S.B. 47
- *SB47*
SENATE BILL NO. 47–COMMITTEE ON COMMERCE AND LABOR
(ON BEHALF OF THE WASHOE REGIONAL
BEHAVIORAL HEALTH POLICY BOARD)
PREFILED NOVEMBER 19, 2024
____________
Referred to Committee on Commerce and Labor
SUMMARY—Provides for a study of certain issues relating to
insurance. (BDR 57-405)
FISCAL NOTE: Effect on Local Government: May have Fiscal Impact.
Effect on the State: Yes.
~
EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted.
AN ACT relating to insurance; providing for a study of certain
issues relating to coverage for behavioral health care;
requiring the submission of certain information for the
purposes of that study; providing for the confidentiality of
such information; and providing other matters properly
relating thereto.
Legislative Counsel’s Digest:
The federal Paul Wellstone and Pete Domenici Mental Health Parity and 1
Addiction Equity Act of 2008 prohibits certain health insurers from imposing terms 2
on benefits for mental health or substance use disorder that are less favorable than 3
the terms imposed on medical and surgical benefits. (42 U.S.C. § 300gg-26) 4
Existing state law requires certain health insurers to: (1) comply with the Act; and 5
(2) provide to the Commissioner of Insurance certain data necessary to evaluate 6
compliance with the Act. (NRS 687B.404) 7
Section 7 of this bill requires the Commissioner to apply for gifts, grants and 8
donations to support a study of the degree to which public and private insurance 9
plans in this State achieve parity between coverage for behavioral health care and 10
coverage for other medical care. To the extent that the Commissioner obtains 11
sufficient money, section 7 requires the Commissioner to enter into a contract with 12
a qualified person or entity to conduct the study. Section 8 of this bill requires 13
public and private health insurers in this State and certain other persons or entities 14
to submit data to the Commissioner or the contractor as necessary to conduct the 15
study. Section 9 of this bill authorizes the Commissioner to issue a subpoena for 16
the production of such data if a person or entity fails to comply with section 8. 17
Sections 8 and 11 of this bill provide for the confidentiality of any personally 18
identifiable information, proprietary financial information, trade secret or other 19
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confidential information that is submitted to the Commissioner pursuant to section 20
8. Section 10 of this bill requires: (1) the Commissioner to submit an annual report 21
to the Legislature concerning the progress of the efforts to fund and conduct the 22
study; and (2) the contractor who conducts the study to report the results to the 23
Commissioner, the Governor and the Legislature upon completion of the study. 24
Sections 3-6 of this bill define certain terms used in sections 3-10. Section 2 of this 25
bill establishes the applicability of those definitions. 26
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1. Chapter 679B of NRS is hereby amended by adding 1
thereto the provisions set forth as sections 2 to 10, inclusive, of this 2
act. 3
Sec. 2. As used in sections 2 to 10, inclusive, of this act, 4
unless the context otherwise requires, the words and terms defined 5
in sections 3 to 6, inclusive, of this act have the meanings ascribed 6
to them in those sections. 7
Sec. 3. “Behavioral health care” means care for a mental 8
illness, other mental health condition, intellectual disability, 9
developmental disability or substance use disorder. 10
Sec. 4. “Developmental disability” has the meaning ascribed 11
to it in NRS 435.007. 12
Sec. 5. “Health insurer” means any insurer, governmental 13
entity or other organization providing health coverage or benefits 14
in accordance with state or federal law. 15
Sec. 6. “Intellectual disability” has the meaning ascribed to 16
it in NRS 435.007. 17
Sec. 7. 1. The Commissioner shall: 18
(a) Apply for gifts, grants and donations to support the study 19
described in paragraph (b); and 20
(b) To the extent money is available pursuant to paragraph (a), 21
enter into a contract with a qualified person or entity to study the 22
degree to which public and private insurance plans in this State 23
achieve parity between: 24
(1) Coverage for behavioral health care; and 25
