S.B. 257
- *SB257*
SENATE BILL NO. 257–SENATORS DONDERO LOOP, CRUZ-
CRAWFORD, KRASNER, OHRENSCHALL; CANNIZZARO,
FLORES, NGUYEN AND PAZINA
FEBRUARY 27, 2025
____________
JOINT SPONSOR: ASSEMBLYMEMBER TORRES-FOSSETT
____________
Referred to Committee on Health and Human Services
SUMMARY—Revises provisions relating to autism. (BDR 38-106)
FISCAL NOTE: Effect on Local Government: May have Fiscal Impact.
Effect on the State: Yes.
CONTAINS UNFUNDED MANDATE (§ 5)
(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 autism; revising requirements governing the
statewide standard for measuring outcomes and assessing
and evaluating certain persons with autism spectrum
disorders; revising requirements governing early
intervention services for persons with autism spectrum
disorders; requiring an insurer to accept as dispositive
certain diagnoses of persons with autism spectrum
disorders for purposes related to required coverage for the
diagnosis and treatment of such disorders; requiring
insurers to cover such diagnosis and treatment provided
by any provider of health care acting within his or her
scope of practice; and providing other matters properly
relating thereto.
Legislative Counsel’s Digest:
Existing law requires the Aging and Disability Services Division of the 1
Department of Health and Human Services to prescribe by regulation a statewide 2
standard for measuring outcomes and assessing and evaluating persons with autism 3
spectrum disorders through the age of 21 years who receive services through the 4
State or a local government or an agency thereof. Existing law requires those 5
regulations to designate a protocol based upon accepted best practices guidelines 6
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which includes at least one standardized assessment instrument that requires direct 7
observation by the professional conducting the assessment for determining whether 8
a person is a person with autism spectrum disorder. Existing law requires such 9
direct observation to include an evaluation to measure behaviors of the person 10
which are consistent with autism spectrum disorder, cognitive functioning, 11
language functioning and adaptive functioning. (NRS 427A.872) Section 3 of this 12
bill removes the requirements that the statewide standard include a specific 13
protocol, a standardized assessment instrument and an evaluation to measure 14
behaviors which are consistent with autism spectrum disorder. Instead, section 3 15
requires the statewide standard to require direct observation and an assessment to 16
determine whether a person is a person with autism spectrum disorder. Section 3 17
authorizes any provider of health care acting within his or her scope of practice to 18
conduct such direct observation and assessment. Section 4 of this bill makes similar 19
revisions relating to early intervention services provided by the Division for 20
children with autism spectrum disorders. Specifically, section 4: (1) replaces 21
references to an evaluation of a child who may have autism spectrum disorder by 22
the Division with references to an assessment of such a child; and (2) authorizes 23
any provider of health care acting within his or her scope of practice to conduct 24
such an assessment. Section 1 of this bill defines the term “provider of health care” 25
for those purposes, and section 2 of this bill prescribes the applicability of that 26
definition. 27
Existing law requires the Division to ensure that employees and contractors of 28
the Division who provide early intervention services to children with autism 29
spectrum disorders possess the knowledge and skills necessary to serve children 30
with autism spectrum disorders, including the screening of a child for autism 31
spectrum disorder at certain age levels and frequency. (NRS 427A.878) Section 4 32
specifies that such persons must possess the knowledge and skills necessary to 33
conduct early and periodic developmental screening of a child for that purpose. 34
Existing law requires certain plans of health insurance, including insurance for 35
public employees and Medicaid managed care plans, to cover screening for and 36
diagnosis of autism spectrum disorders and for treatment of autism spectrum 37
disorders to persons under the age of 18 years or, if enrolled in high school, until 38
the person reaches the age of 22 years. In order for coverage of such treatment to be 39
required, existing law requires: (1) the diagnosis to be rendered by a licensed 40
physician or psychologist; (2) the treatment to be included in a treatment plan 41
developed by a licensed physician or psychologist; and (3) the treatment to be 42
provided by or under the supervision of a licensed physician, psychologist or 43
behavior analyst. (NRS 287.0276, 287.04335, 689A.0435, 689B.0335, 689C.1655, 44
695C.050, 695C.1717, 695G.1645) Sections 5-10 of this bill remove requirements 45
that, in order for such coverage to be required, the diagnosis must be rendered by 46
specific providers of health care and the treatment plan must be developed and 47
carried out by specific providers of health care. Instead, sections 5-10 require 48
certain plans of health insurance to cover such diagnosis and treatment if the 49
diagnosis, development of a treatment plan and treatment are performed by any 50
provider of health care acting within his or her scope of practice. Sections 5-10 also 51
require an insurer to accept as dispositive for the purposes of such coverage any 52
diagnosis of an autism spectrum disorder that is rendered in accordance with the 53
statewide standard prescribed pursuant to section 3. 54
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THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1. Chapter 427A of NRS is hereby amended by 1
adding thereto a new section to read as follows: 2
“Provider of health care” has the meaning ascribed to it in 3
NRS 629.031. 4
Sec. 2. NRS 427A.871 is hereby amended to read as follows: 5
427A.871 As used in NRS 427A.871 to 427A.8803, inclusive, 6
and section 1 of this act, unless the context otherwise requires, the 7
words and terms defined in NRS 427A.8713 and 427A.8715 and 8
section 1 of this act have the meanings ascribed to them in those 9
sections. 10
Sec. 3. NRS 427A.872 is hereby amended to read as follows: 11
427A.872 1. The Division, in cooperation and guidance with 12
the Department of Education, representatives of the school districts 13
in this State and the Commission, shall prescribe by regulation a 14
statewide standard for measuring outcomes and assessing [and 15
evaluating] persons with autism spectrum disorders through the age 16
of 21 years who receive services through the State or a local 17
government or an agency thereof. The regulations must [designate a 18
protocol based upon accepted] align with best practices guidelines 19
[which includes at least one standardized assessment instrument that 20
requires] and require direct observation by [the professional] a 21
provider of health care conducting [the] an assessment for 22
determining whether a person is a person with autism spectrum 23
