plan coverage for:
2466- (a) [Drugs] All drugs approved by the United States Food and
2467-Drug Administration for preventing the acquisition of human
2468-immunodeficiency virus [;] or treating human immunodeficiency
2469-virus or hepatitis C in the form recommended by the prescribing
2470-practitioner, regardless of whether the drug is included in the
2471-formulary of the health maintenance organization;
2472- (b) Laboratory testing that is necessary for therapy that uses
2473-[such] a drug [;] to prevent the acquisition of human
2474-immunodeficiency virus;
2475- (c) Any service to test for, prevent or treat human
2476-immunodeficiency virus or hepatitis C provided by a provider of
2477-primary care if the service is covered when provided by a specialist
2478-and:
2479- (1) The service is within the scope of practice of the
2480-provider of primary care; or
2481- (2) The provider of primary care is capable of providing the
2482-service safely and effectively in consultation with a specialist and
2483-the provider engages in such consultation; and
2484- [(c)] (d) The services described in NRS 639.28085, when
2485-provided by a pharmacist who participates in the network plan of the
2486-health maintenance organization.
2487- 2. A health maintenance organization that offers or issues a
2488-health care plan shall reimburse [a] :
2489- (a) A pharmacist who participates in the network plan of the
2490-health maintenance organization for the services described in NRS
2491-639.28085 at a rate equal to the rate of reimbursement provided to a
2492-physician, physician assistant or advanced practice registered nurse
2493-for similar services.
2494- (b) An advanced practice registered nurse or a physician
2495-assistant who participates in the network plan of the health
2547+- *SB439_R3*
2548+ 6. As used in this section: 1
2549+ (a) “Medical management technique” means a practice which is 2
2550+used to control the cost or use of health care services or prescription 3
2551+drugs. The term includes, without limitation, the use of step therapy, 4
2552+prior authorization and categorizing drugs and devices based on 5
2553+cost, type or method of administration. 6
2554+ (b) “Network plan” means a health care plan offered by a health 7
2555+maintenance organization under which the financing and delivery of 8
2556+medical care, including items and services paid for as medical care, 9
2557+are provided, in whole or in part, through a defined set of providers 10
2558+under contract with the health maintenance organization. The term 11
2559+does not include an arrangement for the financing of premiums. 12
2560+ (c) “Primary care” means the practice of family medicine, 13
2561+pediatrics, internal medicine, obstetrics and gynecology and 14
2562+midwifery. 15
2563+ (d) “Provider of health care” has the meaning ascribed to it in 16
2564+NRS 629.031. 17
2565+ Sec. 69. NRS 695C.330 is hereby amended to read as follows: 18
2566+ 695C.330 1. The Commissioner may suspend or revoke any 19
2567+certificate of authority issued to a health maintenance organization 20
2568+pursuant to the provisions of this chapter if the Commissioner finds 21
2569+that any of the following conditions exist: 22
2570+ (a) The health maintenance organization is operating 23
2571+significantly in contravention of its basic organizational document, 24
2572+its health care plan or in a manner contrary to that described in and 25
2573+reasonably inferred from any other information submitted pursuant 26
2574+to NRS 695C.060, 695C.070 and 695C.140, unless any amendments 27
2575+to those submissions have been filed with and approved by the 28
2576+Commissioner; 29
2577+ (b) The health maintenance organization issues evidence of 30
2578+coverage or uses a schedule of charges for health care services 31
2579+which do not comply with the requirements of NRS 695C.1691 to 32
2580+695C.200, inclusive, and sections 64 and 65 of this act or 33
2581+695C.207; 34
2582+ (c) The health care plan does not furnish comprehensive health 35
2583+care services as provided for in NRS 695C.060; 36
2584+ (d) The Commissioner certifies that the health maintenance 37
2585+organization: 38
2586+ (1) Does not meet the requirements of subsection 1 of NRS 39
2587+695C.080; or 40
2588+ (2) Is unable to fulfill its obligations to furnish health care 41
2589+services as required under its health care plan; 42
2590+ (e) The health maintenance organization is no longer financially 43
2591+responsible and may reasonably be expected to be unable to meet its 44
2592+obligations to enrollees or prospective enrollees; 45
24962593 – 54 –
24972594
24982595
2499-- 82nd Session (2023)
2500-maintenance organization for any service to test for, prevent or
2501-treat human immunodeficiency virus or hepatitis C at a rate equal
2502-to the rate of reimbursement provided to a physician for similar
2503-services.
2504- 3. A health maintenance organization [may subject] shall not:
2505- (a) Subject the benefits required by subsection 1 to [reasonable]
2506-medical management techniques [.] , other than step therapy;
2507- (b) Limit the covered amount of a drug described in paragraph
2508-(a) of subsection 1;
2509- (c) Refuse to cover a drug described in paragraph (a) of
2510-subsection 1 because the drug is dispensed by a pharmacy through
2511-mail order service; or
2512- (d) Prohibit or restrict access to any service or drug to treat
2513-human immunodeficiency virus or hepatitis C on the same day on
2514-which the enrollee is diagnosed.
