Senate majority leader seeks to require insurers, including Medicaid, to cover noninvasive prenatal testing

Senate Majority Leader Nicole Cannizzaro told the Senate Commerce and Labor Committee that Senate Bill 344 would require health insurers, including Medicaid and public-employee plans, to cover noninvasive prenatal screening and carrier screening without prior authorization.

"This bill proposes to require all health insurers to automatically cover this screening without prior authorization or any other conditions," Cannizzaro said, introducing the measure.

Nut graf: Supporters, including obstetricians and genetic testing companies, told the committee that noninvasive prenatal testing (NIPT) is highly accurate, can be done earlier in pregnancy than older screening methods and avoids the risks associated with invasive procedures such as amniocentesis. They urged coverage for low‑risk as well as high‑risk pregnancies and asked that Medicaid and other payers drop prior‑authorization requirements.

What proponents told the committee - Dr. Joseph Adeshak, president of the Nevada State Medical Association and a maternal‑fetal medicine specialist, said NIPT can detect common trisomies and certain sex‑chromosome abnormalities with much higher accuracy than older serum screens and can be performed as early as 10–12 weeks. He said the American College of Obstetricians and Gynecologists (ACOG) recommends offering genetic screening and diagnostic testing to patients regardless of age and risk factors.

- Kyle Prosen of Natera, a genetic testing company, said peer‑reviewed studies indicate prenatal genetic testing can be cost‑effective because earlier detection can reduce costly emergency interventions and improve outcomes by allowing delivery at appropriately equipped centers. He said 41 percent of births in Nevada are covered by Medicaid and urged that any coverage expansion apply to Medicaid without prior authorization.

- Dr. Earl Oke, a maternal‑fetal medicine specialist, described the expansion of carrier screening and the clinical advantages for coordinating care when genetic conditions are known before birth.

Public testimony: Several physicians and organizations voiced support. Jacqueline Nguyen of the Nevada State Medical Association and Dr. Sandra Koch of the Nevada chapter of ACOG testified in favor, and a caller, Katrina Nayak, described using NIPT in her recent pregnancy.

Neutral and fiscal notes: Adam Plaine of the Nevada Division of Insurance said the division was neutral on the measure as policy and had submitted a fiscal note; he said the division's actuarial estimate addresses increased costs in the individual market and does not affect Medicaid.

Opposition and concerns: Shelly Caparo of the Nevada Association of Health Plans warned that mandated coverage can increase consumer costs through higher premiums and reduced plan flexibility. Planners and insurers raised concerns about the bill's fiscal impact on individual market enrollees and on federal matching rules when state mandates change benefits for exchange plans.

What’s next: The committee accepted presentations and public testimony and closed the hearing. No committee vote was recorded at the hearing; the committee may consider amendments or fiscal adjustments before any committee action.