Governor Joe Lombardo opened the joint hearing on Senate Bill 495, the "Nevada Health Care Access Act," saying the measure is intended to address long wait times and provider shortages across the state. "Nevadans seeking medical care face long wait times and have trouble accessing specialists," Lombardo told the Senate and Assembly health committees.

The bill, as presented, would pursue several goals: accelerate licensure and credentialing for clinicians, standardize and shorten prior-authorization timeframes, expand funding and programs to grow the health-care workforce, create an Office of Mental Health and fund a feasibility study on developing an academic medical center in Nevada. Richard Whitley, director of the Department of Health and Human Services (DHHS), described the bill as a multi-topic effort that uses existing data and state structures to cut delays between licensure, health-plan credentialing and hospital onboarding.

Supporters — including hospital systems, medical schools, business groups and patient advocates — said the proposed reforms would make Nevada more competitive for recruits and reduce harmful administrative delays. Karla Perez, regional vice president for Universal Health Services, told the committee that expedited credentialing and prior-authorization reform would help hospitals get newly recruited clinicians caring for patients sooner.

Key provisions and clarifications

- Prior authorization: Stacy Weeks, Nevada Medicaid administrator, told the committee current law allows up to 20 days to respond to a prior-authorization request. "This would align with some of the more best practices that we're seeing, which is closer to 2 business days," Weeks said. The bill includes electronic-processing expectations, maximum response timeframes, and a "gold card" exemption for trusted providers; Weeks said implementation would include regulatory checks to limit abuse of exemptions.

- Credentialing and hiring: The bill seeks to reduce the time from license issuance to hospital onboarding by encouraging use of centralized data and uniform credentialing standards across plans and facilities. Supporters argued this would reduce the months-long waits new recruits currently face.

- Office of Mental Health and behavioral health coordination: The measure creates an Office of Mental Health to coordinate behavioral-health services statewide and direct funding for community-based mental-health services. Proponents framed the office as intended to reduce reliance on emergency departments for behavioral crises and to improve continuity of care for children, adults and older Nevadans.

- Workforce and graduate medical education (GME): The bill originally contained larger funding and programmatic pieces for a Nevada Health Care Workforce and Access Fund and GME expansion, but Whitley said the governor's office submitted an amendment removing sections that created a separate workforce fund and other sections. "There is an amendment from the office of the governor removing the section of the bill creating the Nevada Health workforce and access program and sections related to graduate medical education," Whitley said; he added that section 7 — a biennial workforce assessment — would be retained.

Dental hygienist alternate-pathway controversy

A large portion of public and member testimony focused on proposed alternative pathways to dental-hygienist licensure that appear in the bill (sections referenced in committee discussion as 77–79). Proponents — including some dentists and rural-health advocates — said the pathway would help address acute shortages of dental hygienists statewide, especially in rural communities where some counties have no hygienists at all.

Dr. Amy Abitan, representing the Nevada Dental Association, described the proposal as patterned on a long-standing Alabama model and said the program would include a board-defined curriculum, a board-defined examination and supervised, hands-on training in dental offices: "There is a formal training that goes along with this program. There is going to be a curriculum defined by the board. There is going to be an examination defined by the board." Several dentists and rural providers said the clinic-based training could safely expand capacity in areas where no hygienists are available.

Dental hygienists and allied groups strongly opposed the alternate-pathway language. Multiple licensed hygienists and the Nevada Dental Hygienists Association argued the change would remove established educational safeguards. As Brenna Reynolds, a registered dental hygienist, put it during public comment: "We are not just tooth cleaners. We are preventative healthcare providers who spend 60 minutes with patients multiple times a year." Opponents urged striking sections 77–79 or revising them to require accreditation-level education and independent clinical competency exams.

Other concerns raised

- Fraud, clawbacks and program integrity: Committee members pressed Weeks and other presenters about safeguards around the gold-card prior-authorization exemption and how the state would ensure program integrity. Weeks said the state would build regulatory checks and partner with the Division of Insurance and health plans to monitor high-performing providers and prevent gaming of exemptions.

- Quality versus access trade-offs: Several members noted that states have varied approaches and that standardizing credentialing and prior-authorization rules across payers could limit payers' discretion to set stricter standards in specialized lines. Chair Brown May and others emphasized a need to balance access and patient protection.

Public testimony and next steps

The hearing drew broad stakeholder turnout: hospital systems, business groups, medical and dental schools, rural providers, patient advocates and organized labor. Testimony included personal health narratives, clinical examples of harm attributable to delays, and detailed opposition from dental hygienists about the proposed licensure pathway.

Administrators told the committee some workforce and GME provisions from SB 495 will be pursued in separate legislation. Several speakers asked for clear regulatory details, reporting mechanisms, and sunset/monitoring language for any alternate licensure pathways.

The committee took testimony but did not record a final vote on SB 495 during the hearing. An amendment submitted by the governor's office was discussed on the record that removes several sections previously posted to the bill while retaining the workforce assessment; additional technical and policy amendments were expected to be circulated after the hearing.

Ending

The committees continued to accept public testimony and indicated they would consider written amendments and technical fixes following the hearing. Where the bill moves next will depend on what amendments are ultimately posted and how the committees resolve the competing priorities of expanding access while preserving established education and safety standards.