Existing law creates the Department of Health and Human Services, which consists of the Aging and Disability Services Division, the Division of Public and Behavioral Health, the Division of Welfare and Supportive Services, the Division of Child and Family Services and the Division of Health Care Financing and Policy. (NRS 232.300) This bill creates a new department within the Executive Department of the State Government known as the Nevada Health Authority to assume certain responsibilities of the Department of Health and Human Services and other entities related to the management of certain public health insurance plans, the licensing and regulation of certain persons and entities involved in the provision of health care and the regulation of sanitation in food establishments and certain other locations. Section 18 of this bill creates and establishes the purposes of the Authority, and section 32 of this bill changes the name of the Department to the Department of Human Services. Section 18 provides that the Authority consists of: (1) the Medicaid Division; (2) the Health Care Purchasing and Compliance Division; and (3) the Consumer Health Division. Section 19 of this bill requires the Governor to appoint a Director of the Authority who possesses certain qualifications. Sections 20-23 and 29 of this bill provide for the appointment of officers and the employment of staff for the Authority, including an administrator of each division of the Authority. Sections 24 and 79 of this bill exempt the Authority from provisions of law governing state procurement, with certain exceptions, and section 24 prescribes requirements governing procurement by the Authority. Sections 24 and 61 of this bill provide for the confidentiality of certain information submitted to the Authority during the procurement process. Section 25 of this bill authorizes: (1) the sharing of confidential information within the Authority; and (2) the Authority to share confidential information with certain agencies of local governments in certain circumstances. Sections 26 and 34 of this bill transfer from the Department to the Authority the authority to administer certain programs for persons with developmental disabilities. Section 28 of this bill requires the Director or the Director's designee to adopt each state plan required by the Federal Government for the administration of any program for which the Authority or a division thereof is responsible. Section 31 of this bill creates the Nevada Health Authority Gift Fund to hold gifts, grants and other property which the Authority is authorized to accept. Sections 113 and 227 of this bill require the deposit of certain money in the Fund. Section 36 of this bill updates the name of the Department of Health and Human Services Gift Fund, which is created by existing law, to conform to the change in the name of the Department. (NRS 232.355) Existing law requires the Office of Science, Innovation and Technology in the Office of the Governor to administer the Graduate Medical Education Grant Program, which is a program to award grants to institutions in this State seeking to create, expand or retain programs for residency training and postdoctoral fellowships for physicians. (NRS 223.631-223.639) Sections 2-8 and 26 of this bill transfer to the Consumer Health Division the responsibility for administering the Program. Existing law requires the Board of the Public Employees' Benefits Program to establish the Program to provide group life, accident or health insurance, or any combination thereof, to employees of the State Government. (NRS 287.043) Section 68 of this bill places the Board within the Authority and makes revisions governing the appointment and membership of the Board. Section 68.5 of this bill: (1) removes the authority of the Governor to designate the Chair of the Board and instead requires the Board to elect a Chair annually; and (2) requires the Governor to designate a Vice Chair of the Board. Section 69 of this bill transfers from the Board to the Director of the Authority the responsibility for appointing the Executive Officer of the Program. Section 65.5 of this bill requires the Board to biennially submit to the Legislature a report concerning the cost for a retired state employee to obtain coverage through the Program under Medicare. Section 70 of this bill requires the Executive Officer to submit to the Authority a report regarding the administration and operation of the Program, in addition to certain other entities that currently receive the report. Section 71 of this bill provides that the appointment of officers and unclassified employees to administer the Program is subject to the approval of the Director of the Authority. Sections 72-74 of this bill authorize the Board to utilize certain services of the Authority, including procurement services, or to conduct procurement in accordance with either section 24 or provisions of existing law governing procurement by state