Federal regulations require providers of health care and facilities that receive federal funding to provide interpreter services when necessary to ensure meaningful access for a person with limited English proficiency, including a person who primarily communicates using sign language. (45 C.F.R. § 92.201) Section 1 of this bill requires a hospital or freestanding birthing center to provide a qualified sign language interpreter to a patient who is at the hospital or freestanding birthing center for the purpose of giving birth. Section 1 also requires a hospital or freestanding birthing center to allow a family member of the patient and a doula to be present in the room with the patient during the birthing process. Sections 2-6 of this bill make conforming changes relating to the applicability and enforcement of section 1. Existing law requires Medicaid to cover doula services provided by a doula who enrolls with the Division of Health Care Financing and Policy of the Department of Health and Human Services. (NRS 422.27177) Sections 17, 18, 43, 46, 48, 50, 51, 53, 55, 56 and 61 of this bill require various other public and private insurers who cover maternity care to: (1) cover doula services; and (2) include doulas in their networks of providers. Section 45 of this bill authorizes the Commissioner of Insurance to require certain policies of health insurance issued by a domestic insurer to a person who resides in another state to include the coverage required by section 43. Section 60 of this bill authorizes the Commissioner to suspend or revoke the certificate of a health maintenance organization that fails to provide the coverage required by section 55. The Commissioner is also authorized to take such action against other health insurers who fail to provide the coverage required by sections 43, 46, 48, 50, 51, 53 and 61. (NRS 680A.200) Existing law requires certain health insurers, including Medicaid managed care organizations and insurance for state and local governmental employees, to cover hormone replacement therapy to varying degrees. (NRS 287.010, 287.04335, 689A.0415, 689B.0376, 689C.1678, 695A.1875, 695B.1916, 695C.050, 695C.1694, 695G.1717) Sections 44, 47, 49, 52, 54, 58 and 64 of this bill require such coverage to include coverage of testosterone replacement therapy for menopausal women. Section 20 of this bill requires Medicaid, including where benefits are not provided through managed care, to cover hormone therapy, including testosterone replacement therapy for menopausal women. Section 16 of this bill makes a conforming change to require the Director of the Department to administer the provisions of section 20 in the same manner as other provisions governing Medicaid. Section 21 of this bill expands existing coverage of dental services under Medicaid. (NRS 422.272422) Section 42 of this bill prohibits certain health insurers from denying a request to include a provider of health care in a provider network because the provider of health care is a solo practitioner. Existing law requires: (1) the board of trustees of each school district and the governing body of each charter school or university school for profoundly gifted pupils to adopt a policy for the prevention and treatment of injuries to the head of a pupil; and (2) the board of trustees of each school district and the governing body of each charter school to adopt a policy concerning safe exposure to the sun. (NRS 392.452, 392.453) Section 19 of this bill additionally requires the board of trustees of each school district and the governing body of each charter school or university school for profoundly gifted pupils to adopt a policy concerning the prevention of sudden cardiac arrest during the participation of pupils in competitive sports sponsored by a school. Existing law authorizes a court that finds a child to be in need of protection to: (1) permit the child to remain in the custody of his or her parent or guardian; (2) place the child in the custody of a relative, a fictive kin or another suitable person; or (3) place the child in the temporary custody of a public or private agency or institution. (NRS 432B.550) If such a child is placed other than with a parent and has been diagnosed with a mental or behavioral health condition before or after such placement, section 22 of this bill requires the agency which provides child welfare services to provide for an independent psychiatric evaluation of the child not more than 6 months before the child achieves a permanent placement or transitions to independent living. Section 22 provides that this requirement does not apply if a prior psychiatric evaluation conducted after the initial diagnosis has determined that the child no longer has a mental or behavioral health condition. Sections 7 and 23-25 of this bill make conforming changes to make various provisions governing child welfare proceedings generally applicable to any proceeding related to the provisions of section 22. Existing law prohibits certain unfair trade practices. (NRS 598A.060) Section 26 of this bill prohibits a health carrier or a health insurance administrator from: (1) providing health