S.B. 378
- *SB378*
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 physician;
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
information and electronic signatures and requirements for electronic equivalents of 4
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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 practices are under a certain size or who work 24
only in concierge medicine. However, section 4 requires such high-level providers 25
of health care to furnish the medical records of a patient electronically to the patient 26
upon request of the patient. Section 6 of this bill makes conforming changes to 27
revise the applicability of a provision requiring the Department to notify the 28
licensing board of a provider who fails to comply with requirements governing the 29
electronic maintenance, transmittal and exchange of health information. Section 2 30
of this bill establishes the applicability of the definition set forth in section 1, and 31
sections 24, 25, 29, 35 and 36 of this bill make other conforming changes to 32
indicate the proper placement of section 1 in the Nevada Revised Statutes. Section 33
32 of this bill updates internal 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 owned or operated by, or otherwise part of, a hospital that 38
is structurally separate from the hospital and provides limited services for the 39
treatment of a medical emergency to be licensed as an independent center for 40
emergency medical care. (NRS 449.0151, 449.030) Sections 15 and 16 of this bill 41
prohibit the Division or the State Board of Health from charging a fee for the 42
issuance of such a license. Section 17 of this bill prohibits the Division from 43
issuing a license to operate an independent center for emergency medical care that 44
is located within a 5 mile radius of another independent center for emergency 45
medical care. However, section 37 of this bill requires the Division to issue a 46
license to an independent center for emergency medical care that: (1) is operating 47
on January 1, 2026; (2) is newly required by section 14 to be licensed; and (3) 48
otherwise meets the requirements for licensure, regardless of where the facility is 49
located. Section 18 of this bill requires an independent center for emergency 50
medical care to provide urgent care services during all operating hours and imposes 51
certain additional requirements related to the provision of such urgent care. 52
Existing law establishes programs to increase awareness of information 53
concerning hospitals and surgical centers for ambulatory patients. (NRS 439A.200-54
439A.290) Section 9 of this bill requires the Department to establish a similar 55
program to increase awareness of information concerning independent centers for 56
emergency medical care. Sections 9, 10, 12, 13 and 19 of this bill provide for the 57
Department to collect certain information on the operations of independent centers 58
for emergency medical care and the outcomes for patients treated by independent 59
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centers for emergency medical care. To facilitate such reporting, section 19 60
requires an independent center for emergency medical care to use the same form 61
prescribed by the Director for discharging patients as a hospital is currently 62
required to use. Section 34 of this bill makes a conforming change to reflect that 63
independent centers for emergency medical care will be using the same form. 64
Sections 12 and 13 require the Department to: (1) make certain information 65
concerning independent centers for emergency medical care available upon request; 66
and (2) post certain information concerning independent centers for emergency 67
medical care on an Internet website maintained by the Department. Section 23 of 68
this bill makes a conforming change to reflect the revised content of that Internet 69
website. Section 8 of this bill defines the term “independent center for emergency 70
medical care” for that purpose. Section 11 of this bill establishes the applicability 71
of certain definitions. Section 20 of this bill requires a report prepared by the 72
Director on the status of the programs to increase public awareness of information 73
concerning hospitals and surgical centers for ambulatory patients to additionally 74
include information on the status of the program to increase awareness of 75
information concerning independent centers for emergency medical care. 76
Existing law authorizes a court, upon a petition, to order the sealing of records 77
of certain convictions if the person who was convicted: (1) has not been convicted 78
of any additional offense, except for minor traffic violations, for a specified 79
period of time; and (2) does not have charges pending for any offense, except for 80
minor traffic violations. (NRS 179.245) Existing law also authorizes a court, upon a 81
petition, to order the sealing of records of an arrest where the charges were 82
dismissed, the prosecutor declined to prosecute or the person who was arrested was 83
acquitted. (NRS 179.255) Section 21 of this bill authorizes the Department or the 84
Division of Health Care Financing and Policy of the Department to review certain 85
sealed records for the purpose of determining the suitability of the person to whom 86
the records pertain to serve as a provider of services under Medicaid or to own or 87
serve as an officer, managing employee or managing agent of such a provider of 88
services. 89
Existing law prescribes a procedure for conducting a hearing to review an 90
action taken against a provider of services under Medicaid. (NRS 422.306) Section 91
27 of this bill requires such a provider of services to maintain and provide certain 92
documents to the Department for the purpose of verifying claims. Section 27 93
authorizes the Department to deny a claim or recover money already paid if the 94
Department is unable to verify the claim. Section 28 of this bill: (1) prescribes a 95
process for the Department to review claims for appropriateness and propriety; and 96
(2) authorizes the Department to deny or recover any amount paid pursuant to such 97
a claim or take certain actions based on such a review. Section 22 of this bill makes 98
a conforming change to require the Director to administer sections 27 and 28 in the 99
same manner as other provisions governing Medicaid. 100
Existing law provides that a noncompetition covenant is void unless the 101
covenant: (1) is supported by valuable consideration; (2) does not impose any 102
restraint that is greater than is required for the protection of the employer; (3) does 103
not impose any undue hardship on the employee; and (4) imposes restrictions that 104
are appropriately related to the consideration for the covenant. (NRS 613.195) 105
Section 30 of this bill provides that a noncompetition covenant may not apply to a 106
physician. 107
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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
6. The Director may impose an administrative fine against a 40
health information exchange which operates in this State without 41
holding a certification in an amount established by the Director by 42
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regulation. The Director shall afford a health information exchange 1
so fined an opportunity for a hearing pursuant to the provisions of 2
NRS 233B.121. 3
7. The Director may adopt such regulations as he or she 4
determines are necessary to carry out the provisions of this section. 5
Sec. 4. NRS 439.589 is hereby amended to read as follows: 6
439.589 1. The Director, in consultation with health care 7
providers, third parties and other interested persons and entities, 8
shall by regulation prescribe a framework for the electronic 9
maintenance, transmittal and exchange of electronic health records, 10
prescriptions, health-related information and electronic signatures 11
and requirements for electronic equivalents of written entries or 12
written approvals in accordance with federal law. The regulations 13
must: 14
(a) Establish standards for networks and technologies to be used 15
to maintain, transmit and exchange health information, including, 16
without limitation, standards: 17
(1) That require: 18
(I) The use of networks and technologies that allow 19
patients to access electronic health records directly from the health 20
care provider of the patient and forward such electronic health 21
records electronically to other persons and entities; and 22
(II) The interoperability of such networks and 23
technologies in accordance with the applicable standards for the 24
interoperability of Qualified Health Information Networks 25
prescribed by the Office of the National Coordinator for Health 26
Information Technology of the United States Department of Health 27
and Human Services; 28
(2) To ensure that electronic health records retained or shared 29
are secure; 30
(3) To maintain the confidentiality of electronic health 31
records and health-related information, including, without 32
limitation, standards to maintain the confidentiality of electronic 33
health records relating to a child who has received health care 34
services without the consent of a parent or guardian and which 35
ensure that a child’s right to access such health care services is not 36
impaired; 37
(4) To ensure the privacy of individually identifiable health 38
information, including, without limitation, standards to ensure the 39
privacy of information relating to a child who has received health 40
care services without the consent of a parent or guardian; 41
(5) For obtaining consent from a patient before retrieving the 42
patient’s health records from a health information exchange, 43
including, without limitation, standards for obtaining such consent 44
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from a child who has received health care services without the 1
consent of a parent or guardian; 2
(6) For making any necessary corrections to information or 3
records; 4
(7) For notifying a patient if the confidentiality of 5
information contained in an electronic health record of the patient is 6
breached; 7
(8) Governing the ownership, management and use of 8
electronic health records, health-related information and related 9
data; and 10
(9) For the electronic transmission of prior authorizations for 11
prescription medication; 12
