Senate hears bill to expand access to care for firefighters and police with occupational heart and lung disease

Senate Bill 376, which addresses access to medical care for firefighters and police officers with occupational heart and lung disease, was heard Friday by the Nevada Senate Committee on Commerce and Labor. Sponsor Sen. Skip Daley, R‑District 13, said the bill provides an “off‑ramp” for injured first responders when the existing provider panels do not deliver timely or adequate care.

Under SB 376, an injured employee with covered occupational heart or lung disease may seek treatment from a physician of their choice if the administrator’s panel contains fewer than 12 physicians in the relevant specialty who both accept and will treat injured workers. The bill requires full reimbursement of reasonable out‑of‑pocket expenses for such care and provides penalties — including a statutory enhancement described in testimony as a “triple” penalty — for delayed reimbursement beyond a statutory period (described in testimony as 30 days for reimbursement determinations and first appointments).

Multiple firefighters and union representatives told the committee they encounter long delays and very limited provider availability on the Division of Industrial Relations (DIR) treating panels and on local third‑party administrator lists. Firefighter Ryan Orton described an eight‑month delay to secure the right to see treating specialists after reopening a claim, repeated refusals by pulmonologists to accept workers’‑comp patients, and a de facto reduction of available pulmonologists to one who had performed an independent medical evaluation (IME) and thus could no longer serve as a treating physician. Captain Brad Brazeal and other union witnesses recounted difficulties finding oncologists, cardiologists, pulmonologists and ear/nose/throat specialists who will accept workers’‑comp cases.

Proponents said the current statutory framework (NRS 617.455 and NRS 617.457 were cited in testimony) contemplates a treating‑panel system but does not ensure timely access. Ryan Beaman of Professional Firefighters in Nevada said the bill enforces “accept and treat” standards and a 30‑day first‑appointment expectation in proposed definition language; it also allows reimbursement when members pay out of pocket for necessary treatment because panel providers are unavailable. Jason Mills of the Nevada Justice Association said the master panel list managed by DIR allows physicians to sign up but does not ensure they actually accept or treat workers’‑comp patients; as a result, insurers and local governments often compile sublists that contain the same unavailable providers.

DIR Administrator Victoria Cadyuan and staff said they have begun auditing cardiologists and pulmonologists on the DIR list. They reported verifying 41 cardiologists and 10 pulmonologists who currently accept workers’‑comp patients (from an earlier pool of roughly 127 cardiologists listed prior to verification). DIR said it has removed doctors who indicated they would not accept workers’‑comp patients and is actively recruiting specialists, but staff and union witnesses agreed access remains uneven across Northern and Southern Nevada and in rural areas.

Local government representatives (City of Henderson and City of Las Vegas) registered opposition only to seek technical changes and offered to work with proponents. Appeals‑division staff said they are neutral and working on electronic filing amendments tied to the bill’s implementation.

Proponents and committee members discussed potential next steps and technical amendments. No committee vote on SB 376 was recorded at the hearing.

The bill’s supporters characterized SB 376 as an effort to ensure first responders diagnosed with occupational heart and lung disease can obtain timely specialist care and be reimbursed promptly when they must seek care outside standard panels.