[{"_1":2,"_124":-5,"_125":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"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","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,76,88,100,112],{"_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,"_75":74},"mediaId",6617118,"mediaKeyId","2843877-f318f066bce5a2f9196f406391cc0d65","parentId",2843877,"title","Narrow statutory fix proposed to identify 'inpatient' skilled‑nursing facilities draws technical opposition from providers","audioSeconds",549,"startMs",9567000,"endMs",10116000,"viewUrl","/Search/View?dp=1&key=2843877-f318f066bce5a2f9196f406391cc0d65&start=9567&end=10116","thumbnailUrl","https://assets.pipeline.soar.com/2843877-f318f066bce5a2f9196f406391cc0d65/thumbnail_9567000.jpg","articleUrl","/articles/6617118/Nevada/Narrow-statutory-fix-proposed-to-identify-inpatient-skillednursing-facilities-draws-technical-opposition-from-providers","mediaUrl","https://secure.pipeline.soar.com/6617118-fe8a5c13f2201cc84049d131da0a7b08/orig.mp4?Expires=1771140499&Signature=YBi-GTdxWZvpEkMLVt~tW1mFK1i3ZvH12r~qCyx941IlgczrOguB-yE9plLzOY2FCBPBjJjfgiizgLwqjnhU2e2SxjgRN8ZCi4ijVO4ybTwwuPtdScla~1JpDNTS3up4Pr599XbufUilq9b0lCJfP2CXScoFtIq46zyoBSkQVUpFL8~9QW5KlTxLpG2R6ZCEdatkMSdcUCZ1KogaV8jT4cRfV5HjdRk~iXg36QtBtscnrjmW6KRX7pAqS-YnxPrcFze1K8jNANZVoB7nIped3hSb2usTS4HvyoEveL5-5mapX0rD-7vw30ONFetSTDIOCXcSku1ZYgdSldUNzrdnkg__&Key-Pair-Id=KUT5TJCACFTXG","author","Nevada State Legislature","date","2025-04-02T02:40:44.44Z","article","Lex Anderson, a Nevada registered nurse and community member, told the Senate committee he seeks a single‑word change to NRS 449.0039: add the qualifier \"inpatient\" to clarify that a facility for skilled nursing is an institutional inpatient setting that provides continuous, physician‑directed care.

Sponsor rationale: Anderson and Senator Dina Neal said the lack of an explicit \"inpatient\" qualifier has led, in some local planning and zoning proceedings, to outpatient group homes and other programs being mischaracterized as skilled‑nursing institutions. They said a statutory clarification would help planners, cities and counties avoid erroneous land‑use conclusions that create controversy.

Provider concerns: The Nevada Healthcare Association and several hospital/critical‑access partners opposed the bill in part because skilled nursing providers also offer outpatient services (Medicare Part A vs. Part B) and because a broad statutory change might create unintended operational or licensing consequences across many parts of state law that reference the skilled‑nursing definition. Rural hospitals and critical‑access partners said the definition appears in many statutes and that careful drafting is required to avoid collateral impacts.