(2) Coverage for other medical care. 26
2. The Commissioner may collaborate or enter into a contract 27
with any person or entity to assist in applying for gifts, grants and 28
donations pursuant to paragraph (a) of subsection 1. 29
3. The Commissioner and the person or entity with whom the 30
Commissioner enters into a contract pursuant to subsection 1 may 31
enter into a contract or otherwise collaborate with a non-profit 32
organization that specializes in data analytics relating to health 33
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insurance as necessary to conduct the study pursuant to 1
subsection 1. 2
4. The study conducted pursuant to subsection 1 must 3
include, without limitation: 4
(a) An analysis of the degree to which health insurers in this 5
State comply with the Paul Wellstone and Pete Domenici Mental 6
Health Parity and Addiction Equity Act of 2008, Public Law 110-7
343, Division C, Title V, Subtitle B; 8
(b) A comparison of the terms under which health insurers in 9
this State cover behavioral health care to the terms under which 10
such health insurers cover other forms of medical care, including, 11
without limitation: 12
(1) The adequacy of networks; 13
(2) Rates of reimbursement; 14
(3) Incentives offered by insurers to providers of health 15
care; 16
(4) Rates of denial of coverage; 17
(5) Prior authorization; and 18
(6) Step therapy; and 19
(c) An investigation into: 20
(1) The workforce providing behavioral health care in this 21
State; 22
(2) The results of inadequate behavioral health care, 23
including, without limitation: 24
(I) Increased rates of substance use disorder, suicidal 25
ideation and suicide; and 26
(II) Direct and indirect monetary costs to the State 27
Government, local governments and other persons and entities in 28
this State; 29
(3) The emergency and inpatient care provided to treat 30
behavioral health conditions or related health conditions that are 31
preventable or better treated in an outpatient setting; 32
(4) Rates of unemployment or loss of personal income 33
related to persons suffering from behavioral health conditions; 34
and 35
(5) The cost to the State of claims for disability due to 36
behavioral health conditions. 37
5. The study conducted pursuant to subsection 1 may include 38
a market survey that compares any or all of the metrics described 39
in subsection 4 to the same metrics in other states. If conducted, 40
the market survey must include, without limitation: 41
(a) A comparison to metrics in states that have achieved 42
greater parity between coverage for behavioral health care and 43
coverage for other medical care; and 44
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(b) Consideration for the limited pool of health insurers in this 1
State. 2
6. As used in this section, “network” means a defined set of 3
providers of health care who are under contract with a health 4
insurer to provide health care services. 5
Sec. 8. 1. Notwithstanding any other provision of law and 6
except as otherwise provided in subsection 2, upon a request made 7
to obtain information for the purposes of the study conducted 8
pursuant to section 7 of this act, the following persons and entities 9
shall submit information to the Commissioner or the person or 10
entity with whom the Commissioner enters into a contract 11
pursuant to subsection 1 of section 7 of this act: 12
(a) Health insurers that offer or issue policies of health 13
insurance in this State, including, without limitation, the Public 14
Employees’ Benefits Program; 15
(b) The Department of Health and Human Services and each 16
division and office thereof; 17
(c) The Division; and 18
(d) Any public body established by the Commissioner. 19
2. A provider of health coverage for federal employees, a 20
provider of health coverage that is subject to the Employee 21
Retirement Income Security Act of 1974 or the administrator of a 22
Taft-Hartley trust formed pursuant to 29 U.S.C. § 186(c)(5) is not 23
required to but may submit information to the Commissioner or 24
the person or entity with whom the Commissioner enters into a 25
contract pursuant to subsection 1 of section 7 of this act for the 26
purposes of the study conducted pursuant to that section. 27
3. The Commissioner or the person or entity with whom the 28
