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Senate passes bill tightening rules for freestanding ERs and adding health-record and licensing provisions
Summary
SB378 was amended and passed after extended floor debate about the role of freestanding emergency departments (FSEDs), patient access and cost, and Medicaid fraud protections. Opponents warned the bill could fragment care and harm undocumented patients; supporters said it will increase transparency and curtail upcoding.
Senate Bill 378, as amended, revises provisions concerning the licensing and operation of independent centers for emergency medical care (freestanding emergency departments), the electronic maintenance and exchange of health records, and related licensure and payment provisions.
Senator Donate (Floor sponsor) said the bill was drafted to address consumer protections and alleged problematic billing practices. "This bill has sections that allow Medicaid the ability to stop providers that are upcoding and taking charge of our state," the senator said, arguing the measure helps stop waste, fraud and abuse.
Senator Titus delivered extended floor remarks in strong opposition, arguing SB378 would "jeopardize access to critical health care services, particularly to undocumented immigrants and other vulnerable Nevadans." Titus said the bill's licensing requirements (identified on the floor as sections 14 through 16) and a five-mile restriction for new FSEDs (section 17) risk fragmenting care and increasing costs. She also noted concerns about mandating 24/7 urgent-care services at specified rates and cited EMTALA obligations and rural access concerns.
The Senate adopted finance committee amendment 804, described on the floor as requiring the Director of Health and Human Services to include under Medicaid a system of value-based payments for certain independent centers, modifying licensure provisions, adjusting deadlines for health-record transmittal, and including a general-fund appropriation of $291,296 with authorization of $1,100,000 to implement the bill.
After debate the Senate recorded a roll-call vote: yeses 12, noes 8. The bill was declared passed and ordered to the Assembly.
