Nevada Senate Bill SB316 Amended / Bill

                     	EXEMPT 
 (Reprinted with amendments adopted on April 18, 2025) 
 	FIRST REPRINT S.B. 316 
 
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SENATE BILL NO. 316–SENATORS NGUYEN, STONE, TITUS; BUCK, 
CRUZ-CRAWFORD, DALY, KRASNER, OHRENSCHALL AND 
SCHEIBLE 
 
MARCH 11, 2025 
____________ 
 
Referred to Committee on Commerce and Labor 
 
SUMMARY—Revises provisions relating to insurance. 
(BDR 57-777) 
 
FISCAL NOTE: Effect on Local Government: May have Fiscal Impact. 
 Effect on the State: Yes. 
 
CONTAINS UNFUNDED MANDATE (§ 39) 
(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 insurance; requiring health insurers, pharmacy 
benefit managers and the Commissioner of Insurance to 
prepare certain reports; expanding the scope of certain 
provisions relating to pharmacy benefit managers; 
prohibiting pharmacy benefit managers from engaging in 
certain practices; requiring pharmacy benefit managers to 
make certain disclosures; imposing requirements relating 
to the compensation of pharmacy benefit managers; 
requiring pharmacy benefit managers to pass certain 
discounts, incentives, rebates and other fees along to third 
parties and covered persons; prohibiting insurers from 
assessing certain cost-sharing obligations in certain 
circumstances; requiring insurers to credit certain 
amounts paid by or on behalf of an insured for a 
prescription drug towards certain obligations of an 
insured in certain circumstances; providing civil and 
criminal penalties; and providing other matters properly 
relating thereto. 
Legislative Counsel’s Digest: 
 Existing law requires a pharmacy benefit manager, which is an entity that 1 
manages a pharmacy benefits plan, to obtain a certificate of registration as an 2 
insurance administrator from the Commissioner of Insurance and comply with the 3   
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requirements that apply to insurance administrators generally. (NRS 683A.025, 4 
683A.08522-683A.0893) Existing law additionally imposes certain requirements 5 
specifically regulating the operation of pharmacy benefit managers. (NRS 6 
683A.171-683A.179) Existing law defines “pharmacy benefits plan” to refer to 7 
insurance coverage of prescription drugs. (NRS 683A.175) Section 21 of this bill 8 
expands the scope of that definition to also refer to insurance coverage of 9 
pharmacist services. Section 21 thereby expands the scope of provisions governing 10 
pharmacy benefit managers to also apply to entities that manage such coverage. 11 
Sections 3-14 of this bill define certain other terms relevant to pharmacy benefit 12 
managers, and section 20 of this bill establishes the applicability of those 13 
definitions. Section 15 of this bill prohibits a pharmacy benefit manager that 14 
manages a pharmacy benefits plan which provides coverage through a network 15 
from requiring a person to use a pharmacy affiliated with the pharmacy benefit 16 
manager if there are other, nonaffiliated pharmacies in the network. Section 15 17 
additionally prohibits a pharmacy benefit manager from engaging in certain 18 
practices which are intended or have the effect of steering a person towards an 19 
affiliated pharmacy instead of a nonaffiliated pharmacy in the network. Section 15 20 
also prohibits a pharmacy benefit manager from discriminating against a 21 
nonaffiliated pharmacy.  22 
 Section 16 of this bill requires a pharmacy benefit manager to disclose to a 23 
third party insurer for which the pharmacy benefit manager manages a pharmacy 24 
benefits plan: (1) the amounts and types of fees that the pharmacy benefit manager 25 
charges the third party insurer for managing the plan or otherwise receives from 26 
other entities, including rebates, in connection with managing the plan; and (2) 27 
certain information relating to the clinical efficacy and evidence regarding the 28 
inclusion or exclusion of certain drugs in a formulary. Section 16 additionally 29 
requires a pharmacy benefit manager to make certain contracts available for 30 
inspection by the Commissioner.  31 
 Existing law establishes the basis upon which insurance administrators, which 32 
include pharmacy benefit managers, may be compensated for their services. (NRS 33 
683A.0883) Section 16.5 of this bill prohibits, as of January 1, 2028, a pharmacy 34 
benefit manager from deriving any income from the provision of pharmacy benefit 35 
management services other than income derived from administrative fees paid to 36 
the pharmacy benefit manager by a third party insurer for the provision of such 37 
services pursuant to an agreement that provides for such fees.  38 
 Existing law authorizes the Department of Health and Human Services to enter 39 
into a contract with a pharmacy benefit manager to manage coverage of 40 
prescription drugs under the State Plan for Medicaid and the Children’s Health 41 
Insurance Program that requires the pharmacy benefit manager to provide to the 42 
Department all rebates received for purchasing drugs in relation to those programs. 43 
(NRS 422.4053) Section 16.5 imposes similar requirements for pharmacy benefit 44 
managers that manage other pharmacy benefits plans. Specifically, section 16.5 45 
requires a pharmacy benefit manager to provide: (1) income generated through 46 
discounts, fees and other incentives received from a manufacturer or wholesaler in 47 
connection with providing pharmacy benefit management services for a third party 48 
insurer that provides pharmacy coverage to the third party insurer; and (2) income 49 
generated through rebates received from a manufacturer or wholesaler in 50 
connection with providing pharmacy benefit management services for a third party 51 
insurer to persons covered by the third party insurer. Sections 25, 27-32, 35, 36, 40 52 
and 41 of this bill require certain third party insurers that provide coverage for 53 
prescription drugs to include, when calculating the cost-sharing obligation or 54 
maximum out-of-pocket expense of an insured under certain circumstances, all 55 
amounts paid by the insured or another person on behalf of an insured towards the 56 
cost of a covered prescription drug. Sections 25, 27-32, 35, 36 and 40 also prohibit 57 
third party insurers from imposing on an insured a cost-sharing obligation for a 58   
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prescription drug which is greater than the net amount that the third party insurer 59 
pays for the drug. Section 26 of this bill authorizes the Commissioner to require a 60 
domestic insurer that issues a policy of individual health insurance to a person 61 
residing in another state to meet the requirements of section 25 in certain 62 
circumstances. Sections 33 and 37 of this bill indicate that the requirements of 63 
sections 32 and 36, respectively, are inapplicable to: (1) coverage provided by a 64 
managed care organization to recipients of Medicaid because existing law imposes 65 
similar requirements of the Medicaid program; and (2) coverage provided by a 66 
managed care organization to members of the Public Employees’ Benefits Program. 67 
(NRS 422.4053) Section 41 of this bill makes the requirements of section 36 68 
inapplicable to coverage provided by the Public Employees’ Benefits Program to its 69 
members. Section 34 of this bill authorizes the Commissioner to suspend or revoke 70 
the certificate of a health maintenance organization that fails to comply with the 71 
requirements of section 32. The Commissioner would also be authorized to take 72 
such action against other third party insurers who fail to comply with the 73 
requirements of sections 25, 27-32, 35 and 36. (NRS 680A.200) 74 
 Section 17 of this bill prohibits a pharmacy benefit manager from: (1) 75 
unreasonably obstructing or interfering with the ability of a covered person to 76 
timely access a prescription drug at certain pharmacies; (2) agreeing to exclusively 77 
cover certain drugs; (3) restricting the ability of a nonaffiliated pharmacy to 78 
contract with certain entities; and (4) making or disseminating a false or misleading 79 
statement or advertisement. Section 24 of this bill additionally prohibits a 80 
pharmacy benefit manager from engaging in certain practices while doing business 81 
with pharmacies. 82 
 Section 19 of this bill requires a pharmacy benefit manager to submit to the 83 
Commissioner an annual report detailing certain business practices of the pharmacy 84 
benefit manager as well as certain information regarding pricing and rebates 85 
relating to the prescription drugs administered by the pharmacy benefit manager. 86 
Section 1 of this bill requires third party insurers to submit a similar report to the 87 
Commissioner relating to the pricing of prescription drugs. Section 39 of this bill 88 
provides for the confidentiality of the information contained in those reports. 89 
Sections 1 and 19 require the Commissioner to compile, submit to the Legislature 90 
and publish on the Internet biennial reports on the impact of the cost of prescription 91 
drugs on health insurance premiums in this State and the overall impact of 92 
pharmacy benefit managers on the cost of prescription drugs in this State, based on 93 
the reports submitted by third party insurers and pharmacy benefit managers, 94 
respectively. Additionally, section 18 of this bill requires the Commissioner to 95 
publish on the Internet certain consumer complaints made against pharmacy benefit 96 
managers. 97 
 Existing law exempts certain federally regulated insurance coverage of 98 
prescription drugs provided by employers for their employees from requirements 99 
governing pharmacy benefit managers except where the pharmacy benefit manager 100 
is required by contract to comply with those requirements. (NRS 683A.177) 101 
Section 22 of this bill provides that such federally regulated coverage provided by 102 
employers for their employees is also exempt from the requirements of this bill 103 
governing pharmacy benefit managers, unless required by contract to comply with 104 
those requirements. Additionally, sections 21.5 and 22 of this bill exempt coverage 105 
of prescription drugs provided by the Public Employees’ Benefits Program and 106 
Medicaid managed care organizations from the requirements of this bill governing 107 
pharmacy benefit managers. 108 
 Existing law provides that a pharmacy benefit manager has an obligation of 109 
good faith and fair dealing toward a third party insurer or pharmacy when 110 
performing duties pursuant to a contract to which the pharmacy benefit manager is 111 
a party. (NRS 683A.178) Section 23 of this bill provides that a pharmacy benefit 112 
manager also has a fiduciary duty to persons covered by a third party insurer for 113   
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which the pharmacy benefit manager provides pharmacy benefit services. Section 114 
23 also: (1) prohibits a pharmacy benefit manager from engaging in an activity that 115 
may interfere with the duties and obligations of the pharmacy benefit manager 116 
towards third party insurers, pharmacies and covered persons; and (2) authorizes a 117 
third party insurer to audit the books and records of a pharmacy benefit manager for 118 
certain purposes. 119 
 Section 18 provides that a pharmacy benefit manager that violates provisions of 120 
law governing pharmacy benefit managers, including sections 3-24, is subject to a 121 
civil penalty of not less than $1,000 but not more than $7,500 for each violation. 122 
 Existing law defines various activities involving businesses and occupations 123 
that constitute deceptive trade practices. (NRS 598.0915-589.0925) If a person 124 
engages in a deceptive trade practice, the person may be subject to a civil action 125 
brought by certain persons and certain civil and criminal penalties. (NRS 598.0999) 126 
Section 18 makes certain violations of sections 15 and 24 a deceptive trade 127 
practice, thereby subjecting a violation of those provisions to additional penalties. 128 
However, sections 18, 38 and 42 of this bill provide that such violations do not 129 
give rise to a private right of action. 130 
 
 
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN 
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS: 
 
