S.B. 250
- *SB250*
SENATE BILL NO. 250–SENATORS LANGE;
CRUZ-CRAWFORD AND OHRENSCHALL
FEBRUARY 27, 2025
____________
Referred to Committee on Health and Human Services
SUMMARY—Revises provisions relating to health care records.
(BDR 40-70)
FISCAL NOTE: Effect on Local Government: May have Fiscal Impact.
Effect on the State: Yes.
CONTAINS UNFUNDED MANDATE (§§ 3, 8, 12, 15)
(NOT REQUESTED BY AFFECTED LOCAL GOVERNMENT)
~
EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted.
AN ACT relating to health care; providing that the electronic health
records of a patient are the property of the patient;
requiring certain entities to allow a patient to take certain
actions relating to access to his or her electronic health
records; requiring the establishment of a statewide
electronic health repository; imposing certain
requirements relating to the statewide electronic health
repository; providing a penalty; and providing other
matters properly relating thereto.
Legislative Counsel’s Digest:
Existing law prescribes various requirements governing health information 1
technology and the electronic maintenance, transmittal and exchange of electronic 2
health records and certain other electronic health information. (NRS 439.581-3
439.597) Upon the request of a person who is authorized to request a copy of health 4
records that are maintained electronically, existing law requires a custodian of 5
health care records to electronically transmit a copy of the health records to any 6
person or entity for a fee. (NRS 629.062) Section 3 of this bill provides that the 7
electronic health records of a patient are the property of the patient and requires a 8
health care provider to allow a patient to: (1) access and forward his or her 9
electronic health records without a fee or charge; and (2) request that his or her 10
electronic health records be forwarded to any other person or entity in accordance 11
with existing law. Section 8 of this bill makes a conforming change to remove a 12
requirement that the Director of the Department of Health and Human Services 13
adopt regulations governing the ownership of electronic health records because 14
section 3 establishes that such records are the property of the patient. 15
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With certain exceptions, existing law requires a health care provider, health 16
insurer, health insurance administrator and certain other entities to authorize a 17
person to opt out of having his or her individually identifiable health information 18
disclosed electronically to health care providers, insurers and certain other entities. 19
(NRS 439.597) Section 10 of this bill requires those persons and entities to allow a 20
patient to prohibit any person or entity from accessing his or her individually 21
identifiable health information, with similar exceptions. Section 5 of this bill makes 22
a violation of section 3 or 10, or any regulations adopted to carry out those 23
sections, a misdemeanor. A health care provider, health insurer or health insurance 24
administrator that commits such a violation would also be subject to administrative 25
sanctions. (NRS 439.589, 439.5895, 449.167, 450B.215, 629.051, 680A.225, 26
683A.0891, 695C.329) 27
Existing law requires the Director to adopt regulations that prescribe a 28
framework for the electronic maintenance, transmittal and exchange of electronic 29
health records, prescriptions, health-related information and electronic signatures. 30
Existing law requires state and local governmental entities, health care providers 31
and insurers and certain related entities to maintain, transmit and exchange health 32
information in accordance with that framework, with certain exceptions. (NRS 33
439.589) Existing law establishes that physician group practices and other business 34
entities organized for the purpose of practicing a health care profession with 20 or 35
fewer employees are not required to comply with those provisions until January 1, 36
2030. (Section 2.8 of chapter 278, Statutes of Nevada 2023, at page 1859) Section 37
4 of this bill requires the Director to: (1) establish a statewide electronic health 38
repository for storing the electronic health records of all patients in this State; and 39
(2) adopt regulations to establish a standardized procedure for collecting 40
information from patients and entering the information into the computerized 41
system that serves as a platform for the repository. Section 2 of this bill defines the 42
term “electronic health repository.” Sections 4 and 11 of this bill provide that 43
electronic health records in the statewide electronic health repository are 44
confidential, with certain exceptions. Section 8 requires each health care provider 45
in this State that is not exempt from the requirement to maintain, transmit and 46
exchange electronic health records to: (1) integrate the system used by the health 47
care provider for the maintenance, transmittal and exchange of health information 48
with the statewide electronic health repository; and (2) comply with the 49
standardized procedure established by the Director for collecting patient 50
information and entering patient information into the repository. Section 15 of this 51
bill makes a conforming change related to the requirement for electronic health care 52
records to be integrated into the statewide electronic health repository. Section 17 53
of this bill establishes that physician group practices and other business entities 54
organized for the purpose of practicing a health care profession with 20 or fewer 55
employees are not required to comply with the requirements of section 8 until 56
January 1, 2030. A health care provider who fails to comply with those 57
requirements would be subject to administrative sanctions but would not be guilty 58