2515- 4. A health maintenance organization shall ensure that the
2516-benefits required by subsection 1 are made available to an enrollee
2517-through a provider of health care who participates in the network
2518-plan of the health maintenance organization.
2519- 5. A health care plan subject to the provisions of this chapter
2520-that is delivered, issued for delivery or renewed on or after
2521-[October] January 1, [2021,] 2024, has the legal effect of including
2522-the coverage required by subsection 1, and any provision of the plan
2523-that conflicts with the provisions of this section is void.
2524- 6. As used in this section:
2525- (a) “Medical management technique” means a practice which is
2526-used to control the cost or use of health care services or prescription
2527-drugs. The term includes, without limitation, the use of step therapy,
2528-prior authorization and categorizing drugs and devices based on
2529-cost, type or method of administration.
2530- (b) “Network plan” means a health care plan offered by a health
2531-maintenance organization under which the financing and delivery of
2532-medical care, including items and services paid for as medical care,
2533-are provided, in whole or in part, through a defined set of providers
2534-under contract with the health maintenance organization. The term
2535-does not include an arrangement for the financing of premiums.
2536- (c) “Primary care” means the practice of family medicine,
2537-pediatrics, internal medicine, obstetrics and gynecology and
2538-midwifery.
2539- (d) “Provider of health care” has the meaning ascribed to it in
2540-NRS 629.031.
2596+- *SB439_R3*
2597+ (f) The health maintenance organization has failed to put into 1
2598+effect a mechanism affording the enrollees an opportunity to 2
2599+participate in matters relating to the content of programs pursuant to 3
2600+NRS 695C.110; 4
2601+ (g) The health maintenance organization has failed to put into 5
2602+effect the system required by NRS 695C.260 for: 6
2603+ (1) Resolving complaints in a manner reasonably to dispose 7
2604+of valid complaints; and 8
2605+ (2) Conducting external reviews of adverse determinations 9
2606+that comply with the provisions of NRS 695G.241 to 695G.310, 10
2607+inclusive; 11
2608+ (h) The health maintenance organization or any person on its 12
2609+behalf has advertised or merchandised its services in an untrue, 13
2610+misrepresentative, misleading, deceptive or unfair manner; 14
2611+ (i) The continued operation of the health maintenance 15
2612+organization would be hazardous to its enrollees or creditors or to 16
2613+the general public; 17
2614+ (j) The health maintenance organization fails to provide the 18
2615+coverage required by NRS 695C.1691; or 19
2616+ (k) The health maintenance organization has otherwise failed to 20
2617+comply substantially with the provisions of this chapter. 21
2618+ 2. A certificate of authority must be suspended or revoked only 22
2619+after compliance with the requirements of NRS 695C.340. 23
2620+ 3. If the certificate of authority of a health maintenance 24
2621+organization is suspended, the health maintenance organization shall 25
2622+not, during the period of that suspension, enroll any additional 26
2623+groups or new individual contracts, unless those groups or persons 27
2624+were contracted for before the date of suspension. 28
2625+ 4. If the certificate of authority of a health maintenance 29
2626+organization is revoked, the organization shall proceed, immediately 30
2627+following the effective date of the order of revocation, to wind up its 31
2628+affairs and shall conduct no further business except as may be 32
2629+essential to the orderly conclusion of the affairs of the organization. 33
2630+It shall engage in no further advertising or solicitation of any kind. 34
2631+The Commissioner may, by written order, permit such further 35
2632+operation of the organization as the Commissioner may find to be in 36
2633+the best interest of enrollees to the end that enrollees are afforded 37
2634+the greatest practical opportunity to obtain continuing coverage for 38
2635+health care. 39
2636+ Sec. 70. Chapter 695G of NRS is hereby amended by adding 40
2637+thereto the provisions set forth as sections 71, 72 and 73 of this act. 41
2638+ Sec. 71. 1. A managed care organization that offers or 42
2639+issues a health care plan shall include in the plan coverage for: 43
2640+ (a) All drugs approved by the United States Food and Drug 44
2641+Administration to: 45
25412642 – 55 –
25422643
25432644
2544-- 82nd Session (2023)
2545- Sec. 69. NRS 695C.330 is hereby amended to read as follows:
2546- 695C.330 1. The Commissioner may suspend or revoke any
2547-certificate of authority issued to a health maintenance organization
2548-pursuant to the provisions of this chapter if the Commissioner finds
2549-that any of the following conditions exist:
2550- (a) The health maintenance organization is operating
2551-significantly in contravention of its basic organizational document,
2552-its health care plan or in a manner contrary to that described in and
2553-reasonably inferred from any other information submitted pursuant
2554-to NRS 695C.060, 695C.070 and 695C.140, unless any amendments
2555-to those submissions have been filed with and approved by the
2556-Commissioner;
2557- (b) The health maintenance organization issues evidence of
2558-coverage or uses a schedule of charges for health care services
2559-which do not comply with the requirements of NRS 695C.1691 to
2560-695C.200, inclusive, and sections 64 and 65 of this act or
2561-695C.207;
2562- (c) The health care plan does not furnish comprehensive health
2563-care services as provided for in NRS 695C.060;
2564- (d) The Commissioner certifies that the health maintenance
