AB482 - Revises provisions relating to Medicaid. (BDR 38-809)

A.B. 482 - *AB482* ASSEMBLY BILL NO. 482–COMMITTEE ON HEALTH AND HUMAN SERVICES MARCH 24, 2025 ____________ Referred to Committee on Health and Human Services SUMMARY—Revises provisions relating to Medicaid. (BDR 38-809) FISCAL NOTE: Effect on Local Government: No. Effect on the State: Yes. ~ EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted. AN ACT relating to Medicaid; requiring the State Plan for Medicaid to provide coverage for certain services relating to family planning and language translation; and providing other matters properly relating thereto. Legislative Counsel’s Digest: Existing law requires the Director of the Department of Health and Human 1 Services to develop, and the Department to administer, a State Plan for Medicaid, 2 which includes coverage for certain contraceptive drugs and devices, including: (1) 3 up to a 12-month supply of contraceptive drugs; (2) certain devices for 4 contraception; and (3) voluntary sterilization for women. (NRS 422.063, 422.270, 5 422.27172) This bill additionally requires the State Plan for Medicaid to cover: (1) 6 voluntary sterilization for men; (2) clinical services relating to covered 7 contraceptive drugs, devices and services; and (3) the cost of language translation 8 services provided to facilitate the provision of covered contraceptive drugs, devices 9 and services. This bill further requires the Division of Health Care Financing and 10 Policy of the Department of Health and Human Services to develop a methodology 11 establishing a rate of compensation for such translation services that is cost 12 effective and comparable to the rate paid for translation services by other 13 governmental entities that arrange for the provision of such services. This bill also 14 requires the State Plan to cover certain contraceptive services when provided by 15 any provider of health care for whom the services are within his or her scope of 16 practice, training and experience, regardless of whether the services are provided in 17 an inpatient or outpatient setting. 18 – 2 – - *AB482* THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS: Section 1. NRS 422.27172 is hereby amended to read as 1 follows: 2 422.27172 1. The Director shall include in the State Plan for 3 Medicaid a requirement that the State pay the nonfederal share of 4 expenditures incurred for: 5 (a) Up to a 12-month supply, per prescription, of any type of 6 drug for contraception or its therapeutic equivalent which is: 7 (1) Lawfully prescribed or ordered; 8 (2) Approved by the Food and Drug Administration; and 9 (3) Dispensed in accordance with NRS 639.28075; 10 (b) Any type of device for contraception which is lawfully 11 prescribed or ordered and which has been approved by the Food and 12 Drug Administration; 13 (c) Self-administered hormonal contraceptives dispensed by a 14 pharmacist pursuant to NRS 639.28078; 15 (d) Insertion or removal of a device for contraception, including, 16 without limitation, the insertion of such a device at a hospital 17 immediately after a person gives birth; 18 (e) A contraceptive injection, including, without limitation, such 19 an injection immediately after a person gives birth. 20 (f) Education and counseling relating to the initiation of the use 21 of contraceptives and any necessary follow-up after initiating such 22 use; 23 (g) Management of side effects relating to contraception; [and] 24 (h) Voluntary sterilization [for women.] ; and 25 (i) Any clinical services relating to the drugs, devices and 26 services described in paragraphs (a) to (h), inclusive. Such clinical 27 services include, without limitation, services to monitor the use 28 and effectiveness of contraception. 29 2. Except as otherwise provided in subsections 4 and 5, to 30 obtain any benefit provided in the Plan pursuant to subsection 1, a 31 person enrolled in Medicaid must not be required to: 32 (a) Pay a higher deductible, any copayment or coinsurance; or 33 (b) Be subject to a longer waiting period or any other condition. 34 3. The Director shall ensure that the provisions of this section 35 are carried out in a manner which complies with the requirements 36 established by the Drug Use Review Board and set forth in the list 37 of preferred prescription drugs established by the Department 38 pursuant to NRS 422.4025. 39 4. The Plan may require a person enrolled in Medicaid to pay a 40 higher deductible, copayment or coinsurance for a drug for 41 – 3 – - *AB482* contraception if the person refuses to accept a therapeutic equivalent 1 of the contraceptive drug. 2 5. For each method of contraception which is approved by the 3 Food and Drug Administration, the Plan must include at least one 4 contraceptive drug or device for which no deductible, copayment or 5 coinsurance may be charged to the person enrolled in Medicaid, but 6 the Plan may charge a deductible, copayment or coinsurance for any 7 other contraceptive drug or device that provides the same method of 8 contraception. If the Plan requires a person enrolled in Medicaid to 9 pay a copayment or coinsurance for a drug for contraception, the 10 Plan may only require the person to pay the copayment or 11 coinsurance: 12 (a) Once for the entire amount of the drug dispensed for the plan 13 year; or 14 (b) Once for each 1-month supply of the drug dispensed. 15 6. The Plan must [provide] : 16 (a) Provide for the reimbursement of a pharmacist for providing 17 services described in subsection 1 that are within the scope of 18 practice of the pharmacist to the same extent as if the services were 19 provided by another provider of health care. The Plan must not 20 limit: 21 [(a)] (1) Coverage for such services provided by a pharmacist to 22 a number of occasions less than the coverage for such services when 23 provided by another provider of health care. 24 [(b)] (2) Reimbursement for such services provided by a 25 pharmacist to an amount less than the amount reimbursed for similar 26 services provided by a physician, physician assistant or advanced 27 practice registered nurse. 28 (b) Provide for the reimbursement of a provider of health care 29 for providing services described in subsection 1 if the services are 30 within the scope of practice, training and experience of the 31 provider of health care. 32 (c) Provide coverage for the services described in subsection 1 33 regardless of whether those services are provided in an inpatient 34 or outpatient setting. 35 7. The Plan must not require a recipient of Medicaid to obtain 36 prior authorization for the benefits described in paragraphs (a) and 37 (c) of subsection 1. 38 8. The Director shall include in the State Plan for Medicaid a 39 requirement that the State pay the nonfederal share of 40 expenditures incurred for the costs of any language translation 41 services provided to facilitate the provision of any drugs, devices 42 or services described in subsection 1. The Division shall develop a 43 methodology establishing a rate of compensation for such 44 translation services that is cost effective and comparable to the 45 – 4 – - *AB482* rate paid for translation services by other governmental entities 1 that arrange for the provision of such services. 2 9. As used in this section: 3 (a) “Drug Use Review Board” has the meaning ascribed to it in 4 NRS 422.402. 5 (b) “Provider of health care” has the meaning ascribed to it in 6 NRS 629.031. 7 (c) “Therapeutic equivalent” means a drug which: 8 (1) Contains an identical amount of the same active 9 ingredients in the same dosage and method of administration as 10 another drug; 11 (2) Is expected to have the same clinical effect when 12 administered to a patient pursuant to a prescription or order as 13 another drug; and 14 (3) Meets any other criteria required by the Food and Drug 15 Administration for classification as a therapeutic equivalent. 16 Sec. 2. 1. This section becomes effective upon passage and 17 approval. 18 2. Section 1 of this act becomes effective: 19 (a) Upon passage and approval for the purpose of adopting any 20 regulations and performing any other preparatory 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