Overview
The Nevada legislature convenes in odd-numbered years. For several years, Nevada law has required all healthcare plans to cover telehealth services for an insured to the same extent they would cover services provided by other means. This includes plans from managed care organizations (MCOs), health maintenance organization (HMOs), benefit contracts, and group or blanket health insurance plans.
The state has proposed several legislation to promote price transparency in recent years, including proposals to create a state-funded all-payer claims database (APCD). In the 2019 session, Nevada enacted surprise billing protections to require all health carrier network plans to reimburse for unexpected charges from an out-of-network provider.
The state’s proposal to study the cost and viability of a public option health insurance plan was also unsuccessful. Most notably, the Nevada Care Plan would have allowed anyone without health insurance to buy into the state’s Medicaid program. Since Medicaid has low reimbursement rates for doctors and other providers, the proposal may have provided an economical alternative to private insurance, but with fewer provider options. The legislature approved the Medicaid buy-in bill, but Republican Governor Brian Sandoval vetoed it.
Nevada was also the first state to target medicine prices for a specific ailment when it passed a law that requires more transparency from drug makers regarding their prices for diabetes medicines. The pharmaceutical industry filed and later dropped a lawsuit that claimed the insulin-pricing transparency law was unconstitutional because it interfered with the abilities of drug makers to protect trade secrets.
See below for an overview of existing Nevada state mandates. Click on citation tab for detailed information of specific statutes (click link to download statute text).
State Action
Latest Legislative Session: 2/6/2023 - 6/5/2023 (2023 term). *Current session bill updates are ongoing. Check back weekly for updates.
AB 116 – Nevada
Introduced: 2019 Status: Inactive / Dead
AN ACT relating to Medicaid; requiring an actuarial study to be conducted by the Division of Health Care Financing and Policy of the Department of Health and Human Services to determine the cost to the …
AB 122 – Nevada
Introduced: 2019 Status: Enacted
AN ACT relating to Medicaid; requiring the Department of Health and Human Services to seek a waiver from federal requirements so that certain care provided at a rural facility operated by the Department may be …
AB 141 – Nevada
Introduced: 2019 Status: Enacted
AN ACT relating to pharmacy benefit managers; prohibiting a pharmacy benefit manager from imposing certain limitations on the conduct of a pharmacist or pharmacy; and providing other matters properly relating thereto.
AB 147 – Nevada
Introduced: 2019 Status: Enacted
AN ACT relating to providers of health care; authorizing a physician assistant or advanced practice registered nurse to perform certain services; and providing other matters properly relating thereto.
AB 170 – Nevada
Introduced: 2019 Status: Enacted
AN ACT relating to insurance; requiring an insurer to authorize a service from an out-of-network provider in certain circumstances; requiring an insurer to offer health insurance coverage regardless of health status; and providing other matters …
Nev. Rev. Stat. § 679B.124. Denial of application of provider of health care to be included in network of providers of a health carrier: Form letter for notification by health carrier; copy of form letter to Commissioner; annual report: Commissioner of Insurance — General Provisions – Nevada
Introduced: Status: Enacted
The Commissioner shall annually compile a report using aggregated data from the forms collected pursuant to subsection 2 concerning trends in the denial of applications of providers of health care to be included in the …
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Nev. Rev. Stat. § 679B.152. Review of fees for medical or dental care determined to be usual and customary; plans limiting selection of dentist: Commissioner of Insurance — General Provisions – Nevada
Introduced: Status: Enacted
Every insurer or organization for dental care which pays claims on the basis of fees for medical or dental care which are “usual and customary” shall submit to the Commissioner a complete description of the …
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Nev. Rev. Stat. § 679B.225. Inspection of insurance policies: Commissioner of Insurance — General Provisions – Nevada
Introduced: Status: Enacted
The Commissioner, at any time, may inspect any insurance policy covering any risk in this state. Every policyholder, upon request, shall produce any insurance policy in his or her possession or under his or her …
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Nev. Rev. Stat. § 683A.405. Submission of schedule of payments to provider of health care by administrator, managing general agent, producer of insurance or certain entities acting as administrator: Persons Involved in Sale or Administration of Insurance – Nevada
Introduced: Status: Enacted
Requirements forsubmitting payments when contracting with provider of health care.
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Nev. Rev. Stat. § 686A.385. Schedule of rates and charges to be filed with Commissioner: Trade Practices and Frauds; Financing Premiums– Financing of Premiums – Nevada
Introduced: Status: Enacted
A company shall, immediately after it has been issued a license, file with the Commissioner a schedule of rates and charges it intends to use in this State. The schedule must include, and separately identify, …
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In the Matter of Renown Health, a corporation – Nevada
District Court: United States of America Before The Federal Trade Commission Status: Decided
In 2012, Renown Health settled with the FTC on charges resulting from its acquisition of multiple cardiology practices in Reno, NV. The FTC announced that, …
Federal Trade Commission and State of Idaho v. St. Luke’s Health System, Ltd and Saltzer Medical Group, P.A. – California, Connecticut, Delaware, Idaho, Illinois, Iowa, Kentucky, Maine, Maryland, Mississippi, Montana, Nevada, New Mexico, Oregon, Pennsylvania, Tennessee, Washington
District Court: District of Idaho Status: Decided
In March 2013, the FTC and the Idaho Attorney General filed a joint complaint challenging the merger betweenSt. Luke’s Health System, Idaho’s largest health system, …
In Re: Generic Pharmaceuticals Pricing Antitrust Litigation – Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin
District Court: Eastern District of Pennsylvania Status: Pending
Plaintiffs are attorney generals from 48 states, Puerto Rico, and the District of Columbia, as well as classes of private plaintiffs that filed an antitrust …
PhRMA and BIO v. Sandoval – Nevada
District Court: District of Nevada Status: Decided
In September 2017, just three months after Nevada passed its insulin transparency law (SB 539) in June 2017 to increase transparency over the price of …
Additional Resources
STATE BUDGET
The Nevada state budget operates on a biennium cycle, covering two fiscal years. Nevada’s fiscal year begins on July 1 and ends on June 30 of the following year.
REGULATION & ENFORCEMENT
Nevada was one of 16 states to file an amicus brief supporting the FTC’s winning position in the Ninth Circuit appeal of St. Luke’s Health Care Sys. v. FTC, No. 14-35173 (March 7, 2014), decided February 10, 2015. The States’ brief stated that the acceleration of health care costs due to the growth of large health care provider systems had become a matter of grave concern for the states.