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--- version:As Introduced+++ version:(document, no version)@@ -1,757 +1,453 @@- A.B. 169--- *AB169*--ASSEMBLY BILL NO. 169–ASSEMBLYMEMBER YEAGER--PREFILED JANUARY 31, 2025-____________--Referred to Committee on Commerce and Labor--SUMMARY—Requires that certain health insurance policies and-health plans cover speech-language pathology for-certain purposes. (BDR 57-735)--FISCAL NOTE: Effect on Local Government: May have Fiscal Impact.- Effect on the State: Yes.--CONTAINS UNFUNDED MANDATE (§ 14)-(NOT REQUESTED BY AFFECTED LOCAL GOVERNMENT)--~--EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted.--AN ACT relating to insurance; requiring that certain health-insurance policies and health plans include coverage for-certain forms of speech -language pathology as treatment-for stuttering for persons who are less than 18 years of-age; prohibiting certain limitations on such coverage; and-providing other matters properly relating thereto.-Legislative Counsel’s Digest:- Existing law requires public and private policies of insurance regulated under 1-Nevada law t o include certain coverage. (NRS 287.010, 287.04335, 422.271 72-2-422.272428, 689A.04033 -689A.0465, 689B.0303 -689B.0379, 689C.1652 -3-689C.169, 689C.194 , 689C.1945, 689C.195, 689C.425, 695A.184 -695A.1875, 4-695A.265, 695B.1901 -695B.1948, 695C.050, 695C.1691-695C.176, 695G.162 -5-695G.177) Existing law also requires employers to provide certain benefits for 6-health care to employees, including the coverage required of health insurers, if the 7-employer provides health benefits for its employees. (NRS 608.1555) 8- Sections 2, 4-10, 12 and 14-16 of this bill require that certain public and 9-private policies of health insurance and health plans, including Medicaid, include 10-coverage for habilitative and rehabilitative speech -language pathology as a 11-treatment for stuttering for persons who are less than 18 years of age. Sections 1, 2, 12-4-10, 12 and 14-16 of this bill additionally prohibit an insurer from imposing a 13-maximum annual limit on the coverage, limiting coverage based on the cause of the 14-stuttering or imposing medical management techniques on those benefits . Section 15-13 of this bill makes a conforming change to require the Director of the Department 16-of Health and Human Services to administer the provisions of section 16 in the 17-same manner as other provisions relating to Medicaid. Section 3 of this bill 18-authorizes the Commissioner of Insurance to require that certain policies of health 19-- – 2 –--- *AB169*-insurance issued by a domestic insurer to a person who resides in another state 20-include the coverage required by section 2. Section 11 of this bill authorizes the 21-Commissioner to suspend or revoke the certificate of a health maintenance 22-organization that fails to comply with the requi rements of section 9. The 23-Commissioner would also be authorized to take such action against other health 24-insurers who fail to comply with the requirements of sections 2, 4-8 or 12. 25-(NRS 680A.200) 26--THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN-SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:-- Section 1. NRS 687B.225 is hereby amended to read as 1-follows: 2- 687B.225 1. Except as otherwise provided in NRS 3-689A.0405, 689A.0412, 689A.0413, 689A.0418, 689A.0437, 4-689A.044, 689A.0445, 689A.0459, 689B.031, 689B.0312, 5-689B.0313, 689B.0315, 689B.0317, 689B.0319, 689B.0374, 6-689B.0378, 689C.1665, 689C.1671, 689C.1675, 689C.1676, 7-695A.1843, 695A.1856, 695A.1865, 695A.1874, 695B.1912, 8-695B.1913, 695B.1914, 695B.1919, 695B.19197, 695B.1924, 9-695B.1925, 695B.1942, 695C.1696, 695C.1699, 695C.1713, 10-695C.1735, 695C.1737, 695C.1743, 695C.1745, 695C.1751, 11-695G.170, 695G.1705, 69 5G.171, 695G.1714, 695G.1715, 12-695G.1719 [and] 695G.177, and sections 2, 4, 5, 7, 8, 9 and 12 of 13-this act, any contract for group, blanket or individual health 14-insurance or any contract by a nonprofit hospital, medical or dental 15-service corporation or organization for dental care which provides 16-for payment of a certain part of medical or dental care may require 17-the insured or member to obtain prior authorization for that care 18-from the insurer or organization. The insurer or organization shall: 19- (a) File its procedure for obtaining approv al of care pursuant to 20-this section for approval by the Commissioner; and 21- (b) Unless a shorter time period is prescribed by a specific 22-statute, including, without limitation, NRS 689A.0446, 689B.0361, 23-689C.1688, 695A.1859, 695B.19087, 695C.16932 and 695G. 1703, 24-respond to any request for approval by the insured or member 25-pursuant to this section within 20 days after it receives the request. 26- 2. The procedure for prior authorization may not discriminate 27-among persons licensed to provide the covered care. 28- Sec. 2. Chapter 689A of NRS is hereby amended by adding 29-thereto a new section to read as follows: 30- 1. An insurer that offers or issues a policy of health 31-insurance shall include in the policy coverage for habilitative 32-speech-language pathology and rehabilitative speech-language 33-- – 3 –--- *AB169*-pathology as a treatment for stuttering for insureds who are less 1-than 18 years of age. 2- 2. An insurer shall not: 3- (a) Set a maximum annual limit on the benefits described in 4-subsection 1, including, without limitation, a limit on the number 5-of annual visits to a speech-language pathologist; 6- (b) Limit the benefits described in subsection 1 based on the 7-cause of the stuttering; or 8- (c) Subject the benefits described in subsection 1 to medi cal 9-management techniques. 