of a misdemeanor. (NRS 439.589, 439.5895, 449.167, 450B.215, 629.051) 59
Sections 5, 7, 9, 10, 12-14 and 16 of this bill make conforming changes to: (1) 60
clarify the applicability of sections 3 and 4 and certain provisions of existing law; 61
and (2) indicate the proper placement of sections 2-4 in the Nevada Revised 62
Statutes. 63
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THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1. Chapter 439 of NRS is hereby amended by adding 1
thereto the provisions set forth as sections 2, 3 and 4 of this act. 2
Sec. 2. “Electronic health repository” means an electronic 3
system for the storage of electronic health records. 4
Sec. 3. The electronic health records of a patient are the 5
property of the patient. A health care provider shall: 6
1. Allow a patient unimpeded, secure access to his or her 7
electronic health records without a fee or charge. 8
2. Allow a patient to forward his or her electronic health 9
records to any other person or entity without a fee or charge. 10
3. Ensure that, upon the request of a patient to furnish his or 11
her electronic health records to himself or herself or another 12
person or entity, the electronic health records of the patient are 13
transmitted to the requested person or entity in accordance with 14
NRS 629.062. 15
Sec. 4. 1. The Director shall: 16
(a) Establish a statewide electronic health repository for 17
storing the electronic health records of all patients in this State 18
which must include, without limitation, a computerized system to 19
provide a centralized platform for maintaining, accessing, 20
transmitting and exchanging electronic health records; and 21
(b) Adopt regulations to establish a standardized procedure for 22
collecting information from patients and entering the information 23
into the computerized system established pursuant to 24
paragraph (a). 25
2. The statewide electronic health repository and the 26
computerized system established pursuant to subsection 1 must: 27
(a) Operate in a manner that: 28
(1) Complies with the requirements of NRS 439.589 and 29
any regulations adopted pursuant thereto; 30
(2) Allows for seamless sharing of information between the 31
statewide electronic health repository and the systems used by 32
health care providers for the maintenance, transmittal and 33
exchange of health information; and 34
(3) Minimizes the need for a patient to repeatedly provide 35
demographic information, information relating to his or her 36
medical history and the list of medications that the patient is 37
currently taking or has taken in the past; and 38
(b) Include search and compilation features to allow patients 39
and health care providers to search and organize the information 40
in an electronic health record, including, without limitation, 41
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- *SB250*
information concerning medical conditions, treatments and 1
medications. 2
3. The Director may contract with any person or entity as 3
necessary to carry out the provisions of this section. 4
4. Except as otherwise provided in this subsection and NRS 5
439.597, the electronic health records in the statewide electronic 6
health repository are confidential and are not public records. The 7
Department may use deidentified, aggregated data from the 8
statewide electronic health repository in the performance of its 9
duties relating to public health. 10
Sec. 5. NRS 439.580 is hereby amended to read as follows: 11
439.580 1. Any local health officer or a deputy of a local 12
health officer who neglects or fails to enforce the provisions of this 13
chapter in his or her jurisdiction, or neglects or refuses to perform 14
any of the duties imposed upon him or her by this chapter or by the 15
instructions and directions of the Division shall be punished by a 16
fine of not more than $250. 17
2. Except as otherwise provided in NRS 439.589, each person 18
who violates any of the provisions of this chapter or refuses or 19
neglects to obey any lawful order, rule or regulation of the: 20
(a) State Board of Health or violates any rule or regulation 21
approved by the State Board of Health pursuant to NRS 439.350, 22
439.366, 439.410 and 439.460; or 23
(b) Director adopted pursuant to NRS 439.581 to 439.597, 24
inclusive, and sections 2, 3 and 4 of this act, 25
is guilty of a misdemeanor. 26
Sec. 6. NRS 439.581 is hereby amended to read as follows: 27
439.581 As used in NRS 439.581 to 439.597, inclusive, and 28
sections 2, 3 and 4 of this act, unless the context otherwise requires, 29
the words and terms defined in NRS 439.582 to 439.585, inclusive, 30
and section 2 of this act have the meanings ascribed to them in 31
those sections. 32
Sec. 7. NRS 439.588 is hereby amended to read as follows: 33
439.588 1. A health information exchange shall not operate 34
in this State without first obtaining certification as provided in 35
subsection 2. 36
2. The Director shall by regulation establish the manner in 37
which a health information exchange may apply for certification and 38
the requirements for granting such certification, which must include, 39
without limitation, that the health information exchange demonstrate 40
its financial and operational sustainability, adherence to the privacy, 41
security and patient consent standards adopted pursuant to NRS 42
439.589 and capacity for interoperability with any other health 43
information exchange certified pursuant to this section. 44
– 5 –
- *SB250*
3. The Director may deny an application for certification or 1
may suspend or revoke any certification issued pursuant to 2
subsection 2 for failure to comply with the provisions of NRS 3
439.581 to 439.597, inclusive, and sections 2, 3 and 4 of this act or 4
the regulations adopted pursuant thereto or any applicable federal or 5
state law. 6
4. When the Director intends to deny, suspend or revoke a 7
