EXEMPT
(Reprinted with amendments adopted on April 21, 2025)
FIRST REPRINT S.B. 378
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SENATE BILL NO. 378–SENATORS DOÑATE, CRUZ-CRAWFORD,
NGUYEN, FLORES; CANNIZZARO, LANGE AND OHRENSCHALL
MARCH 17, 2025
____________
JOINT SPONSOR: ASSEMBLYMEMBER GRAY
____________
Referred to Committee on Health and Human Services
SUMMARY—Makes revisions relating to health care.
(BDR 40-705)
FISCAL NOTE: Effect on Local Government: May have Fiscal Impact.
Effect on the State: Yes.
CONTAINS UNFUNDED MANDATE (§ 33)
(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; revising requirements governing
the electronic maintenance, transmittal and exchange of
health information; establishing a program to increase
awareness of information concerning independent centers
for emergency medical care; requiring certain facilities
that are owned or operated by, or otherwise part of,
hospitals to be licensed as independent centers for
emergency medical care; requiring an independent center
for emergency medical care to provide urgent care
services under certain conditions; prohibiting a
noncompetition covenant from applying to a patient-
facing provider of health care; requiring a custodian of
health records to furnish health records within a specified
period of time and without charging a fee under certain
circumstances; and providing other matters properly
relating thereto.
Legislative Counsel’s Digest:
Existing law requires the Director of the Department of Health and Human 1
Services to prescribe by regulation a framework for the electronic maintenance, 2
transmittal and exchange of electronic health records, prescriptions, health-related 3
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information and electronic signatures and requirements for electronic equivalents of 4
written entries or written approvals. With certain exceptions, existing law requires 5
various entities involved in health care, including persons and facilities that provide 6
health care, to maintain, transmit and exchange health information in accordance 7
with those regulations. (NRS 439.589) Section 5 of this bill prohibits those 8
regulations from authorizing such a person or entity to comply with that 9
requirement by connecting with a health information exchange or utilizing any 10
other service that charges a fee for providing electronic health records to such a 11
person or entity or a patient upon request. Section 33 of this bill: (1) requires a 12
custodian of health care records to furnish electronic health records to a patient or 13
another person or entity upon the request of a patient within 2 business days; and 14
(2) prohibits a custodian of health care records from charging a fee to furnish health 15
care records under such circumstances. 16
Sections 4, 31 and 40 of this bill limit the health care providers that must 17
maintain, transmit and exchange health information electronically to medical 18
facilities and high-level providers of health care. Section 1 of this bill defines the 19
term “high-level provider of health care” to mean a physician, physician assistant, 20
dentist, advanced practice registered nurse, chiropractic physician, podiatric 21
physician or physical therapist. Section 4 additionally exempts from requirements 22
to maintain, transmit and exchange health information electronically high-level 23
providers of health care whose solo or group practices are under a certain size. 24
However, section 4 requires such high-level providers of health care to furnish the 25
medical records of a patient electronically to the patient upon request of the patient. 26
Section 6 of this bill makes conforming changes to revise the applicability of a 27
provision requiring the Department to notify the licensing board of a provider who 28
fails to comply with requirements governing the electronic maintenance, transmittal 29
and exchange of health information. Section 2 of this bill establishes the 30
applicability of the definition set forth in section 1, and sections 24, 25, 29, 35 and 31
36 of this bill make other conforming changes to indicate the proper placement of 32
section 1 in the Nevada Revised Statutes. Section 32 of this bill updates internal 33
references changed by section 31. 34
Existing law prohibits a person or entity from operating an independent center 35
for emergency medical care without a license issued by the Division of Public and 36
Behavioral Health of the Department. (NRS 449.030) Section 14 of this bill 37
requires a facility that is structurally separate from the hospital and provides 38
services for the treatment of a medical emergency, including such a facility that is 39
owned or operated by, or otherwise part of, a hospital, to be licensed as an 40
independent center for emergency medical care. (NRS 449.0151, 449.030) Sections 41
15 and 16 of this bill prohibit the Division or the State Board of Health from 42
charging a fee for the issuance of such a license. Section 17 of this bill prohibits the 43
Division from issuing a license to operate an independent center for emergency 44
medical care that is located within a 5 mile radius of another independent center for 45
emergency medical care or a hospital with an emergency department. However, 46
section 37 of this bill requires the Division to issue a license to an independent 47
center for emergency medical care that: (1) is operating on January 1, 2026; (2) is 48
newly required by section 14 to be licensed; and (3) otherwise meets the 49
requirements for licensure, regardless of where the facility is located. Section 37 50
additionally requires the Division to issue a license to an independent center for 51
emergency medical care that has not yet been constructed, but whose owner or 52
operator has taken certain steps toward completing construction prior to January 1, 53
2026, and that otherwise meets the requirements for licensure at the time of the 54
application for licensure, regardless of where the facility is located. Section 18 of 55
this bill requires an independent center for emergency medical care to provide 56
urgent care services during all operating hours and imposes certain additional 57
requirements related to the provision of such urgent care. 58
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Existing law establishes programs to increase awareness of information 59
concerning hospitals and surgical centers for ambulatory patients. (NRS 439A.200-60
439A.290) Section 9 of this bill requires the Department to establish a similar 61
program to increase awareness of information concerning independent centers for 62
emergency medical care. Sections 9, 10, 12, 13 and 19 of this bill provide for the 63
Department to collect certain information on the operations of independent centers 64
for emergency medical care and the outcomes for patients treated by independent 65
centers for emergency medical care. To facilitate such reporting, section 19 66
requires an independent center for emergency medical care to use the same form 67
prescribed by the Director for discharging patients as a hospital is currently 68
required to use. Section 34 of this bill makes a conforming change to reflect that 69
independent centers for emergency medical care will be using the same form. 70
Sections 12 and 13 require the Department to: (1) make certain information 71
concerning independent centers for emergency medical care available upon request; 72
and (2) post certain information concerning independent centers for emergency 73
medical care on an Internet website maintained by the Department. Section 23 of 74
this bill makes a conforming change to reflect the revised content of that Internet 75
website. Section 8 of this bill defines the term “independent center for emergency 76
medical care” for that purpose. Section 11 of this bill establishes the applicability 77
of certain definitions. Section 20 of this bill requires a report prepared by the 78
Director on the status of the programs to increase public awareness of information 79
concerning hospitals and surgical centers for ambulatory patients to additionally 80
include information on the status of the program to increase awareness of 81
information concerning independent centers for emergency medical care. 82
Existing law authorizes a court, upon a petition, to order the sealing of records 83
of certain convictions if the person who was convicted: (1) has not been convicted 84
of any additional offense, except for minor traffic violations, for a specified 85
period of time; and (2) does not have charges pending for any offense, except for 86
minor traffic violations. (NRS 179.245) Existing law also authorizes a court, upon a 87
petition, to order the sealing of records of an arrest where the charges were 88
dismissed, the prosecutor declined to prosecute or the person who was arrested was 89
acquitted. (NRS 179.255) Section 21 of this bill authorizes the Department or the 90
Division of Health Care Financing and Policy of the Department to review certain 91
sealed records for the purpose of determining the suitability of the person to whom 92
the records pertain to serve as a provider of services under Medicaid or to own or 93
serve as an officer, managing employee or managing agent of such a provider of 94
services. 95
Existing law prescribes a procedure for conducting a hearing to review an 96
action taken against a provider of services under Medicaid. (NRS 422.306) Section 97
27 of this bill requires such a provider of services to maintain and provide certain 98
documents to the Department for the purpose of verifying claims. Section 27 99
authorizes the Department to deny a claim or recover money already paid if the 100
Department is unable to verify the claim. Section 28 of this bill: (1) prescribes a 101
process for the Department to review claims for appropriateness and propriety; and 102
(2) authorizes the Department to deny or recover any amount paid pursuant to such 103
a claim or take certain actions based on such a review. Section 22 of this bill makes 104
a conforming change to require the Director to administer sections 27 and 28 in the 105
same manner as other provisions governing Medicaid. 106
Existing law provides that a noncompetition covenant is void unless the 107
covenant: (1) is supported by valuable consideration; (2) does not impose any 108
restraint that is greater than is required for the protection of the employer; (3) does 109
not impose any undue hardship on the employee; and (4) imposes restrictions that 110
are appropriately related to the consideration for the covenant. (NRS 613.195) 111
Section 30 of this bill provides that a noncompetition covenant may not apply to a 112
provider of health care, which section 30 defines as a provider of health care whose 113
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primary duties involve clinical care to patients and who is not employed or 114
contracted to primarily perform administrative tasks. 115
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1. Chapter 439 of NRS is hereby amended by adding 1
thereto a new section to read as follows: 2
“High-level provider of health care” means a physician or 3
physician assistant licensed pursuant to chapter 630 or 633 of 4
NRS, dentist, advanced practice registered nurse, chiropractic 5
physician, podiatric physician or physical therapist. 6
Sec. 2. NRS 439.581 is hereby amended to read as follows: 7
439.581 As used in NRS 439.581 to 439.597, inclusive, and 8
section 1 of this act, unless the context otherwise requires, the 9
words and terms defined in NRS 439.582 to 439.585, inclusive, and 10
section 1 of this act have the meanings ascribed to them in those 11
sections. 12
Sec. 3. NRS 439.588 is hereby amended to read as follows: 13
439.588 1. A health information exchange shall not operate 14
in this State without first obtaining certification as provided in 15
subsection 2. 16
2. The Director shall by regulation establish the manner in 17
which a health information exchange may apply for certification and 18
the requirements for granting such certification, which must include, 19
without limitation, that the health information exchange demonstrate 20
its financial and operational sustainability, adherence to the privacy, 21
security and patient consent standards adopted pursuant to NRS 22
439.589 and capacity for interoperability with any other health 23
information exchange certified pursuant to this section. 24
3. The Director may deny an application for certification or 25
may suspend or revoke any certification issued pursuant to 26
subsection 2 for failure to comply with the provisions of NRS 27
439.581 to 439.597, inclusive, and section 1 of this act or the 28
regulations adopted pursuant thereto or any applicable federal or 29
state law. 30
4. When the Director intends to deny, suspend or revoke a 31
certification, he or she shall give reasonable notice to all parties by 32
certified mail. The notice must contain the legal authority, 33
jurisdiction and reasons for the action to be taken. A health 34
information exchange that wishes to contest the action of the 35
Director must file an appeal with the Director. 36
5. The Director shall adopt regulations establishing the manner 37