2565-organization:
2566- (1) Does not meet the requirements of subsection 1 of NRS
2567-695C.080; or
2568- (2) Is unable to fulfill its obligations to furnish health care
2569-services as required under its health care plan;
2570- (e) The health maintenance organization is no longer financially
2571-responsible and may reasonably be expected to be unable to meet its
2572-obligations to enrollees or prospective enrollees;
2573- (f) The health maintenance organization has failed to put into
2574-effect a mechanism affording the enrollees an opportunity to
2575-participate in matters relating to the content of programs pursuant to
2576-NRS 695C.110;
2577- (g) The health maintenance organization has failed to put into
2578-effect the system required by NRS 695C.260 for:
2579- (1) Resolving complaints in a manner reasonably to dispose
2580-of valid complaints; and
2581- (2) Conducting external reviews of adverse determinations
2582-that comply with the provisions of NRS 695G.241 to 695G.310,
2583-inclusive;
2584- (h) The health maintenance organization or any person on its
2585-behalf has advertised or merchandised its services in an untrue,
2586-misrepresentative, misleading, deceptive or unfair manner;
2645+- *SB439_R3*
2646+ (1) Provide medication-assisted treatment for opioid use 1
2647+disorder, including, without limitation, buprenorphine, methadone 2
2648+and naltrexone. 3
2649+ (2) Support safe withdrawal from substance use disorder, 4
2650+including, without limitation, lofexidine. 5
2651+ (b) Any service for the treatment of substance use disorder 6
2652+provided by a provider of primary care if the service is covered 7
2653+when provided by a specialist and: 8
2654+ (1) The service is within the scope of practice of the 9
2655+provider of primary care; or 10
2656+ (2) The provider of primary care is capable of providing the 11
2657+service safely and effectively in consultation with a specialist and 12
2658+the provider engages in such consultation. 13
2659+ 2. A managed care organization shall provide the coverage 14
2660+required by paragraph (a) of subsection 1 regardless of whether 15
2661+the drug is included in the formulary of the managed care 16
2662+organization. 17
2663+ 3. A managed care organization shall not: 18
2664+ (a) Subject the benefits required by paragraph (a) of 19
2665+subsection 1 to medical management techniques, other than step 20
2666+therapy; 21
2667+ (b) Limit the covered amount of a drug described in paragraph 22
2668+(a) of subsection 1; or 23
2669+ (c) Refuse to cover a drug described in paragraph (a) of 24
2670+subsection 1 because the drug is dispensed by a pharmacy through 25
2671+mail order service. 26
2672+ 4. A managed care organization shall ensure that the benefits 27
2673+required by subsection 1 are made available to an insured through 28
2674+a provider of health care who participates in the network plan of 29
2675+the managed care organization. 30
2676+ 5. A health care plan subject to the provisions of this chapter 31
2677+that is delivered, issued for delivery or renewed on or after 32
2678+January 1, 2024, has the legal effect of including the coverage 33
2679+required by subsection 1, and any provision of the plan that 34
2680+conflicts with the provisions of this section is void. 35
2681+ 6. As used in this section: 36
2682+ (a) “Medical management technique” means a practice which 37
2683+is used to control the cost or use of health care services or 38
2684+prescription drugs. The term includes, without limitation, the use 39
2685+of step therapy, prior authorization and categorizing drugs and 40
2686+devices based on cost, type or method of administration. 41
2687+ (b) “Network plan” means a health care plan offered by a 42
2688+managed care organization under which the financing and 43
2689+delivery of medical care, including items and services paid for as 44
2690+medical care, are provided, in whole or in part, through a defined 45
25872691 – 56 –
25882692
25892693
2590-- 82nd Session (2023)
2591- (i) The continued operation of the health maintenance
2592-organization would be hazardous to its enrollees or creditors or to
2593-the general public;
2594- (j) The health maintenance organization fails to provide the
2595-coverage required by NRS 695C.1691; or
2596- (k) The health maintenance organization has otherwise failed to
2597-comply substantially with the provisions of this chapter.
2598- 2. A certificate of authority must be suspended or revoked only
2599-after compliance with the requirements of NRS 695C.340.
2600- 3. If the certificate of authority of a health maintenance
2601-organization is suspended, the health maintenance organization shall
2602-not, during the period of that suspension, enroll any additional
2603-groups or new individual contracts, unless those groups or persons
2604-were contracted for before the date of suspension.
2605- 4. If the certificate of authority of a health maintenance
2606-organization is revoked, the organization shall proceed, immediately
2607-following the effective date of the order of revocation, to wind up its
2608-affairs and shall conduct no further business except as may be
2609-essential to the orderly conclusion of the affairs of the organization.
2610-It shall engage in no further advertising or solicitation of any kind.
2611-The Commissioner may, by written order, permit such further
2612-operation of the organization as the Commissioner may find to be in
2613-the best interest of enrollees to the end that enrollees are afforded
2614-the greatest practical opportunity to obtain continuing coverage for
2615-health care.
2616- Sec. 70. Chapter 695G of NRS is hereby amended by adding
2617-thereto the provisions set forth as sections 71, 72 and 73 of this act.
