SB268 - Revises provisions relating to insurance coverage for certain dental services. (BDR 57-329)

- 83rd Session (2025) Senate Bill No. 268–Senator Flores CHAPTER.......... AN ACT relating to insurance; requiring certain health insurance to include coverage for certain dental services when provided by certain dental hygienists without the supervision of a dentist to the same extent as if provided by a dental hygienist under the supervision of a dentist; revising provisions governing the services that a dental hygienist with a special endorsement to practice public health dental hygiene may provide; and providing other matters properly relating thereto. Legislative Counsel’s Digest: Existing law authorizes the Board of Dental Examiners of Nevada to issue to a licensed dental hygienist who meets certain qualifications prescribed by the Board a special endorsement that allows the dental hygienist to practice public health dental hygiene. Under existing law, a dental hygienist who holds such a special endorsement is authorized to provide services specified by the Board by regulation without the authorization or supervision of a dentist. (NRS 631.287) Existing regulations of the Board set forth: (1) various services that a dental hygienist who holds a special endorsement may provide without authorization or supervision of a dentist; (2) certain conditions for the provision of such services; and (3) the circumstances under which the authorization to provide such services may be suspended or revoked. (NAC 631.210) Section 12.5 of this bill codifies such authorized services, conditions and circumstances into statute. Sections 1, 3-9, 11, 12 and 14-16 of this bill require certain public and private policies of health insurance and health plans, including Medicaid, who provide coverage for a dental service that a qualified dental hygienist is authorized to provide without the supervision of a dentist to provide coverage for that service when provided by such a qualified dental hygienist without the supervision of a dentist to the same extent as if provided by a qualified dental hygienist under the supervision of a dentist. Sections 1, 3, 4, 6-8, 11, 12 and 16 define the term “qualified dental hygienist” to mean a dental hygienist who holds a special endorsement to practice public health dental hygiene, is employed by a nonprofit organization and provides services within the scope of that employment. Section 13 of this bill makes a conforming change to require the Director of the Department of Health and Human Services to administer the provisions of section 16 in the same manner as other provisions relating to Medicaid. Section 2 of this bill authorizes the Commissioner of Insurance to require that certain policies of health insurance issued by a domestic insurer to a person who resides in another state include the coverage required by section 1. Section 10 of this bill authorizes the Commissioner to suspend or revoke the certificate of authority of a health maintenance organization that fails to comply with the requirements of section 8. The Commissioner would also be authorized to take such action against other private health insurers and organizations for dental care that fail to comply with the requirements of sections 1, 3, 4, 6, 7, 11 and 12. (NRS 680A.200, 695D.300) – 2 – - 83rd Session (2025) 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 689A of NRS is hereby amended by adding thereto a new section to read as follows: 1. An insurer that offers or issues a policy of health insurance which includes coverage for a dental service that a qualified dental hygienist is authorized to provide without the supervision of a dentist shall provide coverage for that service when provided by such a qualified dental hygienist without the supervision of a dentist to the same extent as if provided by a qualified dental hygienist under the supervision of a dentist. 2. A policy of health insurance subject to the provisions of this chapter which provides coverage for a dental service described in subsection 1 and that is delivered, issued for delivery or renewed on or after October 1, 2025, has the legal effect of including the coverage required by this section, and any provision of the policy that conflicts with the provisions of this section is void. 3. As used in this section, “qualified dental hygienist” means a dental hygienist who holds a special endorsement issued by the Board of Dental Examiners of Nevada pursuant to NRS 631.287, is employed by a nonprofit organization and provides services within the scope of that employment. Sec. 2. NRS 689A.330 is hereby amended to read as follows: 689A.330 If any policy is issued by a domestic insurer for delivery to a person residing in another state, and if the insurance commissioner or corresponding public officer of