10- 3. A policy of health insurance subject to the provisions of 11-this chapter that is delivered, issued for delivery or renewed on or 12-after January 1, 2026, has the legal effect of including the 13-coverage required by subsection 1, a nd any provision of the policy 14-that conflicts with the provisions of this section is void. 15- 4. As used in this section: 16- (a) “Habilitative speech-language pathology ” means services 17-that constitute the practice of speech-language pathology which 18-help a per son keep, learn or improve skills and functioning for 19-daily living. 20- (b) “Medical management technique” means a practice which 21-is used to control the cost or use of health care services or 22-prescription drugs. The term includes, without limitation, the use 23-of step therapy, prior authorization and categorizing drugs and 24-devices based on cost, type or method of administration. 25- (c) “Practice of speech -language pathology” has the meaning 26-ascribed to it in NRS 637B.060. 27- (d) “Rehabilitative speech-language patho logy” means 28-services that constitute the practice of speech-language pathology 29-which help a person restore or improve skills and functioning for 30-daily living that have been lost or impaired. 31- Sec. 3. NRS 689A.330 is hereby amended to read as follows: 32- 689A.330 If any policy is issued by a domestic insurer for 33-delivery to a person residing in another state, and if the insurance 34-commissioner or corresponding public officer of that other state has 35-informed the Commissioner that the policy is not subject to approval 36-or disapproval by that officer, the Commissioner may by ruling 37-require that the policy meet the standards set forth in NRS 689A.030 38-to 689A.320, inclusive [.] , and section 2 of this act. 39- Sec. 4. Chapter 689B of NRS is hereby amended by adding 40-thereto a new section to read as follows: 41- 1. An insurer that offers or issues a policy of group health 42-insurance shall include in the policy coverage for habilitative 43-speech-language pathology and rehabilitative speech -language 44-- – 4 –--- *AB169*-pathology as a treatment for stuttering for insureds who are less 1-than 18 years of age. 2- 2. An insurer shall not: 3- (a) Set a maximum annual limit on the benefits described in 4-subsection 1, including, without limitation, a limit on the number 5-of annual visits to a speech-language pathologist; 6- (b) Limit the benefits described in subsection 1 based on the 7-cause of the stuttering; or 8- (c) Subject the benefits described in subsection 1 to medical 9-management techniques. 10- 3. A policy of group health insurance subject to the 11-provisions of this chapter that is delivered, is sued for delivery or 12-renewed on or after January 1, 2026, has the legal effect of 13-including the coverage required by subsection 1, and any 14-provision of the policy that conflicts with the provisions of this 15-section is void. 16- 4. As used in this section: 17- (a) “Habilitative speech -language pathology ” means services 18-that constitute the practice of speech-language pathology which 19-help a person keep, learn or improve skills and functioning for 20-daily living. 21- (b) “Medical management technique” means a practice which 22-is used to control the cost or use of health care services or 23-prescription drugs. The term includes, without limitation, the use 24-of step therapy, prior authorization and categorizing drugs and 25-devices based on cost, type or method of administration. 26- (c) “Practice of speech -language pathology” has the meaning 27-ascribed to it in NRS 637B.060. 28- (d) “Rehabilitative speech-language pathology ” means 29-services that constitute the practice of speech-language pathology 30-which help a person restore or improve ski lls and functioning for 31-daily living that have been lost or impaired. 32- Sec. 5. Chapter 689C of NRS is hereby amended by adding 33-thereto a new section to read as follows: 34- 1. A carrier that offers or issues a health benefit plan shall 35-include in the plan coverage for habilitative speech-language 36-pathology and rehabilitative speech -language pathology as a 37-treatment for stuttering for insureds who are less than 18 years of 38-age. 39- 2. A carrier shall not: 40- (a) Set a maximum annual limit on the benefits described in 41-subsection 1, including, without limitation, a limit on the number 42-of annual visits to a speech-language pathologist; 43- (b) Limit the benefits described in subsection 1 based on the 44-cause of the stuttering; or 45-- – 5 –--- *AB169*- (c) Subject the benefits described in subsection 1 to medical 1-management techniques. 2- 3. A health benefit plan subject to the provisions of this 3-chapter that is delivered, issued for delivery or renewed on or after 4-January 1, 2026, has the legal effect of including the coverage 5-required by subsection 1, and any provision of the plan that 6-conflicts with the provisions of this section is void. 7- 4. As used in this section: 8- (a) “Habilitative speech-language patholo gy” means services 9-that constitute the practice of speech-language pathology which 10-help a person keep, learn or improve skills and functioning for 11-daily living. 