agencies. (Chapter 333 of NRS) Section 72 additionally requires the Board, within the limits of available resources, to take such measures as are necessary to maximize the benefits available to participants in the Program and the ability of participants to access available benefits. Existing law authorizes the Board of the Program to enter into contracts with physicians, surgeons, hospitals and rehabilitative facilities for medical, surgical and rehabilitative care and the evaluation, treatment and nursing care of members of the Program and covered dependents. (NRS 287.0434) Section 367.7 of this bill requires the Authority and the Board to study and report to the Legislature concerning opportunities to directly contract with such providers. Existing law requires: (1) the Department to administer Medicaid and the Children's Health Insurance Program; and (2) the Division of Health Care Financing and Policy of the Department to perform certain duties related to the administration of those programs. (Chapter 422 of NRS) Sections 26, 34, 93-96, 113-117, 120.5 and 359 of this bill transfer from the Department and the Director of the Department to the Medicaid Division and the Director of the Authority the responsibility for administering Medicaid and the Children's Health Insurance Program. Sections 32, 34 and 35 of this bill abolish the Division of Health Care Financing and Policy, and sections 94 and 359 transfer the authority, duties and responsibilities of that Division to the Medicaid Division. Section 86 of this bill authorizes the Authority to delegate to other governmental entities the responsibility for making determinations of eligibility for Medicaid and the Children's Health Insurance Program. Section 87 of this bill creates the Office of the Medicaid Inspector General within the Authority to perform certain duties to ensure the integrity of Medicaid and the Children's Health Insurance Program and to prevent waste, fraud and abuse in those programs. Sections 66, 88-91 and 371 of this bill transfer or provide to the Authority certain responsibilities related to the administration of those programs. Sections 101-104, 109 and 110 of this bill establish provisions governing the qualifications, supervision and activities of the Administrator of the Medicaid Division, which are similar to the qualifications, supervision and activities of the Administrator of the Division of Health Care Financing and Policy. (NRS 422.2354-422.2364, 422.2372) Sections 105-108, 111 and 112 of this bill transfer to the Director certain responsibilities relating to Medicaid and the Children's Health Insurance Program, including the responsibility for adopting regulations governing those programs. Section 116 requires any contract for the expenditure of federal money under Medicaid to be signed by the Director. Section 118 of this bill requires the Authority to: (1) include on an Internet website maintained by the Authority certain information to allow recipients of Medicaid through managed care to compare available plans; and (2) develop and implement a beneficiary support system for such recipients of Medicaid. Section 371 repeals certain fiscal duties previously performed by the Administrator of the Division of Health Care Financing and Policy. Sections 26, 34, 141, 144-146, 194, 217-224, 245-247, 250, 260, 276, 325-327 and 360 of this bill transfer from the Division of Public and Behavioral Health to the Health Care Purchasing and Compliance Division and from the Department of Health and Human Services to the Nevada Health Authority, as applicable, the responsibilities for credentialing and regulating: (1) programs for the treatment of persons who commit domestic violence; (2) health care facilities and certain entities involved in the provision of personal care services; (3) nontransplant anatomical donation organizations; (4) naprapaths; and (5) medical laboratories and their personnel. Section 143 of this bill authorizes the State Board of Health to establish fees for the credentialing functions and certain other functions of the Health Care Purchasing and Compliance Division. Sections 26, 34 and 162-171 of this bill transfer from the Division of Public and Behavioral Health to the Health Care Purchasing and Compliance Division the responsibility for administering provisions governing health and safety at health care facilities, including the reporting of sentinel events. Section 35 reduces the number of deputy administrators in the Division of Public and Behavioral Health to account for the duties removed from that Division. Section 367.8 of this bill requires the Department and the Authority to study and develop a plan to additionally transfer functions relating to behavioral health, maternal health and public health from that Division to the Authority. Sections 26, 34, 141, 144, 145, 147-152, 154-160, 180-187, 197-200, 226-238, 240-244 and 359 of this bill transfer from the Department to the Authority the