AN ACT relating to health care; requiring certain health care facilities and certain providers of health care to provide patients with a form for a non-opioid directive and offer patients treatments that do not utilize an opioid under certain circumstances; requiring the Division of Public and Behavioral Health of the Department of Health and Human Services to create a form for a non-opioid directive; requiring the Administrator of the Division to appoint an advisory board to monitor compliance with laws and regulations relating to the non-opioid directive; requiring certain policies of health insurance to include coverage for at least one drug that is an alternative to opioids; requiring certain insurers to provide the form for a non-opioid directive to new insureds; revising the manner by which money in the Fund for a Resilient Nevada allocates money to projects and grants; and providing other matters properly relating thereto.
Sponsored By: Roberta Lange (Democratic)
Failed
Personalized for You
How does this bill affect your finances?
Personalize government policy and PRIA will tell you what this bill means for your household, plus every other piece of legislation we track. PRIA reads each provision against your financial profile to show you exactly what matters to your wallet.
Bill Overview
Analyzed Economic Effects
12 provisions identified: 9 benefits, 2 costs, 1 mixed.
Health plans must cover opioid alternatives
Covered policies and contracts delivered, issued for delivery, or renewed on or after January 1, 2026, must cover opioid alternatives. They must cover at least one effective non-opioid option for each common opioid use when an alternative exists. Plans cannot add approval or other requirements they would not apply to opioids in the same circumstances. This mandate excludes the specified Medicaid and CHIP managed-care arrangements. Nevada's Insurance Commissioner can extend Nevada standards to certain out-of-state policies from Nevada insurers, but only after the other state's regulator reports lacking approval authority.
Patients gain rights to non-opioid treatment
Covered practitioners and facilities must offer a non-opioid treatment before first opioid use, unless none is suitable or offering one is impractical. Subject to medical exceptions, they must provide non-opioid treatment when a patient has a directive or requests or prefers it. Providers who know or should know about a directive generally cannot give or prescribe opioids. Exceptions cover medically necessary emergency or inpatient care, surgery, and regulation-approved substance use disorder or hospice treatment. After emergency opioid use, practitioners must give prevention information when the emergency ends or at discharge. The specified offer and directive duties start July 1, 2027, or six months after related regulations take effect, whichever is later. Federal facilities, foster homes, and qualifying religious facilities serving people relying solely on spiritual healing are exempt from the facility requirements.
Medicaid reviews access to opioid alternatives
Nevada's Drug Use Review Board must regularly review Medicaid approval and try-another-drug-first rules for FDA-approved opioid alternatives. The reviews aim to ensure recipients have enough access to those drugs. The Board must also review new drug classes containing approved alternatives for uses normally treated with opioids. These reviews do not guarantee coverage of a specific drug.
Patients can record their opioid preferences
Nevada must create and post a non-opioid directive form explaining its legal effect and how to complete or cancel it. You or your legal guardian can make a directive declining opioids. It takes effect when delivered to a covered provider, facility, or coverage provider, which must record it. You can cancel it by communicating your choice; a guardian who made it must cancel in writing. Cancellation takes effect when communicated and must be recorded; coverage providers must also post the form and give it to new enrollees.
Providers must check patients' opioid preferences
Except in emergencies, practitioners must check your record for a non-opioid directive before prescribing, giving, or supervising opioid treatment. If you do not already have one, they must explain the option and provide the form when requested. Covered facilities that give opioids must ensure practitioners follow these steps and post the form if they have a website. These specified duties begin July 1, 2027, or six months after related regulations take effect, whichever is later.
Public employees keep pay during boardwork
Nevada state and local government employees serving on the advisory board keep regular pay while performing board duties. Paid release covers meeting preparation, attendance, and other board work. They cannot be required to make up that time or use annual leave or compensatory time.
Experts oversee patients' non-opioid directive protections
The state health division's administrator must appoint a board to advise on non-opioid directives and monitor compliance. Members must have expertise in safe opioid use in health care and substance use disorder treatment. They serve staggered three-year terms beginning July 1 of their appointment year.
Nevada can fund non-opioid treatment research
Nevada can use Fund for a Resilient Nevada money for statewide research on treatments that do not use opioids. Funding must follow the Fund's statewide plan. The law sets no specific research grant amount.
Public employee plans follow added rules
Local-government group coverage paid through a self-insurance reserve fund must follow an added insurance-law requirement. The Public Employees' Benefits Program Board must also follow an added requirement when it uses a self-insured plan. These changes extend insurance compliance rules to public employee plans. The supplied provisions do not describe the incorporated rules or establish a specific change in enrollee benefits or costs.
Providers face penalties for treatment violations
Facilities violating the new requirements can face license denial, suspension, or revocation, admission limits, required fixes, and fines. Facility fines can reach $5,000 per day per violation; the county district attorney must prosecute when the Division applies. Licensees who help violate the rules at skilled nursing, intermediate care, or group residential facilities face discipline and fines up to $10,000 per violation. Starting July 1, 2026, the Public Option Director may cut or stop provider payments after the required agency finding. The Public Employees' Benefits Program Board has similar payment authority after a Division or licensing-board finding and must notify providers in contracts.