2618- Sec. 71. 1. A managed care organization that offers or
2619-issues a health care plan shall include in the plan coverage for:
2620- (a) All drugs approved by the United States Food and Drug
2621-Administration to:
2622- (1) Provide medication-assisted treatment for opioid use
2623-disorder, including, without limitation, buprenorphine, methadone
2624-and naltrexone.
2625- (2) Support safe withdrawal from substance use disorder,
2626-including, without limitation, lofexidine.
2627- (b) Any service for the treatment of substance use disorder
2628-provided by a provider of primary care if the service is covered
2629-when provided by a specialist and:
2630- (1) The service is within the scope of practice of the
2631-provider of primary care; or
2694+- *SB439_R3*
2695+set of providers under contract with the managed care 1
2696+organization. The term does not include an arrangement for the 2
2697+financing of premiums. 3
2698+ (c) “Primary care” means the practice of family medicine, 4
2699+pediatrics, internal medicine, obstetrics and gynecology and 5
2700+midwifery. 6
2701+ (d) “Provider of health care” has the meaning ascribed to it in 7
2702+NRS 629.031. 8
2703+ Sec. 72. 1. A managed care organization that offers or 9
2704+issues a health care plan shall include in the plan: 10
2705+ (a) Coverage of testing for, treatment of and prevention of 11
2706+sexually transmitted diseases, including, without limitation, 12
2707+Chlamydia trachomatis, gonorrhea, syphilis, human 13
2708+immunodeficiency virus and hepatitis B and C, for all insureds, 14
2709+regardless of age. Such coverage must include, without limitation, 15
2710+the coverage required by NRS 695G.1705 and 695G.1714. 16
2711+ (b) Unrestricted coverage of condoms for insureds who are 13 17
2712+years of age or older. 18
2713+ 2. A health care plan subject to the provisions of this chapter 19
2714+that is delivered, issued for delivery or renewed on or after 20
2715+January 1, 2024, has the legal effect of including the coverage 21
2716+required by subsection 1, and any provision of the plan that 22
2717+conflicts with the provisions of this section is void. 23
2718+ Sec. 73. (Deleted by amendment.) 24
2719+ Sec. 74. NRS 695G.1705 is hereby amended to read as 25
2720+follows: 26
2721+ 695G.1705 1. A managed care organization that offers or 27
2722+issues a health care plan shall include in the plan coverage for: 28
2723+ (a) [Drugs] All drugs approved by the United States Food and 29
2724+Drug Administration for preventing the acquisition of human 30
2725+immunodeficiency virus [;] or treating human immunodeficiency 31
2726+virus or hepatitis C in the form recommended by the prescribing 32
2727+practitioner, regardless of whether the drug is included in the 33
2728+formulary of the managed care organization; 34
2729+ (b) Laboratory testing that is necessary for therapy that uses 35
2730+[such] a drug [;] to prevent the acquisition of human 36
2731+immunodeficiency virus; 37
2732+ (c) Any service to test for, prevent or treat human 38
2733+immunodeficiency virus or hepatitis C provided by a provider of 39
2734+primary care if the service is covered when provided by a specialist 40
2735+and: 41
2736+ (1) The service is within the scope of practice of the 42
2737+provider of primary care; or 43
26322738 – 57 –
26332739
26342740
2635-- 82nd Session (2023)
2636- (2) The provider of primary care is capable of providing the
2637-service safely and effectively in consultation with a specialist and
2638-the provider engages in such consultation.
2639- 2. A managed care organization shall provide the coverage
2640-required by paragraph (a) of subsection 1 regardless of whether
2641-the drug is included in the formulary of the managed care
2642-organization.
2643- 3. A managed care organization shall not:
2644- (a) Subject the benefits required by paragraph (a) of
2645-subsection 1 to medical management techniques, other than step
2646-therapy;
2647- (b) Limit the covered amount of a drug described in paragraph
2648-(a) of subsection 1; or
2649- (c) Refuse to cover a drug described in paragraph (a) of
2650-subsection 1 because the drug is dispensed by a pharmacy through
2651-mail order service.
2652- 4. A managed care organization shall ensure that the benefits
2653-required by subsection 1 are made available to an insured through
2654-a provider of health care who participates in the network plan of
2655-the managed care organization.
2656- 5. A health care plan subject to the provisions of this chapter
2657-that is delivered, issued for delivery or renewed on or after
2658-January 1, 2024, has the legal effect of including the coverage
2659-required by subsection 1, and any provision of the plan that
2660-conflicts with the provisions of this section is void.
2661- 6. As used in this section:
2662- (a) “Medical management technique” means a practice which
2663-is used to control the cost or use of health care services or
2664-prescription drugs. The term includes, without limitation, the use
2665-of step therapy, prior authorization and categorizing drugs and
2666-devices based on cost, type or method of administration.
2667- (b) “Network plan” means a health care plan offered by a
2668-managed care organization under which the financing and
2669-delivery of medical care, including items and services paid for as
2670-medical care, are provided, in whole or in part, through a defined
2671-set of providers under contract with the managed care
2672-organization. The term does not include an arrangement for the
2673-financing of premiums.