disorder . [, which] The statewide standard must be used by 24
personnel employed by the State or a local government or an agency 25
thereof who provide assessments, interventions and diagnoses of 26
persons with autism spectrum disorders through the age of 21 years 27
and by the persons with whom the State or a local government or an 28
agency thereof contracts to provide assessments, interventions and 29
diagnoses of persons with autism spectrum disorders through the 30
age of 21 years. [The protocol must require that the direct 31
observation conducted by a professional pursuant to this subsection 32
include, without limitation, an evaluation to measure behaviors of 33
the person which are consistent with autism spectrum disorder, 34
cognitive functioning, language functioning and adaptive 35
functioning.] 36
2. The statewide standard prescribed pursuant to subsection 1 37
must authorize a provider of health care to directly observe a 38
person and complete an assessment to determine whether the 39
person is a person with autism spectrum disorder so long as 40
conducting such observation and completing such an assessment 41
are within the scope of practice of the provider of health care. 42
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3. The [protocol designated] statewide standard prescribed 1
pursuant to subsection 1 must be used upon intake of a person 2
suspected of having autism spectrum disorder or at any later time if 3
a person is suspected of having autism spectrum disorder after 4
intake. The results of an assessment must be provided to the parent 5
or legal guardian of the person, if applicable. 6
[3.] 4. The Division shall prescribe the form and content of 7
reports relating to persons with autism spectrum disorders through 8
the age of 21 years that must be reported to the Division pursuant to 9
NRS 388.451 and 615.205. Except as otherwise provided in NRS 10
388.451, the Division shall ensure that the information is reported in 11
a manner which: 12
(a) Allows the Division to document the services provided to 13
and monitor the progress of each person with autism spectrum 14
disorder through the age of 21 years who receives services from the 15
State or an agency thereof; and 16
(b) Ensures that information reported for each person who 17
receives services which identifies the person is kept confidential, 18
consistent with the Family Educational Rights and Privacy Act of 19
1974, 20 U.S.C. § 1232g, and any other applicable state and federal 20
privacy laws. 21
[4.] 5. The Division shall prepare annually a summary of the 22
reports submitted pursuant to NRS 388.451 and 615.205 and make 23
the summary publicly available. The Division shall ensure that 24
information contained in the summary does not identify a person 25
who received services. 26
Sec. 4. NRS 427A.878 is hereby amended to read as follows: 27
427A.878 1. The Division shall ensure that the personnel 28
employed by the Division who provide early intervention services to 29
children with autism spectrum disorders and the persons with whom 30
the Division contracts to provide early intervention services to 31
children with autism spectrum disorders possess the knowledge and 32
skills necessary to serve children with autism spectrum disorders, 33
including, without limitation: 34
(a) [The] Early and periodic developmental screening of a child 35
for autism spectrum disorder at the age levels and frequency 36
recommended by the American Academy of Pediatrics, or its 37
successor organization; 38
(b) The procedure for [evaluating] assessing children who 39
demonstrate behaviors that are consistent with autism spectrum 40
disorders, which procedure must require the use of the statewide 41
standard for measuring outcomes and assessing [and evaluating] 42
persons with autism spectrum disorders through the age of 21 years 43
prescribed pursuant to NRS 427A.872; 44
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(c) The procedure for enrolling a child in early intervention 1
services upon determining that the child has autism spectrum 2
disorder; 3
(d) Methods of providing support to children with autism 4
spectrum disorders and their families; and 5
(e) The procedure for developing an individualized family 6
service plan in accordance with Part C of the Individuals with 7
Disabilities Education Act, 20 U.S.C. §§ 1431 et seq., or other 8
appropriate plan for the child. 9
2. The Division shall ensure that the personnel employed by 10
the Division to provide early intervention services to children with 11
autism spectrum disorders and the persons with whom the Division 12
contracts to provide early intervention services to children with 13
autism spectrum disorders: 14
(a) Possess the knowledge and understanding of the scientific 15
research and support for the methods and approaches for serving 16
children with autism spectrum disorders and the ability to recognize 17
the difference between an approach or method that is scientifically 18
validated and one that is not; 19
(b) Possess the knowledge to accurately describe to parents and 20
guardians the research supporting the methods and approaches, 21
including, without limitation, the knowledge necessary to provide an 22
explanation that a method or approach is experimental if it is not 23
supported by scientific evidence; 24
(c) Immediately notify a parent or legal guardian if a child is 25
identified as being at risk for a diagnosis of autism spectrum 26
disorder and refer the parent or legal guardian to the appropriate 27
professionals for further evaluation and simultaneously refer the 28
parent or legal guardian to any appropriate early intervention 29
services and strategies; and 30
(d) Provide the parent or legal guardian with information on 31
evidence-based treatments and interventions that may assist the 32
child in the child’s development and advancement. 33
3. The Division shall ensure that the personnel employed by 34
the Division who provide early intervention screenings to children 35
and the persons with whom the Division contracts to provide early 36
intervention screenings to children perform screenings of children 37
for autism spectrum disorders at the age levels and frequency 38
recommended by the American Academy of Pediatrics, or its 39
successor organization. 40
4. The Division shall ensure that: 41
(a) For a child who may have autism spectrum disorder, the 42
personnel employed by the Division who provide early intervention 43
screenings to children and the persons with whom the Division 44
contracts to provide early intervention screenings to children use the 45
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[protocol designated] statewide standard prescribed pursuant to 1
NRS 427A.872 for determining whether a child has autism spectrum 2
disorder. 3
(b) An initial [evaluation] assessment of the cognitive, 4
communicative, social, emotional and behavioral condition and 5
adaptive skill level of a child with autism spectrum disorder is 6
conducted by a provider of health care acting within his or her 7
