A.B. 282
- *AB282*
ASSEMBLY BILL NO. 282–ASSEMBLYMEMBER ORENTLICHER
FEBRUARY 24, 2025
____________
Referred to Committee on Health and Human Services
SUMMARY—Revises provisions relating to billing for health care.
(BDR 40-785)
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; requiring a medical facility or a
provider of health care who receives notice of or
otherwise discovers a potential error in a medical bill to
review the potential error and refund any overpayment;
authorizing disciplinary action for the failure to comply
with such requirements; and providing other matters
properly relating thereto.
Legislative Counsel’s Digest:
Existing law provides every patient of a medical facility with the right to 1
examine the bill for his or her care and receive an explanation of the bill. (NRS 2
449A.106) Existing law also requires each provider of health care to timely provide 3
a patient with an itemized bill at no additional cost to the patient. (NRS 629.071) 4
Sections 2 and 3 of this bill, respectively, require a medical facility or provider of 5
health care that determines or receives notice that a medical bill may contain one or 6
more billing errors to: (1) review the potential billing errors; (2) notify the patient 7
of the review and the results of the review; and (3) refund any overpayment by the 8
patient. Sections 1 and 4 of this bill, respectively, authorize the suspension or 9
revocation of the license of a medical facility that violates section 2, and the 10
imposition of disciplinary action against and administrator of certain facilities who 11
aids or abets a violation of section 2. Section 3 authorizes the imposition of 12
disciplinary action against a provider of health care who fails to comply with the 13
requirements of section 3. 14
– 2 –
- *AB282*
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1. NRS 449.160 is hereby amended to read as follows: 1
449.160 1. The Division may deny an application for a 2
license or may suspend or revoke any license issued under the 3
provisions of NRS 449.029 to 449.2428, inclusive, upon any of the 4
following grounds: 5
(a) Violation by the applicant or the licensee of any of the 6
provisions of NRS 439B.410, 449.029 to 449.245, inclusive, or 7
449A.100 to 449A.124, inclusive, and section 2 of this act and 8
449A.270 to 449A.286, inclusive, or of any other law of this State 9
or of the standards, rules and regulations adopted thereunder. 10
(b) Aiding, abetting or permitting the commission of any illegal 11
act. 12
(c) Conduct inimical to the public health, morals, welfare and 13
safety of the people of the State of Nevada in the maintenance and 14
operation of the premises for which a license is issued. 15
(d) Conduct or practice detrimental to the health or safety of the 16
occupants or employees of the facility. 17
(e) Failure of the applicant to obtain written approval from the 18
Director of the Department of Health and Human Services as 19
required by NRS 439A.100 or 439A.102 or as provided in any 20
regulation adopted pursuant to NRS 449.001 to 449.430, inclusive, 21
and 449.435 to 449.531, inclusive, and chapter 449A of NRS if such 22
approval is required, including, without limitation, the closure or 23
conversion of any hospital in a county whose population is 100,000 24
or more that is owned by the licensee without approval pursuant to 25
NRS 439A.102. 26
(f) Failure to comply with the provisions of NRS 441A.315 and 27
any regulations adopted pursuant thereto or NRS 449.2486. 28
(g) Violation of the provisions of NRS 458.112. 29
(h) Failure to comply with the provisions of NRS 449A.170 to 30
449A.192, inclusive, and any regulation adopted pursuant thereto. 31
(i) Violation of the provisions of NRS 629.260. 32
2. In addition to the provisions of subsection 1, the Division 33
may revoke a license to operate a facility for the dependent if, with 34
respect to that facility, the licensee that operates the facility, or an 35
agent or employee of the licensee: 36
(a) Is convicted of violating any of the provisions of 37
NRS 202.470; 38
(b) Is ordered to but fails to abate a nuisance pursuant to NRS 39
244.360, 244.3603 or 268.4124; or 40
– 3 –
- *AB282*
(c) Is ordered by the appropriate governmental agency to correct 1
a violation of a building, safety or health code or regulation but fails 2
to correct the violation. 3
3. The Division shall maintain a log of any complaints that it 4
receives relating to activities for which the Division may revoke the 5
license to operate a facility for the dependent pursuant to subsection 6
2. The Division shall provide to a facility for the care of adults 7
during the day: 8
(a) A summary of a complaint against the facility if the 9
investigation of the complaint by the Division either substantiates 10
the complaint or is inconclusive; 11
(b) A report of any investigation conducted with respect to the 12
complaint; and 13
(c) A report of any disciplinary action taken against the facility. 14
The facility shall make the information available to the public 15
pursuant to NRS 449.2486. 16
4. On or before February 1 of each odd-numbered year, the 17
Division shall submit to the Director of the Legislative Counsel 18
Bureau a written report setting forth, for the previous biennium: 19
(a) Any complaints included in the log maintained by the 20
Division pursuant to subsection 3; and 21
(b) Any disciplinary actions taken by the Division pursuant to 22
subsection 2. 23
Sec. 2. Chapter 449A of NRS is hereby amended by adding 24
thereto a new section to read as follows: 25
1. Not later than 30 days after determining or receiving 26
notice from a patient or any other source that a bill may contain 27
one or more billing errors, a medical facility shall: 28
(a) Notify in writing the patient to whom the bill relates: 29
(1) Of each potential billing error; 30
(2) That the medical facility will conduct a review pursuant 31
to paragraph (b); and 32
(3) That during a review conducted pursuant to paragraph 33
(b) the medical facility will not bill the patient for any care that is 34
subject to the review. 35
