THE SIXTIETH DAY
Carson City (Thursday), April 3, 2003
Assembly called to order at 11:28 a.m.
Mr. Speaker presiding.
Roll called.
All present.
Prayer by the Chaplain, Reverend Richard Campbell.
Almighty and Most Gracious God, it is to You that we look for every good and perfect gift. It is to You that we direct our thanksgiving this day. We give thanks for a night of rest and the beauty of a new day. Be present with us and guide us. Make us aware of the needs of the people and grant us wisdom, compassion, and love to serve them in our actions. Bless this Assembly, give them strength and courage to do Your will. We pray in Your name.
Amen.
Pledge of Allegiance to the Flag.
Assemblyman Oceguera moved that further reading of the Journal be dispensed with, and the Speaker and Chief Clerk be authorized to make the necessary corrections and additions.
Motion carried.
REPORTS OF COMMITTEES
Mr. Speaker:
Your Committee on
Judiciary, to which was referred Assembly Bill No. 341, has had the same under
consideration, and begs leave to report the same back with the recommendation:
Do pass.
Also, your Committee on Judiciary, to which was referred Assembly Bill No. 78, has had the same under consideration, and begs leave to report the same back with the recommendation: Amend, and do pass as amended.
Also, your Committee on Judiciary, to which was referred Assembly Bill No. 95, has had the same under consideration, and begs leave to report the same back with the recommendation: Amend, and do pass as amended.
Also, your Committee on Judiciary, to which was referred Assembly Bill No. 107, has had the same under consideration, and begs leave to report the same back with the recommendation: Amend, and do pass as amended.
Also, your Committee on Judiciary, to which was referred Assembly Bill No. 322, has had the same under consideration, and begs leave to report the same back with the recommendation: Amend, and do pass as amended.
Also, your Committee on Judiciary, to which was referred Assembly Bill No. 336, has had the same under consideration, and begs leave to report the same back with the recommendation: Amend, and do pass as amended.
Bernie Anderson, Chairman
MESSAGES FROM THE Senate
Senate Chamber, Carson City, April 2, 2003
To the Honorable the Assembly:
I have the honor to inform
your honorable body that the Senate on this day passed
Assembly Bill No. 90; Senate Bills Nos. 134, 286, 396; Senate Joint Resolution
No. 2.
Also, I have the honor to inform your honorable body that the Senate on
this day passed, as amended, Senate Bills Nos. 40, 197.
|
Mary Jo Mongelli |
|
Assistant Secretary of the Senate |
Senate Chamber, Carson City, April 3, 2003
To the Honorable the Assembly:
I have the honor to inform
your honorable body that the Senate on this day adopted
Senate Concurrent Resolution No. 27.
|
Mary Jo Mongelli |
|
Assistant Secretary of the Senate |
MOTIONS, RESOLUTIONS AND NOTICES
Senate Joint Resolution No. 2.
Assemblywoman Buckley moved that the resolution be referred to the Committee on Natural Resources, Agriculture, and Mining.
Motion carried.
Senate Concurrent Resolution No. 27.
Assemblyman Knecht moved the adoption of the resolution.
Remarks by Assemblyman Knecht.
Resolution adopted unanimously.
INTRODUCTION, FIRST READING AND REFERENCE
Senate Bill No. 40.
Assemblywoman Buckley moved that the bill be referred to the Committee on Judiciary.
Motion carried.
Senate Bill No. 134.
Assemblywoman Buckley moved that the bill be referred to the Committee on Judiciary.
Motion carried.
Senate Bill No. 197.
Assemblywoman Buckley moved that the bill be referred to the Committee on Judiciary.
Motion carried.
Senate Bill No. 286.
Assemblywoman Buckley moved that the bill be referred to the Committee on Judiciary.
Motion carried.
Senate Bill No. 396.
Assemblywoman Buckley moved that the bill be referred to the Committee on Ways and Means.
Motion carried.
SECOND READING AND AMENDMENT
Assembly Bill No. 41.
Bill read second time.
The following amendment was proposed by the Committee on
Natural Resources, Agriculture, and Mining:
Amendment No. 6.
Amend sec. 14, page 6, by deleting lines 35 and 36 and inserting: “chapter 488 of NRS.”.
Amend sec. 16, page 7, line 30, by deleting “Prepare” and inserting: “Prepare , in consultation with the Commission,”.
Amend sec. 16, page 7, by deleting line 33 and inserting: “recommendation before the budget is submitted to the Chief of the Budget”.
Amend the title of the bill by deleting the third through fifth lines and inserting: “Resources into the Department of Wildlife; and providing other matters”.
Assemblyman Collins moved the adoption of the amendment.
Remarks by Assemblyman Collins.
Amendment adopted.
Assemblyman Collins moved that upon return from the
printer
Assembly Bill No. 41 be re-referred to the Committee on Ways and Means.
Motion carried.
Bill ordered
reprinted, engrossed, and to the Committee on
Ways and Means.
Assembly Bill No. 58.
Bill read second time.
The following amendment was proposed by the Committee on Transportation:
Amendment No. 121.
Amend section 1, page 1, by deleting lines 4 and 5 and
inserting: “being operated on a [paved highway within a county whose
population is 100,000 or more,] highway, to ride upon or within any
portion”.
Amend section 1, page 2, by deleting lines 5 through 8 and inserting:
“(1) [Not being operated on a freeway or other
road that has two or more lanes for traffic traveling in one direction;
(2)] Being used in the course of farming or
ranching; or
[(3)] (2) Being driven in a parade
authorized by a local authority.”.
Amend section 1, page 2, line 28, after “(c)” by inserting:
“ “Highway” has the meaning ascribed to it in NRS 484.065.
(d)”.