scope of practice to determine the baseline of the child. 8
(c) A subsequent [evaluation] assessment is conducted by a 9
provider of health care acting within his or her scope of practice 10
upon the child’s conclusion of the early intervention services to 11
determine the progress made by the child from the time of his or her 12
initial screening. 13
Sec. 5. NRS 287.0276 is hereby amended to read as follows: 14
287.0276 1. The governing body of any county, school 15
district, municipal corporation, political subdivision, public 16
corporation or other local governmental agency of the State of 17
Nevada that provides health insurance through a plan of self-18
insurance must provide coverage for screening for and diagnosis of 19
autism spectrum disorders and for treatment of autism spectrum 20
disorders to persons covered by the plan of self-insurance under the 21
age of 18 years or, if enrolled in high school, until the person 22
reaches the age of 22 years. For the purposes of such coverage, the 23
governing body of a county, school district, municipal corporation, 24
political subdivision, public corporation or other local 25
governmental agency shall accept as dispositive any diagnosis of 26
an autism spectrum disorder that is rendered in accordance with 27
the statewide standard for measuring outcomes and assessing 28
persons with autism spectrum disorders through the age of 21 29
years prescribed pursuant to NRS 427A.872. 30
2. Coverage provided under this section is subject to: 31
(a) A maximum benefit of the actuarial equivalent of $72,000 32
per year for applied behavior analysis treatment; and 33
(b) Copayment, deductible and coinsurance provisions and any 34
other general exclusion or limitation of a plan of self-insurance to 35
the same extent as other medical services or prescription drugs 36
covered by the policy. 37
3. A governing body of any county, school district, municipal 38
corporation, political subdivision, public corporation or other local 39
governmental agency of the State of Nevada that provides health 40
insurance through a plan of self-insurance which provides coverage 41
for outpatient care shall not: 42
(a) Require an insured to pay a higher deductible, copayment or 43
coinsurance or require a longer waiting period for coverage for 44
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outpatient care related to autism spectrum disorders than is required 1
for other outpatient care covered by the plan of self-insurance; or 2
(b) Refuse to issue a plan of self-insurance or cancel a plan of 3
self-insurance solely because the person applying for or covered by 4
the plan of self-insurance uses or may use in the future any of the 5
services listed in subsection 1. 6
4. Except as otherwise provided in subsections 1 and 2, a 7
governing body of any county, school district, municipal 8
corporation, political subdivision, public corporation or other local 9
governmental agency of the State of Nevada that provides health 10
insurance through a plan of self-insurance shall not limit the number 11
of visits an insured may make to any person, entity or group for 12
treatment of autism spectrum disorders. 13
5. Treatment of autism spectrum disorders must be identified in 14
a treatment plan and may include medically necessary habilitative or 15
rehabilitative care, prescription care, psychiatric care, psychological 16
care, behavioral therapy or therapeutic care that is: 17
(a) Prescribed for a person diagnosed with an autism spectrum 18
disorder by a [licensed physician or licensed psychologist;] provider 19
of health care acting within his or her scope of practice; and 20
(b) Provided for a person diagnosed with an autism spectrum 21
disorder by a [licensed physician, licensed psychologist, licensed 22
behavior analyst or other provider that is supervised by the licensed 23
physician, psychologist or behavior analyst.] provider of health 24
care acting within his or her scope of practice. 25
A governing body of any county, school district, municipal 26
corporation, political subdivision, public corporation or other local 27
governmental agency of the State of Nevada that provides health 28
insurance through a plan of self-insurance may request a copy of 29
and review a treatment plan created pursuant to this subsection. 30
6. A plan of self-insurance subject to the provisions of this 31
chapter that is delivered, issued for delivery or renewed on or after 32
[July] January 1, [2011,] 2026, has the legal effect of including the 33
coverage required by subsection 1, and any provision of the plan of 34
self-insurance or the renewal which is in conflict with subsection 1 35
or 2 is void. 36
7. Nothing in this section shall be construed as requiring a 37
governing body of any county, school district, municipal 38
corporation, political subdivision, public corporation or other local 39
governmental agency of the State of Nevada that provides health 40
insurance through a plan of self-insurance to provide reimbursement 41
to a school for services delivered through school services. 42
8. As used in this section: 43
(a) “Applied behavior analysis” means the design, 44
implementation and evaluation of environmental modifications 45
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using behavioral stimuli and consequences to produce socially 1
significant improvement in human behavior, including, without 2
limitation, the use of direct observation, measurement and 3
functional analysis of the relations between environment and 4
behavior. 5
(b) “Autism spectrum disorder” has the meaning ascribed to it in 6
NRS 427A.875. 7
(c) “Behavioral therapy” means any interactive therapy derived 8
from evidence-based research, including, without limitation, discrete 9
trial training, early intensive behavioral intervention, intensive 10
intervention programs, pivotal response training and verbal behavior 11
provided by a licensed psychologist, licensed behavior analyst, 12
licensed assistant behavior analyst or registered behavior technician. 13
(d) “Evidence-based research” means research that applies 14
rigorous, systematic and objective procedures to obtain valid 15
knowledge relevant to autism spectrum disorders. 16
(e) “Habilitative or rehabilitative care” means counseling, 17
guidance and professional services and treatment programs, 18
including, without limitation, applied behavior analysis, that are 19
necessary to develop, maintain and restore, to the maximum extent 20
practicable, the functioning of a person. 21
(f) “Licensed assistant behavior analyst” has the meaning 22
ascribed to the term “assistant behavior analyst” in NRS 641D.020. 23
(g) “Licensed behavior analyst” has the meaning ascribed to the 24
term “behavior analyst” in NRS 641D.030. 25
(h) “Prescription care” means medications prescribed by a 26
licensed physician and any health-related services deemed medically 27
necessary to determine the need or effectiveness of the medications. 28
(i) “Provider of health care” has the meaning ascribed to it in 29
NRS 629.031. 30
(j) “Psychiatric care” means direct or consultative services 31
