[{"_1":2,"_99":-5,"_100":-5},"loaderData",{"_3":4,"_25":26},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","routes/v2/article/layout",{"_27":28,"_29":30},"notFound",true,"relatedArticles",[31,75,87],{"_32":33,"_34":35,"_36":37,"_38":39,"_40":41,"_42":43,"_44":45,"_46":47,"_48":49,"_50":51,"_52":53,"_54":55,"_56":57,"_58":59,"_60":61,"_62":63,"_64":65,"_66":67,"_68":69,"_70":71,"_72":73,"_74":73},"mediaId",6643542,"mediaKeyId","2531997-92b8456c00449a3eb9d8bff6dc0383c4","parentId",2531997,"title","Assembly hears AB284 seeking Medicaid reimbursement rates for vagus nerve implants to restore coverage","audioSeconds",744,"startMs",4962000,"endMs",5706000,"viewUrl","/Search/View?dp=1&key=2531997-92b8456c00449a3eb9d8bff6dc0383c4&start=4962&end=5706","thumbnailUrl","https://assets.pipeline.soar.com/2531997-92b8456c00449a3eb9d8bff6dc0383c4/thumbnail_4962000.jpg","articleUrl","/articles/6643542/Nevada/Assembly-hears-AB284-seeking-Medicaid-reimbursement-rates-for-vagus-nerve-implants-to-restore-coverage","mediaUrl","https://secure.pipeline.soar.com/6643542-07256707adda0ce8b1abbaa8b40c981e/orig.mp4?Expires=1770019446&Signature=RMTTt7Qd88VNoHJA-2cTj9S~O-Y1-OjntFn1W5mKUZvmFAlQ7Zxq14sdTdKIXE1VLZOcMfLbTOLbaQOm1dBJgHaehkJz8WgYP~K6KVbGcoWGe-6czinasD3WONb~HXswrUqdOaNy-6xqzkwhhaQy5df7WrVDN-QurYGWF4SkE2Yj0GrvWzdtpcl3Wg54TofDH39qnYme8sQxUP29CIzFPoVHvp~OV788mwTKqP3Qp3zSyzW~1pkMJvQtgKbge75BO9r83TaF9-NGnRo8Td6HzvS6Wy8Rk3RoMFjzgiq988kJykiwjJNrLDXD~rc6RNb80YRBPNKDWE9e7SMDIlAi2Q__&Key-Pair-Id=KUT5TJCACFTXG","author","Nevada Legislature","date","2025-03-10T21:56:46.93Z","article","Assembly Bill 284, sponsored by Assembly Chair Tracy Brown May, would require the director of the Division of Health and Human Services to request that the Centers for Medicare & Medicaid Services (CMS) establish Medicaid reimbursement rates for vagus nerve stimulation (VNS) implant devices and replacement generators used to treat epilepsy.

Brown May described cases where patients with implanted VNS devices need generator replacement every 5–7 years, but Nevada’s Medicaid state plan currently lacks a distinct, adequate reimbursement rate for the devices and replacement procedures. She told the committee that lack of a rate has led to situations where hospitals decline to perform replacements because the facility would sustain a net loss, and individual patients face delays in accessing maintenance for an implanted device that controls seizures.

Why it matters: witnesses and the sponsor told the committee that epilepsy care carries high costs for patients and hospitals — a claim illustrated by a witness who described significant medical debt after epilepsy care and by data the sponsor presented about implant counts and hospital losses.

Evidence presented
Brown May provided utilization figures showing implants and replacements in 2022 and 2023: in 2022 Nevada recorded 26 implants (19 fee‑for‑service Medicaid; 7 managed care), including 10 new implants and 16 replacements; in 2023 there were 33 implants (16 fee‑for‑service; 17 managed care), including 9 new implants and 24 replacements. The sponsor told the committee a new implant cost $45,606 in 2022 and a generator priced at $34,985; she said hospitals experienced average losses of roughly $25,000 per patient under current rates and that total hospital spend was about $739,000 while Nevada fee‑for‑service Medicaid payments totaled $257,000 in the cited period.

