All Roll Calls
Yes: 60 • No: 2
NevadaSB31683rd Regular Session (2025)SenateWALLET
AN ACT relating to insurance; requiring health insurers, pharmacy benefit managers and the Commissioner of Insurance to prepare certain reports; expanding the scope of certain provisions relating to pharmacy benefit managers; prohibiting pharmacy benefit managers from engaging in certain practices; requiring pharmacy benefit managers to make certain disclosures; imposing requirements relating to the compensation of pharmacy benefit managers; revising requirements relating to the collection of certain medical debt; providing civil and criminal penalties; and providing other matters properly relating thereto.
Sponsored By: Jeff Stone (Republican), Robin L. Titus (Republican), Rochelle T. Nguyen (Democratic)
Failed
BDR 57-777
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Bill Overview
Analyzed Economic Effects
12 provisions identified: 11 benefits, 1 costs, 0 mixed.
Patients gain hospital debt cancellation protections
Beginning January 1, 2026, hospitals violating specified state or federal price-transparency rules cannot pursue qualifying medical debt. This covers debt originally billed with a charge above the published amount for the service, product, or device. Hospitals cannot send it to collectors, sue, seek arbitration or mediation, or cause it to be reported to reporting agencies. Collection must stop during investigation when you file with Nevada’s Bureau of Consumer Protection and immediately notify the hospital. If the Bureau finds a violation, the hospital must cancel the covered and related medical debt and refund payments. The protections reach qualifying debt incurred before, on, or after January 1, 2026; operation of the specified sections requires enactment and approval of Assembly Bill 343.
People can request electronic public records
Beginning January 1, 2026, Nevada government entities must provide electronic public records on request, generally in the requested format. They cannot deny access merely because confidential information appears in a record when it can be separated or removed. Exceptions cover records neither created nor available electronically, access to proprietary software, and confidential information that cannot be separated. The requested-format requirement also remains subject to limits in Nevada’s public-records law.
Drug benefit managers must protect patients
Pharmacy benefit managers must put covered patients’ interests first and act fairly toward contracting parties and pharmacies. The duty to patients takes priority when these duties conflict, and waivers of the duties are void. Managers must give written notice of interfering conflicts and avoid practices reasonably expected to create them. They must follow insurance-law requirements when managing benefits for a licensed insurer. They also cannot make or share false, deceptive, or misleading statements or ads.
Drug rebates count toward patient costs
Covered health plans must calculate your prescription drug cost-sharing at the pharmacy counter using the drug’s net price, including rebates. This rule applies when the policy or plan provides prescription drug coverage and falls within the law’s scope. It can lower what you pay when rebates reduce that price, but the law guarantees no fixed savings amount. The law phases in cost-sharing provisions, with some taking effect January 1, 2028.
Patients keep more pharmacy choices
Pharmacy benefit managers cannot steer patients to affiliated pharmacies when an eligible, unaffiliated pharmacy is in the network. They cannot unfairly restrict pharmacy choice, mislead patients about required pharmacies, or obstruct timely access to prescribed drugs or devices. Unaffiliated pharmacies cannot receive worse terms or lose network or preferred status when they accept the terms given to affiliated pharmacies. Managers cannot use pharmacy or pharmacy-services-group contracts to restrict unaffiliated pharmacies from contracting with others. They also cannot make, change, enforce, or renew manufacturer contracts that give plans exclusive coverage of a drug, device, or product.
State employee plans gain insurance oversight
Beginning January 1, 2028, the Nevada Board must follow listed insurance rules when providing health coverage through self-insurance. It must comply in the same manner as a licensed insurer. This includes applicable provisions of this act, except section 36. The change extends oversight but does not set a specific new benefit amount.
Patients and pharmacies gain complaint protections
Nevada’s Insurance Commissioner must receive, investigate, and track complaints about pharmacy benefit managers from people in Nevada. The Commissioner must publish complaints found more likely than not justified by a violation of the covered laws. Managers cannot punish pharmacies for reporting possible insurance-law violations or trying to settle related disputes. Banned retaliation includes specified contract actions, extra audits, and unjustified payment delays. Managers face $1,000 to $7,500 per covered violation; the Attorney General can recover these penalties in addition to other remedies.
Drug benefit contracts become more transparent
Pharmacy benefit managers must give contracting third parties requested written totals and types of charges, fees, commissions, and specified rebates. They must also provide requested clinical evidence about decisions on which drugs a plan covers. Nevada’s Insurance Commissioner can inspect managers’ contracts with pharmacies and third parties upon request. Pharmacies can share their contracts with the Commissioner, and terms blocking that disclosure are void.
