AB511 - Revises provisions relating to insurance. (BDR 57-697)

- 83rd Session (2025) Assembly Bill No. 511–Committee on Commerce and Labor CHAPTER.......... AN ACT relating to insurance; revising provisions relating to reimbursement for certain treatment and services provided by certain providers of health care; and providing other matters properly relating thereto. Legislative Counsel’s Digest: Existing law entitles an insured to reimbursement for treatment by a chiropractic physician if a policy of individual health insurance, policy of group health insurance, nonprofit corporation contract for hospital, medical and dental services or evidence of coverage of a health maintenance organization provides coverage for treatment of an illness which is within the authorized scope of practice of a qualified chiropractic physician. Existing law also contains similar provisions applicable to: (1) a person who performs acupuncture; (2) a licensed psychologist; (3) a licensed marriage and family therapist or licensed clinical professional counselor; (4) a licensed associate in social work, social worker, master social worker, independent social worker or clinical social worker; (5) a licensed podiatrist; (6) a licensed clinical drug and alcohol counselor; and (7) certain registered nurses under certain circumstances. (NRS 608.1575, 689A.0475- 689A.0495, 689B.038-689B.0397, 689B.045, 689B.049, 695B.1951-695B.199, 695C.1765-695C.179) Sections 1-16, 17-24 and 25-33 of this bill revise those provisions to entitle the insured or the provider who provided treatment to the insured, as applicable, to reimbursement for the treatment provided. Existing law authorizes a person insured under a policy of individual health insurance or policy of group or blanket health insurance to assign his or her right to benefits, under certain circumstances, to the provider of health care who provided the services covered by the policy. (NRS 689A.135, 689B.040, 689B.100) Sections 16.5 and 24.5 of this bill similarly authorize a person insured under a contract for hospital, medical or dental services issued by a nonprofit hospital, medical or dental services corporation or a health care plan issued by a health maintenance organization to make such an assignment. EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted. THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS: Section 1. NRS 689A.0475 is hereby amended to read as follows: 689A.0475 If any policy of health insurance provides coverage for acupuncture performed by a physician, the insured [is entitled to reimbursement for acupuncture performed by] or a person who is licensed pursuant to chapter 634A of NRS [.] and performs acupuncture on the insured, as applicable, is entitled to reimbursement for the acupuncture performed. – 2 – - 83rd Session (2025) Sec. 2. NRS 689A.048 is hereby amended to read as follows: 689A.048 If any policy of health insurance provides coverage for treatment [of an illness] which is within the authorized scope of the practice of a qualified psychologist, the insured [is entitled to reimbursement for treatments by] or a licensed psychologist [.] who provides such treatment to the insured, as applicable, is entitled to reimbursement for the treatment provided. Sec. 3. NRS 689A.0483 is hereby amended to read as follows: 689A.0483 If any policy of health insurance provides coverage for treatment [of an illness] which is within the authorized scope of practice of a licensed marriage and family therapist or licensed clinical professional counselor, the insured [is entitled to reimbursement for treatment by] or a marriage and family therapist or clinical professional counselor who is licensed pursuant to chapter 641A of NRS [.] and who provides such treatment to the insured, as applicable, is entitled to reimbursement for the treatment provided. Sec. 4. NRS 689A.0485 is hereby amended to read as follows: 689A.0485 If any policy of health insurance provides coverage for treatment [of an illness] which is within the authorized scope of the practice of a licensed associate in social work, a social worker, a master social worker, an independent social worker or a clinical social worker, the insured [is entitled to reimbursement for treatment by] or an associate in social work, a social worker, a master social worker, an independent social worker or a clinical social worker who is licensed pursuant to chapter 641B of NRS [.] and who provides such treatment to the insured, as applicable, is entitled to reimbursement for the treatment provided. Sec. 5. NRS 689A.0487 is hereby amended to read as follows: 689A.0487 1. If any policy of health insurance provides coverage for treatment [of an illness] which is within the authorized scope of practice of a qualified podiatrist, the insured [is entitled to reimbursement for treatments by] or a podiatrist who is licensed pursuant to chapter 635 of NRS [.] and who provides such treatment to the insured, as applicable, is entitled to reimbursement for the treatment provided. 