provided by a psychiatrist licensed in the state in which the 32
psychiatrist practices. 33
[(j)] (k) “Psychological care” means direct or consultative 34
services provided by a psychologist licensed in the state in which 35
the psychologist practices. 36
[(k)] (l) “Registered behavior technician” has the meaning 37
ascribed to it in NRS 641D.090. 38
[(l)] (m) “Screening for autism spectrum disorders” means all 39
medically appropriate assessments, evaluations or tests to diagnose 40
whether a person has an autism spectrum disorder. 41
[(m)] (n) “Therapeutic care” means services provided by 42
licensed or certified speech-language pathologists, occupational 43
therapists and physical therapists. 44
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[(n)] (o) “Treatment plan” means a plan to treat an autism 1
spectrum disorder that is [prescribed] developed by a [licensed 2
physician or licensed psychologist and may be developed pursuant 3
to a comprehensive evaluation in coordination with a licensed 4
behavior analyst.] provider of health care acting within his or her 5
scope of practice after he or she has assessed the person for whom 6
the treatment plan is developed. 7
Sec. 6. NRS 689A.0435 is hereby amended to read as follows: 8
689A.0435 1. A health benefit plan must provide an option 9
of coverage for screening for and diagnosis of autism spectrum 10
disorders and for treatment of autism spectrum disorders for persons 11
covered by the policy under the age of 18 years or, if enrolled in 12
high school, until the person reaches the age of 22 years. For the 13
purposes of such coverage, an insurer shall accept as dispositive 14
any diagnosis of an autism spectrum disorder that is rendered in 15
accordance with the statewide standard for measuring outcomes 16
and assessing persons with autism spectrum disorders through the 17
age of 21 years prescribed pursuant to NRS 427A.872. 18
2. Optional coverage provided pursuant to this section must be 19
subject to: 20
(a) A maximum benefit of not less than the actuarial equivalent 21
of $72,000 per year for applied behavior analysis treatment; and 22
(b) Copayment, deductible and coinsurance provisions and any 23
other general exclusions or limitations of a policy of health 24
insurance to the same extent as other medical services or 25
prescription drugs covered by the policy. 26
3. A health benefit plan that offers or issues a policy of health 27
insurance which provides coverage for outpatient care shall not: 28
(a) Require an insured to pay a higher deductible, copayment or 29
coinsurance or require a longer waiting period for optional coverage 30
for outpatient care related to autism spectrum disorders than is 31
required for other outpatient care covered by the policy; or 32
(b) Refuse to issue a policy of health insurance or cancel a 33
policy of health insurance solely because the person applying for or 34
covered by the policy uses or may use in the future any of the 35
services listed in subsection 1. 36
4. Except as otherwise provided in subsections 1 and 2, an 37
insurer who offers optional coverage pursuant to subsection 1 shall 38
not limit the number of visits an insured may make to any person, 39
entity or group for treatment of autism spectrum disorders. 40
5. Treatment of autism spectrum disorders must be identified in 41
a treatment plan and may include medically necessary habilitative or 42
rehabilitative care, prescription care, psychiatric care, psychological 43
care, behavioral therapy or therapeutic care that is: 44
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(a) Prescribed for a person diagnosed with an autism spectrum 1
disorder by a [licensed physician or licensed psychologist;] provider 2
of health care acting within his or her scope of practice; and 3
(b) Provided for a person diagnosed with an autism spectrum 4
disorder by a [licensed physician, licensed psychologist, licensed 5
behavior analyst or other provider that is supervised by the licensed 6
physician, psychologist or behavior analyst.] provider of health 7
care acting within his or her scope of practice. 8
An insurer may request a copy of and review a treatment plan 9
created pursuant to this subsection. 10
6. Nothing in this section shall be construed as requiring an 11
insurer to provide reimbursement to a school for services delivered 12
through school services. 13
7. As used in this section: 14
(a) “Applied behavior analysis” means the design, 15
implementation and evaluation of environmental modifications 16
using behavioral stimuli and consequences to produce socially 17
significant improvement in human behavior, including, without 18
limitation, the use of direct observation, measurement and 19
functional analysis of the relations between environment and 20
behavior. 21
(b) “Autism spectrum disorder” has the meaning ascribed to it in 22
NRS 427A.875. 23
(c) “Behavioral therapy” means any interactive therapy derived 24
from evidence-based research, including, without limitation, discrete 25
trial training, early intensive behavioral intervention, intensive 26
intervention programs, pivotal response training and verbal behavior 27
provided by a licensed psychologist, licensed behavior analyst, 28
licensed assistant behavior analyst or registered behavior technician. 29
(d) “Evidence-based research” means research that applies 30
rigorous, systematic and objective procedures to obtain valid 31
knowledge relevant to autism spectrum disorders. 32
(e) “Habilitative or rehabilitative care” means counseling, 33
guidance and professional services and treatment programs, 34
including, without limitation, applied behavior analysis, that are 35
necessary to develop, maintain and restore, to the maximum extent 36
practicable, the functioning of a person. 37
(f) “Licensed assistant behavior analyst” has the meaning 38
ascribed to the term “assistant behavior analyst” in NRS 641D.020. 39
(g) “Licensed behavior analyst” has the meaning ascribed to the 40
term “behavior analyst” in NRS 641D.030. 41
(h) “Prescription care” means medications prescribed by a 42
licensed physician and any health-related services deemed medically 43
necessary to determine the need or effectiveness of the medications. 44
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(i) “Provider of health care” has the meaning ascribed to it in 1
NRS 629.031. 2
(j) “Psychiatric care” means direct or consultative services 3
provided by a psychiatrist licensed in the state in which the 4
psychiatrist practices. 5
[(j)] (k) “Psychological care” means direct or consultative 6
services provided by a psychologist licensed in the state in which 7
the psychologist practices. 8
[(k)] (l) “Registered behavior technician” has the meaning 9
ascribed to it in NRS 641D.100. 10
[(l)] (m) “Screening for autism spectrum disorders” means 11
medically necessary assessments, evaluations or tests to screen and 12
diagnose whether a person has an autism spectrum disorder. 13
[(m)] (n) “Therapeutic care” means services provided by 14
licensed or certified speech-language pathologists, occupational 15