care services directly to patients; or (2) operating or administering any entity that provides health care services directly to patients. The Attorney General or a person injured by a violation of section 26 would be authorized to bring a civil action against a health carrier or health insurance administrator who violates that prohibition. (NRS 598A.160, 598A.180-598A.210) Additionally, a health carrier or health insurance administrator who commits such a violation would be subject to criminal and civil penalties. (NRS 598A.170, 598A.280) Sections 8-15 of this bill authorize the Attorney General to use money from certain fees which are currently used to support investigations of unfair trade practices for the purpose of investigating violations of section 26. Sections 38-41, 57, 59, 62 and 63 of this bill make conforming changes to remove references to the direct provision of health care by health insurers. Existing law provides that a noncompetition covenant is void unless the covenant: (1) is supported by valuable consideration; (2) does not impose any restraint that is greater than is required for the protection of the employer; (3) does not impose an undue hardship on the employee; and (4) imposes restrictions that are appropriately related to the consideration for the covenant. (NRS 613.195) Section 27 of this bill prohibits a hospital from entering into a noncompetition covenant with a provider of health care if the covenant prohibits the provider of health care from providing medical services at another medical facility or office during or after the term of the employment or contract, as applicable. Section 27 provides that any provision of a noncompetition covenant that violates that prohibition is void. Additionally, the provisions of section 27 would be subject to administrative enforcement by the Labor Commissioner. (NRS 607.160) Existing law provides for the regulation of the practices of medicine, nursing and osteopathic medicine by the Board of Medical Examiners, the State Board of Nursing and the State Board of Osteopathic Medicine, respectively. (Chapters 630, 632 and 633 of NRS) Sections 29, 32 and 35 of this bill: (1) require those boards to adopt regulations prescribing a list of race-based health formulas and race-based care standards that are authorized for use by licensees in this State; (2) prohibit those boards from including on that list any race-based health formula or race-based care standard if there is a race-neutral health formula or race-neutral care standard that has been scientifically validated as being at least as effective for the same purpose; and (3) prohibit a physician, physician assistant, nurse or osteopathic physician from using or authorizing the use of a race-based health formula or race-based care standard that is not included on the list. Section 65 of this bill requires the Board of Medical Examiners, the State Board of Osteopathic Medicine, the University of Nevada, Reno, School of Medicine and the University of Nevada, Las Vegas, School of Medicine to study disparities in health care access, the provision of health care and health care outcomes. Sections 30, 33 and 36 of this bill require a physician, physician assistant, advanced practice registered nurse or osteopathic physician to: (1) discuss with a patient, upon diagnosing the patient with arthritis, osteoarthritis or any other condition that is commonly treated using stem cell therapy, the potential use of stem cell therapy to treat the condition; and (2) when acting as a provider of primary care, inform a patient of options that may be available to the patient for donating, banking or storing stem cells for future use by the patient or a donee during the first encounter with the patient. Existing law prescribes certain requirements governing the prescribing or dispensing of a controlled substance listed in schedule II, III or IV for the treatment of pain. (NRS 639.2391-639.23914) Section 37 of this bill clarifies that those requirements do not: (1) apply to the prescribing or dispensing of a controlled substance in other circumstances; or (2) establish a standard of care or grounds for disciplinary action against a practitioner when a controlled substance is prescribed or dispensed in other circumstances.

Statutes affected:
As Introduced: 449.029, 449.0301, 449.160, 449.163, 449.240, 49.295, 78.153, 80.115, 86.264, 86.5462, 87A.295, 87A.565, 88.397, 88.5915, 232.320, 287.010, 287.04335, 422.272422, 432B.250, 432B.420, 432B.4675, 613.195, 639.239145, 682A.434, 682A.436, 682A.544, 682A.546, 687B.692, 689A.0415, 689A.330, 689B.0376, 689C.1678, 689C.425, 695A.1875, 695B.1916, 695C.050, 695C.120, 695C.1694, 695C.187, 695C.330, 695G.040, 695G.125, 695G.1717
BDR: 449.029, 449.0301, 449.160, 449.163, 449.240, 49.295, 78.153, 80.115, 86.264, 86.5462, 87A.295, 87A.565, 88.397, 88.5915, 232.320, 287.010, 287.04335, 422.272422, 432B.250, 432B.420, 432B.4675, 613.195, 639.239145, 682A.434, 682A.436, 682A.544, 682A.546, 687B.692, 689A.0415, 689A.330, 689B.0376, 689C.1678, 689C.425, 695A.1875, 695B.1916, 695C.050, 695C.120, 695C.1694, 695C.187, 695C.330, 695G.040, 695G.125, 695G.1717