A.B. 259 - *AB259* ASSEMBLY BILL NO. 259–ASSEMBLYMEMBER CONSIDINE FEBRUARY 19, 2025 ____________ Referred to Committee on Commerce and Labor SUMMARY—Establishes provisions governing prescription drugs. (BDR 40-165) FISCAL NOTE: Effect on Local Government: May have Fiscal Impact. Effect on the State: Yes. ~ EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted. AN ACT relating to health care; prohibiting certain actions related to pricing and reimbursement for certain drugs; creating a cause of action for violating such prohibitions; and providing other matters properly relating thereto. Legislative Counsel’s Digest: Existing federal law establishes the Medicare program, which is a public health 1 insurance program for persons 65 years of age and older and specified persons with 2 disabilities who are under 65 years of age. (42 U.S.C. §§ 1395 et seq.) Existing 3 federal law requires the United States Secretary of Health and Human Services to 4 negotiate with the manufacturers of certain drugs and to establish the maximum fair 5 price for certain drugs, which is the maximum price at which such drugs may be 6 sold to a recipient of Medicare. (42 U.S.C. §§ 1320f-2, 1320f-3) Existing federal 7 law requires the Secretary of Health and Human Services to publish those 8 maximum fair prices. (42 U.S.C. § 1320f-4) Section 1 of this bill prohibits a person 9 or entity that: (1) purchases a drug which is subject to a maximum fair price in this 10 State from paying a price that is higher than the maximum fair price; or (2) seeks 11 reimbursement for a drug subject to a maximum fair price which is delivered, 12 dispensed or administered to a person in this State from seeking reimbursement at a 13 rate which is higher than the maximum fair price. 14 Existing law: (1) prohibits certain trade practices which are deemed to be 15 deceptive trade practices; and (2) provides for the enforcement of the prohibition on 16 engaging in deceptive trade practices, including by prescribing criminal penalties to 17 be imposed against a person who engages in a deceptive trade practice. (NRS 18 598.0903-598.0999) Section 1 makes it a deceptive trade practice for any person to 19 violate the prohibition on purchasing or seeking reimbursement for a drug at a price 20 higher than the maximum fair price. Sections 1 and 3 of this bill provide that a 21 person who violates the provisions of section 1 is not subject to any criminal 22 penalty set forth in existing law for engaging in a deceptive trade practice, meaning 23 such a person is subject only to the various civil enforcement measures, including 24 – 2 – - *AB259* civil penalties, set forth in existing law for engaging in a deceptive trade practice. 25 (NRS 598.097-598.0999) 26 Existing law authorizes any person who is a victim of consumer fraud, 27 including a deceptive trade practice, to bring a civil action. (NRS 41.600) Section 2 28 of this bill provides that a violation of section 1 constitutes consumer fraud, and 29 sections 1 and 2 authorize a victim of such a violation to bring a civil action.30 WHEREAS, In the 2019 Legislative Session, Senate Bill No. 276 1 directed the Legislative Commission to appoint a committee to 2 conduct an interim study concerning the cost of prescription drugs 3 in this State and the impact of rebates, reductions in price and other 4 remuneration from manufacturers on prescription drug prices; and 5 WHEREAS, In reporting on the findings of the Committee to 6 Conduct an Interim Study Concerning the Costs of Prescription 7 Drugs, LCB Bulletin No. 21-9, published in January 2021, stated 8 that “[i]n 2018, Americans paid an average of $1,229 for 9 prescription drugs, the highest amount per capita in any developed 10 country in the world”; and 11 WHEREAS, LCB Bulletin No. 21-9 also stated that “[i]ncreasing 12 drug prices disproportionately affect uninsured and underinsured 13 patients, while insured patients covered by high-deductible, 14 commercial, or government-sponsored health insurance plans tend 15 to pay more through premium and copay increases”; and 16 WHEREAS, The Nevada Spending and Government Efficiency 17 Commission noted in its final report, “Final Report of the Nevada 18 Spending and Government Efficiency Commission to Governor Jim 19 Gibbons,” published January 7, 2010, that the State of Nevada 20 would realize significant savings on Medicaid, mental health, 21 corrections and other programs if the cost of prescription drugs were 22 better controlled; and 23 WHEREAS, Excessive prices negatively affect the ability of 24 residents of this State to obtain prescription drugs, thereby 25 endangering the health and safety of such residents; and 26 WHEREAS, Excessive prices of prescription drugs threaten the 27 economic well-being of residents of this State, thereby inhibiting 28 their ability to pay for necessary and essential goods and services 29 including housing, food and utilities; and 30 WHEREAS, Excessive costs of prescription drugs contribute 31 significantly to increasing costs of health care and health insurance 32 that threaten the ability of residents of this State to obtain affordable 33 health coverage and maintain or achieve good health; and 34 