 Section 1.  Chapter 679B of NRS is hereby amended by adding 1 
thereto a new section to read as follows: 2 
 1. On or before June 1 of each year, a health insurer shall 3 
compile and submit to the Commissioner a report which contains 4 
the following information: 5 
 (a) Lists of: 6 
  (1) The 25 prescription drugs most frequently prescribed to 7 
insureds in this State during the immediately preceding calendar 8 
year; 9 
  (2) The 25 prescription drugs which accounted for the 10 
largest percentage of spending on prescription drugs in this State 11 
by the health insurer in the immediately preceding year; and 12 
  (3) The 25 prescription drugs with the largest increase in 13 
the percentage of spending on prescription drugs in this State by 14 
the health insurer in the immediately preceding year, as compared 15 
to the previous year; and 16 
 (b) For each prescription drug included on a list compiled 17 
pursuant to paragraph (a) for the immediately preceding year: 18 
  (1) The aggregate wholesale acquisition costs for the drug, 19 
calculated by adding together for all units of the drug dispensed to 20 
insureds in this State the wholesale acquisition cost of the drug at 21 
the time each unit was dispensed; 22 
  (2) The aggregate amount of rebates received by a 23 
pharmacy benefit manager under contract with the insurer 24 
relating to the distribution of the drug to insureds in this State; 25   
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  (3) The aggregate amount of administrative fees received 1 
by a pharmacy benefit manager under contract with the insurer 2 
relating to the distribution of the drug to insureds in this State; 3 
  (4) The aggregate amount paid or reimbursed by a 4 
pharmacy benefit manager under contract with the insurer to 5 
affiliated pharmacies in this State for the drug; 6 
  (5) The aggregate amount paid or reimbursed by a 7 
pharmacy benefit manager under contract with an insurer to 8 
nonaffiliated pharmacies in this State for the drug; and 9 
  (6) The aggregate amount of fees received from any source 10 
by a pharmacy benefit manager under contract with the insurer 11 
relating to the distribution of the drug to insureds in this State. 12 
 2. On or before July 1 of each even-numbered year, the 13 
Commissioner shall: 14 
 (a) Compile a report on the overall impact of prescription drug 15 
costs on premiums for health insurance in this State based on the 16 
reports submitted to the Commissioner pursuant to subsection 1. 17 
The data in the report compiled pursuant to this subsection must 18 
be in aggregated form and must not reveal information specific to 19 
a particular health insurer or manufacturer of a drug, including, 20 
without limitation, information relating to a manufacturer’s 21 
individual or aggregate discounted prices for a prescription drug. 22 
 (b) Submit the report to the Director of the Legislative Counsel 23 
Bureau for transmittal to the Joint Interim Standing Committee 24 
on Health and Human Services and the Joint Interim Standing 25 
Committee on Commerce and Labor. 26 
 (c) Present the report at a meeting of the Joint Interim 27 
Standing Committee on Health and Human Services. 28 
 (d) Post the report on an Internet website operated by the 29 
Division. 30 
 3. Except as otherwise provided in subsection 2, any 31 
information submitted by a health insurer pursuant to this section 32 
is confidential and is not a public record. 33 
 4. As used in this section: 34 
 (a) “Affiliated pharmacy” has the meaning ascribed to it in 35 
section 3 of this act. 36 
 (b) “Health insurer” means any insurer or organization 37 
authorized pursuant to this title to conduct business in this State 38 
that provides or arranges for the provision of health care services, 39 
including, without limitation, an insurer that issues a policy of 40 
health insurance, an insurer that issues a policy of group health 41 
insurance, a carrier serving small employers, a fraternal benefit 42 
society, a hospital or medical services corporation, a health 43 
maintenance organization, a plan for dental care, a prepaid 44   
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limited health service organization and a managed care 1 
organization. 2 
 (c) “Insured” means a person covered by a policy of health 3 
insurance issued in this State by a health insurer. 4 
 (d) “Manufacturer” has the meaning ascribed to it in 42 5 
U.S.C. § 1396r-8(k)(5). 6 
 (e) “National Drug Code” means the numerical code assigned 7 
to a prescription drug by the United States Food and Drug 8 
Administration. 9 
 (f) “Nonaffiliated pharmacy” has the meaning ascribed to it in 10 
section 9 of this act. 11 
 (g) “Pharmacy benefit manager” has the meaning ascribed to 12 
it in NRS 683A.174. 13 
 (h) “Rebate” has the meaning ascribed to it in section 13 of 14 
this act. 15 
 (i) “Wholesale acquisition cost” means the manufacturer’s 16 
published list price for a prescription drug with a unique National 17 
Drug Code for sale to a purchaser or entity that purchases the 18 
prescription drug from the manufacturer, not including any 19 
rebates or other price concessions. 20 
 Sec. 2.  Chapter 683A of NRS is hereby amended by adding 21 
thereto the provisions set forth as sections 3 to 19, inclusive, of this 22 
act. 23 
 Sec. 3.  “Affiliated pharmacy” means a pharmacy that 24 
directly, or indirectly through one or more intermediaries, 25 
controls, is controlled by or is under common control with a 26 
pharmacy benefit manager. 27 
 Sec. 4.  “Claim” means a request for payment for: 28 
 1. Administering, filling or refilling a prescription; or 29 
 2. Providing a pharmacist service or a medical supply or 30 
device to a covered person. 31 
 Sec. 5.  “Control” has the meaning ascribed to it in  32 
NRS 692C.050. 33 
 Sec. 6.  “Cost-sharing obligation” includes, without 34 
limitation, a copayment, coinsurance or deductible imposed upon 35 
or collected from a covered person in connection with filling a 36 
prescription or obtaining other pharmacist services. 37 
 Sec. 7.  “Manufacturer” has the meaning ascribed to it in 42 38 
U.S.C. § 1396r-8(k)(5). 39 
 Sec. 8.  “Network plan” means a pharmacy benefits plan 40 
offered by a third party under which the financing and delivery of 41 
pharmacist services is provided, in whole or in part, through a 42 
defined set of providers under contract with the third party. The 43 
term does not include an arrangement for the financing of 44 
premiums. 45   
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 Sec. 9.  “Nonaffiliated pharmacy” means a pharmacy that: 1 
 1. Directly, or indirectly through a pharmacy services 2 
administrative organization, contracts with a pharmacy benefit 3 
manager; and 4 
 2. Does not control, is not controlled by and is not under 5 
common control with the pharmacy benefit manager. 6 
 Sec. 10.  “Pharmacist services” means the provision of 7 
products, goods or services, or any combination thereof, provided 8 
as a part of the practice of pharmacy, as defined in NRS 639.0124. 9 
 Sec. 11.  “Pharmacy benefit management services” includes, 10 
without limitation: 11 
 1. Negotiating the price of prescription drugs, including, 12 
without limitation, negotiating or contracting for direct or indirect 13 
rebates, discounts or price concessions on prescription drugs. 14 
 2. Managing any aspect of a pharmacy benefits plan, 15 
including, without limitation: 16 
 (a) Developing or managing a formulary; 17 
 (b) Processing and paying claims for prescription drugs; 18 
 (c) Performing reviews of the utilization of prescription drugs; 19 
 (d) Processing requests for prior authorization for 20 
prescriptions; 21 
 (e) Adjudicating appeals and grievances relating to a 22 
pharmacy benefits plan; 23 
 (f) Contracting with pharmacies to provide pharmacist services 24 
for covered persons; 25 
 (g) Managing the cost of covered prescription drugs on behalf 26 
of a third party; and 27 
 (h) Managing or providing data relating to a pharmacy 28 
benefits plan. 29 
 3. Performing any administrative, managerial, clinical, 30 
pricing, financial, reimbursement, data administration, reporting 31 
or billing service for a third party in relation to a pharmacy 32 
benefits plan. 33 
 Sec. 12.  “Pharmacy services administrative organization” 34 
means an entity that provides contracting and other administrative 35 
services relating to prescription drug benefits to pharmacies. 36 
 Sec. 13.  “Rebate” means any discount, remuneration or 37 
other payment paid by a manufacturer or wholesaler to a 38 
pharmacy benefit manager after a claim has been adjudicated or 39 
completed at a pharmacy. The term does not include a bona fide 40 
service fee, as defined in 42 C.F.R. § 447.502. 41 
 Sec. 14.  “Wholesaler” has the meaning ascribed to it in  42 
NRS 639.016. 43 
 Sec. 15.  1. A pharmacy benefit manager that manages a 44 
network plan shall not: 45   
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 (a) Require a covered person to use an affiliated pharmacy to 1 
fill a prescription or obtain other pharmacist services if there is a 2 
nonaffiliated pharmacy in the applicable network; 3 
 (b) Induce, persuade or attempt to induce or persuade a 4 
covered person to transfer a prescription to or otherwise use an 5 
affiliated pharmacy instead of a nonaffiliated pharmacy in the 6 
applicable network; 7 
 (c) Unreasonably restrict a covered person from using a 8 
particular pharmacy in the applicable network for the purpose of 9 
filling a prescription or receiving pharmacist services covered by 10 
the pharmacy benefits plan of the covered person; 11 
 (d) Communicate to a covered person that the covered person 12 
is required to have a prescription filled or receive other pharmacist 13 
services at a particular pharmacy if there are other pharmacies in 14 
the applicable network that have the ability to dispense the 15 
prescription or provide the pharmacist services required by the 16 
covered person; 17 
 (e) Discriminate against a nonaffiliated pharmacy based on 18 
the nonaffiliated status of the pharmacy, including, without 19 
limitation, by: 20 
  (1) Offering materially different terms or conditions to a 21 
nonaffiliated pharmacy based on the status as a nonaffiliated 22 
pharmacy; 23 
  (2) Refusing to renew or terminating a contract with a 24 
nonaffiliated pharmacy on the basis that the pharmacy is a 25 
nonaffiliated pharmacy, or for reasons other than those that apply 26 
equally to affiliated pharmacies; and 27 
  (3) Reimbursing a nonaffiliated pharmacy for a pharmacist 28 
service in an amount that is less than the pharmacy benefit 29 
manager would reimburse an affiliated pharmacy for the same 30 
pharmacist service; or 31 
 (f) Deny a pharmacy the opportunity to participate in a 32 
network or receive a preferred status if the pharmacy is willing to 33 
accept the same terms and conditions that the pharmacy benefit 34 
manager has established for affiliated pharmacies as a condition 35 
for participating in the network or receiving preferred status, as 36 
applicable. 37 
 2. As used in this section, “network” means a defined set of 38 
pharmacies that are under contract to provide pharmacist services 39 
pursuant to a network plan. 40 
 Sec. 16.  A pharmacy benefit manager: 41 
 1. Upon the request of a third party for which the pharmacy 42 
benefit manager manages a pharmacy benefits plan, shall disclose 43 
to the third party, in writing, the amounts and types of charges, 44 
fees and commissions in the aggregate that the pharmacy benefit 45   
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manager charges the third party for providing pharmacy benefit 1 
management services or otherwise receives in connection with 2 
managing the pharmacy benefits plan of the third party, 3 
including, without limitation, administrative fees and rebates 4 
collected from pharmacies, manufacturers and wholesalers. 5 
 2. Shall make available for inspection by the Commissioner, 6 
upon request of the Commissioner, any contract between the 7 
pharmacy benefit manager and a pharmacy or a third party. 8 
 3. Shall disclose to a third party for which the pharmacy 9 
benefit manager manages a pharmacy benefits plan, upon request 10 
of the third party, information relating to the clinical efficacy and 11 
clinical evidence regarding the inclusion, exclusion or limitation 12 
of prescription drugs in a formulary maintained by the pharmacy 13 
benefit manager. 14 
 Sec. 16.5.  1. A pharmacy benefit manager shall not derive 15 
income from providing pharmacy benefit management services in 16 
this State except for income derived from administrative fees paid 17 
by the third party with which the pharmacy benefit manager has 18 
entered into an agreement to provide pharmacy benefit 19 
management services. Such administrative fees must be set forth 20 
in the agreement between the pharmacy benefit manager and the 21 
third party. 22 
 2. A pharmacy benefit manager shall provide: 23 
 (a) Any income generated through discounts offered by a 24 
manufacturer or wholesaler and any fees or other incentives 25 
collected from a manufacturer or wholesaler in connection with 26 
providing pharmacy benefit management services for a third party 27 
to the third party to which the discount, fee or other incentive 28 
pertains; and 29 
 (b) Any income generated through rebates received from a 30 
manufacturer or wholesaler in connection with providing 31 
pharmacy benefit management services to covered persons. 32 
 Sec. 17.  1. A pharmacy benefit manager shall not: 33 
 (a) Unreasonably obstruct or interfere with the ability of a 34 
covered person to timely access a prescription drug or device that 35 
has been prescribed to the covered person at a contract pharmacy 36 
of the person’s choice. 37 
 (b) Enter into, amend, enforce or renew a contract with a 38 
manufacturer that expressly or implicitly provides for the 39 
exclusive coverage of a drug, medical device or other product by a 40 
pharmacy benefits plan or group of pharmacy benefits plans. 41 
 (c) Enter into, amend, enforce or renew a contract with a 42 
pharmacy or pharmacy services administrative organization that 43 
expressly or implicitly restricts the ability of a nonaffiliated 44 
pharmacy to contract with third parties. 45   
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 (d) Make or disseminate any statement, representation or 1 
advertisement that is, or reasonably should be known to be, 2 
untrue, deceptive or misleading. 3 
 2. As used in this section, “contract pharmacy” means a 4 
pharmacy that contracts directly with a pharmacy benefit 5 
manager, or indirectly with a pharmacy benefit manager through 6 
a pharmacy services administrative organization. 7 
 Sec. 18.  1. A pharmacy benefit manager that violates the 8 
provisions of NRS 683A.171 to 683A.179, inclusive, and sections 3 9 
to 19, inclusive, of this act is subject to a civil penalty of not less 10 
than $1,000, but not more than $7,500, for each violation. This 11 
penalty must be recovered in a civil action brought in the name of 12 
the State of Nevada by the Attorney General. 13 
 2. Except as otherwise provided in this subsection, a violation 14 
of paragraph (l) of subsection 1 of NRS 683A.179 or section 15 of 15 
this act constitutes a deceptive trade practice for the purposes of 16 
NRS 598.0903 to 598.0999, inclusive. This subsection does not 17 
create a private right of action. 18 
 3. The Attorney General may: 19 
 (a) Conduct an investigation to determine whether a pharmacy 20 
benefit manager, either directly or indirectly, has violated or is 21 
violating the provisions of NRS 683A.171 to 683A.179, inclusive, 22 
and sections 3 to 19, inclusive, of this act, or any regulations 23 
adopted thereto. 24 
 (b) If he or she believes that a pharmacy benefit manager, 25 
either directly or indirectly, is violating or is about to violate the 26 
provisions of NRS 683A.171 to 683A.179, inclusive, and sections 3 27 
to 19, inclusive, of this act, seek an injunction or other equitable 28 
relief to halt or prevent such a violation. 29 
 4. The remedies and penalties set forth in this section are not 30 
exclusive and are in addition to any other remedies and penalties 31 
provided by law. 32 
 5. The Commissioner shall: 33 
 (a) Establish procedures for receiving, investigating, tracking 34 
and publicly reporting complaints submitted by persons in this 35 
State against pharmacy benefit managers. 36 
 (b) Publish on an Internet website maintained by the 37 
Commissioner each complaint against a pharmacy benefit 38 
manager received pursuant to paragraph (a) which is determined 39 
by the Commissioner to be justified based on a determination by a 40 
preponderance of the evidence that the pharmacy benefit manager 41 
violated the provisions of NRS 683A.171 to 683A.179, inclusive, 42 
and sections 3 to 19, inclusive, of this act. 43 
 Sec. 19.  1. On or before April 1 of each year, a pharmacy 44 
benefit manager shall submit to the Commissioner: 45   
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 (a) A report which includes the information prescribed by 1 
subsection 2; and 2 
 (b) A statement signed under the penalty of perjury affirming 3 
the accuracy of the information in the report. 4 
 2. The report submitted pursuant to paragraph (a) of 5 
subsection 1 must include: 6 
 (a) Lists of: 7 
  (1) The 50 prescription drugs with the highest wholesale 8 
acquisition costs at the time the report is submitted; 9 
  (2) The 50 prescription drugs most frequently prescribed to 10 
covered persons in this State during the immediately preceding 11 
calendar year; and 12 
  (3) The 50 prescription drugs which produced the largest 13 
amount of revenue for the pharmacy benefit manager in this State 14 
during the immediately preceding calendar year. 15 
 (b) For each prescription for a drug included on a list 16 
compiled pursuant to paragraph (a) that was issued to a covered 17 
person in this State during the immediately preceding year: 18 
  (1) The type of pharmacy that filled the prescription. The 19 
type of pharmacy may be an integrated pharmacy, chain 20 
pharmacy, specialty pharmacy, mail order pharmacy or other type 21 
of pharmacy. 22 
  (2) Information relating to pricing of and rebates for the 23 
drug, including, without limitation: 24 
   (I) The total amount that the pharmacy benefit manager 25 
paid to the pharmacy for filling the prescription; 26 
   (II) The net amount that the pharmacy benefit manager 27 
paid to the pharmacy for filling the prescription, after accounting 28 
for any fees or assessments imposed by the pharmacy benefit 29 
manager against the pharmacy; 30 
   (III) The amount of any rebate negotiated by the 31 
pharmacy benefit manager with the manufacturer for the 32 
purchase of the drug; 33 
   (IV) The amount of any rebate described in sub-34 
subparagraph (III) that was passed on to either the applicable 35 
third party or the covered person; and 36 
   (V) The amount that the applicable third party paid the 37 
pharmacy benefit manager for the drug. 38 
 (c) Information prescribed by regulation of the Commissioner 39 
that allows the Commissioner to determine whether each claim for 40 
a prescription drug included on a list compiled pursuant to 41 
paragraph (a) required prior authorization. Such information 42 
must be in deidentified form. 43   
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 (d) For each prescription drug appearing on a list compiled 1 
pursuant to paragraph (a), the aggregate amount for the 2 
immediately preceding year of the: 3 
  (1) Cost of the drug, calculated by adding together for all 4 
units of the drug dispensed in this State the wholesale acquisition 5 
cost of the drug at the time each unit was dispensed; 6 
  (2) Amount of rebates negotiated for the purchase of the 7 
drug in this State; 8 
  (3) Amount of administrative fees received from a 9 
manufacturer or wholesaler for services provided in this State 10 
relating to the drug; 11 
  (4) Amount paid or reimbursed to affiliated pharmacies in 12 
this State for the drug; and 13 
  (5) Amount paid or reimbursed to nonaffiliated pharmacies 14 
in this State for the drug. 15 
 (e) A list of the third parties with which the pharmacy benefit 16 
manager has contracted, the scope of services provided to each 17 
third party and the number of persons covered in this State by 18 
each third party listed. 19 
 (f) The total amount of revenue derived from providing 20 
pharmacy benefit management services in this State in the 21 
immediately preceding year. 22 
 (g) The expenses incurred by providing pharmacy benefit 23 
management services in this State in the immediately preceding 24 
year. 25 
 (h) The identity of each group purchasing organization 26 
employed, contracted or otherwise utilized by or affiliated with the 27 
pharmacy benefit manager. 28 
 (i) A copy of each contract entered into with a group 29 
purchasing organization identified pursuant to paragraph (h). 30 
 (j) The aggregate financial benefit derived in the immediately 31 
preceding year from the use of the group purchasing 32 
organizations identified pursuant to paragraph (h). 33 
 (k) A list of the types and amounts of fees that the pharmacy 34 
benefit manager has collected during the immediately preceding 35 
year for performing pharmacy benefit management services in this 36 
State and a description of how those fees are calculated. 37 
 (l) A copy of all fee agreements entered into with third parties, 38 
pharmacies and pharmacy services administrative organizations 39 
doing business in this State. 40 
 (m) The amount of each premium, deductible, cost-sharing 41 
obligation or fee charged by the pharmacy benefit manager to 42 
covered persons in this State or other persons on behalf of such 43 
covered persons. 44   
 	– 13 – 
 