certification, he or she shall give reasonable notice to all parties by 8
certified mail. The notice must contain the legal authority, 9
jurisdiction and reasons for the action to be taken. A health 10
information exchange that wishes to contest the action of the 11
Director must file an appeal with the Director. 12
5. The Director shall adopt regulations establishing the manner 13
in which a person may file a complaint with the Director regarding a 14
violation of the provisions of this section. 15
6. The Director may impose an administrative fine against a 16
health information exchange which operates in this State without 17
holding a certification in an amount established by the Director by 18
regulation. The Director shall afford a health information exchange 19
so fined an opportunity for a hearing pursuant to the provisions of 20
NRS 233B.121. 21
7. The Director may adopt such regulations as he or she 22
determines are necessary to carry out the provisions of this section. 23
Sec. 8. NRS 439.589 is hereby amended to read as follows: 24
439.589 1. The Director, in consultation with health care 25
providers, third parties and other interested persons and entities, 26
shall by regulation prescribe a framework for the electronic 27
maintenance, transmittal and exchange of electronic health records, 28
prescriptions, health-related information and electronic signatures 29
and requirements for electronic equivalents of written entries or 30
written approvals in accordance with federal law. The regulations 31
must: 32
(a) Establish standards for networks and technologies to be used 33
to maintain, transmit and exchange health information, including, 34
without limitation, standards: 35
(1) That require: 36
(I) The use of networks and technologies that allow 37
patients to access electronic health records directly from the health 38
care provider of the patient and forward such electronic health 39
records electronically to other persons and entities; and 40
(II) The interoperability of such networks and 41
technologies in accordance with the applicable standards for the 42
interoperability of Qualified Health Information Networks 43
prescribed by the Office of the National Coordinator for Health 44
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Information Technology of the United States Department of Health 1
and Human Services; 2
(2) To ensure that electronic health records retained or shared 3
are secure; 4
(3) To maintain the confidentiality of electronic health 5
records and health-related information, including, without 6
limitation, standards to maintain the confidentiality of electronic 7
health records relating to a child who has received health care 8
services without the consent of a parent or guardian and which 9
ensure that a child’s right to access such health care services is not 10
impaired; 11
(4) To ensure the privacy of individually identifiable health 12
information, including, without limitation, standards to ensure the 13
privacy of information relating to a child who has received health 14
care services without the consent of a parent or guardian; 15
(5) For obtaining consent from a patient before retrieving the 16
patient’s health records from a health information exchange, 17
including, without limitation, standards for obtaining such consent 18
from a child who has received health care services without the 19
consent of a parent or guardian; 20
(6) For making any necessary corrections to information or 21
records; 22
(7) For notifying a patient if the confidentiality of 23
information contained in an electronic health record of the patient is 24
breached; 25
(8) Governing the ownership, management and use of 26
[electronic health records,] health-related information and related 27
data [;] and the management and use of electronic health records; 28
and 29
(9) For the electronic transmission of prior authorizations for 30
prescription medication; 31
(b) Ensure compliance with the requirements, specifications and 32
protocols for exchanging, securing and disclosing electronic health 33
records, health-related information and related data prescribed 34
pursuant to the provisions of the Health Information Technology for 35
Economic and Clinical Health Act, 42 U.S.C. §§ 300jj et seq. and 36
17901 et seq., the Health Insurance Portability and Accountability 37
Act of 1996, Public Law 104-191, and other applicable federal and 38
state law; and 39
(c) Be based on nationally recognized best practices for 40
maintaining, transmitting and exchanging health information 41
electronically. 42
2. The standards prescribed pursuant to this section must 43
include, without limitation: 44
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(a) Requirements for the creation, maintenance and transmittal 1
of electronic health records; 2
(b) Requirements for protecting confidentiality, including 3
control over, access to and the collection, organization and 4
maintenance of electronic health records, health-related information 5
and individually identifiable health information; 6
(c) Requirements for the manner in which a patient may, 7
through a health care provider who participates in the sharing of 8
health records using a health information exchange, revoke his or 9
her consent for a health care provider to retrieve the patient’s health 10
records from the health information exchange; 11
(d) A secure and traceable electronic audit system for 12
identifying access points and trails to electronic health records and 13
health information exchanges; and 14
(e) Any other requirements necessary to comply with all 15
applicable federal laws relating to electronic health records, health-16
related information, health information exchanges and the security 17
and confidentiality of such records and exchanges. 18
3. The regulations adopted pursuant to this section must not 19
