Existing law requires a person to obtain the written approval of the: (1) Director of the Department of Health and Human Services before making certain capital expenditures for construction of a new health facility under certain circumstances; or (2) the Chief Medical Officer before operating or undertaking any expenditure for the operation of a new medical helicopter within 150 miles from the base of an existing medical helicopter. (NRS 439A.100, 439A.104) Section 2 of this bill similarly requires a person to obtain the written approval of the Director before closing a hospital in a county whose population is 100,000 or more (currently Clark and Washoe Counties) or converting such a hospital into a different type of health facility. Sections 2 and 7-9 of this bill provide that such approval is a condition to: (1) the issuance or renewal of a license for certain health facilities converted from a hospital; and (2) certain amendments to such a license. Sections 5 and 10 of this bill authorize the Department and the Division of Public and Behavioral Health of the Department to impose certain civil penalties and take certain other disciplinary action against a person who closes a hospital in a county whose population is 100,000 or more or converts a hospital in such a county to a different type of health facility without written approval in violation of section 2. Existing law requires: (1) a hospital to notify the Department of any merger, acquisition or similar transaction involving the hospital; and (2) a physician group practice or a person who owns all or substantially all of a physician group practice to notify the Department of certain similar transactions under certain circumstances. (NRS 439A.126) Section 4 of this bill authorizes the Department to impose an administrative penalty against a hospital that fails to provide timely notice of the information required by existing law. Section 4 also requires the Department to notify the Board of Medical Examiners or the State Board of Osteopathic Medicine, as appropriate, if a physician group practice or a person who owns all or substantially all of a physician group practice fails to provide such timely notice. Upon receiving notice of such failure from the Department, sections 10.7 and 11.5 of this bill require those boards to proceed as if a complaint had been filed. If, after conducting an investigation and a hearing, the Board of Medical Examiners or the State Board of Osteopathic Medicine determines that a physician group practice or a person who owns all or substantially all of a physician group practice has failed to provide timely notice to the Department of a transaction for which notice is required, sections 10.7 and 11.5 authorize the respective board to impose an administrative penalty. Existing law requires each off-campus location of a hospital to obtain and use on all claims for reimbursement or payment a national provider identifier that is distinct from the national provider identifier used by the main campus and any other off-campus location of the hospital. (NRS 449.1818) Section 10.3 of this bill clarifies that the off-campus location: (1) is required to include the national provider identifier on each claim for reimbursement or payment; and (2) may additionally include on such a claim the national provider identifier for the main campus of the hospital. Section 10.3 also requires an independent center for emergency medical care to include its national provider identifier on all claims for reimbursement or payment. Among other sanctions, existing law authorizes the Division of Public and Behavioral Health to impose against a hospital that fails to obtain a national provider identifier for an off-campus location that is distinct from the national provider identifier used by the main campus and any other off-campus location of the hospital an administrative penalty of not more than $5,000 for each day of such failure, together with interest. (NRS 449.163) Section 10.2 of this bill doubles the amount of the administrative penalty that the Division is authorized to impose for such failure. Existing law provides every patient of a medical facility, including a hospital, with the right to receive certain information about the condition and care of the patient and the cost of such care. (NRS 449A.106) If an off-campus location of a hospital provides emergency medical services, section 10.5 of this bill requires the off-campus location to: (1) post conspicuous notice that the off-campus location is an emergency medical facility and will charge patients for an emergency room visit; and (2) provide each patient with certain notice concerning the rights of the patient upon registration. Section 10.5 also requires such an off-campus location to provide each patient with a more detailed notice concerning billing and payment after the patient is found not to have an emergency medical condition or after the emergency medical condition of the patient has been stabilized, as applicable.

Statutes affected:
As Introduced: 439A.126, 439A.310, 449.030, 449.080, 449.087, 449.089, 449.160
Reprint 1: 439A.126, 439A.310, 449.080, 449.087, 449.089, 449.160
Reprint 2: 439A.126, 439A.310, 449.080, 449.087, 449.089, 449.160, 449.163, 449.1818
As Enrolled: 439A.126, 439A.310, 449.080, 449.087, 449.089, 449.160, 449.163, 449.1818
BDR: 439A.126, 439A.310, 449.030, 449.080, 449.087, 449.089, 449.160