in which a person may file a complaint with the Director regarding a 38
violation of the provisions of this section. 39
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6. The Director may impose an administrative fine against a 1
health information exchange which operates in this State without 2
holding a certification in an amount established by the Director by 3
regulation. The Director shall afford a health information exchange 4
so fined an opportunity for a hearing pursuant to the provisions of 5
NRS 233B.121. 6
7. The Director may adopt such regulations as he or she 7
determines are necessary to carry out the provisions of this section. 8
Sec. 4. NRS 439.589 is hereby amended to read as follows: 9
439.589 1. The Director, in consultation with health care 10
providers, third parties and other interested persons and entities, 11
shall by regulation prescribe a framework for the electronic 12
maintenance, transmittal and exchange of electronic health records, 13
prescriptions, health-related information and electronic signatures 14
and requirements for electronic equivalents of written entries or 15
written approvals in accordance with federal law. The regulations 16
must: 17
(a) Establish standards for networks and technologies to be used 18
to maintain, transmit and exchange health information, including, 19
without limitation, standards: 20
(1) That require: 21
(I) The use of networks and technologies that allow 22
patients to access electronic health records directly from the health 23
care provider of the patient and forward such electronic health 24
records electronically to other persons and entities; and 25
(II) The interoperability of such networks and 26
technologies in accordance with the applicable standards for the 27
interoperability of Qualified Health Information Networks 28
prescribed by the Office of the National Coordinator for Health 29
Information Technology of the United States Department of Health 30
and Human Services; 31
(2) To ensure that electronic health records retained or shared 32
are secure; 33
(3) To maintain the confidentiality of electronic health 34
records and health-related information, including, without 35
limitation, standards to maintain the confidentiality of electronic 36
health records relating to a child who has received health care 37
services without the consent of a parent or guardian and which 38
ensure that a child’s right to access such health care services is not 39
impaired; 40
(4) To ensure the privacy of individually identifiable health 41
information, including, without limitation, standards to ensure the 42
privacy of information relating to a child who has received health 43
care services without the consent of a parent or guardian; 44
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(5) For obtaining consent from a patient before retrieving the 1
patient’s health records from a health information exchange, 2
including, without limitation, standards for obtaining such consent 3
from a child who has received health care services without the 4
consent of a parent or guardian; 5
(6) For making any necessary corrections to information or 6
records; 7
(7) For notifying a patient if the confidentiality of 8
information contained in an electronic health record of the patient is 9
breached; 10
(8) Governing the ownership, management and use of 11
electronic health records, health-related information and related 12
data; and 13
(9) For the electronic transmission of prior authorizations for 14
prescription medication; 15
(b) Ensure compliance with the requirements, specifications and 16
protocols for exchanging, securing and disclosing electronic health 17
records, health-related information and related data prescribed 18
pursuant to the provisions of the Health Information Technology for 19
Economic and Clinical Health Act, 42 U.S.C. §§ 300jj et seq. and 20
17901 et seq., the Health Insurance Portability and Accountability 21
Act of 1996, Public Law 104-191, and other applicable federal and 22
state law; and 23
(c) Be based on nationally recognized best practices for 24
maintaining, transmitting and exchanging health information 25
electronically. 26
2. The standards prescribed pursuant to this section must 27
include, without limitation: 28
(a) Requirements for the creation, maintenance and transmittal 29
of electronic health records; 30
(b) Requirements for protecting confidentiality, including 31
control over, access to and the collection, organization and 32
maintenance of electronic health records, health-related information 33
and individually identifiable health information; 34
(c) Requirements for the manner in which a patient may, 35
through a health care provider who participates in the sharing of 36
health records using a health information exchange, revoke his or 37
her consent for a health care provider to retrieve the patient’s health 38
records from the health information exchange; 39
(d) A secure and traceable electronic audit system for 40
identifying access points and trails to electronic health records and 41
health information exchanges; and 42
(e) Any other requirements necessary to comply with all 43
applicable federal laws relating to electronic health records, 44
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health-related information, health information exchanges and the 1
security and confidentiality of such records and exchanges. 2
3. The regulations adopted pursuant to this section must not 3
require any person or entity to use a health information exchange. 4
4. Except as otherwise provided in subsections 5, 6 and 7, the 5
Department and the divisions thereof, other state and local 6
governmental entities, medical facilities, high-level providers of 7
health care , [providers,] third parties, pharmacy benefit managers 8
and other entities licensed or certified pursuant to title 57 of NRS 9
shall maintain, transmit and exchange health information in 10
accordance with the regulations adopted pursuant to this section, the 11
provisions of NRS 439.581 to 439.597, inclusive, and section 1 of 12
this act and any other regulations adopted pursuant thereto. 13
5. The Federal Government and employees thereof, a provider 14
of health coverage for federal employees, a provider of health 15
coverage that is subject to the Employee Retirement Income 16
Security Act of 1974, 29 U.S.C. §§ 1001 et seq., or a Taft-Hartley 17
trust formed pursuant to 29 U.S.C. § 186(c)(5) is not required to but 18
may maintain, transmit and exchange electronic information in 19
accordance with the regulations adopted pursuant to this section. 20
6. A high-level provider of health care [provider] may apply to 21
the Department for a waiver from the provisions of subsection 4 on 22
the basis that the high-level provider of health care [provider] does 23
not have the infrastructure necessary to comply with those 24
provisions, including, without limitation, because the high-level 25
provider of health care [provider] does not have access to the 26
Internet. The Department shall grant a waiver if it determines that: 27
(a) The high-level provider of health care [provider] does not 28
currently have the infrastructure necessary to comply with the 29
provisions of subsection 4; and 30
(b) Obtaining such infrastructure is not reasonably practicable, 31
including, without limitation, because the cost of such infrastructure 32
would make it difficult for the high-level provider of health care 33
[provider] to continue to operate. 34
7. The provisions of subsection 4 do not apply to [the] : 35
(a) The Department of Corrections [.] ; 36
(b) A high-level provider of health care whose solo practice 37
provided care to fewer than 500 patients during the immediately 38
preceding year and reasonably expects to provide care to fewer 39
than 500 patients during the current year; or 40
(c) A high-level provider of health care who, in combination 41
with all other members of his or her group practice provided care 42
to fewer than 500 patients during the immediately preceding year 43
and reasonably expects to provide care to fewer than 500 patients 44
during the current year. 45
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8. A high-level provider of health care described in 1
paragraphs (b) and (c) of subsection 7 shall furnish the medical 2
records of a patient electronically to the patient or, upon the 3
request of the patient, another person or entity, in accordance with 4
NRS 629.062. 5
9. A violation of the provisions of this section or any 6
regulations adopted pursuant thereto is not a misdemeanor. 7
[9.] 10. As used in this section: 8
(a) “Medical facility” has the meaning ascribed to it in 9
NRS 449.0151. 10
(b) “Pharmacy benefit manager” has the meaning ascribed to it 11
in NRS 683A.174. 12
[(b)] (c) “Third party” means any insurer, governmental entity 13
or other organization providing health coverage or benefits in 14
accordance with state or federal law. 15
Sec. 5. NRS 439.589 is hereby amended to read as follows: 16
439.589 1. The Director, in consultation with health care 17
providers, third parties and other interested persons and entities, 18
shall by regulation prescribe a framework for the electronic 19
maintenance, transmittal and exchange of electronic health records, 20
prescriptions, health-related information and electronic signatures 21
and requirements for electronic equivalents of written entries or 22
written approvals in accordance with federal law. The regulations 23
must: 24
(a) Establish standards for networks and technologies to be used 25
to maintain, transmit and exchange health information, including, 26
without limitation, standards: 27
(1) That require: 28
(I) The use of networks and technologies that allow 29
patients to access electronic health records directly from the health 30
care provider of the patient and forward such electronic health 31
records electronically to other persons and entities; and 32
(II) The interoperability of such networks and 33
technologies in accordance with the applicable standards for the 34
interoperability of Qualified Health Information Networks 35
prescribed by the Office of the National Coordinator for Health 36
Information Technology of the United States Department of Health 37
and Human Services; 38
(2) To ensure that electronic health records retained or shared 39
are secure; 40
(3) To maintain the confidentiality of electronic health 41
records and health-related information, including, without 42
limitation, standards to maintain the confidentiality of electronic 43
health records relating to a child who has received health care 44
services without the consent of a parent or guardian and which 45
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ensure that a child’s right to access such health care services is not 1
impaired; 2
(4) To ensure the privacy of individually identifiable health 3
information, including, without limitation, standards to ensure the 4
privacy of information relating to a child who has received health 5
care services without the consent of a parent or guardian; 6
(5) For obtaining consent from a patient before retrieving the 7
patient’s health records from a health information exchange, 8
including, without limitation, standards for obtaining such consent 9
from a child who has received health care services without the 10
consent of a parent or guardian; 11
(6) For making any necessary corrections to information or 12
records; 13
(7) For notifying a patient if the confidentiality of 14
information contained in an electronic health record of the patient is 15
breached; 16
(8) Governing the ownership, management and use of 17
electronic health records, health-related information and related 18
data; and 19
(9) For the electronic transmission of prior authorizations for 20
prescription medication; 21
(b) Ensure compliance with the requirements, specifications and 22
protocols for exchanging, securing and disclosing electronic health 23
records, health-related information and related data prescribed 24
pursuant to the provisions of the Health Information Technology for 25
Economic and Clinical Health Act, 42 U.S.C. §§ 300jj et seq. and 26
17901 et seq., the Health Insurance Portability and Accountability 27
Act of 1996, Public Law 104-191, and other applicable federal and 28
state law; and 29
(c) Be based on nationally recognized best practices for 30
maintaining, transmitting and exchanging health information 31
electronically. 32
2. The standards prescribed pursuant to this section must 33
include, without limitation: 34
(a) Requirements for the creation, maintenance and transmittal 35
of electronic health records; 36
(b) Requirements for protecting confidentiality, including 37
control over, access to and the collection, organization and 38
maintenance of electronic health records, health-related information 39
and individually identifiable health information; 40
(c) Requirements for the manner in which a patient may, 41
through a health care provider who participates in the sharing of 42
health records using a health information exchange, revoke his or 43
her consent for a health care provider to retrieve the patient’s health 44
records from the health information exchange; 45
