Revises provisions relating to public health. (BDR 40-86)

Existing federal regulations require providers of health care and health care facilities that receive funding or certain other assistance from the Federal Government to ensure that communications with persons with disabilities are as effective as communications with persons who do not have disabilities. (45 C.F.R. § 92.202) Those federal regulations: (1) prohibit such providers and facilities from requiring a person with a disability to be accompanied by a person to interpret for him or her; and (2) authorize such providers and facilities to provide qualified interpreters through video remote interpreting services. (28 C.F.R. § 35.160, 45 C.F.R. § 92.202) Section 1 of this bill requires a hospital or freestanding birthing center to provide a qualified sign language interpreter to a patient who is at the hospital or freestanding birthing center for the purpose of giving birth, except where providing such an interpreter would be impractical or delay necessary care. Section 1 also requires a hospital or freestanding birthing center to allow a family member of the patient and a doula to be present in the room with the patient during the birthing process. Sections 2-6 of this bill make conforming changes relating to the applicability and enforcement of section 1. Existing law requires Medicaid to cover doula services provided by a doula who enrolls with the Division of Health Care Financing and Policy of the Department of Health and Human Services. (NRS 422.27177) Sections 18, 43, 46, 48, 50, 51, 53, 55, 56 and 61 of this bill require various other public and private insurers who cover maternity care to: (1) cover doula services; and (2) include doulas in their networks of providers. Section 45 of this bill authorizes the Commissioner of Insurance to require certain policies of health insurance issued by a domestic insurer to a person who resides in another state to include the coverage required by section 43. Section 60 of this bill authorizes the Commissioner to suspend or revoke the certificate of a health maintenance organization that fails to provide the coverage required by section 55. The Commissioner is also authorized to take such action against other health insurers who fail to provide the coverage required by sections 43, 46, 48, 50, 51, 53 and 61. (NRS 680A.200) Existing law requires certain health insurers, including Medicaid managed care organizations and insurance for state and local governmental employees, to cover hormone replacement therapy to varying degrees. (NRS 287.010, 287.04335, 689A.0415, 689B.0376, 689C.1678, 695A.1875, 695B.1916, 695C.050, 695C.1694, 695G.1717) Sections 44, 47, 49, 52, 54, 58 and 64 of this bill require such coverage to include coverage of testosterone replacement therapy for menopausal women. Section 67.5 of this bill requires: (1) private insurers to submit to the Commissioner a plan for complying with that requirement on or before January 1, 2026; and (2) the Commissioner to evaluate those plans and post a bulletin on or before February 1, 2026, stating whether each such insurer is likely to be in compliance with that requirement. Section 42 of this bill prohibits certain health insurers from denying a request to include a provider of health care in a provider network because the provider of health care is a solo practitioner. Existing law authorizes a court that finds a child to be in need of protection to place the child in the temporary custody of a public or private agency or institution. (NRS 432B.550) If such a child is placed in the custody of an agency which provides child welfare services and has been diagnosed with a mental or behavioral health condition before or after such placement, section 22 of this bill requires the agency which provides child welfare services to provide for an independent assessment of the child before the child leaves the custody of the agency which provides child welfare services. Section 22 provides that this requirement does not apply if a prior assessment conducted after the initial diagnosis has determined that the child no longer has a mental or behavioral health condition. Sections 7 and 23-25 of this bill make conforming changes to make various provisions governing child welfare proceedings generally applicable to any proceeding related to the provisions of section 22. Section 33.5 of this bill makes a conforming change to require the State Board of Nursing to establish qualifications for an advanced practice registered nurse to conduct an assessment pursuant to section 22. Existing law provides for the regulation of the practices of medicine, nursing and osteopathic medicine by the Board of Medical Examiners, the State Board of Nursing and the State Board of Osteopathic Medicine, respectively. (Chapters 630, 632 and 633 of NRS) Sections 29, 32 and 35 of this bill: (1) require those boards to adopt regulations prescribing a list of race-based health formulas and race-based care standards that are authorized for use by licensees in this State; (2) prohibit those boards from including on that list any race-based health formula or race-based care standard if there is a race-neutral health formula or race-neutral care standard that has been scientifically validated as being at least as effective for the same purpose; and (3) prohibit a physician, physician assistant, nurse or osteopathic physician from using or authorizing the use of a race-based health formula or race-based care standard that is not included on the list. Section 65 of this bill requires the Board of Medical Examiners, the State Board of Osteopathic Medicine, the University of Nevada, Reno, School of Medicine and the University of Nevada, Las Vegas, School of Medicine to study disparities in health care access, the provision of health care and health care outcomes.