therapists and physical therapists. 16
[(n)] (o) “Treatment plan” means a plan to treat an autism 17
spectrum disorder that is [prescribed] developed by a [licensed 18
physician or licensed psychologist and may be developed pursuant 19
to a comprehensive evaluation in coordination with a licensed 20
behavior analyst.] provider of health care acting within his or her 21
scope of practice after he or she has assessed the person for whom 22
the treatment plan is developed. 23
Sec. 7. NRS 689B.0335 is hereby amended to read as follows: 24
689B.0335 1. A health benefit plan must provide coverage 25
for screening for and diagnosis of autism spectrum disorders and for 26
treatment of autism spectrum disorders to persons covered by the 27
policy of group health insurance under the age of 18 years or, if 28
enrolled in high school, until the person reaches the age of 22 years. 29
For the purposes of such coverage, an insurer shall accept as 30
dispositive any diagnosis of an autism spectrum disorder that is 31
rendered in accordance with the statewide standard for measuring 32
outcomes and assessing persons with autism spectrum disorders 33
through the age of 21 years prescribed pursuant to NRS 427A.872. 34
2. Coverage provided under this section is subject to: 35
(a) A maximum benefit of the actuarial equivalent of $72,000 36
per year for applied behavior analysis treatment; and 37
(b) Copayment, deductible and coinsurance provisions and any 38
other general exclusion or limitation of a policy of group health 39
insurance to the same extent as other medical services or 40
prescription drugs covered by the policy. 41
3. A health benefit plan that offers or issues a policy of group 42
health insurance which provides coverage for outpatient care shall 43
not: 44
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(a) Require an insured to pay a higher deductible, copayment or 1
coinsurance or require a longer waiting period for coverage for 2
outpatient care related to autism spectrum disorders than is required 3
for other outpatient care covered by the policy; or 4
(b) Refuse to issue a policy of group health insurance or cancel a 5
policy of group health insurance solely because the person applying 6
for or covered by the policy uses or may use in the future any of the 7
services listed in subsection 1. 8
4. Except as otherwise provided in subsections 1 and 2, an 9
insurer shall not limit the number of visits an insured may make to 10
any person, entity or group for treatment of autism spectrum 11
disorders. 12
5. Treatment of autism spectrum disorders must be identified in 13
a treatment plan and may include medically necessary habilitative or 14
rehabilitative care, prescription care, psychiatric care, psychological 15
care, behavioral therapy or therapeutic care that is: 16
(a) Prescribed for a person diagnosed with an autism spectrum 17
disorder by a [licensed physician or licensed psychologist;] provider 18
of health care acting within his or her scope of practice; and 19
(b) Provided for a person diagnosed with an autism spectrum 20
disorder by a [licensed physician, licensed psychologist, licensed 21
behavior analyst or other provider that is supervised by the licensed 22
physician, psychologist or behavior analyst.] provider of health 23
care acting within his or her scope of practice. 24
An insurer may request a copy of and review a treatment plan 25
created pursuant to this subsection. 26
6. A policy subject to the provisions of this chapter that is 27
delivered, issued for delivery or renewed on or after January 1, 28
[2011,] 2026, has the legal effect of including the coverage required 29
by subsection 1, and any provision of the policy or the renewal 30
which is in conflict with subsection 1 or 2 is void. 31
7. Nothing in this section shall be construed as requiring an 32
insurer to provide reimbursement to a school for services delivered 33
through school services. 34
8. As used in this section: 35
(a) “Applied behavior analysis” means the design, 36
implementation and evaluation of environmental modifications 37
using behavioral stimuli and consequences to produce socially 38
significant improvement in human behavior, including, without 39
limitation, the use of direct observation, measurement and 40
functional analysis of the relations between environment and 41
behavior. 42
(b) “Autism spectrum disorder” has the meaning ascribed to it in 43
NRS 427A.875. 44
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(c) “Behavioral therapy” means any interactive therapy derived 1
from evidence-based research, including, without limitation, discrete 2
trial training, early intensive behavioral intervention, intensive 3
intervention programs, pivotal response training and verbal behavior 4
provided by a licensed psychologist, licensed behavior analyst, 5
licensed assistant behavior analyst or registered behavior technician. 6
(d) “Evidence-based research” means research that applies 7
rigorous, systematic and objective procedures to obtain valid 8
knowledge relevant to autism spectrum disorders. 9
(e) “Habilitative or rehabilitative care” means counseling, 10
guidance and professional services and treatment programs, 11
including, without limitation, applied behavior analysis, that are 12
necessary to develop, maintain and restore, to the maximum extent 13
practicable, the functioning of a person. 14
(f) “Licensed assistant behavior analyst” has the meaning 15
ascribed to the term “assistant behavior analyst” in NRS 641D.020. 16
(g) “Licensed behavior analyst” has the meaning ascribed to the 17
term “behavior analyst” in NRS 641D.030. 18
(h) “Prescription care” means medications prescribed by a 19
licensed physician and any health-related services deemed medically 20
necessary to determine the need or effectiveness of the medications. 21
(i) “Provider of health care” has the meaning ascribed to it in 22
NRS 629.031. 23
(j) “Psychiatric care” means direct or consultative services 24
provided by a psychiatrist licensed in the state in which the 25
psychiatrist practices. 26
[(j)] (k) “Psychological care” means direct or consultative 27
services provided by a psychologist licensed in the state in which 28
the psychologist practices. 29
[(k)] (l) “Registered behavior technician” has the meaning 30
ascribed to it in NRS 641D.100. 31
[(l)] (m) “Screening for autism spectrum disorders” means 32
medically necessary assessments, evaluations or tests to screen and 33
diagnose whether a person has an autism spectrum disorder. 34
[(m)] (n) “Therapeutic care” means services provided by 35
licensed or certified speech-language pathologists, occupational 36
therapists and physical therapists. 37
[(n)] (o) “Treatment plan” means a plan to treat an autism 38
spectrum disorder that is [prescribed] developed by a [licensed 39
physician or licensed psychologist and may be developed pursuant 40
to a comprehensive evaluation in coordination with a licensed 41
behavior analyst.] provider of health care acting within his or her 42
scope of practice after he or she has assessed the person for whom 43