Amend the title of the bill, fourth line, after “circumstances;” by inserting: “expanding the prohibition from paved highways to all highways; revising provisions governing the exception to the prohibition for certain persons;”.
Amend the summary of the bill to read as follows:
“SUMMARY—Revises provisions governing prohibition against driver of motor vehicle allowing person to ride upon or within certain portions of motor vehicle under certain circumstances. (BDR 43‑668)”.
Assemblywoman Chowning moved the adoption of the amendment.
Remarks by Assemblywoman Chowning.
Amendment adopted.
Bill ordered reprinted, engrossed, and to third reading.
Assembly Bill No. 70.
Bill read second time.
The following amendment was proposed by the Committee on
Commerce and Labor:
Amendment No. 34.
Amend section 1, page 1, lines 3 and 4, by deleting: “facility:
(a) Has” and inserting “facility has”.
Amend section 1, page 1, line 6, before “health” by inserting “covered”.
Amend section 1, page 1, line 9, before “health” by inserting “covered”.
Amend section 1, page 1, line 14, by deleting “(1)” and inserting “(a)”.
Amend section 1, page 1, line 16, by deleting “(2)” and inserting “(b)”.
Amend section 1, page 2, by deleting lines 4 through 9.
Assemblyman Goldwater moved the adoption of the amendment.
Remarks by Assemblyman Goldwater.
Amendment adopted.
Bill ordered reprinted, engrossed, and to third reading.
Assembly Bill No. 79.
Bill read second time.
The following amendment was proposed by the Committee on
Commerce and Labor:
Amendment No. 25.
Amend section 1, page 2, by deleting lines 2 and 3 and inserting: “adding thereto the provisions set forth as sections 2 and 3 of this act.
Sec. 2. 1. An external review organization shall not conduct an”.
Amend section 1, page 2, line 5, by deleting: “6 to 14,” and inserting: “16 to 28,”.
Amend section 1, page 2, line 25, by deleting: “6 to 14,” and inserting: “16 to 28,”.
Amend section 1, page 2, line 34, by deleting: “6 to 14,” and inserting: “16 to 28,”.
Amend section 1, page 3, by deleting lines 40 through 43 and inserting: “(a) “Adverse determination” has the meaning ascribed to it in section 16 of this act.
(b) “External review organization” has the meaning ascribed to it in section 19 of this act.”.
Amend section 1, page 4, by deleting lines 2 and 3 and inserting: “person who is licensed in this state or is licensed, certified or otherwise authorized by any other state to provide any health care service.”.
Amend the bill as a whole by renumbering sections 2 and 3 as sections 11 and 12 and adding new sections designated sections 3 through 10, following section 1, to read as follows:
“Sec. 3. As soon as practicable after preparing an annual list of external review organizations pursuant to subsection 8 of section 2 of this act, the Commissioner shall submit a copy of the list to the Office for Consumer Health Assistance. If a change occurs in the list, the Commissioner shall notify the Office for Consumer Health Assistance of the change.
Sec. 4. NRS 689A.745 is hereby amended to read as follows:
689A.745 1. [Each] Except as otherwise
provided in subsection 4, each insurer that issues a policy of health
insurance in this state shall establish a system for resolving any complaints
of an insured concerning health care services covered under the policy. The
system must be approved by the Commissioner in consultation with the State
Board of Health.
2. A system for resolving complaints established pursuant to subsection 1 must include an initial investigation, a review of the complaint by a review board and a procedure for appealing a determination regarding the complaint. The majority of the members on a review board must be insureds who receive health care services pursuant to a policy of health insurance issued by the insurer.
3. The Commissioner or the State Board of Health may
examine the system for resolving complaints established pursuant to [this
section] subsection 1 at such times as either deems necessary or
appropriate.
4. Each insurer that issues a policy of health
insurance in this state that provides, delivers, arranges for, pays for or
reimburses any cost of health care services through managed care shall provide
a system for resolving any complaints of an insured concerning those health
care services that complies with the provisions of sections 16 to 28,
inclusive, of this act and
NRS 695G.200 to 695G.230, inclusive.
Sec. 5. NRS 689A.750 is hereby amended to read as follows:
689A.750 1. Each insurer that issues a policy of health insurance in this state shall submit to the Commissioner and the State Board of Health an annual report regarding its system for resolving complaints established pursuant to subsection 1 of NRS 689A.745 on a form prescribed by the Commissioner in consultation with the State Board of Health which includes, without limitation:
(a) A description of the procedures used for resolving any complaints of an insured;
(b) The total number of complaints and appeals handled through the system for resolving complaints since the last report and a compilation of the causes underlying the complaints filed;
(c) The current status of each complaint and appeal filed; and
(d) The average amount of time that was needed to resolve a complaint and an appeal, if any.
2. Each insurer shall maintain records of complaints filed with it which concern something other than health care services and shall submit to the Commissioner a report summarizing such complaints at such times and in such format as the Commissioner may require.
Sec. 6. NRS 689B.0285 is hereby amended to read as follows:
689B.0285 1. [Each] Except as otherwise
provided in subsection 4, each insurer that issues a policy of group health
insurance in this state shall establish a system for resolving any complaints
of an insured concerning health care services covered under the policy. The
system must be approved by the Commissioner in consultation with the State
Board of Health.
2. A system for resolving complaints established pursuant to subsection 1 must include an initial investigation, a review of the complaint by a review board and a procedure for appealing a determination regarding the complaint. The majority of the members on a review board must be insureds who receive health care services pursuant to a policy of group health insurance issued by the insurer.
3. The Commissioner or the State Board of Health may
examine the system for resolving complaints established pursuant to [this
section] subsection 1 at such times as either deems necessary or
appropriate.