Nevada can oversee some out-of-state policies
Nevada’s Insurance Commissioner can require specified Nevada standards for policies issued by Nevada-based insurers to residents of another state. The other state’s insurance official must first report that the policy is not subject to that state’s approval or disapproval. The Commissioner applies these standards by ruling. This authority does not guarantee a new coverage amount or lower premium.
Pharmacies face fewer late claim changes
Pharmacy benefit managers generally cannot cut or deny a drug claim after it has been processed. Exceptions cover fraud, services already paid for, or services not provided. Before reversing and resubmitting a claim, managers must notify the pharmacy and try to resolve the issue. Reversal and resubmission must happen within 90 days of the claim’s first approval. Managers cannot refuse payment because a pharmacy contract ended, except while investigating possible insurance fraud.
Pharmacies gain payment floors and protections
Pharmacy benefit managers cannot pay a pharmacy less for a drug than its purchase cost shown on the wholesaler’s invoice. They cannot use later payment reconciliations to lower the pharmacy’s effective payment rate. They also cannot charge pharmacies or pharmacists a fee for processing claims electronically. These rules protect pharmacy revenue but do not require savings to reach patients.
Some plans miss or delay protections
Plans governed by the federal ERISA law are exempt from Nevada’s pharmacy benefit manager rules unless their contracts require compliance. Specified managed-care coverage for Medicaid, CHIP, public employee benefits members, and local government officers, employees, and dependents is also exempt. These exemptions concern the specified coverage, not every obligation elsewhere in the law. The act’s amendments do not apply to agreements made before January 1, 2026, while the original agreements remain in effect. They apply when those agreements renew.
Sponsors & Cosponsors
Sponsors
Jeff Stone
Republican • Senate
Robin L. Titus
Republican • Senate
Rochelle T. Nguyen
Democratic • Senate
Cosponsors
Carrie Ann Buck
Republican • Senate
James Ohrenschall
Democratic • Senate
Lisa Krasner
Republican • Senate
Melanie Scheible
Democratic • Senate
Michelee "Shelly" Cruz-Crawford
Democratic • Senate
Skip Daly
Democratic • Senate
Roll Call Votes
House vote • 6/2/2025
Final Passage - Assembly (3rd Reprint)
Yes: 42 • No: 0
Senate vote • 5/29/2025
Final Passage - Senate (1st Reprint)
Yes: 18 • No: 2
Actions Timeline
From printer. To reengrossment. Reengrossed. Fourth reprint.
6/4/2025House(No further action taken.)
6/3/2025HouseRead third time. Passed, as amended. Title approved, as amended. (Yeas: 42, Nays: None.) To printer.
6/2/2025HouseDispensed with reprinting.
6/2/2025HouseRead third time. Amended. (Amend. No. 999.)
6/2/2025HouseFrom printer. To reengrossment. Reengrossed. Third reprint.
6/2/2025HouseRead third time. Amended. (Amend. No. 957.) To printer.
6/1/2025HouseRead second time.
5/31/2025HousePlaced on Second Reading File.
5/31/2025HouseFrom committee: Do pass.
5/31/2025HouseRead first time. Referred to Committee on Commerce and Labor. To committee.
5/30/2025HouseIn Assembly.
5/30/2025HouseFrom printer. To re-engrossment. Re-engrossed. Second reprint. To Assembly.
5/30/2025SenateRead third time. Passed, as amended. Title approved, as amended. (Yeas: 18, Nays: 2, Excused: 1.) To printer.
5/29/2025SenateReprinting dispensed with.
5/29/2025SenateRead third time. Amended. (Amend. No. 848.)
5/29/2025SenatePlaced on General File.
5/29/2025SenateFrom committee: Amend, and do pass as amended.
5/29/2025SenateTo committee.
4/22/2025SenateFrom printer. To engrossment. Engrossed. First reprint.
4/22/2025SenateTaken from General File. Re-referred to Committee on Finance. Exemption effective. To printer.
4/18/2025SenateRead second time. Amended. (Amend. No. 190.)
4/18/2025SenateNotice of eligibility for exemption.
4/18/2025SenatePlaced on Second Reading File.
4/18/2025SenateFrom committee: Amend, and do pass as amended.
4/18/2025Senate
Bill Text
As Introduced
Reprint 1
Reprint 2
Reprint 3
Reprint 4
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