that other state has informed the Commissioner that the policy is not subject to approval or disapproval by that officer, the Commissioner may by ruling require that the policy meet the standards set forth in NRS 689A.030 to 689A.320, inclusive [.] , and section 1 of this act. Sec. 3. Chapter 689B of NRS is hereby amended by adding thereto a new section to read as follows: 1. An insurer that offers or issues a policy of group health insurance which includes coverage for a dental service that a qualified dental hygienist is authorized to provide without the supervision of a dentist shall provide coverage for that service when provided by such a qualified dental hygienist without the supervision of a dentist to the same extent as if provided by a qualified dental hygienist under the supervision of a dentist. – 3 – - 83rd Session (2025) 2. A policy of group health insurance subject to the provisions of this chapter which provides coverage for a dental service described in subsection 1 and that is delivered, issued for delivery or renewed on or after October 1, 2025, has the legal effect of including the coverage required by this section, and any provision of the policy that conflicts with the provisions of this section is void. 3. As used in this section, “qualified dental hygienist” means a dental hygienist who holds a special endorsement issued by the Board of Dental Examiners of Nevada pursuant to NRS 631.287, is employed by a nonprofit organization and provides services within the scope of that employment. Sec. 4. Chapter 689C of NRS is hereby amended by adding thereto a new section to read as follows: 1. A carrier that offers or issues a health benefit plan which includes coverage for a dental service that a qualified dental hygienist is authorized to provide without the supervision of a dentist shall provide coverage for that service when provided by such a qualified dental hygienist without the supervision of a dentist to the same extent as if provided by a qualified dental hygienist under the supervision of a dentist. 2. A health benefit plan subject to the provisions of this chapter which provides coverage for a dental service described in subsection 1 and that is delivered, issued for delivery or renewed on or after October 1, 2025, has the legal effect of including the coverage required by this section, and any provision of the plan that conflicts with the provisions of this section is void. 3. As used in this section, “qualified dental hygienist” means a dental hygienist who holds a special endorsement issued by the Board of Dental Examiners of Nevada pursuant to NRS 631.287, is employed by a nonprofit organization and provides services within the scope of that employment. Sec. 5. NRS 689C.425 is hereby amended to read as follows: 689C.425 A voluntary purchasing group and any contract issued to such a group pursuant to NRS 689C.360 to 689C.600, inclusive, are subject to the provisions of NRS 689C.015 to 689C.355, inclusive, and section 4 of this act to the extent applicable and not in conflict with the express provisions of NRS 687B.408 and 689C.360 to 689C.600, inclusive. Sec. 6. Chapter 695A of NRS is hereby amended by adding thereto a new section to read as follows: 1. A society that offers or issues a benefit contract which includes coverage for a dental service that a qualified dental – 4 – - 83rd Session (2025) hygienist is authorized to provide without the supervision of a dentist shall provide coverage for that service when provided by such a qualified dental hygienist without the supervision of a dentist to the same extent as if provided by a qualified dental hygienist under the supervision of a dentist. 2. A benefit contract subject to the provisions of this chapter which provides coverage for a dental service described in subsection 1 and that is delivered, issued for delivery or renewed on or after October 1, 2025, has the legal effect of including the coverage required by this section, and any provision of the contract that conflicts with the provisions of this section is void. 3. As used in this section, “qualified dental hygienist” means a dental hygienist who holds a special endorsement issued by the Board of Dental Examiners of Nevada pursuant to NRS 631.287, is employed by a nonprofit organization and provides services within the scope of that employment. Sec. 7. Chapter 695B of NRS is hereby amended by adding thereto a new section to read as follows: 1. An insurer that offers or issues a contract for dental services which includes coverage for a dental service that a qualified dental hygienist is authorized to provide without the supervision of a dentist shall provide coverage for that service when provided by such a qualified dental hygienist without the supervision of a dentist to the same extent as if provided by a qualified dental hygienist under the supervision of a dentist. 