New health insurance regulations restrict benefits denial practices starting October 2025

On April 24, 2025, the Nevada State Legislature introduced Assembly Bill 522, a significant piece of legislation aimed at enhancing access to health care benefits for insured individuals. The bill seeks to address concerns regarding the denial and delay of medical services by insurance providers, particularly in the context of group health insurance policies.

The primary purpose of Assembly Bill 522 is to prohibit insurers from employing practices that discourage insured individuals from accessing their entitled benefits. Key provisions of the bill include restrictions on insurers offering financial incentives to either insured individuals or health care providers that could lead to the denial, reduction, or delay of necessary medical services. Specifically, the bill outlines that insurers cannot:

- Offer material inducements to discourage insured individuals from utilizing their benefits.
- Provide financial incentives to health care providers to limit access to benefits.
- Impose any restrictions or delays on the access of insured individuals to their entitled benefits.

The bill mandates that any group health insurance policy delivered, issued, or renewed after October 1, 2025, must comply with these provisions, rendering any conflicting policy terms void. Additionally, while insurers may still utilize medical management techniques to determine treatment frequency or provider selection, these practices must not infringe upon the rights of insured individuals to access their benefits.

Debate surrounding Assembly Bill 522 has highlighted concerns from both supporters and opponents. Advocates argue that the bill is essential for protecting patients' rights and ensuring timely access to necessary medical care. Critics, however, express concerns about the potential financial implications for insurers and the broader health care system, fearing that the bill may lead to increased costs for insurance providers.

The implications of Assembly Bill 522 extend beyond immediate access to health care. Experts suggest that by safeguarding patient rights, the bill could foster a more equitable health care environment in Nevada, potentially influencing similar legislative efforts in other states. As the bill progresses through the legislative process, its outcomes may set a precedent for how health care access is managed nationwide.

In conclusion, Assembly Bill 522 represents a pivotal step in addressing the challenges faced by insured individuals in accessing health care benefits. As discussions continue, the bill's potential impact on the health care landscape in Nevada and beyond remains a focal point for lawmakers and stakeholders alike.