responsibility for administering; (1) the State Program for Oral Health; (2) provisions governing health information technology; (3) the programs to increase public awareness of health care information concerning hospitals and surgical centers for ambulatory patients in this State; (4) provisions governing the reporting of information relating to the cost of certain prescription drugs and certain information concerning pharmacies; (5) the Nevada Health Facilities Assistance Act, which establishes a program to construct new health facilities in this State; and (6) certain requirements to ensure the quality of care offered by hospitals in this State and the financial stability of such hospitals. Section 197 additionally authorizes the Authority to require the reporting of information concerning the cost of certain additional prescription drugs for which reporting is not currently required. Existing law: (1) creates the Patient Protection Commission within the Office of the Director of the Department; and (2) requires the Commission to perform certain duties to improve the quality, accessibility and affordability of health care in this State. (NRS 439.908, 439.918) Sections 26, 34, 172 and 173 of this bill transfer the Commission to the Consumer Health Division. Sections 172 and 173 also transfer from the Governor to the Director of the Authority the responsibility for appointing the members and Executive Director of the Commission. Sections 174 and 175 of this bill require the Commission to make certain recommendations and submit certain reports to the Director of the Authority. Existing law authorizes the Division of Public and Behavioral Health to establish a secure Internet website which makes certain information available for a website client to conduct background investigations of certain persons who are required by law to undergo such an investigation. (NRS 449.942) Sections 175.3 and 175.6 of this bill authorize the Authority to access information on that Internet website without restriction and without becoming a website client. Existing law requires the Department to establish an all-payer claims database of information relating to health insurance claims resulting from medical, dental or pharmacy benefits provided in this State. (NRS 439B.835) Section 29 creates the Office of Data Analytics within the Authority, and sections 26, 34, 202-204 and 359 of this bill transfer to the Office the responsibility for operating the all-payer claims database. Existing law: (1) requires the Division of Public and Behavioral Health to enforce provisions governing sanitation and food establishments under certain circumstances; and (2) requires each county where the Division provides such enforcement to pay an assessment to the Division. (NRS 439.4905, chapters 444 and 446 of NRS) Sections 26, 34, 206-208 and 210-216 of this bill transfer to the Authority the authority to enforce provisions governing sanitation and food establishments, and sections 30 and 153 of this bill require counties who currently pay to the Division an assessment for those functions to instead pay the assessment to the Authority. Existing law requires the State Board of Health to license and regulate music therapists and dietitians. (Chapters 640D and 640E of NRS) Sections 26, 283-297 and 300-323 of this bill transfer to the Health Care Purchasing and Compliance Division the responsibilities for issuing and renewing licenses to those professionals and enforcing provisions of law and regulations governing those professionals and leave the authority to adopt regulations governing those professions with the State Board. Existing law creates the Silver State Health Insurance Exchange. (NRS 695I.200) Existing law requires the Exchange to: (1) create and administer a state-based health insurance exchange; (2) facilitate the purchase and sale of qualified health plans; (3) provide for the establishment of a program to help certain small employers in Nevada in facilitating the enrollment of employees in qualified health plans; and (4) perform all other duties required pursuant to the federal Patient Protection and Affordable Care Act, the federal Health Care and Education Reconciliation Act of 2010 and any amendments to or regulations or guidance issued pursuant to those Acts. (Pub. L. No. 111-148, Pub. L. No. 111-152; NRS 695I.200, 695I.210) The Exchange is governed by the Board of Directors consisting of five voting members appointed by the Governor, one voting member appointed by the Senate Majority Leader, one voting member appointed by the Speaker of the Assembly and three ex officio, nonvoting members. (NRS 695I.300) Sections 346-348 of this bill place the Exchange under the authority of the Consumer Health Division. Section 348: (1) reduces the number of members of the Board appointed by the Governor from five to two; (2) adds three heads of agencies whose work relates to public health or health insurance as ex officio, voting members of