Public testimony and supporters
Health system and hospital representatives testified in support, as did individual patients. Catherine Nielsen, testifying in a personal capacity, described severe epilepsy care that required significant surgery and subsequent medical debt and urged coverage for device maintenance and replacement. Hospital advocacy (Hospital Corporation of America) and provider groups said restoring a separate rate would ensure continuity of care and sustain hospital willingness to perform replacement procedures.

Committee questions and next steps
Members asked about specific rate calculations and referenced an 82% figure used in the draft language; Medicaid staff indicated the approach aligns with what other states have used when negotiating vendor pricing for expensive devices. The bill directs Nevada Medicaid to seek a rate from CMS and to ensure replacement devices are reimbursed separately from other medically necessary costs for the implantation procedure. The hearing closed with no vote recorded; the sponsor said the bill is intended to restore coverage and allow Medicaid to negotiate or secure an appropriate fee schedule entry through CMS.

Ending
If enacted, AB284 would require Medicaid to pursue distinct CMS rates for VNS implants and replacement generators, a step supporters said is necessary to maintain access for patients who require generator replacement every several years.","mediaType","Video","parentTitle","3/10/2025 - Assembly Committee on Health and Human Services","oneSentenceSummary","AB284 would require Nevada Medicaid to seek reimbursement rates from CMS for vagus nerve stimulation devices and replacement generators used to treat refractory epilepsy. Sponsors said hospitals are losing money on replacements and patients are sometimes unable to obtain maintenance; supporters urged reinstating a separate Medicaid rate.","taxTitle","2025 Legislature NV, Nevada","taxId",78440,"location","Nevada","headline","","shortSummary",{"_32":76,"_34":35,"_36":37,"_38":77,"_40":78,"_42":79,"_44":80,"_46":81,"_48":82,"_50":83,"_52":84,"_54":55,"_56":57,"_58":85,"_60":61,"_62":63,"_64":86,"_66":67,"_68":69,"_70":71,"_72":73,"_74":73},6643546,"Committee hears AB315 to tighten Medicaid provider enrollment with notarization or electronic identity checks",997,3915000,4912000,"/Search/View?dp=1&key=2531997-92b8456c00449a3eb9d8bff6dc0383c4&start=3915&end=4912","https://assets.pipeline.soar.com/2531997-92b8456c00449a3eb9d8bff6dc0383c4/thumbnail_3915000.jpg","/articles/6643546/Nevada/Committee-hears-AB315-to-tighten-Medicaid-provider-enrollment-with-notarization-or-electronic-identity-checks","https://secure.pipeline.soar.com/6643546-e67d206015501eda2a63180f4ef66e73/orig.mp4?Expires=1770019446&Signature=nFaHhvDUvAQTyPw3GYn3sy93tCWNrpBQCocboTCiNutDTPYyFWA5VCdM4NPN-04FqTAjq3OVDJPsra7vOK7Vlm46-0ayik-OCp7mFkQlsiFFLUZ6mTzWd-fTwnv52lVKwzkkwxhKxlh6xM9IS6Q5TeU8vzLkCVMWYITHu8mIdhUqFUUgAAPuEtvJgwUQU063E1SK1rl-pXlgZCksA24nEeVg4ixPQiEJoLMeiKPVsG6Gat9CXpFNwLkPJPki-v04nYu4suunyePvAVrxuPU~ZPcvGfnkrxJ-4H0JjaZIZ2HJ4rZ4FWNRBcnffHLRGEop-RW24xT8BK2GBQmbo7SNbw__&Key-Pair-Id=KUT5TJCACFTXG","Assembly Bill 315, introduced by Assemblymember Rebecca Edgeworth (Assembly District 35), would require signature verification for entities and individuals applying to enroll as Medicaid providers in Nevada — either by notarization or by an approved electronic identity verification process — to limit provider enrollment fraud.

The bill and an accompanying amendment were described in a joint presentation by Edgeworth, Medicaid Division staff and representatives of the Attorney General’s Medicaid Fraud Control Unit (MFCU). Stacy Weeks, an official with Nevada Medicaid, told the committee the division is already planning a provider‑portal revamp that will include \"liveness verification\" (a facial‑scan/photo ID audit trail) to make online enrollment more secure. She said the proposed bill includes both notarization and electronic options so the division’s planned digital approach is preserved.

Why it matters: witnesses said criminal provider fraud causes substantial loss of public funds and complicates recovery of improperly paid dollars. Supporters argued identity verification at enrollment would help prove who submitted an application when fraud is later investigated.