4. Each insurer that issues a policy of group health insurance in this state that provides, delivers, arranges for, pays for or reimburses any cost of health care services through managed care shall provide a system for resolving any complaints of an insured concerning the health care services that complies with the provisions of sections 16 to 28, inclusive, of this act and NRS 695G.200 to 695G.230, inclusive.
Sec. 7. NRS 689B.029 is hereby amended to read as follows:
689B.029 1. Each insurer that issues a policy of group health insurance in this state shall submit to the Commissioner and the State Board of Health an annual report regarding its system for resolving complaints established pursuant to subsection 1 of NRS 689B.0285 on a form prescribed by the Commissioner in consultation with the State Board of Health which includes, without limitation:
(a) A description of the procedures used for resolving any complaints of an insured;
(b) The total number of complaints and appeals handled through the system for resolving complaints since the last report and a compilation of the causes underlying the complaints filed;
(c) The current status of each complaint and appeal filed; and
(d) The average amount of time that was needed to resolve a complaint and an appeal, if any.
2. Each insurer shall maintain records of complaints filed with it which concern something other than health care services and shall submit to the Commissioner a report summarizing such complaints at such times and in such format as the Commissioner may require.
Sec. 8. NRS 689C.156 is hereby amended to read as follows:
689C.156 1. As a condition of transacting business in this state with small employers, a carrier shall actively market to a small employer each health benefit plan which is actively marketed in this state by the carrier to any small employer in this state. The health insurance plans marketed pursuant to this section by the carrier must include, without limitation, a basic health benefit plan and a standard health benefit plan. A carrier shall be deemed to be actively marketing a health benefit plan when it makes available any of its plans to a small employer that is not currently receiving coverage under a health benefit plan issued by that carrier.
2. A carrier shall issue to a small employer any health benefit plan marketed in accordance with this section if the eligible small employer applies for the plan and agrees to make the required premium payments and satisfy the other reasonable provisions of the health benefit plan that are not inconsistent with NRS 689C.015 to 689C.355, inclusive, and 689C.610 to 689C.980, inclusive, except that a carrier is not required to issue a health benefit plan to a self-employed person who is covered by, or is eligible for coverage under, a health benefit plan offered by another employer.
3. If a health benefit plan marketed pursuant to this section provides, delivers, arranges for, pays for or reimburses any cost of health care services through managed care, the carrier shall provide a system for resolving any complaints of an employee concerning those health care services that complies with the provisions of sections 16 to 28, inclusive, of this act and NRS 695G.200 to 695G.230, inclusive.
Sec. 9. NRS 695B.380 is hereby amended to read as follows:
695B.380 1. [Each] Except as otherwise
provided in subsection 4, each insurer that issues a contract for hospital
or medical services in this state shall establish a system for resolving any
complaints of an insured concerning health care services covered under the
policy. The system must be approved by the Commissioner in consultation with
the State Board of Health.
2. A system for resolving complaints established pursuant to subsection 1 must include an initial investigation, a review of the complaint by a review board and a procedure for appealing a determination regarding the complaint. The majority of the members on a review board must be insureds who receive health care services pursuant to a contract for hospital or medical services issued by the insurer.
3. The Commissioner or the State Board of Health may
examine the system for resolving complaints established pursuant to [this
section] subsection 1 at such times as either deems necessary or
appropriate.
4. Each insurer that issues a contract specified in subsection 1 shall, if the contract provides, delivers, arranges for, pays for or reimburses any cost of health care services through managed care, provide a system for resolving any complaints of an insured concerning those health care services that complies with the provisions of sections 16 to 28, inclusive, of this act and NRS 695G.200 to 695G.230, inclusive.
Sec. 10. NRS 695B.390 is hereby amended to read as follows:
695B.390 1. Each insurer that issues a contract for hospital or medical services in this state shall submit to the Commissioner and the State Board of Health an annual report regarding its system for resolving complaints established pursuant to subsection 1 of NRS 695B.380 on a form prescribed by the Commissioner in consultation with the State Board of Health which includes, without limitation:
(a) A description of the procedures used for resolving any complaints of an insured;
(b) The total number of complaints and appeals handled through the system for resolving complaints since the last report and a compilation of the causes underlying the complaints filed;
(c) The current status of each complaint and appeal filed; and
(d) The average amount of time that was needed to resolve a complaint and an appeal, if any.
2. Each insurer shall maintain records of complaints filed with it which concern something other than health care services and shall submit to the Commissioner a report summarizing such complaints at such times and in such format as the Commissioner may require.”.
Amend sec. 3, page 5, lines 18 and 19, by deleting: “6 to 14,” and inserting: “16 to 28,”.
Amend the bill as a whole by renumbering section 4 as section 13.
Amend sec. 4, page 6, line 13, by deleting: “6 to 14,” and inserting: “16 to 28,”.
Amend the bill as a whole by renumbering sec. 5 as sec. 15 and adding a new section designated sec. 14, following sec. 4, to read as follows:
“Sec. 14. NRS 695F.230 is hereby amended to read as follows:
695F.230 1. Each prepaid limited health service organization shall establish a system for the resolution of written complaints submitted by enrollees and providers.
2. The provisions of subsection 1 do not prohibit an enrollee or provider from filing a complaint with the Commissioner or limit the Commissioner’s authority to investigate such a complaint.
3. Each prepaid limited health service organization that issues any evidence of coverage that provides, delivers, arranges for, pays for or reimburses any cost of health care services through managed care shall provide a system for resolving any complaints of an enrollee or subscriber concerning those health care services that complies with the provisions of sections 16 to 28, inclusive, of this act and NRS 695G.200 to 695G.230, inclusive.”.
Amend sec. 5, page 6, line 40, by deleting: “6 to 14,” and inserting: “16 to 28,”.