require any person or entity to use a health information exchange. 20
4. Except as otherwise provided in subsections 5, 6 and 7 [, 21
the] : 22
(a) The Department and the divisions thereof, other state and 23
local governmental entities, health care providers, third parties, 24
pharmacy benefit managers and other entities licensed or certified 25
pursuant to title 57 of NRS shall maintain, transmit and exchange 26
health information in accordance with the regulations adopted 27
pursuant to this section, the provisions of NRS 439.581 to 439.597, 28
inclusive, and sections 2, 3 and 4 of this act and any other 29
regulations adopted pursuant thereto. 30
(b) Each health care provider in this State shall: 31
(1) Integrate the system used by the health care provider for 32
the maintenance, transmittal and exchange of health information 33
with the statewide electronic health repository established 34
pursuant to section 4 of this act; and 35
(2) Use the procedure established pursuant to section 4 of 36
this act when collecting information from patients and entering 37
that information into the computerized system established 38
pursuant to section 4 of this act. 39
5. The Federal Government and employees thereof, a provider 40
of health coverage for federal employees, a provider of health 41
coverage that is subject to the Employee Retirement Income 42
Security Act of 1974, 29 U.S.C. §§ 1001 et seq., or a Taft-Hartley 43
trust formed pursuant to 29 U.S.C. § 186(c)(5) is not required to but 44
– 8 –
- *SB250*
may maintain, transmit and exchange electronic information in 1
accordance with the regulations adopted pursuant to this section. 2
6. A health care provider may apply to the Department for a 3
waiver from the provisions of subsection 4 on the basis that the 4
health care provider does not have the infrastructure necessary to 5
comply with those provisions, including, without limitation, because 6
the health care provider does not have access to the Internet. The 7
Department shall grant a waiver if it determines that: 8
(a) The health care provider does not currently have the 9
infrastructure necessary to comply with the provisions of subsection 10
4; and 11
(b) Obtaining such infrastructure is not reasonably practicable, 12
including, without limitation, because the cost of such infrastructure 13
would make it difficult for the health care provider to continue to 14
operate. 15
7. The provisions of subsection 4 do not apply to the 16
Department of Corrections. 17
8. A violation of the provisions of this section or any 18
regulations adopted pursuant thereto is not a misdemeanor. 19
9. As used in this section: 20
(a) “Pharmacy benefit manager” has the meaning ascribed to it 21
in NRS 683A.174. 22
(b) “Third party” means any insurer, governmental entity or 23
other organization providing health coverage or benefits in 24
accordance with state or federal law. 25
Sec. 9. NRS 439.593 is hereby amended to read as follows: 26
439.593 A health care provider who with reasonable care 27
transmits, accesses, utilizes, discloses, relies upon or provides to a 28
patient an apparently genuine electronic health record in accordance 29
with NRS 439.581 to 439.597, inclusive, and sections 2, 3 and 4 of 30
this act and the regulations adopted pursuant thereto is immune 31
from civil or criminal liability for any decision concerning the 32
provision of health care to a patient and any civil or criminal 33
liability resulting from the provision of the record to a patient if: 34
1. The electronic health record is inaccurate; 35
2. The inaccuracy was not caused by the health care provider; 36
3. The inaccuracy resulted in an inappropriate health care 37
decision; and 38
4. The health care decision was appropriate based upon the 39
information contained in the inaccurate electronic health record. 40
Sec. 10. NRS 439.597 is hereby amended to read as follows: 41
439.597 1. If a covered entity transmits electronically 42
individually identifiable health information in compliance with the 43
provisions of: 44
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(a) The Health Insurance Portability and Accountability Act of 1
1996, Public Law 104-191; and 2
(b) NRS 439.581 to 439.597, inclusive, and sections 2, 3 and 4 3
of this act and the regulations adopted pursuant thereto, 4
which govern the electronic transmission of such information, the 5
covered entity is, for purposes of the electronic transmission, 6
exempt from any state law that contains more stringent requirements 7
or provisions concerning the privacy or confidentiality of 8
individually identifiable health information. 9
2. A covered entity that makes individually identifiable health 10
information available electronically pursuant to subsection 1 shall 11
allow any person to opt out of having his or her individually 12
identifiable health information disclosed electronically to other 13
covered entities [,] or to prohibit any person or entity from 14
accessing his or her individually identifiable health information, 15
except: 16
(a) As required by the administrative simplification provisions 17
of the Health Insurance Portability and Accountability Act of 1996, 18
Public Law 104-191. 19
(b) As otherwise required by a state law. 20
(c) That a person who is a recipient of Medicaid or insurance 21
pursuant to the Children’s Health Insurance Program may not [opt] : 22
(1) Opt out of having his or her individually identifiable 23
health information disclosed electronically [.] ; or 24
(2) Prohibit any person or entity from accessing his or her 25
individually identifiable health information where access for that 26
person or entity is deemed necessary by the Department for 27
purposes of Medicaid or the Children’s Health Insurance 28
Program. 29
3. As used in this section, “covered entity” has the meaning 30
ascribed to it in 45 C.F.R. § 160.103. 31