 
- *SB316_R1* 
 3. On or before July 1 of each even-numbered year, the 1 
Commissioner shall: 2 
 (a) Compile a report on the overall impact of pharmacy benefit 3 
managers on the cost of prescription drugs in this State based on 4 
the reports submitted to the Commissioner pursuant to subsection 5 
1. The data in the report compiled pursuant to this subsection 6 
must be in aggregated form and must not reveal information 7 
specifically concerning an individual purchaser or manufacturer 8 
of a drug, including, without limitation, information relating to a 9 
manufacturer’s individual or aggregate discounted prices for a 10 
prescription drug. 11 
 (b) Submit the report to the Director of the Legislative Counsel 12 
Bureau for transmittal to the Joint Interim Standing Committee 13 
on Health and Human Services and the Joint Interim Standing 14 
Committee on Commerce and Labor. 15 
 (c) Present the report at a meeting of the Joint Interim 16 
Standing Committee on Health and Human Services. 17 
 (d) Post the report on an Internet website operated by the 18 
Division. 19 
 4. Except as otherwise provided in subsection 3, any 20 
information submitted by a pharmacy benefit manager pursuant to 21 
this section is confidential and is not a public record. 22 
 5. Nothing in this section shall be construed to impose any 23 
recordkeeping obligation on a third party for which a pharmacy 24 
benefit manager manages a pharmacy benefits plan. 25 
 6. As used in this section: 26 
 (a) “Group purchasing organization” means a person 27 
employed, contracted or otherwise utilized by or affiliated with a 28 
pharmacy benefit manager to negotiate, obtain or procure rebates 29 
from manufacturers or wholesalers. 30 
 (b) “National Drug Code” means the numerical code assigned 31 
to a prescription drug by the United States Food and Drug 32 
Administration. 33 
 (c) “Wholesale acquisition cost” means the manufacturer’s 34 
published list price for a prescription drug with a unique National 35 
Drug Code for sale to a wholesaler or any other purchaser or 36 
entity that purchases the prescription drug from the manufacturer, 37 
not including any rebates or other price concessions. 38 
 Sec. 20.  NRS 683A.171 is hereby amended to read as follows: 39 
 683A.171 As used in NRS 683A.171 to 683A.179, inclusive, 40 
and sections 3 to 19, inclusive, of this act, unless the context 41 
otherwise requires, the words and terms defined in NRS 683A.172 42 
to 683A.176, inclusive, and sections 3 to 14, inclusive, of this act 43 
have the meanings ascribed to them in those sections. 44   
 	– 14 – 
 
