Committee hears bill to expand direct access to gynecological and obstetrical services; stakeholder language fixes proposed

Senator Roberta Lang introduced Senate Bill 246 to the Senate Commerce and Labor Committee to expand direct access to gynecological and obstetrical services by removing referral or prior‑authorization requirements for covered women under certain health plans.

Lang told the committee she brought the bill after a constituent on an HMO said she could not see a gynecologist without first seeing a primary care doctor; Lang said the bill would address barriers that disproportionately affect people who cannot afford PPOs. Lang summarized the bill’s scope: it would apply direct‑access requirements to additional plan types, including plans for employees of small private employers, fraternal benefit societies, managed care organizations, the Public Employees' Benefit Program and Nevada Medicaid, with an effective date of Jan. 1, 2026.

Supporters stressed potential clinical consequences of prior authorization delays for obstetrical and gynecological care, citing studies and examples that can delay cancer care and create disparities. "Waiting for prior authorization for that could be life ending," said Sarah Adler of Silver State Government Relations, who testified on behalf of the Nevada section of the American College of Obstetricians and Gynecologists (ACOG). Adler said ACOG regretted opposing the bill as written but hoped to work with the sponsor to remove language that may unintentionally prevent women from designating OB/GYNs as their primary care physicians.

Health plan representatives and legal staff flagged drafting problems and offered specific language changes to the sections they said could be read to prohibit naming an OB/GYN as a primary care physician. Shelly Caparo of the Nevada Association of Health Plans proposed simple alternative wording for sections 2, 4, 6 and 9 to clarify that carriers “shall not require a woman covered by the plan to obtain a referral from her primary care physician for covered gynecological or obstetrical services.” Caparo said the suggested revisions would be clearer and expressed that the association had worked with the sponsor to try to ensure the bill’s intent is preserved.

Jeff Koulime from the Attorney General's legal division noted that the language the sponsor proposes is modeled on existing Nevada statutes on the books since the late 1990s and that the new bill extends similar language into additional chapters. Adam Plaine of the Division of Insurance said the division does not view the bill as a new federal preemption or deferral trigger and that the fiscal notes filed indicated no fiscal impact for reviewing agencies.

ACOG’s Nevada section said it could support the bill if the problematic paragraph referencing primary care were removed; Adler said the association would be agreeable if that drafting change were made. Committee members and staff discussed the possibility of amending the bill to harmonize language across multiple chapters so that the statute text is consistent across existing code sections that currently contain older language.

Ending: Senator Lang said the bill could help address racial and access disparities by removing barriers to timely OB/GYN care and indicated a willingness to work on the drafting adjustments stakeholders proposed. The hearing closed with no committee vote recorded in the transcript.