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(d) A secure and traceable electronic audit system for 1
identifying access points and trails to electronic health records and 2
health information exchanges; and 3
(e) Any other requirements necessary to comply with all 4
applicable federal laws relating to electronic health records, health-5
related information, health information exchanges and the security 6
and confidentiality of such records and exchanges. 7
3. The regulations adopted pursuant to this section must not 8
[require] : 9
(a) Require any person or entity to use a health information 10
exchange [.] ; or 11
(b) Authorize a person or entity described in subsection 4 to 12
comply with the requirements of that subsection by: 13
(1) Connecting with a health information exchange; or 14
(2) Utilizing any other service that charges a fee to such a 15
person or entity or a patient for providing electronic health 16
records to a patient upon request in violation of NRS 629.062. 17
4. Except as otherwise provided in subsections 5, 6 and 7, the 18
Department and the divisions thereof, other state and local 19
governmental entities, medical facilities, high-level providers of 20
health care, third parties, pharmacy benefit managers and other 21
entities licensed or certified pursuant to title 57 of NRS shall 22
maintain, transmit and exchange health information in accordance 23
with the regulations adopted pursuant to this section, the provisions 24
of NRS 439.581 to 439.597, inclusive, and section 1 of this act and 25
any other regulations adopted pursuant thereto. 26
5. The Federal Government and employees thereof, a provider 27
of health coverage for federal employees, a provider of health 28
coverage that is subject to the Employee Retirement Income 29
Security Act of 1974, 29 U.S.C. §§ 1001 et seq., or a Taft-Hartley 30
trust formed pursuant to 29 U.S.C. § 186(c)(5) is not required to but 31
may maintain, transmit and exchange electronic information in 32
accordance with the regulations adopted pursuant to this section. 33
6. A high-level provider of health care may apply to the 34
Department for a waiver from the provisions of subsection 4 on the 35
basis that the high-level provider of health care does not have 36
the infrastructure necessary to comply with those provisions, 37
including, without limitation, because the high-level provider of 38
health care does not have access to the Internet. The Department 39
shall grant a waiver if it determines that: 40
(a) The high-level provider of health care does not currently 41
have the infrastructure necessary to comply with the provisions of 42
subsection 4; and 43
(b) Obtaining such infrastructure is not reasonably practicable, 44
including, without limitation, because the cost of such infrastructure 45
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would make it difficult for the high-level provider of health care to 1
continue to operate. 2
7. The provisions of subsection 4 do not apply to: 3
(a) The Department of Corrections; 4
(b) A high-level provider of health care whose solo practice 5
provided to fewer than 500 patients during the immediately 6
preceding year and reasonably expects to provide care to fewer than 7
500 patients during the current year; or 8
(c) A high-level provider of health care who, in combination 9
with all other members of his or her group practice provided care to 10
fewer than 500 patients during the immediately preceding year and 11
reasonably expects to provide care to fewer than 500 patients during 12
the current year. 13
8. A high-level provider of health care described in paragraphs 14
(b) and (c) of subsection 7 shall furnish the medical records of a 15
patient electronically to the patient or, upon the request of the 16
patient, another person or entity, in accordance with NRS 629.062. 17
9. A violation of the provisions of this section or any 18
regulations adopted pursuant thereto is not a misdemeanor. 19
10. As used in this section: 20
(a) “Medical facility” has the meaning ascribed to it in 21
NRS 449.0151. 22
(b) “Pharmacy benefit manager” has the meaning ascribed to it 23
in NRS 683A.174. 24
(c) “Third party” means any insurer, governmental entity or 25
other organization providing health coverage or benefits in 26
accordance with state or federal law. 27
Sec. 6. NRS 439.5895 is hereby amended to read as follows: 28
439.5895 1. The Department shall notify each regulatory 29
body of this State that has issued a current, valid license to a 30
licensed provider or insurer if: 31
(a) The Department determines that the licensed provider or 32
insurer is not in compliance with the requirements of subsection 4 of 33
NRS 439.589 [;] and 34
[(b) The] the licensed provider or insurer: 35
(1) Is not exempt from those requirements pursuant to 36
subsection 5 or 7 of NRS 439.589; and 37
(2) Has not received a waiver of those requirements pursuant 38
to subsection 6 of NRS 439.589 [.] ; or 39
(b) The licensed provider or insurer is a high-level provider of 40
health care who is exempt from the requirements of subsection 4 41
of NRS 439.589 pursuant to paragraph (b) or (c) of subsection 7 42
of NRS 439.589 and the Department determines that the high-level 43
provider of health care is not in compliance with subsection 8 of 44
NRS 439.589. 45
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2. If the Department determines that a licensed provider or 1
insurer for which notice was previously provided pursuant to 2
subsection 1 has come into compliance with the requirements of 3
subsection 4 or 8, as applicable, of NRS 439.589, the Department 4
shall immediately notify the regulatory body that issued the license. 5
3. As used in this section: 6
(a) “License” means any license, certificate, registration, permit 7
or similar type of authorization to practice an occupation or 8
profession or engage in a business in this State issued to a licensed 9
provider or insurer. 10
(b) “Licensed provider or insurer” means: 11
(1) A medical facility licensed pursuant to chapter 449 of 12
NRS; 13
(2) [The holder of a permit to operate an ambulance, an air 14
ambulance or a vehicle of a fire-fighting agency pursuant to chapter 15
450B of NRS; 16
(3)] A high-level provider of health care ; [, as defined in 17
NRS 629.031, who is licensed pursuant to title 54 of NRS;] or 18
[(4)] (3) Any person licensed pursuant to title 57 of NRS. 19
(c) “Regulatory body” means any governmental entity that 20
issues a license. 21
Sec. 7. Chapter 439A of NRS is hereby amended by adding 22
thereto the provisions set forth as sections 8, 9 and 10 of this act. 23
Sec. 8. “Independent center for emergency medical care” 24
has the meaning ascribed to it in NRS 449.013. 25
Sec. 9. 1. The Department shall establish and maintain a 26
program to increase public awareness of health care information 27
concerning the independent centers for emergency medical care in 28
this State. The program must be designed to assist consumers with 29
comparing the quality of care provided by the independent centers 30
for emergency medical care in this State and the charges for that 31
care. 32
2. The program must include, without limitation, the 33
collection, maintenance and provision of information concerning: 34
(a) Patients of each independent center for emergency medical 35
care in this State as reported in the forms submitted pursuant to 36
NRS 449.485; 37
(b) The quality of care provided by each independent center 38
for emergency medical care in this State as determined by 39
applying measures of quality endorsed by the entities described in 40
subparagraph (1) of paragraph (b) of subsection 1 of section 10 of 41
this act, expressed as a number of events and rate of occurrence, if 42
such measures can be applied to the information reported in the 43
forms submitted pursuant to NRS 449.485; 44
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(c) How consistently each independent center for emergency 1
medical care follows recognized practices to prevent the infection 2
of patients, to speed the recovery of patients and to avoid medical 3
complications of patients; 4
(d) The total number of patients discharged from the 5
independent center for emergency medical care and the total 6
number of potentially preventable readmissions to a hospital or 7
independent center for emergency medical care, which must be 8
expressed as a total number and a rate of occurrence of potentially 9
preventable readmissions, and the average length of stay and the 10
average billed charges for those potentially preventable 11
readmissions; and 12
(e) Any other information relating to the charges imposed and 13
the quality of the services provided by the independent centers for 14
emergency medical care in this State which the Department 15
determines is: 16
(1) Useful to consumers; 17
(2) Nationally recognized; and 18
(3) Reported in a standard and reliable manner. 19
Sec. 10. 1. The Department shall, by regulation: 20
(a) Prescribe the information that each independent center for 21
emergency medical care in this State must submit to the 22
Department for the program established pursuant to section 9 of 23
this act. 24
(b) Prescribe the measures of quality for independent centers 25
for emergency medical care that are required pursuant to 26
paragraph (b) of subsection 2 of section 9 of this act. In adopting 27
the regulations, the Department shall: 28
(1) Use the measures of quality endorsed by the Agency for 29
Healthcare Research and Quality, the National Quality Forum, 30
Centers for Medicare and Medicaid Services of the United States 31
Department of Health and Human Services, a quality 32
improvement organization of the Centers for Medicare and 33
Medicaid Services and the Joint Commission; 34
(2) Prescribe a reasonable number of measures of quality 35
which must not be unduly burdensome on the independent centers 36
for emergency medical care; and 37
(3) Take into consideration the financial burden placed on 38
the independent centers for emergency medical care to comply 39
with the regulations. 40
(c) Prescribe the manner in which an independent center for 41
emergency medical care must determine whether the readmission 42
of a patient must be reported pursuant to section 9 of this act as a 43
potentially preventable readmission and prescribe the form for 44
submission of such information. 45
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(d) Require each independent center for emergency medical 1
care to provide the information prescribed in paragraphs (a), (b) 2
and (c) in the format required by the Department. 3
2. The information required pursuant to this section and 4
section 9 of this act must be submitted to the Department not later 5
than 45 days after the last day of each calendar month. 6
3. If an independent center for emergency medical care fails 7
to submit the information required pursuant to this section or 8
section 9 of this act or submits information that is incomplete or 9
inaccurate, the Department shall send a notice of such failure to 10
the independent center for emergency medical care and to the 11
Division of Public and Behavioral Health of the Department. 12
Sec. 11. NRS 439A.200 is hereby amended to read as follows: 13
439A.200 As used in NRS 439A.200 to 439A.290, inclusive, 14
and sections 8, 9 and 10 of this act, unless the context otherwise 15
requires, the words and terms defined in NRS 439A.205, 439A.207 16
and 439A.210 and section 8 of this act have the meanings ascribed 17
to them in those sections. 18
Sec. 12. NRS 439A.260 is hereby amended to read as follows: 19
439A.260 1. The Department shall collect and maintain all 20
information that it receives from the hospitals , [and] surgical 21
centers for ambulatory patients and independent centers for 22
emergency medical care in this State pursuant to NRS 439A.220 to 23
439A.250, inclusive [.] and sections 9 and 10 of this act. Upon 24
request, the Department shall make a summary of the information 25
available to: 26
(a) Consumers of health care; 27
(b) Providers of health care; 28
(c) Representatives of the health insurance industry; and 29
(d) The general public. 30
2. The Department shall ensure that the information it provides 31
pursuant to this section is aggregated so as not to reveal the identity 32
of a specific inpatient or outpatient of a hospital , [or] of a surgical 33
center for ambulatory patients [.] or of an independent center for 34
emergency medical care. 35
Sec. 13. NRS 439A.270 is hereby amended to read as follows: 36
439A.270 1. The Department shall establish and maintain an 37
Internet website that includes the information concerning the 38
charges imposed and the quality of the services provided by the 39
hospitals , [and] surgical centers for ambulatory patients and 40
independent centers for emergency medical care in this State as 41
required by the programs established pursuant to NRS 439A.220 42
and 439A.240 [.] and section 9 of this act. The information must: 43
(a) Include, for each hospital in this State, the: 44
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(1) Total number of patients discharged, the average length 1
of stay and the average billed charges, reported for the diagnosis-2