Amend the bill as a whole by renumbering sec. 6 as sec. 17 and adding a new section designated sec. 16, following sec. 5, to read as follows:
“Sec. 16. “Adverse determination” means a determination of a managed care organization that an allocation of health care resources and services that is provided or proposed to be provided to an insured is not medically necessary or appropriate or is experimental or investigational. The term does not include a determination of a managed care organization that such an allocation is not a covered benefit.”.
Amend sec. 6, page 6, line 45, by deleting: “6 to 14,” and inserting: “16 to 28,”.
Amend the bill as a whole by renumbering sec. 7 as sec. 18.
Amend sec. 7, page 7, lines 3 and 4, by deleting: “the Board of Medical Examiners” and inserting: “a member board of the American Board of Medical Specialties”.
Amend the bill as a whole by deleting sections 8 and 9, renumbering sec. 10 as sec. 20 and adding a new section designated sec. 19, following sec. 7, to read as follows:
“Sec. 19. “External review organization” means an organization that:
1. Conducts an external review of a final adverse determination; and
2. Is certified by the Commissioner in accordance with section 2 of this act.”.
Amend sec. 10, page 7, line 29, by deleting “are:” and inserting: “are necessary and:”.
Amend sec. 10, page 7, line 33, by deleting “and”.
Amend sec. 10, page 7, line 35, by deleting “care.” and inserting: “care;
4. Required to improve a specific health condition of an insured or to preserve his existing state of health; and
5. The most clinically appropriate level of health care that may be safely provided to the insured.”.
Amend the bill as a whole by renumbering sec. 11 as sec. 22 and adding a new section designated sec. 21, following sec. 10, to read as follows:
“Sec. 21. 1. For the purposes of sections 16 to 28, inclusive, of this act and NRS 695G.200 to 695G.230, inclusive, an adverse determination is final if the insured has exhausted all procedures set forth in the health care plan for reviewing the adverse determination within the managed care organization.
2. An adverse determination shall be deemed final for the purpose of submitting the adverse determination to an external review organization for an external review:
(a) If an insured exhausts all procedures set forth in the health care plan for reviewing the adverse determination within the managed care organization and the managed care organization fails to render a decision within the period required to render that decision set forth in the health care plan; or
(b) If the managed care organization submits the adverse determination to the external review organization without requiring the insured to exhaust all procedures set forth in the health care plan for reviewing the adverse determination within the managed care organization.”.
Amend sec. 11, page 8, by deleting lines 8 through 20 and inserting:
“3. As soon as practicable after receiving a notice
pursuant to
subsection 2, the Office for Consumer Health Assistance shall assign an
external review organization from the list maintained pursuant to section 2 of
this act. Each assignment made pursuant to this subsection must be completed on
a rotating basis.
4. Within 5 days after receiving notification from the Office for Consumer Health Assistance specifying the external review organization assigned pursuant to”.
Amend sec. 12, page 8, by deleting lines 35 and 36 and inserting:
“Sec. 23. 1. Except as otherwise provided in section 24 of this act, upon receipt of a request for an external review pursuant to section 22 of this act, the external review organization”.
Amend sec. 12, page 8, line 39, by deleting “11” and inserting “22”.
Amend sec. 12, page 8, line 43, by deleting “subsection 3,” and inserting: “section 24 of this act,”.
Amend sec. 12, page 9, line 6, after “any;” by inserting “and”.
Amend sec. 12, page 9, by deleting lines 7 through 30 and inserting:
“(d) The managed care organization.”.
Amend the bill as a whole by renumbering sec. 13 as sec. 26 and adding new sections designated sections 24 and 25, following sec. 12, to read as follows:
“Sec. 24. 1. A managed care organization shall approve or deny a request for an external review of a final adverse determination in an expedited manner not later than 72 hours after it receives proof from the insured’s provider of health care that failure to proceed in an expedited manner may jeopardize the life or health of the insured.
2. If a managed care organization approves a request for an external review pursuant to subsection 1, the managed care organization shall:
(a) In accordance with subsections 4 and 5, assign the request to an external review organization not later than 1 working day after approving the request; and
(b) At the time of assigning the request, provide to the external review organization all documents and materials specified in subsection 4 of section 22 of this act.
3. An external review organization that is assigned to conduct an external review pursuant to subsection 2 shall, if it accepts the assignment:
(a) Complete its external review not later than 2 working days after receiving the assignment, unless the insured and the managed care organization agree to a longer period;
(b) Not later than 1 working day after completing its external review, notify the insured, the physician of the insured, the authorized representative of the insured, if any, and the managed care organization by telephone of its determination; and
(c) Not later than 5 working days after completing its external review, submit a written decision of its external review to the insured, the physician of the insured, the authorized representative of the insured, if any, and the managed care organization.
4. At least once each month, the Office for Consumer Health Assistance shall designate at least 2 external review organizations to conduct external reviews in an expedited manner pursuant to this section. As soon as practicable after designating an external review organization pursuant to this section, the Office for Consumer Health Assistance shall notify each managed care organization of the designation.
5. As soon as practicable after assigning an external review organization to conduct an external review pursuant to this section, the managed care organization shall notify the Office for Consumer Health Assistance of the assignment. Each assignment made by a managed care organization pursuant to this section must be completed on a rotating basis.
Sec. 25. The decision of an external review organization concerning a request for an external review must be based on:
1. Documentary evidence, including any recommendation of the physician of the insured submitted pursuant to section 22 of this act;
2. Medical evidence, including, without limitation:
(a) Professional standards of safety and effectiveness for diagnosis, care and treatment that are generally recognized in the United States;
(b) Any report published in literature that is peer-reviewed;
(c) Evidence-based medicine, including, without limitation, reports and guidelines that are published by professional organizations that are recognized nationally and that include supporting scientific data; and
(d) An opinion of an independent physician who, as determined by the external review organization, is an expert in the health specialty that is the subject of the external review; and
3. The terms and conditions for benefits set forth in the evidence of coverage issued to the insured by the managed care organization.”.
