All Roll Calls
Yes: 59 • No: 2
NevadaSB38983rd Regular Session (2025)SenateWALLET
AN ACT relating to prescription drugs; requiring the Department of Health and Human Services to select and contract with a state pharmacy benefit manager to manage pharmacy benefits for Medicaid and certain other health benefit plans; requiring the Department to establish certain methodologies for the payment of and rates of reimbursement for prescription drugs under Medicaid; requiring the Department to establish a benchmark to measure certain data relating to the cost of prescription drugs; prescribing certain duties of the state pharmacy benefit manager; requiring that the Department approve certain contracts entered into by the state pharmacy benefit manager; prohibiting the state pharmacy benefit manager from engaging in certain activities; requiring a Medicaid managed care organization to contract with and utilize the state pharmacy benefit manager to manage pharmacy benefits; requiring a Medicaid managed care organization to provide certain information to the Department upon request; and providing other matters properly relating thereto.
Sponsored By: JeffAssistant Minority Leader Stone (Republican), MelanieChief Majority Whip Scheible (Democratic)
Signed by Governor
BDR 38-240
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Bill Overview
Analyzed Economic Effects
5 provisions identified: 3 benefits, 0 costs, 2 mixed.
Skip step therapy for late-stage cancer
If you have stage 3 or 4 cancer on Medicaid, you or your doctor can ask to skip step therapy. A doctor, nurse, or pharmacist reviews it and must decide within 72 hours, faster if a delay risks your health. When approved, the State pays the nonfederal share of the drug. It may cover one week first, then continue if your doctor says it works. The Department, the state PBM, and HMOs post the exemption form online.
State PBM runs Medicaid drug benefits
The Department selects one state pharmacy benefit manager to run Medicaid and CHIP drug payments and rebates. Every Medicaid HMO must use this state PBM for all pharmacy benefits. The first state PBM contract takes effect on or before January 1, 2030. The Department may adjust payment arrangements with HMOs or the PBM to stay compliant with federal and state law.
Stronger oversight of PBM and HMOs
PBM applicants must disclose conflicts, fees charged to pharmacies, ownership ties, and deals with drug makers. The Department sets who qualifies to serve as the state PBM. The state PBM must submit every pharmacy contract and change for Department approval before it takes effect. The state audits the PBM and HMOs each year and posts results online. HMOs must share pharmacy spending when asked. The Department sets a preferred drug list for Medicaid and CHIP and posts a yearly report by February 1.
PBM pricing rules and 340B protections
The state PBM must send all manufacturer rebates to the Department. PBM contracts ban spread pricing, unapproved fees, underpaying dispensing fees, and steering patients to PBM-owned or mail-order pharmacies. Any PBM contract that conflicts with Department rules is void. PBMs cannot discriminate against 340B providers or drugs through fees, network limits, or higher patient costs. However, those 340B nondiscrimination rules do not bind the state PBM when it manages Medicaid.
New Medicaid pharmacy payment rules
The Department sets how pharmacies are paid for Medicaid and CHIP, including rules for 340B-owned pharmacies and dispensing fees. It aims to save the State, base rates on actual acquisition cost, and use a Nevada average acquisition cost when adopted. The Department may create that Nevada benchmark only if it lowers state drug spending. Providers who buy from 340B-owned pharmacies may be required to submit claims data on what they actually paid. Dispensing fees may vary by pharmacy type if federal law allows.
Sponsors & Cosponsors
Sponsors
JeffAssistant Minority Leader Stone
Republican • Senate
MelanieChief Majority Whip Scheible
Democratic • Senate
Cosponsors
SkipDeputy Majority Whip Daly
Democratic • Senate
Roll Call Votes
House vote • 5/31/2025
Final Passage - Assembly (2nd Reprint)
Yes: 41 • No: 0
Senate vote • 5/26/2025
Final Passage - Senate (2nd Reprint)
Yes: 18 • No: 2
Actions Timeline
Chapter 390.
6/6/2025legislatureApproved by the Governor.
6/6/2025legislatureEnrolled and delivered to Governor.
6/4/2025legislatureTo enrollment.
6/2/2025SenateIn Senate.
6/1/2025SenateRead third time. Passed. Title approved. (Yeas: 41, Nays: None, Excused: 1.) To Senate.
5/31/2025HouseRead second time.
5/30/2025HousePlaced on Second Reading File.
5/30/2025HouseFrom committee: Do pass.
5/30/2025HouseRead first time. Referred to Committee on Commerce and Labor. To committee.
5/27/2025HouseIn Assembly.
5/27/2025HouseFrom printer. To re-engrossment. Re-engrossed. Second reprint. To Assembly.
5/27/2025SenateRead third time. Passed, as amended. Title approved, as amended. (Yeas: 18, Nays: 2, Excused: 1.) To printer.
5/26/2025SenateReprinting dispensed with.
5/26/2025SenateRead third time. Amended. (Amend. No. 725.)
5/26/2025SenatePlaced on General File.
5/26/2025SenateFrom committee: Amend, and do pass as amended.
5/26/2025SenateFrom 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. 465.)
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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