related groups for inpatients and the 50 medical treatments for 3
outpatients that the Department determines are most useful for 4
consumers; 5
(2) Total number of potentially preventable readmissions 6
reported pursuant to NRS 439A.220, the rate of occurrence of 7
potentially preventable readmissions, and the average length of stay 8
and average billed charges of those potentially preventable 9
readmissions, reported by the diagnosis-related group for inpatients 10
for which the patient originally received treatment at a hospital; and 11
(3) Name of each physician who performed a surgical 12
procedure in the hospital and the total number of surgical 13
procedures performed by each physician in the hospital, reported for 14
the most frequent surgical procedures that the Department 15
determines are most useful for consumers if the information is 16
available; 17
(b) Include, for each surgical center for ambulatory patients in 18
this State, the: 19
(1) Total number of patients discharged and the average 20
billed charges, reported for 50 medical treatments for outpatients 21
that the Department determines are most useful for consumers; and 22
(2) Name of each physician who performed a surgical 23
procedure in the surgical center for ambulatory patients and the total 24
number of surgical procedures performed by each physician in the 25
surgical center for ambulatory patients, reported for the most 26
frequent surgical procedures that the Department determines are 27
most useful for consumers; 28
(c) Include, for each independent center for emergency 29
medical care in this State, the: 30
(1) Total number of patients discharged and the average 31
billed charges, reported for the 50 medical treatments for patients 32
of independent centers for emergency medical care that the 33
Department determines are most useful for consumers; and 34
(2) Total number of potentially preventable readmissions 35
reported pursuant to section 9 of this act, the rate of occurrence of 36
potentially preventable readmissions, and the average length of 37
stay and average billed charges of those potentially preventable 38
readmissions, reported for the diagnosis for which the patient 39
originally received treatment at an independent center for 40
emergency medical care; 41
(d) Be presented in a manner that allows a person to view and 42
compare the information for the hospitals by: 43
(1) Geographic location of each hospital; 44
(2) Type of medical diagnosis; and 45
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(3) Type of medical treatment; 1
[(d)] (e) Be presented in a manner that allows a person to view 2
and compare the information for the surgical centers for ambulatory 3
patients by: 4
(1) Geographic location of each surgical center for 5
ambulatory patients; 6
(2) Type of medical diagnosis; and 7
(3) Type of medical treatment; 8
[(e)] (f) Be presented in a manner that allows a person to view 9
and compare the information for the independent centers for 10
emergency medical care by: 11
(1) Geographic location of each independent center for 12
emergency medical care; 13
(2) Type of medical diagnosis; and 14
(3) Type of medical treatment; 15
(g) Be presented in a manner that allows a person to view and 16
compare the information separately for: 17
(1) The inpatients and outpatients of each hospital; [and] 18
(2) The outpatients of each surgical center for ambulatory 19
patients; and 20
(3) The patients of each independent center for emergency 21
medical care; 22
[(f)] (h) Be readily accessible and understandable by a member 23
of the general public; 24
[(g)] (i) Include the annual summary of reports of sentinel 25
events prepared for each health facility pursuant to paragraph (c) of 26
subsection 1 of NRS 439.840; 27
[(h)] (j) Include the annual summary of reports of sentinel 28
events prepared pursuant to paragraph (d) of subsection 1 of 29
NRS 439.840; 30
[(i)] (k) Include the reports of information prepared for each 31
medical facility pursuant to paragraph (b) of subsection 4 of 32
NRS 439.847; 33
[(j)] (l) Include a link to electronic copies of all reports, 34
summaries, compilations and supplementary reports required by 35
NRS 449.450 to 449.530, inclusive; 36
[(k)] (m) Include, for each hospital with 100 or more beds, a 37
summary of financial information which is readily understandable 38
by a member of the general public and which includes, without 39
limitation, a summary of: 40
(1) The expenses of the hospital which are attributable to 41
providing community benefits and in-kind services as reported 42
pursuant to NRS 449.490; 43
(2) The capital improvement report submitted to the 44
Department pursuant to NRS 449.490; 45
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(3) The net income of the hospital; 1
(4) The net income of the consolidated corporation, if the 2
hospital is owned by such a corporation and if that information is 3
publicly available; 4
(5) The operating margin of the hospital; 5
(6) The ratio of the cost of providing care to patients covered 6
by Medicare to the charges for such care; 7
(7) The ratio of the total costs to charges of the hospital; and 8
(8) The average daily occupancy of the hospital; and 9
[(l)] (n) Provide any other information relating to the charges 10
imposed and the quality of the services provided by the hospitals , 11
[and] surgical centers for ambulatory patients and independent 12
centers for emergency medical care in this State which the 13
Department determines is: 14
(1) Useful to consumers; 15
(2) Nationally recognized; and 16
(3) Reported in a standard and reliable manner. 17
2. The Department shall: 18
(a) Publicize the availability of the Internet website; 19
(b) Update the information contained on the Internet website at 20
least quarterly; 21
(c) Ensure that the information contained on the Internet website 22
is accurate and reliable; 23
(d) Ensure that the information reported by a hospital , [or] 24
surgical center for ambulatory patients or independent center for 25
emergency medical care for inpatients and outpatients which is 26
contained on the Internet website is expressed as a total number and 27
as a rate, and [must be] is reported in a manner so as not to reveal 28
the identity of a specific inpatient or outpatient of a hospital , [or] 29
surgical center for ambulatory patients [;] or independent center for 30
emergency medical care; 31
(e) Post a disclaimer on the Internet website indicating that the 32
information contained on the website is provided to assist with the 33
comparison of hospitals and independent centers for emergency 34
medical care and is not a guarantee by the Department or its 35
employees as to the charges imposed by the hospitals and 36
independent centers for emergency medical care in this State or the 37
quality of the services provided by the hospitals and independent 38
centers for emergency medical care in this State, including, without 39
limitation, an explanation that the actual amount charged to a person 40
by a particular hospital or independent center for emergency 41
medical care may not be the same charge as posted on the website 42
for that hospital [;] or independent center for emergency medical 43
care; 44
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(f) Provide on the Internet website established pursuant to this 1
section a link to the Internet website of the Centers for Medicare and 2
Medicaid Services of the United States Department of Health and 3
Human Services; and 4
(g) Upon request, make the information that is contained on the 5
Internet website available in printed form. 6
3. As used in this section, “diagnosis-related group” means 7
groupings of medical diagnostic categories used as a basis for 8
hospital payment schedules by Medicare and other third-party health 9
care plans. 10
Sec. 14. NRS 449.013 is hereby amended to read as follows: 11
449.013 “Independent center for emergency medical care” 12
means a facility, structurally separate [and distinct] from a hospital, 13
which provides [limited] services for the treatment of a medical 14
emergency. The term includes, without limitation, such a facility 15
that is owned or operated by, or otherwise part of, a hospital but is 16
located more than 250 yards from the hospital. 17
Sec. 15. NRS 449.0308 is hereby amended to read as follows: 18
449.0308 1. Except as otherwise provided in this section, the 19
Division may charge and collect from a medical facility, facility for 20
the dependent or facility which is required by the regulations 21
adopted by the Board pursuant to NRS 449.0303 to be licensed or a 22
person who operates such a facility without a license issued by the 23
Division the actual costs incurred by the Division for the 24
enforcement of the provisions of NRS 449.029 to 449.2428, 25
inclusive, including, without limitation, the actual cost of 26
conducting an inspection or investigation of the facility. 27
2. The Division shall not charge and collect the actual cost for 28
enforcement pursuant to subsection 1 if the enforcement activity is: 29
(a) Related to the issuance or renewal of a license for which the 30
Board charges a fee pursuant to NRS 449.050 or 449.089; 31
(b) Related to the issuance or renewal of a license to an 32
independent center for emergency medical care that is owned or 33
operated by, or otherwise part of, a hospital; or 34
[(b)] (c) Conducted pursuant to an agreement with the Federal 35
Government which has appropriated money for that purpose. 36
3. Any money collected pursuant to subsection 1 may be used 37
by the Division to administer and carry out the provisions of NRS 38
449.029 to 449.2428, inclusive, and the regulations adopted 39
pursuant thereto. 40
4. The provisions of this section do not apply to any costs 41
incurred by the Division for the enforcement of the provisions of 42
NRS 449.24185, 449.2419 or 449.24195. 43
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Sec. 16. NRS 449.050 is hereby amended to read as follows: 1
449.050 1. [Each] Except as otherwise provided in this 2
section, each application for a license must be accompanied by such 3
fee as may be determined by regulation of the Board. The Board 4
may, by regulation, allow or require payment of a fee for a license in 5
installments and may fix the amount of each payment and the date 6
that the payment is due. 7
2. The fee imposed by the Board for a facility for transitional 8
living for released offenders must be based on the type of facility 9
that is being licensed and must be calculated to produce the revenue 10
estimated to cover the costs related to the license, but in no case 11
may a fee for a license exceed the actual cost to the Division of 12
issuing or renewing the license. 13
3. If an application for a license for a facility for transitional 14
living for released offenders is denied, any amount of the fee paid 15
pursuant to this section that exceeds the expenses and costs incurred 16
by the Division must be refunded to the applicant. 17
4. The Board shall not require a fee for the issuance or 18
renewal of the license of an independent center for emergency 19
medical care that is owned or operated by, or otherwise part of, a 20
hospital. 21
Sec. 17. NRS 449.080 is hereby amended to read as follows: 22
449.080 1. [If,] Except as otherwise provided in this section, 23
if, after investigation, the Division finds that the: 24
(a) Applicant is in full compliance with the provisions of NRS 25
449.029 to 449.2428, inclusive; 26
(b) Applicant is in substantial compliance with the standards and 27
regulations adopted by the Board; 28
(c) Applicant, if he or she has undertaken a project for which 29
approval is required pursuant to NRS 439A.100 or 439A.102, has 30
obtained the approval of the Director of the Department of Health 31
and Human Services; and 32
(d) Facility conforms to the applicable zoning regulations, 33
the Division shall issue the license to the applicant. 34
2. Any investigation of an applicant for a license to provide 35
community-based living arrangement services conducted pursuant 36
to subsection 1 must include, without limitation, an inspection of 37
any building operated by the applicant in which the applicant 38
proposes to provide community-based living arrangement services. 39
3. The Division may not issue a license to operate an 40
independent center for emergency medical care that is located 41
within a 5 mile radius of: 42
(a) An existing independent center for emergency medical 43
care; or 44
(b) A hospital with an emergency department. 45
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4. A license applies only to the person to whom it is issued, is 1
valid only for the premises described in the license and is not 2
transferable. 3
Sec. 18. NRS 449.1818 is hereby amended to read as follows: 4
449.1818 1. Each off-campus location of a hospital shall 5
obtain and use , and include on all claims for reimbursement or 6
payment for health care services provided at the location , a national 7
provider identifier that is distinct from the national provider 8
identifier used by the main campus and any other off-campus 9
location of the hospital. If the off-campus location includes the 10
national provider identifier on such a claim, the off-campus location 11
