S.B. 352
- *SB352*
SENATE BILL NO. 352–SENATORS SCHEIBLE, CRUZ-CRAWFORD;
CANNIZZARO, DALY, DOÑATE, DONDERO LOOP, FLORES,
LANGE, NGUYEN, OHRENSCHALL AND PAZINA
MARCH 13, 2025
____________
JOINT SPONSORS: ASSEMBLYMEMBERS ROTH,
GONZÁLEZ AND DALIA
____________
Referred to Committee on Commerce and Labor
SUMMARY—Revises provisions relating to health care.
(BDR 57-712)
FISCAL NOTE: Effect on Local Government: May have Fiscal Impact.
Effect on the State: Yes.
CONTAINS UNFUNDED MANDATE (§ 2 & NRS 287.010)
(NOT REQUESTED BY AFFECTED LOCAL GOVERNMENT)
~
EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted.
AN ACT relating to health care; prohibiting certain health insurers
and providers of health care from engaging in certain
discriminatory actions; and providing other matters
properly relating thereto.
Legislative Counsel’s Digest:
Existing federal law prohibits certain health care entities from discriminating 1
on the basis of race, color, national origin, sex, age or disability. (45 C.F.R. §§ 2
92.101, 92.206, 92.208, 92.209) Existing law prohibits certain public and private 3
policies of health insurance from discriminating against any person with respect to 4
participation or coverage under the policy on basis of actual or perceived gender 5
identity or expression. (NRS 287.010, 287.04335, 422.2701, 608.1555, 689A.033, 6
689B.0675, 689C.1975, 689C.425, 695A.198, 695B.3167, 695C.050, 695C.204, 7
695G.415) Sections 1-8 of this bill additionally prohibit public and private policies 8
of health insurance, including Medicaid, from discriminating against any person on 9
the basis of actual or perceived race, color, national origin, sex, age or disability. 10
Section 9 of this bill similarly prohibits a provider of health care from 11
discriminating against a person on the basis of those same characteristics, as well as 12
gender identity or expression. Section 9 also authorizes a board, agency or other 13
entity in this State that licenses, certifies or regulates providers of health care to: 14
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(1) adopt regulations prescribing the specific types of discrimination prohibited; 15
and (2) discipline a provider of health care who violates section 9. 16
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1. NRS 689A.033 is hereby amended to read as 1
follows: 2
689A.033 1. An insurer that issues a policy of health 3
insurance shall not discriminate against any person with respect to 4
participation or coverage under the policy on the basis of an actual 5
or perceived [gender identity or expression.] protected 6
characteristic. 7
2. Prohibited discrimination includes, without limitation: 8
[1.] (a) Denying, cancelling, limiting or refusing to issue or 9
renew a policy of health insurance on the basis of [the] an actual or 10
perceived [gender identity or expression] protected characteristic of 11
a person or a family member of the person; 12
[2.] (b) Imposing a payment or premium that is based on [the] 13
an actual or perceived [gender identity or expression] protected 14
characteristic of an insured or a family member of the insured; 15
[3.] (c) Designating [the] an actual or perceived [gender 16
identity or expression] protected characteristic of a person or a 17
family member of the person as grounds to deny, cancel or limit 18
participation or coverage; and 19
[4.] (d) Denying, cancelling or limiting participation or 20
coverage on the basis of an actual or perceived [gender identity or 21
expression,] protected characteristic, including, without limitation, 22
by limiting or denying coverage for health care services that are: 23
[(a)] (1) Related to gender transition, provided that there is 24
coverage under the policy for the services when the services are not 25
related to gender transition; or 26
[(b)] (2) Ordinarily or exclusively available to persons of any 27
sex. 28
3. As used in this section, “protected characteristic” means: 29
(a) Race, color, national origin, age, physical or mental 30
disability, sexual orientation or gender identity or expression; or 31
(b) Sex, including, without limitation, sex characteristics, 32
intersex traits and pregnancy or related conditions. 33
Sec. 2. NRS 689B.0675 is hereby amended to read as follows: 34
689B.0675 1. An insurer that issues a policy of group health 35
insurance shall not discriminate against any person with respect to 36
participation or coverage under the policy on the basis of an actual 37
or perceived [gender identity or expression.] protected 38
characteristic. 39
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2. Prohibited discrimination includes, without limitation: 1
[1.] (a) Denying, cancelling, limiting or refusing to issue or 2
renew a policy of group health insurance on the basis of [the] an 3
actual or perceived [gender identity or expression] protected 4
characteristic of a person or a family member of the person; 5
[2.] (b) Imposing a payment or premium that is based on [the] 6
an actual or perceived [gender identity or expression] protected 7
characteristic of an insured or a family member of the insured; 8
