Existing law requires the Director of the Department of Health and Human Services to adopt regulations governing health information exchanges and the transmittal, ownership, management, use and confidentiality of electronic health records. (NRS 439.587, 439.589) Section 1.08 of this bill requires the Director to prescribe by regulation a framework for the electronic maintenance, transmittal and exchange of electronic health records, prescriptions and health-related information. Section 1.08 requires that framework to establish standards for networks and technologies to be used to maintain, transmit and exchange health information, including standards that require: (1) the ability for patients to access and forward their records; and (2) the interoperability of such networks and technologies. Section 2.7 of this bill requires the Director to convene an advisory group to advise the Director in the adoption of those standards. With certain exceptions, sections 1.08, 1.94, 1.96, 2 and 2.8 of this bill require governmental entities, health care providers, insurers, pharmacy benefit managers and other insurance administrators to maintain, transmit and exchange health information electronically in accordance with those standards and other provisions governing electronic health records, beginning on: (1) July 1, 2024, for hospitals and large physician group practices; (2) July 1, 2025, for governmental entities, other large health care practices, insurers, pharmacy benefit managers and other insurance administrators; and (3) January 1, 2030, for small physician group practices and other small health care practices. Sections 1.02 and 1.08 of this bill provide that a health care provider, insurer, pharmacy benefit manager or other insurance administrator that fails to comply with that requirement is not guilty of a misdemeanor. Instead, section 1 of this bill requires the Department to notify any regulatory body that has issued a license, certificate, registration, permit or similar credential to a health care provider, insurer, pharmacy benefit manager or other insurance administrator if the holder of the credential fails to comply with that requirement. After receiving such notice, sections 1.3, 1.92, 2, 2.2 and 2.35 of this bill authorize a regulatory body to impose corrective action or an administrative penalty on the health care provider, insurer, pharmacy benefit manager or other insurance administrator. Section 1 of this bill requires the Department to notify the relevant regulatory body if a health care provider, insurer, pharmacy benefit manager or other insurance administrator that was previously out of compliance with the requirement to maintain, transmit and exchange health information electronically comes into compliance with that requirement. Section 1.06 of this bill removes duplicative requirements concerning the adoption of regulations governing electronic health records. Sections 1.02-1.07, 1.4-1.9, 1.98, 2.05, 2.15, 2.25, 2.3, 2.4 and 2.45 of this bill make conforming changes to indicate the proper placement of sections 1, 1.3, 2.1 and 2.2 in the Nevada Revised Statutes. Existing law authorizes the Director of the Department of Health and Human Services to contract with not more than one health information exchange to be responsible for compiling statewide master indexes of patients, health care providers and payers. (NRS 439.587) Section 1.06 of this bill authorizes the Director to contract with multiple health information exchanges to perform those functions. Section 1.06 also removes a requirement that the Director encourage the use of health information exchanges. Existing law requires that, with certain exceptions, a patient consent before his or her electronic health record is retrieved from a health information exchange. (NRS 439.591) Section 1.09 of this bill clarifies that such consent must be affirmative. Existing law provides that a health care provider who with reasonable care relies upon an apparently genuine electronic health record accessed from a health information exchange to make a decision concerning the provision of health care to a patient is immune from civil or criminal liability for the decision if: (1) the electronic health record is inaccurate; (2) the inaccuracy was not caused by the health care provider; (3) the inaccuracy resulted in an inappropriate health care decision; and (4) the health care decision was appropriate based upon the information contained in the inaccurate electronic health record. (NRS 439.593) Section 1.1 of this bill expands this immunity from liability to also apply to any health care provider who transmits, accesses, utilizes, discloses, relies upon or provides to the patient any apparently genuine electronic health record in accordance with applicable law and regulations. Section 1.2 of this bill provides that transmitting, accessing, utilizing or disclosing an electronic health record is not an unfair trade practice. Section 2.5 of this bill makes an appropriation to the Department to award grants to certain small facilities and providers of health care who work in small business settings to assist in compliance with the requirements of section 1.08.

Statutes affected:
As Introduced: 439.593, 629.051
Reprint 1: 439.587, 439.593, 439.595, 449.029, 449.0301, 449.089, 449.160, 449.163, 449.220, 449.240, 629.051
Reprint 2: 439.580, 439.581, 439.587, 439.588, 439.589, 439.591, 439.593, 439.595, 449.029, 449.0301, 449.089, 449.160, 449.163, 449.220, 449.240, 287.010, 287.04335, 603A.100, 629.051, 654.190, 680A.095, 683A.3683, 692A.270, 719.200, 720.140
Reprint 3: 439.580, 439.581, 439.587, 439.588, 439.589, 439.591, 439.593, 439.595, 449.029, 449.0301, 449.089, 449.160, 449.163, 449.220, 449.240, 287.010, 287.04335, 603A.100, 629.051, 654.190, 680A.095, 683A.3683, 692A.270, 719.200, 720.140
As Enrolled: 439.580, 439.581, 439.587, 439.588, 439.589, 439.591, 439.593, 439.595, 449.029, 449.0301, 449.089, 449.160, 449.163, 449.220, 449.240, 287.010, 287.04335, 603A.100, 629.051, 654.190, 680A.095, 683A.3683, 692A.270, 719.200, 720.140
BDR: 439.593, 629.051