(b) Ensure compliance with the requirements, specifications and 13
protocols for exchanging, securing and disclosing electronic health 14
records, health-related information and related data prescribed 15
pursuant to the provisions of the Health Information Technology for 16
Economic and Clinical Health Act, 42 U.S.C. §§ 300jj et seq. and 17
17901 et seq., the Health Insurance Portability and Accountability 18
Act of 1996, Public Law 104-191, and other applicable federal and 19
state law; and 20
(c) Be based on nationally recognized best practices for 21
maintaining, transmitting and exchanging health information 22
electronically. 23
2. The standards prescribed pursuant to this section must 24
include, without limitation: 25
(a) Requirements for the creation, maintenance and transmittal 26
of electronic health records; 27
(b) Requirements for protecting confidentiality, including 28
control over, access to and the collection, organization and 29
maintenance of electronic health records, health-related information 30
and individually identifiable health information; 31
(c) Requirements for the manner in which a patient may, 32
through a health care provider who participates in the sharing of 33
health records using a health information exchange, revoke his or 34
her consent for a health care provider to retrieve the patient’s health 35
records from the health information exchange; 36
(d) A secure and traceable electronic audit system for 37
identifying access points and trails to electronic health records and 38
health information exchanges; and 39
(e) Any other requirements necessary to comply with all 40
applicable federal laws relating to electronic health records, health-41
related information, health information exchanges and the security 42
and confidentiality of such records and exchanges. 43
3. The regulations adopted pursuant to this section must not 44
require any person or entity to use a health information exchange. 45
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4. Except as otherwise provided in subsections 5, 6 and 7, the 1
Department and the divisions thereof, other state and local 2
governmental entities, medical facilities, high-level providers of 3
health care , [providers,] third parties, pharmacy benefit managers 4
and other entities licensed or certified pursuant to title 57 of NRS 5
shall maintain, transmit and exchange health information in 6
accordance with the regulations adopted pursuant to this section, the 7
provisions of NRS 439.581 to 439.597, inclusive, and section 1 of 8
this act and any other regulations adopted pursuant thereto. 9
5. The Federal Government and employees thereof, a provider 10
of health coverage for federal employees, a provider of health 11
coverage that is subject to the Employee Retirement Income 12
Security Act of 1974, 29 U.S.C. §§ 1001 et seq., or a Taft-Hartley 13
trust formed pursuant to 29 U.S.C. § 186(c)(5) is not required to but 14
may maintain, transmit and exchange electronic information in 15
accordance with the regulations adopted pursuant to this section. 16
6. A high-level provider of health care [provider] may apply to 17
the Department for a waiver from the provisions of subsection 4 on 18
the basis that the high-level provider of health care [provider] does 19
not have the infrastructure necessary to comply with those 20
provisions, including, without limitation, because the high-level 21
provider of health care [provider] does not have access to the 22
Internet. The Department shall grant a waiver if it determines that: 23
(a) The high-level provider of health care [provider] does not 24
currently have the infrastructure necessary to comply with the 25
provisions of subsection 4; and 26
(b) Obtaining such infrastructure is not reasonably practicable, 27
including, without limitation, because the cost of such infrastructure 28
would make it difficult for the high-level provider of health care 29
[provider] to continue to operate. 30
7. The provisions of subsection 4 do not apply to [the] : 31
(a) The Department of Corrections [.] ; 32
(b) A high-level provider of health care whose solo practice: 33
(1) Provided care to fewer than 500 patients during the 34
immediately preceding year and reasonably expects to provide care 35
to fewer than 500 patients during the current year; or 36
(2) Only provides health care through concierge medicine; 37
or 38
(c) A high-level provider of health care who, in combination 39
with all other members of his or her group practice: 40
(1) Provided care to fewer than 500 patients during the 41
immediately preceding year and reasonably expects to provide care 42
to fewer than 500 patients during the current year; or 43
(2) Only provides health care through concierge medicine. 44
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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) “Concierge medicine” means the provision of health care 9
services for an established period of time in exchange for a fee. 10
(b) “Medical facility” has the meaning ascribed to it in 11
NRS 449.0151. 12
(c) “Pharmacy benefit manager” has the meaning ascribed to it 13
in NRS 683A.174. 14
[(b)] (d) “Third party” means any insurer, governmental entity 15
or other organization providing health coverage or benefits in 16
accordance with state or federal law. 17
Sec. 5. NRS 439.589 is hereby amended to read as follows: 18
439.589 1. The Director, in consultation with health care 19
providers, third parties and other interested persons and entities, 20
shall by regulation prescribe a framework for the electronic 21
maintenance, transmittal and exchange of electronic health records, 22
prescriptions, health-related information and electronic signatures 23
and requirements for electronic equivalents of written entries or 24
written approvals in accordance with federal law. The regulations 25
must: 26
(a) Establish standards for networks and technologies to be used 27
to maintain, transmit and exchange health information, including, 28
without limitation, standards: 29
(1) That require: 30
(I) The use of networks and technologies that allow 31
patients to access electronic health records directly from the health 32
care provider of the patient and forward such electronic health 33
records electronically to other persons and entities; and 34
(II) The interoperability of such networks and 35
technologies in accordance with the applicable standards for the 36
interoperability of Qualified Health Information Networks 37
prescribed by the Office of the National Coordinator for Health 38
Information Technology of the United States Department of Health 39
and Human Services; 40
(2) To ensure that electronic health records retained or shared 41
are secure; 42
(3) To maintain the confidentiality of electronic health 43
records and health-related information, including, without 44
limitation, standards to maintain the confidentiality of electronic 45
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health records relating to a child who has received health care 1
services without the consent of a parent or guardian and which 2
ensure that a child’s right to access such health care services is not 3
impaired; 4
(4) To ensure the privacy of individually identifiable health 5
information, including, without limitation, standards to ensure the 6
privacy of information relating to a child who has received health 7
care services without the consent of a parent or guardian; 8
(5) For obtaining consent from a patient before retrieving the 9
patient’s health records from a health information exchange, 10
including, without limitation, standards for obtaining such consent 11
from a child who has received health care services without the 12
consent of a parent or guardian; 13
(6) For making any necessary corrections to information or 14
records; 15
(7) For notifying a patient if the confidentiality of 16
information contained in an electronic health record of the patient is 17
breached; 18
(8) Governing the ownership, management and use of 19
electronic health records, health-related information and related 20
data; and 21
(9) For the electronic transmission of prior authorizations for 22
prescription medication; 23
(b) Ensure compliance with the requirements, specifications and 24
protocols for exchanging, securing and disclosing electronic health 25
records, health-related information and related data prescribed 26
pursuant to the provisions of the Health Information Technology for 27
Economic and Clinical Health Act, 42 U.S.C. §§ 300jj et seq. and 28
17901 et seq., the Health Insurance Portability and Accountability 29
Act of 1996, Public Law 104-191, and other applicable federal and 30
state law; and 31
(c) Be based on nationally recognized best practices for 32
maintaining, transmitting and exchanging health information 33
electronically. 34
2. The standards prescribed pursuant to this section must 35
include, without limitation: 36
(a) Requirements for the creation, maintenance and transmittal 37
of electronic health records; 38
(b) Requirements for protecting confidentiality, including 39
control over, access to and the collection, organization and 40
maintenance of electronic health records, health-related information 41
and individually identifiable health information; 42
(c) Requirements for the manner in which a patient may, 43
through a health care provider who participates in the sharing of 44
health records using a health information exchange, revoke his or 45
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her consent for a health care provider to retrieve the patient’s health 1
records from the health information exchange; 2
(d) A secure and traceable electronic audit system for 3
identifying access points and trails to electronic health records and 4
health information exchanges; and 5
(e) Any other requirements necessary to comply with all 6
applicable federal laws relating to electronic health records, health-7
related information, health information exchanges and the security 8
and confidentiality of such records and exchanges. 9
3. The regulations adopted pursuant to this section must not 10
[require] : 11
(a) Require any person or entity to use a health information 12
exchange [.] ; or 13
(b) Authorize a person or entity described in subsection 4 to 14
comply with the requirements of that subsection by: 15
(1) Connecting with a health information exchange; or 16
(2) Utilizing any other service that charges a fee to such a 17
