SB352 - Revises provisions relating to health care. (BDR 57-712)

(Reprinted with amendments adopted on June 2, 2025) THIRD REPRINT S.B. 352 - *SB352_R3* SENATE BILL NO. 352–SENATORS SCHEIBLE, CRUZ-CRAWFORD; CANNIZZARO, DALY, DOÑATE, DONDERO LOOP, FLORES, LANGE, NGUYEN, OHRENSCHALL AND PAZINA MARCH 13, 2025 ____________ JOINT SPONSORS: ASSEMBLYMEMBERS ROTH, GONZÁLEZ AND DALIA ____________ Referred to Committee on Commerce and Labor SUMMARY—Revises provisions relating to health care. (BDR 57-712) FISCAL NOTE: Effect on Local Government: May have Fiscal Impact. Effect on the State: Yes. CONTAINS UNFUNDED MANDATE (§ 2 & NRS 287.010) (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 health care; prohibiting certain health insurers and providers of health care from engaging in certain discriminatory actions; and providing other matters properly relating thereto. Legislative Counsel’s Digest: Existing federal law prohibits certain health care entities from discriminating 1 on the basis of race, color, national origin, sex, age or disability. (45 C.F.R. §§ 2 92.101, 92.206, 92.208, 92.209) Existing law prohibits certain public and private 3 policies of health insurance from discriminating against any person with respect to 4 participation or coverage under the policy on the basis of actual or perceived gender 5 identity or expression. (NRS 287.010, 287.04335, 422.2701, 608.1555, 689A.033, 6 689B.0675, 689C.1975, 689C.425, 695A.198, 695B.3167, 695C.050, 695C.204, 7 695G.415) Sections 1-8 of this bill additionally prohibit certain public and private 8 policies of health insurance, including Medicaid, from discriminating against any 9 person on the basis of actual or perceived race, color, national origin, sex, age, 10 sexual orientation or disability. Section 9 of this bill similarly prohibits a provider 11 of health care from discriminating against a person on the basis of those same 12 characteristics, as well as gender identity or expression. Section 9 also authorizes a 13 board, agency or other entity in this State that licenses, certifies or regulates 14 providers of health care to: (1) adopt regulations prescribing the specific types of 15 – 2 – - *SB352_R3* discrimination prohibited; and (2) discipline a provider of health care who violates 16 section 9. 17 THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS: Section 1. NRS 689A.033 is hereby amended to read as 1 follows: 2 689A.033 1. An insurer that issues a policy of health 3 insurance shall not discriminate against any person with respect to 4 participation or coverage under the policy on the basis of an actual 5 or perceived [gender identity or expression.] protected 6 characteristic. 7 2. Prohibited discrimination includes, without limitation: 8 [1.] (a) Denying, cancelling, limiting or refusing to issue or 9 renew a policy of health insurance on the basis of [the] an actual or 10 perceived [gender identity or expression] protected characteristic of 11 a person or a family member of the person; 12 [2. Imposing] 13 (b) Except as otherwise provided by subsection 3, imposing a 14 payment or premium that is based on [the] an actual or perceived 15 [gender identity or expression] protected characteristic of an 16 insured or a family member of the insured; 17 [3.] (c) Designating [the] an actual or perceived [gender 18 identity or expression] protected characteristic of a person or a 19 family member of the person as grounds to deny, cancel or limit 20 participation or coverage; and 21 [4.] (d) Denying, cancelling or limiting participation or 22 coverage on the basis of an actual or perceived [gender identity or 23 expression,] protected characteristic, including, without limitation, 24 by limiting or denying coverage for health care services that are: 25 [(a)] (1) Related to gender transition, provided that there is 26 coverage under the policy for the services when the services are not 27 related to gender transition; or 28 [(b)] (2) Ordinarily or exclusively available to persons of any 29 sex. 30 3. The provisions of this section do not prohibit an insurer 31 from taking the age of an insured into account in a manner that is 32 otherwise authorized by state or federal law when determining the 33 applicable premium rate. 34 4. The provisions of this section must not be construed to 35 apply to a policy that provides coverage only for a specified disease 36 or illness or other limited benefit. The Division shall not interpret 37 the term “policy of health insurance” for the purposes of this 38 section in a manner contrary to the provisions of this subsection. 