 
- *SB316_R1* 
 Sec. 21.  NRS 683A.175 is hereby amended to read as follows: 1 
 683A.175 “Pharmacy benefits plan” means coverage of 2 
prescription drugs and pharmacist services provided by a third 3 
party. 4 
 Sec. 21.5.  NRS 683A.176 is hereby amended to read as 5 
follows: 6 
 683A.176 “Third party” means: 7 
 1.  An insurer, as that term is defined in NRS 679B.540; 8 
 2.  A health benefit plan, as that term is defined in NRS 9 
687B.470, for employees which provides a pharmacy benefits plan; 10 
 3.  A [participating public agency, as that term is defined in 11 
NRS 287.04052, and any other] local governmental agency of the 12 
State of Nevada which provides a system of health insurance for the 13 
benefit of its officers and employees, and the dependents of officers 14 
and employees, pursuant to chapter 287 of NRS; or 15 
 4.  The public option established pursuant to NRS 695K.200; or 16 
 5. Any other insurer or organization that provides health 17 
coverage or benefits or coverage of prescription drugs as part of 18 
workers’ compensation insurance in accordance with state or federal 19 
law. 20 
 The term does not include the Public Employees’ Benefits 21 
Program or an insurer that provides coverage under a policy of 22 
casualty or property insurance. 23 
 Sec. 22.  NRS 683A.177 is hereby amended to read as follows: 24 
 683A.177 1.  Except as otherwise provided in subsection 2, 25 
the requirements of NRS 683A.171 to 683A.179, inclusive, and 26 
sections 3 to 19, inclusive, of this act and any regulations adopted 27 
by the Commissioner pursuant thereto do not apply to the coverage 28 
of prescription drugs under a plan that is subject to the Employee 29 
Retirement Income Security Act of 1974 or any information relating 30 
to such coverage. 31 
 2.  A plan described in subsection 1 may, by contract, require a 32 
pharmacy benefit manager that manages the coverage of 33 
prescription drugs under the plan to comply with the requirements 34 
of NRS 683A.171 to 683A.179, inclusive, and sections 3 to 19, 35 
inclusive, of this act and any regulations adopted by the 36 
Commissioner pursuant thereto. 37 
 3. The requirements of NRS 683A.171 to 683A.179, inclusive, 38 
and sections 3 to 19, inclusive, of this act do not apply to the 39 
coverage of prescription drugs provided by a managed care 40 
organization for: 41 
 (a) Recipients of Medicaid under the State Plan for Medicaid 42 
or the Children’s Health Insurance Program pursuant to a 43 
contract with the Division of Health Care Financing and Policy of 44   
 	– 15 – 
 
 
- *SB316_R1* 
the Department of Health and Human Services entered into 1 
pursuant to NRS 422.273; or 2 
 (b) Members of the Public Employees’ Benefits Program. 3 
 Sec. 23.  NRS 683A.178 is hereby amended to read as follows: 4 
 683A.178 1. A pharmacy benefit manager has [an] : 5 
 (a) A fiduciary duty to persons covered by a third party with 6 
which the pharmacy benefit manager has entered into an 7 
agreement to provide pharmacy benefit management services; and 8 
 (b) An obligation of good faith and fair dealing toward a third 9 
party or pharmacy when performing duties pursuant to a contract to 10 
which the pharmacy benefit manager is a party. [Any provision of a 11 
contract that waives or limits that obligation is against public policy, 12 
void and unenforceable.] 13 
 2. A pharmacy benefit manager [shall] : 14 
 (a) Shall notify a third party or pharmacy with which it has 15 
entered into a contract in writing of any activity, policy or practice 16 
of the pharmacy benefit manager that presents a conflict of interest 17 
that interferes with the duties or obligations imposed by  18 
subsection 1. 19 
 (b) Shall not engage in any activity or implement any policy or 20 
practice that the pharmacy benefit manager reasonably anticipates 21 
will present a conflict of interest that interferes with the ability of 22 
the pharmacy benefit manager to discharge any duty or obligation 23 
imposed by subsection 1. 24 
 3. A third party with which a pharmacy benefit manager has 25 
entered into an agreement may audit all books and records of the 26 
pharmacy benefit manager to the extent necessary to fulfill all 27 
contractual obligations to covered persons and ensure compliance 28 
with the provisions of the agreement, this chapter and the 29 
regulations adopted pursuant thereto. Such an audit may include, 30 
without limitation, an examination of claims for pharmacy 31 
benefits, rebates and any other information necessary to 32 
accomplish the purposes set forth in this subsection. 33 
 4. A pharmacy benefit manager that manages prescription drug 34 
benefits for an insurer licensed pursuant to this title shall comply 35 
with the provisions of this title which are applicable to the insurer 36 
when managing such benefits for the insurer. 37 
 5. Any provision of a contract that waives or limits any duty 38 
or obligation imposed by this section is against public policy, void 39 
and unenforceable. 40 
 Sec. 24.  NRS 683A.179 is hereby amended to read as follows: 41 
 683A.179 1.  A pharmacy benefit manager shall not: 42 
 (a) Prohibit a pharmacist or pharmacy from providing 43 
information to a covered person concerning: 44   
 	– 16 – 
 
 
- *SB316_R1* 
  (1) The amount of any copayment or coinsurance for a 1 
prescription drug; or 2 
  (2) The availability of a less expensive alternative or generic 3 
drug including, without limitation, information concerning clinical 4 
efficacy of such a drug;  5 
 (b) Penalize a pharmacist or pharmacy for providing the 6 
information described in paragraph (a) or selling a less expensive 7 
alternative or generic drug to a covered person; 8 
 (c) Prohibit a pharmacy from offering or providing delivery 9 
services directly to a covered person as an ancillary service of the 10 
pharmacy; [or] 11 
 (d) If the pharmacy benefit manager manages a pharmacy 12 
benefits plan that provides coverage through a network plan, charge 13 
a copayment or coinsurance for a prescription drug in an amount 14 
that is greater than the total amount paid to a pharmacy that is in the 15 
network of providers under contract with the third party [.] ; 16 
 (e) Restrict, by contract or otherwise, the ability of a pharmacy 17 
to share or disclose the details of a contract between the pharmacy 18 
and the pharmacy benefit manager with the Commissioner; 19 
 (f) Reimburse a pharmacy for a prescription drug in an 20 
amount that is less than the pharmacy pays a wholesaler for the 21 
prescription drug, as reflected on the invoice provided by the 22 
wholesaler to the pharmacy; 23 
 (g) Directly or indirectly reduce or allow the reduction of any 24 
payment to a pharmacy under a pharmacy benefits plan managed 25 
by the pharmacy benefit manager under a reconciliation process 26 
to an effective rate of reimbursement; 27 
 (h) Directly or indirectly retroactively reduce or deny a claim 28 
after the claim has been adjudicated unless: 29 
  (1) The original claim is fraudulent; 30 
  (2) The original payment of the claim was incorrect 31 
because the pharmacy or pharmacist had already been paid for the 32 
pharmacist services to which the claim relates; or 33 
  (3) The pharmacy or pharmacist that submitted the claim 34 
did not properly render the pharmacist services to which the claim 35 
relates; 36 
 (i) Reverse and resubmit the claim of a pharmacy: 37 
  (1) Without notifying and attempting to reconcile the claim 38 
with the pharmacy; or 39 
  (2) More than 90 days after the claim was first affirmatively 40 
adjudicated; 41 
 (j) Charge a pharmacy or a pharmacist a fee to process a claim 42 
electronically; 43   
 	– 17 – 
 
 
- *SB316_R1* 
 (k) Refuse to pay a claim after terminating a contract with a 1 
pharmacy, except where the pharmacy benefit manager is 2 
investigating possible insurance fraud; or 3 
 (l) Retaliate against a pharmacy for reporting a potential or 4 
actual violation of this title or attempting to settle a dispute with a 5 
pharmacy benefit manager based on a potential or actual violation 6 
of this title. 7 
 2.  The provisions of this section: 8 
 (a) Must not be construed to authorize a pharmacist to dispense 9 
a drug that has not been prescribed by a practitioner, as defined in 10 
NRS 639.0125, except to the extent authorized by a specific 11 
provision of law, including, without limitation, NRS 453C.120, 12 
639.28078 and 639.28085. 13 
 (b) Do not apply to an institutional pharmacy, as defined in NRS 14 
639.0085, or a pharmacist working in such a pharmacy as an 15 
employee or independent contractor. 16 
 3. Any provision of a contract that restricts the ability of a 17 
pharmacy to share information pursuant to paragraph (e) of 18 
subsection 1 is against public policy, void and unenforceable. 19 
 4. As used in this section, [“network plan” means a health 20 
benefit plan offered by a health carrier under which the financing 21 
and delivery of medical care is provided, in whole or in part, 22 
through a defined set of providers under contract with the carrier. 23 
The term does not include an arrangement for the financing of 24 
premiums.] “retaliate” includes, without limitation: 25 
 (a) Terminating or refusing to renew a contract with a 26 
pharmacy. 27 
 (b) Making the renewal of a contract with a pharmacy 28 
contingent on the pharmacy acceding to terms and conditions not 29 
applicable to other pharmacies. 30 
 (c) Subjecting the pharmacy to increased audits. 31 
 (d) Failing to promptly pay or reimburse a pharmacy without 32 
substantial justification. 33 
 Sec. 25.  Chapter 689A of NRS is hereby amended by adding 34 
thereto a new section to read as follows: 35 
 1. An insurer that offers or issues a policy of health 36 
insurance which provides coverage for prescription drugs: 37 
 (a) Shall not impose a cost-sharing obligation against an 38 
insured for a prescription drug that exceeds the net amount that 39 
the insurer pays for the drug, inclusive of any rebate received from 40 
a pharmacy benefit manager in connection with providing 41 
coverage for the drug. 42 
 (b) Shall include all amounts paid by an insured or another 43 
person on behalf of an insured towards the cost of a covered 44 
prescription drug when calculating the cost-sharing obligation of 45   
 	– 18 – 
 
 
- *SB316_R1* 
the insured for the drug or the maximum out-of-pocket expense 1 
that the insured is required to pay for prescription drugs if: 2 
  (1) The drug does not have a generic equivalent; or 3 
  (2) The drug has a generic equivalent and the insured has: 4 
   (I) Obtained prior authorization, if required by the 5 
insurer; 6 
   (II) Complied with any required step therapy protocol; 7 
or 8 
   (III) Otherwise received approval from the insurer for 9 
coverage of the prescription drug, including, without limitation, 10 
through an exception, an appeals process established by the 11 
insurer or other review process. 12 
 2. The provisions of paragraph (b) of subsection 1 do not 13 
apply with respect to the required deductible of a high deductible 14 
health plan, as defined in 26 U.S.C. § 223 (c)(2). 15 
 3. As used in this section: 16 
 (a) “Amounts paid” includes, without limitation, a discount, 17 
incentive, coupon or other assistance provided to an insured by a 18 
manufacturer or wholesaler of a prescription drug which is meant 19 
to reduce the out-of-pocket cost that the insured is required to pay 20 
for a prescription drug at the point of sale. 21 
 (b) “Cost-sharing obligation” has the meaning ascribed to it in 22 
section 6 of this act. 23 
 (c) “Generic equivalent” means a prescription drug that is 24 
biologically equivalent and has the same active ingredient or 25 
ingredients of the same strength, quantity and form of dosage as a 26 
drug with a brand name. 27 
 Sec. 26.  NRS 689A.330 is hereby amended to read as follows: 28 
 689A.330 If any policy is issued by a domestic insurer for 29 
delivery to a person residing in another state, and if the insurance 30 
commissioner or corresponding public officer of that other state has 31 
informed the Commissioner that the policy is not subject to approval 32 
or disapproval by that officer, the Commissioner may by ruling 33 
require that the policy meet the standards set forth in NRS 689A.030 34 
to 689A.320, inclusive [.] , and section 25 of this act. 35 
 Sec. 27.  Chapter 689B of NRS is hereby amended by adding 36 
thereto a new section to read as follows: 37 
 1. An insurer that offers or issues a policy of group health 38 
insurance which provides coverage for prescription drugs: 39 
 (a) Shall not impose a cost-sharing obligation against an 40 
insured for a prescription drug that exceeds the net amount that 41 
the insurer pays for the drug, inclusive of any rebate received from 42 
a pharmacy benefit manager in connection with providing 43 
coverage for the drug. 44   
 	– 19 – 
 
