(Reprinted with amendments adopted on April 15, 2025)
FIRST REPRINT S.B. 352
- *SB352_R1*
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 the 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, sexual 10
orientation or disability. Section 9 of this bill similarly prohibits a provider of 11
health care from discriminating against a person on the basis of those same 12
characteristics, as well as gender identity or expression. Section 9 also authorizes a 13
board, agency or other entity in this State that licenses, certifies or regulates 14
providers of health care to: (1) adopt regulations prescribing the specific types of 15
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discrimination prohibited; and (2) discipline a provider of health care who violates 16
section 9. 17
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] Except as otherwise provided by subsection 13
3, imposing a payment or premium that is based on [the] an actual 14
or perceived [gender identity or expression] protected characteristic 15
of an insured or a family member of the insured; 16
[3.] (c) Designating [the] an actual or perceived [gender 17
identity or expression] protected characteristic of a person or a 18
family member of the person as grounds to deny, cancel or limit 19
participation or coverage; and 20
[4.] (d) Denying, cancelling or limiting participation or 21
coverage on the basis of an actual or perceived [gender identity or 22
expression,] protected characteristic, including, without limitation, 23
by limiting or denying coverage for health care services that are: 24
[(a)] (1) Related to gender transition, provided that there is 25
coverage under the policy for the services when the services are not 26
related to gender transition; or 27
[(b)] (2) Ordinarily or exclusively available to persons of any 28
sex. 29
3. The provisions of this section do not prohibit an insurer 30
from taking the age of an insured into account in a manner that is 31
otherwise authorized by state or federal law when determining the 32
applicable premium rate. 33
4. As used in this section, “protected characteristic” means: 34
(a) Race, color, national origin, age, physical or mental 35
disability, sexual orientation or gender identity or expression; or 36
(b) Sex, including, without limitation, sex characteristics, 37
intersex traits and pregnancy or related conditions. 38
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Sec. 2. NRS 689B.0675 is hereby amended to read as follows: 1
689B.0675 1. An insurer that issues a policy of group health 2
insurance shall not discriminate against any person with respect to 3
participation or coverage under the policy on the basis of an actual 4
or perceived [gender identity or expression.] protected 5
characteristic. 6
2. Prohibited discrimination includes, without limitation: 7
[1.] (a) Denying, cancelling, limiting or refusing to issue or 8
renew a policy of group health insurance on the basis of [the] an 9
actual or perceived [gender identity or expression] protected 10
characteristic of a person or a family member of the person; 11
[2.] (b) [Imposing] Except as otherwise provided by subsection 12
3, imposing a payment or premium that is based on [the] an actual 13
or perceived [gender identity or expression] protected characteristic 14
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. The provisions of this section do not prohibit an insurer 29
from taking the age of an insured into account in a manner that is 30
otherwise authorized by state or federal law when determining the 31
applicable premium rate. 32
4. As used in this section, “protected characteristic” means: 33
(a) Race, color, national origin, age, physical or mental 34
disability, sexual orientation or gender identity or expression; or 35
(b) Sex, including, without limitation, sex characteristics, 36
intersex traits and pregnancy or related conditions. 37
Sec. 3. NRS 689C.1975 is hereby amended to read as follows: 38
689C.1975 1. A carrier that issues a health benefit plan shall 39
not discriminate against any person with respect to participation or 40
coverage under the plan on the basis of an actual or perceived 41
[gender identity or expression.] protected characteristic. 42
2. Prohibited discrimination includes, without limitation: 43
[1.] (a) Denying, cancelling, limiting or refusing to issue or 44
renew a health benefit plan on the basis of [the] an actual or 45
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perceived [gender identity or expression] protected characteristic of 1
a person or a family member of the person; 2
[2.] (b) [Imposing] Except as otherwise provided by subsection 3
3, imposing a payment or premium that is based on [the] an actual 4
or perceived [gender identity or expression] protected characteristic 5
of an insured or a family member of the insured; 6