12- (b) “Medical management technique” means a practice which 13-is used to control the cost or use o f health care services or 14-prescription drugs. The term includes, without limitation, the use 15-of step therapy, prior authorization and categorizing drugs and 16-devices based on cost, type or method of administration. 17- (c) “Practice of speech -language pathology” has the meaning 18-ascribed to it in NRS 637B.060. 19- (d) “Rehabilitative speech-language pathology ” means 20-services that constitute the practice of speech-language pathology 21-which help a person restore or improve skills and functioning for 22-daily living that have been lost or impaired. 23- Sec. 6. NRS 689C.425 is hereby amended to read as follows: 24- 689C.425 A voluntary purchasing group and any contract 25-issued to such a group pursuant to NRS 689C.360 to 689C.600, 26-inclusive, are subject to the provisions of NRS 689C.015 to 27-689C.355, inclusive, and section 5 of this act to the extent 28-applicable and not in conflict with the express provisions of NRS 29-687B.408 and 689C.360 to 689C.600, inclusive. 30- Sec. 7. Chapter 695A of NRS is hereby amended by adding 31-thereto a new section to read as follows: 32- 1. A society that offers or issues a benefit contract shall 33-include in the contract coverage for habilitative speech-language 34-pathology and rehabilitative speech -language pathology as a 35-treatment for stuttering for insureds who are less than 18 years of 36-age. 37- 2. A society shall not: 38- (a) Set a maximum annual limit on the benefits described in 39-subsection 1, including, without limitation, a limit on the number 40-of annual visits to a speech-language pathologist; 41- (b) Limit the benefits described in subsection 1 based on the 42-cause of the stuttering; or 43- (c) Subject the benefits described in subsection 1 to medical 44-management techniques. 45-- – 6 –--- *AB169*- 3. A benefit contract subject to the provisions of this chapter 1-that is delivered, issued for delivery or renew ed on or after 2-January 1, 2026, has the legal effect of including the coverage 3-required by subsection 1, and any provision of the contract that 4-conflicts with the provisions of this section is void. 5- 4. As used in this section: 6- (a) “Habilitative speech-language pathology ” means services 7-that constitute the practice of speech-language pathology which 8-help a person keep, learn or improve skills and functioning for 9-daily living. 10- (b) “Medical management technique” means a practice which 11-is used to control th e cost or use of health care services or 12-prescription drugs. The term includes, without limitation, the use 13-of step therapy, prior authorization and categorizing drugs and 14-devices based on cost, type or method of administration. 15- (c) “Practice of speech -language pathology” has the meaning 16-ascribed to it in NRS 637B.060. 17- (d) “Rehabilitative speech-language pathology ” means 18-services that constitute the practice of speech-language pathology 19-which help a person restore or improve skills and functioning for 20-daily living that have been lost or impaired. 21- Sec. 8. Chapter 695B of NRS is hereby amended by adding 22-thereto a new section to read as follows: 23- 1. A hospital or medical services corporation that offers or 24-issues a policy of health insurance shall include in the policy 25-coverage for habilitative speech-language pathology and 26-rehabilitative speech -language pathology as a treatment for 27-stuttering for insureds who are less than 18 years of age. 28- 2. A hospital or medical services corporation shall not: 29- (a) Set a maximum annual limit on the benefits described in 30-subsection 1, including, without limitation, a limit on the number 31-of annual visits to a speech-language pathologist; 32- (b) Limit the benefits described in subsection 1 based on the 33-cause of the stuttering; or 34- (c) Subject the benefits described in subsection 1 to medical 35-management techniques. 36- 3. A policy of health insurance subject to the provisions of 37-this chapter that is delivered, issued for delivery or renewed on or 38-after January 1, 2026, has the legal effect of including the 39-coverage required by subsection 1, and any provision of the policy 40-that conflicts with the provisions of this section is void. 41- 4. As used in this section: 42- (a) “Habilitative speech-language pathology ” means services 43-that constitute the practice of speech -language pathology which 44-- – 7 –--- *AB169*-help a person keep, learn or improve skills and functioning for 1-daily living. 2- (b) “Medical management technique” means a practice which 3-is used to control the cost or use of health care services or 4-prescription drugs. The term includes, without limitation, the use 5-of step therapy, prior authorization and categorizing drugs and 6-devices based on cost, type or method of administration. 7- (c) “Practice of speech -language pathology” has the meaning 8-ascribed to it in NRS 637B.060. 9- (d) “Rehabilitative speech-language pathology ” means 10-services that constitute the practice of speech-language pathology 11-which help a p erson restore or improve skills and functioning for 12-daily living that have been lost or impaired. 