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Nevada bill would shorten insurer prompt-pay timelines for medical claims; sponsors and providers say it could aid small practices
Summary
Assembly Bill 52 would shorten statutory timelines for private insurers to approve and pay claims: 15 calendar days for electronically submitted claims, with 30 days retained for non-electronic claims under a conceptual amendment presented to the committee.
Assembly Bill 52, presented March 5 to the Assembly Commerce and Labor Committee by Gabriela Wyatt of the Nevada Commission on Minority Affairs and sponsored by Assemblymember Sandra Howdge, would shorten statutory timelines for private insurers to approve and pay claims.
Under the conceptual amendment described in the hearing, an administrator or insurer would have 15 calendar days to approve or deny a claim submitted electronically and 15 days after approval to pay the claim. Claims submitted by other means would keep a 30-calendar-day timeframe for approval and payment. If an insurer needs more information, it must request that information within 20 days of receiving the claim; after receiving the additional material, payment timelines restart from the date of approval.
Proponents told the committee the change reflects the availability of electronic claims processing and would improve small-practice cash flow, help retain and recruit doctors in Nevada, and reduce the closure risk for small practices. Gabriela Wyatt described the bill as a response to provider instability that can leave underserved communities with fewer local health care options. Sponsoring Assemblymember Sandra Howdge emphasized the bill aims to make Nevada more attractive to practicing physicians and noted existing prompt-payment rules already apply to some public programs.
Supporters from medical and provider groups, including the Nevada State Medical Association, NAMI Nevada, Las Vegas Heals and other local provider coalitions, told the committee that timely reimbursement is critical to small clinical practices that must meet payroll and buy medications and supplies.
Several stakeholders told the committee they had worked with the bill sponsor on a conceptual amendment that would: (1) change the denial/approval timeline language to calendar days for clarity; (2) exclude certain self-managed or employer-administered plans from the statutory changes; and (3) allow the Division of Insurance to adopt implementing rules and penalties for noncompliance. The sponsor also said she will work with the division to scope and, if needed, reduce any fiscal impact from required outreach.
The Division of Insurance told the committee it has an undetermined fiscal note for the bill because section 1 would require outreach and support programs that the division is not currently staffed to deliver; the division said costs could range from negligible (a web posting) to higher amounts if extensive outreach or staff additions were required.
No committee vote was taken at the hearing. Supporters and insurers said they would continue technical discussions; several groups said they expected to reach agreement on language that would address plan-type carveouts and clarify consumer protections.