the treatment plan is developed. 44
– 14 –
- *SB257*
Sec. 8. NRS 689C.1655 is hereby amended to read as follows: 1
689C.1655 1. A health benefit plan must provide coverage 2
for screening for and diagnosis of autism spectrum disorders and for 3
treatment of autism spectrum disorders to persons covered by the 4
health benefit plan under the age of 18 years or, if enrolled in high 5
school, until the person reaches the age of 22 years. For the 6
purposes of such coverage, a carrier shall accept as dispositive any 7
diagnosis of an autism spectrum disorder that is rendered in 8
accordance with the statewide standard for measuring outcomes 9
and assessing persons with autism spectrum disorders through the 10
age of 21 years prescribed pursuant to NRS 427A.872. 11
2. Coverage provided under this section is subject to: 12
(a) A maximum benefit of the actuarial equivalent of $72,000 13
per year for applied behavior analysis treatment; and 14
(b) Copayment, deductible and coinsurance provisions and any 15
other general exclusion or limitation of a health benefit plan to the 16
same extent as other medical services or prescription drugs covered 17
by the plan. 18
3. A health benefit plan that offers or issues a policy of group 19
health insurance which provides coverage for outpatient care shall 20
not: 21
(a) Require an insured to pay a higher deductible, copayment or 22
coinsurance or require a longer waiting period for coverage for 23
outpatient care related to autism spectrum disorders than is required 24
for other outpatient care covered by the plan; or 25
(b) Refuse to issue a health benefit plan or cancel a health 26
benefit plan solely because the person applying for or covered by 27
the plan uses or may use in the future any of the services listed in 28
subsection 1. 29
4. Except as otherwise provided in subsections 1 and 2, a 30
carrier shall not limit the number of visits an insured may make to 31
any person, entity or group for treatment of autism spectrum 32
disorders. 33
5. Treatment of autism spectrum disorders must be identified in 34
a treatment plan and may include medically necessary habilitative or 35
rehabilitative care, prescription care, psychiatric care, psychological 36
care, behavioral therapy or therapeutic care that is: 37
(a) Prescribed for a person diagnosed with an autism spectrum 38
disorder by a [licensed physician or licensed psychologist;] provider 39
of health care acting within his or her scope of practice; and 40
(b) Provided for a person diagnosed with an autism spectrum 41
disorder by a [licensed physician, licensed psychologist, licensed 42
behavior analyst or other provider that is supervised by the licensed 43
physician, psychologist or behavior analyst.] provider of health 44
care acting within his or her scope of practice. 45
– 15 –
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A carrier may request a copy of and review a treatment plan 1
created pursuant to this subsection. 2
6. A health benefit plan subject to the provisions of this chapter 3
that is delivered, issued for delivery or renewed on or after 4
January 1, [2011,] 2026, has the legal effect of including the 5
coverage required by subsection 1, and any provision of the plan or 6
the renewal which is in conflict with subsection 1 or 2 is void. 7
7. Nothing in this section shall be construed as requiring a 8
carrier to provide reimbursement to a school for services delivered 9
through school services. 10
8. As used in this section: 11
(a) “Applied behavior analysis” means the design, 12
implementation and evaluation of environmental modifications 13
using behavioral stimuli and consequences to produce socially 14
significant improvement in human behavior, including, without 15
limitation, the use of direct observation, measurement and 16
functional analysis of the relations between environment and 17
behavior. 18
(b) “Autism spectrum disorder” has the meaning ascribed to it in 19
NRS 427A.875. 20
(c) “Behavioral therapy” means any interactive therapy derived 21
from evidence-based research, including, without limitation, discrete 22
trial training, early intensive behavioral intervention, intensive 23
intervention programs, pivotal response training and verbal behavior 24
provided by a licensed psychologist, licensed behavior analyst, 25
licensed assistant behavior analyst or registered behavior technician. 26
(d) “Evidence-based research” means research that applies 27
rigorous, systematic and objective procedures to obtain valid 28
knowledge relevant to autism spectrum disorders. 29
(e) “Habilitative or rehabilitative care” means counseling, 30
guidance and professional services and treatment programs, 31
including, without limitation, applied behavior analysis, that are 32
necessary to develop, maintain and restore, to the maximum extent 33
practicable, the functioning of a person. 34
(f) “Licensed assistant behavior analyst” has the meaning 35
ascribed to the term “assistant behavior analyst” in NRS 641D.020. 36
(g) “Licensed behavior analyst” has the meaning ascribed to the 37
term “behavior analyst” in NRS 641D.030. 38
(h) “Prescription care” means medications prescribed by a 39
licensed physician and any health-related services deemed medically 40
necessary to determine the need or effectiveness of the medications. 41
(i) “Provider of health care” has the meaning ascribed to it in 42
NRS 629.031. 43
– 16 –
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(j) “Psychiatric care” means direct or consultative services 1
provided by a psychiatrist licensed in the state in which the 2
psychiatrist practices. 3
[(j)] (k) “Psychological care” means direct or consultative 4
services provided by a psychologist licensed in the state in which 5
the psychologist practices. 6
[(k)] (l) “Registered behavior technician” has the meaning 7
ascribed to it in NRS 641D.100. 8
[(l)] (m) “Screening for autism spectrum disorders” means 9
medically necessary assessments, evaluations or tests to screen and 10
diagnose whether a person has an autism spectrum disorder. 11
[(m)] (n) “Therapeutic care” means services provided by 12
licensed or certified speech-language pathologists, occupational 13
therapists and physical therapists. 14
[(n)] (o) “Treatment plan” means a plan to treat an autism 15
spectrum disorder that is [prescribed] developed by a [licensed 16
physician or licensed psychologist and may be developed pursuant 17
to a comprehensive evaluation in coordination with a licensed 18
behavior analyst.] provider of health care acting within his or her 19
scope of practice after he or she has assessed the person for whom 20
the treatment plan is developed. 21
Sec. 9. NRS 695C.1717 is hereby amended to read as follows: 22
695C.1717 1. A health care plan issued by a health 23
maintenance organization must provide coverage for screening for 24
and diagnosis of autism spectrum disorders and for treatment of 25
autism spectrum disorders to persons covered by the health care 26
plan under the age of 18 years or, if enrolled in high school, until the 27
person reaches the age of 22 years. For the purposes of such 28