13- Sec. 9. Chapter 695C of NRS is hereby amended by adding 14-thereto a new section to read as follows: 15- 1. A health maintenance organization that offers or issues a 16-health care plan shall include in the plan coverage for habilitative 17-speech-language pathology and rehabilitative speech -language 18-pathology as a treatment for stuttering for enrollees who are less 19-than 18 years of age. 20- 2. A health maintenance organization shall not: 21- (a) Set a maximum annual limit on the benefits described in 22-subsection 1, including, without limitation, a limit on the number 23-of annual visits to a speech-language pathologist; 24- (b) Limit the benefits des cribed in subsection 1 based on the 25-cause of the stuttering; or 26- (c) Subject the benefits described in subsection 1 to medical 27-management techniques. 28- 3. A health care plan subject to the provisions of this chapter 29-that is delivered, issued for delivery or renewed on or after 30-January 1, 2026, has the legal effect of including the coverage 31-required by subsection 1, and any provision of the plan that 32-conflicts with the provisions of this section is void. 33- 4. As used in this section: 34- (a) “Habilitative speech-language pathology ” means services 35-that constitute the practice of speech-language pathology which 36-help a person keep, learn or improve skills and functioning for 37-daily living. 38- (b) “Medical management technique” means a practice which 39-is used to control the cost or use of health care services or 40-prescription drugs. The term includes, without limitation, the use 41-of step therapy, prior authorization and categorizing drugs an d 42-devices based on cost, type or method of administration. 43- (c) “Practice of speech -language pathology” has the meaning 44-ascribed to it in NRS 637B.060. 45-- – 8 –--- *AB169*- (d) “Rehabilitative speech-language pathology ” means 1-services that constitute the practice of speech-language pathology 2-which help a person restore or improve skills and functioning for 3-daily living that have been lost or impaired. 4- Sec. 10. NRS 695C.050 is hereby amended to read as follows: 5- 695C.050 1. Except as otherw ise provided in this chapter or 6-in specific provisions of this title, the provisions of this title are not 7-applicable to any health maintenance organization granted a 8-certificate of authority under this chapter. This provision does not 9-apply to an insurer licensed and regulated pursuant to this title 10-except with respect to its activities as a health maintenance 11-organization authorized and regulated pursuant to this chapter. 12- 2. Solicitation of enrollees by a health maintenance 13-organization granted a certificate of authority, or its representatives, 14-must not be construed to violate any provision of law relating to 15-solicitation or advertising by practitioners of a healing art. 16- 3. Any health maintenance organization authorized under this 17-chapter shall not be deemed to be practicing medicine and is exempt 18-from the provisions of chapter 630 of NRS. 19- 4. The provisions of NRS 695C.110, 695C.125, 695C.1691, 20-695C.1693, 695C.170, 695C.1703, 695C.1705, 695C.1709 to 21-695C.173, inclusive, 695C.1733, 695C.17335, 695C.17 34, 22-695C.1751, 695C.1755, 695C.1759, 695C.176 to 695C.200, 23-inclusive, and 695C.265 do not apply to a health maintenance 24-organization that provides health care services through managed 25-care to recipients of Medicaid under the State Plan for Medicaid or 26-insurance pursuant to the Children’s Health Insurance Program 27-pursuant to a contract with the Division of Health Care Financing 28-and Policy of the Department of Health and Human Services. This 29-subsection does not exempt a health maintenance organization from 30-any provision of this chapter for services provided pursuant to any 31-other contract. 32- 5. The provisions of NRS 695C.16932 to 695C.1699, 33-inclusive, 695C.1701, 695C.1708, 695C.1728, 695C.1731, 34-695C.17333, 695C.17345, 695C.17347, 695C.1736 to 695C.1745, 35-inclusive, 695C.1757 and 695C.204 and section 9 of this act apply 36-to a health maintenance organization that provides health care 37-services through managed care to recipients of Medicaid under the 38-State Plan for Medicaid. 39- 6. The provisions of NRS 69 5C.17095 do not apply to a health 40-maintenance organization that provides health care services to 41-members of the Public Employees’ Benefits Program. This 42-subsection does not exempt a health maintenance organization from 43-any provision of this chapter for ser vices provided pursuant to any 44-other contract. 45-- – 9 –--- *AB169*- 7. The provisions of NRS 695C.1735 do not apply to a health 1-maintenance organization that provides health care services to: 2- (a) The officers and employees, and the dependents of officers 3-and employees, of the governing body of any county, school district, 4-municipal corporation, political subdivision, public corporation or 5-other local governmental agency of this State; or 6- (b) Members of the Public Employees’ Benefits Program. 7- This subsection does not exem pt a health maintenance 8-organization from any provision of this chapter for services 9-provided pursuant to any other contract. 