 
- *SB316_R1* 
 (b) Shall include all amounts paid by an insured or another 1 
person on behalf of an insured towards the cost of a covered 2 
prescription drug when calculating the cost-sharing obligation of 3 
the insured for the drug or the maximum out-of-pocket expense 4 
that the insured is required to pay for prescription drugs if: 5 
  (1) The drug does not have a generic equivalent; or 6 
  (2) The drug has a generic equivalent and the insured has: 7 
   (I) Obtained prior authorization, if required by the 8 
insurer; 9 
   (II) Complied with any required step therapy protocol; 10 
or 11 
   (III) Otherwise received approval from the insurer for 12 
coverage of the prescription drug, including, without limitation, 13 
through an exception, an appeals process established by the 14 
insurer or other review process. 15 
 2. The provisions of paragraph (b) of subsection 1 do not 16 
apply with respect to the required deductible of a high deductible 17 
health plan, as defined in 26 U.S.C. § 223(c)(2). 18 
 3. As used in this section: 19 
 (a) “Amounts paid” includes, without limitation, a discount, 20 
incentive, coupon or other assistance provided to an insured by a 21 
manufacturer or wholesaler of a prescription drug which is meant 22 
to reduce the out-of-pocket cost that the insured is required to pay 23 
for a prescription drug at the point of sale. 24 
 (b) “Cost-sharing obligation” has the meaning ascribed to it in 25 
section 6 of this act. 26 
 (c) “Generic equivalent” means a prescription drug that is 27 
biologically equivalent and has the same active ingredient or 28 
ingredients of the same strength, quantity and form of dosage as a 29 
drug with a brand name. 30 
 Sec. 28.  Chapter 689C of NRS is hereby amended by adding 31 
thereto a new section to read as follows: 32 
 1. A carrier that offers or issues a health benefit plan which 33 
provides coverage for prescription drugs: 34 
 (a) Shall not impose a cost-sharing obligation against an 35 
insured for a prescription drug that exceeds the net amount that 36 
the carrier pays for the drug, inclusive of any rebate received from 37 
a pharmacy benefit manager in connection with providing 38 
coverage for the drug. 39 
 (b) Shall include all amounts paid by an insured or another 40 
person on behalf of an insured towards the cost of a covered 41 
prescription drug when calculating the cost-sharing obligation of 42 
the insured for the drug or the maximum out-of-pocket expense 43 
that the insured is required to pay for prescription drugs if: 44 
  (1) The drug does not have a generic equivalent; or 45   
 	– 20 – 
 
 
- *SB316_R1* 
  (2) The drug has a generic equivalent and the insured has: 1 
   (I) Obtained prior authorization, if required by the 2 
carrier; 3 
   (II) Complied with any required step therapy protocol; 4 
or 5 
   (III) Otherwise received approval from the carrier for 6 
coverage of the prescription drug, including, without limitation, 7 
through an exception, an appeals process established by the 8 
carrier or other review process. 9 
 2. The provisions of paragraph (b) of subsection 1 do not 10 
apply with respect to the required deductible of a high deductible 11 
health plan, as defined in 26 U.S.C. § 223(c)(2). 12 
 3. As used in this section: 13 
 (a) “Amounts paid” includes, without limitation, a discount, 14 
incentive, coupon or other assistance provided to an insured by a 15 
manufacturer or wholesaler of a prescription drug which is meant 16 
to reduce the out-of-pocket cost that the insured is required to pay 17 
for a prescription drug at the point of sale. 18 
 (b) “Cost-sharing obligation” has the meaning ascribed to it in 19 
section 6 of this act. 20 
 (c) “Generic equivalent” means a prescription drug that is 21 
biologically equivalent and has the same active ingredient or 22 
ingredients of the same strength, quantity and form of dosage as a 23 
drug with a brand name. 24 
 Sec. 29.  NRS 689C.425 is hereby amended to read as follows: 25 
 689C.425 A voluntary purchasing group and any contract 26 
issued to such a group pursuant to NRS 689C.360 to 689C.600, 27 
inclusive, are subject to the provisions of NRS 689C.015 to 28 
689C.355, inclusive, and section 28 of this act, to the extent 29 
applicable and not in conflict with the express provisions of NRS 30 
687B.408 and 689C.360 to 689C.600, inclusive. 31 
 Sec. 30.  Chapter 695A of NRS is hereby amended by adding 32 
thereto a new section to read as follows: 33 
 1. A society that offers or issues a benefit contract which 34 
provides coverage for prescription drugs: 35 
 (a) Shall not impose a cost-sharing obligation against an 36 
insured for a prescription drug that exceeds the net amount that 37 
the society pays for the drug, inclusive of any rebate received from 38 
a pharmacy benefit manager in connection with providing 39 
coverage for the drug. 40 
 (b) Shall include all amounts paid by an insured or another 41 
person on behalf of an insured towards the cost of a covered 42 
prescription drug when calculating the cost-sharing obligation of 43 
the insured for the drug or the maximum out-of-pocket expense 44 
that the insured is required to pay for prescription drugs if: 45   
 	– 21 – 
 
 
- *SB316_R1* 
  (1) The drug does not have a generic equivalent; or 1 
  (2) The drug has a generic equivalent and the insured has: 2 
   (I) Obtained prior authorization, if required by the 3 
society; 4 
   (II) Complied with any required step therapy protocol; 5 
or 6 
   (III) Otherwise received approval from the society for 7 
coverage of the prescription drug, including, without limitation, 8 
through an exception, an appeals process established by the 9 
society or other review process. 10 
 2. The provisions of paragraph (b) of subsection 1 do not 11 
apply with respect to the required deductible of a high deductible 12 
health plan, as defined in 26 U.S.C. § 223(c)(2). 13 
 3. As used in this section: 14 
 (a) “Amounts paid” includes, without limitation, a discount, 15 
incentive, coupon or other assistance provided to an insured by a 16 
manufacturer or wholesaler of a prescription drug which is meant 17 
to reduce the out-of-pocket cost that the insured is required to pay 18 
for a prescription drug at the point of sale. 19 
 (b) “Cost-sharing obligation” has the meaning ascribed to it in 20 
section 6 of this act. 21 
 (c) “Generic equivalent” means a prescription drug that is 22 
biologically equivalent and has the same active ingredient or 23 
ingredients of the same strength, quantity and form of dosage as a 24 
drug with a brand name. 25 
 Sec. 31.  Chapter 695B of NRS is hereby amended by adding 26 
thereto a new section to read as follows: 27 
 1. A hospital or medical services corporation that offers or 28 
issues a policy of health insurance which provides coverage for 29 
prescription drugs: 30 
 (a) Shall not impose a cost-sharing obligation against an 31 
insured for a prescription drug that exceeds the net amount that 32 
the hospital or medical services corporation pays for the drug, 33 
inclusive of any rebate received from a pharmacy benefit manager 34 
in connection with providing coverage for the drug. 35 
 (b) Shall include all amounts paid by an insured or another 36 
person on behalf of an insured towards the cost of a covered 37 
prescription drug when calculating the cost-sharing obligation of 38 
the insured for the drug or the maximum out-of-pocket expense 39 
that the insured is required to pay for prescription drugs if: 40 
  (1) The drug does not have a generic equivalent; or 41 
  (2) The drug has a generic equivalent and the insured has: 42 
   (I) Obtained prior authorization, if required by the 43 
hospital or medical services corporation; 44   
 	– 22 – 
 
 
- *SB316_R1* 
   (II) Complied with any required step therapy protocol; 1 
or 2 
   (III) Otherwise received approval from the hospital or 3 
medical services corporation for coverage of the prescription drug, 4 
including, without limitation, through an exception, an appeals 5 
process established by the hospital or medical services corporation 6 
or other review process. 7 
 2. The provisions of paragraph (b) of subsection 1 do not 8 
apply with respect to the required deductible of a high deductible 9 
health plan, as defined in 26 U.S.C. § 223(c)(2). 10 
 3. As used in this section: 11 
 (a) “Amounts paid” includes, without limitation, a discount, 12 
incentive, coupon or other assistance provided to an insured by a 13 
manufacturer or wholesaler of a prescription drug which is meant 14 
to reduce the out-of-pocket cost that the insured is required to pay 15 
for a prescription drug at the point of sale. 16 
 (b) “Cost-sharing obligation” has the meaning ascribed to it in 17 
section 6 of this act. 18 
 (c) “Generic equivalent” means a prescription drug that is 19 
biologically equivalent and has the same active ingredient or 20 
ingredients of the same strength, quantity and form of dosage as a 21 
drug with a brand name. 22 
 Sec. 32.  Chapter 695C of NRS is hereby amended by adding 23 
thereto a new section to read as follows: 24 
 1. A health maintenance organization that offers or issues a 25 
health care plan which provides coverage for prescription drugs: 26 
 (a) Shall not impose a cost-sharing obligation against an 27 
enrollee for a prescription drug that exceeds the net amount that 28 
the health maintenance organization pays for the drug, inclusive 29 
of any rebate received from a pharmacy benefit manager in 30 
connection with providing coverage for the drug. 31 
 (b) Shall include all amounts paid by an enrollee or another 32 
person on behalf of an enrollee towards the cost of a covered 33 
prescription drug when calculating the cost-sharing obligation of 34 
the enrollee for the drug or the maximum out-of-pocket expense 35 
that the enrollee is required to pay for prescription drugs if: 36 
  (1) The drug does not have a generic equivalent; or 37 
  (2) The drug has a generic equivalent and the enrollee has: 38 
   (I) Obtained prior authorization, if required by the 39 
health maintenance organization; 40 
   (II) Complied with any required step therapy protocol; 41 
or 42 
   (III) Otherwise received approval from the health 43 
maintenance organization for coverage of the prescription drug, 44 
including, without limitation, through an exception, an appeals 45   
 	– 23 – 
 