person or entity or a patient for providing electronic health 18
records to a patient upon request in violation of NRS 629.062. 19
4. Except as otherwise provided in subsections 5, 6 and 7, the 20
Department and the divisions thereof, other state and local 21
governmental entities, medical facilities, high-level providers of 22
health care, third parties, pharmacy benefit managers and other 23
entities licensed or certified pursuant to title 57 of NRS shall 24
maintain, transmit and exchange health information in accordance 25
with the regulations adopted pursuant to this section, the provisions 26
of NRS 439.581 to 439.597, inclusive, and section 1 of this act and 27
any other regulations adopted pursuant thereto. 28
5. The Federal Government and employees thereof, a provider 29
of health coverage for federal employees, a provider of health 30
coverage that is subject to the Employee Retirement Income 31
Security Act of 1974, 29 U.S.C. §§ 1001 et seq., or a Taft-Hartley 32
trust formed pursuant to 29 U.S.C. § 186(c)(5) is not required to but 33
may maintain, transmit and exchange electronic information in 34
accordance with the regulations adopted pursuant to this section. 35
6. A high-level provider of health care may apply to the 36
Department for a waiver from the provisions of subsection 4 on the 37
basis that the high-level provider of health care does not have 38
the infrastructure necessary to comply with those provisions, 39
including, without limitation, because the high-level provider of 40
health care does not have access to the Internet. The Department 41
shall grant a waiver if it determines that: 42
(a) The high-level provider of health care does not currently 43
have the infrastructure necessary to comply with the provisions of 44
subsection 4; and 45
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(b) Obtaining such infrastructure is not reasonably practicable, 1
including, without limitation, because the cost of such infrastructure 2
would make it difficult for the high-level provider of health care to 3
continue to operate. 4
7. The provisions of subsection 4 do not apply to: 5
(a) The Department of Corrections; 6
(b) A high-level provider of health care whose solo practice: 7
(1) Provided care to fewer than 500 patients during the 8
immediately preceding year and reasonably expects to provide care 9
to fewer than 500 patients during the current year; or 10
(2) Only provides health care through concierge medicine; or 11
(c) A high-level provider of health care who, in combination 12
with all other members of his or her group practice: 13
(1) Provided care to fewer than 500 patients during the 14
immediately preceding year and reasonably expects to provide care 15
to fewer than 500 patients during the current year; or 16
(2) Only provides health care through concierge medicine. 17
8. A high-level provider of health care described in paragraphs 18
(b) and (c) of subsection 7 shall furnish the medical records of a 19
patient electronically to the patient or, upon the request of the 20
patient, another person or entity, in accordance with NRS 629.062. 21
9. A violation of the provisions of this section or any 22
regulations adopted pursuant thereto is not a misdemeanor. 23
10. As used in this section: 24
(a) “Concierge medicine” means the provision of health care 25
services for an established period of time in exchange for a fee. 26
(b) “Medical facility” has the meaning ascribed to it in 27
NRS 449.0151. 28
(c) “Pharmacy benefit manager” has the meaning ascribed to it 29
in NRS 683A.174. 30
(d) “Third party” means any insurer, governmental entity or 31
other organization providing health coverage or benefits in 32
accordance with state or federal law. 33
Sec. 6. NRS 439.5895 is hereby amended to read as follows: 34
439.5895 1. The Department shall notify each regulatory 35
body of this State that has issued a current, valid license to a 36
licensed provider or insurer if: 37
(a) The Department determines that the licensed provider or 38
insurer is not in compliance with the requirements of subsection 4 of 39
NRS 439.589 [;] and 40
[(b) The] the licensed provider or insurer: 41
(1) Is not exempt from those requirements pursuant to 42
subsection 5 or 7 of NRS 439.589; and 43
(2) Has not received a waiver of those requirements pursuant 44
to subsection 6 of NRS 439.589 [.] ; or 45
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(b) The licensed provider or insurer is a high-level provider of 1
health care who is exempt from the requirements of subsection 4 2
of NRS 439.589 pursuant to paragraph (b) or (c) of subsection 7 3
of NRS 439.589 and the Department determines that the high-level 4
provider of health care is not in compliance with subsection 8 of 5
NRS 439.589. 6
2. If the Department determines that a licensed provider or 7
insurer for which notice was previously provided pursuant to 8
subsection 1 has come into compliance with the requirements of 9
subsection 4 or 8, as applicable, of NRS 439.589, the Department 10
shall immediately notify the regulatory body that issued the license. 11
3. As used in this section: 12
(a) “License” means any license, certificate, registration, permit 13
or similar type of authorization to practice an occupation or 14
profession or engage in a business in this State issued to a licensed 15
provider or insurer. 16
(b) “Licensed provider or insurer” means: 17
(1) A medical facility licensed pursuant to chapter 449 of 18
NRS; 19
(2) [The holder of a permit to operate an ambulance, an air 20
ambulance or a vehicle of a fire-fighting agency pursuant to chapter 21
450B of NRS; 22
(3)] A high-level provider of health care ; [, as defined in 23
NRS 629.031, who is licensed pursuant to title 54 of NRS;] or 24
[(4)] (3) Any person licensed pursuant to title 57 of NRS. 25
(c) “Regulatory body” means any governmental entity that 26
issues a license. 27
Sec. 7. Chapter 439A of NRS is hereby amended by adding 28
thereto the provisions set forth as sections 8, 9 and 10 of this act. 29
Sec. 8. “Independent center for emergency medical care” 30
has the meaning ascribed to it in NRS 449.013. 31
Sec. 9. 1. The Department shall establish and maintain a 32
program to increase public awareness of health care information 33
concerning the independent centers for emergency medical care in 34
this State. The program must be designed to assist consumers with 35
comparing the quality of care provided by the independent centers 36
for emergency medical care in this State and the charges for that 37
care. 38
2. The program must include, without limitation, the 39
collection, maintenance and provision of information concerning: 40
(a) Patients of each independent center for emergency medical 41
care in this State as reported in the forms submitted pursuant to 42
NRS 449.485; 43
(b) The quality of care provided by each independent center 44
for emergency medical care in this State as determined by 45
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applying measures of quality endorsed by the entities described in 1
subparagraph (1) of paragraph (b) of subsection 1 of section 10 of 2
this act, expressed as a number of events and rate of occurrence, if 3
such measures can be applied to the information reported in the 4
forms submitted pursuant to NRS 449.485; 5
(c) How consistently each independent center for emergency 6
medical care follows recognized practices to prevent the infection 7
of patients, to speed the recovery of patients and to avoid medical 8
complications of patients; 9
(d) The total number of patients discharged from the 10
independent center for emergency medical care and the total 11
number of potentially preventable readmissions to a hospital or 12
independent center for emergency medical care, which must be 13
expressed as a total number and a rate of occurrence of potentially 14
preventable readmissions, and the average length of stay and the 15
average billed charges for those potentially preventable 16
readmissions; and 17
(e) Any other information relating to the charges imposed and 18
the quality of the services provided by the independent centers for 19
emergency medical care in this State which the Department 20
determines is: 21
(1) Useful to consumers; 22
(2) Nationally recognized; and 23
(3) Reported in a standard and reliable manner. 24
Sec. 10. 1. The Department shall, by regulation: 25
(a) Prescribe the information that each independent center for 26
emergency medical care in this State must submit to the 27
Department for the program established pursuant to section 9 of 28
this act. 29
(b) Prescribe the measures of quality for independent centers 30
for emergency medical care that are required pursuant to 31
paragraph (b) of subsection 2 of section 9 of this act. In adopting 32
the regulations, the Department shall: 33
(1) Use the measures of quality endorsed by the Agency for 34
Healthcare Research and Quality, the National Quality Forum, 35
Centers for Medicare and Medicaid Services of the United States 36
Department of Health and Human Services, a quality 37
improvement organization of the Centers for Medicare and 38
Medicaid Services and the Joint Commission; 39
(2) Prescribe a reasonable number of measures of quality 40
which must not be unduly burdensome on the independent centers 41
for emergency medical care; and 42
(3) Take into consideration the financial burden placed on 43
the independent centers for emergency medical care to comply 44
with the regulations. 45
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(c) Prescribe the manner in which an independent center for 1
emergency medical care must determine whether the readmission 2
of a patient must be reported pursuant to section 9 of this act as a 3
potentially preventable readmission and prescribe the form for 4
submission of such information. 5
(d) Require each independent center for emergency medical 6
care to provide the information prescribed in paragraphs (a), (b) 7
and (c) in the format required by the Department. 8
2. The information required pursuant to this section and 9
section 9 of this act must be submitted to the Department not later 10
than 45 days after the last day of each calendar month. 11
3. If an independent center for emergency medical care fails 12
to submit the information required pursuant to this section or 13
section 9 of this act or submits information that is incomplete or 14
inaccurate, the Department shall send a notice of such failure to 15
the independent center for emergency medical care and to the 16