Amend sec. 13, page 9, line 42, by deleting: “6 to 14,” and inserting: “16 to 28,”.
Amend sec. 13, page 9, line 43, by deleting: “to the Office for Consumer Health Assistance”.
Amend the bill as a whole by renumbering sec. 14 as sec. 27.
Amend sec. 14, page 10, line 6, by deleting: “6 to 14,” and inserting: “16 to 28,”.
Amend sec. 14, page 10, line 12, by deleting: “6 to 14,” and inserting: “16 to 28,”.
Amend the bill as a whole by renumbering sections 15 and 16 as sections 29 and 30 and adding a new section designated sec. 28, following sec. 14, to read as follows:
“Sec. 28. On or before January 31 of each year, each managed care organization shall file a written report with the Office for Consumer Health Assistance setting forth the total number of:
1. Requests for external review that were received by the managed care organization during the immediately preceding year; and
2. Final adverse determinations of the managed care organization that were:
(a) Approved during the immediately preceding year;
(b) Reversed during the immediately preceding year; and
(c) Modified during the immediately preceding year.”.
Amend sec. 15, page 10, line 17, by deleting: “6 to 10,” and inserting: “16 to 20,”.
Amend sec. 16, page 10, line 25, by deleting: “6 to 14,” and inserting: “16 to 28,”.
Amend the bill as a whole by renumbering sections 17 and 18 as sections 32 and 33 and adding a new section designated sec. 31, following sec. 16, to read as follows:
“Sec. 31. NRS 695G.090 is hereby amended to read as follows:
695G.090 1. The provisions of this chapter apply to each organization and insurer that operates as a managed care organization and may include, without limitation, an insurer that issues a policy of health insurance, an insurer that issues a policy of individual or group health insurance, a carrier serving small employers, a fraternal benefit society, a hospital or medical service corporation , and a health maintenance organization.
2. In addition to the provisions of this chapter, each managed care organization shall comply with any other applicable provision of this title.
3. The provisions of NRS 695G.200 to 695G.230, inclusive, do not apply to an 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 Human Resources. This subsection does not exempt a managed care organization from any provision of this chapter for services provided pursuant to any other contract.”.
Amend sec. 17, page 10, line 28, by deleting “14” and inserting “27”.
Amend sec. 18, page 11, line 35, by deleting: “6 to 14,” and inserting: “16 to 28,”.
Amend the bill as a whole by deleting sec. 19 and renumbering sec. 20 as sec. 34.
Amend sec. 20, page 13, lines 18 and 19, by deleting: “6 to 14,” and inserting: “16 to 28,”.
Amend sec. 20, page 13, line 20, by deleting “reviews.” and inserting: “reviews as reported pursuant to section 28 of this act.”.
Amend the bill as a whole by renumbering sec. 21 as sec. 35.
Amend sec. 21, page 13, line 25, by deleting: “6 to 14,” and inserting: “16 to 28,”.
Amend the bill as a whole by renumbering sec. 22 as sec. 37 and adding a new section designated sec. 36, following sec. 22, to read as follows:
“Sec. 36. NRS 422.273 is hereby amended to read as follows:
422.273 1. For any Medicaid managed care program established in the State of Nevada, the Department shall contract only with a health maintenance organization that has:
(a) Negotiated in good faith with a federally-qualified health center to provide health care services for the health maintenance organization;
(b) Negotiated in good faith with the University Medical Center of Southern Nevada to provide inpatient and ambulatory services to recipients of Medicaid; and
(c) Negotiated in good faith with the University of Nevada School of Medicine to provide health care services to recipients of Medicaid.
Nothing in this section shall be construed as exempting a federally-qualified health center, the University Medical Center of Southern Nevada or the University of Nevada School of Medicine from the requirements for contracting with the health maintenance organization.
2. During the development and implementation of any Medicaid managed care program, the Department shall cooperate with the University of Nevada School of Medicine by assisting in the provision of an adequate and diverse group of patients upon which the school may base its educational programs.
3. The University of Nevada School of Medicine may establish a nonprofit organization to assist in any research necessary for the development of a Medicaid managed care program, receive and accept gifts, grants and donations to support such a program and assist in establishing educational services about the program for recipients of Medicaid.
4. For the purpose of contracting with a Medicaid managed care program pursuant to this section, a health maintenance organization is exempt from the provisions of NRS 695C.123.
5. The provisions of this section apply to any managed care organization, including a health maintenance organization, that provides health care services to recipients of Medicaid under the State Plan for Medicaid or the Children’s Health Insurance Program pursuant to a contract with the Division of Health Care Financing and Policy of the Department of Human Resources. Such a managed care organization or health maintenance organization is not required to establish a system for conducting external reviews of final adverse determinations in accordance with chapter 695B, 695C or 695G of NRS. This subsection does not exempt such a managed care organization or health maintenance organization for services provided pursuant to any other contract.
6. As used in this section, unless the context otherwise requires:
(a) “Federally-qualified health center” has the meaning
ascribed to it in
42 U.S.C. § 1396d(l)(2)(B).
(b) “Health maintenance organization” has the meaning ascribed to it in NRS 695C.030.
(c) “Managed care organization” has the meaning
ascribed to it in
NRS 695G.050.”.
Amend sec. 22, page 13, by deleting lines 31 through 35 and inserting:
“2. Sections 1 to 36, inclusive, of this act become”.
Amend sec. 22, page 13, line 41, by deleting “1” and inserting “2”.