2. A contract for dental services subject to the provisions of this chapter which provides coverage for a dental service described in subsection 1 and that is delivered, issued for delivery or renewed on or after October 1, 2025, has the legal effect of including the coverage required by this section, and any provision of the contract that conflicts with the provisions of this section is void. 3. As used in this section, “qualified dental hygienist” means a dental hygienist who holds a special endorsement issued by the Board of Dental Examiners of Nevada pursuant to NRS 631.287, is employed by a nonprofit organization and provides services within the scope of that employment. Sec. 8. Chapter 695C of NRS is hereby amended by adding thereto a new section to read as follows: 1. A health maintenance organization that offers or issues a health care plan which includes coverage for a dental service that a qualified dental hygienist is authorized to provide without the supervision of a dentist shall provide coverage for that service – 5 – - 83rd Session (2025) when provided by such a qualified dental hygienist without the supervision of a dentist to the same extent as if provided by a qualified dental hygienist under the supervision of a dentist. 2. A health care plan subject to the provisions of this chapter which provides coverage for a dental service described in subsection 1 and that is delivered, issued for delivery or renewed on or after October 1, 2025, has the legal effect of including the coverage required by this section, and any provision of the plan that conflicts with the provisions of this section is void. 3. As used in this section, “qualified dental hygienist” means a dental hygienist who holds a special endorsement issued by the Board of Dental Examiners of Nevada pursuant to NRS 631.287, is employed by a nonprofit organization and provides services within the scope of that employment. Sec. 9. NRS 695C.050 is hereby amended to read as follows: 695C.050 1. Except as otherwise provided in this chapter or in specific provisions of this title, the provisions of this title are not applicable to any health maintenance organization granted a certificate of authority under this chapter. This provision does not apply to an insurer licensed and regulated pursuant to this title except with respect to its activities as a health maintenance organization authorized and regulated pursuant to this chapter. 2. Solicitation of enrollees by a health maintenance organization granted a certificate of authority, or its representatives, must not be construed to violate any provision of law relating to solicitation or advertising by practitioners of a healing art. 3. Any health maintenance organization authorized under this chapter shall not be deemed to be practicing medicine and is exempt from the provisions of chapter 630 of NRS. 4. The provisions of NRS 695C.110, 695C.125, 695C.1691, 695C.1693, 695C.170, 695C.1703, 695C.1705, 695C.1709 to 695C.173, inclusive, 695C.1733, 695C.17335, 695C.1734, 695C.1751, 695C.1755, 695C.1759, 695C.176 to 695C.200, inclusive, and 695C.265 do not apply to a health maintenance organization that provides health care services through managed care to recipients of Medicaid under the State Plan for Medicaid or insurance pursuant to the Children’s Health Insurance Program pursuant to a contract with the Division of Health Care Financing and Policy of the Department of Health and Human Services. This subsection does not exempt a health maintenance organization from any provision of this chapter for services provided pursuant to any other contract. – 6 – - 83rd Session (2025) 5. The provisions of NRS 695C.16932 to 695C.1699, inclusive, 695C.1701, 695C.1708, 695C.1728, 695C.1731, 695C.17333, 695C.17345, 695C.17347, 695C.1736 to 695C.1745, inclusive, 695C.1757 and 695C.204 and section 8 of this act apply to a health maintenance organization that provides health care services through managed care to recipients of Medicaid under the State Plan for Medicaid. 6. The provisions of NRS 695C.17095 do not apply to a health maintenance organization that provides health care services to members of the Public Employees’ Benefits Program. This subsection does not exempt a health maintenance organization from any provision of this chapter for services provided pursuant to any other contract. 7. The provisions of NRS 695C.1735 do not apply to a health maintenance organization that provides health care services to: (a) The officers and employees, and the dependents of officers and employees, of the governing body of any county, school district, municipal corporation, political subdivision, public corporation or other local governmental agency [Text truncated for display. Full text available on LegiScan.]