Sec. 11. NRS 239.010 is hereby amended to read as follows: 32
239.010 1. Except as otherwise provided in this section and 33
NRS 1.4683, 1.4687, 1A.110, 3.2203, 41.0397, 41.071, 49.095, 34
49.293, 62D.420, 62D.440, 62E.516, 62E.620, 62H.025, 62H.030, 35
62H.170, 62H.220, 62H.320, 75A.100, 75A.150, 76.160, 78.152, 36
80.113, 81.850, 82.183, 86.246, 86.54615, 87.515, 87.5413, 37
87A.200, 87A.580, 87A.640, 88.3355, 88.5927, 88.6067, 88A.345, 38
88A.7345, 89.045, 89.251, 90.730, 91.160, 116.757, 116A.270, 39
116B.880, 118B.026, 119.260, 119.265, 119.267, 119.280, 40
119A.280, 119A.653, 119A.677, 119B.370, 119B.382, 120A.640, 41
120A.690, 125.130, 125B.140, 126.141, 126.161, 126.163, 126.730, 42
127.007, 127.057, 127.130, 127.140, 127.2817, 128.090, 130.312, 43
130.712, 136.050, 159.044, 159A.044, 164.041, 172.075, 172.245, 44
176.01334, 176.01385, 176.015, 176.0625, 176.09129, 176.156, 45
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176A.630, 178.39801, 178.4715, 178.5691, 178.5717, 179.495, 1
179A.070, 179A.165, 179D.160, 180.600, 200.3771, 200.3772, 2
200.5095, 200.604, 202.3662, 205.4651, 209.392, 209.3923, 3
209.3925, 209.419, 209.429, 209.521, 211A.140, 213.010, 213.040, 4
213.095, 213.131, 217.105, 217.110, 217.464, 217.475, 218A.350, 5
218E.625, 218F.150, 218G.130, 218G.240, 218G.350, 218G.615, 6
224.240, 226.462, 226.796, 228.270, 228.450, 228.495, 228.570, 7
231.069, 231.1285, 231.1473, 232.1369, 233.190, 237.300, 8
239.0105, 239.0113, 239.014, 239B.026, 239B.030, 239B.040, 9
239B.050, 239C.140, 239C.210, 239C.230, 239C.250, 239C.270, 10
239C.420, 240.007, 241.020, 241.030, 241.039, 242.105, 244.264, 11
244.335, 247.540, 247.545, 247.550, 247.560, 250.087, 250.130, 12
250.140, 250.145, 250.150, 268.095, 268.0978, 268.490, 268.910, 13
269.174, 271A.105, 281.195, 281.805, 281A.350, 281A.680, 14
281A.685, 281A.750, 281A.755, 281A.780, 284.4068, 284.4086, 15
286.110, 286.118, 287.0438, 289.025, 289.080, 289.387, 289.830, 16
293.4855, 293.5002, 293.503, 293.504, 293.558, 293.5757, 293.870, 17
293.906, 293.908, 293.909, 293.910, 293B.135, 293D.510, 331.110, 18
332.061, 332.351, 333.333, 333.335, 338.070, 338.1379, 338.1593, 19
338.1725, 338.1727, 348.420, 349.597, 349.775, 353.205, 20
353A.049, 353A.085, 353A.100, 353C.240, 353D.250, 360.240, 21
360.247, 360.255, 360.755, 361.044, 361.2242, 361.610, 365.138, 22
366.160, 368A.180, 370.257, 370.327, 372A.080, 378.290, 378.300, 23
379.0075, 379.008, 379.1495, 385A.830, 385B.100, 387.626, 24
387.631, 388.1455, 388.259, 388.501, 388.503, 388.513, 388.750, 25
388A.247, 388A.249, 391.033, 391.035, 391.0365, 391.120, 26
391.925, 392.029, 392.147, 392.264, 392.271, 392.315, 392.317, 27
392.325, 392.327, 392.335, 392.850, 393.045, 394.167, 394.16975, 28
394.1698, 394.447, 394.460, 394.465, 396.1415, 396.1425, 396.143, 29
396.159, 396.3295, 396.405, 396.525, 396.535, 396.9685, 30
398A.115, 408.3885, 408.3886, 408.3888, 408.5484, 412.153, 31
414.280, 416.070, 422.2749, 422.305, 422A.342, 422A.350, 32
425.400, 427A.1236, 427A.872, 427A.940, 432.028, 432.205, 33
432B.175, 432B.280, 432B.290, 432B.4018, 432B.407, 432B.430, 34
432B.560, 432B.5902, 432C.140, 432C.150, 433.534, 433A.360, 35
439.4941, 439.4988, 439.5282, 439.840, 439.914, 439A.116, 36
439A.124, 439B.420, 439B.754, 439B.760, 439B.845, 440.170, 37
441A.195, 441A.220, 441A.230, 442.330, 442.395, 442.735, 38
442.774, 445A.665, 445B.570, 445B.7773, 449.209, 449.245, 39
449.4315, 449A.112, 450.140, 450B.188, 450B.805, 453.164, 40
453.720, 458.055, 458.280, 459.050, 459.3866, 459.555, 459.7056, 41
459.846, 463.120, 463.15993, 463.240, 463.3403, 463.3407, 42
463.790, 467.1005, 480.535, 480.545, 480.935, 480.940, 481.063, 43
481.091, 481.093, 482.170, 482.368, 482.5536, 483.340, 483.363, 44
483.575, 483.659, 483.800, 484A.469, 484B.830, 484B.833, 45
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484E.070, 485.316, 501.344, 503.452, 522.040, 534A.031, 561.285, 1
571.160, 584.655, 587.877, 598.0964, 598.098, 598A.110, 2
598A.420, 599B.090, 603.070, 603A.210, 604A.303, 604A.710, 3
604D.500, 604D.600, 612.265, 616B.012, 616B.015, 616B.315, 4
616B.350, 618.341, 618.425, 622.238, 622.310, 623.131, 623A.137, 5
624.110, 624.265, 624.327, 625.425, 625A.185, 628.418, 628B.230, 6
628B.760, 629.043, 629.047, 629.069, 630.133, 630.2671, 7
630.2672, 630.2673, 630.2687, 630.30665, 630.336, 630A.327, 8
630A.555, 631.332, 631.368, 632.121, 632.125, 632.3415, 9
632.3423, 632.405, 633.283, 633.301, 633.427, 633.4715, 633.4716, 10
633.4717, 633.524, 634.055, 634.1303, 634.214, 634A.169, 11
634A.185, 634B.730, 635.111, 635.158, 636.262, 636.342, 637.085, 12
637.145, 637B.192, 637B.288, 638.087, 638.089, 639.183, 13
639.2485, 639.570, 640.075, 640.152, 640A.185, 640A.220, 14
640B.405, 640B.730, 640C.580, 640C.600, 640C.620, 640C.745, 15
640C.760, 640D.135, 640D.190, 640E.225, 640E.340, 641.090, 16
641.221, 641.2215, 641A.191, 641A.217, 641A.262, 641B.170, 17
641B.281, 641B.282, 641C.455, 641C.760, 641D.260, 641D.320, 18
642.524, 643.189, 644A.870, 645.180, 645.625, 645A.050, 19
645A.082, 645B.060, 645B.092, 645C.220, 645C.225, 645D.130, 20
645D.135, 645G.510, 645H.320, 645H.330, 647.0945, 647.0947, 21
648.033, 648.197, 649.065, 649.067, 652.126, 652.228, 653.900, 22
654.110, 656.105, 657A.510, 661.115, 665.130, 665.133, 669.275, 23
669.285, 669A.310, 670B.680, 671.365, 671.415, 673.450, 673.480, 24
675.380, 676A.340, 676A.370, 677.243, 678A.470, 678C.710, 25
678C.800, 679B.122, 679B.124, 679B.152, 679B.159, 679B.190, 26
679B.285, 679B.690, 680A.270, 681A.440, 681B.260, 681B.410, 27
681B.540, 683A.0873, 685A.077, 686A.289, 686B.170, 686C.306, 28
687A.060, 687A.115, 687B.404, 687C.010, 688C.230, 688C.480, 29
688C.490, 689A.696, 692A.117, 692C.190, 692C.3507, 692C.3536, 30
692C.3538, 692C.354, 692C.420, 693A.480, 693A.615, 696B.550, 31
696C.120, 703.196, 704B.325, 706.1725, 706A.230, 710.159, 32