WHEREAS, Excessive costs of prescription drugs contribute 35 significantly to rising costs for health care provided and paid for 36 through health insurance programs for public employees, including 37 employees of the State, municipalities, counties, school districts, 38 – 3 – - *AB259* institutions for higher education and retirees whose health costs are 1 funded by taxpayer dollars, thereby threatening the ability of the 2 State and local governments to fund other programs necessary for 3 the public good and safety, such as public safety, police, fire and 4 education; and 5 WHEREAS, To protect residents of this State from the negative 6 effects from excessive costs of prescription drugs, and to protect the 7 safety, health and economic well-being of Nevadans, the Legislature 8 finds that legislation regarding affordable access to prescription 9 drugs is necessary for residents of this State to achieve and maintain 10 good health; now, therefore, 11 12 THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN 13 SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS: 14 15 Section 1. Chapter 439B of NRS is hereby amended by adding 16 thereto a new section to read as follows: 17 1. A person or entity that purchases a referenced drug in this 18 State shall not pay a price for the referenced drug that, excluding 19 any fee paid to a pharmacy for dispensing the referenced drug, is 20 higher than the maximum fair price for that referenced drug 21 during the price applicability period. 22 2. A person or entity that seeks reimbursement for a 23 referenced drug which is delivered, dispensed or administered to a 24 person in this State shall not seek reimbursement for the 25 referenced drug at a rate which, excluding any fee paid to a 26 pharmacy for dispensing the referenced drug, is higher than the 27 maximum fair price for that referenced drug during the price 28 applicability period. 29 3. Except as otherwise provided in subsection 4, a violation of 30 subsection 1 or 2 by any person constitutes a deceptive trade 31 practice for the purposes of NRS 598.0903 to 598.0999, inclusive. 32 Each such violation of subsection 1 or 2 constitutes a separate 33 deceptive trade practice. 34 4. A person who violates the provisions of subsection 1 or 2 is 35 not subject to any criminal penalty set forth in subsection 3 of 36 NRS 598.0999. 37 5. A person aggrieved by a violation of subsection 1 or 2 may 38 bring an action for consumer fraud pursuant to NRS 41.600. 39 6. The Department may adopt any regulations necessary to 40 carry out the provisions of this section. 41 7. As used in this section: 42 (a) “Maximum fair price” means the maximum fair price for a 43 drug published by the United States Secretary of Health and 44 Human Services pursuant to 42 U.S.C. § 1320f-4. 45 – 4 – - *AB259* (b) “Price applicability period” has the meaning ascribed to it 1 in 42 U.S.C. § 1320f(b)(2). 2 (c) “Referenced drug” means a drug subject to a maximum 3 fair price. 4 Sec. 2. NRS 41.600 is hereby amended to read as follows: 5 41.600 1. An action may be brought by any person who is a 6 victim of consumer fraud. 7 2. As used in this section, “consumer fraud” means: 8 (a) An unlawful act as defined in NRS 119.330; 9 (b) An unlawful act as defined in NRS 205.2747; 10 (c) An act prohibited by NRS 482.36655 to 482.36667, 11 inclusive; 12 (d) An act prohibited by NRS 482.351; 13 (e) A deceptive trade practice as defined in NRS 598.0915 to 14 598.0925, inclusive; [or] 15 (f) A violation of NRS 417.133 or 417.135 [.] ; or 16 (g) A violation of section 1 of this act. 17 3. If the claimant is the prevailing party, the court shall award 18 the claimant: 19 (a) Any damages that the claimant has sustained; 20 (b) Any equitable relief that the court deems appropriate; and 21 (c) The claimant’s costs in the action and reasonable attorney’s 22 fees. 23 4. Any action brought pursuant to this section is not an action 24 upon any contract underlying the original transaction. 25 Sec. 3. NRS 598.0999 is hereby amended to read as follows: 26 598.0999 1. Except as otherwise provided in NRS 598.0974, 27 a person who violates a court order or injunction issued pursuant to 28 the provisions of NRS 598.0903 to 598.0999, inclusive, upon a 29 complaint brought by the Commissioner, the Director, the district 30 attorney of any county of this State or the Attorney General shall 31 forfeit and pay to the State General Fund a civil penalty of not more 32 than $10,000 for each violation. For the purpose of this section, the 33 court issuing the order or injunction retains jurisdiction over the 34 action or proceeding. Such civil penalties are in addition to any 35 other penalty or remedy available for the enforcement of the 36 provisions of NRS 598.0903 to 598.0999, inclusive. 37 2. Except as otherwise provided in NRS 598.0974, in any 38 action brought pursuant to the provisions of NRS 598.0903 to 39 598.0999, inclusive, if the court finds that a person has willfully 40 engaged in a deceptive trade practice, the Commissioner, the 41 Director, the district attorney of any county in this State or the 42 Attorney General bringing the action may recover a civil penalty not 43 to exceed $15,000 for each violation. The court in any such action 44 – 5 – - *AB259* may, in addition to any other relief or reimbursement, award 1 reasonable attorney’s fees and costs. 