 
- *SB316_R1* 
process established by the health maintenance organization or 1 
other review process. 2 
 2. The provisions of paragraph (b) of subsection 1 do not 3 
apply with respect to the required deductible of a high deductible 4 
health plan, as defined in 26 U.S.C. § 223(c)(2). 5 
 3. As used in this section: 6 
 (a) “Amounts paid” includes, without limitation, a discount, 7 
incentive, coupon or other assistance provided to an enrollee by a 8 
manufacturer or wholesaler of a prescription drug which is meant 9 
to reduce the out-of-pocket cost that the enrollee is required to pay 10 
for a prescription drug at the point of sale. 11 
 (b) “Cost-sharing obligation” has the meaning ascribed to it in 12 
section 6 of this act. 13 
 (c) “Generic equivalent” means a prescription drug that is 14 
biologically equivalent and has the same active ingredient or 15 
ingredients of the same strength, quantity and form of dosage as a 16 
drug with a brand name. 17 
 Sec. 33.  NRS 695C.050 is hereby amended to read as follows: 18 
 695C.050 1.  Except as otherwise provided in this chapter or 19 
in specific provisions of this title, the provisions of this title are not 20 
applicable to any health maintenance organization granted a 21 
certificate of authority under this chapter. This provision does not 22 
apply to an insurer licensed and regulated pursuant to this title 23 
except with respect to its activities as a health maintenance 24 
organization authorized and regulated pursuant to this chapter. 25 
 2.  Solicitation of enrollees by a health maintenance 26 
organization granted a certificate of authority, or its representatives, 27 
must not be construed to violate any provision of law relating to 28 
solicitation or advertising by practitioners of a healing art. 29 
 3.  Any health maintenance organization authorized under this 30 
chapter shall not be deemed to be practicing medicine and is exempt 31 
from the provisions of chapter 630 of NRS. 32 
 4.  The provisions of NRS 695C.110, 695C.125, 695C.1691, 33 
695C.1693, 695C.170, 695C.1703, 695C.1705, 695C.1709 to 34 
695C.173, inclusive, 695C.1733, 695C.17335, 695C.1734, 35 
695C.1751, 695C.1755, 695C.1759, 695C.176 to 695C.200, 36 
inclusive, and 695C.265 and section 32 of this act do not apply to a 37 
health maintenance organization that provides health care services 38 
through managed care to recipients of Medicaid under the State Plan 39 
for Medicaid or insurance pursuant to the Children’s Health 40 
Insurance Program pursuant to a contract with the Division of 41 
Health Care Financing and Policy of the Department of Health and 42 
Human Services. This subsection does not exempt a health 43 
maintenance organization from any provision of this chapter for 44 
services provided pursuant to any other contract. 45   
 	– 24 – 
 
 
- *SB316_R1* 
 5.  The provisions of NRS 695C.16932 to 695C.1699, 1 
inclusive, 695C.1701, 695C.1708, 695C.1728, 695C.1731, 2 
695C.17333, 695C.17345, 695C.17347, 695C.1736 to 695C.1745, 3 
inclusive, 695C.1757 and 695C.204 apply to a health maintenance 4 
organization that provides health care services through managed 5 
care to recipients of Medicaid under the State Plan for Medicaid. 6 
 6.  The provisions of NRS 695C.17095 and section 32 of this 7 
act do not apply to a health maintenance organization that provides 8 
health care services to members of the Public Employees’ Benefits 9 
Program. This subsection does not exempt a health maintenance 10 
organization from any provision of this chapter for services 11 
provided pursuant to any other contract. 12 
 7.  The provisions of NRS 695C.1735 do not apply to a health 13 
maintenance organization that provides health care services to: 14 
 (a) The officers and employees, and the dependents of officers 15 
and employees, of the governing body of any county, school district, 16 
municipal corporation, political subdivision, public corporation or 17 
other local governmental agency of this State; or 18 
 (b) Members of the Public Employees’ Benefits Program.  19 
 This subsection does not exempt a health maintenance 20 
organization from any provision of this chapter for services 21 
provided pursuant to any other contract. 22 
 Sec. 34.  NRS 695C.330 is hereby amended to read as follows: 23 
 695C.330 1.  The Commissioner may suspend or revoke any 24 
certificate of authority issued to a health maintenance organization 25 
pursuant to the provisions of this chapter if the Commissioner finds 26 
that any of the following conditions exist: 27 
 (a) The health maintenance organization is operating 28 
significantly in contravention of its basic organizational document, 29 
its health care plan or in a manner contrary to that described in and 30 
reasonably inferred from any other information submitted pursuant 31 
to NRS 695C.060, 695C.070 and 695C.140, unless any amendments 32 
to those submissions have been filed with and approved by the 33 
Commissioner; 34 
 (b) The health maintenance organization issues evidence of 35 
coverage or uses a schedule of charges for health care services 36 
which do not comply with the requirements of NRS 695C.1691 to 37 
695C.200, inclusive, and section 32 of this act or 695C.204 or 38 
695C.207; 39 
 (c) The health care plan does not furnish comprehensive health 40 
care services as provided for in NRS 695C.060; 41 
 (d) The Commissioner certifies that the health maintenance 42 
organization: 43 
  (1) Does not meet the requirements of subsection 1 of NRS 44 
695C.080; or 45   
 	– 25 – 
 
 
- *SB316_R1* 
  (2) Is unable to fulfill its obligations to furnish health care 1 
services as required under its health care plan; 2 
 (e) The health maintenance organization is no longer financially 3 
responsible and may reasonably be expected to be unable to meet its 4 
obligations to enrollees or prospective enrollees; 5 
 (f) The health maintenance organization has failed to put into 6 
effect a mechanism affording the enrollees an opportunity to 7 
participate in matters relating to the content of programs pursuant to 8 
NRS 695C.110; 9 
 (g) The health maintenance organization has failed to put into 10 
effect the system required by NRS 695C.260 for: 11 
  (1) Resolving complaints in a manner reasonably to dispose 12 
of valid complaints; and 13 
  (2) Conducting external reviews of adverse determinations 14 
that comply with the provisions of NRS 695G.241 to 695G.310, 15 
inclusive; 16 
 (h) The health maintenance organization or any person on its 17 
behalf has advertised or merchandised its services in an untrue, 18 
misrepresentative, misleading, deceptive or unfair manner; 19 
 (i) The continued operation of the health maintenance 20 
organization would be hazardous to its enrollees or creditors or to 21 
the general public; 22 
 (j) The health maintenance organization fails to provide the 23 
coverage required by NRS 695C.1691; or 24 
 (k) The health maintenance organization has otherwise failed to 25 
comply substantially with the provisions of this chapter. 26 
 2.  A certificate of authority must be suspended or revoked only 27 
after compliance with the requirements of NRS 695C.340. 28 
 3.  If the certificate of authority of a health maintenance 29 
organization is suspended, the health maintenance organization shall 30 
not, during the period of that suspension, enroll any additional 31 
groups or new individual contracts, unless those groups or persons 32 
were contracted for before the date of suspension. 33 
 4.  If the certificate of authority of a health maintenance 34 
organization is revoked, the organization shall proceed, immediately 35 
following the effective date of the order of revocation, to wind up its 36 
affairs and shall conduct no further business except as may be 37 
essential to the orderly conclusion of the affairs of the organization. 38 
It shall engage in no further advertising or solicitation of any kind. 39 
The Commissioner may, by written order, permit such further 40 
operation of the organization as the Commissioner may find to be in 41 
the best interest of enrollees to the end that enrollees are afforded 42 
the greatest practical opportunity to obtain continuing coverage for 43 
health care. 44   
 	– 26 – 
 
 
- *SB316_R1* 
 Sec. 35.  Chapter 695F of NRS is hereby amended by adding 1 
thereto a new section to read as follows: 2 
 1. A prepaid limited health service organization that provides 3 
coverage for prescription drugs: 4 
 (a) Shall not impose a cost-sharing obligation against an 5 
enrollee for a prescription drug that exceeds the net amount that 6 
the prepaid limited health service organization pays for the drug, 7 
inclusive of any rebate received from a pharmacy benefit manager 8 
in connection with providing coverage for the drug. 9 
 (b) Shall include all amounts paid by an enrollee or another 10 
person on behalf of an enrollee towards the cost of a covered 11 
prescription drug when calculating the cost-sharing obligation of 12 
the enrollee for the drug or the maximum out-of-pocket expense 13 
that the enrollee is required to pay for prescription drugs if: 14 
  (1) The drug does not have a generic equivalent; or 15 
  (2) The drug has a generic equivalent and the enrollee has: 16 
   (I) Obtained prior authorization, if required by the 17 
prepaid limited health service organization; 18 
   (II) Complied with any required step therapy protocol; 19 
or 20 
   (III) Otherwise received approval from the prepaid 21 
limited health service organization for coverage of the prescription 22 
drug, including, without limitation, through an exception, an 23 
appeals process established by the prepaid limited health service 24 
organization or other review process. 25 
 2. The provisions of paragraph (b) of subsection 1 do not 26 
apply with respect to the required deductible of a high deductible 27 
health plan, as defined in 26 U.S.C. § 223(c)(2). 28 
 3. As used in this section: 29 
 (a) “Amounts paid” includes, without limitation, a discount, 30 
incentive, coupon or other assistance provided to an enrollee by a 31 
manufacturer or wholesaler of a prescription drug which is meant 32 
to reduce the out-of-pocket cost that the enrollee is required to pay 33 
for a prescription drug at the point of sale. 34 
 (b) “Cost-sharing obligation” has the meaning ascribed to it in 35 
section 6 of this act. 36 
 (c) “Generic equivalent” means a prescription drug that is 37 
biologically equivalent and has the same active ingredient or 38 
ingredients of the same strength, quantity and form of dosage as a 39 
drug with a brand name. 40 
 Sec. 36.  Chapter 695G of NRS is hereby amended by adding 41 
thereto a new section to read as follows: 42 
 1. A managed care organization that offers or issues a health 43 
care plan which provides coverage for prescription drugs: 44   
 	– 27 – 
 
 
- *SB316_R1* 
 (a) Shall not impose a cost-sharing obligation against an 1 
insured for a prescription drug that exceeds the net amount that 2 
the managed care organization pays for the drug, inclusive of any 3 
rebate received from a pharmacy benefit manager in connection 4 
with providing coverage for the drug. 5 
 (b) Shall include all amounts paid by an insured or another 6 
person on behalf of an insured towards the cost of a covered 7 
prescription drug when calculating the cost-sharing obligation of 8 
the insured for the drug or the maximum out-of-pocket expense 9 
that the insured is required to pay for prescription drugs if: 10 
  (1) The drug does not have a generic equivalent; or 11 
  (2) The drug has a generic equivalent and the insured has: 12 
   (I) Obtained prior authorization, if required by the 13 
managed care organization; 14 
   (II) Complied with any required step therapy protocol; 15 
or 16 
   (III) Otherwise received approval from the managed 17 
care organization for coverage of the prescription drug, including, 18 
without limitation, through an exception, an appeals process 19 
established by the managed care organization or other review 20 
process. 21 
 2. The provisions of paragraph (b) of subsection 1 do not 22 
apply with respect to the required deductible of a high deductible 23 
health plan, as defined in 26 U.S.C. § 223(c)(2). 24 
 3. As used in this section: 25 
 (a) “Amounts paid” includes, without limitation, a discount, 26 
incentive, coupon or other assistance provided to an insured by a 27 
manufacturer or wholesaler of a prescription drug which is meant 28 
to reduce the out-of-pocket cost that the insured is required to pay 29 
for a prescription drug at the point of sale. 30 
 (b) “Cost-sharing obligation” has the meaning ascribed to it in 31 
section 6 of this act. 32 
 (c) “Generic equivalent” means a prescription drug that is 33 
biologically equivalent and has the same active ingredient or 34 
ingredients of the same strength, quantity and form of dosage as a 35 
drug with a brand name. 36 
 Sec. 37.  NRS 695G.090 is hereby amended to read as follows: 37 
 695G.090 1.  Except as otherwise provided in subsection 3, 38 
the provisions of this chapter apply to each organization and insurer 39 
that operates as a managed care organization and may include, 40 
without limitation, an insurer that issues a policy of health 41 
insurance, an insurer that issues a policy of individual or group 42 
health insurance, a carrier serving small employers, a fraternal 43 
benefit society, a hospital or medical service corporation and a 44 
health maintenance organization. 45   
 	– 28 – 
 