may also include on the claim the national provider identifier used 12
by the main campus of the hospital. If the off-campus location 13
includes both the national provider identifier used by the off-campus 14
location and the national provider identifier used by the main 15
campus on a claim, the claim must clearly identify which national 16
provider identifier corresponds to the off-campus location and 17
which national provider identifier corresponds to the main campus. 18
2. An independent center for emergency medical care shall 19
include on all claims for reimbursement or payment for health care 20
services provided at the independent center for emergency medical 21
care the national provider identifier used by the independent center 22
for emergency medical care. 23
3. An independent center for emergency medical care: 24
(a) Shall provide urgent care during all operating hours 25
through: 26
(1) A separate urgent care unit within the independent 27
center for emergency medical care; or 28
(2) A system that uses the severity of the patient’s condition 29
to determine whether the patient receives emergency services or 30
urgent care; 31
(b) Shall not charge more for urgent care than the amount 32
customarily charged for urgent care by an urgent care center; 33
(c) If urgent care services are sufficient to treat or manage the 34
condition of a patient, shall inform the patient that he or she may 35
receive urgent care rather than emergency services; and 36
(d) Shall not require a patient to wait longer to receive urgent 37
care services than a patient with the same condition would be 38
required to wait to receive emergency services. 39
4. As used in this section: 40
(a) “National provider identifier” means the standard, unique 41
health identifier for health care providers that is issued by the 42
national provider system in accordance with 45 C.F.R. Part 162. 43
(b) “Off-campus location” means a facility: 44
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(1) With operations that are directly or indirectly owned or 1
controlled by, in whole or in part, a hospital or which is affiliated 2
with a hospital, regardless of whether it is operated by the same 3
governing body as the hospital; 4
(2) That is located more than 250 yards from the main 5
campus of the hospital; 6
(3) That provides services which are organizationally and 7
functionally integrated with the hospital; and 8
(4) That is an outpatient facility providing ambulatory 9
surgery, urgent care or emergency room services. 10
(c) “Urgent care” means health care that is furnished to a 11
person whose medical condition is sufficiently acute to require 12
treatment unavailable through, or inappropriate to be provided by, 13
a clinic or the office of a provider of health care, but not so acute 14
as to require treatment in an emergency room. 15
Sec. 19. NRS 449.485 is hereby amended to read as follows: 16
449.485 1. Each hospital and independent center for 17
emergency medical care in this State shall use for all patients 18
discharged a form prescribed by the Director and shall include in the 19
form all information required by the Department. Any form 20
prescribed by the Director must be a form that is commonly used 21
nationwide by hospitals [,] and independent centers for emergency 22
medical care, if applicable, and comply with federal laws and 23
regulations. 24
2. Each hospital and independent center for emergency 25
medical care in this State shall, on a monthly basis, report to the 26
Department the information required to be included in the form for 27
each patient. The information reported must be complete, accurate 28
and timely. 29
3. Each insurance company or other payer shall accept the form 30
as the bill for services provided by hospitals and independent 31
centers for emergency medical care in this State. 32
4. Except as otherwise provided in subsection 5, each hospital 33
and independent center for emergency medical care in this State 34
shall provide the information required pursuant to subsection 2 in an 35
electronic form specified by the Department. 36
5. The Director may exempt a hospital or independent center 37
for emergency medical care from the requirements of subsection 4 38
if requiring the hospital or independent center for emergency 39
medical care, as applicable, to comply with the requirements would 40
cause the hospital financial hardship. 41
6. The Department shall use the information submitted 42
pursuant to this section for the [program] programs established 43
pursuant to NRS 439A.220 and section 9 of this act to increase 44
public awareness of health care information concerning the hospitals 45
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and independent centers for emergency medical care, respectively, 1
in this State. 2
Sec. 20. NRS 449.520 is hereby amended to read as follows: 3
449.520 1. On or before October 1 of each year, the Director 4
shall prepare and transmit to the Governor, the Joint Interim 5
Standing Committee on Health and Human Services and the Interim 6
Finance Committee a report of the Department’s operations and 7
activities for the preceding fiscal year. 8
2. The report prepared pursuant to subsection 1 must include: 9
(a) Copies of all reports, summaries, compilations and 10
supplementary reports required by NRS 449.450 to 449.530, 11
inclusive, together with such facts, suggestions and policy 12
recommendations as the Director deems necessary; 13
(b) A summary of the trends of the audits of hospitals in this 14
State that the Department required or performed during the previous 15
year; 16
(c) An analysis of the trends in the costs, expenses and profits of 17
hospitals in this State; 18
(d) An analysis of the methodologies used to determine the 19
corporate home office allocation of hospitals in this State; 20
(e) An examination and analysis of the manner in which 21
hospitals are reporting the information that is required to be filed 22
pursuant to NRS 449.490, including, without limitation, an 23
examination and analysis of whether that information is being 24
reported in a standard and consistent manner, which fairly reflect the 25
operations of each hospital; 26
(f) A review and comparison of the policies and procedures used 27
by hospitals in this State to provide discounted services to, and to 28
reduce charges for services provided to, persons without health 29
insurance; 30
(g) A review and comparison of the policies and procedures 31
used by hospitals in this State to collect unpaid charges for services 32
provided by the hospitals; and 33
(h) A summary of the status of the programs established 34
pursuant to NRS 439A.220 and 439A.240 and section 9 of this act 35
to increase public awareness of health care information concerning 36
the hospitals , [and] surgical centers for ambulatory patients and 37
independent centers for emergency medical care in this State, 38
including, without limitation, the information that was posted in the 39
preceding fiscal year on the Internet website maintained for those 40
programs pursuant to NRS 439A.270. 41
3. The Joint Interim Standing Committee on Health and 42
Human Services shall develop a comprehensive plan concerning the 43
provision of health care in this State which includes, without 44
limitation: 45
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(a) A review of the health care needs in this State as identified 1
by state agencies, local governments, providers of health care and 2
the general public; and 3
(b) A review of the capital improvement reports submitted by 4
hospitals pursuant to subsection 2 of NRS 449.490. 5
Sec. 21. NRS 179.301 is hereby amended to read as follows: 6
179.301 1. The Nevada Gaming Control Board and the 7
Nevada Gaming Commission and their employees, agents and 8
representatives may inquire into and inspect any records sealed 9
pursuant to NRS 179.245 or 179.255, if the event or conviction was 10
related to gaming, to determine the suitability or qualifications of 11
any person to hold a state gaming license, manufacturer’s, seller’s or 12
distributor’s license or registration as a gaming employee pursuant 13
to chapter 463 of NRS. Events and convictions, if any, which are the 14
subject of an order sealing records: 15
(a) May form the basis for recommendation, denial or 16
revocation of those licenses. 17
(b) Must not form the basis for denial or rejection of a gaming 18
work permit unless the event or conviction relates to the applicant’s 19
suitability or qualifications to hold the work permit. 20
2. The Division of Insurance of the Department of Business 21
and Industry and its employees may inquire into and inspect any 22
records sealed pursuant to NRS 179.245 or 179.255, if the event 23
or conviction was related to insurance, to determine the suitability or 24
qualifications of any person to hold a license, certification or 25
authorization issued in accordance with title 57 of NRS. Events and 26
convictions, if any, which are the subject of an order sealing records 27
may form the basis for recommendation, denial or revocation of 28
those licenses, certifications and authorizations. 29
3. The Department of Health and Human Services, the 30
Division of Health Care Financing and Policy of the Department 31
and their employees, agents and representatives may inquire into 32
and inspect any records sealed pursuant to NRS 179.245 or 33
179.255, if the event or conviction was related to Medicare or 34
Medicaid or the provision of professional services for which a 35
license or certification is required. Such inquiry or inspection 36
must be for the purpose of determining the suitability of the 37
person to render such professional services as a provider of 38
services under Medicaid or to own or serve as an officer, 39
managing employee or managing agent of a business seeking to 40
enter into a contract with the Department or a health maintenance 41
organization with which the Department has entered into a 42
contract pursuant to NRS 422.273 for the provision of services 43
under Medicaid. Events and convictions, if any, which are the 44
subject of an order sealing records may form the basis of a 45
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decision of the Department to refuse to enter into or terminate 1
such a contract. 2
4. A prosecuting attorney may inquire into and inspect any 3
records sealed pursuant to NRS 179.245 or 179.255 if: 4
(a) The records relate to a violation or alleged violation of NRS 5
202.485; and 6
(b) The person who is the subject of the records has been 7
arrested or issued a citation for violating NRS 202.485. 8
[4.] 5. The Central Repository for Nevada Records of Criminal 9
History and its employees may inquire into and inspect any records 10
sealed pursuant to NRS 179.245 or 179.255 that constitute 11
information relating to sexual offenses, and may notify employers of 12
the information in accordance with federal laws and regulations. 13
[5.] 6. Records which have been sealed pursuant to NRS 14
179.245 or 179.255 and which are retained in the statewide registry 15
established pursuant to NRS 179B.200 may be inspected pursuant to 16
chapter 179B of NRS by an officer or employee of the Central 17
Repository for Nevada Records of Criminal History or a law 18
enforcement officer in the regular course of his or her duties. 19
[6.] 7. The State Board of Pardons Commissioners and its 20
agents and representatives may inquire into and inspect any records 21
sealed pursuant to NRS 179.245 or 179.255 if the person who is the 22
subject of the records has applied for a pardon from the Board. 23
[7.] 8. As used in this section: 24
(a) “Information relating to sexual offenses” means information 25
contained in or concerning a record relating in any way to a sexual 26
offense. 27
(b) “Sexual offense” has the meaning ascribed to it in 28
NRS 179A.073. 29
Sec. 22. NRS 232.320 is hereby amended to read as follows: 30
232.320 1. The Director: 31
(a) Shall appoint, with the consent of the Governor, 32
administrators of the divisions of the Department, who are 33
respectively designated as follows: 34
(1) The Administrator of the Aging and Disability Services 35
Division; 36
(2) The Administrator of the Division of Welfare and 37
Supportive Services; 38
(3) The Administrator of the Division of Child and Family 39
Services; 40
(4) The Administrator of the Division of Health Care 41
Financing and Policy; and 42
(5) The Administrator of the Division of Public and 43
Behavioral Health. 44
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(b) Shall administer, through the divisions of the Department, 1
the provisions of chapters 63, 424, 425, 427A, 432A to 442, 2
inclusive, 446 to 450, inclusive, 458A and 656A of NRS, NRS 3
127.220 to 127.310, inclusive, 422.001 to 422.410, inclusive, and 4
sections 27 and 28 of this act, 422.580, 432.010 to 432.133, 5
inclusive, 432B.6201 to 432B.626, inclusive, 444.002 to 444.430, 6
inclusive, and 445A.010 to 445A.055, inclusive, and all other 7
provisions of law relating to the functions of the divisions of the 8
Department, but is not responsible for the clinical activities of the 9
Division of Public and Behavioral Health or the professional line 10
