Existing law: (1) creates the Patient Protection Commission within the Office of the Director of the Department of Health and Human Services; and (2) requires the Commission to perform certain duties relating to the provision of health care in this State. Such duties include conducting a systematic review of issues related to the health care needs of residents of this State and the quality, accessibility and affordability of health care in this State. (NRS 439.902-439.918) In 2021, the Governor issued Executive Order 2021-29, which establishes targets, known as health care cost growth targets, for the growth of spending on health care for each year, beginning in 2022 and ending in 2026. Executive Order 2021-29 requires the Division of Insurance of the Department of Business and Industry, the Department of Health and Human Services and other relevant state agencies to engage relevant parties to develop strategies to meet those targets and monitor and publish certain reports concerning the growth of health care spending. (Executive Order 2021-29 (12-27-2021))
Sections 3-9 of this bill define terms relevant to health care cost growth benchmarks. Section 10 of this bill requires the Director of the Department to annually establish a health care cost growth benchmark for the immediately following year in an amount equal to the health care cost growth target established by the Governor in Executive Order 2021-29. Beginning in 2026 and every 5 years thereafter: (1) section 13 of this bill requires the Commission to establish and submit to the Director recommendations for health care cost growth benchmarks for each of the immediately following 5 years; and (2) section 18 of this bill requires the Director to consider those recommendations and establish the health care cost growth benchmark for each of those years. Section 13 authorizes the Commission to recommend that the Director modify the health care cost growth benchmark or the manner in which the growth in health care spending relative to the health care cost growth benchmark is assessed, if the Commission determines that economic conditions warrant the modification. Section 10 authorizes the Director to modify the health care cost growth benchmark in response to such a recommendation. Section 10 requires the Department, the Division of Insurance of the Department of Business and Industry and other relevant state agencies to collaborate to develop and engage relevant persons and entities to implement strategies for meeting the health care cost growth benchmark.
Section 11 of this bill requires insurers to report to the Director certain data prescribed by regulation of the Director relating to health care spending. Section 11 also requires the Director to request certain information relating to health care spending from the Federal Government. Section 12 of this bill requires the Director to compile and submit to the Governor and the Legislature an annual report of certain data and analysis relating to health care spending in this State that is based on the data collected from insurers pursuant to section 11. Section 12 requires the report to include the rate of growth in total health care spending compared to the applicable health care cost growth benchmark. Beginning in 2025, section 14 of this bill requires the Commission to annually: (1) hold an informational public hearing to compare the rate of growth in total health care spending in the most recent year for which such information is available to the health care cost growth benchmark for that year; and (2) compile and submit to the Governor, the Director and the Legislature a report of recommendations for strategies to assist the health care system in this State in meeting the health care cost growth benchmark.
Existing law requires the Commission to examine the cost of health care and the primary factors impacting those costs as part of its systemic review of issues relating to health care in this State. (NRS 439.916) Section 15 of this bill requires that examination to include an examination of the information contained in the report compiled by the Director pursuant to section 12. Sections 16 and 17 of this bill make conforming changes to clarify that the activities of the Commission prescribed by sections 13 and 14 are part of the duties of the Commission. Section 18.5 of this bill makes an appropriation to the Division of Health Care Financing and Policy of the Department of Health and Human Services and authorizes certain related expenditures to carry out the provisions of this bill.
Statutes affected: As Introduced: 439.916, 439.918
Reprint 1: 439.916, 439.918
BDR: 439.916, 439.918