All Roll Calls
Yes: 63 • No: 0
NevadaAB5283rd Regular Session (2025)HouseWALLET
AN ACT relating to insurance; requiring the Commissioner of Insurance to establish programs to inform providers of health care and insureds under health insurance policies of certain information relating to the payment of claims; revising provisions governing the payment of claims under policies of health insurance; establishing certain administrative penalties; requiring a health carrier to provide certain information to participating providers of health care and covered persons; requiring a health carrier to establish certain procedures for challenging the denial of a claim; and providing other matters properly relating thereto.
Sponsored By: Assembly Committee on Commerce and Labor
Signed by Governor
BDR 57-367
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Bill Overview
Analyzed Economic Effects
14 provisions identified: 11 benefits, 1 costs, 2 mixed.
10% interest on late health claims
Insurers, carriers, and administrators must add interest if they pay an approved claim late. The rate is 10% per year. Interest runs from the legal due date for payment until the day you are paid. Limited exceptions apply for events beyond the payer’s control.
Clear denial and appeal notices for plans
Your insurer must send clear, timely denial notices. The notice must list all reasons and facts, the policy rules used, and how to challenge or file a complaint. Timing is 21 days if information was electronic, 30 days if not, or 10 working days if no claim was received. Carriers must also give you plain-language notices about complaint and fast-review rights.
Faster claim decisions on private plans
The law sets firm claim timelines for most private health plans. Carriers must decide and pay electronic claims within 21 days, or 30 days if not electronic. If they need more information, they must ask within 20 working days and then decide within 21 or 30 days after they get it. Plans cannot deny without a good reason, demand the same documents again without cause, or pay only part of a fully payable claim.
Faster MCO payments and stronger remedies
Beginning January 1, 2026, managed care plans must decide and pay electronic claims in 21 days, or 30 days if not. If more information is needed, they must ask within 20 working days and then decide within 21 or 30 days after they get it. Late approved payments owe 10% yearly interest, and interest can be waived only for an act of God or causes beyond the plan’s control. Plans cannot deny without a good reason or demand duplicate paperwork to delay. If you sue and win under these rules, the court awards your reasonable attorney’s fees and costs. The Commissioner can require 95% or 90% on‑time performance, fine plans, suspend or revoke licenses for repeat issues, and requires yearly compliance reports by February 1.
Faster payments and protections in dental plans
Dental plans must decide and pay electronic claims in 21 days, or 30 days if not electronic. Late approved payments owe 10% yearly interest from the due date. Dental plans cannot deny without a good reason, ask for duplicate paperwork to delay, or pay only part of a fully payable claim. Regulators can check on-time payments (95% by count or 90% by dollars) and fine or suspend repeat violators.
Quicker payments by medical service plans
Medical service corporations must decide and pay electronic claims in 21 days, or 30 days if not. If they pay late, they owe 10% yearly interest. They cannot deny without a good reason, ask for duplicate paperwork to delay, or pay only part of a fully payable claim. Regulators can require proof of 95% on-time payments by count or 90% by dollars and can fine or suspend repeat offenders.
Stronger payment rules for fraternal insurers
Fraternal insurers that issue health certificates must decide and pay electronic claims in 21 days, or 30 days if not. Late approved payments owe 10% yearly interest from the due date. They cannot deny without a good reason, ask for duplicate paperwork without cause, or pay only part of a fully payable claim. The Insurance Commissioner can enforce 95% or 90% on‑time standards and penalize repeat failures.
Provider network transparency and dispute rights
Health carriers with networks must give providers and covered people a yearly, plain-English explanation of how claims are paid and who to contact about denials. Carriers must have a fast process for providers to challenge denied claims and resolve them in a reasonable time. Starting January 1, 2026, HMO provider contracts must include the law’s claim‑payment schedule; contracts missing it are treated as if they include it. These duties do not apply to Medicaid, CHIP, or Public Employees’ Benefits Program network services.
Administrators: yearly reports and penalties
Third‑party administrators must file a report by February 1 each year with counts of late claims and the total interest paid. The Commissioner can require proof of on‑time performance (95% by count or 90% by dollars), fine violators, and suspend or revoke registrations after repeat findings.
Insurers: yearly reports and penalties
Insurers must prove timely payments when asked, such as paying 95% of approved claims on time or 90% of dollars on time. They must also file a February 1 annual report showing late‑claim counts and total interest paid. The Commissioner can fine violators and suspend or revoke licenses after repeat problems.
Medicaid/PEBP carve‑outs and PEBP rules
Claims under Medicaid, CHIP, and the Public Employees’ Benefits Program are excluded from these new timing and 10% interest rules. Beginning January 1, 2026, managed care plans serving Medicaid or CHIP under state contracts, and plans serving PEBP members, are exempt from the listed sections while under those contracts. When PEBP offers self‑insured coverage, it must follow an updated list of insurance laws like a licensed insurer.
State help for small medical practices
The Division of Insurance runs a public campaign and a help program for small or new medical practices. It gives guidance on reimbursement, claim timelines, and how to hold insurers to the law. This program provides support and information; it does not create new payments.
Transition dates and repeals for 2026
The new rules apply to claims sent on or after January 1, 2026. Contracts or policies issued before that date keep their terms until renewal; renewals must follow the new rules. Two statutes are repealed on January 1, 2026: NRS 695C.128 and NRS 695C.185.
New insurance rules start Jan 2026
The law takes effect January 1, 2026. Most claim, notice, payment, and appeal rules start on that date. Existing contracts and claims follow the law’s transition rules. Provider contracts signed or renewed on or after January 1, 2026 must match the required payment timelines, even if the contract is silent.
Sponsors & Cosponsors
Sponsor
Assembly Committee on Commerce and Labor
Affiliation unavailable
Cosponsors
There are no cosponsors for this bill.
Roll Call Votes
Senate vote • 5/31/2025
Final Passage - Senate (2nd Reprint)
Yes: 21 • No: 0
House vote • 5/28/2025
Final Passage - Assembly (2nd Reprint)
Yes: 42 • No: 0
Actions Timeline
Chapter 366.
6/6/2025legislatureApproved by the Governor.
6/6/2025legislatureEnrolled and delivered to Governor.
6/4/2025legislatureIn Assembly. To enrollment.
6/1/2025HouseRead third time. Passed. Title approved. Preamble adopted. (Yeas: 21, Nays: None.) To Assembly.
5/31/2025SenateRead second time.
5/30/2025SenatePlaced on Second Reading File.
5/30/2025SenateFrom committee: Do pass.
5/30/2025SenateRead first time. Referred to Committee on Commerce and Labor. To committee.
5/29/2025SenateIn Senate.
5/29/2025SenateTo Senate.
5/28/2025HouseRead third time. Passed, as amended. Title approved. Preamble adopted. (Yeas: 42, Nays: None.)
5/28/2025HouseFrom printer. To reengrossment. Reengrossed. Second reprint.
5/28/2025HouseRead third time. Amended. (Amend. No. 824.) To printer.
5/27/2025HousePlaced on General File.
5/27/2025HouseFrom committee: Amend, and do pass as amended.
5/27/2025HouseTo 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. 235.)
4/21/2025HousePlaced on Second Reading File.
4/21/2025HouseFrom committee: Amend, and do pass as amended.
4/21/2025HouseNotice of eligibility for exemption.
3/5/2025House
Bill Text
As Enrolled
As Introduced
Reprint 1
Reprint 2
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