Division of Public and Behavioral Health of the Department. 17
Sec. 11. NRS 439A.200 is hereby amended to read as follows: 18
439A.200 As used in NRS 439A.200 to 439A.290, inclusive, 19
and sections 8, 9 and 10 of this act, unless the context otherwise 20
requires, the words and terms defined in NRS 439A.205, 439A.207 21
and 439A.210 and section 8 of this act have the meanings ascribed 22
to them in those sections. 23
Sec. 12. NRS 439A.260 is hereby amended to read as follows: 24
439A.260 1. The Department shall collect and maintain all 25
information that it receives from the hospitals , [and] surgical 26
centers for ambulatory patients and independent centers for 27
emergency medical care in this State pursuant to NRS 439A.220 to 28
439A.250, inclusive [.] and sections 9 and 10 of this act. Upon 29
request, the Department shall make a summary of the information 30
available to: 31
(a) Consumers of health care; 32
(b) Providers of health care; 33
(c) Representatives of the health insurance industry; and 34
(d) The general public. 35
2. The Department shall ensure that the information it provides 36
pursuant to this section is aggregated so as not to reveal the identity 37
of a specific inpatient or outpatient of a hospital , [or] of a surgical 38
center for ambulatory patients [.] or of an independent center for 39
emergency medical care. 40
Sec. 13. NRS 439A.270 is hereby amended to read as follows: 41
439A.270 1. The Department shall establish and maintain an 42
Internet website that includes the information concerning the 43
charges imposed and the quality of the services provided by the 44
hospitals , [and] surgical centers for ambulatory patients and 45
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independent centers for emergency medical care in this State as 1
required by the programs established pursuant to NRS 439A.220 2
and 439A.240 [.] and section 9 of this act. The information must: 3
(a) Include, for each hospital in this State, the: 4
(1) Total number of patients discharged, the average length 5
of stay and the average billed charges, reported for the diagnosis-6
related groups for inpatients and the 50 medical treatments for 7
outpatients that the Department determines are most useful for 8
consumers; 9
(2) Total number of potentially preventable readmissions 10
reported pursuant to NRS 439A.220, the rate of occurrence of 11
potentially preventable readmissions, and the average length of stay 12
and average billed charges of those potentially preventable 13
readmissions, reported by the diagnosis-related group for inpatients 14
for which the patient originally received treatment at a hospital; and 15
(3) Name of each physician who performed a surgical 16
procedure in the hospital and the total number of surgical 17
procedures performed by each physician in the hospital, reported for 18
the most frequent surgical procedures that the Department 19
determines are most useful for consumers if the information is 20
available; 21
(b) Include, for each surgical center for ambulatory patients in 22
this State, the: 23
(1) Total number of patients discharged and the average 24
billed charges, reported for 50 medical treatments for outpatients 25
that the Department determines are most useful for consumers; and 26
(2) Name of each physician who performed a surgical 27
procedure in the surgical center for ambulatory patients and the total 28
number of surgical procedures performed by each physician in the 29
surgical center for ambulatory patients, reported for the most 30
frequent surgical procedures that the Department determines are 31
most useful for consumers; 32
(c) Include, for each independent center for emergency 33
medical care in this State, the: 34
(1) Total number of patients discharged and the average 35
billed charges, reported for the 50 medical treatments for patients 36
of independent centers for emergency medical care that the 37
Department determines are most useful for consumers; and 38
(2) Total number of potentially preventable readmissions 39
reported pursuant to section 9 of this act, the rate of occurrence of 40
potentially preventable readmissions, and the average length of 41
stay and average billed charges of those potentially preventable 42
readmissions, reported for the diagnosis for which the patient 43
originally received treatment at an independent center for 44
emergency medical care; 45
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(d) Be presented in a manner that allows a person to view and 1
compare the information for the hospitals by: 2
(1) Geographic location of each hospital; 3
(2) Type of medical diagnosis; and 4
(3) Type of medical treatment; 5
[(d)] (e) Be presented in a manner that allows a person to view 6
and compare the information for the surgical centers for ambulatory 7
patients by: 8
(1) Geographic location of each surgical center for 9
ambulatory patients; 10
(2) Type of medical diagnosis; and 11
(3) Type of medical treatment; 12
[(e)] (f) Be presented in a manner that allows a person to view 13
and compare the information for the independent centers for 14
emergency medical care by: 15
(1) Geographic location of each independent center for 16
emergency medical care; 17
(2) Type of medical diagnosis; and 18
(3) Type of medical treatment; 19
(g) Be presented in a manner that allows a person to view and 20
compare the information separately for: 21
(1) The inpatients and outpatients of each hospital; [and] 22
(2) The outpatients of each surgical center for ambulatory 23
patients; and 24
(3) The patients of each independent center for emergency 25
medical care; 26
[(f)] (h) Be readily accessible and understandable by a member 27
of the general public; 28
[(g)] (i) Include the annual summary of reports of sentinel 29
events prepared for each health facility pursuant to paragraph (c) of 30
subsection 1 of NRS 439.840; 31
[(h)] (j) Include the annual summary of reports of sentinel 32
events prepared pursuant to paragraph (d) of subsection 1 of 33
NRS 439.840; 34
[(i)] (k) Include the reports of information prepared for each 35
medical facility pursuant to paragraph (b) of subsection 4 of 36
NRS 439.847; 37
[(j)] (l) Include a link to electronic copies of all reports, 38
summaries, compilations and supplementary reports required by 39
NRS 449.450 to 449.530, inclusive; 40
[(k)] (m) Include, for each hospital with 100 or more beds, a 41
summary of financial information which is readily understandable 42
by a member of the general public and which includes, without 43
limitation, a summary of: 44
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(1) The expenses of the hospital which are attributable to 1
providing community benefits and in-kind services as reported 2
pursuant to NRS 449.490; 3
(2) The capital improvement report submitted to the 4
Department pursuant to NRS 449.490; 5
(3) The net income of the hospital; 6
(4) The net income of the consolidated corporation, if the 7
hospital is owned by such a corporation and if that information is 8
publicly available; 9
(5) The operating margin of the hospital; 10
(6) The ratio of the cost of providing care to patients covered 11
by Medicare to the charges for such care; 12
(7) The ratio of the total costs to charges of the hospital; and 13
(8) The average daily occupancy of the hospital; and 14
[(l)] (n) Provide any other information relating to the charges 15
imposed and the quality of the services provided by the hospitals , 16
[and] surgical centers for ambulatory patients and independent 17
centers for emergency medical care in this State which the 18
Department determines is: 19
(1) Useful to consumers; 20
(2) Nationally recognized; and 21
(3) Reported in a standard and reliable manner. 22
2. The Department shall: 23
(a) Publicize the availability of the Internet website; 24
(b) Update the information contained on the Internet website at 25
least quarterly; 26
(c) Ensure that the information contained on the Internet website 27
is accurate and reliable; 28
(d) Ensure that the information reported by a hospital , [or] 29
surgical center for ambulatory patients or independent center for 30
emergency medical care for inpatients and outpatients which is 31
contained on the Internet website is expressed as a total number and 32
as a rate, and [must be] is reported in a manner so as not to reveal 33
the identity of a specific inpatient or outpatient of a hospital , [or] 34
surgical center for ambulatory patients [;] or independent center for 35
emergency medical care; 36
(e) Post a disclaimer on the Internet website indicating that the 37
information contained on the website is provided to assist with the 38
comparison of hospitals and independent centers for emergency 39
medical care and is not a guarantee by the Department or its 40
employees as to the charges imposed by the hospitals and 41
independent centers for emergency medical care in this State or the 42
quality of the services provided by the hospitals and independent 43
centers for emergency medical care in this State, including, without 44
limitation, an explanation that the actual amount charged to a person 45
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by a particular hospital or independent center for emergency 1
medical care may not be the same charge as posted on the website 2
for that hospital [;] or independent center for emergency medical 3
care; 4
(f) Provide on the Internet website established pursuant to this 5
section a link to the Internet website of the Centers for Medicare and 6
Medicaid Services of the United States Department of Health and 7
Human Services; and 8
(g) Upon request, make the information that is contained on the 9
Internet website available in printed form. 10
3. As used in this section, “diagnosis-related group” means 11
groupings of medical diagnostic categories used as a basis for 12
hospital payment schedules by Medicare and other third-party health 13
care plans. 14
Sec. 14. NRS 449.013 is hereby amended to read as follows: 15
449.013 “Independent center for emergency medical care” 16
means a facility, structurally separate [and distinct] from a hospital, 17
which provides limited services for the treatment of a medical 18
emergency. The term includes, without limitation, such a facility 19
that is owned or operated by, or otherwise part of, a hospital but is 20
located more than 250 yards from the hospital. 21
Sec. 15. NRS 449.0308 is hereby amended to read as follows: 22
