[{"_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",6612909,"mediaKeyId","2879309-dda92a445da7d98c3ae1f2feef7f027c","parentId",2879309,"title","Bipartisan bill to reform prior authorization draws wide stakeholder support; sets enforceable timelines and AI limits","audioSeconds",2742,"startMs",3818000,"endMs",6560000,"viewUrl","/Search/View?dp=1&key=2879309-dda92a445da7d98c3ae1f2feef7f027c&start=3818&end=6560","thumbnailUrl","https://assets.pipeline.soar.com/2879309-dda92a445da7d98c3ae1f2feef7f027c/thumbnail_3818000.jpg","articleUrl","/articles/6612909/Nevada/Bipartisan-bill-to-reform-prior-authorization-draws-wide-stakeholder-support-sets-enforceable-timelines-and-AI-limits","mediaUrl","https://secure.pipeline.soar.com/6612909-ab63c14ca2dafe41adb7e7f9d0b914c4/orig.mp4?Expires=1770709010&Signature=ceV58Tt-lzYmJHo9Hjt2hsScJjt-wjW3DX0CMnzBk2SshUX-VWVpfDj3fWV2LrS2UlVuVz9goDZuUSebEjYr~xPvJalNWlxjpDs5r5ce95k6up517q85orM4dFQVGA0n0qYiQNVx61neTzsKZhYk80gEkgf4vtFdyrQt46VX6O6YKu0ougvjQtx7fh81LpFgvTihOmAO~Kduzd29G5HvBbjoQVsrEJrkJsEBc0oFnpw9IxMFL~soAWK0Z4-U-Z4RMwmdyitVal6V0LpwJrwvQ9pPulf3Zd4RJBIPpB~AdNkWVRaLdLB7osU5gTKODmH1gfeFGYWXz9y-E~nGeUpZcw__&Key-Pair-Id=KUT5TJCACFTXG","author","Nevada Legislature","date","2025-04-04T22:57:32.07Z","article","Assembly Bill 290, a bipartisan measure to tighten and make transparent the prior authorization process used by health insurers, drew broad support and detailed stakeholder negotiation during a lengthy Friday hearing.

Sponsor Assemblymember Yuwing Wing (pronounced Yu‑wing) and co‑sponsor Assemblymember Toby Urich described the bill as the result of months of work with doctors, insurers, pharmacies and other stakeholders. Dr. Florence Jamieson, a practicing obstetrician‑gynecologist who founded the Volunteers in Medicine free clinic in Southern Nevada, described the human consequences of long prior‑authorization waits: \"When we asked our patients, what challenges are you facing with your insurance? The most common response we receive overwhelmingly is prior authorization,\" she told the committee, adding that delays have contributed to adverse patient outcomes in national surveys.

Under the conceptual amendment presented at the hearing, AB290 would require that an initial adverse determination be made only by a licensed physician or dentist who holds an unrestricted license in any U.S. state and has relevant clinical experience for the condition under review. Before issuing a denial based on medical necessity, the insurer must offer the treating provider a live phone or video conversation with the reviewing provider. Any denial must be communicated promptly in writing with the specific reason, missing documentation identified, and clear appeal instructions. The amendment also sets response timeframes: insurers must respond to non‑urgent prior authorization requests within 7 calendar days and to urgent requests within 48 hours; if the insurer requests additional documentation within those timeframes the insurer must decide within 7 days (nonurgent) or 48 hours (urgent) after receiving the information.

The amendment further establishes that prior authorizations remain valid for six months and that prior approvals issued by a previous plan must be honored for the first 90 days after a patient changes insurance (provided the authorization was issued within the prior six months and documentation is transmitted). The bill would also require insurers to publish prior‑authorization procedures and criteria in clear, conspicuous language accessible to laypersons and to disclose whether they use artificial intelligence (AI) or automated decision tools. If AI is used in a decision, a licensed provider must independently review and affirm any adverse determination.

Health providers and nurse advocates said these reforms will reduce delays for diagnostic testing, specialist care and medication starts. \"This is about restoring accountability, transparency, and critical oversight,\" Assemblymember Toby Urich said. Dr. Jamieson gave repeated clinical examples—including diagnostic cascades for breast cancer—where sequential prior‑authorization delays can meaningfully delay treatment.

Representatives of insurers and trade groups testified in neutral and said they supported many of the collaborative changes but raised definitional and implementation issues. Adam Plain of the Division of Insurance noted the insurance code's complexity and flagged a theoretical scenario in which reciprocal honoring of prior authorizations from another insurer could be abused; he also said state jurisdictional limits could affect whether ERISA (self‑insured employer) plans must reciprocate. The division noted it had adopted AI model bulletins and said the bill's AI language aligns with existing Division standards.