Next steps: Sponsors and stakeholder groups said they will continue technical talks to find language that preserves the zoning clarity advocates seek while avoiding unintended regulatory effects on facilities that provide both inpatient and outpatient services. No committee vote was recorded during the hearing.","mediaType","Video","parentTitle","4/1/2025 - Senate Committee on Health and Human Services","oneSentenceSummary","Senate Bill 330 would add the word \"inpatient\" to Nevada's statutory definition of a facility for skilled nursing, aiming to make clear these are 24/7 institutional inpatient settings; supporters said it would prevent zoning errors, while providers warned of unintended consequences.","taxTitle","2025 Legislature NV, Nevada","taxId",78440,"location","Nevada","headline","","shortSummary",{"_33":77,"_35":36,"_37":38,"_39":78,"_41":79,"_43":80,"_45":81,"_47":82,"_49":83,"_51":84,"_53":85,"_55":56,"_57":58,"_59":86,"_61":62,"_63":64,"_65":87,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6617113,"Panel debates freestanding emergency departments, access to records and noncompete rules in broad health‑care bill",2051,10241000,12292000,"/Search/View?dp=1&key=2843877-f318f066bce5a2f9196f406391cc0d65&start=10241&end=12292","https://assets.pipeline.soar.com/2843877-f318f066bce5a2f9196f406391cc0d65/thumbnail_10241000.jpg","/articles/6617113/Nevada/Panel-debates-freestanding-emergency-departments-access-to-records-and-noncompete-rules-in-broad-healthcare-bill","https://secure.pipeline.soar.com/6617113-ec3465cac843ccf4bef7444f04b4b31f/orig.mp4?Expires=1771140499&Signature=WnvYTNrjOXtT748MaZfvoKgn6gx5yS34KPFOHfv8ZMo~Qu4hLhjdqgxIlpnQOs3Bf1BQWsVOmZqrkOK-SzZ5uRIGNzxyf5~Tl2WVhy2d~fpQ2sLCGo5cQDpexLlvxd8Z8BrUXRG1zXYWFe8x~TBVA8xJk3df92QHyA4CNci2pOqbPQdUER-FOwH58T-ZqdSmeK3x16-ITr7JmoHT6LUKJ2Bkk0P1qubb7sIIStbS45TcKqNJf6TU~KTtOvBSk8GNN8JhPxotR~z~vLrwnXR~TLy-y2a1cPGk8SqwXjAHaysDsBhKlBa4cJyfM5trq649oMIj0WEOg54alz4ahcIqgg__&Key-Pair-Id=KUT5TJCACFTXG","Senator Fabian Donate presented Senate Bill 378 as a package of health‑care provisions aimed at increasing transparency and patient access to records, curbing billing practices tied to freestanding emergency departments (FSEDs), and strengthening Medicaid fraud review. Donate said the bill would require separate licensure or clear classification of FSEDs, require that some FSEDs offer urgent care services under certain conditions, prohibit certain noncompete covenants for physicians, and require custodians of health records to furnish records promptly under set conditions.

Supporters' arguments: Labor groups, health‑plan coalitions and unions told the committee they back several elements of the bill. The Health Services Coalition (representing self‑funded employer plans covering roughly 300,000 lives) said FSEDs are often sited in commercially attractive locations and can charge hospital‑level fees while appearing to patients like urgent care; the coalition urged requiring urgent‑care offerings or clearer licensure to limit surprise facility fees. Health‑worker unions, firefighters and nonprofit patient advocates also supported greater transparency and stronger HIE access and said unclear labeling and billing create consumer confusion and higher costs.

Hospitals, urgent care operators and HIEs raised concerns: Hospital representatives warned parts of section 18 could conflict with EMTALA (the federal emergency‑room screening and stabilization law) if the bill permitted triage approaches that fall short of an EMTALA medical screening exam. HCA Sunrise and other system witnesses said FSEDs alleviate ER crowding and provide needed access; they opposed limits that would reduce licensure flexibility near existing hospitals. CareNow and other urgent‑care operators urged caution: urgent care and emergency care are clinically different, and they said limiting FSEDs could reduce access in underserved areas. Healthy Nevada (the state's certified health information exchange) and national HIE advocates urged caution about language that would limit HIEs' role; speakers said a patient‑directed forwarding model is not a practicable substitute for timely HIE exchange and warned that proposed language in the bill could harm interoperability and patient safety.

Noncompete and records provisions: The bill would bar noncompete covenants from applying to physicians in many circumstances; specialty providers argued a blanket ban could destabilize physician‑owned practices and harm continuity of care. Sponsors said the prohibition aims to expand provider‑level access in underserved areas. SB 378 would also strengthen timeliness and cost provisions for providing medical records and direct the department to create a consumer awareness program explaining facility types and where to seek urgent vs. emergency care.