Local costs receive different legal treatment
Starting July 1, 2026, NRS 354.599 does not apply to extra local government expenses related to this law. The provision changes the legal treatment of those added costs. It states no expense amount or direct change to household taxes or services.
Patient protections phase in with referrals
The law delays specified treatment and directive duties until July 1, 2027, or six months after related regulations take effect, whichever is later. Facility and practitioner compliance reviews cannot begin before January 1, 2029, or 18 months after those regulations take effect, whichever is later. Starting July 1, 2026, a transition-period rule requires referrals when practitioners identify a non-opioid patient but cannot offer a required alternative. They must refer that patient to a provider who can offer it; the supplied excerpt does not state the transition period's end date.
Sponsors & Cosponsors
Sponsor
Roberta Lange
Democratic • Senate
Cosponsors
There are no cosponsors for this bill.
Roll Call Votes
No roll call votes available for this bill.
Actions Timeline
(No further action taken.)
6/3/2025SenateFrom printer. To engrossment. Engrossed. First reprint. To committee.
4/24/2025SenateTaken from General File. Re-referred to Committee on Finance. Exemption effective. To printer.
4/21/2025SenateNotice of eligibility for exemption.
4/21/2025SenateRead second time. Amended. (Amend. No. 464.)
4/21/2025SenatePlaced on Second Reading File.
4/21/2025SenateFrom committee: Amend, and do pass as amended.
4/21/2025SenateFrom printer. To committee.
3/13/2025SenateRead first time. Referred to Committee on Health and Human Services. To printer.
3/12/2025Senate
Bill Text
As Introduced
Reprint 1
Related Bills
SB217, AN ACT relating to health care; prohibiting a governmental entity from substantially burdening certain activity relating to assisted reproduction under certain circumstances; authorizing a person whose engagement in such activity has been so burdened to assert the violation as a claim or defense in a judicial proceeding; authorizing a court to award damages against a governmental entity that substantially burdens such activity in certain circumstances; providing certain immunity from civil and criminal liability and administrative sanctions for certain persons and entities involved in the provision of assisted reproduction; providing that a fertilized egg or human embryo that exists before implantation in a human uterus is not a person for legal purposes; requiring certain health insurers to authorize a pregnant person to enroll in a health plan during a specified period; requiring certain public and private health insurers to provide certain coverage for the treatment of infertility and fertility preservation; providing a penalty; and providing other matters properly relating thereto.
AB499, AN ACT relating to elections; requiring, with certain exceptions, a registered voter show photo identification to vote in person; requiring the Department of Motor Vehicles, under certain circumstances, to issue identification cards at no charge; requiring the Secretary of State to issue digital identification cards; requiring a county clerk in certain counties to establish a certain number of locations for a voter to return his or her mail ballot to a mail ballot drop box during the period between the last day for early voting and the day before the date of the general election; authorizing a county clerk in certain counties to establish such locations; authorizing a person, under certain circumstances, to return a mail ballot to a mail ballot drop box established at such a location on behalf of a voter; requiring the Secretary of State to establish and maintain a voter services portal on the Internet website of the Office of the Secretary of State; requiring the county clerk to include certain information relating to the voter services portal on any communication to a registered voter; requiring the Department of Motor Vehicles to submit electronically to the Secretary of State certain information relating to each person who has a driver's license or identification card issued by the Department; requiring the Secretary of State to include certain information received from the Department in the centralized, top-down database that is established by the Secretary of State for purposes of creating the statewide voter registration list; requiring certain information to be included on the return envelope for a mail ballot; revising provisions relating to curing mail ballots; requiring mail ballot drop boxes to be monitored and secured; providing that certain information on the statewide voter registration list relating to a voter is confidential and not a public record; making various other changes relating to elections; making appropriations; and providing other matters properly relating thereto.
AB397, AN ACT relating to higher education; revising provisions governing certain waivers of fees provided by the Board of Regents of the University of Nevada; revising the criteria of eligibility for a waiver of fees by the Board of Regents for certain persons who are or were unaccompanied for a certain period of time; revising the criteria of eligibility for a waiver of fees by the Board of Regents for certain Native American students; providing for the continuity of waivers previously provided for certain Native American students; repealing certain provisions requiring the Chancellor of the Nevada System of Higher Education to cause to be analyzed certain natural materials upon the request of a resident of this State; and providing other matters properly relating thereto.
AB259, AN ACT relating to health care; prohibiting certain actions related to pricing and reimbursement for certain drugs; creating a cause of action for violating such prohibitions; and providing other matters properly relating thereto.
AB188, AN ACT relating to the Public Employees' Benefits Program; requiring the Board of the Public Employees' Benefits Program to report certain information relating to the costs of health insurance for certain retirees; revising provisions relating to the subsidy paid for certain health and welfare benefits for certain state employees who have retired with state service; revising requirements for certain retired public officers and employees to reinstate insurance under the Program; revising provisions relating to certain subsidies paid to the Program for the 2025-2027 biennium; requiring the Joint Interim Standing Committee on Government Affairs to conduct an interim study on the Program; making an appropriation; and providing other matters properly relating thereto.
SB309, AN ACT relating to crimes; revising provisions relating to driving under the influence of alcohol or certain other prohibited substances; providing penalties; and providing other matters properly relating thereto.