SUMMARY--Regulates access to and use of genetic information of person. (BDR 57-335)
FISCAL NOTE: Effect on Local Government: Yes.
Effect on the State or on Industrial Insurance: No.
EXPLANATION - Matter in italics is new; matter in brackets [ ] is material to be omitted.
AN ACT relating to genetic information; prohibiting certain insurers from requiring an insured person or a member of his family to take a genetic test, to disclose whether he or a member of his family has taken a genetic test or to disclose genetic information concerning himself or a member of his family; prohibiting certain insurers from conditioning rates or other aspects of coverage for health care on the requirement that an insured person or a member of his family take a genetic test or on genetic information concerning an insured person or a member of his family; prohibiting the obtaining, retention or disclosure of any genetic information of a person under certain circumstances; providing for a civil action for damages caused by the unlawful disclosure of the genetic information of a person; providing penalties; and providing other matters properly relating thereto.
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
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Section 1 Chapter 689A of NRS is hereby amended by adding thereto a new section to read as follows:
1. An insurer who provides health insurance shall not:
(a) Require an insured person or any member of his family to take a genetic test;
(b) Require an insured person to disclose whether he or any member of his family has taken a genetic test or any genetic information of the insured person or a member of his family; or
(c) Determine the rates or any other aspect of the coverage or benefits for health care provided to an insured person based on:
(1) Whether the insured person or any member of his family has taken a genetic test; or
(2) Any genetic information of the insured person or any member of his family.
2. As used in this section:
(a) "Genetic information" means any information that is obtained from a genetic test.
(b) "Genetic test" means a test, including a laboratory test that uses deoxyribonucleic acid extracted from the cells of a person or a diagnostic test, to determine the presence of abnormalities or deficiencies, including carrier status, that:
(1) Are linked to physical or mental disorders or impairments;
(2) Indicate a susceptibility to illness, disease, impairment or any other disorder, whether physical or mental; or
(3) Demonstrate genetic or chromosomal damage caused by environmental factors.
Sec. 2 Chapter 689B of NRS is hereby amended by adding thereto a new section to read as follows:
1. An insurer who provides group health insurance shall not:
(a) Require an insured person or any member of his family to take a genetic test;
(b) Require an insured person to disclose whether he or any member of his family has taken a genetic test or any genetic information of the insured person or a member of his family; or
(c) Determine the rates or any other aspect of the coverage or benefits for health care provided to an insured person based on:
(1) Whether the insured person or any member of his family has taken a genetic test; or
(2) Any genetic information of the insured person or any member of his family.
2. As used in this section:
(a) "Genetic information" means any information that is obtained from a genetic test.
(b) "Genetic test" means a test, including a laboratory test that uses deoxyribonucleic acid extracted from the cells of a person or a diagnostic test, to determine the presence of abnormalities or deficiencies, including carrier status, that:
(1) Are linked to physical or mental disorders or impairments;
(2) Indicate a susceptibility to illness, disease, impairment or any other disorder, whether physical or mental; or
(3) Demonstrate genetic or chromosomal damage caused by environmental factors.
Sec. 3 Chapter 689C of NRS is hereby amended by adding thereto a new section to read as follows:
1. A carrier serving small employers shall not:
(a) Require an insured person or any member of his family to take a genetic test;
(b) Require an insured person to disclose whether he or any member of his family has taken a genetic test or any genetic information of the insured person or a member of his family; or
(c) Determine the rates or any other aspect of the coverage or benefits for health care provided to an insured person based on:
(1) Whether the insured person or any member of his family has taken a genetic test; or
(2) Any genetic information of the insured person or any member of his family.
2. As used in this section:
(a) "Genetic information" means any information that is obtained from a genetic test.
(b) "Genetic test" means a test, including a laboratory test that uses deoxyribonucleic acid extracted from the cells of a person or a diagnostic test, to determine the presence of abnormalities or deficiencies, including carrier status, that:
(1) Are linked to physical or mental disorders or impairments;
(2) Indicate a susceptibility to illness, disease, impairment or any other disorder, whether physical or mental; or
(3) Demonstrate genetic or chromosomal damage caused by environmental factors.
Sec. 4 Chapter 695B of NRS is hereby amended by adding thereto a new section to read as follows:
1. A corporation that provides health insurance shall not:
(a) Require an insured person or any member of his family to take a genetic test;
(b) Require an insured person to disclose whether he or any member of his family has taken a genetic test or any genetic information of the insured person or a member of his family; or
(c) Determine the rates or any other aspect of the coverage or benefits for health care provided to an insured person based on:
(1) Whether the insured person or any member of his family has taken a genetic test; or
(2) Any genetic information of the insured person or any member of his family.
2. As used in this section:
(a) "Genetic information" means any information that is obtained from a genetic test.