[3.] (c) Designating [the] an actual or perceived [gender 9
identity or expression] protected characteristic of a person or a 10
family member of the person as grounds to deny, cancel or limit 11
participation or coverage; and 12
[4.] (d) Denying, cancelling or limiting participation or 13
coverage on the basis of an actual or perceived [gender identity or 14
expression,] protected characteristic, including, without limitation, 15
by limiting or denying coverage for health care services that are: 16
[(a)] (1) Related to gender transition, provided that there is 17
coverage under the policy for the services when the services are not 18
related to gender transition; or 19
[(b)] (2) Ordinarily or exclusively available to persons of any 20
sex. 21
3. As used in this section, “protected characteristic” means: 22
(a) Race, color, national origin, age, physical or mental 23
disability, sexual orientation or gender identity or expression; or 24
(b) Sex, including, without limitation, sex characteristics, 25
intersex traits and pregnancy or related conditions. 26
Sec. 3. NRS 689C.1975 is hereby amended to read as follows: 27
689C.1975 1. A carrier that issues a health benefit plan shall 28
not discriminate against any person with respect to participation or 29
coverage under the plan on the basis of an actual or perceived 30
[gender identity or expression.] protected characteristic. 31
2. Prohibited discrimination includes, without limitation: 32
[1.] (a) Denying, cancelling, limiting or refusing to issue or 33
renew a health benefit plan on the basis of [the] an actual or 34
perceived [gender identity or expression] protected characteristic of 35
a person or a family member of the person; 36
[2.] (b) Imposing a payment or premium that is based on [the] 37
an actual or perceived [gender identity or expression] protected 38
characteristic of an insured or a family member of the insured; 39
[3.] (c) Designating [the] an actual or perceived [gender 40
identity or expression] protected characteristic of a person or a 41
family member of the person as grounds to deny, cancel or limit 42
participation or coverage; and 43
[4.] (d) Denying, cancelling or limiting participation or 44
coverage on the basis of an actual or perceived [gender identity or 45
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expression,] protected characteristic, including, without limitation, 1
by limiting or denying coverage for health care services that are: 2
[(a)] (1) Related to gender transition, provided that there is 3
coverage under the plan for the services when the services are not 4
related to gender transition; or 5
[(b)] (2) Ordinarily or exclusively available to persons of any 6
sex. 7
3. As used in this section, “protected characteristic” means: 8
(a) Race, color, national origin, age, physical or mental 9
disability, sexual orientation or gender identity or expression; or 10
(b) Sex, including, without limitation, sex characteristics, 11
intersex traits and pregnancy or related conditions. 12
Sec. 4. NRS 695A.198 is hereby amended to read as follows: 13
695A.198 1. A society that issues a benefit contract shall not 14
discriminate against any person with respect to participation or 15
coverage under the contract on the basis of an actual or perceived 16
[gender identity or expression.] protected characteristic. 17
2. Prohibited discrimination includes, without limitation: 18
[1.] (a) Denying, cancelling, limiting or refusing to issue or 19
renew a benefit contract on the basis of [the] an actual or perceived 20
[gender identity or expression] protected characteristic of a person 21
or a family member of the person; 22
[2.] (b) Imposing a payment or premium that is based on [the] 23
an actual or perceived [gender identity or expression] protected 24
characteristic of an insured or a family member of the insured; 25
[3.] (c) Designating [the] an actual or perceived [gender 26
identity or expression] protected characteristic of a person or a 27
family member of the person as grounds to deny, cancel or limit 28
participation or coverage; and 29
[4.] (d) Denying, cancelling or limiting participation or 30
coverage on the basis of an actual or perceived [gender identity or 31
expression,] protected characteristic, including, without limitation, 32
by limiting or denying coverage for health care services that are: 33
[(a)] (1) Related to gender transition, provided that there is 34
coverage under the contract for the services when the services are 35
not related to gender transition; or 36
[(b)] (2) Ordinarily or exclusively available to persons of any 37
sex. 38
3. As used in this section, “protected characteristic” means: 39
(a) Race, color, national origin, age, physical or mental 40
disability, sexual orientation or gender identity or expression; or 41
(b) Sex, including, without limitation, sex characteristics, 42
intersex traits and pregnancy or related conditions. 43
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Sec. 5. NRS 695B.3167 is hereby amended to read as follows: 1
695B.3167 1. A hospital or medical services corporation that 2