The Division of Healthcare Finance and Policy (DHCFP) said its fiscal note would be reduced to zero if the conceptual amendment is fully accepted. Sponsors said they removed provisions applying the changes to Medicaid, CHIP and Medicare Advantage from the bill to avoid triggering a substantial fiscal note and federal compliance complications; they said they would seek future inclusion after refining the approach.

Committee members asked technical questions—Assemblymember Anderson asked whether \"7 days\" meant calendar days; sponsors agreed to clarify the language to say \"7 calendar days.\" Several members praised the collaborative stakeholder process. The transcript records no committee vote on AB290 at this hearing.","mediaType","Video","parentTitle","4/4/2025 - Assembly Committee on Commerce and Labor","oneSentenceSummary","AB290 would require medical reviews for prior‑authorization decisions to be performed by licensed clinicians, set firm response timelines (7 calendar days for nonurgent, 48 hours for urgent), require live provider‑to‑provider conversations before denials, and mandate public reporting and disclosure when AI is used.","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},6612914,"Bill to waive small‑business license fees and streamline wireless co‑location advances to hearing; local governments and industry negotiated language",671,2696000,3367000,"/Search/View?dp=1&key=2879309-dda92a445da7d98c3ae1f2feef7f027c&start=2696&end=3367","https://assets.pipeline.soar.com/2879309-dda92a445da7d98c3ae1f2feef7f027c/thumbnail_2696000.jpg","/articles/6612914/Nevada/Bill-to-waive-smallbusiness-license-fees-and-streamline-wireless-colocation-advances-to-hearing-local-governments-and-industry-negotiated-language","https://secure.pipeline.soar.com/6612914-0438a3c06d71c942903f046e44af8c23/orig.mp4?Expires=1770709010&Signature=jdYxGgVo1WlLauYlH-FdmCMYnXR0Yod4UzGGU5YKxphcR8LpmHlNhQYLdgyjcHhGsHYFQw9Uly~iz02eUFDlDvA2a9wT9eHcyk1Pz~vcA1dksDKvErKNizgfjia3imcYJFINabxalXeC1IQU4s7OWDhyCz1OhFqF3F8BMSIGtx9bEenzbdoIf7rMbUr~iVllajdaLTiszYg0U6U6cCVEYuwCiT6G07oEXsH1-4gmcV1CbKcnRtTAroXh94pDEiJRs8hjJ9C4kw-0ecsU0X6sF3ZH9MxmynaVmX6in7gjVYgS~9M3b7QH9bGZQWnd--6RqSXmY2RU9A4NlhFpgjs-eg__&Key-Pair-Id=KUT5TJCACFTXG","Assembly Bill 4 23 drew a broad set of supporters and local government officials to the Commerce and Labor Committee on Friday. Sponsor Assemblymember Lisa Cole said the bill has three main parts: an option for certain sole proprietors to elect a reimbursement framework in place of unemployment insurance contributions; a temporary waiver of state business license fees for qualifying small businesses recruited by GOED and regional economic development authorities; and a streamlined process for co‑location of personal wireless facilities on existing towers.

\"Small businesses are the backbone of our economy,\" sponsor Lisa Cole said. She told the committee the proposed fee exemption would eliminate the cost of state business license fees for up to two years (\"between $400 to a thousand dollars total over 2 years depending on the type of entity the business forms\"), that participating businesses would have to meet metrics or repay the state, and that the Department of Employment, Training and Rehabilitation (DETR) provided a friendly amendment on the unemployment portion.

The bill also contains language supported by the wireless industry to simplify municipal permitting for co‑location of wireless equipment. Carmen Rajamani of the Wireless Infrastructure Association said the shortened Section 10 in the amendment instructs applicants and municipalities to comply with applicable FCC rules governing telecommunications tower facilities. \"This language will encourage deployment of innovative technologies,\" Rajamani said, and she emphasized co‑location on existing towers as the \"fastest and least intrusive means of installing needed wireless infrastructure,\" a point AT&T reiterated.

Jody Stephens of the Wireless Infrastructure Association said the original draft had been more prescriptive but was significantly simplified after talks with Clark County, Henderson and municipalities. City of Henderson representative Nicole Rourke and Clark County planning official Ashley Kennedy testified in neutral to thank sponsors for negotiating changes and said the revised language alleviates local concerns while preserving compliance with federal rules.