449.0308 1. Except as otherwise provided in this section, the 23
Division may charge and collect from a medical facility, facility for 24
the dependent or facility which is required by the regulations 25
adopted by the Board pursuant to NRS 449.0303 to be licensed or a 26
person who operates such a facility without a license issued by the 27
Division the actual costs incurred by the Division for the 28
enforcement of the provisions of NRS 449.029 to 449.2428, 29
inclusive, including, without limitation, the actual cost of 30
conducting an inspection or investigation of the facility. 31
2. The Division shall not charge and collect the actual cost for 32
enforcement pursuant to subsection 1 if the enforcement activity is: 33
(a) Related to the issuance or renewal of a license for which the 34
Board charges a fee pursuant to NRS 449.050 or 449.089; 35
(b) Related to the issuance or renewal of a license to an 36
independent center for emergency medical care that is owned or 37
operated by, or otherwise part of, a hospital; or 38
[(b)] (c) Conducted pursuant to an agreement with the Federal 39
Government which has appropriated money for that purpose. 40
3. Any money collected pursuant to subsection 1 may be used 41
by the Division to administer and carry out the provisions of NRS 42
449.029 to 449.2428, inclusive, and the regulations adopted 43
pursuant thereto. 44
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4. The provisions of this section do not apply to any costs 1
incurred by the Division for the enforcement of the provisions of 2
NRS 449.24185, 449.2419 or 449.24195. 3
Sec. 16. NRS 449.050 is hereby amended to read as follows: 4
449.050 1. [Each] Except as otherwise provided in this 5
section, each application for a license must be accompanied by such 6
fee as may be determined by regulation of the Board. The Board 7
may, by regulation, allow or require payment of a fee for a license in 8
installments and may fix the amount of each payment and the date 9
that the payment is due. 10
2. The fee imposed by the Board for a facility for transitional 11
living for released offenders must be based on the type of facility 12
that is being licensed and must be calculated to produce the revenue 13
estimated to cover the costs related to the license, but in no case 14
may a fee for a license exceed the actual cost to the Division of 15
issuing or renewing the license. 16
3. If an application for a license for a facility for transitional 17
living for released offenders is denied, any amount of the fee paid 18
pursuant to this section that exceeds the expenses and costs incurred 19
by the Division must be refunded to the applicant. 20
4. The Board shall not require a fee for the issuance or 21
renewal of the license of an independent center for emergency 22
medical care that is owned or operated by, or otherwise part of, a 23
hospital. 24
Sec. 17. NRS 449.080 is hereby amended to read as follows: 25
449.080 1. [If,] Except as otherwise provided in this section, 26
if, after investigation, the Division finds that the: 27
(a) Applicant is in full compliance with the provisions of NRS 28
449.029 to 449.2428, inclusive; 29
(b) Applicant is in substantial compliance with the standards and 30
regulations adopted by the Board; 31
(c) Applicant, if he or she has undertaken a project for which 32
approval is required pursuant to NRS 439A.100 or 439A.102, has 33
obtained the approval of the Director of the Department of Health 34
and Human Services; and 35
(d) Facility conforms to the applicable zoning regulations, 36
the Division shall issue the license to the applicant. 37
2. Any investigation of an applicant for a license to provide 38
community-based living arrangement services conducted pursuant 39
to subsection 1 must include, without limitation, an inspection of 40
any building operated by the applicant in which the applicant 41
proposes to provide community-based living arrangement services. 42
3. The Division may not issue a license to operate an 43
independent center for emergency medical care that is located 44
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within a 5 mile radius of an existing independent center for 1
emergency medical care. 2
4. A license applies only to the person to whom it is issued, is 3
valid only for the premises described in the license and is not 4
transferable. 5
Sec. 18. NRS 449.1818 is hereby amended to read as follows: 6
449.1818 1. Each off-campus location of a hospital shall 7
obtain and use , and include on all claims for reimbursement or 8
payment for health care services provided at the location , a national 9
provider identifier that is distinct from the national provider 10
identifier used by the main campus and any other off-campus 11
location of the hospital. If the off-campus location includes the 12
national provider identifier on such a claim, the off-campus location 13
may also include on the claim the national provider identifier used 14
by the main campus of the hospital. If the off-campus location 15
includes both the national provider identifier used by the off-campus 16
location and the national provider identifier used by the main 17
campus on a claim, the claim must clearly identify which national 18
provider identifier corresponds to the off-campus location and 19
which national provider identifier corresponds to the main campus. 20
2. An independent center for emergency medical care shall 21
include on all claims for reimbursement or payment for health care 22
services provided at the independent center for emergency medical 23
care the national provider identifier used by the independent center 24
for emergency medical care. 25
3. An independent center for emergency medical care: 26
(a) Shall provide urgent care during all operating hours 27
through: 28
(1) A separate urgent care unit within the independent 29
center for emergency medical care; or 30
(2) A system that uses the severity of the patient’s condition 31
to determine whether the patient receives emergency services or 32
urgent care; 33
(b) Shall not charge more for urgent care than the amount 34
customarily charged for urgent care by an urgent care center; 35
(c) If urgent care services are sufficient to treat or manage the 36
condition of a patient, shall inform the patient that he or she may 37
receive urgent care rather than emergency services; and 38
(d) Shall not require a patient to wait longer to receive urgent 39
care services than a patient with the same condition would be 40
required to wait to receive emergency services. 41
4. As used in this section: 42
(a) “National provider identifier” means the standard, unique 43
health identifier for health care providers that is issued by the 44
national provider system in accordance with 45 C.F.R. Part 162. 45
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(b) “Off-campus location” means a facility: 1
(1) With operations that are directly or indirectly owned or 2
controlled by, in whole or in part, a hospital or which is affiliated 3
with a hospital, regardless of whether it is operated by the same 4
governing body as the hospital; 5
(2) That is located more than 250 yards from the main 6
campus of the hospital; 7
(3) That provides services which are organizationally and 8
functionally integrated with the hospital; and 9
(4) That is an outpatient facility providing ambulatory 10
surgery, urgent care or emergency room services. 11
(c) “Urgent care” means health care that is furnished to a 12
person whose medical condition is sufficiently acute to require 13
treatment unavailable through, or inappropriate to be provided by, 14
a clinic or the office of a provider of health care, but not so acute 15
as to require treatment in an emergency room. 16
Sec. 19. NRS 449.485 is hereby amended to read as follows: 17
449.485 1. Each hospital and independent center for 18
emergency medical care in this State shall use for all patients 19
discharged a form prescribed by the Director and shall include in the 20
form all information required by the Department. Any form 21
prescribed by the Director must be a form that is commonly used 22
nationwide by hospitals [,] and independent centers for emergency 23
medical care, if applicable, and comply with federal laws and 24
regulations. 25
2. Each hospital and independent center for emergency 26
medical care in this State shall, on a monthly basis, report to the 27
Department the information required to be included in the form for 28
each patient. The information reported must be complete, accurate 29
and timely. 30
3. Each insurance company or other payer shall accept the form 31
as the bill for services provided by hospitals and independent 32
centers for emergency medical care in this State. 33
4. Except as otherwise provided in subsection 5, each hospital 34
and independent center for emergency medical care in this State 35
shall provide the information required pursuant to subsection 2 in an 36
electronic form specified by the Department. 37
5. The Director may exempt a hospital or independent center 38
for emergency medical care from the requirements of subsection 4 39
if requiring the hospital or independent center for emergency 40
medical care, as applicable, to comply with the requirements would 41
cause the hospital financial hardship. 42
6. The Department shall use the information submitted 43
pursuant to this section for the [program] programs established 44
pursuant to NRS 439A.220 and section 9 of this act to increase 45
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public awareness of health care information concerning the hospitals 1
and independent centers for emergency medical care, respectively, 2
in this State. 3
Sec. 20. NRS 449.520 is hereby amended to read as follows: 4
449.520 1. On or before October 1 of each year, the Director 5
shall prepare and transmit to the Governor, the Joint Interim 6
Standing Committee on Health and Human Services and the Interim 7
Finance Committee a report of the Department’s operations and 8
activities for the preceding fiscal year. 9
2. The report prepared pursuant to subsection 1 must include: 10
(a) Copies of all reports, summaries, compilations and 11
supplementary reports required by NRS 449.450 to 449.530, 12
inclusive, together with such facts, suggestions and policy 13
recommendations as the Director deems necessary; 14
(b) A summary of the trends of the audits of hospitals in this 15
State that the Department required or performed during the previous 16