Evidence and enforcement perspective
Andrew Schulke, chief deputy attorney general and director of the Medicaid Fraud Control Unit, testified in a neutral capacity that the proposed language would be useful in prosecuting cases where an individual has enrolled and committed fraud. Cynthia Leach of Medicaid’s surveillance and utilization review program said the MFCU receives roughly 40–45 credible allegations of fraud per year; she described signature verification as an additional enforcement tool. The presenters agreed to provide the committee with statistics from federal reports that track convictions and civil settlements for health‑care fraud.

Public and stakeholder testimony
Providers and health‑care organizations broadly supported the bill. Diego Trujillo of Las Vegas Heals (a provider coalition) and representatives of physician and hospital groups testified in favor, saying the measure protects public dollars and the integrity of provider networks. The Nevada State Medical Association and other provider groups expressed support. No callers or witnesses opposed the bill during the hearing.

Committee questions and next steps
Members asked how the requirement would apply to providers already enrolled and how it would affect entities with many owners. Medicaid staff said the liveness verification would be required for initial enrollment, the provider agreement and the contract, and that all owners would need to complete the verification. Staff emphasized the bill’s electronic verification option is designed to reduce paperwork burdens for legitimate providers while deterring bad actors. The hearing closed with no committee vote recorded; presenters offered to provide additional statistics on fraud cases and convictions.

Ending
AB315 drew bipartisan support in the hearing from medical and provider stakeholders. Committee members requested detailed fraud‑statistic reports for staff and members before the bill moves forward for policy and potential budget considerations.","AB315 would require notarized or electronic identity verification for Medicaid provider enrollment to reduce provider fraud. State Medicaid and the Medicaid Fraud Control Unit described planned electronic 'liveness' verification; supporters include physicians' groups and provider coalitions. No opposition spoke and no vote was recorded.",{"_32":88,"_34":35,"_36":37,"_38":89,"_40":90,"_42":91,"_44":92,"_46":93,"_48":94,"_50":95,"_52":96,"_54":55,"_56":57,"_58":97,"_60":61,"_62":63,"_64":98,"_66":67,"_68":69,"_70":71,"_72":73,"_74":73},6643549,"Nevada committee hears proposal to expand access to electromagnetic brain‑pulse treatment for PTSD, addiction and gambling disorder",2833,1153000,3986000,"/Search/View?dp=1&key=2531997-92b8456c00449a3eb9d8bff6dc0383c4&start=1153&end=3986","https://assets.pipeline.soar.com/2531997-92b8456c00449a3eb9d8bff6dc0383c4/thumbnail_1153000.jpg","/articles/6643549/Nevada/Nevada-committee-hears-proposal-to-expand-access-to-electromagnetic-brainpulse-treatment-for-PTSD-addiction-and-gambling-disorder","https://secure.pipeline.soar.com/6643549-3b966c7ea046b541978b3a2170df9257/orig.mp4?Expires=1770019446&Signature=PYKgBqVRHe4O-FPUvQfGHArveJT5EITk7w~M0UJ0zIgzGoIQuPR0wLdlGX5w8y24MrLcwNmu-2mRQABISX5rgRbei1nqcTdtNbIthWspBG3HwCPK-qqtJNAqoBxzmPYcsHOyMiZxYh90BtCsgG3ZCT0PqWkwLLIaWELNQb68cQFqA6uy99N27xWa5SvpRfglRCuE8DS92~VdqHWd0pxpUnNm6SGGvOerX9hajHi842mhNP~RQsPb94OQPoZ0P2zr2JtOFhV8psPpe5fCmsmijfuYHfc9HYn-gF5zqK1YWk7Pg9V0miQ1KNVn-cUSskJSTFMBa4C~uRyvYFeeZ70btA__&Key-Pair-Id=KUT5TJCACFTXG","Assembly Bill 304, which would create a pilot to expand access to electromagnetic brain‑pulse (EMBP) treatment for post‑traumatic stress disorder, substance use disorder and gambling disorder, was the subject of a lengthy hearing before the Nevada Assembly Committee on Health and Human Services on [date of hearing].