Business groups including the Vegas Chamber, LVGEA and the Retail Association of Nevada testified in support of the bill's small‑business provisions, saying the measure would create recruitment tools for GOED and the eight regional economic development authorities and give new small businesses a modest financial incentive to locate in Nevada.

No committee vote was recorded on AB423 at this hearing. Committee members asked sponsor Cole to follow up on technical questions about whether a husband‑and‑wife business could qualify for the DETR reimbursement option; Cole said she would check with DETR.","Assembly Bill 4 23 would let certain sole proprietors elect a reimbursement option instead of paying unemployment insurance contributions, waive state business license fees for qualifying small businesses for up to two years, and simplify municipal permitting for wireless co‑location by instructing compliance with FCC rules.",{"_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},6612904,"Heated hearing on AB225: sponsor seeks apprenticeship and carve‑outs; barber and cosmetology boards oppose",7547,6309000,13856000,"/Search/View?dp=1&key=2879309-dda92a445da7d98c3ae1f2feef7f027c&start=6309&end=13856","https://assets.pipeline.soar.com/2879309-dda92a445da7d98c3ae1f2feef7f027c/thumbnail_6309000.jpg","/articles/6612904/Nevada/Heated-hearing-on-AB225-sponsor-seeks-apprenticeship-and-carveouts-barber-and-cosmetology-boards-oppose","https://secure.pipeline.soar.com/6612904-6876473ee3af2812371e1f5301cd35e4/orig.mp4?Expires=1770709010&Signature=CBXctLQiqGJS0i3nJLFduZ7J78e3pjiy9UmsQNUnUZZkiyny1yAuK~h8W66dBGEz9hZs~24lNHIrpM06yvK7SdGP-Yvk4yRysLJrqQL1NIePpILLgTixQw5JXesDAEQNn6XTOb35jWAhWNxROSjggiewHN1cMhaY3VofVOqnbyQCMVdYdIwIvTssv2NBGI--dbW5btoORRRQb6d5Wv~IHeWwGBIJNo-j5OaJM4fmQ8HwjVudEpIC0MSWJHW0qQ1ZD0w3F8KM0ySaA-LR3yD30vLyyV3VrT-k6TKZ9BIcFFmp1ARaC2bp580V7g7pAMiVb84F9aPiBO6e7hovDiY5Ng__&Key-Pair-Id=KUT5TJCACFTXG","Assembly Bill 225, which would change licensing and training paths for barbering and cosmetology in Nevada, produced one of the longest and most contentious hearings of the day as supporters and education and licensing stakeholders clashed over safety, workforce access and economic opportunity.

Sponsor Assemblymember Yuwing Wing said AB225 aims to \"modernize Nevada cosmetology and barber industry by eliminating unnecessary barriers that have burdening aspiring professionals, promoting comprehensive training, and encouraging business innovation.\" Jennifer McDonough of the Institute for Justice summarized the bill’s key changes: exempting limited services such as blow‑dry styling from hair‑designer licensing; allowing unlicensed individuals to perform work under direct supervision while pursuing apprenticeship training; and providing an apprenticeship route (including federally registered apprenticeships) as an alternative path to licensure. The bill as amended keeps the cosmetology classroom hour requirement at 1,600 and retains a 1,000‑hour hair‑designer threshold in the sponsor’s proposed amendment while reducing barber classroom hours from 1,500 to 1,000 and permitting a 2,000‑hour apprenticeship pathway that includes 144 hours of related instruction.

Supporters—salon owners, barbershop owners, trade groups and immigrant‑community advocates—testified that high hours, tuition costs and lengthy training keep prospective entrants from the profession, limit workforce supply and raise consumer prices. \"My salon has the capacity to employ 25 to 50 full and part time individuals,\" said salon owner Savannah Harmon, who said students often graduate without being prepared to compete in the local market and owners must invest more training. Several speakers from Las Vegas and Reno described apprenticeship and supervised entry as a pathway for immigrants, younger workers and lower‑income residents to earn while they learn, particularly in areas and cultures where braid and specialty services are widely in demand.

Opponents included the State Board of Cosmetology, the State Barbers Health and Sanitation Board, cosmetology and barber school directors and many instructors and students. Board representatives said they had offered amendments that the sponsor did not adopt. William Horn of the Cosmetology Board and Antoinette Maestas of the Barbers Board emphasized public safety and sanitation as core board responsibilities and said lowering or removing licensing for certain services could jeopardize public protection. \"The board's responsibility, first and foremost, is the protection and safety of the populace,\" Horn said.

