All Roll Calls
Yes: 62 • No: 0
NevadaAB46383rd Regular Session (2025)HouseWALLET
AN ACT relating to insurance; requiring certain health insurers to respond to requests for prior authorization for medical or dental care within a certain amount of time; prohibiting certain insurers from requiring prior authorization for certain types of medical care; and providing other matters properly relating thereto.
Sponsored By: Shea M. Backus (Democratic)
Signed by Governor
BDR 57-825
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Bill Overview
Analyzed Economic Effects
8 provisions identified: 5 benefits, 2 costs, 1 mixed.
Employer health plans must match rules
Starting January 1, 2026, any employer that provides health benefits in Nevada must give the same benefits and pay providers the same way as an insurance policy under state law. This brings employer health plans in line with the act’s prior‑authorization and related standards.
Faster Medicaid prior authorization answers
Starting January 1, 2026, Nevada’s health department and Medicaid managed care plans must answer prior authorization requests within 2 business days. If national operating rules allow more time, they still must answer within 7 calendar days. If the Department rejects a rule change and gives notice within 30 days after its hearing, later requests must get a 2‑business‑day answer.
Faster, fairer prior authorization rules
Starting January 1, 2026, insurers must answer prior authorization requests within 2 business days, or within 7 calendar days at most if national rules allow more time. If the Insurance Commissioner rejects a rule change and gives notice within 30 days after the hearing, later requests must get a 2‑business‑day answer. If an insurer breaks these prior‑authorization laws on a specific request, that request is deemed approved. Insurers must file their prior‑authorization procedure with the Insurance Commissioner for approval, and cannot favor or exclude equally licensed providers. Certain nonprofit hospital and medical or dental service corporations must follow these same rules.
Medicaid: no pre-approval for prevention
Starting January 1, 2026, Nevada Medicaid and CHIP do not require prior authorization for preventive services rated A or B by the U.S. Preventive Services Task Force and the women’s preventive care listed in 45 C.F.R. 147.130(a)(iv). No prior approval is needed for pediatric hospice care in a licensed hospice or for neonatal abstinence care by pediatric pain or palliative specialists. This applies when the provider is enrolled in the State Plan for those services.
No prior approval for key care
Starting January 1, 2026, Nevada health insurers cannot require prior authorization for several services. These include outpatient substance use treatment; preventive services rated A or B by the U.S. Preventive Services Task Force; and certain women’s preventive care. It also bars prior approval for pediatric hospice in a licensed hospice, neonatal abstinence care by pediatric pain or palliative specialists, and blood glucose test strips for people with diabetes. This applies to dental plans and review companies working for insurers.
Some managed care plans are exempt
Starting January 1, 2026, the new private‑plan prior‑authorization rules do not apply while certain plans serve specific groups. Exemptions cover HMOs or managed care plans serving Medicaid or CHIP under a state contract, plans serving the Public Employees’ Benefits Program, and review companies working for those plans. The exemption lasts only while the plan is providing those services.
When the new rules apply
The new prior authorization rules do not apply to requests sent before January 1, 2026 under a policy issued before that date. They do apply to requests under any policy renewed on or after January 1, 2026. Requests to the state Medicaid agency or Medicaid managed care plans sent before January 1, 2026 are also not subject to the new rules. To keep using prior authorization in policies issued or renewed after January 1, 2026, a carrier must create a compliant procedure and get approval from the Insurance Commissioner.
Medicaid coverage limits stay the same
Starting January 1, 2026, these rules do not expand what Medicaid or CHIP must cover. The state and plans do not have to pay for care that is not a covered benefit. They also do not have to cover people who are not eligible on the day the care is given.
Sponsors & Cosponsors
Sponsor
Shea M. Backus
Democratic • House
Cosponsors
There are no cosponsors for this bill.
Roll Call Votes
Senate vote • 6/2/2025
Final Passage - Senate (2nd Reprint)
Yes: 20 • No: 0
House vote • 5/30/2025
Final Passage - Assembly (1st Reprint)
Yes: 42 • No: 0
Actions Timeline
Chapter 475.
6/11/2025legislatureApproved by the Governor.
6/10/2025legislatureEnrolled and delivered to Governor.
6/6/2025legislatureIn Assembly. To enrollment.
6/4/2025HouseTo Assembly.
6/2/2025SenateRead third time. Passed. Title approved. (Yeas: 20, Nays: None, Excused: 1.)
6/2/2025SenateRead second time.
6/1/2025SenateFrom committee: Do pass.
5/31/2025SenateRead first time. Referred to Committee on Health and Human Services. To committee.
5/31/2025SenateIn Senate.
5/31/2025SenateTo Senate.
5/31/2025HouseFrom printer. To reengrossment. Reengrossed. Second reprint.
5/31/2025HouseTo printer.
5/30/2025HouseRead third time. Passed, as amended. Title approved, as amended. (Yeas: 42, Nays: None.)
5/30/2025HouseDispensed with reprinting.
5/30/2025HouseRead third time. Amended. (Amend. No. 866.)
5/30/2025HousePlaced on General File.
5/30/2025HouseFrom committee: Amend, and do pass as amended.
5/30/2025HouseTo committee.
4/24/2025HouseFrom printer. To engrossment. Engrossed. First reprint.
4/24/2025HouseTo printer.
4/21/2025HouseRereferred to Committee on Ways and Means. Exemption effective.
4/21/2025HouseTaken from General File.
4/21/2025HouseRead second time. Amended. (Amend. No. 480.)
4/21/2025HousePlaced on Second Reading File.
4/21/2025House
Bill Text
As Enrolled
As Introduced
Reprint 1
Reprint 2
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