(b) "Genetic test" means a test, including a laboratory test that uses deoxyribonucleic acid extracted from the cells of a person or a diagnostic test, to determine the presence of abnormalities or deficiencies, including carrier status, that:
(1) Are linked to physical or mental disorders or impairments;
(2) Indicate a susceptibility to illness, disease, impairment or any other disorder, whether physical or mental; or
(3) Demonstrate genetic or chromosomal damage caused by environmental factors.
Sec. 5 Chapter 695C of NRS is hereby amended by adding thereto a new section to read as follows:
1. A health maintenance organization shall not:
(a) Require an enrollee or any member of his family to take a genetic test;
(b) Require an enrollee to disclose whether he or any member of his family has taken a genetic test or the genetic information of the enrollee or a member of his family; or
(c) Determine the rates or any other aspect of the coverage or benefits for health care provided to an enrollee based on:
(1) Whether the enrollee or any member of his family has taken a genetic test; or
(2) Any genetic information of the enrollee or any member of his family.
2. As used in this section:
(a) "Genetic information" means any information that is obtained from a genetic test.
(b) "Genetic test" means a test, including or a laboratory test which uses deoxyribonucleic acid extracted from the cells of a person or a diagnostic test, to determine the presence of abnormalities or deficiencies, including carrier status, that:
(1) Are linked to physical or mental disorders or impairments;
(2) Indicate a susceptibility to illness, disease, impairment or any other disorder, whether physical or mental; or
(3) Demonstrate genetic or chromosomal damage caused by environmental factors.
Sec. 6 NRS 695C.330 is hereby amended to read as follows:
695C.3301. The commissioner may suspend or revoke any certificate of authority issued to a health maintenance organization under this chapter if he finds that any of the following conditions exist:
(a) The health maintenance organization is operating significantly in contravention of its basic organizational document, its health care plan or in a manner contrary to that described in and reasonably inferred from any other information submitted under NRS 695C.060, 695C.070 and 695C.140, unless amendments to those submissions have been filed with and approved by the commissioner;
(b) The health maintenance organization issues evidence of coverage or uses a schedule of charges for health care services which do not comply with the requirements of NRS 695C.170 to 695C.200, inclusive [;] and section 5 of this act;
(c) The health care plan does not furnish comprehensive health care services as provided for in subsection 2 of NRS 695C.030;
(d) The state board of health certifies to the commissioner that:
(1) The health maintenance organization does not meet the requirements of subsection 2 of NRS 695C.080; or
(2) The health maintenance organization is unable to fulfill its obligations to furnish health care services as required under its health care plan;
(e) The health maintenance organization is no longer financially responsible and may reasonably be expected to be unable to meet its obligations to enrollees or prospective enrollees;
(f) The health maintenance organization has failed to put into effect a mechanism affording the enrollees an opportunity to participate in matters relating to the content of programs under NRS 695C.110;
(g) The health maintenance organization has failed to put into effect the system for complaints required by NRS 695C.260 in a manner reasonably to dispose of valid complaints;
(h) The health maintenance organization or any person on its behalf has advertised or merchandised its services in an untrue, misrepresentative, misleading, deceptive or unfair manner;
(i) The continued operation of the health maintenance organization would be hazardous to its enrollees; or
(j) The health maintenance organization has otherwise failed to substantially comply with this chapter.
2. A certificate of authority must be suspended or revoked only after compliance with the requirements of NRS 695C.340.
3. When the certificate of authority of a health maintenance organization is suspended, the health maintenance organization shall not, during the period of that suspension, enroll any additional groups or new individual contracts, unless those groups or persons were contracted for before the date of suspension.
4. When the certificate of authority of a health maintenance organization is revoked, the organization shall proceed, immediately following the effective date of the order of revocation, to wind up its affairs and shall conduct no further business except as may be essential to the orderly conclusion of the affairs of the organization. It shall engage in no further advertising or solicitation whatsoever. The commissioner may by written order permit such further operation of the organization as he may find to be in the best interest of enrollees to the end that enrollees will be afforded the greatest practical opportunity to obtain continuing coverage for health care.
Sec. 7 Chapter 629 of NRS is hereby amended by adding thereto the provisions set forth as sections 8 to 18, inclusive, of this act.
Sec. 8 As used in sections 8 to 18, inclusive, of this act, unless the context otherwise requires, the words and terms defined in sections 9 and 10 of this act have the meanings ascribed to them in those sections.
Sec. 9 "Genetic information" means any information that is obtained from a genetic test.