activities of the other divisions. 11
(c) Shall administer any state program for persons with 12
developmental disabilities established pursuant to the 13
Developmental Disabilities Assistance and Bill of Rights Act of 14
2000, 42 U.S.C. §§ 15001 et seq. 15
(d) Shall, after considering advice from agencies of local 16
governments and nonprofit organizations which provide social 17
services, adopt a master plan for the provision of human services in 18
this State. The Director shall revise the plan biennially and deliver a 19
copy of the plan to the Governor and the Legislature at the 20
beginning of each regular session. The plan must: 21
(1) Identify and assess the plans and programs of the 22
Department for the provision of human services, and any 23
duplication of those services by federal, state and local agencies; 24
(2) Set forth priorities for the provision of those services; 25
(3) Provide for communication and the coordination of those 26
services among nonprofit organizations, agencies of local 27
government, the State and the Federal Government; 28
(4) Identify the sources of funding for services provided by 29
the Department and the allocation of that funding; 30
(5) Set forth sufficient information to assist the Department 31
in providing those services and in the planning and budgeting for the 32
future provision of those services; and 33
(6) Contain any other information necessary for the 34
Department to communicate effectively with the Federal 35
Government concerning demographic trends, formulas for the 36
distribution of federal money and any need for the modification of 37
programs administered by the Department. 38
(e) May, by regulation, require nonprofit organizations and state 39
and local governmental agencies to provide information regarding 40
the programs of those organizations and agencies, excluding 41
detailed information relating to their budgets and payrolls, which the 42
Director deems necessary for the performance of the duties imposed 43
upon him or her pursuant to this section. 44
(f) Has such other powers and duties as are provided by law. 45
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2. Notwithstanding any other provision of law, the Director, or 1
the Director’s designee, is responsible for appointing and removing 2
subordinate officers and employees of the Department. 3
Sec. 23. NRS 232.459 is hereby amended to read as follows: 4
232.459 1. The Advocate shall: 5
(a) Respond to written and telephonic inquiries received from 6
consumers and injured employees regarding concerns and problems 7
related to health care and workers’ compensation; 8
(b) Assist consumers and injured employees in understanding 9
their rights and responsibilities under health care plans, including, 10
without limitation, the Public Employees’ Benefits Program and the 11
Public Option, and policies of industrial insurance; 12
(c) Identify and investigate complaints of consumers and injured 13
employees regarding their health care plans, including, without 14
limitation, the Public Employees’ Benefits Program and the Public 15
Option, and policies of industrial insurance and assist those 16
consumers and injured employees to resolve their complaints, 17
including, without limitation: 18
(1) Referring consumers and injured employees to the 19
appropriate agency, department or other entity that is responsible for 20
addressing the specific complaint of the consumer or injured 21
employee; and 22
(2) Providing counseling and assistance to consumers and 23
injured employees concerning health care plans, including, without 24
limitation, the Public Employees’ Benefits Program and the Public 25
Option, and policies of industrial insurance; 26
(d) Provide information to consumers and injured employees 27
concerning health care plans, including, without limitation, the 28
Public Employees’ Benefits Program and the Public Option, and 29
policies of industrial insurance in this State; 30
(e) Establish and maintain a system to collect and maintain 31
information pertaining to the written and telephonic inquiries 32
received by the Office for Consumer Health Assistance; 33
(f) Take such actions as are necessary to ensure public 34
awareness of the existence and purpose of the services provided by 35
the Advocate pursuant to this section; 36
(g) In appropriate cases and pursuant to the direction of the 37
Advocate, refer a complaint or the results of an investigation to the 38
Attorney General for further action; 39
(h) Provide information to and applications for prescription drug 40
programs for consumers without insurance coverage for prescription 41
drugs or pharmaceutical services; 42
(i) Establish and maintain an Internet website which includes: 43
(1) Information concerning purchasing prescription drugs 44
from Canadian pharmacies that have been recommended by the 45
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- *SB378_R1*
State Board of Pharmacy for inclusion on the Internet website 1
pursuant to subsection 4 of NRS 639.2328; 2
(2) Links to websites of Canadian pharmacies which have 3
been recommended by the State Board of Pharmacy for inclusion on 4
the Internet website pursuant to subsection 4 of NRS 639.2328; and 5
(3) A link to the website established and maintained pursuant 6
to NRS 439A.270 which provides information to the general public 7
concerning the charges imposed and the quality of the services 8
provided by the hospitals , [and] surgical centers for ambulatory 9
patients and independent centers for emergency medical care in 10
this State; 11
(j) Assist consumers with accessing a navigator, case manager 12
or facilitator to help the consumer obtain health care services; 13
(k) Assist consumers with scheduling an appointment with a 14
provider of health care who is in the network of providers under 15
contract to provide services to participants in the health care plan 16
under which the consumer is covered; 17
(l) Assist consumers with filing complaints against health care 18
facilities and health care professionals; 19
(m) Assist consumers with filing complaints with the 20
Commissioner of Insurance against issuers of health care plans; and 21
(n) On or before January 31 of each year, compile a report of 22
aggregated information submitted to the Office for Consumer 23
Health Assistance pursuant to NRS 687B.675, aggregated for each 24
type of provider of health care for which such information is 25
provided and submit the report to the Director of the Legislative 26
Counsel Bureau for transmittal to: 27
(1) In even-numbered years, the Joint Interim Standing 28
Committee on Health and Human Services; and 29
(2) In odd-numbered years, the next regular session of the 30
Legislature. 31
2. The Advocate may adopt regulations to carry out the 32
provisions of this section and NRS 232.461 and 232.462. 33
3. As used in this section: 34
(a) “Health care facility” has the meaning ascribed to it in 35
NRS 162A.740. 36
(b) “Navigator, case manager or facilitator” has the meaning 37
ascribed to it in NRS 687B.675. 38
(c) “Public Option” means the Public Option established 39
pursuant to NRS 695K.200. 40
Sec. 24. NRS 287.010 is hereby amended to read as follows: 41
287.010 1. The governing body of any county, school 42
district, municipal corporation, political subdivision, public 43
corporation or other local governmental agency of the State of 44
Nevada may: 45
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- *SB378_R1*
(a) Adopt and carry into effect a system of group life, accident 1
or health insurance, or any combination thereof, for the benefit of its 2
officers and employees, and the dependents of officers and 3
employees who elect to accept the insurance and who, where 4
necessary, have authorized the governing body to make deductions 5
from their compensation for the payment of premiums on the 6
insurance. 7
(b) Purchase group policies of life, accident or health insurance, 8
or any combination thereof, for the benefit of such officers and 9
employees, and the dependents of such officers and employees, as 10
have authorized the purchase, from insurance companies authorized 11
to transact the business of such insurance in the State of Nevada, 12
and, where necessary, deduct from the compensation of officers and 13
employees the premiums upon insurance and pay the deductions 14
upon the premiums. 15
(c) Provide group life, accident or health coverage through a 16
self-insurance reserve fund and, where necessary, deduct 17
contributions to the maintenance of the fund from the compensation 18
of officers and employees and pay the deductions into the fund. The 19
money accumulated for this purpose through deductions from the 20
compensation of officers and employees and contributions of the 21
governing body must be maintained as an internal service fund as 22
defined by NRS 354.543. The money must be deposited in a state or 23
national bank or credit union authorized to transact business in the 24
State of Nevada. Any independent administrator of a fund created 25
under this section is subject to the licensing requirements of chapter 26
683A of NRS, and must be a resident of this State. Any contract 27
with an independent administrator must be approved by the 28
Commissioner of Insurance as to the reasonableness of 29
administrative charges in relation to contributions collected and 30
benefits provided. The provisions of NRS 439.581 to 439.597, 31
inclusive, and section 1 of this act, 686A.135, 687B.352, 687B.408, 32
687B.692, 687B.723, 687B.725, 687B.805, 689B.030 to 33
689B.0317, inclusive, paragraphs (b) and (c) of subsection 1 of NRS 34
689B.0319, subsections 2, 4, 6 and 7 of NRS 689B.0319, 689B.033 35
to 689B.0369, inclusive, 689B.0375 to 689B.050, inclusive, 36
689B.0675, 689B.265, 689B.287 and 689B.500 apply to coverage 37
provided pursuant to this paragraph, except that the provisions of 38
NRS 689B.0378, 689B.03785 and 689B.500 only apply to coverage 39
for active officers and employees of the governing body, or the 40
dependents of such officers and employees. 41
(d) Defray part or all of the cost of maintenance of a self-42
insurance fund or of the premiums upon insurance. The money for 43
contributions must be budgeted for in accordance with the laws 44
governing the county, school district, municipal corporation, 45
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- *SB378_R1*
political subdivision, public corporation or other local governmental 1
agency of the State of Nevada. 2
2. If a school district offers group insurance to its officers and 3
employees pursuant to this section, members of the board of trustees 4
of the school district must not be excluded from participating in the 5
group insurance. If the amount of the deductions from compensation 6
required to pay for the group insurance exceeds the compensation to 7
which a trustee is entitled, the difference must be paid by the trustee. 8
3. In any county in which a legal services organization exists, 9
the governing body of the county, or of any school district, 10
municipal corporation, political subdivision, public corporation or 11
other local governmental agency of the State of Nevada in the 12
county, may enter into a contract with the legal services 13
organization pursuant to which the officers and employees of the 14
legal services organization, and the dependents of those officers and 15
employees, are eligible for any life, accident or health insurance 16
provided pursuant to this section to the officers and employees, and 17
the dependents of the officers and employees, of the county, school 18
district, municipal corporation, political subdivision, public 19
corporation or other local governmental agency. 20
4. If a contract is entered into pursuant to subsection 3, the 21
officers and employees of the legal services organization: 22
(a) Shall be deemed, solely for the purposes of this section, to be 23
officers and employees of the county, school district, municipal 24
corporation, political subdivision, public corporation or other local 25
governmental agency with which the legal services organization has 26
contracted; and 27
(b) Must be required by the contract to pay the premiums or 28
contributions for all insurance which they elect to accept or of which 29
they authorize the purchase. 30
5. A contract that is entered into pursuant to subsection 3: 31
(a) Must be submitted to the Commissioner of Insurance for 32
approval not less than 30 days before the date on which the contract 33
is to become effective. 34
(b) Does not become effective unless approved by the 35
Commissioner. 36
(c) Shall be deemed to be approved if not disapproved by the 37
Commissioner within 30 days after its submission. 38
6. As used in this section, “legal services organization” means 39
an organization that operates a program for legal aid and receives 40
money pursuant to NRS 19.031. 41
Sec. 25. NRS 287.04335 is hereby amended to read as 42
follows: 43
287.04335 If the Board provides health insurance through a 44
plan of self-insurance, it shall comply with the provisions of 45
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NRS 439.581 to 439.597, inclusive, and section 1 of this act, 1
686A.135, 687B.352, 687B.409, 687B.692, 687B.723, 687B.725, 2