2674- (c) “Primary care” means the practice of family medicine,
2675-pediatrics, internal medicine, obstetrics and gynecology and
2676-midwifery.
2677- (d) “Provider of health care” has the meaning ascribed to it in
2678-NRS 629.031.
2741+- *SB439_R3*
2742+ (2) The provider of primary care is capable of providing the 1
2743+service safely and effectively in consultation with a specialist and 2
2744+the provider engages in such consultation; and 3
2745+ [(c)] (d) The services described in NRS 639.28085, when 4
2746+provided by a pharmacist who participates in the network plan of the 5
2747+managed care organization. 6
2748+ 2. A managed care organization that offers or issues a health 7
2749+care plan shall reimburse [a] : 8
2750+ (a) A pharmacist who participates in the network plan of the 9
2751+managed care organization for the services described in NRS 10
2752+639.28085 at a rate equal to the rate of reimbursement provided to a 11
2753+physician, physician assistant or advanced practice registered nurse 12
2754+for similar services. 13
2755+ (b) An advanced practice registered nurse or a physician 14
2756+assistant who participates in the network plan of the managed care 15
2757+organization for any service to test for, prevent or treat human 16
2758+immunodeficiency virus or hepatitis C at a rate equal to the rate of 17
2759+reimbursement provided to a physician for similar services. 18
2760+ 3. A managed care organization [may subject] shall not: 19
2761+ (a) Subject the benefits required by subsection 1 to [reasonable] 20
2762+medical management techniques [.] , other than step therapy; 21
2763+ (b) Limit the covered amount of a drug described in paragraph 22
2764+(a) of subsection 1; 23
2765+ (c) Refuse to cover a drug described in paragraph (a) of 24
2766+subsection 1 because the drug is dispensed by a pharmacy through 25
2767+mail order service; or 26
2768+ (d) Prohibit or restrict access to any service or drug to treat 27
2769+human immunodeficiency virus or hepatitis C on the same day on 28
2770+which the insured is diagnosed. 29
2771+ 4. A managed care organization shall ensure that the benefits 30
2772+required by subsection 1 are made available to an insured through a 31
2773+provider of health care who participates in the network plan of the 32
2774+managed care organization. 33
2775+ 5. A health care plan subject to the provisions of this chapter 34
2776+that is delivered, issued for delivery or renewed on or after 35
2777+[October] January 1, [2021,] 2024, has the legal effect of including 36
2778+the coverage required by subsection 1, and any provision of the plan 37
2779+that conflicts with the provisions of this section is void. 38
2780+ 6. As used in this section: 39
2781+ (a) “Medical management technique” means a practice which is 40
2782+used to control the cost or use of health care services or prescription 41
2783+drugs. The term includes, without limitation, the use of step therapy, 42
2784+prior authorization and categorizing drugs and devices based on 43
2785+cost, type or method of administration. 44
26792786 – 58 –
26802787
26812788
2682-- 82nd Session (2023)
2683- Sec. 72. 1. A managed care organization that offers or
2684-issues a health care plan shall include in the plan:
2685- (a) Coverage of testing for, treatment of and prevention of
2686-sexually transmitted diseases, including, without limitation,
2687-Chlamydia trachomatis, gonorrhea, syphilis, human
2688-immunodeficiency virus and hepatitis B and C, for all insureds,
2689-regardless of age. Such coverage must include, without limitation,
2690-the coverage required by NRS 695G.1705 and 695G.1714.
2691- (b) Unrestricted coverage of condoms for insureds who are 13
2692-years of age or older.
2693- 2. A health care plan subject to the provisions of this chapter
2694-that is delivered, issued for delivery or renewed on or after
2695-January 1, 2024, has the legal effect of including the coverage
2696-required by subsection 1, and any provision of the plan that
2697-conflicts with the provisions of this section is void.
2698- Sec. 73. (Deleted by amendment.)
2699- Sec. 74. NRS 695G.1705 is hereby amended to read as
2700-follows:
2701- 695G.1705 1. A managed care organization that offers or
2702-issues a health care plan shall include in the plan coverage for:
2703- (a) [Drugs] All drugs approved by the United States Food and
2704-Drug Administration for preventing the acquisition of human
2705-immunodeficiency virus [;] or treating human immunodeficiency
2706-virus or hepatitis C in the form recommended by the prescribing
2707-practitioner, regardless of whether the drug is included in the
2708-formulary of the managed care organization;
2709- (b) Laboratory testing that is necessary for therapy that uses
2710-[such] a drug [;] to prevent the acquisition of human
2711-immunodeficiency virus;
2712- (c) Any service to test for, prevent or treat human
2713-immunodeficiency virus or hepatitis C provided by a provider of
2714-primary care if the service is covered when provided by a specialist
2715-and:
2716- (1) The service is within the scope of practice of the
2717-provider of primary care; or
2718- (2) The provider of primary care is capable of providing the
2719-service safely and effectively in consultation with a specialist and
2720-the provider engages in such consultation; and
2721- [(c)] (d) The services described in NRS 639.28085, when
2722-provided by a pharmacist who participates in the network plan of the
2723-managed care organization.