Amend the title of the bill to read as follows:
“AN ACT relating to health care; requiring an external review organization to be certified by the Commissioner of Insurance before conducting an external review of a final adverse determination of a managed care organization, health maintenance organization or certain insurers; authorizing an insured under certain health care plans to submit to a managed care organization, health maintenance organization or certain insurers a request for such a review under certain circumstances; requiring an external review organization to approve, modify or reverse a final adverse determination within a certain period; providing that an external review organization is not liable in a civil action for damages relating to a determination issued by the external review organization under certain circumstances; and providing other matters properly relating thereto.”.
Amend the summary of the bill to read as follows:
“SUMMARY—Provides for external review of final adverse determinations made by managed care organizations, health maintenance organizations and certain insurers. (BDR 57‑955)”.
Assemblyman Goldwater moved the adoption of the amendment.
Remarks by Assemblyman Goldwater.
Amendment adopted.
Bill ordered reprinted, engrossed, and to third reading.
Assembly Bill No. 83.
Bill read second time.
The following amendment was proposed by the Committee on Transportation:
Amendment No. 95.
Amend section 1, page 1, line 4, by deleting “may” and inserting “shall not”.
Amend section 1, page 1, line 5, by deleting “if:” and inserting “unless:”.
Amend section 1, page 2, by deleting lines 5 through 9 and inserting:
“2. A person who violates the provisions of this section is”.
Assemblywoman Chowning moved the adoption of the amendment.
Remarks by Assemblywoman Chowning.
Amendment adopted.
Bill ordered reprinted, engrossed, and to third reading.
Assembly Bill No. 85.
Bill read second time.
The following amendment was proposed by the Committee on Government Affairs:
Amendment No. 116.
Amend sec. 2, pages 2 and 3, by deleting line 45 on page
2 and lines 1 and 2 on page 3 and inserting: “the Director;] ;
(d) The Director provides notice of the request for the financing of the project to the governing body of the city or county in which the project is proposed to be located, and has not received a copy of a resolution from the governing body objecting to the project within 25 business days after the notice is provided; and
(e) The Director complies with the provisions of NRS 349.590”.
Assemblyman Manendo moved the adoption of the amendment.
Remarks by Assemblyman Manendo.
Amendment adopted.
Bill ordered reprinted, engrossed, and to third reading.
Assembly Bill No. 144.
Bill read second time.
The following amendment was proposed by the Committee on
Commerce and Labor:
Amendment No. 127.
Amend the bill as a whole by deleting section 1 and adding a new section designated section 1, following the enacting clause, to read as follows:
“Section 1. Chapter 639 of NRS is hereby amended by adding thereto a new section to read as follows:
1. A pharmacist shall not refuse to fill or refill a prescription as written unless the pharmacist knows or has reasonable cause to believe that the prescription is:
(a) Fraudulent;
(b) Issued contrary to law; or
(c) Contraindicated.
2. If a pharmacist refuses to dispense a prescription pursuant to paragraph (c) of subsection 1, the pharmacist shall consult with the prescribing practitioner as soon as practicable.
3. The provisions of this section do not:
(a) Require a pharmacist to stock a particular drug; or
(b) Prohibit a pharmacist from:
(1) Substituting a drug pursuant to NRS 639.2583; or
(2) Requiring payment for a drug in the normal course of business.
4. A pharmacist is not subject to any penalty for violation of this section except as provided in NRS 639.255.”.
Amend the title of the bill to read as follows:
“AN ACT relating to pharmacy; prohibiting a pharmacist from refusing to fill or refill a prescription under certain circumstances; and providing other matters properly relating thereto.”.
Amend the summary of the bill to read as follows:
“SUMMARY—Prohibits pharmacist from refusing to fill or refill prescription under certain circumstances. (BDR 54‑210)”.
Assemblyman Goldwater moved the adoption of the amendment.
Remarks by Assemblymen Goldwater, Mabey, Hardy, and Hettrick.
Amendment adopted.
Bill ordered reprinted, engrossed, and to third reading.
Assembly Bill No. 170.
Bill read second time.
The following amendment was proposed by the Committee on Transportation:
Amendment No. 128.
Amend sec. 3, page 6, line 2, after “law.” by inserting: “The application must also inform the applicant that by registering with the Selective Service System in compliance with federal law, the applicant remains eligible for federal student loans, grants, benefits relating to job training, most federal jobs and, if applicable, citizenship in the United States.”.
Amend sec. 4, page 6, line 21, after “law.” by inserting: “The application must also inform the applicant that by registering with the Selective Service System in compliance with federal law, the applicant remains eligible for federal student loans, grants, benefits relating to job training, most federal jobs and, if applicable, citizenship in the United States.”.
Amend sec. 5, page 6, line 43, after “law.” by inserting: “The application must also inform the applicant that by registering with the Selective Service System in compliance with federal law, the applicant remains eligible for federal student loans, grants, benefits relating to job training, most federal jobs and, if applicable, citizenship in the United States.”.
Assemblywoman Chowning moved the adoption of the amendment.
Remarks by Assemblywoman Chowning.
Amendment adopted.
Assemblywoman Chowning moved that upon return from the printer Assembly Bill No. 170 be re-referred to the Committee on Ways and Means.
Motion carried.
Bill ordered
reprinted, engrossed, and to the Committee on
Ways and Means.
Assembly Bill No. 315.
Bill read second time.
The following amendment was proposed by the Committee on
Health and Human Services:
Amendment No. 180.
Amend section 1, page 1, line 3, after “Officer” by inserting: “or a qualified person designated by the Administrator of the Health Division”.
Amend section 1, page 1, lines 8 and 10, after “Officer” by inserting: “or the person designated pursuant to subsection 1”.
Amend the title of the bill by deleting the first through third lines and inserting:
“AN ACT relating to cancer; requiring the State Health Officer or a person designated by the Administrator of the Health Division of the Department of Human Resources to analyze information reported by health facilities concerning cancer; requiring the State Health Officer or person designated by the Administrator of the Health Division to”.