711.600, and section 4 of this act, sections 35, 38 and 41 of chapter 33
478, Statutes of Nevada 2011 and section 2 of chapter 391, Statutes 34
of Nevada 2013 and unless otherwise declared by law to be 35
confidential, all public books and public records of a governmental 36
entity must be open at all times during office hours to inspection by 37
any person, and may be fully copied or an abstract or memorandum 38
may be prepared from those public books and public records. Any 39
such copies, abstracts or memoranda may be used to supply the 40
general public with copies, abstracts or memoranda of the records or 41
may be used in any other way to the advantage of the governmental 42
entity or of the general public. This section does not supersede or in 43
any manner affect the federal laws governing copyrights or enlarge, 44
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diminish or affect in any other manner the rights of a person in any 1
written book or record which is copyrighted pursuant to federal law. 2
2. A governmental entity may not reject a book or record 3
which is copyrighted solely because it is copyrighted. 4
3. A governmental entity that has legal custody or control of a 5
public book or record shall not deny a request made pursuant to 6
subsection 1 to inspect or copy or receive a copy of a public book or 7
record on the basis that the requested public book or record contains 8
information that is confidential if the governmental entity can 9
redact, delete, conceal or separate, including, without limitation, 10
electronically, the confidential information from the information 11
included in the public book or record that is not otherwise 12
confidential. 13
4. If requested, a governmental entity shall provide a copy of a 14
public record in an electronic format by means of an electronic 15
medium. Nothing in this subsection requires a governmental entity 16
to provide a copy of a public record in an electronic format or by 17
means of an electronic medium if: 18
(a) The public record: 19
(1) Was not created or prepared in an electronic format; and 20
(2) Is not available in an electronic format; or 21
(b) Providing the public record in an electronic format or by 22
means of an electronic medium would: 23
(1) Give access to proprietary software; or 24
(2) Require the production of information that is confidential 25
and that cannot be redacted, deleted, concealed or separated from 26
information that is not otherwise confidential. 27
5. An officer, employee or agent of a governmental entity who 28
has legal custody or control of a public record: 29
(a) Shall not refuse to provide a copy of that public record in the 30
medium that is requested because the officer, employee or agent has 31
already prepared or would prefer to provide the copy in a different 32
medium. 33
(b) Except as otherwise provided in NRS 239.030, shall, upon 34
request, prepare the copy of the public record and shall not require 35
the person who has requested the copy to prepare the copy himself 36
or herself. 37
Sec. 12. NRS 287.010 is hereby amended to read as follows: 38
287.010 1. The governing body of any county, school 39
district, municipal corporation, political subdivision, public 40
corporation or other local governmental agency of the State of 41
Nevada may: 42
(a) Adopt and carry into effect a system of group life, accident 43
or health insurance, or any combination thereof, for the benefit of its 44
officers and employees, and the dependents of officers and 45
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employees who elect to accept the insurance and who, where 1
necessary, have authorized the governing body to make deductions 2
from their compensation for the payment of premiums on the 3
insurance. 4
(b) Purchase group policies of life, accident or health insurance, 5
or any combination thereof, for the benefit of such officers and 6
employees, and the dependents of such officers and employees, as 7
have authorized the purchase, from insurance companies authorized 8
to transact the business of such insurance in the State of Nevada, 9
and, where necessary, deduct from the compensation of officers and 10
employees the premiums upon insurance and pay the deductions 11
upon the premiums. 12
(c) Provide group life, accident or health coverage through a 13
self-insurance reserve fund and, where necessary, deduct 14
contributions to the maintenance of the fund from the compensation 15
of officers and employees and pay the deductions into the fund. The 16
money accumulated for this purpose through deductions from the 17
compensation of officers and employees and contributions of the 18
governing body must be maintained as an internal service fund as 19
defined by NRS 354.543. The money must be deposited in a state or 20
national bank or credit union authorized to transact business in the 21
State of Nevada. Any independent administrator of a fund created 22
under this section is subject to the licensing requirements of chapter 23
683A of NRS, and must be a resident of this State. Any contract 24
with an independent administrator must be approved by the 25
Commissioner of Insurance as to the reasonableness of 26
administrative charges in relation to contributions collected and 27
benefits provided. The provisions of NRS 439.581 to 439.597, 28
inclusive, and sections 2, 3 and 4 of this act, 686A.135, 687B.352, 29
687B.408, 687B.692, 687B.723, 687B.725, 687B.805, 689B.030 to 30
689B.0317, inclusive, paragraphs (b) and (c) of subsection 1 of NRS 31
689B.0319, subsections 2, 4, 6 and 7 of NRS 689B.0319, 689B.033 32
to 689B.0369, inclusive, 689B.0375 to 689B.050, inclusive, 33
689B.0675, 689B.265, 689B.287 and 689B.500 apply to coverage 34
provided pursuant to this paragraph, except that the provisions of 35
NRS 689B.0378, 689B.03785 and 689B.500 only apply to coverage 36