Several practitioners and school officials highlighted hands‑on training, standardized curricula and testing as essential for sanitation and technical competency. Barber school and cosmetology school representatives provided data and arguments about graduation rates, program costs and pass rates; some witnesses said Nevada's pass and placement rates are strong while others cited long student debt burdens and low completion rates in some programs.

Committee members asked detailed questions about instructor qualifications, transferability of hours between schools, whether rural areas have barber schools, and how apprentices would be supervised and paid. Sponsor Wing said the bill is a work in progress and called for additional stakeholder discussion.

The hearing produced no recorded committee vote on AB225. Several witnesses who were not able to testify were encouraged to submit written testimony to the committee secretary; the committee chair said those submissions would be uploaded to NELIS.","AB225 would create apprenticeship pathways and exempt certain limited services from current cosmetology and barber licensing requirements while adjusting classroom‑hour requirements; supporters called it a workforce access measure, while licensing boards and educators warned it would risk public safety.",{"_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},6612898,"Work session: Committee votes to do‑pass four bills in brief business session",349,1250000,1599000,"/Search/View?dp=1&key=2879309-dda92a445da7d98c3ae1f2feef7f027c&start=1250&end=1599","https://assets.pipeline.soar.com/2879309-dda92a445da7d98c3ae1f2feef7f027c/thumbnail_1250000.jpg","/articles/6612898/Nevada/Work-session-Committee-votes-to-dopass-four-bills-in-brief-business-session","https://secure.pipeline.soar.com/6612898-c8fc0a06d582024f0710f6ca26f5f822/orig.mp4?Expires=1770709010&Signature=nInsZ3VfFR-NH8noe1v-PRjde27WhuiznUv0d8I2fcPD1~4lZu1rhj6k75wXhoTWGIe7AeDaLS47ih05OqMlz6F6AcS3TdwPe0NbIxvfD0KvnvNhK8GmL98jU1K00K~Eg6QPN0nDZEhmcE2YZsCyce9Fr7pOGYF-Su565zjxyFiZojjYqp-TkHVwAFqEgYW32otM-DMuVqi0xscpJ7KUYVrUpcEk90FhMRuBrKyTi5cmP-rNQwjVl6voR3DfPVBHYKqQ3~NcA2oERNJ7BmciS8sqEHCBBk1E-EvKy2Z397EXjfjpPZxcDvqa57MNRB0Ds1W9dKSA7vieUWs5xw2Ecw__&Key-Pair-Id=KUT5TJCACFTXG","During the committee's work session before the hearings, members considered and passed four bills by motion to amend and do‑pass.

- Assembly Bill 44 (prohibiting manipulation of the price of an essential good or service): Motion to amend and do pass carried. Motion made and seconded; the transcript identified Assemblymember Miller as mover and Assemblymember Torres Fawcett as second. The clerk recorded four named nays: Assemblymembers Kasama, Urich, Cole and Hardy; the motion nevertheless passed and the chair assigned the floor statement to Assemblymember Miller.

- Assembly Bill 177 (various changes relating to audiology, fitting and dispensing hearing aids and speech‑language pathology): Motion to amend and do pass carried. The transcript shows Assemblymember Miller moved the motion and Assemblymember Anderson seconded; the chair assigned the floor statement to Assemblymember Gonzales.

- Assembly Bill 259 (provisions governing prescription drugs): Motion to amend and do pass carried. The transcript shows a motion from Assemblymember Miller with a second from Assemblymember Torres Fawcett; the chair assigned the floor statement to Assemblymember Considine.

- Assembly Bill 466 (revised portable electronics insurance notice requirements): Motion to do pass carried. Motion recorded from Assemblymember Miller and seconded by Assemblymember Torres Fawcett; the chair assigned the floor statement to Assemblymember Kusama.