Amend the summary of the bill to read as follows:
“SUMMARY—Requires State Health Officer or person designated by Administrator of Health Division of Department of Human Resources to analyze information reported by health facilities concerning cancer to determine trends in incidence of cancer. (BDR 40‑75)”.
Assemblywoman Koivisto moved the adoption of the amendment.
Remarks by Assemblywoman Koivisto.
Amendment adopted.
Bill ordered reprinted, engrossed, and to third reading.
Assembly Bill No. 328.
Bill read second time and ordered to third reading.
Assembly Bill No. 371.
Bill read second time.
The following amendment was proposed by the Committee on
Natural Resources, Agriculture, and Mining:
Amendment No. 120.
Amend section 1, page 1, line 1, by deleting “The” and inserting:
“1. Except as otherwise provided in subsection 2, the”.
Amend section 1, page 1, between lines 10 and 11, by inserting:
“2. The conveyance of the parcel of land pursuant to subsection 1 must not include any property or interest in the parcel that is currently owned by the Department of Transportation.”.
Amend sec. 2, page 2, line 2, by deleting “groups.” and inserting: “groups, as well as use for charitable or civic purposes by corporations for public benefit.”.
Amend sec. 2, page 2, line 5, after “Nevada.” by inserting: “As used in this subsection, “corporation for public benefit” has the meaning ascribed to it in NRS 82.021.”.
Amend sec. 3, page 2, line 12, by deleting: “on July 1, 2003.” and inserting: “upon passage and approval.”.
Assemblyman Collins moved the adoption of the amendment.
Remarks by Assemblyman Collins.
Amendment adopted.
Bill ordered reprinted, engrossed, and to the Concurrent Committee on Ways and Means.
Assembly Bill No. 402.
Bill read second time and ordered to third reading.
Assembly Bill No. 409.
Bill read second time.
The following amendment was proposed by the Committee on Government Affairs:
Amendment No. 123.
Amend section 1, page 3, line 15, after “mail.” by inserting: “The inability of a public body, as a result of technical problems with its electronic mail system, to provide a public notice, information or material required by this section to a person who has agreed to receive such notice, information or material by electronic mail shall not be deemed to be a violation of the provisions of this chapter.”.
Assemblyman Manendo moved the adoption of the amendment.
Remarks by Assemblyman Manendo.
Amendment adopted.
Bill ordered reprinted, engrossed, and to third reading.
Assembly Bill No. 456.
Bill read second time and ordered to third reading.
Assembly Bill No. 520.
Bill read second time and ordered to third reading.
general file and third reading
Assembly Bill No. 19.
Bill read third time.
Remarks by Assemblymen Chowning, Goldwater, and Giunchigliani.
Roll call on Assembly Bill No. 19:
Yeas—29.
Nays—Beers, Brown, Conklin, Geddes, Giunchigliani, Goicoechea, Goldwater, Grady, Horne, Koivisto, Mabey, McCleary, Perkins—13.
Assembly Bill No. 19 having received a two-thirds majority, Mr. Speaker declared it passed, as amended.
Bill ordered transmitted to the Senate.
Assembly Bill No. 35.
Bill read third time.
Remarks by Assemblyman Parks.
Roll call on Assembly Bill No. 35:
Yeas—42.
Nays—None.
Assembly Bill No. 35 having received a constitutional
majority,
Mr. Speaker declared it passed, as amended.
Bill ordered transmitted to the Senate.
Assembly Bill No. 67.
Bill read third time.
Remarks by Assemblyman Hardy.
Roll call on Assembly Bill No. 67:
Yeas—42.
Nays—None.
Assembly Bill No. 67 having received a constitutional
majority,
Mr. Speaker declared it passed, as amended.
Bill ordered transmitted to the Senate.
Assembly Bill No. 119.
Bill read third time.
Remarks by Assemblyman Williams.
Roll call on Assembly Bill No. 119:
Yeas—42.
Nays—None.
Assembly Bill No. 119 having received a constitutional
majority,
Mr. Speaker declared it passed, as amended.
Bill ordered transmitted to the Senate.
Assembly Bill No. 139.
Bill read third time.
Remarks by Assemblyman Goldwater.
Roll call on Assembly Bill No. 139:
Yeas—42.
Nays—None.
Assembly Bill No. 139 having received a constitutional
majority,
Mr. Speaker declared it passed, as amended.
Bill ordered transmitted to the Senate.
Assembly Bill No. 182.
Bill read third time.
Remarks by Assemblymen Kovisto, McClain, Hettrick, Claborn, Pierce, and Collins.
Potential conflict of interest declared by Assemblywoman McClain.
Roll call on Assembly Bill No. 182:
Yeas—23.
Nays—Andonov, Angle, Beers, Brown, Carpenter, Christensen, Geddes, Gibbons, Goicoechea, Grady, Griffin, Gustavson, Hardy, Hettrick, Knecht, Mabey, Marvel, Sherer, Weber—19.
Assembly Bill No. 182 having received a constitutional
majority,
Mr. Speaker declared it passed.
Bill ordered transmitted to the Senate.
Assembly Bill No. 190.
Bill read third time.
Remarks by Assemblyman Goldwater.
Roll call on Assembly Bill No. 190:
Yeas—42.
Nays—None.
Assembly Bill No. 190 having received a constitutional
majority,
Mr. Speaker declared it passed, as amended.
Bill ordered transmitted to the Senate.
Assembly Bill No. 221.
Bill read third time.
Remarks by Assemblywoman Chowning.
Roll call on Assembly Bill No. 221:
Yeas—41.
Nays—None.
Excused—Weber.
