This article was created by AI using a key topic of the bill. It summarizes the key points discussed, but for full details and context, please refer to the full bill. Link to Bill
Assembly Bill 290, introduced in the Nevada State Legislature on February 26, 2025, aims to overhaul the prior authorization process for medical and dental care, addressing long-standing frustrations among patients and healthcare providers. The bill mandates that insurers clearly outline the specific goods and services requiring prior authorization and the clinical criteria used to evaluate these requests, ensuring transparency and accessibility for consumers.
Key provisions include a strict timeline for insurers to respond to prior authorization requests—five days for non-urgent care and 24 hours for urgent cases. Additionally, any adverse determinations must be made by qualified licensed physicians or dentists, with a requirement for insurers to allow healthcare providers to discuss requests directly with decision-makers. This change is expected to streamline the process and reduce delays in patient care.
Notably, the bill prohibits insurers from denying claims for care that did not require prior authorization at the time of service, a significant shift aimed at protecting patients from unexpected costs. It also ensures that approved requests remain valid for 12 months and that new insurers honor prior approvals for the first 90 days of coverage.
The legislation has sparked debates among stakeholders. Supporters argue it will enhance patient access to necessary care and reduce bureaucratic hurdles, while opponents express concerns about potential increased costs for insurers. The implications of AB290 could be far-reaching, potentially reshaping the landscape of healthcare delivery in Nevada by prioritizing patient needs and expediting care.
As the bill progresses through the legislative process, its fate remains uncertain, but its introduction marks a pivotal moment in the ongoing conversation about healthcare accessibility and efficiency in the state. If passed, AB290 could set a precedent for similar reforms across the nation, reflecting a growing demand for transparency and accountability in healthcare practices.
Key provisions include a strict timeline for insurers to respond to prior authorization requests—five days for non-urgent care and 24 hours for urgent cases. Additionally, any adverse determinations must be made by qualified licensed physicians or dentists, with a requirement for insurers to allow healthcare providers to discuss requests directly with decision-makers. This change is expected to streamline the process and reduce delays in patient care.
Notably, the bill prohibits insurers from denying claims for care that did not require prior authorization at the time of service, a significant shift aimed at protecting patients from unexpected costs. It also ensures that approved requests remain valid for 12 months and that new insurers honor prior approvals for the first 90 days of coverage.
The legislation has sparked debates among stakeholders. Supporters argue it will enhance patient access to necessary care and reduce bureaucratic hurdles, while opponents express concerns about potential increased costs for insurers. The implications of AB290 could be far-reaching, potentially reshaping the landscape of healthcare delivery in Nevada by prioritizing patient needs and expediting care.
As the bill progresses through the legislative process, its fate remains uncertain, but its introduction marks a pivotal moment in the ongoing conversation about healthcare accessibility and efficiency in the state. If passed, AB290 could set a precedent for similar reforms across the nation, reflecting a growing demand for transparency and accountability in healthcare practices.
Converted from Assembly Bill 290 bill
Link to Bill
Comments
View Bill
This article is based on a bill currently being presented in the state government—explore the full text of the bill for a deeper understanding and compare it to the constitution
View Bill