SB262 - Revises provisions relating to graduate medical education. (BDR 18-120)

- 83rd Session (2025) Senate Bill No. 262–Senators Pazina, Dondero Loop, Cannizzaro, Doñate, Nguyen; Cruz-Crawford, Daly, Flores, Lange, Neal, Ohrenschall, Scheible and Taylor Joint Sponsors: Assemblymembers Marzola, Monroe-Moreno, Brown-May, Considine, Watts; Anderson, Backus, Dalia, D’Silva, Edgeworth, Flanagan, González, Goulding, Hunt, Jackson, Jauregui, Karris, La Rue Hatch, Moore, Mosca, Nadeem, Nguyen, Orentlicher, Roth, Torres-Fossett and Yeager CHAPTER.......... AN ACT relating to health care; prohibiting certain institutions from eliminating or reducing the size of a program for residency training and postdoctoral fellowships without the approval of the Department of Health and Human Services; transferring the administration of the Graduate Medical Education Grant Program and the Account for the Program from the Office of Science, Innovation and Technology in the Office of the Governor to the Department; expanding the purposes for which institutions that provide programs for residency training and postdoctoral fellowships in this State may receive grants under the Program; establishing the criteria for prioritizing the awarding of such grants; requiring the Department to explore ways to use federal financial participation in Medicaid to support graduate medical education; making an appropriation to the Account for the Program; and providing other matters properly relating thereto. Legislative Counsel’s Digest: Existing law establishes the Office of Science, Innovation and Technology in the Office of the Governor and requires the Director of the Office to implement the Graduate Medical Education Grant Program. (NRS 223.600, 223.610) Existing law: (1) requires the Office to establish and administer the Program to award grants to institutions in this State seeking to create, expand or retain programs for residency training and postdoctoral fellowships for physicians; (2) creates the Account for the Graduate Medical Education Grant Program, administered by the Director; and (3) creates the Advisory Council on Graduate Medical Education to evaluate applications and make recommendations for such grants. (NRS 223.631-223.639) Sections 3-7 of this bill transfer the Advisory Council and the duties to administer the Program and the Account from the Office to the Department of Health and Human Services. Sections 1.5 and 2 of this bill make conforming changes to remove the Program and the Advisory Council from the duties required to be performed by the Director. Section 1 of this bill prohibits an institution that receives a grant through the Program from eliminating or reducing the size of a program for residency training and postdoctoral fellowships without the approval of the Department. Sections 3 and 6 expand the grants that may be made from the – 2 – - 83rd Session (2025) Account under the Program to include grants to institutions which operate programs for residency training that are training a number of residents that exceeds the number of full-time equivalent residents for which the institution receives certain payments from Medicare. Section 6 authorizes the Department to award limited grants to assist in building administrative and operational capacity for a new program for residency training and postdoctoral fellowships and recruiting personnel essential to the operation of such a program. Section 6 also establishes the criteria for prioritizing the awarding of grants. Section 7.7 of this bill requires the Department, in collaboration with the Advisory Council, to explore ways to use federal financial participation in Medicaid to support programs for residency training and postdoctoral fellowships. Section 7.3 makes a conforming change to require the Director of the Department to administer section 7.7 in the same manner as other provisions governing Medicaid. Section 8 of this bill makes an appropriation to the Account for the Program. 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. Chapter 223 of NRS is hereby amended by adding thereto a new section to read as follows: 1. An institution that receives a grant through the Graduate Medical Education Grant Program established pursuant to NRS 223.637 shall not eliminate or reduce the size of a program for residency training and postdoctoral fellowships operated by the institution without the approval of the Department of Health and Human Services. 2. To obtain the approval of the Department of Health and Human Services for the elimination or reduction of the size of a program for residency training and postdoctoral fellowships pursuant to subsection 1, an institution must apply to the Department in the form prescribed by the Department. The application must include, without limitation: (a) An analysis of the current and projected needs of patients in the geographic area served by the program, including, without limitation, the need for physicians who practice in any specialty in which the program provides residency training; (b) A detailed explanation of the reasons for the proposed elimination or reduction and justification of the elimination or reduction; and (c) A description of efforts to mitigate the impact of the elimination or reduction, which may include, without limitation, transferring resources to areas of higher need. 3. The Department of Health and Human Services shall not approve an application to eliminate or reduce the size of a – 3 – - 83rd Session (2025) program for residency training and postdoctoral fellowships submitted pursuant to subsection 2 unless the application demonstrates that the elimination or reduction: (a) Is justified by a decrease in the needs of patients in the geographic area served by the program, including, without limitation, the need for physicians who practice in any specialty in which the program provides residency training; and (b) Is not likely to negatively impact the overall availability of providers of health care in this State. 4. If an institution violates subsection 1, the Department of Health and Human Services may: (a) Suspend or revoke the grant awarded to the institution through the Graduate Medical Education Grant Program; or (b) Disqualify the institution from receiving future grants through the Graduate Medical Education Grant Program. Sec. 1.5. NRS 223.610 is hereby amended to read as follows: 223.610 The Director of the Office of Science, Innovation and Technology shall: 1. Advise the Governor and the Executive Director of the Office of Economic Development on matters relating to science, innovation and technology. 2. Work in coordination with the Office of Economic Development to establish criteria and goals for economic development and diversification in this State in the areas of science, innovation and technology. 3. As directed by the Governor, identify, recommend and carry out policies related to science, innovation and technology. 4. Report periodically to the Executive Director of the Office of Economic Development concerning the administration of the policies and programs of the Office of Science, Innovation and Technology. 