Sec. 10 "Genetic test" means a test, including a laboratory test that uses deoxyribonucleic acid extracted from the cells of a person or a diagnostic test, to determine the presence of abnormalities or deficiencies, including carrier status, that:
1. Are linked to physical or mental disorders or impairments;
2. Indicate a susceptibility to illness, disease, impairment or any other disorder, whether physical or mental; or
3. Demonstrate genetic or chromosomal damage caused by environmental factors.
Sec. 11 1. The genetic information of a person is the property of that person.
2. A person who takes a genetic test may inspect, request the correction of or obtain any genetic information included in the records of his test.
Sec. 12 It is unlawful to obtain any genetic information of a person without first obtaining the informed consent of the person or the person's legal guardian pursuant to section 16 of this act, unless the information is obtained:
1. By a federal, state, county or city law enforcement agency to establish the identity of a person or dead human body;
2. To determine the parentage or identity of a person pursuant to NRS 56.020;
3. To determine the paternity of a person pursuant to NRS 126.121 or 425.384;
4. For use in a study where the identities of the persons from whom the genetic information is obtained are not disclosed to the person conducting the study;
5. To determine the presence of certain inheritable disorders in an infant pursuant to NRS 442.115 or a provision of federal law; or
6. Pursuant to an order of a court of competent jurisdiction.
Sec. 13 1. It is unlawful to retain the genetic information of a person, without first obtaining the informed consent of the person or the person's legal guardian pursuant to section 16 of this act, unless retention of the genetic information is:
(a) Necessary to conduct a criminal investigation, an investigation concerning the death of a person or a criminal or juvenile proceeding; or
(b) Authorized pursuant to an order of a court of competent jurisdiction.
2. A person who has authorized another person to retain his genetic information may request that person to destroy the genetic information. If so requested, the person who retains that genetic information shall destroy the information, unless retention of that information is:
(a) Necessary to conduct a criminal investigation, an investigation concerning the death of a person or a criminal or juvenile proceeding; or
(b) Authorized by an order of a court of competent jurisdiction.
3. Except as otherwise provided in subsection 4, a person who obtains the genetic information of a person for use in a study shall destroy that information upon:
(a) The completion of the study;
(b) The withdrawal of the person from the study,
whichever occurs first.
4. A person whose genetic information is used in a study may authorize the person who conducts the study to retain that genetic information after the study is completed or upon his withdrawal from the study.
Sec. 14 It is unlawful to disclose or to compel a person to disclose the identity of a person who was the subject of a genetic test or to disclose genetic information of that person in a manner that allows identification of the person, without first obtaining the informed consent of that person or his legal guardian pursuant to section 16 of this act, unless the information is disclosed:
1. To conduct a criminal investigation, an investigation concerning the death of a person or a criminal or juvenile proceeding;
2. To determine the parentage or identity of a person pursuant to NRS 56.020;
3. To determine the paternity of a person pursuant to NRS 126.121 or 425.384;
4. Pursuant to an order of a court of competent jurisdiction;
5. By a physician and is the genetic information of a deceased person that will assist in the medical diagnosis of persons related to the deceased person by blood;
6. To a federal, state, county or city law enforcement agency to establish the identity of a person or dead human body;
7. To determine the presence of certain inheritable preventable disorders in an infant pursuant to NRS 442.115 or a provision of federal law; or
8. By an agency of criminal justice pursuant to NRS 179A.075.
Sec. 15 1. A person who performs a genetic test or receives the results of a genetic test shall notify the person tested, in writing, that:
(a) The test has been performed; or
(b) The results of the test have been received,
within 10 days after the completion of the test or the receipt of the results.
2. The written notice must include a statement that the person who conducted the test or received the results of the test is prohibited from disclosing any information concerning the test to any person without first obtaining the informed consent of the person tested pursuant to section 16 of this act, unless the disclosure is made pursuant to section 14 of this act.
Sec. 16 The state board of health shall by regulation:
1. Establish a procedure for obtaining the informed consent of a person pursuant to sections 8 to 18, inclusive, of this act.
2. Prescribe a form for use in obtaining the informed consent of a person. The form must include:
(a) A statement that the person tested is entitled to receive notice of the results of the test pursuant to section 15 of this act;
(b) Information relating to the use and confidentiality of the genetic information of the person set forth in sections 8 to 18, inclusive, of this act; and
(c) Any other information the state board of health may prescribe.
Sec. 17 A person who violates any of the provisions of section 12, 13 or 14 of this act is guilty of a misdemeanor.
Sec. 18 Any person who suffers an injury as a result of the disclosure of his genetic information by another person in violation of section 14 of this act may bring a civil action for the recovery of his actual damages, including costs and attorney's fees.
Sec. 19 The provisions of this act do not apply to offenses that are committed before October 1, 1997.
Sec. 20 The provisions of subsection 1 of NRS 354.599 do not apply to any additional expenses of a local government that are related to the provisions of this act.