2 3. [A] Except as otherwise provided in section 1 of this act, a 3 natural person, firm, or any officer or managing agent of any 4 corporation or association who knowingly and willfully engages in a 5 deceptive trade practice: 6 (a) For an offense involving a loss of property or services valued 7 at $1,200 or more but less than $5,000, is guilty of a category D 8 felony and shall be punished as provided in NRS 193.130. 9 (b) For an offense involving a loss of property or services 10 valued at $5,000 or more but less than $25,000, is guilty of a 11 category C felony and shall be punished as provided in 12 NRS 193.130. 13 (c) For an offense involving a loss of property or services valued 14 at $25,000 or more but less than $100,000, is guilty of a category B 15 felony and shall be punished by imprisonment in the state prison for 16 a minimum term of not less than 1 year and a maximum term of not 17 more than 10 years, and by a fine of not more than $10,000. 18 (d) For an offense involving a loss of property or services 19 valued at $100,000 or more, is guilty of a category B felony and 20 shall be punished by imprisonment in the state prison for a 21 minimum term of not less than 1 year and a maximum term of not 22 more than 20 years, and by a fine of not more than $15,000. 23 (e) For any offense other than an offense described in 24 paragraphs (a) to (d), inclusive, is guilty of a misdemeanor. 25 The court may require the natural person, firm, or officer or 26 managing agent of the corporation or association to pay to the 27 aggrieved party damages on all profits derived from the knowing 28 and willful engagement in a deceptive trade practice and treble 29 damages on all damages suffered by reason of the deceptive trade 30 practice. 31 4. If a person violates any provision of NRS 598.0903 to 32 598.0999, inclusive, 598.100 to 598.2801, inclusive, 598.405 33 to 598.525, inclusive, 598.741 to 598.787, inclusive, 598.840 to 34 598.966, inclusive, or 598.9701 to 598.9718, inclusive, fails to 35 comply with a judgment or order of any court in this State 36 concerning a violation of such a provision, or fails to comply with 37 an assurance of discontinuance or other agreement concerning an 38 alleged violation of such a provision, the Commissioner or the 39 district attorney of any county may bring an action in the name of 40 the State of Nevada seeking: 41 (a) The suspension of the person’s privilege to conduct business 42 within this State; or 43 (b) If the defendant is a corporation, dissolution of the 44 corporation. 45 – 6 – - *AB259* The court may grant or deny the relief sought or may order other 1 appropriate relief. 2 5. If a person violates any provision of NRS 228.500 to 3 228.640, inclusive, fails to comply with a judgment or order of any 4 court in this State concerning a violation of such a provision, or fails 5 to comply with an assurance of discontinuance or other agreement 6 concerning an alleged violation of such a provision, the Attorney 7 General may bring an action in the name of the State of Nevada 8 seeking: 9 (a) The suspension of the person’s privilege to conduct business 10 within this State; or 11 (b) If the defendant is a corporation, dissolution of the 12 corporation. 13 The court may grant or deny the relief sought or may order other 14 appropriate relief. 15 6. In an action brought by the Commissioner or the Attorney 16 General pursuant to subsection 4 or 5, process may be served by an 17 employee of the Consumer Affairs Unit of the Department of 18 Business and Industry or an employee of the Attorney General. 19 7. As used in this section: 20 (a) “Property” has the meaning ascribed to it in NRS 193.0225. 21 (b) “Services” has the meaning ascribed to it in NRS 205.0829. 22 (c) “Value” means the fair market value of the property or 23 services at the time the deceptive trade practice occurred. The value 24 of a written instrument which does not have a readily ascertainable 25 market value is the greater of the face amount of the instrument less 26 the portion satisfied or the amount of economic loss to the owner of 27 the instrument resulting from the deprivation of the instrument. The 28 trier of fact shall determine the value of all other property whose 29 value is not readily ascertainable, and may, in making that 30 determination, consider all relevant evidence, including evidence of 31 the value of the property to its owner. 32 Sec. 4. The provisions of this act do not apply to any contract 33 for the sale of or reimbursement for a drug entered into before 34 January 1, 2026, but do apply to any renewal or extension of such a 35 contract. 36 Sec. 5. 1. This section becomes effective upon passage and 37 approval. 38 2. Sections 1 to 4, inclusive, of this act become effective: 39 (a) Upon passage and approval for the purpose of adopting any 40 regulations and performing any other preparatory administrative 41 tasks that are necessary to carry out the provisions of this act; and 42 (b) On January 1, 2026, for all other purposes. 43 H