2. The terms of the policy must not limit: (a) Coverage for treatments by a podiatrist to a number less than for treatments by other physicians. (b) Reimbursement for treatments by a podiatrist to an amount less than that reimbursed for similar treatments by other physicians. – 3 – - 83rd Session (2025) Sec. 6. NRS 689A.049 is hereby amended to read as follows: 689A.049 1. If any policy of health insurance provides coverage for treatment [of an illness] which is within the authorized scope of practice of a qualified chiropractic physician, the insured [is entitled to reimbursement for treatments by] or a chiropractic physician who is licensed pursuant to chapter 634 of NRS [.] and who provides such treatment to the insured, as applicable, is entitled to reimbursement for the treatment provided. 2. The terms of the policy must not limit: (a) Coverage for treatments by a chiropractic physician to a number less than for treatments by other physicians. (b) Reimbursement for treatments by a chiropractic physician to an amount less than that reimbursed for similar treatments by other physicians. Sec. 7. NRS 689A.0493 is hereby amended to read as follows: 689A.0493 If any policy of health insurance provides coverage for treatment [of an illness] which is within the authorized scope of practice of a licensed clinical alcohol and drug counselor, the insured [is entitled to reimbursement for treatment by] or a clinical alcohol and drug counselor who is licensed pursuant to chapter 641C of NRS [unless] and who provides such treatment to the insured, as applicable, is entitled to reimbursement for the treatment provided, including, without limitation, if the clinical alcohol and drug counselor must be directly reimbursed pursuant to: 1. An assignment of benefits described in NRS 687B.409; or 2. Any other applicable assignment of benefits. Sec. 8. NRS 689A.0495 is hereby amended to read as follows: 689A.0495 1. If any policy of health insurance provides coverage for services which are within the authorized scope of practice of a registered nurse who is authorized pursuant to chapter 632 of NRS to perform additional acts in an emergency or under other special conditions as prescribed by the State Board of Nursing, and which are reimbursed when provided by another provider of health care, the insured [is entitled to reimbursement for services provided by such] or a registered nurse [.] who provides such services to the insured, as applicable, is entitled to reimbursement for the services provided. 2. The terms of the policy must not limit: (a) Coverage for services provided by such a registered nurse to a number of occasions less than for services provided by another provider of health care. – 4 – - 83rd Session (2025) (b) Reimbursement for services provided by such a registered nurse to an amount less than that reimbursed for similar services provided by another provider of health care. 3. An insurer is not required to pay for services provided by such a registered nurse which duplicate services provided by another provider of health care. Sec. 9. NRS 689B.038 is hereby amended to read as follows: 689B.038 If any policy of group health insurance provides coverage for treatment [of an illness] which is within the authorized scope of the practice of a qualified psychologist, the insured [is entitled to reimbursement for treatment by] or a licensed psychologist [.] who provides such treatment to the insured, as applicable, is entitled to reimbursement for the treatment provided. Sec. 10. NRS 689B.0383 is hereby amended to read as follows: 689B.0383 If any policy of group health insurance provides coverage for treatment [of an illness] which is within the authorized scope of practice of a licensed marriage and family therapist or licensed clinical professional counselor, the insured [is entitled to reimbursement for treatment by] or a marriage and family therapist or clinical professional counselor who is licensed pursuant to chapter 641A of NRS [.] and who provides such treatment to the insured, as applicable, is entitled to reimbursement for the treatment provided. Sec. 11. NRS 689B.0385 is hereby amended to read as follows: 689B.0385 If any policy of group health insurance provides coverage for treatment [of an illness] which is within the authorized scope of the practice of a licensed associate in social work, a social worker, a master social worker, an independent social worker or a clinical social worker, the insured [is entitled to reimbursement for treatment by an associate in social work,] or a social worker, a master social worker, an independent social worker or a clinical social worker who is licensed pursuant to chapter 641B of NRS [.] and who provides such treatment to the insured, as applicable, is entitled to reimbursement for the treatment provided. Sec. 12. NRS 689B.039 is hereby amended to read as follows: 689B.039 1. If any group policy of health insurance provides coverage for treatment [of an illness] which is within the authorized scope of practice of a qualified chiropractic physician, the insured [is entitled to reimbursement for treatments by] or a chiropractic physician who is licensed pursuant to chapter 634 of NRS [.] and – 5 – - 83rd Session (2025) who provides such treatment to the insured, as applicable, is entitled to reimbursement for the treatment provided. 