issues a policy of health insurance shall not discriminate against any 3
person with respect to participation or coverage under the policy on 4
the basis of an actual or perceived [gender identity or expression.] 5
protected characteristic. 6
2. Prohibited discrimination includes, without limitation: 7
[1.] (a) Denying, cancelling, limiting or refusing to issue or 8
renew a policy of health insurance on the basis of [the] an actual or 9
perceived [gender identity or expression] protected characteristic of 10
a person or a family member of the person; 11
[2.] (b) Imposing a payment or premium that is based on [the] 12
an actual or perceived [gender identity or expression] protected 13
characteristic of an insured or a family member of the insured; 14
[3.] (c) Designating [the] an actual or perceived [gender 15
identity or expression] protected characteristic of a person or a 16
family member of the person as grounds to deny, cancel or limit 17
participation or coverage; and 18
[4.] (d) Denying, cancelling or limiting participation or 19
coverage on the basis of an actual or perceived [gender identity or 20
expression,] protected characteristic, including, without limitation, 21
by limiting or denying coverage for health care services that are: 22
[(a)] (1) Related to gender transition, provided that there is 23
coverage under the policy for the services when the services are not 24
related to gender transition; or 25
[(b)] (2) Ordinarily or exclusively available to persons of any 26
sex. 27
3. As used in this section, “protected characteristic” means: 28
(a) Race, color, national origin, age, physical or mental 29
disability, sexual orientation or gender identity or expression; or 30
(b) Sex, including, without limitation, sex characteristics, 31
intersex traits and pregnancy or related conditions. 32
Sec. 6. NRS 695C.204 is hereby amended to read as follows: 33
695C.204 1. A health maintenance organization that issues a 34
health care plan shall not discriminate against any person with 35
respect to participation or coverage under the plan on the basis of an 36
actual or perceived [gender identity or expression.] protected 37
characteristic. 38
2. Prohibited discrimination includes, without limitation: 39
[1.] (a) Denying, cancelling, limiting or refusing to issue or 40
renew a health care plan on the basis of [the] an actual or perceived 41
[gender identity or expression] protected characteristic of a person 42
or a family member of the person; 43
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[2.] (b) Imposing a payment or premium that is based on [the] 1
an actual or perceived [gender identity or expression] protected 2
characteristic of an enrollee or a family member of the enrollee; 3
[3.] (c) Designating [the] an actual or perceived [gender 4
identity or expression] protected characteristic of a person or a 5
family member of the person as grounds to deny, cancel or limit 6
participation or coverage; and 7
[4.] (d) Denying, cancelling or limiting participation or 8
coverage on the basis of an actual or perceived [gender identity or 9
expression,] protected characteristic, including, without 10
limitation, by limiting or denying coverage for health care services 11
that are: 12
[(a)] (1) Related to gender transition, provided that there is 13
coverage under the plan for the services when the services are not 14
related to gender transition; or 15
[(b)] (2) Ordinarily or exclusively available to persons of any 16
sex. 17
3. As used in this section, “protected characteristic” 18
means: 19
(a) Race, color, national origin, age, physical or mental 20
disability, sexual orientation or gender identity or expression; or 21
(b) Sex, including, without limitation, sex characteristics, 22
intersex traits and pregnancy or related conditions. 23
Sec. 7. NRS 695G.415 is hereby amended to read as follows: 24
695G.415 1. A managed care organization that issues a 25
health care plan shall not discriminate against any person with 26
respect to participation or coverage under the plan on the basis of an 27
actual or perceived [gender identity or expression.] protected 28
characteristic. 29
2. Prohibited discrimination includes, without limitation: 30
[1.] (a) Denying, cancelling, limiting or refusing to issue or 31
renew a health care plan on the basis of [the] an actual or perceived 32
[gender identity or expression] protected characteristic of a person 33
or a family member of the person; 34
[2.] (b) Imposing a payment or premium that is based on [the] 35
an actual or perceived [gender identity or expression] protected 36
characteristic of an insured or a family member of the insured; 37
[3.] (c) Designating [the] an actual or perceived [gender 38
identity or expression] protected characteristic of a person or a 39
family member of the person as grounds to deny, cancel or limit 40
participation or coverage; and 41
[4.] (d) Denying, cancelling or limiting participation or 42
coverage on the basis of an actual or perceived [gender identity or 43
expression,] protected characteristic, including, without 44