10- Sec. 11. NRS 695C.330 is hereby amended to read as follows: 11- 695C.330 1. The Commissioner may s uspend or revoke any 12-certificate of authority issued to a health maintenance organization 13-pursuant to the provisions of this chapter if the Commissioner finds 14-that any of the following conditions exist: 15- (a) The health maintenance organization is operating 16-significantly in contravention of its basic organizational document, 17-its health care plan or in a manner contrary to that described in and 18-reasonably inferred from any other information submitted pursuant 19-to NRS 695C.060, 695C.070 and 695C.140, unless any amendments 20-to those submissions have been filed with and approved by the 21-Commissioner; 22- (b) The health maintenance organization issues evidence of 23-coverage or uses a schedule of charges for health care services 24-which do not comply with the requirements of NRS 695C.1691 to 25-695C.200, inclusive, and section 9 of this act, 695C.204 or 26-695C.207; 27- (c) The health care plan does not furnish comprehensive health 28-care services as provided for in NRS 695C.060; 29- (d) The Commissioner certifies that the health maintenance 30-organization: 31- (1) Does not meet the requirements of subsection 1 of NRS 32-695C.080; or 33- (2) Is unable to fulfill its obligations to furnish health care 34-services as required under its health care plan; 35- (e) The health maintenance organization is no longer financially 36-responsible and may reasonably be expected to be unable to meet its 37-obligations to enrollees or prospective enrollees; 38- (f) The health mainte nance organization has failed to put into 39-effect a mechanism affording the enrollees an opportunity to 40-participate in matters relating to the content of programs pursuant to 41-NRS 695C.110; 42- (g) The health maintenance organization has failed to put into 43-effect the system required by NRS 695C.260 for: 44-- – 10 –--- *AB169*- (1) Resolving complaints in a manner reasonably to dispose 1-of valid complaints; and 2- (2) Conducting external reviews of adverse determinations 3-that comply with the provisions of NRS 695G.241 to 695G.310, 4-inclusive; 5- (h) The health maintenance organization or any person on its 6-behalf has advertised or merchandised its services in an untrue, 7-misrepresentative, misleading, deceptive or unfair manner; 8- (i) The continued operation of the health maintenance 9-organization would be hazardous to its enrollees or creditors or to 10-the general public; 11- (j) The health maintenance organization fails to provide the 12-coverage required by NRS 695C.1691; or 13- (k) The health maintenance organization has otherwise failed to 14-comply substantially with the provisions of this chapter. 15- 2. A certificate of authority must be suspended or revoked only 16-after compliance with the requirements of NRS 695C.340. 17- 3. If the certificate of authority of a health maintenance 18-organization is suspended, the health maintenance organization shall 19-not, during the period of that suspension, enroll any additional 20-groups or new individual contracts, unless those groups or persons 21-were contracted for before the date of suspension. 22- 4. If the certific ate of authority of a health maintenance 23-organization is revoked, the organization shall proceed, immediately 24-following the effective date of the order of revocation, to wind up its 25-affairs and shall conduct no further business except as may be 26-essential to the orderly conclusion of the affairs of the organization. 27-It shall engage in no further advertising or solicitation of any kind. 28-The Commissioner may, by written order, permit such further 29-operation of the organization as the Commissioner may find to be in 30-the best interest of enrollees to the end that enrollees are afforded 31-the greatest practical opportunity to obtain continuing coverage for 32-health care. 33- Sec. 12. Chapter 695G of NRS is hereby amended by adding 34-thereto a new section to read as follows: 35- 1. A managed care organization that offers or issues a health 36-care plan shall include in the plan coverage for habilitative 37-speech-language pathology and rehabilitative speech -language 38-pathology as a treatment for stutteri ng for insureds who are less 39-than 18 years of age. 40- 2. A managed care organization shall not: 41- (a) Set a maximum annual limit on the benefits described in 42-subsection 1, including, without limitation, a limit on the number 43-of annual visits to a speech-language pathologist; 44-- – 11 –--- *AB169*- (b) Limit the benefits described in subsection 1 based on the 1-cause of the stuttering; or 2- (c) Subject the benefits described in subsection 1 to medical 3-management techniques. 4- 3. A health care plan subject to the provisions of this chapter 5-that is delivered, issued for delivery or renewed on or after 6-January 1, 2026, has the legal effect of including the coverage 7-required by subsection 1, and any provision of the plan that 8-conflicts with the provisions of this section is void. 9- 4. As used in this section: 10- (a) “Habilitative speech-language pathology ” means services 11-that constitute the practice of speech-language pathology which 12-help a person keep, learn or improve skills and functioning for 13-daily living. 14- (b) “Medical management technique” means a practice which 15-is used to control the cost or use of health care services or 16-prescription drugs. The term includes, without limitation, the use 17-of step therapy, prior authorization and categorizing drugs and 18-devices based on cost, type or method of administration. 19- (c) “Practice of speech -language pathology” has the meaning 20-ascribed to it in NRS 637B.060. 