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: Jeff Stone (Republican), Melanie Scheible (Democratic)
Signed by Governor
BDR 38-240
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Bill Overview
Analyzed Economic Effects
6 provisions identified: 3 benefits, 0 costs, 3 mixed.
Cancer patients can skip step therapy
Beginning January 1, 2030, a Nevada Medicaid recipient with stage 3 or 4 cancer can ask to skip step therapy. You, your doctor, or a designated advocate can apply and give clinical reasons. A qualified doctor, nurse, or pharmacist reviews it. The reviewer must decide within 72 hours, or faster if your doctor says delay could seriously harm you. The agency, PBM, and HMOs must post an easy online form and tell you the reviewers’ qualifications. If approved, the State pays the nonfederal share. Coverage may start with a 1‑week supply and continue if it works, with reviews no more than once per quarter and a report sent to you.
Single state manager for Medicaid drugs
Starting January 1, 2030, the Department selects and contracts with a single state pharmacy benefit manager to run drug benefits. Medicaid managed care plans must use this manager and give the Department spending details when asked. Contracts must follow all state and federal laws and require the manager to negotiate purchases for drugs on the preferred list unless another contract covers them. The first contract must start by January 1, 2030. Parts of the law take effect earlier only to let the Department write rules and prepare.
Stronger rules and full drug rebate pass-through
Beginning January 1, 2030, the state’s drug benefit manager must give the Department 100% of all drug rebates. Contracts ban spread pricing, pharmacy steering, and required mail‑order, and they must not pay less than the State’s approved dispensing fee. The manager and HMOs must disclose fees, rebates, and cost controls, and submit to yearly audits the Department posts online. The Department also sets a preferred drug list and posts a yearly report by February 1 on the contracts’ financial effects.
New Medicaid pharmacy pay and fees
The Department sets how pharmacies are paid and the dispensing fees for Medicaid, with separate rules for pharmacies owned by 340B covered‑entity facilities. Fees can differ by pharmacy type where federal law allows. Payment aims to use a drug’s actual acquisition cost and the Nevada Average Acquisition Cost benchmark if the Department establishes one. These changes can lower program costs and also change pharmacy revenue.
Medicaid rules for 340B drug discounts
Beginning January 1, 2030, some 340B protections do not apply when the state’s drug manager runs Medicaid pharmacy benefits. The Department and Medicaid plans may set terms to prevent duplicate discounts and protect Medicaid finances. This can change how 340B providers are paid and how networks operate.
Nevada drug price benchmark and data
The Department may set a Nevada Average Acquisition Cost benchmark only if it will reduce State spending. It can use surveys and data from the state’s drug manager to set it, and must report savings to lawmakers every two years by February 1. Providers that run pharmacies for 340B covered entities must send claims data on actual drug acquisition costs as the Department requires.
Sponsors & Cosponsors
Sponsors
Jeff Stone
Republican • Senate
Melanie Scheible
Democratic • Senate
Cosponsors
Skip 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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