AB290
AN ACT relating to insurance; imposing requirements governing prior authorization for medical or dental care; prohibiting an insurer from requiring prior authorization for covered emergency services or denying coverage for covered, medically necessary emergency services; requiring an insurer to publish certain information relating to requests for prior authorization on the Internet; requiring an insurer and the Commissioner of Insurance to compile certain reports; and providing other matters properly relating thereto. Close title AN ACT relating to insurance; imposing requirements governing prior authorization for medical or dental care; prohibiting an insurer from requiring prior authorization for covered emergency services or denying coverage for covered, medically necessary emergency services; requiring an insurer to publish certain information relating to requests for prior authorization on the Internet; requiring an insurer and the Commissioner of Insurance to compile certain reports; and providing other matters properly relating thereto.
Introduction Date
Tuesday, February 25, 2025
Primary Sponsor
?
Public exhibits
5
Support 2 · Opp 0 · Neutral 1
Auditor findings
0
recusal 0 · QPQ 0
AN ACT relating to insurance; imposing requirements governing prior authorization for medical or dental care; prohibitin
Existing law authorizes certain health insurers to require prior authorization before an insured may receive coverage for health and dental care in certain circumstances. If an insurer requires prior authorization, existing law requires the insurer to: (1) file its procedure for obtaining prior authorization with the Commissioner of Insurance for approval; and (2) respond to a request for prior authorization within 20 days after receiving the request. (NRS 687B.225) This bill establishes additional requirements relating to the use of prior authorization for health and dental care by health insurers, including insurance for public employees as well as specific requirements relating to prior authorization under Medicaid and the Children's Health Insurance Program (CHIP). Specifically, sections 19 and 34 of this bill require that a procedure for obtaining prior authorization includes: (1) a list of the items and services for which the insurer requires prior authorization; and (2) the clinical review criteria used by the insurer to evaluate requests for prior authorization. Sections 19 and 34 also require an insurer to publish its procedure for obtaining prior authorization on its Internet website. Sections 19 and 34 prohibit an insurer from denying a claim for payment for medical or dental care because of the failure to obtain prior authorization if the insurer's procedures for obtaining prior authorization in effect on the date that the care was provided did not require
NELIS exhibits (5 on file)
Support (2)
- Sarah Lanford — The Nevada Oncology Society (NOS) and the Association for Clinical Oncology (ASCO) (Testimony)
- Samantha Barnes — Comprehensive Cancer Centers (Testimony)
Neutral (1)
- Adam Plain — Business and Industry Division of Insurance (Testimony)
Bill text + amendments: view on NELIS →