2. The terms of the policy must not limit: (a) Coverage for treatments by a chiropractic physician to a number less than for treatments by other physicians. (b) Reimbursement for treatments by a chiropractic physician to an amount less than that charged for similar treatments by other physicians. Sec. 13. NRS 689B.0393 is hereby amended to read as follows: 689B.0393 1. If any group policy of health insurance provides coverage for treatment [of an illness] which is within the authorized scope of practice of a qualified podiatrist, the insured [is entitled to reimbursement for treatments by] or a podiatrist who is licensed pursuant to chapter 635 of NRS [.] and who provides such treatment to the insured, as applicable, is entitled to reimbursement for the treatment provided. 2. The terms of the policy must not limit: (a) Coverage for treatments by a podiatrist to a number less than for treatments by other physicians. (b) Reimbursement for treatments by a podiatrist to an amount less than that reimbursed for similar treatments by other physicians. Sec. 14. NRS 689B.0397 is hereby amended to read as follows: 689B.0397 If any policy of group health insurance provides coverage for treatment [of an illness] which is within the authorized scope of practice of a licensed clinical alcohol and drug counselor, the insured [is entitled to reimbursement for treatment by] or a clinical alcohol and drug counselor who is licensed pursuant to chapter 641C of NRS [unless] and who provides such treatment to the insured, as applicable, is entitled to reimbursement for the treatment provided, including, without limitation, if the clinical alcohol and drug counselor must be directly reimbursed pursuant to: 1. An assignment of benefits described in NRS 687B.409; or 2. Any other applicable assignment of benefits. Sec. 15. NRS 689B.045 is hereby amended to read as follows: 689B.045 1. If any group policy of health insurance provides coverage for services which are within the authorized scope of practice of a registered nurse who is authorized pursuant to chapter 632 of NRS to perform additional acts in an emergency or under other special conditions as prescribed by the State Board of Nursing, and which are reimbursed when provided by another provider of health care, the insured [is entitled to reimbursement for services – 6 – - 83rd Session (2025) provided by such] or a registered nurse [.] who provides such services to the insured, as applicable, is entitled to reimbursement for the services provided. 2. The terms of the policy must not limit: (a) Coverage for services provided by such a registered nurse to a number of occasions less than for services provided by another provider of health care. (b) Reimbursement for services provided by such a registered nurse to an amount less than that reimbursed for similar services provided by another provider of health care. 3. An insurer is not required to pay for services provided by such a registered nurse which duplicate services provided by another provider of health care. Sec. 16. NRS 689B.049 is hereby amended to read as follows: 689B.049 If any policy of group health insurance provides coverage for acupuncture performed by a physician, the insured [is entitled to reimbursement for acupuncture performed by] or a person who is licensed pursuant to chapter 634A of NRS [.] and performs acupuncture on the insured, as applicable, is entitled to reimbursement for the acupuncture performed. Sec. 16.5. Chapter 695B of NRS is hereby amended by adding thereto a new section to read as follows: 1. A person insured under a contract for hospital, medical or dental services may assign his or her right to benefits to the provider of health care who provided the services covered by the contract. The nonprofit hospital, medical or dental service corporation shall pay all the benefits or the part of the benefits assigned by the insured to the person designated by the insured. A payment made pursuant to this subsection discharges the obligation of the corporation to pay those benefits. [Text truncated for display. Full text available on LegiScan.]