All Roll Calls
Yes: 39 • No: 23
NevadaSB37883rd Regular Session (2025)SenateWALLET
AN ACT relating to health care; revising requirements governing the electronic maintenance, transmittal and exchange of health information; establishing a program to increase awareness of information concerning independent centers for emergency medical care; requiring certain facilities that are owned or operated by, or otherwise part of, hospitals to be licensed as independent centers for emergency medical care; requiring certain independent centers for emergency medical care to provide urgent care services under certain conditions; authorizing the review of certain sealed records to determine the suitability of a person to provide services under Medicaid; requiring Medicaid to include a system of value-based payments for independent centers for emergency medical care; requiring a provider of services under Medicaid to maintain certain records; authorizing audits of such records, the review and denial of claims under Medicaid and the recovery of money paid under Medicaid under certain circumstances; prohibiting a noncompetition covenant from applying to a patient-facing provider of health care; requiring a custodian of health records to furnish health records within a specified period of time and without charging a fee under certain circumstances; making an appropriation; and providing other matters properly relating thereto.
Sponsored By: Ken Gray (Republican), Edgar Flores (Democratic), Fabian Doñate (Democratic), Michelee "Shelly" Cruz-Crawford (Democratic), Rochelle T. Nguyen (Democratic)
Vetoed
BDR 40-705
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Bill Overview
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14 provisions identified: 5 benefits, 4 costs, 5 mixed.
Emergency centers must offer lower-cost urgent care
Independent emergency centers must offer urgent care throughout their operating hours, through a separate unit or patient triage. When urgent care is enough for a patient's condition, the center must explain that option. Urgent-care charges cannot exceed the amount customarily charged by an urgent care center. Urgent-care patients cannot wait longer than emergency-service patients with the same condition.
Patient-facing clinicians gain freedom from noncompetes
Noncompete agreements cannot apply to health providers whose main duties involve clinical patient care. Providers employed or contracted mainly for administrative work are not covered. When a court finds an agreement violates this protection, it must award the covered employee or contractor reasonable attorney's fees and costs.
Patients get faster, free electronic records
Beginning January 1, 2026, patients requesting electronic records for themselves or a covered entity get them free within seven business days. Other electronic record fees generally cannot exceed $40 or the applicable per-page charge, whichever is less, subject to specified exceptions. Sending records to a third party requires the patient's written permission, and electronic delivery must be secure. State rules cannot allow record-sharing services to charge fees that violate the record-access law. Pharmacists providing health care must also give applicable notices about record retention and possible destruction, subject to statutory exceptions.
Small practices get electronic record exemptions
Qualifying solo practices are exempt from electronic record maintenance, transmission, and exchange requirements. They must have served fewer than 500 patients last year and reasonably expect fewer than 500 this year. Group practices qualify only when all members together meet both patient limits. Exempt providers must still furnish records electronically to patients or their chosen recipients.
Medicaid ties emergency payments to quality
Nevada Medicaid must include quality-based payments for independent emergency centers, to the extent federal law allows and money is available. Centers delivering high-quality care at the appropriate service level receive higher reimbursement under the system. When funding is available, the Department must seek any needed federal waiver or State Plan change. Effective July 1, 2026, the law provides $291,296 in state funding and authorizes $1.149153 million from other sources for 2026–2027 implementation of payment and oversight changes. Appropriated funds cannot be committed after June 30, 2027; remaining funds must return to the State General Fund by September 17, 2027.
Medicaid applicants face sealed-record screening
State health agencies may inspect certain sealed records to screen Medicaid providers and business owners or managers seeking Medicaid contracts. Records must concern Medicare, Medicaid, or professional services requiring a license or certification. Agencies may use the review when deciding whether to enter or end a Medicaid services contract. This authority does not directly change recipients' eligibility or benefits.
Local governments face changed expense rules
Beginning January 1, 2026, NRS 354.599 does not apply to additional local-government expenses related to this law. The supplied text does not explain the excluded budget rule or state how much these expenses total. It also does not specify how local governments must pay them.
Medicaid providers face tighter claim reviews
Beginning October 1, 2026, Medicaid providers must keep claim-supporting records for periods set by regulation and provide them on request. The Department may audit records, deny unverifiable claims, and recover payments. It must review claims when it suspects unnecessary, excessive, or noncompliant care, reviewing unpaid claims before payment. Providers must receive notice and a documentation deadline; reviews must finish within 60 days after records arrive. The Department may require prior authorization or take other authorized action under hearing procedures, with exceptions for missed documentation deadlines.
