This bill introduces comprehensive healthcare pricing transparency requirements for hospitals in Nevada. It mandates that hospitals annually compile and publish detailed lists of standard charges for all items and services, including shoppable services, on their public websites. These lists must include specific pricing information such as the highest and lowest negotiated charges with third parties, cash prices, and billing codes. The bill prohibits hospitals from collecting medical debt while non-compliant with these transparency requirements and allows patients to bring civil actions against hospitals that violate these provisions. Additionally, the bill requires health care entities to provide patients with itemized statements and receipts before collecting medical debt, with potential financial penalties for non-compliance. The Department of Health and Human Services will be responsible for monitoring hospital compliance, with the ability to impose administrative penalties ranging from $5,000 to $30,000 for repeated violations. The bill’s provisions will become effective on January 1, 2026, with some preparatory administrative tasks allowed to begin immediately upon passage, and it aims to provide patients with more clarity and understanding of healthcare costs.

In December 2017, UnitedHealth Group announced its subsidiary, Optum, would acquire DaVita Medical Group. This would have primarily affected facilities in Nevada and Colorado. The U.S. Federal Trade Commission investigated the merger, with an interest in the Nevada market, but declining to take action in Colorado. The Colorado Attorney General’s Office proceeded on its own, filing a suit on June 19, 2019 claiming the merger was anticompetitive and would prevent other competing health care plans from competing effectively in Colorado Springs. Eventually the merger was approved with conditions in both states. In the Nevada market, the companies reached a settlement with the FTC that would require UnitedHealth Group to divest DaVita’s HealthCare Partners of Nevada to Intermountain Healthcare, a Utah-based healthcare provider and insurer. Separately, Colorado Attorney General Phil Weiser also imposed restrictions on the merger requiring 1) UnitedHealthcare, UnitedHealth’s insurance division, to lift its exclusive contract with Centura Health for at least 3 1/2 years, expanding the network of healthcare providers available to Medicare Advantage plan seniors, and 2) DaVita to extend its agreement with Medicare insurer Humana, UnitedHealthcare’s main competitor in Colorado Springs, through at least 2020.

This bill would prohibit corporate hospitals and hospital systems from directly hiring physicians. While Nevada hospitals already generally refrained from hiring physicians directly (instead hiring physicians as independent contractors), this bill would have codified the practice. AB 11 would have also prohibited hospitals from restricting other medical care workers from discussing salaries, wages, and working conditions with others and removed the ability of hospitals to institute non-compete agreements against other medical facilities.

This bill enacts the Uniform Antitrust Pre-Merger Notification Act, which requires certain businesses to file copies of their federal Hart-Scott-Rodino (HSR) pre-merger notifications with the Nevada Attorney General. Specifically, businesses must file an electronic copy of their HSR form with the Attorney General if they either have their principal place of business in Nevada or had annual net sales in Nevada of at least 20% of the federal filing threshold. Companies with their principal place of business in Nevada must also submit any additional documentary material filed with their federal notification. The bill includes strong confidentiality protections, prohibiting the Attorney General from publicly disclosing these filings except under limited circumstances, such as with a protective court order or when sharing with attorneys general from other states with similar confidentiality laws. The Attorney General can seek civil penalties of up to $10,000 per day for non-compliance, and the law aims to promote uniformity with similar laws in other jurisdictions. The provisions will apply to pre-merger notifications filed on or after October 1, 2025, and the bill defines several key terms related to pre-merger notifications and the notification process.

AN ACT relating to health care; requiring written approval to close or convert a hospital into a different type of health facility; requiring written approval to establish an independent center for emergency medical care in a certain location; requiring an independent center for
emergency medical care to be licensed separately from certain other facilities; establishing certain civil penalties; and providing other matters properly relating thereto