 
- *SB316_R1* 
 2.  In addition to the provisions of this chapter, each managed 1 
care organization shall comply with: 2 
 (a) The provisions of chapter 686A of NRS, including all 3 
obligations and remedies set forth therein; and 4 
 (b) Any other applicable provision of this title. 5 
 3.  The provisions of NRS 695G.127, 695G.1639, 695G.164, 6 
695G.1645, 695G.167 and 695G.200 to 695G.230, inclusive, and 7 
section 36 of this act do not apply to a managed care organization 8 
that provides health care services to recipients of Medicaid under 9 
the State Plan for Medicaid or insurance pursuant to the Children’s 10 
Health Insurance Program pursuant to a contract with the Division 11 
of Health Care Financing and Policy of the Department of Health 12 
and Human Services.  13 
 4. The provisions of NRS 695C.1735 and 695G.1639 and 14 
section 36 of this act do not apply to a managed care organization 15 
that provides health care services to members of the Public 16 
Employees’ Benefits Program. 17 
 5. Subsections 3 and 4 do not exempt a managed care 18 
organization from any provision of this chapter for services 19 
provided pursuant to any other contract. 20 
 Sec. 38.  NRS 41.600 is hereby amended to read as follows: 21 
 41.600 1.  [An] Except as otherwise provided in section 18 of 22 
this act, an action may be brought by any person who is a victim of 23 
consumer fraud. 24 
 2.  As used in this section, “consumer fraud” means: 25 
 (a) An unlawful act as defined in NRS 119.330; 26 
 (b) An unlawful act as defined in NRS 205.2747; 27 
 (c) An act prohibited by NRS 482.36655 to 482.36667, 28 
inclusive; 29 
 (d) An act prohibited by NRS 482.351; 30 
 (e) A deceptive trade practice as defined in NRS 598.0915 to 31 
598.0925, inclusive; or 32 
 (f) A violation of NRS 417.133 or 417.135. 33 
 3.  If the claimant is the prevailing party, the court shall award 34 
the claimant: 35 
 (a) Any damages that the claimant has sustained; 36 
 (b) Any equitable relief that the court deems appropriate; and 37 
 (c) The claimant’s costs in the action and reasonable attorney’s 38 
fees. 39 
 4.  Any action brought pursuant to this section is not an action 40 
upon any contract underlying the original transaction. 41 
 Sec. 39.  NRS 239.010 is hereby amended to read as follows: 42 
 239.010 1.  Except as otherwise provided in this section and 43 
NRS 1.4683, 1.4687, 1A.110, 3.2203, 41.0397, 41.071, 49.095, 44 
49.293, 62D.420, 62D.440, 62E.516, 62E.620, 62H.025, 62H.030, 45   
 	– 29 – 
 
 
- *SB316_R1* 
62H.170, 62H.220, 62H.320, 75A.100, 75A.150, 76.160, 78.152, 1 
80.113, 81.850, 82.183, 86.246, 86.54615, 87.515, 87.5413, 2 
87A.200, 87A.580, 87A.640, 88.3355, 88.5927, 88.6067, 88A.345, 3 
88A.7345, 89.045, 89.251, 90.730, 91.160, 116.757, 116A.270, 4 
116B.880, 118B.026, 119.260, 119.265, 119.267, 119.280, 5 
119A.280, 119A.653, 119A.677, 119B.370, 119B.382, 120A.640, 6 
120A.690, 125.130, 125B.140, 126.141, 126.161, 126.163, 126.730, 7 
127.007, 127.057, 127.130, 127.140, 127.2817, 128.090, 130.312, 8 
130.712, 136.050, 159.044, 159A.044, 164.041, 172.075, 172.245, 9 
176.01334, 176.01385, 176.015, 176.0625, 176.09129, 176.156, 10 
176A.630, 178.39801, 178.4715, 178.5691, 178.5717, 179.495, 11 
179A.070, 179A.165, 179D.160, 180.600, 200.3771, 200.3772, 12 
200.5095, 200.604, 202.3662, 205.4651, 209.392, 209.3923, 13 
209.3925, 209.419, 209.429, 209.521, 211A.140, 213.010, 213.040, 14 
213.095, 213.131, 217.105, 217.110, 217.464, 217.475, 218A.350, 15 
218E.625, 218F.150, 218G.130, 218G.240, 218G.350, 218G.615, 16 
224.240, 226.462, 226.796, 228.270, 228.450, 228.495, 228.570, 17 
231.069, 231.1285, 231.1473, 232.1369, 233.190, 237.300, 18 
239.0105, 239.0113, 239.014, 239B.026, 239B.030, 239B.040, 19 
239B.050, 239C.140, 239C.210, 239C.230, 239C.250, 239C.270, 20 
239C.420, 240.007, 241.020, 241.030, 241.039, 242.105, 244.264, 21 
244.335, 247.540, 247.545, 247.550, 247.560, 250.087, 250.130, 22 
250.140, 250.145, 250.150, 268.095, 268.0978, 268.490, 268.910, 23 
269.174, 271A.105, 281.195, 281.805, 281A.350, 281A.680, 24 
281A.685, 281A.750, 281A.755, 281A.780, 284.4068, 284.4086, 25 
286.110, 286.118, 287.0438, 289.025, 289.080, 289.387, 289.830, 26 
293.4855, 293.5002, 293.503, 293.504, 293.558, 293.5757, 293.870, 27 
293.906, 293.908, 293.909, 293.910, 293B.135, 293D.510, 331.110, 28 
332.061, 332.351, 333.333, 333.335, 338.070, 338.1379, 338.1593, 29 
338.1725, 338.1727, 348.420, 349.597, 349.775, 353.205, 30 
353A.049, 353A.085, 353A.100, 353C.240, 353D.250, 360.240, 31 
360.247, 360.255, 360.755, 361.044, 361.2242, 361.610, 365.138, 32 
366.160, 368A.180, 370.257, 370.327, 372A.080, 378.290, 378.300, 33 
379.0075, 379.008, 379.1495, 385A.830, 385B.100, 387.626, 34 
387.631, 388.1455, 388.259, 388.501, 388.503, 388.513, 388.750, 35 
388A.247, 388A.249, 391.033, 391.035, 391.0365, 391.120, 36 
391.925, 392.029, 392.147, 392.264, 392.271, 392.315, 392.317, 37 
392.325, 392.327, 392.335, 392.850, 393.045, 394.167, 394.16975, 38 
394.1698, 394.447, 394.460, 394.465, 396.1415, 396.1425, 396.143, 39 
396.159, 396.3295, 396.405, 396.525, 396.535, 396.9685, 40 
398A.115, 408.3885, 408.3886, 408.3888, 408.5484, 412.153, 41 
414.280, 416.070, 422.2749, 422.305, 422A.342, 422A.350, 42 
425.400, 427A.1236, 427A.872, 427A.940, 432.028, 432.205, 43 
432B.175, 432B.280, 432B.290, 432B.4018, 432B.407, 432B.430, 44 
432B.560, 432B.5902, 432C.140, 432C.150, 433.534, 433A.360, 45   
 	– 30 – 
 
 
- *SB316_R1* 
439.4941, 439.4988, 439.5282, 439.840, 439.914, 439A.116, 1 
439A.124, 439B.420, 439B.754, 439B.760, 439B.845, 440.170, 2 
441A.195, 441A.220, 441A.230, 442.330, 442.395, 442.735, 3 
442.774, 445A.665, 445B.570, 445B.7773, 449.209, 449.245, 4 
449.4315, 449A.112, 450.140, 450B.188, 450B.805, 453.164, 5 
453.720, 458.055, 458.280, 459.050, 459.3866, 459.555, 459.7056, 6 
459.846, 463.120, 463.15993, 463.240, 463.3403, 463.3407, 7 
463.790, 467.1005, 480.535, 480.545, 480.935, 480.940, 481.063, 8 
481.091, 481.093, 482.170, 482.368, 482.5536, 483.340, 483.363, 9 
483.575, 483.659, 483.800, 484A.469, 484B.830, 484B.833, 10 
484E.070, 485.316, 501.344, 503.452, 522.040, 534A.031, 561.285, 11 
571.160, 584.655, 587.877, 598.0964, 598.098, 598A.110, 12 
598A.420, 599B.090, 603.070, 603A.210, 604A.303, 604A.710, 13 
604D.500, 604D.600, 612.265, 616B.012, 616B.015, 616B.315, 14 
616B.350, 618.341, 618.425, 622.238, 622.310, 623.131, 623A.137, 15 
624.110, 624.265, 624.327, 625.425, 625A.185, 628.418, 628B.230, 16 
628B.760, 629.043, 629.047, 629.069, 630.133, 630.2671, 17 
630.2672, 630.2673, 630.2687, 630.30665, 630.336, 630A.327, 18 
630A.555, 631.332, 631.368, 632.121, 632.125, 632.3415, 19 
632.3423, 632.405, 633.283, 633.301, 633.427, 633.4715, 633.4716, 20 
633.4717, 633.524, 634.055, 634.1303, 634.214, 634A.169, 21 
634A.185, 634B.730, 635.111, 635.158, 636.262, 636.342, 637.085, 22 
637.145, 637B.192, 637B.288, 638.087, 638.089, 639.183, 23 
639.2485, 639.570, 640.075, 640.152, 640A.185, 640A.220, 24 
640B.405, 640B.730, 640C.580, 640C.600, 640C.620, 640C.745, 25 
640C.760, 640D.135, 640D.190, 640E.225, 640E.340, 641.090, 26 
641.221, 641.2215, 641A.191, 641A.217, 641A.262, 641B.170, 27 
641B.281, 641B.282, 641C.455, 641C.760, 641D.260, 641D.320, 28 
642.524, 643.189, 644A.870, 645.180, 645.625, 645A.050, 29 
645A.082, 645B.060, 645B.092, 645C.220, 645C.225, 645D.130, 30 
645D.135, 645G.510, 645H.320, 645H.330, 647.0945, 647.0947, 31 
648.033, 648.197, 649.065, 649.067, 652.126, 652.228, 653.900, 32 
654.110, 656.105, 657A.510, 661.115, 665.130, 665.133, 669.275, 33 
669.285, 669A.310, 670B.680, 671.365, 671.415, 673.450, 673.480, 34 
675.380, 676A.340, 676A.370, 677.243, 678A.470, 678C.710, 35 
678C.800, 679B.122, 679B.124, 679B.152, 679B.159, 679B.190, 36 
679B.285, 679B.690, 680A.270, 681A.440, 681B.260, 681B.410, 37 
681B.540, 683A.0873, 685A.077, 686A.289, 686B.170, 686C.306, 38 
687A.060, 687A.115, 687B.404, 687C.010, 688C.230, 688C.480, 39 
688C.490, 689A.696, 692A.117, 692C.190, 692C.3507, 692C.3536, 40 
692C.3538, 692C.354, 692C.420, 693A.480, 693A.615, 696B.550, 41 
696C.120, 703.196, 704B.325, 706.1725, 706A.230, 710.159, 42 
711.600, and sections 1 and 19 of this act, sections 35, 38 and 41 of 43 
chapter 478, Statutes of Nevada 2011 and section 2 of chapter 391, 44 
Statutes of Nevada 2013 and unless otherwise declared by law to be 45   
 	– 31 – 
 