687B.805, 689B.0353, 689B.255, 695C.1723, 695G.150, 695G.155, 3
695G.160, 695G.162, 695G.1635, 695G.164, 695G.1645, 4
695G.1665, 695G.167, 695G.1675, 695G.170 to 695G.1712, 5
inclusive, 695G.1714 to 695G.174, inclusive, 695G.176, 695G.177, 6
695G.200 to 695G.230, inclusive, 695G.241 to 695G.310, inclusive, 7
695G.405 and 695G.415, in the same manner as an insurer that is 8
licensed pursuant to title 57 of NRS is required to comply with those 9
provisions. 10
Sec. 26. Chapter 422 of NRS is hereby amended by adding 11
thereto the provisions set forth as sections 27 and 28 of this act. 12
Sec. 27. 1. A provider of services under Medicaid shall: 13
(a) Maintain such documents as are required by regulation of 14
the Administrator for the verification of claims for the period of 15
time specified in those regulations; and 16
(b) Provide the documents maintained pursuant to paragraph 17
(a) to the Department upon the request of the Department. 18
2. The Department may audit any documents provided 19
pursuant to paragraph (b) of subsection 1. If the Department is 20
unable to verify a claim using the documents maintained pursuant 21
to subsection 1, the Department may deny the claim or, if the 22
Department has already paid the claim, recover the amount of the 23
payment from the provider. 24
Sec. 28. 1. If the Department determines that a provider of 25
services under Medicaid may be prescribing or providing services 26
in a manner that exceeds the needs of recipients of Medicaid, is 27
unnecessary or otherwise conflicts with applicable professional 28
standards or the requirements of the Medicaid program, the 29
Department shall perform a review of the relevant claims to 30
evaluate the appropriateness and propriety of the services for 31
which payment is claimed. If the Department has not paid the 32
claims, the review must occur before the Department pays the 33
claims. 34
2. Upon deciding to conduct a review pursuant to subsection 35
1, the Department shall: 36
(a) Notify the provider of services who submitted the claims 37
subject to the review; and 38
(b) Require the provider of services to submit to the 39
Department within a period of time specified by the Department 40
any documentation necessary to substantiate the claims. 41
3. If a provider of services fails to submit the documentation 42
required by the Department pursuant to paragraph (b) of 43
subsection 2 within the time specified pursuant to that paragraph, 44
the Department may take the actions described in paragraph (a) of 45
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- *SB378_R1*
subsection 5 without the opportunity for a hearing pursuant to 1
NRS 422.306. 2
4. Not later than 60 days after receiving the documentation 3
requested pursuant to paragraph (b) of subsection 2, the 4
Department shall complete a review pursuant to this section and 5
either: 6
(a) Pay the claims that were subject to the review or, if the 7
Department has already paid such a claim, notify the provider of 8
services who made the claim that the claim has been upheld; or 9
(b) Take an action described in paragraph (a) of subsection 5 10
with respect to the claims that were subject to the review. 11
5. If the Department determines after conducting a review 12
pursuant to this section that a provider of services has prescribed 13
or provided services in a manner that exceeds the needs of 14
recipients of Medicaid, is unnecessary or otherwise conflicts with 15
applicable professional standards or the requirements of the 16
Medicaid program, the Department may, after the opportunity for 17
a hearing pursuant to NRS 422.306: 18
(a) Deny the affected claims or, if the Department has already 19
paid an affected claim, recover the amount of the payment from 20
the provider; 21
(b) Require the provider to request and receive authorization 22
for the delivery of services to recipients of Medicaid before 23
delivering the services; or 24
(c) Take any other action authorized by this chapter and the 25
regulations adopted pursuant thereto. 26
Sec. 29. NRS 603A.100 is hereby amended to read as follows: 27
603A.100 1. The provisions of NRS 603A.010 to 603A.290, 28
inclusive, do not apply to the maintenance or transmittal of 29
information in accordance with NRS 439.581 to 439.597, inclusive, 30
and section 1 of this act and the regulations adopted pursuant 31
thereto. 32
2. A data collector who is also an operator, as defined in NRS 33
603A.330, shall comply with the provisions of NRS 603A.300 to 34
603A.360, inclusive. 35
3. Any waiver of the provisions of NRS 603A.010 to 36
603A.290, inclusive, is contrary to public policy, void and 37
unenforceable. 38
Sec. 30. NRS 613.195 is hereby amended to read as follows: 39
613.195 1. A noncompetition covenant is void and 40
unenforceable unless the noncompetition covenant: 41
(a) Is supported by valuable consideration; 42
(b) Does not impose any restraint that is greater than is required 43
for the protection of the employer for whose benefit the restraint is 44
imposed; 45
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- *SB378_R1*
(c) Does not impose any undue hardship on the employee; and 1
(d) Imposes restrictions that are appropriate in relation to the 2
valuable consideration supporting the noncompetition covenant. 3
2. A noncompetition covenant may not restrict, and an 4
employer may not bring an action to restrict, a former employee of 5
an employer from providing service to a former customer or client 6
if: 7
(a) The former employee did not solicit the former customer or 8
client; 9
(b) The customer or client voluntarily chose to leave and seek 10
services from the former employee; and 11
(c) The former employee is otherwise complying with the 12
limitations in the covenant as to time, geographical area and scope 13
of activity to be restrained, other than any limitation on providing 14
services to a former customer or client who seeks the services of the 15
former employee without any contact instigated by the former 16
employee. 17
Any provision in a noncompetition covenant which violates the 18
provisions of this subsection is void and unenforceable. 19
3. A noncompetition covenant may not apply to [an] : 20
(a) An employee who is paid solely on an hourly wage basis, 21
exclusive of any tips or gratuities [.] ; or 22
(b) A patient-facing provider of health care. 23
4. An employer in this State who negotiates, executes or 24
attempts to enforce a noncompetition covenant that is void and 25
unenforceable under this section does not violate the provisions of 26
NRS 613.200. 27
5. If the termination of the employment of an employee is the 28
result of a reduction of force, reorganization or similar restructuring 29
of the employer, a noncompetition covenant is only enforceable 30
during the period in which the employer is paying the employee’s 31
salary, benefits or equivalent compensation, including, without 32
limitation, severance pay. 33
6. If an employer brings an action to enforce a noncompetition 34
covenant or an employee brings an action to challenge a 35
noncompetition covenant and the court finds the covenant is 36
supported by valuable consideration but contains limitations as to 37
time, geographical area or scope of activity to be restrained that are 38
not reasonable, imposes a greater restraint than is necessary for the 39
protection of the employer for whose benefit the restraint is imposed 40
or imposes undue hardship on the employee, the court shall revise 41
the covenant to the extent necessary and enforce the covenant as 42
revised. Such revisions must cause the limitations contained in the 43
covenant as to time, geographical area and scope of activity to be 44
restrained to be reasonable, to not impose undue hardship on the 45
– 33 –
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employee and to impose a restraint that is not greater than is 1
necessary for the protection of the employer for whose benefit the 2
restraint is imposed. 3
7. If an employer brings an action to enforce a noncompetition 4
covenant or an employee or contractor brings an action to challenge 5
a noncompetition covenant and the court finds that the 6
noncompetition covenant applies to [an employee] a person 7
described in subsection 3 or that the employer has restricted or 8
attempted to restrict a former employee in the manner described in 9
subsection 2, the court shall award the employee or contractor 10
reasonable attorney’s fees and costs. Nothing in this subsection shall 11
be construed as prohibiting a court from otherwise awarding 12
attorney’s fees to a prevailing party pursuant to NRS 18.010. 13
8. As used in this section: 14
(a) “Employer” means every person having control or custody of 15
any employment, place of employment or any employee. 16
(b) “Noncompetition covenant” means an agreement between an 17
employer and employee which, upon termination of the employment 18
of the employee, prohibits the employee from pursuing a similar 19
vocation in competition with or becoming employed by a competitor 20
of the employer. 21
(c) “Patient-facing provider of health care” means a provider 22
of health care, as defined in NRS 629.031: 23
(1) Whose primary duties involve providing clinical care to 24
patients; and 25
(2) Who is not employed or contracted to primarily perform 26
administrative tasks. 27
Sec. 31. NRS 629.051 is hereby amended to read as follows: 28
629.051 1. Except as otherwise provided in this section and 29
in regulations adopted by the State Board of Health pursuant to NRS 30
652.135 with regard to the records of a medical laboratory and 31
unless a longer period is provided by federal law, each custodian of 32
health care records shall retain the health care records of patients as 33
part of the regularly maintained records of the custodian for 5 years 34
after their receipt or production. Health care records may be retained 35
in written form, or by microfilm or any other recognized form of 36
size reduction, including, without limitation, microfiche, computer 37
disc, magnetic tape and optical disc, which does not adversely affect 38
their use for the purposes of NRS 629.061. 39
2. A high-level provider of health care shall comply with the 40
requirements of subsection 4 of NRS 439.589 concerning the 41
maintenance, transmittal and exchange of health records. Health 42
care records [: 43
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- *SB378_R1*
(a) Must, except as otherwise provided in subsections 5 and 6 of 1
NRS 439.589, be created, maintained, transmitted and exchanged 2
electronically as required by subsection 4 of NRS 439.589; and 3
(b) May] may be created, authenticated and stored in a health 4
information exchange which meets the requirements of NRS 5
439.581 to 439.597, inclusive, and section 1 of this act and the 6
regulations adopted pursuant thereto. 7
[2.] 3. A provider of health care shall post, in a conspicuous 8
place in each location at which the provider of health care performs 9
health care services, a sign which discloses to patients that their 10
health care records may be destroyed after the period set forth in 11
subsection 1. 12
[3.] 4. When a provider of health care performs health care 13
services for a patient for the first time, the provider of health care 14
shall deliver to the patient a written statement which discloses to the 15
patient that the health care records of the patient may be destroyed 16
after the period set forth in subsection 1. 17
[4.] 5. If a provider of health care fails to deliver the written 18
statement to the patient pursuant to subsection [3,] 4, the provider of 19
health care shall deliver to the patient the written statement 20
described in subsection [3] 4 when the provider of health care next 21
performs health care services for the patient. 22
[5.] 6. In addition to delivering a written statement pursuant to 23
subsection [3 or] 4 [,] or 5, a provider of health care may deliver 24
such a written statement to a patient at any other time. 25
[6.] 7. A written statement delivered to a patient pursuant to 26
this section may be included with other written information 27
delivered to the patient by a provider of health care. 28
[7.] 8. A custodian of health care records shall not destroy the 29
health care records of a person who is less than 23 years of age on 30
the date of the proposed destruction of the records. The health care 31
records of a person who has attained the age of 23 years may be 32
destroyed in accordance with this section for those records which 33
have been retained for at least 5 years or for any longer period 34
provided by federal law. 35
[8.] 9. If a health care licensing board receives notification 36
from the Department of Health and Human Services pursuant to 37
NRS 439.5895 that a high-level provider of health care to which the 38
health care licensing board has issued a license is not in compliance 39
with the requirements of subsection 4 or 8, as applicable, of NRS 40
439.589, the health care licensing board may, after notice and the 41
opportunity for a hearing in accordance with the provisions of this 42
title, require corrective action or impose an administrative penalty in 43
an amount not to exceed the maximum penalty that the health care 44