Outcome: The hearing drew extensive pro and con testimony across labor, provider, payer and technology sectors. Stakeholders urged tailored drafting to avoid conflicts with federal law (EMTALA) and to preserve effective health‑information exchange; the sponsor and stakeholders committed to continued negotiations. No committee vote was recorded in the hearing transcript.","SB 378 would tighten rules for freestanding emergency departments, improve patient access to health records and bar some physician noncompete covenants; supporters sought clearer labelling and HIE access, while hospitals and HIEs warned of federal‑law and interoperability conflicts.",{"_33":89,"_35":36,"_37":38,"_39":90,"_41":91,"_43":92,"_45":93,"_47":94,"_49":95,"_51":96,"_53":97,"_55":56,"_57":58,"_59":98,"_61":62,"_63":64,"_65":99,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6617123,"Senate bill to delay license suspension for child‑support arrears draws opposition from district attorneys",1759,7741000,9500000,"/Search/View?dp=1&key=2843877-f318f066bce5a2f9196f406391cc0d65&start=7741&end=9500","https://assets.pipeline.soar.com/2843877-f318f066bce5a2f9196f406391cc0d65/thumbnail_7741000.jpg","/articles/6617123/Nevada/Senate-bill-to-delay-license-suspension-for-childsupport-arrears-draws-opposition-from-district-attorneys","https://secure.pipeline.soar.com/6617123-cf1be7502bf3ed5e219f9fae2271b274/orig.mp4?Expires=1771140499&Signature=iwtBG9cbvx7fSWW~~G1xqUs-KHdny0P78hO073V8sufTbHxIkwHM5bsf3TCibMh267YhIdTjJQNmmAsARSeOSQRIkNEhZHtsvzF8hT9jcuSPbOMZD5AnJ5W92MUvKdPyHgwAxsHEqCBGVUu8cCUgcRfzXyHSowNhmNP79nAfqQgubIl2a3AG-VPaMJw2anxQaa0YJpB2gWYuW3e-tVg3GS9yxGeZRs8LtKqRtZaPCrtTUWX3FmBUipH~wYnMeIZsbZxB62K4WdwcpZFhoVP7JNKInBRGSLjRzxiwumifCpPpA352Zu8bj07tkYMSGlO2cx~cw8pizzXA362xw8MFIA__&Key-Pair-Id=KUT5TJCACFTXG","Senate Bill 390, presented by Senator Dina Neal, would alter the state's child‑support enforcement tools by making reporting to the DMV optional rather than mandatory, redefining arrears for DMV reporting, and prohibiting license suspensions when doing so would impede employment. The bill would also change the delinquency threshold for DMV action from approximately two months to six months before a parent is reported.

Sponsor's rationale: Senator Neal told the committee she introduced the change to reduce collateral consequences on low‑income parents who lose driving privileges and therefore jobs, arguing that license suspension often traps people in a cycle of nonpayment. Neal cited other states with longer delinquency windows and said the change preserves tools while delaying the use of license suspension as a first resort.

Opposition from prosecutors and counties: The Nevada District Attorneys Association, Washoe and Clark County child support divisions and other county representatives strongly opposed the bill. John Jones and county program managers described the suspension process as a graduated enforcement tool that is not used for mere inability to pay but for non‑engagement with the child‑support system. They warned a six‑month delay would risk reduced collections for families, greater reliance on state welfare, and loss of federal incentive funds that help run county child‑support programs. Clark County said DMV‑sourced suspensions alone generated an estimated $16.5 million per year in collections.

Equity and data questions: Senator Neal and some committee members raised concerns about disparate impacts on low‑income communities and people of color. District attorneys said they would attempt to supply race/ethnicity data on license suspensions to the committee; county offices argued the current process already provides notices, hearings and options before suspension and that the bill would extend a period with no engagement.

Next steps: The sponsor said she would continue talks with DA offices and stakeholders; the committee was left with competing priorities — reducing collateral consequences that can impede employment versus maintaining a strong enforcement tool to collect support for children. No committee vote was recorded in the hearing transcript.","Senate Bill 390 would make reporting noncompliance to DMV optional and raise the arrears trigger from roughly two months to six months; sponsors said the change protects low‑income parents from losing employment, while district attorneys and county child‑support offices warned it would reduce collections for children and risk federal incentives.",{"_33":101,"_35":36,"_37":38,"_39":102,"_41":103,"_43":104,"_45":105,"_47":106,"_49":107,"_51":108,"_53":109,"_55":56,"_57":58,"_59":110,"_61":62,"_63":64,"_65":111,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6617128,"Senate committee advances narrow rewrite of child‑welfare consent timelines after stakeholder talks",861,7605000,8466000,"/Search/View?dp=1&key=2843877-f318f066bce5a2f9196f406391cc0d65&start=7605&end=8466","https://assets.pipeline.soar.com/2843877-f318f066bce5a2f9196f406391cc0d65/thumbnail_7605000.jpg","/articles/6617128/Nevada/Senate-committee-advances-narrow-rewrite-of-childwelfare-consent-timelines-after-stakeholder-talks","https://secure.pipeline.soar.com/6617128-81529bbca32b7d26c400d6c957520263/orig.mp4?Expires=1771140499&Signature=g9eVOoubhF74JB7qUW4k4PoNAE1GH5wuVUA-DWS9n7A9EyuKwubw4WeAat4AYGEEOgphWJ9NM5UA43voKNdjJXTILTs0b3bZZ9deo6DeUZdj6pgeX9IwD-75CQ1bRJVaWrvyPqis-vRaZI8ESZHNcmOyBsjtC7lBbqZIsnsO~e4FgmaNPXiQ52lze9cHJ98AW7gCvAQBc3giv4EQx2JbQ1kZ65bh3DEMWZFzZAc5~NIdUF0N00qiwXEAsrOOjVIuSlNlzBivhBK0GXcfugDgeE9zBt3UFkIXGxRCMPFmoAUP4nzdR29VRZ67ZCSZeoQlK3fCfYZM8bbq3vfFd1bWZw__&Key-Pair-Id=KUT5TJCACFTXG","Senators Julie Pazina and Rochelle Winn presented an amended version of Senate Bill 187 to the Senate Health and Human Services Committee, saying stakeholder discussions substantially shortened the bill. The amendment deletes many earlier sections and leaves a focused requirement that child welfare agencies either grant or deny consent for medical or mental‑health treatment for children in custody within 14 days of request.