coverage, a health maintenance organization shall accept as 29
dispositive any diagnosis of an autism spectrum disorder that is 30
rendered in accordance with the statewide standard for measuring 31
outcomes and assessing persons with autism spectrum disorders 32
through the age of 21 years prescribed pursuant to NRS 427A.872. 33
2. Coverage provided under this section is subject to: 34
(a) A maximum benefit of the actuarial equivalent of $72,000 35
per year for applied behavior analysis treatment; and 36
(b) Copayment, deductible and coinsurance provisions and any 37
other general exclusion or limitation of a health care plan to the 38
same extent as other medical services or prescription drugs covered 39
by the plan. 40
3. A health care plan issued by a health maintenance 41
organization that provides coverage for outpatient care shall not: 42
(a) Require an enrollee to pay a higher deductible, copayment or 43
coinsurance or require a longer waiting period for coverage for 44
– 17 –
- *SB257*
outpatient care related to autism spectrum disorders than is required 1
for other outpatient care covered by the plan; or 2
(b) Refuse to issue a health care plan or cancel a health care plan 3
solely because the person applying for or covered by the plan uses 4
or may use in the future any of the services listed in subsection 1. 5
4. Except as otherwise provided in subsections 1 and 2, a 6
health maintenance organization shall not limit the number of visits 7
an enrollee may make to any person, entity or group for treatment of 8
autism spectrum disorders. 9
5. Treatment of autism spectrum disorders must be identified in 10
a treatment plan and may include medically necessary habilitative or 11
rehabilitative care, prescription care, psychiatric care, psychological 12
care, behavioral therapy or therapeutic care that is: 13
(a) Prescribed for a person diagnosed with an autism spectrum 14
disorder by a [licensed physician or licensed psychologist;] provider 15
of health care acting within his or her scope of practice; and 16
(b) Provided for a person diagnosed with an autism spectrum 17
disorder by a [licensed physician, licensed psychologist, licensed 18
behavior analyst or other provider that is supervised by the licensed 19
physician, psychologist or behavior analyst.] provider of health 20
care acting within his or her scope of practice. 21
A health maintenance organization may request a copy of and 22
review a treatment plan created pursuant to this subsection. 23
6. Evidence of coverage subject to the provisions of this 24
chapter that is delivered, issued for delivery or renewed on or after 25
January 1, [2011,] 2026, has the legal effect of including the 26
coverage required by subsection 1, and any provision of the 27
evidence of coverage or the renewal which is in conflict with 28
subsection 1 or 2 is void. 29
7. Nothing in this section shall be construed as requiring a 30
health maintenance organization to provide reimbursement to a 31
school for services delivered through school services. 32
8. As used in this section: 33
(a) “Applied behavior analysis” means the design, 34
implementation and evaluation of environmental modifications 35
using behavioral stimuli and consequences to produce socially 36
significant improvement in human behavior, including, without 37
limitation, the use of direct observation, measurement and 38
functional analysis of the relations between environment and 39
behavior. 40
(b) “Autism spectrum disorder” has the meaning ascribed to it in 41
NRS 427A.875. 42
(c) “Behavioral therapy” means any interactive therapy derived 43
from evidence-based research, including, without limitation, discrete 44
trial training, early intensive behavioral intervention, intensive 45
– 18 –
- *SB257*
intervention programs, pivotal response training and verbal behavior 1
provided by a licensed psychologist, licensed behavior analyst, 2
licensed assistant behavior analyst or registered behavior technician. 3
(d) “Evidence-based research” means research that applies 4
rigorous, systematic and objective procedures to obtain valid 5
knowledge relevant to autism spectrum disorders. 6
(e) “Habilitative or rehabilitative care” means counseling, 7
guidance and professional services and treatment programs, 8
including, without limitation, applied behavior analysis, that are 9
necessary to develop, maintain and restore, to the maximum extent 10
practicable, the functioning of a person. 11
(f) “Licensed assistant behavior analyst” has the meaning 12
ascribed to the term “assistant behavior analyst” in NRS 641D.020. 13
(g) “Licensed behavior analyst” has the meaning ascribed to the 14
term “behavior analyst” in NRS 641D.030. 15
(h) “Prescription care” means medications prescribed by a 16
licensed physician and any health-related services deemed medically 17
necessary to determine the need or effectiveness of the medications. 18
(i) “Provider of health care” has the meaning ascribed to it in 19
NRS 629.031. 20
(j) “Psychiatric care” means direct or consultative services 21
provided by a psychiatrist licensed in the state in which the 22
psychiatrist practices. 23
[(j)] (k) “Psychological care” means direct or consultative 24
services provided by a psychologist licensed in the state in which 25
the psychologist practices. 26
[(k)] (l) “Registered behavior technician” has the meaning 27
ascribed to it in NRS 641D.100. 28
[(l)] (m) “Screening for autism spectrum disorders” means 29
medically necessary assessments, evaluations or tests to screen and 30
diagnose whether a person has an autism spectrum disorder. 31
[(m)] (n) “Therapeutic care” means services provided by 32
licensed or certified speech-language pathologists, occupational 33
therapists and physical therapists. 34
[(n)] (o) “Treatment plan” means a plan to treat an autism 35
spectrum disorder that is [prescribed] developed by a [licensed 36
physician or licensed psychologist and may be developed pursuant 37
to a comprehensive evaluation in coordination with a licensed 38
behavior analyst.] provider of health care acting within his or her 39
scope of practice after he or she has assessed the person for whom 40
the treatment plan is developed. 41
Sec. 10. NRS 695G.1645 is hereby amended to read as 42
follows: 43
695G.1645 1. A health care plan issued by a managed care 44
organization for group coverage must provide coverage for 45
– 19 –
- *SB257*
screening for and diagnosis of autism spectrum disorders and for 1
treatment of autism spectrum disorders to persons covered by the 2
health care plan under the age of 18 years or, if enrolled in high 3
school, until the person reaches the age of 22 years. For the 4
purposes of such coverage, a managed care organization shall 5
accept as dispositive any diagnosis of an autism spectrum disorder 6
that is rendered in accordance with the statewide standard for 7
measuring outcomes and assessing persons with autism spectrum 8
disorders through the age of 21 years prescribed pursuant to 9
NRS 427A.872. 10
2. A health care plan issued by a managed care organization for 11