licensing board is authorized to impose for other violations. The 45
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- *SB378_R1*
health care licensing board shall not suspend or revoke a license for 1
failure to comply with the requirements of subsection 4 or 8 of 2
NRS 439.589. 3
[9. The provisions of this section, except for the provisions of 4
paragraph (a) of subsection 1 and subsection 8, do not apply to a 5
pharmacist.] 6
10. The State Board of Health shall adopt: 7
(a) Regulations prescribing the form, size, contents and 8
placement of the signs and written statements required pursuant to 9
this section; and 10
(b) Any other regulations necessary to carry out the provisions 11
of this section. 12
11. As used in this section: 13
(a) “Health care licensing board” means: 14
(1) A board created pursuant to chapter 630, 630A, 631, 632, 15
633, 634, 634A, 635, 636, 637, 637B, 639, 640, 640A, 640B, 640C, 16
641, 641A, 641B, 641C or 641D of NRS. 17
(2) The Division of Public and Behavioral Health of the 18
Department of Health and Human Services. 19
(3) The State Board of Health with respect to licenses issued 20
pursuant to chapter 640D or 640E of NRS. 21
(b) “High-level provider of health care” has the meaning 22
ascribed to it in section 1 of this act. 23
(c) “License” has the meaning ascribed to it in NRS 439.5895. 24
Sec. 32. NRS 629.053 is hereby amended to read as follows: 25
629.053 1. The State Board of Health and each board created 26
pursuant to chapter 630, 630A, 631, 632, 633, 634, 634A, 635, 636, 27
637, 637B, 640, 640A, 640B, 640C, 641, 641A, 641B, 641C or 28
641D of NRS shall post on its website on the Internet, if any, a 29
statement which discloses that: 30
(a) Pursuant to the provisions of subsection [7] 8 of 31
NRS 629.051: 32
(1) The health care records of a person who is less than 23 33
years of age may not be destroyed; and 34
(2) The health care records of a person who has attained the 35
age of 23 years may be destroyed for those records which have been 36
retained for at least 5 years or for any longer period provided by 37
federal law; and 38
(b) Except as otherwise provided in subsection [7] 8 of NRS 39
629.051 and unless a longer period is provided by federal law, the 40
health care records of a patient who is 23 years of age or older may 41
be destroyed after 5 years pursuant to subsection 1 of NRS 629.051. 42
2. The State Board of Health shall adopt regulations 43
prescribing the contents of the statements required pursuant to this 44
section. 45
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Sec. 33. NRS 629.062 is hereby amended to read as follows: 1
629.062 1. If a person who is authorized to request a copy of 2
health care records of a patient pursuant to NRS 629.061 requests 3
that a copy of such records be furnished electronically, the custodian 4
of health care records must electronically transmit a copy of the 5
requested records to the person or, if the patient has provided 6
written authorization for records to be furnished to another person or 7
entity, to that person or entity. Such records must be furnished in an 8
electronic format using a method of secure electronic transmission 9
that complies with applicable federal and state law. If a patient 10
requests that a copy his or her health care records be furnished 11
electronically to the patient or any other person or entity, the 12
custodian of health records shall furnish the copy not later than 13
the end of the second business day after the request is made. 14
2. Except as otherwise provided in this subsection and 15
subsections 3 and 4, if a custodian of health care records maintains 16
health care records electronically, any fee to furnish those records 17
electronically pursuant to subsection 1 must not exceed $40 or the 18
amount per page prescribed by NRS 629.061, whichever is less. A 19
custodian of health care records shall not charge a fee to furnish 20
health care records to a patient or, if the patient has requested a 21
copy of his or her health care records to be furnished to another 22
person or entity, to that person or entity. 23
3. If the total amount of the fee chargeable pursuant to 24
subsection 2 for the furnishing of health care records electronically 25
is less than $5, a custodian of health care records, other than a 26
custodian of the health care records of a state or local governmental 27
entity, may charge a fee of $5 for the furnishing of those health care 28
records. 29
4. [A] Except as otherwise provided in subsection 2, a 30
custodian of health care records, other than a custodian of the health 31
care records of a state or local governmental entity, may charge the 32
following fees to furnish health care records electronically, in 33
addition to the total amount of the fee charged pursuant to 34
subsection 2 or 3: 35
(a) A fee of $5 for written confirmation that no health care 36
records were found. 37
(b) A fee of $5 for furnishing a copy of a certificate of the 38
custodian of health care records. 39
(c) A fee of $20 for a copy of a printed film sheet. 40
(d) A fee of $25 for furnishing a copy of radiologic images in 41
any form other than a printed film sheet. 42
5. As used in this section: 43
(a) “Custodian of health care records” has the meaning ascribed 44
to it in NRS 629.016 and additionally includes a covered entity or 45
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business associate, as those terms are defined in 45 C.F.R. 1
§ 160.103. 2
(b) “Health care records” has the meaning ascribed to it in NRS 3
629.021 and additionally includes individually identifiable health 4
information, as defined in 45 C.F.R. § 160.103. 5
(c) “Secure electronic transmission” means the sending of 6
information from one computer system to another computer system 7
in such a manner as to ensure that: 8
(1) No person other than the intended recipient receives the 9
information; 10
(2) The identity and signature of the sender of the 11
information can be authenticated; and 12
(3) The information which is received by the intended 13
recipient is identical to the information that was sent. 14
Sec. 34. NRS 686A.315 is hereby amended to read as follows: 15
686A.315 1. If a hospital or independent center for 16
emergency medical care submits to an insurer the form prescribed 17
by the Director of the Department of Health and Human Services 18
pursuant to NRS 449.485, that form must contain or be 19
accompanied by a statement that reads substantially as follows: 20
21
Any person who misrepresents or falsifies essential 22
information requested on this form may, upon conviction, be 23
subject to a fine and imprisonment under state or federal law, 24
or both. 25
26
2. If a person who is licensed to practice one of the health 27
professions regulated by title 54 of NRS submits to an insurer the 28
form commonly referred to as the “HCFA-1500” for a patient who 29
is not covered by any governmental program which offers insurance 30
coverage for health care, the form must be accompanied by a 31
statement that reads substantially as follows: 32
33
Any person who knowingly files a statement of claim 34
containing any misrepresentation or any false, incomplete or 35
misleading information may be guilty of a criminal act 36
punishable under state or federal law, or both, and may be 37
subject to civil penalties. 38
39
3. The failure to provide any of the statements required by this 40
section is not a defense in a prosecution for insurance fraud pursuant 41
to NRS 686A.291. 42
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Sec. 35. NRS 719.200 is hereby amended to read as follows: 1
719.200 1. Except as otherwise provided in subsection 2, the 2
provisions of this chapter apply to electronic records and electronic 3
signatures relating to a transaction. 4
2. The provisions of this chapter do not apply to a transaction 5
to the extent it is governed by: 6
(a) Except as otherwise specifically provided by law, a law 7
governing the creation and execution of wills, codicils or 8
testamentary trusts; 9
(b) The Uniform Commercial Code other than NRS 104.1306, 10
104.2101 to 104.2725, inclusive, and 104A.2101 to 104A.2532, 11
inclusive; or 12
(c) The provisions of NRS 439.581 to 439.597, inclusive, and 13
section 1 of this act and the regulations adopted pursuant thereto. 14
3. The provisions of this chapter apply to an electronic record 15
or electronic signature otherwise excluded from the application of 16
this chapter under subsection 2 to the extent it is governed by a law 17
other than those specified in subsection 2. 18
4. A transaction subject to the provisions of this chapter is also 19
subject to other applicable substantive law. 20
Sec. 36. NRS 720.140 is hereby amended to read as follows: 21
720.140 1. Except as otherwise provided in this subsection, 22
the provisions of this chapter apply to any transaction for which a 23
digital signature is used to sign an electronic record. The provisions 24
of this chapter do not apply to a digital signature that is used to sign 25
an electronic health record in accordance with NRS 439.581 to 26
439.597, inclusive, and section 1 of this act and the regulations 27
adopted pursuant thereto. 28
2. As used in this section, “electronic record” has the meaning 29
ascribed to it in NRS 719.090. 30
Sec. 37. 1. Notwithstanding the amendatory provisions of 31
section 14 of this act, an independent center for emergency medical 32
care that is owned or operated by, or otherwise part of, a hospital 33
may continue to operate without obtaining a license separate from 34
the license of the hospital pursuant to NRS 449.080 until July 1, 35
2026. 36
2. Notwithstanding the amendatory provisions of section 17 of 37
this act, the Division of Public and Behavioral Health of the 38
Department of Health and Human Services shall issue a license to 39
operate an independent center for emergency medical care that is 40
owned or operated by, or otherwise part of, a hospital, is operating 41
on January 1, 2026, and is located within 5 miles of another 42
independent center for emergency medical care or a hospital with an 43
emergency department if the independent center for emergency 44
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- *SB378_R1*
medical care otherwise qualifies for licensure pursuant to 1
NRS 449.080. 2
3. Notwithstanding the amendatory provisions of section 17 of 3
this act, the Division of Public and Behavioral Health of the 4
Department of Health and Human Services shall issue a license to 5
operate an independent center for emergency medical care that is 6
located within 5 miles of another independent center for emergency 7
medical care or a hospital with an emergency department and that 8
otherwise qualifies for licensure pursuant to NRS 449.080 at the 9
time of the application for licensure if, on or before January 1, 2026, 10
the owner or operator of the independent center for emergency 11
medical care has: 12
(a) Acquired the land upon which the independent center for 13
emergency medical care is to be constructed; 14
(b) Obtained or is in the process of obtaining all necessary 15
permits, licenses or other required approvals necessary for the 16
construction of the independent center for emergency medical care; 17
and 18
(c) Commenced the process of obtaining approval from the 19
Director of the Department of Health and Human Services pursuant 20
to NRS 439A.100 or 439A.102, if applicable. 21
4. As used in this section, “independent center for emergency 22
medical care” has the meaning ascribed to it in NRS 449.013, as 23
amended by section 14 of this act. 24
Sec. 38. The provisions of subsection 1 of NRS 218D.380 do 25
not apply to any provision of this act which adds or revises a 26
requirement to submit a report to the Legislature. 27
Sec. 39. 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. 40. NRS 450B.215 is hereby repealed. 31
Sec. 41. 1. This section and sections 1 to 4, inclusive, 6, 21, 32
22, 24 to 32, inclusive, 35, 36 and 40 of this act become effective 33
upon passage and approval. 34
2. Sections 5, 7 to 20, inclusive, 23, 33, 34, 37, 38 and 39 of 35
this act become effective: 36
(a) Upon passage and approval for the purpose of adopting any 37
regulations and performing any other preliminary administrative 38
tasks that are necessary to carry out the provisions of this act; and 39
(b) On January 1, 2026, for all other purposes. 40
– 40 –
- *SB378_R1*
TEXT OF REPEALED SECTION
450B.215 Administrative sanctions for failure to comply
with requirements concerning electronic health information.
1. If the health authority receives notification from the
Department of Health and Human Services pursuant to NRS
439.5895 that the holder of a permit to operate an ambulance, air
ambulance or vehicle of a fire-fighting agency is not in compliance
with the requirements of subsection 4 of NRS 439.589, the health
authority may, after notice and the opportunity for a hearing in
accordance with the provisions of this chapter, require corrective
action or impose an administrative penalty in an amount established
by regulation of the board.
2. The health authority shall not suspend or revoke a permit
for failure to comply with the requirements of subsection 4 of
NRS 439.589.
H