Sponsor intent and context: Pazina and Winn said the change aims to prevent delays in medically necessary care for children in protective custody. They described constituent reports that foster and adoptive caregivers were unable to obtain timely consent for treatment, which sometimes left children without needed services.

What the bill requires: As presented, the bill requires an agency providing child welfare services to make a prompt decision on consent (grant or deny) and to make reasonable efforts to initiate consent and to provide prompt notice of the agency's decision to caregivers. The sponsors said they removed other sections after extensive stakeholder engagement and will continue working with counties on final language.

County response and neutral stance: Clark and Washoe County representatives said they are neutral on the bill and are working on amendments with sponsors. Joanna Jacob of Clark County said counties and foster parents need clearer communications and timing guardrails, but they wanted the statutory language aligned with casework realities. Committee counsel said the term \"reasonable efforts\" is a common legal standard and would be evaluated case‑by‑case, taking into account local resources.

Public testimony and support: Children's advocacy groups, union representatives, and public commenters expressed support for the bill's goal of improving timeliness and preventing children from languishing while approvals are sought. No final vote was recorded during the hearing; sponsors and county representatives said they expect continued negotiations prior to work session.

Ending: Sponsors asked committee members to consider the revised, narrowed text and noted that additional amendments may be filed based on ongoing stakeholder input.","Senate Bill 187 (amended) would require child‑welfare agencies to grant or deny consent for a child's medical or mental health treatment within 14 days and to make reasonable efforts to initiate consent. Counties said they are neutral and continuing work with the sponsors on precise language.",{"_33":113,"_35":36,"_37":38,"_39":114,"_41":115,"_43":116,"_45":117,"_47":118,"_49":119,"_51":120,"_53":121,"_55":56,"_57":58,"_59":122,"_61":62,"_63":64,"_65":123,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6617131,"Senate committee hears Ruby's Law to extend emergency Medicaid continuity for children with life‑threatening illness",5706,231000,5937000,"/Search/View?dp=1&key=2843877-f318f066bce5a2f9196f406391cc0d65&start=231&end=5937","https://assets.pipeline.soar.com/2843877-f318f066bce5a2f9196f406391cc0d65/thumbnail_231000.jpg","/articles/6617131/Nevada/Senate-committee-hears-Rubys-Law-to-extend-emergency-Medicaid-continuity-for-children-with-lifethreatening-illness","https://secure.pipeline.soar.com/6617131-4fd143220af36afd28993ac5f0797e3e/orig.mp4?Expires=1771140499&Signature=f-pjkM2YIuGqIfPLUe8DUrOHf8D4X8aWuHgoCZvpQhIek1nYCYY7ZnnvgqKmI4Qu7eaBjvd4fiFee1AY7sdwtmX00qIJn6lqaMdkUayuLDB8p-7KZZX0M~lgGQroCnIJjLQWhldq72dVn1cDi6Uw~by7qIZXlOJlOCa4zPlBkpKtu2ju2Kp08QP3pl60QXyIMBGeitdw~VCcGoYoPM7rHH9KQ5xhQ1gNV4b9QGMm~09D6LA06yhbCfziinkn~jgA-0tC~iuknvHAUvgz0KJ3NhRhUwdUJF~2rzMoM6KS-W7pIi-hxavK0FU-A--~FEJMLZa~Dq7xo2bGARNSS5biZg__&Key-Pair-Id=KUT5TJCACFTXG","Senator Fabian Donate, sponsor of Senate Bill 234, told the Senate Committee on Health and Human Services that the bill — called Ruby's Law — would close a gap in Nevada's emergency Medicaid program by allowing limited continuing coverage for life‑threatening conditions for people 21 and under.