Commissioner enters into a contract pursuant to subsection 1 of 29
section 7 of this act may submit a request pursuant to NRS 30
439B.850 to obtain data from the all-payer claims database 31
established pursuant to NRS 439B.835, including, without 32
limitation, data that has not been de-identified or that includes 33
proprietary financial information. The Department of Health and 34
Human Services shall release such data upon the submission of 35
such a request. The Commissioner and the person or entity shall 36
comply with the provisions of subsection 4 of this section and 37
subsection 5 of NRS 439B.855 with respect to any such data. 38
4. Any personally identifiable information, proprietary 39
financial information, trade secret or information deemed 40
confidential by law that is provided pursuant to this section to the 41
Commissioner or any person or entity with whom the 42
Commissioner enters into a contract is confidential. Such 43
information must not be included in a report compiled pursuant to 44
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section 10 of this act or otherwise disclosed to any other person or 1
entity. 2
Sec. 9. 1. If a person or entity fails to comply with the 3
provisions of subsection 1 or 3 of section 8 of this act, the 4
Commissioner may issue a subpoena to compel the person or 5
entity to comply with those requirements. 6
2. A subpoena issued pursuant to this section shall have the 7
same force and effect and shall be served in the same manner as if 8
issued from a court of record. 9
3. If any person or entity fails to obey a subpoena issued 10
pursuant to this section, the Commissioner may file a written 11
report thereof and proof of service of the subpoena in any court of 12
competent jurisdiction, for such action as the court may 13
determine. 14
Sec. 10. 1. On or before January 31 of each year, the 15
Commissioner shall: 16
(a) Compile a report describing the progress made toward the 17
objectives described in subsection 1 of section 7 of this act during 18
the immediately preceding calendar year; and 19
(b) Submit the report to the Director of the Legislative Counsel 20
Bureau for transmittal to: 21
(1) In an odd-numbered year, the next regular session of 22
the Legislature; and 23
(2) In an even-numbered year, the Joint Interim Standing 24
Committee on Health and Human Services. 25
2. Upon completion of the study conducted pursuant to 26
section 7 of this act, the person or entity with whom the 27
Commissioner enters into a contract pursuant subsection 1 of that 28
section shall compile and submit to the Commissioner, the 29
Governor and the Director of the Legislative Counsel Bureau for 30
transmittal to the Legislature a report that includes, without 31
limitation: 32
(a) The results of the study; 33
(b) Recommendations to improve the reporting of data by 34
health insurers and the analysis of such data to ensure compliance 35
with the Paul Wellstone and Pete Domenici Mental Health Parity 36
and Addiction Equity Act of 2008, Public Law 110-343, Division 37
C, Title V, Subtitle B; 38
(c) Recommendations for policies to improve the degree to 39
which public and private insurance plans in this State achieve 40
parity between: 41
(1) Coverage for behavioral health care; and 42
(2) Coverage for other medical care; and 43
(d) Recommendations for policies to increase access to 44
behavioral health care in this State. 45
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Sec. 11. NRS 239.010 is hereby amended to read as follows: 1
239.010 1. Except as otherwise provided in this section and 2
NRS 1.4683, 1.4687, 1A.110, 3.2203, 41.0397, 41.071, 49.095, 3
49.293, 62D.420, 62D.440, 62E.516, 62E.620, 62H.025, 62H.030, 4
62H.170, 62H.220, 62H.320, 75A.100, 75A.150, 76.160, 78.152, 5
80.113, 81.850, 82.183, 86.246, 86.54615, 87.515, 87.5413, 6
87A.200, 87A.580, 87A.640, 88.3355, 88.5927, 88.6067, 88A.345, 7
88A.7345, 89.045, 89.251, 90.730, 91.160, 116.757, 116A.270, 8
116B.880, 118B.026, 119.260, 119.265, 119.267, 119.280, 9
119A.280, 119A.653, 119A.677, 119B.370, 119B.382, 120A.640, 10
120A.690, 125.130, 125B.140, 126.141, 126.161, 126.163, 126.730, 11
127.007, 127.057, 127.130, 127.140, 127.2817, 128.090, 130.312, 12
130.712, 136.050, 159.044, 159A.044, 164.041, 172.075, 172.245, 13
176.01334, 176.01385, 176.015, 176.0625, 176.09129, 176.156, 14