[3.] (c) Designating [the] an actual or perceived [gender 7
identity or expression] protected characteristic of a person or a 8
family member of the person as grounds to deny, cancel or limit 9
participation or coverage; and 10
[4.] (d) Denying, cancelling or limiting participation or 11
coverage on the basis of an actual or perceived [gender identity or 12
expression,] protected characteristic, including, without limitation, 13
by limiting or denying coverage for health care services that are: 14
[(a)] (1) Related to gender transition, provided that there is 15
coverage under the plan for the services when the services are not 16
related to gender transition; or 17
[(b)] (2) Ordinarily or exclusively available to persons of any 18
sex. 19
3. The provisions of this section do not prohibit a carrier 20
from taking the age of an insured into account in a manner that is 21
otherwise authorized by state or federal law when determining the 22
applicable premium rate. 23
4. As used in this section, “protected characteristic” means: 24
(a) Race, color, national origin, age, physical or mental 25
disability, sexual orientation or gender identity or expression; or 26
(b) Sex, including, without limitation, sex characteristics, 27
intersex traits and pregnancy or related conditions. 28
Sec. 4. NRS 695A.198 is hereby amended to read as follows: 29
695A.198 1. A society that issues a benefit contract shall not 30
discriminate against any person with respect to participation or 31
coverage under the contract on the basis of an actual or perceived 32
[gender identity or expression.] protected characteristic. 33
2. Prohibited discrimination includes, without limitation: 34
[1.] (a) Denying, cancelling, limiting or refusing to issue or 35
renew a benefit contract on the basis of [the] an actual or perceived 36
[gender identity or expression] protected characteristic of a person 37
or a family member of the person; 38
[2.] (b) [Imposing] Except as otherwise provided by subsection 39
3, imposing a payment or premium that is based on [the] an actual 40
or perceived [gender identity or expression] protected characteristic 41
of an insured or a family member of the insured; 42
[3.] (c) Designating [the] an actual or perceived [gender 43
identity or expression] protected characteristic of a person or a 44
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family member of the person as grounds to deny, cancel or limit 1
participation or coverage; and 2
[4.] (d) Denying, cancelling or limiting participation or 3
coverage on the basis of an actual or perceived [gender identity or 4
expression,] protected characteristic, including, without limitation, 5
by limiting or denying coverage for health care services that are: 6
[(a)] (1) Related to gender transition, provided that there is 7
coverage under the contract for the services when the services are 8
not related to gender transition; or 9
[(b)] (2) Ordinarily or exclusively available to persons of any 10
sex. 11
3. The provisions of this section do not prohibit a society from 12
taking the age of an insured into account in a manner that is 13
otherwise authorized by state or federal law when determining the 14
applicable premium rate. 15
4. As used in this section, “protected characteristic” means: 16
(a) Race, color, national origin, age, physical or mental 17
disability, sexual orientation or gender identity or expression; or 18
(b) Sex, including, without limitation, sex characteristics, 19
intersex traits and pregnancy or related conditions. 20
Sec. 5. NRS 695B.3167 is hereby amended to read as follows: 21
695B.3167 1. A hospital or medical services corporation that 22
issues a policy of health insurance shall not discriminate against any 23
person with respect to participation or coverage under the policy on 24
the basis of an actual or perceived [gender identity or expression.] 25
protected characteristic. 26
2. Prohibited discrimination includes, without limitation: 27
[1.] (a) Denying, cancelling, limiting or refusing to issue or 28
renew a policy of health insurance on the basis of [the] an actual or 29
perceived [gender identity or expression] protected characteristic of 30
a person or a family member of the person; 31
[2.] (b) [Imposing] Except as otherwise provided by subsection 32
3, imposing a payment or premium that is based on [the] an actual 33
or perceived [gender identity or expression] protected characteristic 34
of an insured or a family member of the insured; 35
[3.] (c) Designating [the] an actual or perceived [gender 36
identity or expression] protected characteristic of a person or a 37
family member of the person as grounds to deny, cancel or limit 38
participation or coverage; and 39
[4.] (d) Denying, cancelling or limiting participation or 40
coverage on the basis of an actual or perceived [gender identity or 41
expression,] protected characteristic, including, without limitation, 42