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limitation, by limiting or denying coverage for health care services 1
that are: 2
[(a)] (1) Related to gender transition, provided that there is 3
coverage under the plan for the services when the services are not 4
related to gender transition; or 5
[(b)] (2) Ordinarily or exclusively available to persons of any 6
sex. 7
3. As used in this section, “protected characteristic” means: 8
(a) Race, color, national origin, age, physical or mental 9
disability, sexual orientation or gender identity or expression; or 10
(b) Sex, including, without limitation, sex characteristics, 11
intersex traits and pregnancy or related conditions. 12
Sec. 8. NRS 422.2701 is hereby amended to read as follows: 13
422.2701 1. The Department shall not discriminate against 14
any person with respect to participation or coverage under Medicaid 15
on the basis of an actual or perceived [gender identity or 16
expression.] protected characteristic. 17
2. Prohibited discrimination includes, without limitation: 18
[1.] (a) Denying, cancelling, limiting or refusing to issue a 19
payment or coverage on the basis of [the] an actual or perceived 20
[gender identity or expression] protected characteristic of a person 21
or a family member of the person; 22
[2.] (b) Imposing a payment that is based on [the] an actual or 23
perceived [gender identity or expression] protected characteristic of 24
a recipient of Medicaid or a family member of the recipient; 25
[3.] (c) Designating [the] an actual or perceived [gender 26
identity or expression] protected characteristic of a person or a 27
family member of the person as grounds to deny, cancel or limit 28
participation or coverage; and 29
[4.] (d) Denying, cancelling or limiting participation or 30
coverage on the basis of an actual or perceived [gender identity or 31
expression,] protected characteristic, including, without limitation, 32
by limiting or denying payment or coverage for health care services 33
that are: 34
[(a)] (1) Related to gender transition, provided that there is 35
coverage under Medicaid for the services when the services are not 36
related to gender transition; or 37
[(b)] (2) Ordinarily or exclusively available to persons of any 38
sex. 39
3. As used in this section, “protected characteristic” 40
means: 41
(a) Race, color, national origin, age, physical or mental 42
disability, sexual orientation or gender identity or expression; 43
or 44
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(b) Sex, including, without limitation, sex characteristics, 1
intersex traits and pregnancy or related conditions. 2
Sec. 9. Chapter 629 of NRS is hereby amended by adding 3
thereto a new section to read as follows: 4
1. A provider of health care shall not discriminate in the 5
provision of services to a person seeking to receive or receiving 6
services from the provider of health care based wholly or partially 7
on the actual or perceived: 8
(a) Race, color, national origin, age, physical or mental 9
disability, sexual orientation or gender identity or expression of 10
the person, family member of the person or a person with whom 11
the person associates; or 12
(b) Sex, including, without limitation, sex characteristics, 13
intersex traits and pregnancy or related conditions, of the person, 14
a family member of the person or a person with whom the person 15
associates. 16
2. A health care licensing board may adopt regulations 17
prescribing the specific types of discrimination prohibited by 18
subsection 1 of this act. 19
3. A provider of health care who violates any provision of this 20
section or regulation adopted pursuant thereto is guilty of 21
unprofessional conduct and is subject to disciplinary action by the 22
health care licensing board by which he or she is licensed, 23
certified or regulated. 24
4. The provisions of this section shall not be construed to: 25
(a) Require a provider of health care to take or refrain from 26
taking any action in violation of reasonable medical standards; 27
or 28
(b) Prohibit a provider of health care from adopting a policy 29
that is applied uniformly and in a nondiscriminatory manner. 30
5. As used in this section, “health care licensing board” 31
means: 32
(a) A board created pursuant to chapter 630, 630A, 631, 632, 33
633, 634, 634A, 635, 636, 637, 637B, 639, 640, 640A, 640B, 640C, 34
641, 641A, 641B, 641C or 641D of NRS. 35
(b) The State Board of Health with respect to licenses issued 36
pursuant to chapter 640D or 640E of NRS. 37
Sec. 10. The provisions of NRS 354.599 do not apply to any 38
additional expenses of a local government that are related to the 39
provisions of this act. 40
Sec. 11. 1. This section and section 10 become effective 41
upon passage and approval. 42
2. Sections 1 to 9, inclusive, of this act become effective: 43
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(a) Upon passage and approval for the purpose of adopting any 1
regulations and performing any other preparatory administrative 2
tasks that are necessary to carry out the provisions of this act; and 3
(b) On January 1, 2026, for all other purposes. 4
H