for active officers and employees of the governing body, or the 37
dependents of such officers and employees. 38
(d) Defray part or all of the cost of maintenance of a self-39
insurance fund or of the premiums upon insurance. The money for 40
contributions must be budgeted for in accordance with the laws 41
governing the county, school district, municipal corporation, 42
political subdivision, public corporation or other local governmental 43
agency of the State of Nevada. 44
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2. If a school district offers group insurance to its officers and 1
employees pursuant to this section, members of the board of trustees 2
of the school district must not be excluded from participating in the 3
group insurance. If the amount of the deductions from compensation 4
required to pay for the group insurance exceeds the compensation to 5
which a trustee is entitled, the difference must be paid by the trustee. 6
3. In any county in which a legal services organization exists, 7
the governing body of the county, or of any school district, 8
municipal corporation, political subdivision, public corporation or 9
other local governmental agency of the State of Nevada in the 10
county, may enter into a contract with the legal services 11
organization pursuant to which the officers and employees of the 12
legal services organization, and the dependents of those officers and 13
employees, are eligible for any life, accident or health insurance 14
provided pursuant to this section to the officers and employees, and 15
the dependents of the officers and employees, of the county, school 16
district, municipal corporation, political subdivision, public 17
corporation or other local governmental agency. 18
4. If a contract is entered into pursuant to subsection 3, the 19
officers and employees of the legal services organization: 20
(a) Shall be deemed, solely for the purposes of this section, to be 21
officers and employees of the county, school district, municipal 22
corporation, political subdivision, public corporation or other local 23
governmental agency with which the legal services organization has 24
contracted; and 25
(b) Must be required by the contract to pay the premiums or 26
contributions for all insurance which they elect to accept or of which 27
they authorize the purchase. 28
5. A contract that is entered into pursuant to subsection 3: 29
(a) Must be submitted to the Commissioner of Insurance for 30
approval not less than 30 days before the date on which the contract 31
is to become effective. 32
(b) Does not become effective unless approved by the 33
Commissioner. 34
(c) Shall be deemed to be approved if not disapproved by the 35
Commissioner within 30 days after its submission. 36
6. As used in this section, “legal services organization” means 37
an organization that operates a program for legal aid and receives 38
money pursuant to NRS 19.031. 39
Sec. 13. NRS 287.04335 is hereby amended to read as 40
follows: 41
287.04335 If the Board provides health insurance through a 42
plan of self-insurance, it shall comply with the provisions of NRS 43
439.581 to 439.597, inclusive, and sections 2, 3 and 4 of this act, 44
686A.135, 687B.352, 687B.409, 687B.692, 687B.723, 687B.725, 45
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687B.805, 689B.0353, 689B.255, 695C.1723, 695G.150, 695G.155, 1
695G.160, 695G.162, 695G.1635, 695G.164, 695G.1645, 2
695G.1665, 695G.167, 695G.1675, 695G.170 to 695G.1712, 3
inclusive, 695G.1714 to 695G.174, inclusive, 695G.176, 695G.177, 4
695G.200 to 695G.230, inclusive, 695G.241 to 695G.310, inclusive, 5
695G.405 and 695G.415, in the same manner as an insurer that is 6
licensed pursuant to title 57 of NRS is required to comply with those 7
provisions. 8
Sec. 14. NRS 603A.100 is hereby amended to read as follows: 9
603A.100 1. The provisions of NRS 603A.010 to 603A.290, 10
inclusive, do not apply to the maintenance or transmittal of 11
information in accordance with NRS 439.581 to 439.597, inclusive, 12
and sections 2, 3 and 4 of this act, and the regulations adopted 13
pursuant thereto. 14
2. A data collector who is also an operator, as defined in NRS 15
603A.330, shall comply with the provisions of NRS 603A.300 to 16
603A.360, inclusive. 17
3. Any waiver of the provisions of NRS 603A.010 to 18
603A.290, inclusive, is contrary to public policy, void and 19
unenforceable. 20
Sec. 15. NRS 629.051 is hereby amended to read as follows: 21
629.051 1. Except as otherwise provided in this section and 22
in regulations adopted by the State Board of Health pursuant to NRS 23
652.135 with regard to the records of a medical laboratory and 24
unless a longer period is provided by federal law, each custodian of 25
health care records shall retain the health care records of patients as 26
part of the regularly maintained records of the custodian for 5 years 27
after their receipt or production. Health care records may be retained 28
in written form, or by microfilm or any other recognized form of 29
size reduction, including, without limitation, microfiche, computer 30
disc, magnetic tape and optical disc, which does not adversely affect 31
their use for the purposes of NRS 629.061. Health care records: 32
(a) Must, except as otherwise provided in subsections 5 and 6 of 33
NRS 439.589, be created, maintained, transmitted and exchanged 34
electronically and integrated into the statewide electronic health 35
repository established pursuant to section 4 of this act, as required 36
by subsection 4 of NRS 439.589; and 37
(b) May be created, authenticated and stored in a health 38
information exchange which meets the requirements of NRS 39
439.581 to 439.597, inclusive, and sections 2, 3 and 4 of this act 40
and the regulations adopted pursuant thereto. 41
2. A provider of health care shall post, in a conspicuous place 42