The committee did not read the full floor statements on the record during the work session; the chair recorded the floor‑statement assignments for floor managers. The transcript records votes (including nominated nays for AB44) where noted; full roll‑call tallies were not listed for all measures in the transcript.","During the meeting's work session the committee moved to amend and do‑pass four bills: AB44 (price‑manipulation prohibition), AB177 (audiology/hearing aids changes), AB259 (prescription drugs provisions), and AB466 (portable electronics insurance notice changes). Votes were recorded and floor statement assignments were made.",{"_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},6612919,"Committee hears bill to clarify treatment of subscription legal plans; insurer regulator takes neutral stance",1306,1472000,2778000,"/Search/View?dp=1&key=2879309-dda92a445da7d98c3ae1f2feef7f027c&start=1472&end=2778","https://assets.pipeline.soar.com/2879309-dda92a445da7d98c3ae1f2feef7f027c/thumbnail_1472000.jpg","/articles/6612919/Nevada/Committee-hears-bill-to-clarify-treatment-of-subscription-legal-plans-insurer-regulator-takes-neutral-stance","https://secure.pipeline.soar.com/6612919-b8553c7fd95381c501895c4daf2162cf/orig.mp4?Expires=1770709010&Signature=Oz4GOGRkj5hiv2jUl-BYOW--lTmjeTosSOAB4s6mX6fY8WEANZVHr74ELTJgiiW-dzGz39WX~gzTFcSmeSyU054sU0lG2Qg~gvohEnLy7FQ7NF8GqVSiSVCxHTD0tWgWWDbaQqDDA1OBWzazjIrNwCLblrLED6Y02c3qf1llG6cUuMf2QzYVUrDvcbZdWg8QF7qpEP1QGUg-xl2PfQ9A1EHM2BjSKnCsUFEircRD~Px-OUPcIcQhmWCTCFo2vQpeLxDsGlwJCZHX2mjyGfqyZezkwGKErGail4gbfi0N-q~UUj97npDQc90ShXZAHhCccD90HgtbGlmuyuhgLFaw3w__&Key-Pair-Id=KUT5TJCACFTXG","The Assembly Commerce and Labor Committee on Friday heard testimony on Assembly Bill 512, which would clarify that non‑indemnity legal plans—subscription arrangements that give members access to provider law firms—are not casualty insurance under Nevada law.

Proponents, including representatives of LegalShield, said the bill would modernize Nevada’s statute and align the state with the majority of other states that treat the plans as non‑insurance. \"This proposed legislation simply will bring clarity and modernization to the law here in Nevada and exempt these modern non indemnity legal plans from insurance,\" said Mark Nelms, vice president and assistant general counsel for prepaid legal services (LegalShield). He described the plan model as one in which members contact a provider law firm for consultations, document review or referrals, and emphasized that LegalShield does not indemnify members or pay claims.

Nelms said LegalShield’s provider law‑firm model uses a first point of contact at the firm and that the company has provider firms around the country; he told the committee the plans do not reimburse legal expenses and \"we do not indemnify our members for legal fees. We don't pay claims. We don't reimburse members.\" Trey Abney, speaking with Nelms for LegalShield, said the change would align Nevada with states that have adopted similar clarifying statutes and argued the plans increase access to legal help for people who do not qualify for legal aid.

Representing the Nevada Division of Insurance, Adam Plain testified the division is neutral on AB512. Plain told the committee the division has regulated certain legal‑expense products under the existing miscellaneous category and currently applies a \"fortuitous event\" standard to determine whether an undefined product should be treated as insurance. \"We're fine with the redefinition if that's what the legislature chooses,\" Plain said, but he noted the division will continue to enforce the law as the legislature defines it.

No callers or members of the public registered testimony in support or opposition during the hearing; no formal committee vote on AB512 was recorded in the transcript of this meeting.

Supporters said the bill is narrowly written to distinguish non‑indemnity legal plans from casualty insurance by clarifying that plans that reimburse or pay for specific legal expenses would remain within the insurance code, while fixed, prearranged payment plans that provide access to provider attorneys would be exempt. LegalShield and its witnesses repeatedly described the product as an access model—members pay a subscription for legal access rather than submit claims for reimbursement.

Committee staff posted a version of proposed amendments on the bill page and LegalShield witnesses said they worked from the amendment posted to NELIS. The division of insurance said it submitted written testimony and a constituent letter and will adapt enforcement to whatever legislative definition is adopted.

The committee did not take a final vote on AB512 during the hearing. Unless the bill moves to a committee vote at a later meeting, the committee's record at this hearing consists of proponent testimony from LegalShield and a neutral position from the Division of Insurance.","Supporters of AB512 told the Assembly Commerce and Labor Committee that the bill would exempt non‑indemnity subscription legal plans from the Nevada Insurance Code. The Nevada Division of Insurance said it is neutral and noted it has regulated certain legal‑expense products under the miscellaneous category.","actionData","errors"]

Article not found

Bipartisan bill to reform prior authorization draws wide stakeholder support; sets enforceable timelines and AI limits

Bill to waive small‑business license fees and streamline wireless co‑location advances to hearing; local governments and industry negotiated language

Heated hearing on AB225: sponsor seeks apprenticeship and carve‑outs; barber and cosmetology boards oppose

Work session: Committee votes to do‑pass four bills in brief business session

Committee hears bill to clarify treatment of subscription legal plans; insurer regulator takes neutral stance