(b) Review the potential billing errors. During such a review, 36
the medical facility shall not bill the patient for any care that is 37
subject to the review. 38
2. Not later than 30 days after completing a review pursuant 39
to paragraph (b) of subsection 1, a medical facility shall: 40
(a) Notify the patient in writing of the completion and results 41
of the review. The notice must include, without limitation: 42
(1) Notice of whether the review resulted in the discovery of 43
any billing errors and: 44
– 4 –
- *AB282*
(I) If the review resulted in the discovery of any billing 1
errors, an explanation of each billing error and the manner in 2
which the billing error was corrected; or 3
(II) If the review did not result in the discovery of any 4
billing errors, an explanation of the reasons why the potential 5
errors identified pursuant to subsection 1 are not actual billing 6
errors; and 7
(2) Applicable coding guidelines, references to medical 8
records and other information relevant to the explanation 9
provided pursuant to subparagraph (1). 10
(b) If the review resulted in the discovery of a billing error 11
which resulted in the patient overpaying for care, refund to the 12
patient the amount of the overpayment. 13
Sec. 3. Chapter 629 of NRS is hereby amended by adding 14
thereto a new section to read as follows: 15
1. Not later than 30 days after determining or receiving 16
notice from a patient or any other source that a bill may contain 17
one or more billing errors, a provider of health care shall: 18
(a) Notify in writing the patient to whom the bill relates: 19
(1) Of each potential billing error; 20
(2) That the provider of health care will conduct a review 21
pursuant to paragraph (b); and 22
(3) That during a review conducted pursuant to paragraph 23
(b) the provider of health care will not bill the patient for any care 24
that is subject to the review. 25
(b) Review the potential billing errors. During such a review, 26
the provider of health care shall not bill the patient for any care 27
that is subject to the review. 28
2. Not later than 30 days after completing a review pursuant 29
to paragraph (b) of subsection 1, a provider of health care shall: 30
(a) Notify the patient in writing of the completion and results 31
of the review. The notice must include, without limitation: 32
(1) Notice of whether the review resulted in the discovery of 33
any billing errors and: 34
(I) If the review resulted in the discovery of any billing 35
errors, an explanation of each billing error and the manner in 36
which the billing error was corrected; or 37
(II) If the review did not result in the discovery of any 38
billing errors, an explanation of the reasons why the potential 39
errors identified pursuant to subsection 1 are not actual billing 40
errors; and 41
(2) Applicable coding guidelines, references to medical 42
records and other information relevant to the explanation 43
provided pursuant to subparagraph (1). 44
– 5 –
- *AB282*
(b) If the review resulted in the discovery of a billing error 1
which resulted in the patient overpaying for care, refund to the 2
patient the amount of the overpayment. 3
3. A provider of health care who violates any provision of this 4
section is guilty of unprofessional conduct and is subject to 5
disciplinary action by the board, agency or other entity in this 6
State by which he or she is licensed, certified or regulated. 7
Sec. 4. NRS 654.190 is hereby amended to read as follows: 8
654.190 1. The Board may, after notice and an opportunity 9
for a hearing as required by law, impose an administrative fine of 10
not more than $10,000 for each violation on, recover reasonable 11
investigative fees and costs incurred from, suspend, revoke, deny 12
the issuance or renewal of or place conditions on the license of, and 13
place on probation or impose any combination of the foregoing on 14
any licensee who: 15
(a) Is convicted of a felony relating to the practice of 16
administering a facility for skilled nursing or facility for 17
intermediate care or residential facility for groups or of any offense 18
involving moral turpitude. 19
(b) Has obtained his or her license by the use of fraud or deceit. 20
(c) Violates any of the provisions of this chapter. 21
(d) Aids or abets any person in the violation of any of the 22
provisions of NRS 449.029 to 449.2428, inclusive, or 449A.100 to 23
449A.124, inclusive, and section 2 of this act and 449A.270 to 24
449A.286, inclusive, as those provisions pertain to a facility for 25
skilled nursing, facility for intermediate care or residential facility 26
for groups. 27
(e) Violates any regulation of the Board prescribing additional 28
standards of conduct for licensees, including, without limitation, a 29
code of ethics. 30
(f) Engages in conduct that violates the trust of a patient or 31
resident or exploits the relationship between the licensee and the 32
patient or resident for the financial or other gain of the licensee. 33
2. If a licensee requests a hearing pursuant to subsection 1, the 34
Board shall give the licensee written notice of a hearing pursuant to 35
NRS 233B.121 and 241.0333. A licensee may waive, in writing, his 36
or her right to attend the hearing. 37
3. The Board may compel the attendance of witnesses or the 38
production of documents or objects by subpoena. The Board may 39
adopt regulations that set forth a procedure pursuant to which the 40
Chair of the Board may issue subpoenas on behalf of the Board. 41
Any person who is subpoenaed pursuant to this subsection may 42
request the Board to modify the terms of the subpoena or grant 43
additional time for compliance. 44
– 6 –
- *AB282*
4. An order that imposes discipline and the findings of fact and 1
conclusions of law supporting that order are public records. 2
5. The expiration of a license by operation of law or by order 3
or decision of the Board or a court, or the voluntary surrender of a 4
license, does not deprive the Board of jurisdiction to proceed with 5
any investigation of, or action or disciplinary proceeding against, the 6
licensee or to render a decision suspending or revoking the license. 7
H