AN ACT relating to health care; prescribing requirements governing the denial of requests for prior authorization; making certain legislative findings and declarations; encouraging licensed physicians, physician assistants, advanced practice registered nurses and osteopathic physicians to discuss with patients in certain circumstances information relating to stem cell treatment, storage and donation; and providing other matters properly relating thereto.

Existing law authorizes certain health insurers to require an insured to obtain prior authorization from the insurer before receiving certain care. (NRS 687B.225) Sections 1, 4 and 5 of this bill prohibit certain health insurers, including insurance for public employees, from solely using, employing or relying upon an artificial intelligence system or an automated decision tool to: (1) deny a request for prior authorization for medical or dental care; (2) modify a request for prior authorization for such care submitted by a provider of health care; (3) reduce the scope of services or amount of coverage for such care that is included within a request for prior authorization; or (4) terminate, reduce or modify coverage for previously approved medical or dental care. Sections 1, 4 and 5 also require such health insurers to approve a request for prior authorization for medical or dental care that is covered by the insurer, unless a licensed health care professional with the education, training and expertise necessary to evaluate the condition at issue determines that the care requested is not medically necessary or is experimental or investigational. Sections 6 and 7 of this bill make conforming changes to clarify that certain provisions generally applicable to members of plans of self-insurance for employees of local governments and are applicable to the provisions of sections 4 and 5, respectively. Existing law requires a physician, physician assistant, advanced practice registered nurse or an osteopathic physician to counsel and provide certain information to a patient who is diagnosed with certain conditions. (NRS 630.3737, 632.2383, 633.6947) Sections 9-11 of this bill make certain legislative findings and declarations relating to the use of stem cell therapy, including a declaration encouraging physicians, physician assistants, advanced practice registered nurses and osteopathic physicians to: (1) discuss with a patient, upon diagnosing the patient with arthritis, osteoarthritis or any other condition that is regularly treated using stem cell therapy, the potential use of stem cell therapy to treat the condition; and (2) when acting as providers of primary care during the first encounter with a new patient, inform the patient of options that may be available to the patient for donating, banking or storing stem cells for future use by the patient or a donee.