Assemblymember Venise Karas (Assembly District 10) introduced the bill and said the concept is to expand access rather than to begin a basic safety study because, she said, federal agencies have already assessed device safety. \"This amendment shifts the program's focus to expanding access to EMBP to treat people with post traumatic stress, substance use disorder, and gambling disorder,\" Karas told the committee.

The bill drew detailed technical and patient‑experience testimony from Judy Kosterman, cofounder of the Brain Health Leadership Foundation, who described the EMBP workflow as a two‑step medical protocol: EEG‑based individualized assessment followed by transcranial magnetic stimulation (TMS) tailored to a patient’s EEG fingerprint. \"This just brings another tool to the box that works from the medical side that can actually change the brain,\" Kosterman said, adding the protocol is nonpharmaceutical and noninvasive.

Why it matters: proponents told the committee the treatment can fill gaps in current behavioral and pharmaceutical care for a range of neuropsychiatric conditions and could improve access to care for veterans, first responders and people in recovery. Supporters said some payers are already reimbursing the protocol for specific plans in Nevada. Opponents did not appear and no formal committee vote occurred.

Supporting evidence and pilot work
Kosterman said the approach uses an EEG cap to map a patient’s brain‑frequency \"fingerprint,\" then feeds that analysis into a TMS device to \"nudge\" neurons toward a more normative firing pattern. She described published clinical trials, a Department of Defense trial treating veterans with PTSD and several local pilot efforts: a Washoe County specialty‑court pilot that has completed data collection, a private grant to treat Reno first responders that is underway, and two licensed clinics in Nevada (Reno and Las Vegas). Kosterman told the committee some trials reported rapid clinical improvement — she cited a randomized placebo‑controlled PTSD trial in veterans that delivered daily sessions for two weeks and reported large symptom reductions which prompted the institutional review board to offer the active treatment to the placebo arm.

Payers and access
Testimony noted the existence of CPT billing codes and that Prominence Health Plan (a regional association health plan) has begun reimbursing the protocol for its association members. Kosterman and supporters said broader third‑party reimbursement (including Medicaid and Medicare) is a critical barrier to patient access and that a Nevada pilot could help generate state‑specific evidence to encourage broader payment. Several committee members asked for more peer‑reviewed data specific to the populations Nevada intends to treat, and presenters agreed to provide study references and local pilot data to staff.

Public testimony
A number of residents and providers offered personal accounts supporting AB304. Corrado De Gasparis, executive chairman and CEO of Comstock Inc., described his own experience with the protocol and said he has been abstinent from alcohol for more than four years after treatment. Jason Rich, a former Navy SEAL, described traumatic brain injury and PTSD symptoms and said the protocol gave him the \"best sleep\" since military service. Providers and industry advocates — including the Nevada Hospital Association and the Vegas Chamber — testified in support and asked the committee to consider how data from a pilot could help develop a Nevada clinical and payment pathway.

Committee questions and next steps
Committee members asked about the strength and scope of existing evidence, device approvals and the appropriate role of a policy committee versus a budget committee in funding pilots. Kosterman said the devices (EEG and TMS) have FDA clearance or approval in their marketed indications and that the current effort is to scale a technology‑driven protocol and test it for the targeted indications named in the bill. Committee members requested more detailed outcome data tied to the bill’s specific target populations. Chair Tracy Brown May noted that financial feasibility would be reviewed by other committees if the policy committee advances the measure. The hearing closed without a vote and the committee invited the bill sponsor and presenters to provide additional materials to staff.

Ending
No formal committee action was recorded at the hearing. Supporters pledged to provide clinical trial reports and pilot results to the committee staff; members requested population‑specific evidence before making a policy recommendation.","A Nevada Assembly committee heard testimony on AB304 to create a pilot expanding access to electromagnetic brain‑pulse (EMBP) therapy for post‑traumatic stress disorder, substance use disorder and gambling disorder. Presenters described clinical use, existing reimbursement in some plans and pilot programs in Northern Nevada; no vote was taken.","actionData","errors"]

Article not found

Assembly hears AB284 seeking Medicaid reimbursement rates for vagus nerve implants to restore coverage

Committee hears AB315 to tighten Medicaid provider enrollment with notarization or electronic identity checks

Nevada committee hears proposal to expand access to electromagnetic brain‑pulse treatment for PTSD, addiction and gambling disorder