Assembly hears AB360 to require rapid syphilis testing and same‑visit treatment for pregnant patients without prenatal care

Assemblymembers reviewed AB360, a bill intended to reduce congenital syphilis by expanding testing and enabling treatment during a single ED visit for pregnant people who have not received prenatal care.

Assemblymember Heather Golding, the bill sponsor, said AB360 builds on earlier legislation (AB192, 2021) and seeks to close gaps where pregnant people who do not access prenatal care still encounter the health system — often in emergency departments. Golding told the committee Nevada ranks high nationally for congenital syphilis and cited statewide and county statistics to underscore the problem.

Jennifer Howell, sexually transmitted disease (STD) program supervisor at Northern Nevada Public Health, described case‑review findings: many maternal cases involved polysubstance use, unplanned pregnancy, untreated partners and missed opportunities in emergency departments. Howell said public health becomes involved when positive tests are reported and that investigation and partner services are resource‑intensive; congenital syphilis hospitalization and public‑health follow‑up can be costly and prolonged.

Dr. Tim McFerrin, an obstetrician‑gynecologist, urged routine, rapid testing in EDs for pregnant patients without prenatal care. He described a finger‑stick rapid syphilis test that can deliver results in 15 minutes, costs about $10, and is highly sensitive and specific, allowing treatment to begin immediately. Multiple clinicians and hospital representatives said rapid, point‑of‑care testing combined with immediate treatment could prevent infant deaths and long‑term disability.

The proposed amendment posted with the bill would require rapid or point‑of‑care testing “regardless of the reason the pregnant woman presents to the emergency room,” require documentation when testing is refused, and require Medicaid to cover the test and treatment. The amendment also asks medical facilities to adopt policies to ensure testing and treatment are implemented consistent with clinical guidance. Heather Golding and testifiers said the statutory language allows flexibility for standard laboratory serologic testing in appropriate circumstances and for cases with recent testing history.

Committee questions addressed reimbursement, coverage for uninsured pregnant people, and which clinical staff and units (for example, labor and delivery) the requirement would include. The sponsor said the bill is designed principally to reach people who lack prenatal care and that Medicaid coverage language in the amendment is intended to reduce hospitals’ concerns about uncompensated costs. Celestina Glover, executive officer of the Public Employees’ Benefits Program (PEBP), said PEBB does not contract directly with hospitals and could not guarantee savings, but that the program might benefit depending on negotiated agreements.

Neutral witnesses — including the Nevada Division of Insurance and the Nevada Association of Health Plans — raised concerns about mandates increasing costs and urged collaboration. LCB legal staff reviewed related insurance code cross‑references. A hospital laboratory director asked that conventional serologic tests already performed in hospital labs remain acceptable; the sponsor said the bill’s amendment permits use of rapid or point‑of‑care tests or appropriate laboratory testing depending on the clinical situation.

Supporters included emergency physicians, neonatal and pediatric specialists, public‑health districts and advocacy groups. Pediatricians described the intensive and invasive workup newborns with congenital syphilis require — spinal taps, imaging, deep IV lines and a 10‑day course of IV penicillin — and urged prevention through early maternal testing and treatment.

No formal vote was recorded during the hearing. The sponsor closed by saying AB360 seeks to save lives, reduce costs and reduce health disparities by ensuring testing and treatment happen at the point of care when prenatal care has been missed.

Why it matters: public‑health witnesses told the committee that many maternal cases had at least one ED visit and that immediate testing and treatment in those encounters is a high‑leverage prevention point for congenital syphilis.

What’s next: committee discussion and possible amendments; several members asked the sponsor and stakeholders for follow‑up information about coverage for uninsured patients and implementation details.