21- (d) “Rehabilitative speech-language pathology ” means 22-services that constitute the practice of speech language pathology 23-which help a person restore or improve skills and functioning for 24-daily living that have been lost or impaired. 25- Sec. 13. NRS 232.320 is hereby amended to read as follows: 26- 232.320 1. The Director: 27- (a) Shall appoint, with the consent of the Governor, 28-administrators of the divisions of the Department, who are 29-respectively designated as follows: 30- (1) The Administrator of the Aging and Disability Services 31-Division; 32- (2) The Administrator of the Division of Welfare and 33-Supportive Services; 34- (3) The Administrator of the Division of Child and Family 35-Services; 36- (4) The Administrator of the Division of Health Care 37-Financing and Policy; and 38- (5) The Administrator of the Division of Public and 39-Behavioral Health. 40- (b) Shall administer, through the divisions of the Department, 41-the provisions of chapters 63, 424, 425, 427A, 432A to 442, 42-inclusive, 446 to 450, inclusive, 458A and 656A of NRS, NRS 43-127.220 to 127.310, inclusive, 422.001 to 422.410, inclusive, and 44-section 16 of this act, 422.580, 432.010 to 432.133, inclusive, 45-- – 12 –--- *AB169*-432B.6201 to 432B.626, inclusive, 444.002 to 444.430, inclusive, 1-and 445A.010 to 445A.055, inclusive, and all other provisions of 2-law relating to the functions of the divisions of the Department, but 3-is not responsible for the clinical activities of the Division of Public 4-and Behavioral Health or the professional line activities of the other 5-divisions. 6- (c) Shall administer any state program for persons with 7-developmental disabilities established pursuant to the 8-Developmental Disabilities Assistance and Bill of Rights Act of 9-2000, 42 U.S.C. §§ 15001 et seq. 10- (d) Shall, after considering advice from agencies of local 11-governments and nonprofit organizations which provide social 12-services, adopt a master plan for the prov ision of human services in 13-this State. The Director shall revise the plan biennially and deliver a 14-copy of the plan to the Governor and the Legislature at the 15-beginning of each regular session. The plan must: 16- (1) Identify and assess the plans and program s of the 17-Department for the provision of human services, and any 18-duplication of those services by federal, state and local agencies; 19- (2) Set forth priorities for the provision of those services; 20- (3) Provide for communication and the coordination of tho se 21-services among nonprofit organizations, agencies of local 22-government, the State and the Federal Government; 23- (4) Identify the sources of funding for services provided by 24-the Department and the allocation of that funding; 25- (5) Set forth sufficient info rmation to assist the Department 26-in providing those services and in the planning and budgeting for the 27-future provision of those services; and 28- (6) Contain any other information necessary for the 29-Department to communicate effectively with the Federal 30-Government concerning demographic trends, formulas for the 31-distribution of federal money and any need for the modification of 32-programs administered by the Department. 33- (e) May, by regulation, require nonprofit organizations and state 34-and local governmental age ncies to provide information regarding 35-the programs of those organizations and agencies, excluding 36-detailed information relating to their budgets and payrolls, which the 37-Director deems necessary for the performance of the duties imposed 38-upon him or her pursuant to this section. 39- (f) Has such other powers and duties as are provided by law. 40- 2. Notwithstanding any other provision of law, the Director, or 41-the Director’s designee, is responsible for appointing and removing 42-subordinate officers and employees of the Department. 43-- – 13 –--- *AB169*- Sec. 14. NRS 287.010 is hereby amended to read as follows: 1- 287.010 1. The governing body of any county, school 2-district, municipal corporation, political subdivision, public 3-corporation or other local governmental agency of the State of 4-Nevada may: 5- (a) Adopt and carry into effect a system of group life, accident 6-or health insurance, or any combination thereof, for the benefit of its 7-officers and employees, and the dependents of officers and 8-employees w ho elect to accept the insurance and who, where 9-necessary, have authorized the governing body to make deductions 10-from their compensation for the payment of premiums on the 11-insurance. 12- (b) Purchase group policies of life, accident or health insurance, 13-or an y combination thereof, for the benefit of such officers and 14-employees, and the dependents of such officers and employees, as 15-have authorized the purchase, from insurance companies authorized 16-to transact the business of such insurance in the State of Nevada , 17-and, where necessary, deduct from the compensation of officers and 18-employees the premiums upon insurance and pay the deductions 19-upon the premiums. 