by limiting or denying coverage for health care services that are: 43
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[(a)] (1) Related to gender transition, provided that there is 1
coverage under the policy for the services when the services are not 2
related to gender transition; or 3
[(b)] (2) Ordinarily or exclusively available to persons of any 4
sex. 5
3. The provisions of this section do not prohibit a hospital or 6
medical services corporation from taking the age of an insured 7
into account in a manner that is otherwise authorized by state or 8
federal law when determining the applicable premium rate. 9
4. As used in this section, “protected characteristic” means: 10
(a) Race, color, national origin, age, physical or mental 11
disability, sexual orientation or gender identity or expression; or 12
(b) Sex, including, without limitation, sex characteristics, 13
intersex traits and pregnancy or related conditions. 14
Sec. 6. NRS 695C.204 is hereby amended to read as follows: 15
695C.204 1. A health maintenance organization that issues a 16
health care plan shall not discriminate against any person with 17
respect to participation or coverage under the plan on the basis of an 18
actual or perceived [gender identity or expression.] protected 19
characteristic. 20
2. Prohibited discrimination includes, without limitation: 21
[1.] (a) Denying, cancelling, limiting or refusing to issue or 22
renew a health care plan on the basis of [the] an actual or perceived 23
[gender identity or expression] protected characteristic of a person 24
or a family member of the person; 25
[2.] (b) [Imposing] Except as otherwise provided by subsection 26
3, imposing a payment or premium that is based on [the] an actual 27
or perceived [gender identity or expression] protected characteristic 28
of an enrollee or a family member of the enrollee; 29
[3.] (c) Designating [the] an actual or perceived [gender 30
identity or expression] protected characteristic of a person or a 31
family member of the person as grounds to deny, cancel or limit 32
participation or coverage; and 33
[4.] (d) Denying, cancelling or limiting participation or 34
coverage on the basis of an actual or perceived [gender identity or 35
expression,] protected characteristic, including, without limitation, 36
by limiting or denying coverage for health care services that are: 37
[(a)] (1) Related to gender transition, provided that there is 38
coverage under the plan for the services when the services are not 39
related to gender transition; or 40
[(b)] (2) Ordinarily or exclusively available to persons of any 41
sex. 42
3. The provisions of this section do not prohibit a health 43
maintenance organization from taking the age of an enrollee into 44
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account in a manner that is otherwise authorized by state or 1
federal law when determining the applicable premium rate. 2
4. As used in this section, “protected characteristic” means: 3
(a) Race, color, national origin, age, physical or mental 4
disability, sexual orientation or gender identity or expression; or 5
(b) Sex, including, without limitation, sex characteristics, 6
intersex traits and pregnancy or related conditions. 7
Sec. 7. NRS 695G.415 is hereby amended to read as follows: 8
695G.415 1. A managed care organization that issues a 9
health care plan shall not discriminate against any person with 10
respect to participation or coverage under the plan on the basis of an 11
actual or perceived [gender identity or expression.] protected 12
characteristic. 13
2. Prohibited discrimination includes, without limitation: 14
[1.] (a) Denying, cancelling, limiting or refusing to issue or 15
renew a health care plan on the basis of [the] an actual or perceived 16
[gender identity or expression] protected characteristic of a person 17
or a family member of the person; 18
[2.] (b) [Imposing] Except as otherwise provided by subsection 19
3, imposing a payment or premium that is based on [the] an actual 20
or perceived [gender identity or expression] protected characteristic 21
of an insured or a family member of the insured; 22
[3.] (c) Designating [the] an actual or perceived [gender 23
identity or expression] protected characteristic of a person or a 24
family member of the person as grounds to deny, cancel or limit 25
participation or coverage; and 26
[4.] (d) Denying, cancelling or limiting participation or 27
coverage on the basis of an actual or perceived [gender identity or 28
expression,] protected characteristic, including, without limitation, 29
by limiting or denying coverage for health care services that are: 30
[(a)] (1) Related to gender transition, provided that there is 31
coverage under the plan for the services when the services are not 32
related to gender transition; or 33
[(b)] (2) Ordinarily or exclusively available to persons of any 34