The bill responds to cases in which children first receive life‑saving stabilization in an emergency department, qualify for emergency Medicaid while hospitalized, but lose that coverage on discharge and must return to the ER for follow‑ups such as chemotherapy. Donate said the proposal does not expand eligibility but would preserve continuity of care for a narrow set of critically ill children and reduce readmissions and overall costs.

Why it matters: Witnesses and medical providers told senators that treating childhood cancer and other severe conditions in an outpatient oncology setting is clinically preferable and far less costly than repeated emergency encounters. Sponsor testimony used a case study in which treatment for acute lymphoblastic leukemia for a 16‑year‑old was estimated at roughly $695,000 over a standard course, while a single emergency‑room admission for cancer‑related care was estimated at about $15,000. Proponents said early outpatient care could reduce the fiscal burden on hospitals and taxpayers.

What the bill would do: As presented, SB 234 would allow the Department of Health and Human Services to provide limited Medicaid coverage for cancer treatment and renal disease for individuals under age 21 if the department determines the care is medically necessary. The bill would also allow limited coverage for continuing care in a skilled nursing facility, require the department to administer provisions consistently with Medicaid rules and direct the department to apply for any federal waivers or state‑plan amendments necessary to implement the changes.

Personal testimony and provider support: Ruby, introduced as a Las Vegas resident and childhood cancer survivor, described delays and barriers her family faced while undocumented. \"My status shouldn't have determined my outcome and treatment, and this needs to change,\" she told the committee. Katya, a DACA recipient and cancer survivor, described being denied emergency Medicaid because a state reviewer said her cancer \"wasn't considered an emergency,\" and the family subsequently relied on community fundraising to pay for surgery.

Hospitals and provider groups supported the bill. Connor Kane of HCA Healthcare (Sunrise Hospital and Sunrise Children's Hospital) said emergency Medicaid applications are frequent and that the hospital system treats many Medicaid recipients. Testimony from charity and pediatric providers — including Cure for the Kids/Care for the Kids representatives and clinical social workers — emphasized that delayed outpatient care commonly leads to costlier hospitalizations and poorer outcomes.

Opposition and fiscal questions: Opponents argued the change could increase state costs and raised questions about immigration policy. Lynn Chapman and other speakers said Nevada cannot afford expanded taxpayer‑funded services for undocumented residents. Senator Stone asked whether the federal environment would allow waivers; Donate declined to predict federal action, saying the state must respond to the needs of residents.

Policy precedents: Donate and supporters cited Minnesota and Utah as states that have implemented broader emergency medical assistance programs; proponents said Minnesota's program informed the Nevada draft. Supporters said the bill will apply only to a small number of children statewide (Donate cited an estimate of about \"10 to 30 children\") and that the change could save money by shifting care to outpatient settings.

Committee action and next steps: The committee heard about 15 minutes of proponent testimony, 15 minutes of opposition, and public commenters by phone. No final vote was recorded in the hearing transcript. The bill sponsor indicated work on an amendment and urged committee members to focus on the clinical and cost benefits of continuity of care for critically ill children.

Ending: Proponents left written materials and cost breakdowns with the committee staff. Senators and agency representatives signaled continued discussions; the bill will advance through committee and likely require federal approvals if enacted.","Senate Bill 234 (\"Ruby's Law\") would allow limited continuing emergency Medicaid coverage for medically necessary cancer and renal services for children under 21, aiming to reduce repeated emergency‑room care and overall costs. Sponsors, patients and hospitals testified in support; opponents raised fiscal and immigration concerns.","actionData","errors"]

Article not found

Narrow statutory fix proposed to identify 'inpatient' skilled‑nursing facilities draws technical opposition from providers

Panel debates freestanding emergency departments, access to records and noncompete rules in broad health‑care bill

Senate bill to delay license suspension for child‑support arrears draws opposition from district attorneys

Senate committee advances narrow rewrite of child‑welfare consent timelines after stakeholder talks

Senate committee hears Ruby's Law to extend emergency Medicaid continuity for children with life‑threatening illness