the Board; and (3) reduces the nonvoting membership of the Board. Sections 349 and 350 of this bill make revisions governing the terms of the members and officers of the Board. Section 352 of this bill transfers from the Board to the Director of the Authority or his or her designee the responsibility for appointing the Executive Director of the Exchange. Sections 351 and 352 of this bill transfer certain duties relating to auditing and reports from the Board to the Executive Director. Sections 353 and 354 of this bill transfer certain other duties related to the Exchange to Authority and its Director. Existing law requires the Director of the Department, in consultation with the Commissioner of Insurance and the Executive Director of the Exchange, to design, establish and operate a health benefit plan known as the Public Option. (NRS 695K.200) Section 355 of this bill transfers the responsibility for designing, establishing and operating the Public Option to the Director of the Authority. Section 27 of this bill requires the Director and the Authority to: (1) take certain actions to facilitate determinations of eligibility for and the selection of plans under Medicaid and certain other public health insurance programs under the jurisdiction of the Authority; and (2) assess and recommend improvements to the Public Employees' Benefits Program. Sections 9-13, 38-60, 62, 77, 78, 80, 81, 83, 96-98, 100, 121, 123, 125, 128-139, 142, 161, 178, 179, 188, 189, 195, 196, 205, 209, 248, 249, 251-275, 277-280, 324, 328-336, 338-341 and 356-358 of this bill make various conforming changes to reflect the authority transferred by the provisions of this bill. Sections 32, 34, 38, 46, 99, 122, 127, 239, 287, 307 and 326 of this bill change the name of the Division of Welfare and Supportive Services of the Department to the Division of Social Services of the Department. Sections 33, 37, 82, 119, 120, 123, 124, 126-128 and 368 of this bill revise the terminology to refer to certain programs operated by that Division from “welfare” to “public assistance.” Section 132 revises the term “transitional assistance” to “child care assistance” to describe certain assistance provided pursuant to federal Temporary Assistance for Needy Families program. Sections 1, 16, 17, 64, 65, 85, 140, 176, 191, 192, 225, 240, 281, 298, 343 and 344 of this bill define certain terms, and sections 15, 67, 75, 76, 92, 177, 193, 201, 282, 299, 337 and 345 of this bill make conforming changes to indicate the applicability of those definitions. Section 371 eliminates certain definitions that are no longer necessary. Sections 58.5 and 120.5 of this bill authorize the Board of State Prison Commissioners to obtain prescription drugs for the treatment of offenders through collaborative purchasing conducted by the Authority for Medicaid and certain public and nonprofit health plans. Section 361 of this bill transfers to the Authority the duty to carry out any requirements of a bill that is enacted by the Legislature during this session and approved by the Governor to: (1) require the Department of Health and Human Services to operate a program to award money to support projects to address shortages of providers of health care in this State; or (2) impose certain requirements on Medicaid or the Children's Health Insurance Program.

Statutes affected:
As Introduced: 223.610, 223.630, 223.631, 223.633, 223.635, 223.637, 223.639, 223.950, 226.454, 228.410, 228.470, 231.3737, 232.300, 232.310, 232.320, 232.350, 232.355, 232.359, 233B.039, 21.090, 108.850, 108.860, 108.870, 111.689, 111.779, 115.090, 123.259, 132.390, 146.070, 146.080, 147.070, 147.195, 150.230, 159.034, 159.047, 159.113, 159A.047, 159A.113, 200.5093, 217.180, 218E.405, 239.010, 277.0655, 287.012, 287.0402, 287.041, 287.0424, 287.0425, 287.0426, 287.043, 287.0433, 287.04345, 287.048, 287.0485, 293.5768, 293.57682, 333.020, 361.585, 387.1225, 388.1336, 396.908, 422.001, 422.040, 422.041, 422.061, 422.063, 422.065, 422.151, 422.185, 422.205, 422.2354, 422.2356, 422.2357, 422.2364, 422.2366, 422.2368, 422.23685, 422.2369, 422.2372, 422.2374, 422.240, 422.242, 422.260, 422.265, 422.267, 422.270, 422.273, 422.308, 422.309, 422.410, 422A.030, 422A.065, 422A.155, 422A.180, 422A.195, 422A.232, 422A.338, 422A.342, 422A.372, 422A.376, 422A.575, 422A.700, 424.042, 428.090, 428.206, 428.285, 428.295, 432B.220, 439.005, 439.010, 439.015, 439.150, 439.155, 439.160, 439.258, 439.272, 439.279, 439.2791, 439.2792, 439.2793, 439.2794, 439.4905, 439.580, 439.587, 439.588, 439.589, 439.5895, 439.590, 439.591, 439.803, 439.835, 439.840, 439.841, 439.843, 439.845, 439.847, 439.856, 439.873, 439.875, 439.885, 439.908, 439.914, 439.916, 439.918, 439A.010, 439A.100, 439A.102, 439A.220, 439A.230, 439A.240, 439A.250, 439A.260, 439A.270, 439A.280, 439A.290, 439A.300, 439A.310, 439B.010, 439B.110, 439B.410, 439B.618, 439B.630, 439B.650, 439B.680, 439B.695, 439B.800, 439B.835, 439B.870, 439B.875, 441A.220, 444.003, 444.16