in each location at which the provider of health care performs health 43
care services, a sign which discloses to patients that their health care 44
records may be destroyed after the period set forth in subsection 1. 45
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3. When a provider of health care performs health care services 1
for a patient for the first time, the provider of health care shall 2
deliver to the patient a written statement which discloses to the 3
patient that the health care records of the patient may be destroyed 4
after the period set forth in subsection 1. 5
4. If a provider of health care fails to deliver the written 6
statement to the patient pursuant to subsection 3, the provider of 7
health care shall deliver to the patient the written statement 8
described in subsection 3 when the provider of health care next 9
performs health care services for the patient. 10
5. In addition to delivering a written statement pursuant to 11
subsection 3 or 4, a provider of health care may deliver such a 12
written statement to a patient at any other time. 13
6. A written statement delivered to a patient pursuant to this 14
section may be included with other written information delivered to 15
the patient by a provider of health care. 16
7. A custodian of health care records shall not destroy the 17
health care records of a person who is less than 23 years of age on 18
the date of the proposed destruction of the records. The health care 19
records of a person who has attained the age of 23 years may be 20
destroyed in accordance with this section for those records which 21
have been retained for at least 5 years or for any longer period 22
provided by federal law. 23
8. If a health care licensing board receives notification from the 24
Department of Health and Human Services pursuant to NRS 25
439.5895 that a provider of health care to which the health care 26
licensing board has issued a license is not in compliance with the 27
requirements of subsection 4 of NRS 439.589, the health care 28
licensing board may, after notice and the opportunity for a hearing 29
in accordance with the provisions of this title, require corrective 30
action or impose an administrative penalty in an amount not to 31
exceed the maximum penalty that the health care licensing board is 32
authorized to impose for other violations. The health care licensing 33
board shall not suspend or revoke a license for failure to comply 34
with the requirements of subsection 4 of NRS 439.589. 35
9. The provisions of this section, except for the provisions of 36
paragraph (a) of subsection 1 and subsection 8, do not apply to a 37
pharmacist. 38
10. The State Board of Health shall adopt: 39
(a) Regulations prescribing the form, size, contents and 40
placement of the signs and written statements required pursuant to 41
this section; and 42
(b) Any other regulations necessary to carry out the provisions 43
of this section. 44
11. As used in this section: 45
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(a) “Health care licensing board” means: 1
(1) A board created pursuant to chapter 630, 630A, 631, 632, 2
633, 634, 634A, 635, 636, 637, 637B, 639, 640, 640A, 640B, 640C, 3
641, 641A, 641B, 641C or 641D of NRS. 4
(2) The Division of Public and Behavioral Health of the 5
Department of Health and Human Services. 6
(3) The State Board of Health with respect to licenses issued 7
pursuant to chapter 640D or 640E of NRS. 8
(b) “License” has the meaning ascribed to it in NRS 439.5895. 9
Sec. 16. NRS 719.200 is hereby amended to read as follows: 10
719.200 1. Except as otherwise provided in subsection 2, the 11
provisions of this chapter apply to electronic records and electronic 12
signatures relating to a transaction. 13
2. The provisions of this chapter do not apply to a transaction 14
to the extent it is governed by: 15
(a) Except as otherwise specifically provided by law, a law 16
governing the creation and execution of wills, codicils or 17
testamentary trusts; 18
(b) The Uniform Commercial Code other than NRS 104.1306, 19
104.2101 to 104.2725, inclusive, and 104A.2101 to 104A.2532, 20
inclusive; or 21
(c) The provisions of NRS 439.581 to 439.597, inclusive, and 22
sections 2, 3 and 4 of this act and the regulations adopted pursuant 23
thereto. 24
3. The provisions of this chapter apply to an electronic record 25
or electronic signature otherwise excluded from the application of 26
this chapter under subsection 2 to the extent it is governed by a law 27
other than those specified in subsection 2. 28
4. A transaction subject to the provisions of this chapter is also 29
subject to other applicable substantive law. 30
Sec. 17. 1. Notwithstanding the amendatory provisions of 31
sections 8 and 15 of this act, physician group practices or other 32
business entities organized for the purpose of practicing a health 33
care profession with 20 or fewer employees, including, without 34
limitation, sole proprietorships, are not required to comply with the 35
provisions of subsection 4 of NRS 439.589, as amended by section 36
8 of this act, until January 1, 2030. 37
2. As used in this section, “physician group practice” means 38
any business entity organized for the purpose of the practice of 39
medicine or osteopathic medicine by more than one physician. 40
Sec. 18. The provisions of NRS 354.599 do not apply to any 41
additional expenses of a local government that are related to the 42
provisions of this act. 43
Sec. 19. 1. This section becomes effective upon passage and 44
approval. 45
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2. Sections 1 to 18, inclusive, of this act become effective: 1
(a) Upon passage and approval for the purpose of adopting any 2
regulations and performing any other preliminary administrative 3
tasks that are necessary to carry out the provisions of this act; and 4
(b) On January 1, 2026, for all other purposes. 5
H