39 – 3 – - *SB352_R3* 5. As used in this section, “protected characteristic” means: 1 (a) Race, color, national origin, age, physical or mental 2 disability, sexual orientation or gender identity or expression; or 3 (b) Sex, including, without limitation, sex characteristics, 4 intersex traits and pregnancy or related conditions. 5 Sec. 2. NRS 689B.0675 is hereby amended to read as follows: 6 689B.0675 1. An insurer that issues a policy of group health 7 insurance shall not discriminate against any person with respect to 8 participation or coverage under the policy on the basis of an actual 9 or perceived [gender identity or expression.] protected 10 characteristic. 11 2. Prohibited discrimination includes, without limitation: 12 [1.] (a) Denying, cancelling, limiting or refusing to issue or 13 renew a policy of group health insurance on the basis of [the] an 14 actual or perceived [gender identity or expression] protected 15 characteristic of a person or a family member of the person; 16 [2. Imposing] 17 (b) Except as otherwise provided by subsection 3, imposing a 18 payment or premium that is based on [the] an actual or perceived 19 [gender identity or expression] protected characteristic of an 20 insured or a family member of the insured; 21 [3.] (c) Designating [the] an actual or perceived [gender 22 identity or expression] protected characteristic of a person or a 23 family member of the person as grounds to deny, cancel or limit 24 participation or coverage; and 25 [4.] (d) Denying, cancelling or limiting participation or 26 coverage on the basis of an actual or perceived [gender identity or 27 expression,] protected characteristic, including, without limitation, 28 by limiting or denying coverage for health care services that are: 29 [(a)] (1) Related to gender transition, provided that there is 30 coverage under the policy for the services when the services are not 31 related to gender transition; or 32 [(b)] (2) Ordinarily or exclusively available to persons of any 33 sex. 34 3. The provisions of this section do not prohibit an insurer 35 from taking the age of an insured into account in a manner that is 36 otherwise authorized by state or federal law when determining the 37 applicable premium rate. 38 4. The provisions of this section must not be construed to 39 apply to a policy that provides coverage only for a specified disease 40 or illness or other limited benefit. The Division shall not interpret 41 the term “policy of group health insurance” for the purposes of 42 this section in a manner contrary to the provisions of this 43 subsection. 44 5. As used in this section, “protected characteristic” means: 45 – 4 – - *SB352_R3* (a) Race, color, national origin, age, physical or mental 1 disability, sexual orientation or gender identity or expression; or 2 (b) Sex, including, without limitation, sex characteristics, 3 intersex traits and pregnancy or related conditions. 4 Sec. 3. NRS 689C.1975 is hereby amended to read as follows: 5 689C.1975 1. A carrier that issues a health benefit plan shall 6 not discriminate against any person with respect to participation or 7 coverage under the plan on the basis of an actual or perceived 8 [gender identity or expression.] protected characteristic. 9 2. Prohibited discrimination includes, without limitation: 10 [1.] (a) Denying, cancelling, limiting or refusing to issue or 11 renew a health benefit plan on the basis of [the] an actual or 12 perceived [gender identity or expression] protected characteristic of 13 a person or a family member of the person; 14 [2. Imposing] 15 (b) Except as otherwise provided by subsection 3, imposing a 16 payment or premium that is based on [the] an actual or perceived 17 [gender identity or expression] protected characteristic of an 18 insured or a family member of the insured; 19 [3.] (c) Designating [the] an actual or perceived [gender 20 identity or expression] protected characteristic of a person or a 21 family member of the person as grounds to deny, cancel or limit 22 participation or coverage; and 23 [4.] (d) Denying, cancelling or limiting participation or 24 coverage on the basis of an actual or perceived [gender identity or 25 expression,] protected characteristic, including, without limitation, 26 by limiting or denying coverage for health care services that are: 27 [(a)] (1) Related to gender transition, provided that there is 28 coverage under the plan for the services when the services are not 29 related to gender transition; or 30 [(b)] (2) Ordinarily or exclusively available to persons of any 31 sex. 32 3. The provisions of this section do not prohibit a carrier 33 from taking the age of an insured into account in a manner that is 34 otherwise authorized by state or federal law when determining the 35 applicable premium rate. 36 4. As used in this section, “protected characteristic” means: 37 (a) Race, color, national origin, age, physical or mental 38 disability, sexual orientation or gender identity or expression; or 39 (b) Sex, including, without limitation, sex characteristics, 40 intersex traits and pregnancy or related conditions. 