176A.630, 178.39801, 178.4715, 178.5691, 178.5717, 179.495, 15
179A.070, 179A.165, 179D.160, 180.600, 200.3771, 200.3772, 16
200.5095, 200.604, 202.3662, 205.4651, 209.392, 209.3923, 17
209.3925, 209.419, 209.429, 209.521, 211A.140, 213.010, 213.040, 18
213.095, 213.131, 217.105, 217.110, 217.464, 217.475, 218A.350, 19
218E.625, 218F.150, 218G.130, 218G.240, 218G.350, 218G.615, 20
224.240, 226.462, 226.796, 228.270, 228.450, 228.495, 228.570, 21
231.069, 231.1285, 231.1473, 232.1369, 233.190, 237.300, 22
239.0105, 239.0113, 239.014, 239B.026, 239B.030, 239B.040, 23
239B.050, 239C.140, 239C.210, 239C.230, 239C.250, 239C.270, 24
239C.420, 240.007, 241.020, 241.030, 241.039, 242.105, 244.264, 25
244.335, 247.540, 247.545, 247.550, 247.560, 250.087, 250.130, 26
250.140, 250.145, 250.150, 268.095, 268.0978, 268.490, 268.910, 27
269.174, 271A.105, 281.195, 281.805, 281A.350, 281A.680, 28
281A.685, 281A.750, 281A.755, 281A.780, 284.4068, 284.4086, 29
286.110, 286.118, 287.0438, 289.025, 289.080, 289.387, 289.830, 30
293.4855, 293.5002, 293.503, 293.504, 293.558, 293.5757, 293.870, 31
293.906, 293.908, 293.909, 293.910, 293B.135, 293D.510, 331.110, 32
332.061, 332.351, 333.333, 333.335, 338.070, 338.1379, 338.1593, 33
338.1725, 338.1727, 348.420, 349.597, 349.775, 353.205, 34
353A.049, 353A.085, 353A.100, 353C.240, 353D.250, 360.240, 35
360.247, 360.255, 360.755, 361.044, 361.2242, 361.610, 365.138, 36
366.160, 368A.180, 370.257, 370.327, 372A.080, 378.290, 378.300, 37
379.0075, 379.008, 379.1495, 385A.830, 385B.100, 387.626, 38
387.631, 388.1455, 388.259, 388.501, 388.503, 388.513, 388.750, 39
388A.247, 388A.249, 391.033, 391.035, 391.0365, 391.120, 40
391.925, 392.029, 392.147, 392.264, 392.271, 392.315, 392.317, 41
392.325, 392.327, 392.335, 392.850, 393.045, 394.167, 394.16975, 42
394.1698, 394.447, 394.460, 394.465, 396.1415, 396.1425, 396.143, 43
396.159, 396.3295, 396.405, 396.525, 396.535, 396.9685, 44
398A.115, 408.3885, 408.3886, 408.3888, 408.5484, 412.153, 45
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414.280, 416.070, 422.2749, 422.305, 422A.342, 422A.350, 1
425.400, 427A.1236, 427A.872, 427A.940, 432.028, 432.205, 2
432B.175, 432B.280, 432B.290, 432B.4018, 432B.407, 432B.430, 3
432B.560, 432B.5902, 432C.140, 432C.150, 433.534, 433A.360, 4
439.4941, 439.4988, 439.5282, 439.840, 439.914, 439A.116, 5
439A.124, 439B.420, 439B.754, 439B.760, 439B.845, 440.170, 6
441A.195, 441A.220, 441A.230, 442.330, 442.395, 442.735, 7
442.774, 445A.665, 445B.570, 445B.7773, 449.209, 449.245, 8
449.4315, 449A.112, 450.140, 450B.188, 450B.805, 453.164, 9
453.720, 458.055, 458.280, 459.050, 459.3866, 459.555, 459.7056, 10
459.846, 463.120, 463.15993, 463.240, 463.3403, 463.3407, 11
463.790, 467.1005, 480.535, 480.545, 480.935, 480.940, 481.063, 12
481.091, 481.093, 482.170, 482.368, 482.5536, 483.340, 483.363, 13
483.575, 483.659, 483.800, 484A.469, 484B.830, 484B.833, 14
484E.070, 485.316, 501.344, 503.452, 522.040, 534A.031, 561.285, 15
571.160, 584.655, 587.877, 598.0964, 598.098, 598A.110, 16
598A.420, 599B.090, 603.070, 603A.210, 604A.303, 604A.710, 17
604D.500, 604D.600, 612.265, 616B.012, 616B.015, 616B.315, 18
616B.350, 618.341, 618.425, 622.238, 622.310, 623.131, 623A.137, 19
624.110, 624.265, 624.327, 625.425, 625A.185, 628.418, 628B.230, 20
628B.760, 629.043, 629.047, 629.069, 630.133, 630.2671, 21
630.2672, 630.2673, 630.2687, 630.30665, 630.336, 630A.327, 22
630A.555, 631.332, 631.368, 632.121, 632.125, 632.3415, 23
632.3423, 632.405, 633.283, 633.301, 633.427, 633.4715, 633.4716, 24
633.4717, 633.524, 634.055, 634.1303, 634.214, 634A.169, 25
634A.185, 634B.730, 635.111, 635.158, 636.262, 636.342, 637.085, 26
637.145, 637B.192, 637B.288, 638.087, 638.089, 639.183, 27
639.2485, 639.570, 640.075, 640.152, 640A.185, 640A.220, 28
640B.405, 640B.730, 640C.580, 640C.600, 640C.620, 640C.745, 29
640C.760, 640D.135, 640D.190, 640E.225, 640E.340, 641.090, 30
641.221, 641.2215, 641A.191, 641A.217, 641A.262, 641B.170, 31
641B.281, 641B.282, 641C.455, 641C.760, 641D.260, 641D.320, 32
642.524, 643.189, 644A.870, 645.180, 645.625, 645A.050, 33
645A.082, 645B.060, 645B.092, 645C.220, 645C.225, 645D.130, 34
645D.135, 645G.510, 645H.320, 645H.330, 647.0945, 647.0947, 35
648.033, 648.197, 649.065, 649.067, 652.126, 652.228, 653.900, 36
