Assembly committee hears bill to require insurers to cover pediatric mental-health screenings and assessments

Assembly Member David Orangelicker on behalf of the Assembly Health and Human Services Committee introduced Assembly Bill 3 40 to the Assembly Commerce and Labor Committee on March 12, saying the measure would expand insurance coverage for screenings and assessments to help identify children with significant mental or cognitive conditions and connect them to early interventions.

The bill would require health insurers operating in Nevada — including Medicaid, health maintenance organizations and fee‑for‑service plans — to cover screening and diagnostic assessments for attention deficit hyperactivity disorder, fetal alcohol spectrum disorders, intellectual disabilities and specific learning disabilities. It also would extend coverage for evaluations through age 22 for young people still enrolled in high school.

Supporters told the committee that routine screenings in pediatric and primary care settings and in schools can identify children who need early services, reduce emergency room visits and lower long‑term costs. ‘‘AB 340 will help us do a better job of identifying children with significant conditions that affect their mental and cognitive health and that will help ensure that the children receive the early interventions that are critical to their long term well‑being,’’ Assembly Member David Orangelicker said. Tara Raines, deputy director of the Children’s Advocacy Alliance, said the bill grew out of the group’s children’s mental health action coalition and that screening data are needed to understand how many children in Nevada are affected.

Several pediatricians and clinicians testified in support. ‘‘Primary care pediatricians can screen for all of these things in their office,’’ said Dr. Terrence McAllister, president of the Nevada chapter of the American Academy of Pediatrics. He added that assessments can be time‑consuming and need appropriate compensation. Leann McAllister, executive director of the Nevada chapter of the AAP, said many pediatricians are in solo practice and uncertain whether insurers will reimburse for the extra time required for screening and assessment.

Family members and youth described personal experiences of long waits and high costs for evaluations. ‘‘My parents are still paying thousands of dollars every few years for testing,’’ said Talies Carpenter, a 15‑year‑old who testified in support. Testimony from advocacy groups — including the Children’s Advocacy Alliance, Nevada Psychiatric Association, NAMI Nevada, Planned Parenthood Votes Nevada and the Nevada State Medical Association — emphasized access and equity concerns for families who currently face wait lists and prohibitive costs; one witness said assessments can cost ‘‘anywhere from $3,000 to $5,000 out of pocket.’’

Committee members asked how the bill would work in practice. Assemblymember Cole asked whether networks would need every provider to offer assessments or if a network could have at least one provider; Tara Raines said the intent is to require that each network include at least one provider offering the services, not to require, for example, dentists to perform assessments. Assemblymember Hardy asked how parents would access screenings; Raines and witnesses said screenings could be done in pediatric well visits and schools, and that pediatricians in Nevada support that approach.

Officials who testified in neutral included Adam Plain from the Nevada Division of Insurance, who said the agency’s written analysis determined the bill, as drafted, ‘‘does not look to trigger federal deferral provisions’’ and that the draft language appears to require network access to a provider who offers the service rather than requiring that every in‑network provider provide assessments. Several self‑insured, employer‑sponsored plans and health plan representatives — including the Professional Firefighters, Clark County, and the Las Vegas Metro Health Trust — said they were neutral and appreciated stakeholder engagement on language for self‑funded plans.

Committee discussion also noted the state’s existing autism screening requirement under state law; Raines said NRS chapter 287.0276 requires screening, assessment and treatment for autism spectrum disorders and that AB340 focuses first on screening and assessment to better estimate needs before adding treatment mandates. The bill sponsor said stakeholders are working on technical amendments that will be submitted after the hearing.

The committee held the hearing and took testimony but did not vote on AB340 at the March 12 meeting.