sex. 35
3. The provisions of this section do not prohibit a managed 36
care organization from taking the age of an insured into account 37
in a manner that is otherwise authorized by state or federal law 38
when determining the applicable premium rate. 39
4. As used in this section, “protected characteristic” means: 40
(a) Race, color, national origin, age, physical or mental 41
disability, sexual orientation or gender identity or expression; or 42
(b) Sex, including, without limitation, sex characteristics, 43
intersex traits and pregnancy or related conditions. 44
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Sec. 8. NRS 422.2701 is hereby amended to read as follows: 1
422.2701 1. The Department shall not discriminate against 2
any person with respect to participation or coverage under Medicaid 3
on the basis of an actual or perceived [gender identity or 4
expression.] protected characteristic. 5
2. Prohibited discrimination includes, without limitation: 6
[1.] (a) Denying, cancelling, limiting or refusing to issue a 7
payment or coverage on the basis of [the] an actual or perceived 8
[gender identity or expression] protected characteristic of a person 9
or a family member of the person; 10
[2.] (b) Imposing a payment that is based on [the] an actual or 11
perceived [gender identity or expression] protected characteristic of 12
a recipient of Medicaid or a family member of the recipient; 13
[3.] (c) Designating [the] an actual or perceived [gender 14
identity or expression] protected characteristic of a person or a 15
family member of the person as grounds to deny, cancel or limit 16
participation or coverage; and 17
[4.] (d) Denying, cancelling or limiting participation or 18
coverage on the basis of an actual or perceived [gender identity or 19
expression,] protected characteristic, including, without limitation, 20
by limiting or denying payment or coverage for health care services 21
that are: 22
[(a)] (1) Related to gender transition, provided that there is 23
coverage under Medicaid 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. 9. Chapter 629 of NRS is hereby amended by adding 33
thereto a new section to read as follows: 34
1. A provider of health care shall not discriminate in the 35
provision of services to a person seeking to receive or receiving 36
services from the provider of health care based wholly or partially 37
on the actual or perceived: 38
(a) Race, color, national origin, age, physical or mental 39
disability, sexual orientation or gender identity or expression of 40
the person, family member of the person or a person with whom 41
the person associates; or 42
(b) Sex, including, without limitation, sex characteristics, 43
intersex traits and pregnancy or related conditions of the person, a 44
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family member of the person or a person with whom the person 1
associates. 2
2. A health care licensing board may adopt regulations 3
prescribing the specific types of discrimination prohibited by 4
subsection 1. 5
3. A provider of health care who violates any provision of this 6
section or any regulation adopted pursuant thereto is guilty of 7
unprofessional conduct and is subject to disciplinary action by the 8
health care licensing board by which he or she is licensed, 9
certified or regulated. 10
4. The provisions of this section shall not be construed to: 11
(a) Require a provider of health care to take or refrain from 12
taking any action in violation of reasonable medical standards; 13
(b) Require a provider of health care to engage in any 14
diagnosis, treatment or other conduct which the provider of health 15
care is not qualified to perform; or 16
(c) Prohibit a provider of health care from adopting a policy 17
that is applied uniformly and in a nondiscriminatory manner. 18
5. As used in this section, “health care licensing board” 19
means: 20
(a) A board created pursuant to chapter 630, 630A, 631, 632, 21
633, 634, 634A, 635, 636, 637, 637B, 639, 640, 640A, 640B, 641, 22
641A, 641B, 641C or 641D of NRS. 23
(b) The State Board of Health with respect to licenses issued 24
pursuant to chapter 640D or 640E of NRS. 25
(c) The Division of Public and Behavioral Health of the 26
Department of Health and Human Services. 27
Sec. 10. The provisions of NRS 354.599 do not apply to any 28
additional expenses of a local government that are related to the 29
provisions of this act. 30
Sec. 11. 1. This section and section 10 of this act become 31
effective upon passage and approval. 32
2. Sections 1 to 9, inclusive, of this act become effective: 33
(a) Upon passage and approval for the purpose of adopting any 34
regulations and performing any other preparatory administrative 35
tasks that are necessary to carry out the provisions of this act; and 36
(b) On January 1, 2026, for all other purposes. 37
H