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Committee hears bill to eliminate prior authorization for gynecological and obstetrical visits
Summary
SB 246 would let patients see an OB/GYN without prior authorization or a referral in many insured plans and extend direct-access requirements to additional plan types; supporters said it reduces delays in care and disparities while insurers urged further negotiation on cost and implementation details.
Sen. Roberta Lang presented Senate Bill 246 to the Assembly Commerce and Labor Committee as a measure to increase access to gynecological and obstetrical care by removing prior-authorization and referral requirements that can delay medically necessary services.
Lang told the committee prior authorization processes can delay critical care, citing studies that show an average delay of about two weeks for cancer care and data indicating disparities: Medicare Advantage enrollees faced a 76 percent increased rate of prior authorization and patients of Asian descent a 60 percent increased risk in one study she referenced.
SB 246 would expand existing Nevada statutory requirements that allow direct access to OB/GYN services to additional plan types, including small-employer plans, fraternal benefit societies, managed-care organizations, the Public Employees’ Benefits Program, and Nevada Medicaid. The bill’s effective date is set for Jan. 1, 2026.
Committee counsel and witnesses discussed whether an OB/GYN may be designated a primary care physician under federal law. Adam Plain of the Nevada Division of Insurance corrected an earlier statement during public comment: the Affordable Care Act requires that plans allow a woman to see an OB/GYN without prior authorization, but it does not require states to define OB/GYNs as primary care physicians; Nevada currently does not do so.
The Nevada State Medical Association testified in strong support, calling prior-authorization reform a priority for patients and providers. Testimony emphasized that removing referral requirements can shorten time to specialty care for urgent women’s health issues and reduce administrative burdens on clinicians.
The Nevada Association of Health Plans said it had signed in as opposed because the bill’s drafting made it appear to be a broader prior-authorization reform; the witness asked for further discussions with the sponsor to clarify intent and implementation details. The Division of Insurance offered to provide federal citations to committee staff and to work with stakeholders on regulatory implications.
Committee members asked whether granting patients direct access was likely to increase premiums; Lang said insurers had mentioned possible price impacts and that she expected continued stakeholder conversations and potential amendments.
The hearing record does not reflect a committee vote. Senator Lang said she intends to return with an amendment and continue discussions with stakeholders.