20- (c) Provide group life, accident or health coverage through a 21-self-insurance reserve fund and, where neces sary, deduct 22-contributions to the maintenance of the fund from the compensation 23-of officers and employees and pay the deductions into the fund. The 24-money accumulated for this purpose through deductions from the 25-compensation of officers and employees and co ntributions of 26-the governing body must be maintained as an internal service fund 27-as defined by NRS 354.543. The money must be deposited in a state 28-or national bank or credit union authorized to transact business in 29-the State of Nevada. Any independent admi nistrator of a fund 30-created under this section is subject to the licensing requirements of 31-chapter 683A of NRS, and must be a resident of this State. Any 32-contract with an independent administrator must be approved by the 33-Commissioner of Insurance as to the reasonableness of 34-administrative charges in relation to contributions collected and 35-benefits provided. The provisions of NRS 439.581 to 439.597, 36-inclusive, 686A.135, 687B.352, 687B.408, 687B.692, 687B.723, 37-687B.725, 687B.805, 689B.030 to 689B.0317, inclusive, paragraphs 38-(b) and (c) of subsection 1 of NRS 689B.0319, subsections 2, 4, 6 39-and 7 of NRS 689B.0319, 689B.033 to 689B.0369, inclusive, and 40-section 4 of this act, 689B.0375 to 689B.050, inclusive, 689B.0675, 41-689B.265, 689B.287 and 689B.500 apply to coverage provided 42-pursuant to this paragraph, except that the provisions of NRS 43-689B.0378, 689B.03785 and 689B.500 only apply to coverage for 44-- – 14 –--- *AB169*-active officers an d employees of the governing body, or the 1-dependents of such officers and employees. 2- (d) Defray part or all of the cost of maintenance of a self -3-insurance fund or of the premiums upon insurance. The money for 4-contributions must be budgeted for in accordan ce with the laws 5-governing the county, school district, municipal corporation, 6-political subdivision, public corporation or other local governmental 7-agency of the State of Nevada. 8- 2. If a school district offers group insurance to its officers and 9-employees pursuant to this section, members of the board of trustees 10-of the school district must not be excluded from participating in the 11-group insurance. If the amount of the deductions from compensation 12-required to pay for the group insurance exceeds the compensation to 13-which a trustee is entitled, the difference must be paid by the trustee. 14- 3. In any county in which a legal services organization exists, 15-the governing body of the county, or of any school district, 16-municipal corporation, political subdivision, public corporation or 17-other local governmental agency of the State of Nevada in the 18-county, may enter into a contract with the legal services 19-organization pursuant to which the officers and employees of the 20-legal services organization, and the dependents of those officers and 21-employees, are eligible for any life, accident or health insurance 22-provided pursuant to this section to the officers and employees, and 23-the dependents of the officers and employees, of the county, school 24-district, municipal corporatio n, political subdivision, public 25-corporation or other local governmental agency. 26- 4. If a contract is entered into pursuant to subsection 3, the 27-officers and employees of the legal services organization: 28- (a) Shall be deemed, solely for the purposes of this section, to be 29-officers and employees of the county, school district, municipal 30-corporation, political subdivision, public corporation or other local 31-governmental agency with which the legal services organization has 32-contracted; and 33- (b) Must be require d by the contract to pay the premiums or 34-contributions for all insurance which they elect to accept or of which 35-they authorize the purchase. 36- 5. A contract that is entered into pursuant to subsection 3: 37- (a) Must be submitted to the Commissioner of Insurance for 38-approval not less than 30 days before the date on which the contract 39-is to become effective. 40- (b) Does not become effective unless approved by the 41-Commissioner. 42- (c) Shall be deemed to be approved if not disapproved by the 43-Commissioner within 30 days after its submission. 44-- – 15 –--- *AB169*- 6. As used in this section, “legal services organization” means 1-an organization that operates a program for legal aid and receives 2-money pursuant to NRS 19.031. 3- Sec. 15. NRS 287.04335 is her eby amended to read as 4-follows: 5- 287.04335 If the Board provides health insurance through a 6-plan of self -insurance, it shall comply with the provisions of NRS 7-439.581 to 439.597, inclusive, 686A.135, 687B.352, 687B.409, 8-687B.692, 687B.723, 687B.725, 687B. 805, 689B.0353, 689B.255, 9-695C.1723, 695G.150, 695G.155, 695G.160, 695G.162, 10-695G.1635, 695G.164, 695G.1645, 695G.1665, 695G.167, 11-695G.1675, 695G.170 to 695G.1712, inclusive, 695G.1714 to 12-695G.174, inclusive, and section 12 of this act, 695G.176, 13-695G.177, 695G.200 to 695G.230, inclusive, 695G.241 to 14-695G.310, inclusive, 695G.405 and 695G.415, in the same manner 15-as an insurer that is licensed pursuant to ti tle 57 of NRS is required 16-to comply with those provisions. 