41 Sec. 4. NRS 695A.198 is hereby amended to read as follows: 42 695A.198 1. A society that issues a benefit contract shall not 43 discriminate against any person with respect to participation or 44 – 5 – - *SB352_R3* coverage under the contract on the basis of an actual or perceived 1 [gender identity or expression.] protected characteristic. 2 2. Prohibited discrimination includes, without limitation: 3 [1.] (a) Denying, cancelling, limiting or refusing to issue or 4 renew a benefit contract on the basis of [the] an actual or perceived 5 [gender identity or expression] protected characteristic of a person 6 or a family member of the person; 7 [2. Imposing] 8 (b) Except as otherwise provided by subsection 3, imposing a 9 payment or premium that is based on [the] an actual or perceived 10 [gender identity or expression] protected characteristic of an 11 insured or a family member of the insured; 12 [3.] (c) Designating [the] an actual or perceived [gender 13 identity or expression] protected characteristic of a person or a 14 family member of the person as grounds to deny, cancel or limit 15 participation or coverage; and 16 [4.] (d) Denying, cancelling or limiting participation or 17 coverage on the basis of an actual or perceived [gender identity or 18 expression,] protected characteristic, including, without limitation, 19 by limiting or denying coverage for health care services that are: 20 [(a)] (1) Related to gender transition, provided that there is 21 coverage under the contract for the services when the services are 22 not related to gender transition; or 23 [(b)] (2) Ordinarily or exclusively available to persons of any 24 sex. 25 3. The provisions of this section do not prohibit a society from 26 taking the age of an insured into account in a manner that is 27 otherwise authorized by state or federal law when determining the 28 applicable premium rate. 29 4. As used in this section, “protected characteristic” means: 30 (a) Race, color, national origin, age, physical or mental 31 disability, sexual orientation or gender identity or expression; or 32 (b) Sex, including, without limitation, sex characteristics, 33 intersex traits and pregnancy or related conditions. 34 Sec. 5. NRS 695B.3167 is hereby amended to read as follows: 35 695B.3167 1. A hospital or medical services corporation that 36 issues a policy of health insurance shall not discriminate against any 37 person with respect to participation or coverage under the policy on 38 the basis of an actual or perceived [gender identity or expression.] 39 protected characteristic. 40 2. Prohibited discrimination includes, without limitation: 41 [1.] (a) Denying, cancelling, limiting or refusing to issue or 42 renew a policy of health insurance on the basis of [the] an actual or 43 perceived [gender identity or expression] protected characteristic of 44 a person or a family member of the person; 45 – 6 – - *SB352_R3* [2. Imposing] 1 (b) Except as otherwise provided by subsection 3, imposing a 2 payment or premium that is based on [the] an actual or perceived 3 [gender identity or expression] protected characteristic of an 4 insured or a family member of the insured; 5 [3.] (c) Designating [the] an actual or perceived [gender 6 identity or expression] protected characteristic of a person or a 7 family member of the person as grounds to deny, cancel or limit 8 participation or coverage; and 9 [4.] (d) Denying, cancelling or limiting participation or 10 coverage on the basis of an actual or perceived [gender identity or 11 expression,] protected characteristic, including, without limitation, 12 by limiting or denying coverage for health care services that are: 13 [(a)] (1) Related to gender transition, provided that there is 14 coverage under the policy for the services when the services are not 15 related to gender transition; or 16 [(b)] (2) Ordinarily or exclusively available to persons of any 17 sex. 18 3. The provisions of this section do not prohibit a hospital or 19 medical services corporation from taking the age of an insured 20 into account in a manner that is otherwise authorized by state or 21 federal law when determining the applicable premium rate. 22 4. As used in this section, “protected characteristic” means: 23 (a) Race, color, national origin, age, physical or mental 24 disability, sexual orientation or gender identity or expression; or 25 (b) Sex, includi [Text truncated for display. Full text available on LegiScan.]