year; 17
(c) An analysis of the trends in the costs, expenses and profits of 18
hospitals in this State; 19
(d) An analysis of the methodologies used to determine the 20
corporate home office allocation of hospitals in this State; 21
(e) An examination and analysis of the manner in which 22
hospitals are reporting the information that is required to be filed 23
pursuant to NRS 449.490, including, without limitation, an 24
examination and analysis of whether that information is being 25
reported in a standard and consistent manner, which fairly reflect the 26
operations of each hospital; 27
(f) A review and comparison of the policies and procedures used 28
by hospitals in this State to provide discounted services to, and to 29
reduce charges for services provided to, persons without health 30
insurance; 31
(g) A review and comparison of the policies and procedures 32
used by hospitals in this State to collect unpaid charges for services 33
provided by the hospitals; and 34
(h) A summary of the status of the programs established 35
pursuant to NRS 439A.220 and 439A.240 and section 9 of this act 36
to increase public awareness of health care information concerning 37
the hospitals , [and] surgical centers for ambulatory patients and 38
independent centers for emergency medical care in this State, 39
including, without limitation, the information that was posted in the 40
preceding fiscal year on the Internet website maintained for those 41
programs pursuant to NRS 439A.270. 42
3. The Joint Interim Standing Committee on Health and 43
Human Services shall develop a comprehensive plan concerning the 44
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provision of health care in this State which includes, without 1
limitation: 2
(a) A review of the health care needs in this State as identified 3
by state agencies, local governments, providers of health care and 4
the general public; and 5
(b) A review of the capital improvement reports submitted by 6
hospitals pursuant to subsection 2 of NRS 449.490. 7
Sec. 21. NRS 179.301 is hereby amended to read as follows: 8
179.301 1. The Nevada Gaming Control Board and the 9
Nevada Gaming Commission and their employees, agents and 10
representatives may inquire into and inspect any records sealed 11
pursuant to NRS 179.245 or 179.255, if the event or conviction was 12
related to gaming, to determine the suitability or qualifications of 13
any person to hold a state gaming license, manufacturer’s, seller’s or 14
distributor’s license or registration as a gaming employee pursuant 15
to chapter 463 of NRS. Events and convictions, if any, which are the 16
subject of an order sealing records: 17
(a) May form the basis for recommendation, denial or 18
revocation of those licenses. 19
(b) Must not form the basis for denial or rejection of a gaming 20
work permit unless the event or conviction relates to the applicant’s 21
suitability or qualifications to hold the work permit. 22
2. The Division of Insurance of the Department of Business 23
and Industry and its employees may inquire into and inspect any 24
records sealed pursuant to NRS 179.245 or 179.255, if the event 25
or conviction was related to insurance, to determine the suitability or 26
qualifications of any person to hold a license, certification or 27
authorization issued in accordance with title 57 of NRS. Events and 28
convictions, if any, which are the subject of an order sealing records 29
may form the basis for recommendation, denial or revocation of 30
those licenses, certifications and authorizations. 31
3. The Department of Health and Human Services, the 32
Division of Health Care Financing and Policy of the Department 33
and their employees, agents and representatives may inquire into 34
and inspect any records sealed pursuant to NRS 179.245 or 35
179.255, if the event or conviction was related to Medicare or 36
Medicaid or the provision of professional services for which a 37
license or certification is required. Such inquiry or inspection 38
must be for the purpose of determining the suitability of the 39
person to render such professional services as a provider of 40
services under Medicaid or to own or serve as an officer, 41
managing employee or managing agent of a business seeking to 42
enter into a contract with the Department or a health maintenance 43
organization with which the Department has entered into a 44
contract pursuant to NRS 422.273 for the provision of services 45
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under Medicaid. Events and convictions, if any, which are the 1
subject of an order sealing records may form the basis of a 2
decision of the Department to refuse to enter into or terminate 3
such a contract. 4
4. A prosecuting attorney may inquire into and inspect any 5
records sealed pursuant to NRS 179.245 or 179.255 if: 6
(a) The records relate to a violation or alleged violation of NRS 7
202.485; and 8
(b) The person who is the subject of the records has been 9
arrested or issued a citation for violating NRS 202.485. 10
[4.] 5. The Central Repository for Nevada Records of Criminal 11
History and its employees may inquire into and inspect any records 12
sealed pursuant to NRS 179.245 or 179.255 that constitute 13
information relating to sexual offenses, and may notify employers of 14
the information in accordance with federal laws and regulations. 15
[5.] 6. Records which have been sealed pursuant to NRS 16
179.245 or 179.255 and which are retained in the statewide registry 17
established pursuant to NRS 179B.200 may be inspected pursuant to 18
chapter 179B of NRS by an officer or employee of the Central 19
Repository for Nevada Records of Criminal History or a law 20
enforcement officer in the regular course of his or her duties. 21
[6.] 7. The State Board of Pardons Commissioners and its 22
agents and representatives may inquire into and inspect any records 23
sealed pursuant to NRS 179.245 or 179.255 if the person who is the 24
subject of the records has applied for a pardon from the Board. 25
[7.] 8. As used in this section: 26
(a) “Information relating to sexual offenses” means information 27
contained in or concerning a record relating in any way to a sexual 28
offense. 29
(b) “Sexual offense” has the meaning ascribed to it in 30
NRS 179A.073. 31
Sec. 22. NRS 232.320 is hereby amended to read as follows: 32
232.320 1. The Director: 33
(a) Shall appoint, with the consent of the Governor, 34
administrators of the divisions of the Department, who are 35
respectively designated as follows: 36
(1) The Administrator of the Aging and Disability Services 37
Division; 38
(2) The Administrator of the Division of Welfare and 39
Supportive Services; 40
(3) The Administrator of the Division of Child and Family 41
Services; 42
(4) The Administrator of the Division of Health Care 43
Financing and Policy; and 44
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(5) The Administrator of the Division of Public and 1
Behavioral Health. 2
(b) Shall administer, through the divisions of the Department, 3
the provisions of chapters 63, 424, 425, 427A, 432A to 442, 4
inclusive, 446 to 450, inclusive, 458A and 656A of NRS, NRS 5
127.220 to 127.310, inclusive, 422.001 to 422.410, inclusive, and 6
sections 27 and 28 of this act, 422.580, 432.010 to 432.133, 7
inclusive, 432B.6201 to 432B.626, inclusive, 444.002 to 444.430, 8
inclusive, and 445A.010 to 445A.055, inclusive, and all other 9
provisions of law relating to the functions of the divisions of the 10
Department, but is not responsible for the clinical activities of the 11
Division of Public and Behavioral Health or the professional line 12
activities of the other divisions. 13
(c) Shall administer any state program for persons with 14
developmental disabilities established pursuant to the 15
Developmental Disabilities Assistance and Bill of Rights Act of 16
2000, 42 U.S.C. §§ 15001 et seq. 17
(d) Shall, after considering advice from agencies of local 18
governments and nonprofit organizations which provide social 19
services, adopt a master plan for the provision of human services in 20
this State. The Director shall revise the plan biennially and deliver a 21
copy of the plan to the Governor and the Legislature at the 22
beginning of each regular session. The plan must: 23
(1) Identify and assess the plans and programs of the 24
Department for the provision of human services, and any 25
duplication of those services by federal, state and local agencies; 26
(2) Set forth priorities for the provision of those services; 27
(3) Provide for communication and the coordination of those 28
services among nonprofit organizations, agencies of local 29
government, the State and the Federal Government; 30
(4) Identify the sources of funding for services provided by 31
the Department and the allocation of that funding; 32
(5) Set forth sufficient information to assist the Department 33
in providing those services and in the planning and budgeting for the 34
future provision of those services; and 35
(6) Contain any other information necessary for the 36
Department to communicate effectively with the Federal 37
Government concerning demographic trends, formulas for the 38
distribution of federal money and any need for the modification of 39
programs administered by the Department. 40
(e) May, by regulation, require nonprofit organizations and state 41
and local governmental agencies to provide information regarding 42
the programs of those organizations and agencies, excluding 43
detailed information relating to their budgets and payrolls, which the 44
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Director deems necessary for the performance of the duties imposed 1
upon him or her pursuant to this section. 2
(f) Has such other powers and duties as are provided by law. 3
2. Notwithstanding any other provision of law, the Director, or 4
the Director’s designee, is responsible for appointing and removing 5
subordinate officers and employees of the Department. 6
Sec. 23. NRS 232.459 is hereby amended to read as follows: 7
232.459 1. The Advocate shall: 8
(a) Respond to written and telephonic inquiries received from 9
consumers and injured employees regarding concerns and problems 10
related to health care and workers’ compensation; 11
(b) Assist consumers and injured employees in understanding 12
their rights and responsibilities under health care plans, including, 13
without limitation, the Public Employees’ Benefits Program and the 14