5. Coordinate activities in this State relating to the planning, mapping and procurement of broadband service in a competitively neutral and nondiscriminatory manner, which must include, without limitation: (a) Development of a strategic plan to improve the delivery of broadband services in this State to schools, libraries, providers of health care, transportation facilities, prisons and other community facilities; (b) Applying for state and federal grants on behalf of eligible entities and managing state matching money that has been appropriated by the Legislature; – 4 – - 83rd Session (2025) (c) Coordinating and processing applications for state and federal money relating to broadband services; (d) Prioritizing construction projects which affect or involve the expansion or deployment of broadband services in this State; (e) In consultation with providers of health care from various health care settings, the expansion of telehealth services to reduce health care costs and increase health care quality and access in this State, especially in rural, unserved and underserved areas of this State; (f) Expansion of the fiber optic infrastructure in this State for the benefit of the public safety radio and communications systems in this State; (g) Collection and storage of data relating to agreements and contracts entered into by the State for the provision of fiber optic assets in this State; (h) Administration of the trade policy for fiber optic infrastructure in this State; and (i) Establishing and administering a program of infrastructure grants for the development or improvement of broadband services for persons with low income and persons in rural areas of this State using money from the Account for the Grant Program for Broadband Infrastructure created by NRS 223.660. The Director may adopt regulations to carry out his or her duties pursuant to this paragraph. 6. [Provide support to the Advisory Council on Graduate Medical Education and implement the Graduate Medical Education Grant Program established pursuant to NRS 223.637. 7.] In carrying out his or her duties pursuant to this section, consult with the Executive Director of the Office of Economic Development and cooperate with the Executive Director in implementing the State Plan for Economic Development developed by the Executive Director pursuant to subsection 2 of NRS 231.053. [8.] 7. Administer such grants as are provided by legislative appropriation. Sec. 2. NRS 223.630 is hereby amended to read as follows: 223.630 1. The Account for the Office of Science, Innovation and Technology is hereby created in the State General Fund. The Account must be administered by the Director of the Office of Science, Innovation and Technology. 2. Except as otherwise provided in NRS [223.631 and] 223.660, any money accepted pursuant to NRS 223.620 must be deposited in the Account. – 5 – - 83rd Session (2025) 3. The interest and income earned on the money in the Account, after deducting any applicable charges, must be credited to the Account. 4. The money in the Account must only be used to carry out the duties of the Director. 5. Claims against the Account must be paid as other claims against the State are paid. Sec. 3. NRS 223.631 is hereby amended to read as follows: 223.631 1. The Account for the Graduate Medical Education Grant Program is hereby created in the State General Fund. The Director of the [Office of Science, Innovation and Technology] Department of Health and Human Services shall administer the Account. 2. The Director of the [Office of Science, Innovation and Technology] Department of Health and Human Services may: (a) Accept any gift, donation, bequest or devise; and (b) Apply for and accept any grant, loan or other source of money,  for deposit in the Account to assist the Director in carrying out the Graduate Medical Education Grant Program established pursuant to NRS 223.637. 3. The interest and income earned on the money in the Account, after deducting any applicable charges, must be credited to the Account. 4. The money in the Account must only be used to: (a) Award competitive grants to institutions in this State [seeking] : (1) Seeking to create, expand or retain programs for residency training and postdoctoral fellowships that are approved by the Accreditation Council for Graduate Medical Education or its successor organization; [and] or (2) Operating programs for residency training that are approved by the Accreditation Council for Graduate Medical Education, or its successor organization, and that are training a number of residents that exceeds the maximum number of full- time equivalent resident positions for which the institution receives direct graduate medical education or indirect medical education payments from Medicare; and (b) Defray the costs of establishing and administering the Graduate Medical Education Grant Program established pursuant to NRS 223.637. – 6 – - 83rd Session (2025) 5. Any money remaining in the Account at the end of the fiscal year does not revert to the State General Fund, and the balance in the Account must be carried forward to the next fiscal year. 6. Claims against the Account must be paid as other claims against the State are paid. Sec. 4. NRS 223.633 is hereby amended to read as follows: 223.633 1. The Advisory Council on Graduate Medical Education is hereby created within the [Office of Science, Innovation and Technology.] Department of Health and Human Services. The Council consists of: (a) The dean of each medical school in this State that is accredited by the Liaison Committee on Medical Education of the American Medical Association and the Association of American Medical Colleges or their successor organizations, or his or her designee; (b) The dean of each school of osteopathic medicine in this State that is accredited by the Commission on Osteopathic College Accreditation of the American Osteopathic Association or its successor organization, or his or her designee; (c) Two members appointed by the Governor who are physicians licensed pursuant to chapter 630 or 633 of NRS; (d) One member appointed by the Governor who represents hospitals located in counties whose population is less than 100,000; (e) One member appointed by the Governor who represents hospitals located in counties whose population is 100,000 or more but less than 700,000; (f) One member appointed by the Governor who represents hospitals located in a county whose population is 700,000 or more; (g) One member appointed by the Governor who represents the medical corps of any of the Armed Forces of the United States; (h) One member appointed by the Governor who represents the Department of Health and Human Services; and (i) One member appointed by the Governor who represents the Office of Economic Development in the Office of the Governor. 2. In addition to the members appointed by the Governor pursuant to subsection 1, the Governor may appoint two members as the Governor determines necessary to carry out the provisions of NRS 223.631 to 223.639, inclusive [.] , and section 1 of this act. 3. After the initial terms, the term of each member of the Council is 3 years, and members shall serve at the pleasure of the Governor. – 7 – [Text truncated for display. Full text available on LegiScan.]