Assembly Bill No. 221 having received a constitutional
majority,
Mr. Speaker declared it passed, as amended.
Bill ordered transmitted to the Senate.
Assembly Bill No. 231.
Bill read third time.
Remarks by Assemblyman Goldwater.
Roll call on Assembly Bill No. 231:
Yeas—41.
Nays—None.
Excused—Weber.
Assembly Bill No. 231 having received a two-thirds majority, Mr. Speaker declared it passed, as amended.
Bill ordered transmitted to the Senate.
Assembly Bill No. 443
Bill read third time.
Remarks by Assemblyman Anderson.
Assemblyman Anderson moved that Assembly Bill No. 443 be taken from the General File and placed on the Chief Clerk's desk.
Motion carried.
REPORTS OF COMMITTEES
Mr. Speaker:
Your Committee on Transportation, to which were referred Assembly Bills Nos. 30, 77, has had the same under consideration, and begs leave to report the same back with the recommendation: Amend, and do pass as amended.
Vonne Chowning, Chairman
MOTIONS, RESOLUTIONS AND NOTICES
Assemblyman Parks moved that Assembly Bill No. 361 be taken from the Chief Clerk’s desk and placed on the General File for the next legislative day.
Motion carried.
UNFINISHED BUSINESS
Signing of Bills and Resolutions
There being no objections, the Speaker and Chief Clerk signed Assembly Concurrent Resolution No. 13.
GUESTS EXTENDED PRIVILEGE OF ASSEMBLY FLOOR
On
request of Assemblyman Anderson, the privilege of the floor of the Assembly
Chamber for this day was extended to Ingrid Kovacs,
Karen Bowman, Conda Arteaga, Richard Waller, Robert Mitchell,
Rolann Aronson, David Miller, Chris Johnson, Jake Ward, Amelia Wilson, Cody
Hamilton, Peter Klipfel, Nathan Crumrine, Justin Sykes,
Tom Schumacher, Linda Wrubel, Anna Louie, Jason Lin, Kylie Stevens, David Love,
Tré Johnson, Corry Coss, Lexus Fisher, Patrick Daniels, Shizette Smith, Morgan
Triplett, Brianna Bakker, Nikola Petrovic,
Michael Brookshire, Josh Lundin, Brandon Rieken, Christian Manning,
Zach Denhardt, Carlos Garcia, Matt Stewart Francis, Greg Witezak,
Lechelle Smith, Paul Nevis, Jay Cortez, Andrew Millette, and Taylor Yancy.
On request of Assemblyman Andonov, the privilege of the floor of the Assembly Chamber for this day was extended to Michael Bass.
On request of Assemblyman Atkinson, the privilege of the floor of the Assembly Chamber for this day was extended to Amber Johnson and Elizabeth Floyd.
On request of Assemblywoman Buckley, the privilege of the floor of the Assembly Chamber for this day was extended to Wade Wagner.
On request of Assemblywoman Chowning, the privilege of the floor of the Assembly Chamber for this day was extended to Marsha Neel, Mike Spears, and Kaylan Hanson.
On request of Assemblyman Claborn, the privilege of the floor of the Assembly Chamber for this day was extended to Zach Dice.
On request of Assemblyman Collins, the privilege of the floor of the Assembly Chamber for this day was extended to Devanny Novak.
On request of Assemblyman Conklin, the privilege of the floor of the Assembly Chamber for this day was extended to Alicia Norton.
On
request of Assemblywoman Giunchigliani, the privilege of the floor of the
Assembly Chamber for this day was extended to Ruth Johnson and
John Sullivan.
On request of Assemblyman Goldwater, the privilege of the floor of the Assembly Chamber for this day was extended to Javier Muruato.
On request of Assemblyman
Horne, the privilege of the floor of the Assembly Chamber for this day was
extended to Matthew Dice and
Geoffrey Frasz.
On request of Assemblyman Knecht, the privilege of the floor of the Assembly Chamber for this day was extended to Edward Lynn, Steve Lee, George Alm, Paul Richied, and Mark McDonald.
On request of Assemblywoman Koivisto, the privilege of the floor of the Assembly Chamber for this day was extended to Shaina Johnson.
On request of Assemblywoman Leslie, the privilege of the floor of the Assembly Chamber for this day was extended to Bill Horn.
On request of Assemblyman Manendo, the privilege of the floor of the Assembly Chamber for this day was extended to Caitlin Johnson.
On request of Assemblywoman McClain, the privilege of the floor of the Assembly Chamber for this day was extended to Johnalee Collier.
On request of Assemblyman McCleary, the privilege of the floor of the Assembly Chamber for this day was extended to Trevor Bergstrom.
On request of Assemblyman Mortenson, the privilege of the floor of the Assembly Chamber for this day was extended to Jordan Quarles.
On request of Assemblyman Oceguera, the privilege of the floor of the Assembly Chamber for this day was extended to Elizabeth Floyd.
On request of Assemblywoman Ohrenschall, the privilege of the floor of the Assembly Chamber for this day was extended to Megan Danser.
On request of Assemblyman Parks, the privilege of the floor of the Assembly Chamber for this day was extended to Chelsey Johnson.
On request of Assemblywoman Pierce, the privilege of the floor of the Assembly Chamber for this day was extended to Kelly Gibbs.
On request of Assemblyman
Sherer, the privilege of the floor of the Assembly Chamber for this day was
extended to Neal Couch and
Elissa Couch.
On request of Assemblyman Williams, the privilege of the floor of the Assembly Chamber for this day was extended to Mark Kovacs.
Assemblywoman Buckley moved that the Assembly adjourn until Friday, April 4, 2003, at 10:30 a.m.
Motion carried.
Assembly adjourned at 12:46 p.m.
Approved: Richard D. Perkins
Attest: Jacqueline Sneddon