2724- 2. A managed care organization that offers or issues a health
2725-care plan shall reimburse [a] :
2789+- *SB439_R3*
2790+ (b) “Network plan” means a health care plan offered by a 1
2791+managed care organization under which the financing and delivery 2
2792+of medical care, including items and services paid for as medical 3
2793+care, are provided, in whole or in part, through a defined set of 4
2794+providers under contract with the managed care organization. The 5
2795+term does not include an arrangement for the financing of 6
2796+premiums. 7
2797+ (c) “Primary care” means the practice of family medicine, 8
2798+pediatrics, internal medicine, obstetrics and gynecology and 9
2799+midwifery. 10
2800+ (d) “Provider of health care” has the meaning ascribed to it in 11
2801+NRS 629.031. 12
2802+ Sec. 75. 1. The first application that a physician, osteopathic 13
2803+physician or physician assistant licensed pursuant to chapter 630 or 14
2804+633 of NRS or a nurse who provides or supervises the provision of 15
2805+emergency medical services in a hospital or primary care and who is 16
2806+licensed on January 1, 2024, submits to renew his or her license on 17
2807+or after that date must include, without limitation, proof that the 18
2808+applicant has completed at least 2 hours of training in the stigma, 19
2809+discrimination and unrecognized bias toward persons who have 20
2810+acquired or are at a high risk of acquiring human immunodeficiency 21
2811+virus, as required by NRS 630.253, 632.343 and 633.471, as 22
2812+amended by sections 28, 29 and 30 of this act, respectively, as 23
2813+applicable. 24
2814+ 2. As used in this section, “primary care” means the practice of 25
2815+family medicine, pediatrics, internal medicine, obstetrics and 26
2816+gynecology and midwifery. 27
2817+ Sec. 76. The Legislature hereby finds and declares that: 28
2818+ 1. In Lapinski v. State, 84 Nev. 611, 613 (1968), the Nevada 29
2819+Supreme Court held that “the power to define crimes and penalties 30
2820+lies exclusively in the legislature.” 31
2821+ 2. The Nevada Supreme Court has further held in Tellis v. 32
2822+State, 84 Nev. 587, 591 (1968), Sparkman v. State, 95 Nev. 76, 82 33
2823+(1979) and State v. Dist. Ct. (Pullin), 124 Nev. 564, 567-68 (2008), 34
2824+that the penalty for a crime is determined by the law in effect at the 35
2825+time the offender committed the crime and not the law in effect at 36
2826+the time the offender is sentenced unless the Legislature has 37
2827+expressed its clear intent that a statute ameliorating the penalty 38
2828+apply retroactively. 39
2829+ 3. NRS 441A.118 states that “[t]he Legislature hereby finds 40
2830+and declares that the spread of communicable diseases is best 41
2831+addressed through public health measures rather than 42
2832+criminalization.” 43
27262833 – 59 –
27272834
27282835
2729-- 82nd Session (2023)
2730- (a) A pharmacist who participates in the network plan of the
2731-managed care organization for the services described in NRS
2732-639.28085 at a rate equal to the rate of reimbursement provided to a
2733-physician, physician assistant or advanced practice registered nurse
2734-for similar services.
2735- (b) An advanced practice registered nurse or a physician
2736-assistant who participates in the network plan of the managed care
2737-organization for any service to test for, prevent or treat human
2738-immunodeficiency virus or hepatitis C at a rate equal to the rate of
2739-reimbursement provided to a physician for similar services.
2740- 3. A managed care organization [may subject] shall not:
2741- (a) Subject the benefits required by subsection 1 to [reasonable]
2742-medical management techniques [.] , other than step therapy;
2743- (b) Limit the covered amount of a drug described in paragraph
2744-(a) of subsection 1;
2745- (c) Refuse to cover a drug described in paragraph (a) of
2746-subsection 1 because the drug is dispensed by a pharmacy through
2747-mail order service; or
2748- (d) Prohibit or restrict access to any service or drug to treat
2749-human immunodeficiency virus or hepatitis C on the same day on
2750-which the insured is diagnosed.
2751- 4. A managed care organization shall ensure that the benefits
2752-required by subsection 1 are made available to an insured through a
2753-provider of health care who participates in the network plan of the
2754-managed care organization.
2755- 5. A health care plan subject to the provisions of this chapter
2756-that is delivered, issued for delivery or renewed on or after
2757-[October] January 1, [2021,] 2024, has the legal effect of including
2758-the coverage required by subsection 1, and any provision of the plan
2759-that conflicts with the provisions of this section is void.
2760- 6. As used in this section:
2761- (a) “Medical management technique” means a practice which is
2762-used to control the cost or use of health care services or prescription
2763-drugs. The term includes, without limitation, the use of step therapy,
2764-prior authorization and categorizing drugs and devices based on
2765-cost, type or method of administration.
2766- (b) “Network plan” means a health care plan offered by a
2767-managed care organization under which the financing and delivery
2768-of medical care, including items and services paid for as medical
2769-care, are provided, in whole or in part, through a defined set of
2770-providers under contract with the managed care organization. The
2771-term does not include an arrangement for the financing of
2772-premiums.