17- Sec. 16. Chapter 422 of NRS is hereby amended by adding 18-thereto a new section to read as follows: 19- 1. To the extent federal financial participation is available, 20-the Director shall include under Medicaid coverage for 21-habilitative speech-language pathology and rehabilitative speech -22-language pathology as a treatment for stuttering for persons who 23-are less than 18 years of age. 24- 2. Except where necessary to obtain federal financial 25-participation, the Department shall not: 26- (a) Set a maximum annual limit on the benefits described in 27-subsection 1, including, without limitation, a limit on the number 28-of annual visits to a speech-language pathologist; 29- (b) Limit the benefits described in subsection 1 based on the 30-cause of the stuttering; or 31- (c) Subject the benefits described in subsection 1 to medical 32-management techniques. 33- 3. The Department shall: 34- (a) Apply to the Secretary of Health and Human Services for 35-any waiver of federal law or apply for any amendment of the State 36-Plan for Medicaid that is necessary for the Department to receive 37-federal funding to provide the coverage described in subsection 1. 38- (b) Fully cooperate in good faith with the Federal Government 39-during the application process to satisfy the requirements of the 40-Federal Government for obtaining a waiver or amendment 41-pursuant to paragraph (a). 42- 4. As used in this section: 43- (a) “Habilitative speech-language pathology ” means services 44-that constitute the practice of speech-language pathology which 45-- – 16 –--- *AB169*-help a person keep, learn or improve skills and functioning for 1-daily living. 2- (b) “Medical management technique” means a practice which 3-is used to c ontrol the cost or use of health care services or 4-prescription drugs. The term includes, without limitation, the use 5-of step therapy, prior authorization and categorizing drugs and 6-devices based on cost, type or method of administration. 7- (c) “Practice of speech-language pathology” has the meaning 8-ascribed to it in NRS 637B.060. 9- (d) “Rehabilitative speech-language pathology ” means 10-services that constitute the practice of speech -language pathology 11-which help a person restore or improve skills and functioning for 12-daily living that have been lost or impaired. 13- Sec. 17. The provisions of NRS 354.599 do not apply to any 14-additional expenses of a local government that are relate d to the 15-provisions of this act. 16- Sec. 18. 1. This section becomes effective upon passage and 17-approval. 18- 2. Sections 1 to 17, inclusive, of this act become effective: 19- (a) Upon passage and approval for the purpose of adopting any 20-regulations and performing any other preparator y administrative 21-tasks that are necessary to carry out the provisions of this act; and 22- (b) On January 1, 2026, for all other purposes. 23--H+ Nevada Speech-Language-Hearing Association (NSHA) PO BOX 40126 Reno, NV 89504 775-870-3680 katie@summitvoiceandswallowing.com February 27, 2025 The Honorable Elaine Marzola, Chair Committee on Commerce and Labor State Capitol 401 S Carson St, #4108 Carson City, NV 89701 Subject: Support for AB169 – Enhancing Access to Speech-Language Pathology Services in+Nevada+ Dear Chair Marzola and Members of the Committee, On behalf of the Nevada Speech-Language Hearing Association (NSHA), we write to express+our++strong++support++for++Assembly++Bill++169,++a++critical++piece++of++legislation++aimed++at++improving++access++to++speech-language++pathology++services++across++Nevada.++As++professionals++dedicated++to++serving++individuals++with++communication++disorders,++which++includes++the++diagnosis++of++stuttering,++we++recognize++the++need++for++legislative++action++to++ensure++quality++care++for++all++Nevadans++who++stutter.+ AB169 is a vital step toward removing insurance barriers to cover adequate services those who+stutter.++It++is++reported++by++NSHA++members++that++while++insurance++companies++include++benefits++for++stuttering,++some++companies++are++known++to++also++deny++authorization++for++additional++sessions++if++needed++in++the++treatment++plan.++This++bill++would++enhance++the++ability++of++speech-language++pathologists++(SLPs)++to++provide++effective++interventions++to++the++level++needed++for++those++who++stutter.+ While AB169 is an important step forward, we strongly urge that it be expanded to encompass+individuals++of++all++ages,++rather++than++limiting++its++focus++to++specific++age++groups.++Stuttering++is++not++a++condition++that++is++confined++to++childhood;++it++affects++individuals++across++their++lifespan.++Adults++who++stutter++face++unique++challenges,++including++barriers++to++employment,++social++integration,++and++mental++health.++Without++adequate++support++and++services,++these++challenges++can++lead++to++long-term++struggles++with++self-esteem++and++overall++well-being.++AB169++will++help++ensure++that++individuals++who++stutter++receive++the++support++they++need++through++evidence-based++therapies,++increasing++their++confidence++and++ability++to++participate++fully++in++society.+ We urge you and your colleagues to vote in favor of AB169 and support policies that strengthen+the++speech-language++pathology++profession++while++improving++access++to++services++for++Nevadans.++The++Nevada++Speech-Language++Hearing++Association++appreciates++your++leadership++and++commitment++to++the++well-being++of++our++communities.++Please do not hesitate to contact us should you require additional information or wish to discuss+this++matter++further.+ Thank you for your time and consideration. Sincerely,+ Katie Allen, PhD, CCC-SLP President Nevada Speech-Language-Hearing Association (NSHA) PO BOX 40126 Reno, NV 89504 775-870-3680 katie@summitvoiceandswallowing.com
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