 
- *SB316_R1* 
confidential, all public books and public records of a governmental 1 
entity must be open at all times during office hours to inspection by 2 
any person, and may be fully copied or an abstract or memorandum 3 
may be prepared from those public books and public records. Any 4 
such copies, abstracts or memoranda may be used to supply the 5 
general public with copies, abstracts or memoranda of the records or 6 
may be used in any other way to the advantage of the governmental 7 
entity or of the general public. This section does not supersede or in 8 
any manner affect the federal laws governing copyrights or enlarge, 9 
diminish or affect in any other manner the rights of a person in any 10 
written book or record which is copyrighted pursuant to federal law. 11 
 2.  A governmental entity may not reject a book or record 12 
which is copyrighted solely because it is copyrighted. 13 
 3.  A governmental entity that has legal custody or control of a 14 
public book or record shall not deny a request made pursuant to 15 
subsection 1 to inspect or copy or receive a copy of a public book or 16 
record on the basis that the requested public book or record contains 17 
information that is confidential if the governmental entity can 18 
redact, delete, conceal or separate, including, without limitation, 19 
electronically, the confidential information from the information 20 
included in the public book or record that is not otherwise 21 
confidential. 22 
 4.  If requested, a governmental entity shall provide a copy of a 23 
public record in an electronic format by means of an electronic 24 
medium. Nothing in this subsection requires a governmental entity 25 
to provide a copy of a public record in an electronic format or by 26 
means of an electronic medium if: 27 
 (a) The public record: 28 
  (1) Was not created or prepared in an electronic format; and 29 
  (2) Is not available in an electronic format; or 30 
 (b) Providing the public record in an electronic format or by 31 
means of an electronic medium would: 32 
  (1) Give access to proprietary software; or 33 
  (2) Require the production of information that is confidential 34 
and that cannot be redacted, deleted, concealed or separated from 35 
information that is not otherwise confidential. 36 
 5. An officer, employee or agent of a governmental entity who 37 
has legal custody or control of a public record: 38 
 (a) Shall not refuse to provide a copy of that public record in the 39 
medium that is requested because the officer, employee or agent has 40 
already prepared or would prefer to provide the copy in a different 41 
medium. 42 
 (b) Except as otherwise provided in NRS 239.030, shall, upon 43 
request, prepare the copy of the public record and shall not require 44   
 	– 32 – 
 
 
- *SB316_R1* 
the person who has requested the copy to prepare the copy himself 1 
or herself. 2 
 Sec. 40.  NRS 287.010 is hereby amended to read as follows: 3 
 287.010 1.  The governing body of any county, school 4 
district, municipal corporation, political subdivision, public 5 
corporation or other local governmental agency of the State of 6 
Nevada may: 7 
 (a) Adopt and carry into effect a system of group life, accident 8 
or health insurance, or any combination thereof, for the benefit of its 9 
officers and employees, and the dependents of officers and 10 
employees who elect to accept the insurance and who, where 11 
necessary, have authorized the governing body to make deductions 12 
from their compensation for the payment of premiums on the 13 
insurance. 14 
 (b) Purchase group policies of life, accident or health insurance, 15 
or any combination thereof, for the benefit of such officers and 16 
employees, and the dependents of such officers and employees, as 17 
have authorized the purchase, from insurance companies authorized 18 
to transact the business of such insurance in the State of Nevada, 19 
and, where necessary, deduct from the compensation of officers and 20 
employees the premiums upon insurance and pay the deductions 21 
upon the premiums. 22 
 (c) Provide group life, accident or health coverage through a 23 
self-insurance reserve fund and, where necessary, deduct 24 
contributions to the maintenance of the fund from the compensation 25 
of officers and employees and pay the deductions into the fund. The 26 
money accumulated for this purpose through deductions from the 27 
compensation of officers and employees and contributions of the 28 
governing body must be maintained as an internal service fund as 29 
defined by NRS 354.543. The money must be deposited in a state or 30 
national bank or credit union authorized to transact business in the 31 
State of Nevada. Any independent administrator of a fund created 32 
under this section is subject to the licensing requirements of chapter 33 
683A of NRS, and must be a resident of this State. Any contract 34 
with an independent administrator must be approved by the 35 
Commissioner of Insurance as to the reasonableness of 36 
administrative charges in relation to contributions collected and 37 
benefits provided. The provisions of NRS 439.581 to 439.597, 38 
inclusive, 686A.135, 687B.352, 687B.408, 687B.692, 687B.723, 39 
687B.725, 687B.805, 689B.030 to 689B.0317, inclusive, paragraphs 40 
(b) and (c) of subsection 1 of NRS 689B.0319, subsections 2, 4, 6 41 
and 7 of NRS 689B.0319, 689B.033 to 689B.0369, inclusive, 42 
689B.0375 to 689B.050, inclusive, 689B.0675, 689B.265, 689B.287 43 
and 689B.500 and section 27 of this act apply to coverage provided 44 
pursuant to this paragraph, except that the provisions of  45   
 	– 33 – 
 
 
- *SB316_R1* 
NRS 689B.0378, 689B.03785 and 689B.500 only apply to coverage 1 
for active officers and employees of the governing body, or the 2 
dependents of such officers and employees. 3 
 (d) Defray part or all of the cost of maintenance of a self-4 
insurance fund or of the premiums upon insurance. The money for 5 
contributions must be budgeted for in accordance with the laws 6 
governing the county, school district, municipal corporation, 7 
political subdivision, public corporation or other local governmental 8 
agency of the State of Nevada. 9 
 2.  If a school district offers group insurance to its officers and 10 
employees pursuant to this section, members of the board of trustees 11 
of the school district must not be excluded from participating in the 12 
group insurance. If the amount of the deductions from compensation 13 
required to pay for the group insurance exceeds the compensation to 14 
which a trustee is entitled, the difference must be paid by the trustee. 15 
 3.  In any county in which a legal services organization exists, 16 
the governing body of the county, or of any school district, 17 
municipal corporation, political subdivision, public corporation or 18 
other local governmental agency of the State of Nevada in the 19 
county, may enter into a contract with the legal services 20 
organization pursuant to which the officers and employees of the 21 
legal services organization, and the dependents of those officers and 22 
employees, are eligible for any life, accident or health insurance 23 
provided pursuant to this section to the officers and employees, and 24 
the dependents of the officers and employees, of the county, school 25 
district, municipal corporation, political subdivision, public 26 
corporation or other local governmental agency. 27 
 4.  If a contract is entered into pursuant to subsection 3, the 28 
officers and employees of the legal services organization: 29 
 (a) Shall be deemed, solely for the purposes of this section, to be 30 
officers and employees of the county, school district, municipal 31 
corporation, political subdivision, public corporation or other local 32 
governmental agency with which the legal services organization has 33 
contracted; and 34 
 (b) Must be required by the contract to pay the premiums or 35 
contributions for all insurance which they elect to accept or of which 36 
they authorize the purchase. 37 
 5.  A contract that is entered into pursuant to subsection 3: 38 
 (a) Must be submitted to the Commissioner of Insurance for 39 
approval not less than 30 days before the date on which the contract 40 
is to become effective. 41 
 (b) Does not become effective unless approved by the 42 
Commissioner. 43 
 (c) Shall be deemed to be approved if not disapproved by the 44 
Commissioner within 30 days after its submission. 45   
 	– 34 – 
 
 
- *SB316_R1* 
 6.  As used in this section, “legal services organization” means 1 
an organization that operates a program for legal aid and receives 2 
money pursuant to NRS 19.031. 3 
 Sec. 41.  NRS 287.04335 is hereby amended to read as 4 
follows: 5 
 287.04335 If the Board provides health insurance through a 6 
plan of self-insurance, it shall comply with the provisions of  7 
NRS 439.581 to 439.597, inclusive, 686A.135, 687B.352, 8 
687B.409, 687B.692, 687B.723, 687B.725, 687B.805, 689B.0353, 9 
689B.255, 695C.1723, 695G.150, 695G.155, 695G.160, 695G.162, 10 
695G.1635, 695G.164, 695G.1645, 695G.1665, 695G.167, 11 
695G.1675, 695G.170 to 695G.1712, inclusive, 695G.1714 to 12 
695G.174, inclusive, 695G.176, 695G.177, 695G.200 to 695G.230, 13 
inclusive, other than section 36 of this act, 695G.241 to 695G.310, 14 
inclusive, 695G.405 and 695G.415, in the same manner as an 15 
insurer that is licensed pursuant to title 57 of NRS is required to 16 
comply with those provisions. 17 
 Sec. 42.  NRS 598.0977 is hereby amended to read as follows: 18 
 598.0977 Except as otherwise provided in NRS 603A.550 [,] 19 
and section 18 of this act, if an elderly person or a person with a 20 
disability suffers damage or injury as a result of a deceptive trade 21 
practice, he or she or his or her legal representative, if any, may 22 
commence a civil action against any person who engaged in the 23 
practice to recover the actual damages suffered by the elderly person 24 
or person with a disability, punitive damages, if appropriate, and 25 
reasonable attorney’s fees. The collection of any restitution awarded 26 
pursuant to this section has a priority over the collection of any civil 27 
penalty imposed pursuant to NRS 598.0973. 28 
 Sec. 43.  The amendatory provisions of this act do not apply to 29 
any contract or other agreement entered into before January 1, 2026, 30 
but apply to the renewal of any such contract or other agreement. 31 
 Sec. 44.  The provisions of subsection 1 of NRS 218D.380 do 32 
not apply to any provision of this act which adds or revises a 33 
requirement to submit a report to the Legislature. 34 
 Sec. 45.  The provisions of NRS 354.599 do not apply to any 35 
additional expenses of a local government that are related to the 36 
provisions of this act. 37 
 Sec. 46.  1. This section becomes effective upon passage and 38 
approval. 39 
 2. Sections 1 to 16, inclusive, and 17 to 45, inclusive, of this 40 
act become effective: 41 
 (a) Upon passage and approval for the purpose of adopting any 42 
regulations and performing any other preparatory administrative 43 
tasks that are necessary to carry out the provisions of this act; and 44 
 (b) On January 1, 2026, for all other purposes. 45   
 	– 35 – 
 
 
- *SB316_R1* 
 3. Section 16.5 of this act becomes effective: 1 
 (a) Upon passage and approval for the purpose of adopting any 2 
regulations and performing any other preparatory administrative 3 
tasks that are necessary to carry out the provisions of this act; and 4 
 (b) On January 1, 2028, for all other purposes. 5 
 
H