2836+- *SB439_R3*
2837+ 4. For those reasons, the Legislature is exercising its exclusive 1
2838+power to define the acts which subject a person to criminal penalties 2
2839+by: 3
2840+ (a) Retroactively applying the provisions of section 24 of 4
2841+chapter 491, Statutes of Nevada 2021, at page 3199, which repealed 5
2842+certain criminal offenses that were based on a person having the 6
2843+human immunodeficiency virus, to apply to conduct that occurred 7
2844+before those offenses were repealed; and 8
2845+ (b) Making certain offenses which were punishable as category 9
2846+A felonies before the effective date of section 13 of this act based on 10
2847+the potential to spread a communicable disease instead punishable 11
2848+as category B felonies, category D felonies or gross misdemeanors. 12
2849+ Sec. 77. 1. The provisions of section 24 of chapter 491, 13
2850+Statutes of Nevada 2021, at page 3199, apply to any violation of 14
2851+NRS 201.205 or 201.358, as those sections existed before the 15
2852+enactment of section 24 of chapter 491, Statutes of Nevada 2021, at 16
2853+page 3199, if the violation occurred before, on or after June 6, 2021, 17
2854+and the person was convicted on or after the effective date of this 18
2855+section. 19
2856+ 2. If, before June 6, 2021, a person committed a violation of a 20
2857+NRS 201.205 or 201.358, as those sections existed before the 21
2858+enactment of section 24 of chapter 491, Statutes of Nevada 2021, at 22
2859+page 3199, and the person was not charged for that violation before 23
2860+the effective date of this section, the person must not be charged for 24
2861+that violation. 25
2862+ 3. Each court in this State shall cancel each outstanding bench 26
2863+warrant issued by the court for a person who failed to appear in 27
2864+court in relation to an alleged violation of NRS 201.205 or 201.358, 28
2865+as those sections existed before the enactment of section 24 of 29
2866+chapter 491, Statutes of Nevada 2021, at page 3199. 30
2867+ 4. The Central Repository for Nevada Records of Criminal 31
2868+History shall remove from each database or compilation of records 32
2869+of criminal history maintained by the Central Repository all records 33
2870+of bench warrants issued for a person who failed to appear in court 34
2871+in relation to an alleged violation of NRS 201.205 or 201.358, as 35
2872+those sections existed before the enactment of section 24 of chapter 36
2873+491, Statutes of Nevada 2021, at page 3199. 37
2874+ Sec. 78. 1. The provisions of NRS 212.189, as amended by 38
2875+section 13 of this act, apply to any violation of that section, that 39
2876+occurred before, on or after the effective date of that section, if the 40
2877+person was not convicted before the effective date of that section. 41
2878+ 2. If a person commits a violation of a NRS 212.189 which is 42
2879+punishable as a category A felony before the effective date of 43
2880+section 13 of this act, and the violation is punishable as a category B 44
2881+felony, a category D felony or a gross misdemeanor pursuant to 45
27732882 – 60 –
27742883
27752884
2776-- 82nd Session (2023)
2777- (c) “Primary care” means the practice of family medicine,
2778-pediatrics, internal medicine, obstetrics and gynecology and
2779-midwifery.
2780- (d) “Provider of health care” has the meaning ascribed to it in
2781-NRS 629.031.
2782- Sec. 75. 1. The first application that a physician, osteopathic
2783-physician or physician assistant licensed pursuant to chapter 630 or
2784-633 of NRS or a nurse who provides or supervises the provision of
2785-emergency medical services in a hospital or primary care and who is
2786-licensed on January 1, 2024, submits to renew his or her license on
2787-or after that date must include, without limitation, proof that the
2788-applicant has completed at least 2 hours of training in the stigma,
2789-discrimination and unrecognized bias toward persons who have
2790-acquired or are at a high risk of acquiring human immunodeficiency
2791-virus, as required by NRS 630.253, 632.343 and 633.471, as
2792-amended by sections 28, 29 and 30 of this act, respectively, as
2793-applicable.
2794- 2. As used in this section, “primary care” means the practice of
2795-family medicine, pediatrics, internal medicine, obstetrics and
2796-gynecology and midwifery.
2797- Sec. 76. The Legislature hereby finds and declares that:
2798- 1. In Lapinski v. State, 84 Nev. 611, 613 (1968), the Nevada
2799-Supreme Court held that “the power to define crimes and penalties
2800-lies exclusively in the legislature.”
2801- 2. The Nevada Supreme Court has further held in Tellis v.
2802-State, 84 Nev. 587, 591 (1968), Sparkman v. State, 95 Nev. 76, 82
2803-(1979) and State v. Dist. Ct. (Pullin), 124 Nev. 564, 567-68 (2008),
2804-that the penalty for a crime is determined by the law in effect at the
2805-time the offender committed the crime and not the law in effect at
2806-the time the offender is sentenced unless the Legislature has
2807-expressed its clear intent that a statute ameliorating the penalty
2808-apply retroactively.
2809- 3. NRS 441A.118 states that “[t]he Legislature hereby finds
2810-and declares that the spread of communicable diseases is best
2811-addressed through public health measures rather than
2812-criminalization.”