Public employee plans follow information rules
Local-government group health coverage through a self-insurance reserve fund must follow the specified health-information and insurance requirements. The state Public Employees' Benefits Program must also follow the law's specified requirements when it uses self-insurance. Its self-insured plan must comply in the same way as a licensed insurer. These provisions do not specify changes to employees' benefits, premiums, or other costs.
Hospitals and emergency centers standardize bills
Hospitals and independent emergency centers must use the state discharge form and report required patient information monthly. Reporting must be electronic unless the Director grants a financial-hardship exemption. Insurers and other payers must accept the form as the bill for services. Beginning January 1, 2026, these forms must warn that false information may bring criminal penalties. Licensed practitioners submitting HCFA-1500 claims for patients without government health coverage must also include a false-claim warning.
New rules govern health information sharing
The law changes which organizations must maintain, send, and exchange electronic health information. Covered groups include specified government bodies, medical facilities, higher-level health providers, insurers, third parties, and pharmacy benefit managers. State standards govern health information exchange, including privacy, security, and compatibility between systems. Information maintained or sent under the specified health-information rules is exempt from Nevada's general consumer health-data provisions.
Patients can compare emergency center costs
Nevada must run a public-awareness program with emergency-center charge, quality, readmission, patient, and length-of-stay information. Public information must support comparisons while protecting patient identities. Centers must submit required monthly data within 45 days after each month ends. The Department must notify centers and facility regulators about missing, incomplete, or inaccurate submissions. The consumer health website must link to the state's hospital, surgery-center, and emergency-center comparison website, which is updated quarterly.
Emergency center locations face limits and exceptions
New independent emergency centers generally cannot be licensed within five miles of another center or a hospital emergency department. Beginning January 1, 2026, otherwise-qualified centers operating when the law was enacted must receive licenses despite that distance limit. Proposed centers also qualify if, by January 1, 2025, owners acquired the site, obtained or pursued construction approvals, and began the applicable state approval process. Centers licensed when the law was enacted are exempt from a specified licensing requirement. The law also repeals NRS 450B.215; the supplied text does not describe the repealed rule.
Hospital emergency centers need separate licenses
Qualifying hospital-affiliated facilities more than 250 yards from the hospital fall under the independent emergency-center licensing rules. Beginning January 1, 2026, hospital-affiliated centers may operate under the hospital's license until July 1, 2026. The state cannot charge these centers license issuance or renewal fees. It also cannot recover enforcement costs tied to issuing or renewing their licenses; other charges may still apply.
Sponsors & Cosponsors
Sponsors
Ken Gray
Republican • House
Edgar Flores
Democratic • Senate
Fabian Doñate
Democratic • Senate
Michelee "Shelly" Cruz-Crawford
Democratic • Senate
Rochelle T. Nguyen
Democratic • Senate
Cosponsors
James Ohrenschall
Democratic • Senate
Nicole J. Cannizzaro
Democratic • Senate
Roberta Lange
Democratic • Senate
Roll Call Votes
House vote • 6/2/2025
Final Passage - Assembly (2nd Reprint)
Yes: 27 • No: 15
Senate vote • 5/27/2025
Final Passage - Senate (2nd Reprint)
Yes: 12 • No: 8
Actions Timeline
Vetoed by the Governor.
6/11/2025legislatureEnrolled and delivered to Governor.
6/5/2025legislatureTo enrollment.
6/4/2025SenateIn Senate.
6/3/2025SenateRead third time. Passed. Title approved. (Yeas: 27, Nays: 15.) To Senate.
6/2/2025HouseRead second time.
6/1/2025HousePlaced on Second Reading File.
6/1/2025HouseFrom committee: Do pass.
6/1/2025HouseRead first time. Referred to Committee on Ways and Means. To committee.
5/28/2025HouseIn Assembly.
5/28/2025HouseFrom printer. To re-engrossment. Re-engrossed. Second reprint. To Assembly.
5/28/2025SenateRead third time. Passed, as amended. Title approved, as amended. (Yeas: 12, Nays: 8, Excused: 1.) To printer.
5/27/2025SenateReprinting dispensed with.
5/27/2025SenateRead third time. Amended. (Amend. No. 804.)
5/27/2025SenatePlaced on General File.
5/27/2025SenateFrom committee: Amend, and do pass as amended.
5/27/2025SenateFrom 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. 537.)
4/21/2025SenatePlaced on Second Reading File.
4/21/2025SenateFrom committee: Amend, and do pass as amended.
4/21/2025SenateFrom printer. To committee.
3/18/2025SenateRead first time. Referred to Committee on Health and Human Services. To printer.
3/17/2025Senate
Bill Text
As Enrolled
As Introduced
Reprint 1
Reprint 2
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