654.110, 656.105, 657A.510, 661.115, 665.130, 665.133, 669.275, 37
669.285, 669A.310, 670B.680, 671.365, 671.415, 673.450, 673.480, 38
675.380, 676A.340, 676A.370, 677.243, 678A.470, 678C.710, 39
678C.800, 679B.122, 679B.124, 679B.152, 679B.159, 679B.190, 40
679B.285, 679B.690, 680A.270, 681A.440, 681B.260, 681B.410, 41
681B.540, 683A.0873, 685A.077, 686A.289, 686B.170, 686C.306, 42
687A.060, 687A.115, 687B.404, 687C.010, 688C.230, 688C.480, 43
688C.490, 689A.696, 692A.117, 692C.190, 692C.3507, 692C.3536, 44
692C.3538, 692C.354, 692C.420, 693A.480, 693A.615, 696B.550, 45
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696C.120, 703.196, 704B.325, 706.1725, 706A.230, 710.159, 1
711.600, section 8 of this act, sections 35, 38 and 41 of chapter 478, 2
Statutes of Nevada 2011 and section 2 of chapter 391, Statutes of 3
Nevada 2013 and unless otherwise declared by law to be 4
confidential, all public books and public records of a governmental 5
entity must be open at all times during office hours to inspection by 6
any person, and may be fully copied or an abstract or memorandum 7
may be prepared from those public books and public records. Any 8
such copies, abstracts or memoranda may be used to supply the 9
general public with copies, abstracts or memoranda of the records or 10
may be used in any other way to the advantage of the governmental 11
entity or of the general public. This section does not supersede or in 12
any manner affect the federal laws governing copyrights or enlarge, 13
diminish or affect in any other manner the rights of a person in any 14
written book or record which is copyrighted pursuant to federal law. 15
2. A governmental entity may not reject a book or record 16
which is copyrighted solely because it is copyrighted. 17
3. A governmental entity that has legal custody or control of a 18
public book or record shall not deny a request made pursuant to 19
subsection 1 to inspect or copy or receive a copy of a public book or 20
record on the basis that the requested public book or record contains 21
information that is confidential if the governmental entity can 22
redact, delete, conceal or separate, including, without limitation, 23
electronically, the confidential information from the information 24
included in the public book or record that is not otherwise 25
confidential. 26
4. If requested, a governmental entity shall provide a copy of a 27
public record in an electronic format by means of an electronic 28
medium. Nothing in this subsection requires a governmental entity 29
to provide a copy of a public record in an electronic format or by 30
means of an electronic medium if: 31
(a) The public record: 32
(1) Was not created or prepared in an electronic format; and 33
(2) Is not available in an electronic format; or 34
(b) Providing the public record in an electronic format or by 35
means of an electronic medium would: 36
(1) Give access to proprietary software; or 37
(2) Require the production of information that is confidential 38
and that cannot be redacted, deleted, concealed or separated from 39
information that is not otherwise confidential. 40
5. An officer, employee or agent of a governmental entity who 41
has legal custody or control of a public record: 42
(a) Shall not refuse to provide a copy of that public record in the 43
medium that is requested because the officer, employee or agent has 44
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already prepared or would prefer to provide the copy in a different 1
medium. 2
(b) Except as otherwise provided in NRS 239.030, shall, upon 3
request, prepare the copy of the public record and shall not require 4
the person who has requested the copy to prepare the copy himself 5
or herself. 6
Sec. 12. The provisions of subsection 1 of NRS 218D.380 do 7
not apply to any provision of this act which adds or revises a 8
requirement to submit a report to the Legislature. 9
Sec. 13. This act becomes effective upon passage and approval 10
and expires by limitation on the date on which the person or entity 11
with whom the Commissioner of Insurance enters into a contract 12
pursuant to subsection 1 of section 7 of this act submits the report 13
described in subsection 2 of section 10 of this act to the 14
Commissioner of Insurance, the Governor and the Director of the 15
Legislative Counsel Bureau. 16
H