2813- 4. For those reasons, the Legislature is exercising its exclusive
2814-power to define the acts which subject a person to criminal penalties
2815-by:
2816- (a) Retroactively applying the provisions of section 24 of
2817-chapter 491, Statutes of Nevada 2021, at page 3199, which repealed
2818-certain criminal offenses that were based on a person having the
2819- – 61 –
2820-
2821-
2822-- 82nd Session (2023)
2823-human immunodeficiency virus, to apply to conduct that occurred
2824-before those offenses were repealed; and
2825- (b) Making certain offenses which were punishable as category
2826-A felonies before the effective date of section 13 of this act based on
2827-the potential to spread a communicable disease instead punishable
2828-as category B felonies, category D felonies or gross misdemeanors.
2829- Sec. 77. 1. The provisions of section 24 of chapter 491,
2830-Statutes of Nevada 2021, at page 3199, apply to any violation of
2831-NRS 201.205 or 201.358, as those sections existed before the
2832-enactment of section 24 of chapter 491, Statutes of Nevada 2021, at
2833-page 3199, if the violation occurred before, on or after June 6, 2021,
2834-and the person was convicted on or after the effective date of this
2835-section.
2836- 2. If, before June 6, 2021, a person committed a violation of a
2837-NRS 201.205 or 201.358, as those sections existed before the
2838-enactment of section 24 of chapter 491, Statutes of Nevada 2021, at
2839-page 3199, and the person was not charged for that violation before
2840-the effective date of this section, the person must not be charged for
2841-that violation.
2842- 3. Each court in this State shall cancel each outstanding bench
2843-warrant issued by the court for a person who failed to appear in
2844-court in relation to an alleged violation of NRS 201.205 or 201.358,
2845-as those sections existed before the enactment of section 24 of
2846-chapter 491, Statutes of Nevada 2021, at page 3199.
2847- 4. The Central Repository for Nevada Records of Criminal
2848-History shall remove from each database or compilation of records
2849-of criminal history maintained by the Central Repository all records
2850-of bench warrants issued for a person who failed to appear in court
2851-in relation to an alleged violation of NRS 201.205 or 201.358, as
2852-those sections existed before the enactment of section 24 of chapter
2853-491, Statutes of Nevada 2021, at page 3199.
2854- Sec. 78. 1. The provisions of NRS 212.189, as amended by
2855-section 13 of this act, apply to any violation of that section, that
2856-occurred before, on or after the effective date of that section, if the
2857-person was not convicted before the effective date of that section.
2858- 2. If a person commits a violation of a NRS 212.189 which is
2859-punishable as a category A felony before the effective date of
2860-section 13 of this act, and the violation is punishable as a category B
2861-felony, a category D felony or a gross misdemeanor pursuant to
2862-NRS 212.189, as amended by section 13 of this act, the person must
2863-not be charged with or convicted of a category A felony, if the
2864-violation occurs on or after the effective date of section 13 of this
2865-act, and may only be charged with and convicted of a category B
2866- – 62 –
2867-
2868-
2869-- 82nd Session (2023)
2870-felony, category D felony or gross misdemeanor, as applicable, on
2871-or after the effective date of section 13 of this act.
2872- Sec. 79. The provisions of NRS 354.599 do not apply to any
2873-additional expenses of a local government that are related to the
2874-provisions of this act.
2875- Sec. 80. 1. This section and sections 3 to 10, inclusive, 13,
2876-76, 77 and 78 of this act become effective upon passage and
2877-approval.
2878- 2. Sections 1, 2, 11, 12, 14 to 75, inclusive, and 79 of this act
2879-become effective:
2880- (a) Upon passage and approval for the purpose of adopting any
2881-regulations and performing any other preparatory administrative
2882-tasks that are necessary to carry out the provisions of this act; and
2883- (b) On January 1, 2024, for all other purposes.
2884-
2885-20 ~~~~~ 23
2886-
2885+- *SB439_R3*
2886+NRS 212.189, as amended by section 13 of this act, the person must 1
2887+not be charged with or convicted of a category A felony, if the 2
2888+violation occurs on or after the effective date of section 13 of this 3
2889+act, and may only be charged with and convicted of a category B 4
2890+felony, category D felony or gross misdemeanor, as applicable, on 5
2891+or after the effective date of section 13 of this act. 6
2892+ Sec. 79. The provisions of NRS 354.599 do not apply to any 7
2893+additional expenses of a local government that are related to the 8
2894+provisions of this act. 9
2895+ Sec. 80. 1. This section and sections 3 to 10, inclusive, 13, 10
2896+76, 77 and 78 of this act become effective upon passage and 11
2897+approval. 12
2898+ 2. Sections 1, 2, 11, 12, 14 to 75, inclusive, and 79 of this act 13
2899+become effective: 14
2900+ (a) Upon passage and approval for the purpose of adopting any 15
2901+regulations and performing any other preparatory administrative 16
2902+tasks that are necessary to carry out the provisions of this act; and 17
2903+ (b) On January 1, 2024, for all other purposes. 18
2904+
2905+H
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