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Bill would require emergency departments to offer rapid syphilis testing and on‑site treatment to pregnant patients, sponsors say it could prevent infant deaths
Summary
AB 360 requires emergency departments to perform rapid or point‑of‑care syphilis testing for pregnant patients and to initiate treatment during the same visit if positive; Medicaid reimbursement language aims to cover rapid tests; doctors, public health officials and hospital groups supported the measure.
Assemblywoman Heather Golding presented Assembly Bill 360 as a public health response to a statewide rise in congenital syphilis. The bill would require emergency departments to offer rapid or point‑of‑care syphilis screening to pregnant patients during an emergency visit if serologic results cannot be reasonably obtained before the patient leaves, and it would require treatment initiation during that visit if the patient tests positive and does not decline treatment. The bill also includes reimbursement language to ensure Medicaid covers rapid testing and asks hospitals to adopt written policies aligning screening and treatment protocols with best practices.
Golding said the bill builds on AB 192 (2021), which required ED syphilis testing for pregnant women when presenting for pregnancy‑related complaints; sponsors said AB 360 closes a gap for patients who present for nonpregnancy complaints but are pregnant and at risk.
Dr. Nehal Naik, an emergency physician in Las Vegas, told the committee that a high percentage of pregnant patients use the emergency department during early pregnancy and that point‑of‑care testing plus treatment could reach patients who lack prenatal care. “The amount of time it takes to do the effort for what's right for the patient and the right for future Nevadans ... is so much more valuable than that short amount of time it takes,” Naik said.
Dr. Kris Deeter, chair of pediatrics at the University of Nevada, Reno School of Medicine and physician in chief at Renown Children’s Hospital, described the clinical consequences of congenital syphilis and the intensive care newborns can require: prolonged hospital stays, spinal taps, intravenous antibiotics and long‑term monitoring for hearing, vision and developmental problems. He said many of those outcomes are preventable with maternal screening and timely treatment.
Public health officials and hospital associations supported the bill. Jennifer Howell of Northern Nevada Public Health testified that Nevada’s congenital syphilis rate is more than double the national rate, and Washoe and Clark counties reported large shares of cases in recent years with many mothers lacking prenatal care and visiting emergency departments during pregnancy. The Southern Nevada Health District and Nevada Hospital Association urged support; Dignity Health and other hospital systems described existing programs that screen and link positive patients to care.
The Nevada Association of Health Plans urged caution about insurance mandates and possible cost implications, and the Division of Insurance submitted neutral technical comments noting broader statutory cross‑references to preventive services. Sponsors said the bill primarily addresses an at‑risk, often uninsured population who rely on EDs for care and emphasized the Medicaid reimbursement language, which the sponsor said unbundles the cost of rapid tests from global pregnancy bundles.
The committee closed the hearing on AB 360; no vote was taken at this hearing. Sponsors asked the legislature to adopt the bill to reduce preventable congenital syphilis cases and associated infant morbidity and mortality.