Public Option, and policies of industrial insurance; 15
(c) Identify and investigate complaints of consumers and injured 16
employees regarding their health care plans, including, without 17
limitation, the Public Employees’ Benefits Program and the Public 18
Option, and policies of industrial insurance and assist those 19
consumers and injured employees to resolve their complaints, 20
including, without limitation: 21
(1) Referring consumers and injured employees to the 22
appropriate agency, department or other entity that is responsible for 23
addressing the specific complaint of the consumer or injured 24
employee; and 25
(2) Providing counseling and assistance to consumers and 26
injured employees concerning health care plans, including, without 27
limitation, the Public Employees’ Benefits Program and the Public 28
Option, and policies of industrial insurance; 29
(d) Provide information to consumers and injured employees 30
concerning health care plans, including, without limitation, the 31
Public Employees’ Benefits Program and the Public Option, and 32
policies of industrial insurance in this State; 33
(e) Establish and maintain a system to collect and maintain 34
information pertaining to the written and telephonic inquiries 35
received by the Office for Consumer Health Assistance; 36
(f) Take such actions as are necessary to ensure public 37
awareness of the existence and purpose of the services provided by 38
the Advocate pursuant to this section; 39
(g) In appropriate cases and pursuant to the direction of the 40
Advocate, refer a complaint or the results of an investigation to the 41
Attorney General for further action; 42
(h) Provide information to and applications for prescription drug 43
programs for consumers without insurance coverage for prescription 44
drugs or pharmaceutical services; 45
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(i) Establish and maintain an Internet website which includes: 1
(1) Information concerning purchasing prescription drugs 2
from Canadian pharmacies that have been recommended by the 3
State Board of Pharmacy for inclusion on the Internet website 4
pursuant to subsection 4 of NRS 639.2328; 5
(2) Links to websites of Canadian pharmacies which have 6
been recommended by the State Board of Pharmacy for inclusion on 7
the Internet website pursuant to subsection 4 of NRS 639.2328; and 8
(3) A link to the website established and maintained pursuant 9
to NRS 439A.270 which provides information to the general public 10
concerning the charges imposed and the quality of the services 11
provided by the hospitals , [and] surgical centers for ambulatory 12
patients and independent centers for emergency medical care in 13
this State; 14
(j) Assist consumers with accessing a navigator, case manager 15
or facilitator to help the consumer obtain health care services; 16
(k) Assist consumers with scheduling an appointment with a 17
provider of health care who is in the network of providers under 18
contract to provide services to participants in the health care plan 19
under which the consumer is covered; 20
(l) Assist consumers with filing complaints against health care 21
facilities and health care professionals; 22
(m) Assist consumers with filing complaints with the 23
Commissioner of Insurance against issuers of health care plans; and 24
(n) On or before January 31 of each year, compile a report of 25
aggregated information submitted to the Office for Consumer 26
Health Assistance pursuant to NRS 687B.675, aggregated for each 27
type of provider of health care for which such information is 28
provided and submit the report to the Director of the Legislative 29
Counsel Bureau for transmittal to: 30
(1) In even-numbered years, the Joint Interim Standing 31
Committee on Health and Human Services; and 32
(2) In odd-numbered years, the next regular session of the 33
Legislature. 34
2. The Advocate may adopt regulations to carry out the 35
provisions of this section and NRS 232.461 and 232.462. 36
3. As used in this section: 37
(a) “Health care facility” has the meaning ascribed to it in 38
NRS 162A.740. 39
(b) “Navigator, case manager or facilitator” has the meaning 40
ascribed to it in NRS 687B.675. 41
(c) “Public Option” means the Public Option established 42
pursuant to NRS 695K.200. 43
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Sec. 24. NRS 287.010 is hereby amended to read as follows: 1
287.010 1. The governing body of any county, school 2
district, municipal corporation, political subdivision, public 3
corporation or other local governmental agency of the State of 4
Nevada may: 5
(a) Adopt and carry into effect a system of group life, accident 6
or health insurance, or any combination thereof, for the benefit of its 7
officers and employees, and the dependents of officers and 8
employees who elect to accept the insurance and who, where 9
necessary, have authorized the governing body to make deductions 10
from their compensation for the payment of premiums on the 11
insurance. 12
(b) Purchase group policies of life, accident or health insurance, 13
or any combination thereof, for the benefit of such officers and 14
employees, and the dependents of such officers and employees, as 15
have authorized the purchase, from insurance companies authorized 16
to transact the business of such insurance in the State of Nevada, 17
and, where necessary, deduct from the compensation of officers and 18
employees the premiums upon insurance and pay the deductions 19
upon the premiums. 20
(c) Provide group life, accident or health coverage through a 21
self-insurance reserve fund and, where necessary, deduct 22
contributions to the maintenance of the fund from the compensation 23
of officers and employees and pay the deductions into the fund. The 24
money accumulated for this purpose through deductions from the 25
compensation of officers and employees and contributions of the 26
governing body must be maintained as an internal service fund as 27
defined by NRS 354.543. The money must be deposited in a state or 28
national bank or credit union authorized to transact business in the 29
State of Nevada. Any independent administrator of a fund created 30
under this section is subject to the licensing requirements of chapter 31
683A of NRS, and must be a resident of this State. Any contract 32
with an independent administrator must be approved by the 33
Commissioner of Insurance as to the reasonableness of 34
administrative charges in relation to contributions collected and 35
benefits provided. The provisions of NRS 439.581 to 439.597, 36
inclusive, and section 1 of this act, 686A.135, 687B.352, 687B.408, 37
687B.692, 687B.723, 687B.725, 687B.805, 689B.030 to 38
689B.0317, inclusive, paragraphs (b) and (c) of subsection 1 of NRS 39
689B.0319, subsections 2, 4, 6 and 7 of NRS 689B.0319, 689B.033 40
to 689B.0369, inclusive, 689B.0375 to 689B.050, inclusive, 41
689B.0675, 689B.265, 689B.287 and 689B.500 apply to coverage 42
provided pursuant to this paragraph, except that the provisions of 43
NRS 689B.0378, 689B.03785 and 689B.500 only apply to coverage 44
– 29 –
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for active officers and employees of the governing body, or the 1
dependents of such officers and employees. 2
(d) Defray part or all of the cost of maintenance of a self-3
insurance fund or of the premiums upon insurance. The money for 4
contributions must be budgeted for in accordance with the laws 5
governing the county, school district, municipal corporation, 6
political subdivision, public corporation or other local governmental 7
agency of the State of Nevada. 8
2. If a school district offers group insurance to its officers and 9
employees pursuant to this section, members of the board of trustees 10
of the school district must not be excluded from participating in the 11
group insurance. If the amount of the deductions from compensation 12
required to pay for the group insurance exceeds the compensation to 13
which a trustee is entitled, the difference must be paid by the trustee. 14
3. In any county in which a legal services organization exists, 15
the governing body of the county, or of any school district, 16
municipal corporation, political subdivision, public corporation or 17
other local governmental agency of the State of Nevada in the 18
county, may enter into a contract with the legal services 19
organization pursuant to which the officers and employees of the 20
legal services organization, and the dependents of those officers and 21
employees, are eligible for any life, accident or health insurance 22
provided pursuant to this section to the officers and employees, and 23
the dependents of the officers and employees, of the county, school 24
district, municipal corporation, political subdivision, public 25
corporation or other local governmental agency. 26
4. If a contract is entered into pursuant to subsection 3, the 27
officers and employees of the legal services organization: 28
(a) Shall be deemed, solely for the purposes of this section, to be 29
officers and employees of the county, school district, municipal 30
corporation, political subdivision, public corporation or other local 31
governmental agency with which the legal services organization has 32
contracted; and 33
(b) Must be required by the contract to pay the premiums or 34
contributions for all insurance which they elect to accept or of which 35
they authorize the purchase. 36
5. A contract that is entered into pursuant to subsection 3: 37
(a) Must be submitted to the Commissioner of Insurance for 38
approval not less than 30 days before the date on which the contract 39
is to become effective. 40
(b) Does not become effective unless approved by the 41
Commissioner. 42
(c) Shall be deemed to be approved if not disapproved by the 43
Commissioner within 30 days after its submission. 44
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6. As used in this section, “legal services organization” means 1
an organization that operates a program for legal aid and receives 2
money pursuant to NRS 19.031. 3
Sec. 25. NRS 287.04335 is hereby amended to read as 4
follows: 5
287.04335 If the Board provides health insurance through a 6
plan of self-insurance, it shall comply with the provisions of NRS 7
439.581 to 439.597, inclusive, and section 1 of this act, 686A.135, 8
687B.352, 687B.409, 687B.692, 687B.723, 687B.725, 687B.805, 9
689B.0353, 689B.255, 695C.1723, 695G.150, 695G.155, 695G.160, 10