individual coverage must provide an option for coverage for 12
screening for and diagnosis of autism spectrum disorders and 13
for treatment of autism spectrum disorders to persons covered by the 14
health care plan under the age of 18 years or, if enrolled in high 15
school, until the person reaches the age of 22 years. For the 16
purposes of that coverage, the managed care organization shall 17
accept as dispositive any diagnosis of an autism spectrum disorder 18
that is rendered in accordance with the statewide standard for 19
measuring outcomes and assessing persons with autism spectrum 20
disorders through the age of 21 years prescribed pursuant to 21
NRS 427A.872. 22
3. Coverage provided under this section is subject to: 23
(a) A maximum benefit of the actuarial equivalent of $72,000 24
per year for applied behavior analysis treatment; and 25
(b) Copayment, deductible and coinsurance provisions and any 26
other general exclusion or limitation of a health care plan to the 27
same extent as other medical services or prescription drugs covered 28
by the plan. 29
4. A managed care organization that offers or issues a health 30
care plan which provides coverage for outpatient care shall not: 31
(a) Require an insured to pay a higher deductible, copayment or 32
coinsurance or require a longer waiting period for coverage for 33
outpatient care related to autism spectrum disorders than is required 34
for other outpatient care covered by the plan; or 35
(b) Refuse to issue a health care plan or cancel a health care plan 36
solely because the person applying for or covered by the plan uses 37
or may use in the future any of the services listed in subsection 1. 38
5. Except as otherwise provided in subsections 1, 2 and 3, a 39
managed care organization shall not limit the number of visits an 40
insured may make to any person, entity or group for treatment of 41
autism spectrum disorders. 42
6. Treatment of autism spectrum disorders must be identified in 43
a treatment plan and may include medically necessary habilitative or 44
– 20 –
- *SB257*
rehabilitative care, prescription care, psychiatric care, psychological 1
care, behavioral therapy or therapeutic care that is: 2
(a) Prescribed for a person diagnosed with an autism spectrum 3
disorder by a [licensed physician or licensed psychologist;] provider 4
of health care acting within his or her scope of practice; and 5
(b) Provided for a person diagnosed with an autism spectrum 6
disorder by [a licensed physician, licensed psychologist, licensed 7
behavior analyst or other provider that is supervised by the licensed 8
physician, psychologist or behavior analyst.] provider of health 9
care acting within his or her scope of practice. 10
A managed care organization may request a copy of and review a 11
treatment plan created pursuant to this subsection. 12
7. An evidence of coverage subject to the provisions of this 13
chapter that is delivered, issued for delivery or renewed on or after 14
January 1, [2011,] 2026, has the legal effect of including the 15
coverage required by subsection 1, and any provision of the 16
evidence of coverage or the renewal which is in conflict with 17
subsection 1 or 3 is void. 18
8. Nothing in this section shall be construed as requiring a 19
managed care organization to provide reimbursement to a school for 20
services delivered through school services. 21
9. As used in this section: 22
(a) “Applied behavior analysis” means the design, 23
implementation and evaluation of environmental modifications 24
using behavioral stimuli and consequences to produce socially 25
significant improvement in human behavior, including, without 26
limitation, the use of direct observation, measurement and 27
functional analysis of the relations between environment and 28
behavior. 29
(b) “Autism spectrum disorder” has the meaning ascribed to it in 30
NRS 427A.875. 31
(c) “Behavioral therapy” means any interactive therapy derived 32
from evidence-based research, including, without limitation, discrete 33
trial training, early intensive behavioral intervention, intensive 34
intervention programs, pivotal response training and verbal behavior 35
provided by a licensed psychologist, licensed behavior analyst, 36
licensed assistant behavior analyst or registered behavior technician. 37
(d) “Evidence-based research” means research that applies 38
rigorous, systematic and objective procedures to obtain valid 39
knowledge relevant to autism spectrum disorders. 40
(e) “Habilitative or rehabilitative care” means counseling, 41
guidance and professional services and treatment programs, 42
including, without limitation, applied behavior analysis, that are 43
necessary to develop, maintain and restore, to the maximum extent 44
practicable, the functioning of a person. 45
– 21 –
- *SB257*
(f) “Licensed assistant behavior analyst” has the meaning 1
ascribed to the term “assistant behavior analyst” in NRS 641D.020. 2
(g) “Licensed behavior analyst” has the meaning ascribed to the 3
term “behavior analyst” in NRS 641D.030. 4
(h) “Prescription care” means medications prescribed by a 5
licensed physician and any health-related services deemed medically 6
necessary to determine the need or effectiveness of the medications. 7
(i) “Provider of health care” has the meaning ascribed to it in 8
NRS 629.031. 9
(j) “Psychiatric care” means direct or consultative services 10
provided by a psychiatrist licensed in the state in which the 11
psychiatrist practices. 12
[(j)] (k) “Psychological care” means direct or consultative 13
services provided by a psychologist licensed in the state in which 14
the psychologist practices. 15
[(k)] (l) “Registered behavior technician” has the meaning 16
ascribed to it in NRS 641D.100. 17
[(l)] (m) “Screening for autism spectrum disorders” means 18
medically necessary assessments, evaluations or tests to screen and 19
diagnose whether a person has an autism spectrum disorder. 20
[(m)] (n) “Therapeutic care” means services provided by 21
licensed or certified speech-language pathologists, occupational 22
therapists and physical therapists. 23
[(n)] (o) “Treatment plan” means a plan to treat an autism 24
spectrum disorder that is [prescribed] developed by a [licensed 25
physician or licensed psychologist and may be developed pursuant 26
to a comprehensive evaluation in coordination with a licensed 27
behavior analyst.] provider of health care acting within his or her 28
scope of practice after he or she has assessed the person for whom 29
the treatment plan is developed. 30
Sec. 11. The provisions of NRS 354.599 do not apply to any 31
additional expenses of a local government that are related to the 32
provisions of this act. 33
Sec. 12. 1. This section becomes effective upon passage and 34
approval. 35
2. Sections 1 to 11, inclusive, of this act become effective: 36
(a) Upon passage and approval for the purpose of adopting any 37
regulations and performing any other preparatory administrative 38
tasks that are necessary to carry out the provisions of this act; and 39
(b) On January 1, 2026, for all other purposes. 40
H