695G.162, 695G.1635, 695G.164, 695G.1645, 695G.1665, 11
695G.167, 695G.1675, 695G.170 to 695G.1712, inclusive, 12
695G.1714 to 695G.174, inclusive, 695G.176, 695G.177, 695G.200 13
to 695G.230, inclusive, 695G.241 to 695G.310, inclusive, 695G.405 14
and 695G.415, in the same manner as an insurer that is licensed 15
pursuant to title 57 of NRS is required to comply with those 16
provisions. 17
Sec. 26. Chapter 422 of NRS is hereby amended by adding 18
thereto the provisions set forth as sections 27 and 28 of this act. 19
Sec. 27. 1. A provider of services under Medicaid shall: 20
(a) Maintain such documents as are required by regulation of 21
the Administrator for the verification of claims for the period of 22
time specified in those regulations; and 23
(b) Provide the documents maintained pursuant to paragraph 24
(a) to the Department upon the request of the Department. 25
2. The Department may audit any documents provided 26
pursuant to paragraph (b) of subsection 1. If the Department is 27
unable to verify a claim using the documents maintained pursuant 28
to subsection 1, the Department may deny the claim or, if the 29
Department has already paid the claim, recover the amount of the 30
payment from the provider. 31
Sec. 28. 1. If the Department determines that a provider of 32
services under Medicaid may be prescribing or providing services 33
in a manner that exceeds the needs of recipients of Medicaid, is 34
unnecessary or otherwise conflicts with applicable professional 35
standards or the requirements of the Medicaid program, the 36
Department shall perform a review of the relevant claims to 37
evaluate the appropriateness and propriety of the services for 38
which payment is claimed. If the Department has not paid the 39
claims, the review must occur before the Department pays the 40
claims. 41
2. Upon deciding to conduct a review pursuant to subsection 42
1, the Department shall: 43
(a) Notify the provider of services who submitted the claims 44
subject to the review; and 45
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(b) Require the provider of services to submit to the 1
Department within a period of time specified by the Department 2
any documentation necessary to substantiate the claims. 3
3. If a provider of services fails to submit the documentation 4
required by the Department pursuant to paragraph (b) of 5
subsection 2 within the time specified pursuant to that paragraph, 6
the Department may take the actions described in paragraph (a) of 7
subsection 5 without the opportunity for a hearing pursuant to 8
NRS 422.306. 9
4. Not later than 60 days after receiving the documentation 10
requested pursuant to paragraph (b) of subsection 2, the 11
Department shall complete a review pursuant to this section and 12
either: 13
(a) Pay the claims that were subject to the review or, if the 14
Department has already paid such a claim, notify the provider of 15
services who made the claim that the claim has been upheld; or 16
(b) Take an action described in paragraph (a) of subsection 5 17
with respect to the claims that were subject to the review. 18
5. If the Department determines after conducting a review 19
pursuant to this section that a provider of services has prescribed 20
or provided services in a manner that exceeds the needs of 21
recipients of Medicaid, is unnecessary or otherwise conflicts with 22
applicable professional standards or the requirements of the 23
Medicaid program, the Department may, after the opportunity for 24
a hearing pursuant to NRS 422.306: 25
(a) Deny the affected claims or, if the Department has already 26
paid an affected claim, recover the amount of the payment from 27
the provider; 28
(b) Require the provider to request and receive authorization 29
for the delivery of services to recipients of Medicaid before 30
delivering the services; or 31
(c) Take any other action authorized by this chapter and the 32
regulations adopted pursuant thereto. 33
Sec. 29. NRS 603A.100 is hereby amended to read as follows: 34
603A.100 1. The provisions of NRS 603A.010 to 603A.290, 35
inclusive, do not apply to the maintenance or transmittal of 36
information in accordance with NRS 439.581 to 439.597, inclusive, 37
and section 1 of this act and the regulations adopted pursuant 38
thereto. 39
2. A data collector who is also an operator, as defined in NRS 40
603A.330, shall comply with the provisions of NRS 603A.300 to 41
603A.360, inclusive. 42
3. Any waiver of the provisions of NRS 603A.010 to 43
603A.290, inclusive, is contrary to public policy, void and 44
unenforceable. 45
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Sec. 30. NRS 613.195 is hereby amended to read as follows: 1
613.195 1. A noncompetition covenant is void and 2
unenforceable unless the noncompetition covenant: 3
(a) Is supported by valuable consideration; 4
(b) Does not impose any restraint that is greater than is required 5
for the protection of the employer for whose benefit the restraint is 6
imposed; 7
(c) Does not impose any undue hardship on the employee; and 8
(d) Imposes restrictions that are appropriate in relation to the 9
valuable consideration supporting the noncompetition covenant. 10
2. A noncompetition covenant may not restrict, and an 11
employer may not bring an action to restrict, a former employee of 12
an employer from providing service to a former customer or client 13
if: 14
(a) The former employee did not solicit the former customer or 15
client; 16
(b) The customer or client voluntarily chose to leave and seek 17
services from the former employee; and 18
(c) The former employee is otherwise complying with the 19
limitations in the covenant as to time, geographical area and scope 20
of activity to be restrained, other than any limitation on providing 21
services to a former customer or client who seeks the services of the 22
former employee without any contact instigated by the former 23
employee. 24
Any provision in a noncompetition covenant which violates the 25
provisions of this subsection is void and unenforceable. 26
3. A noncompetition covenant may not apply to a physician or 27
an employee who is paid solely on an hourly wage basis, exclusive 28
of any tips or gratuities. 29
4. An employer in this State who negotiates, executes or 30
attempts to enforce a noncompetition covenant that is void and 31
unenforceable under this section does not violate the provisions of 32
NRS 613.200. 33
5. If the termination of the employment of an employee is the 34
result of a reduction of force, reorganization or similar restructuring 35
of the employer, a noncompetition covenant is only enforceable 36
during the period in which the employer is paying the employee’s 37
salary, benefits or equivalent compensation, including, without 38
limitation, severance pay. 39
6. If an employer brings an action to enforce a noncompetition 40
covenant or an employee brings an action to challenge a 41
noncompetition covenant and the court finds the covenant is 42
supported by valuable consideration but contains limitations as to 43
time, geographical area or scope of activity to be restrained that are 44
not reasonable, imposes a greater restraint than is necessary for the 45
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protection of the employer for whose benefit the restraint is imposed 1
or imposes undue hardship on the employee, the court shall revise 2
the covenant to the extent necessary and enforce the covenant as 3
revised. Such revisions must cause the limitations contained in the 4
covenant as to time, geographical area and scope of activity to be 5
restrained to be reasonable, to not impose undue hardship on the 6
employee and to impose a restraint that is not greater than is 7
necessary for the protection of the employer for whose benefit the 8
restraint is imposed. 9
7. If an employer brings an action to enforce a noncompetition 10
covenant or an employee or contractor brings an action to challenge 11
a noncompetition covenant and the court finds that the 12
noncompetition covenant applies to [an employee] a person 13
described in subsection 3 or that the employer has restricted or 14
attempted to restrict a former employee in the manner described in 15
subsection 2, the court shall award the employee or contractor 16
reasonable attorney’s fees and costs. Nothing in this subsection shall 17
be construed as prohibiting a court from otherwise awarding 18
attorney’s fees to a prevailing party pursuant to NRS 18.010. 19
8. As used in this section: 20
(a) “Employer” means every person having control or custody of 21
any employment, place of employment or any employee. 22
(b) “Noncompetition covenant” means an agreement between an 23
employer and employee which, upon termination of the employment 24
of the employee, prohibits the employee from pursuing a similar 25
vocation in competition with or becoming employed by a competitor 26
of the employer. 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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(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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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 if the independent 43
center for emergency medical care otherwise qualifies for licensure 44
pursuant to NRS 449.080. 45
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- *SB378*
3. As used in this section, “independent center for emergency 1
medical care” has the meaning ascribed to it in NRS 449.013, as 2
amended by section 14 of this act. 3
Sec. 38. The provisions of subsection 1 of NRS 218D.380 do 4
not apply to any provision of this act which adds or revises a 5
requirement to submit a report to the Legislature. 6
Sec. 39. The provisions of NRS 354.599 do not apply to any 7
additional expenses of a local government that are related to the 8
provisions of this act. 9
Sec. 40. NRS 450B.215 is hereby repealed. 10
Sec. 41. 1. This section and sections 1 to 4, inclusive, 6, 21, 11
22, 24 to 32, inclusive, 35, 36 and 40 of this act become effective 12
upon passage and approval. 13
2. Sections 5, 7 to 20, inclusive, 23, 33, 34, 37, 38 and 39 of 14
this act become effective: 15
(a) Upon passage and approval for the purpose of adopting any 16
regulations and performing any other preliminary administrative 17
tasks that are necessary to carry out the provisions of this act; and 18
(b) On January 1, 2026, for all other purposes. 19
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