Bill > AB290

This bill revises provisions relating to prior authorization for medical or dental care under health insurance plans. The bill establishes comprehensive new requirements for health carriers (insurance companies) and Medicaid managed care entities when processing prior authorization requests. Key provisions include mandating that prior authorization decisions be made by licensed physicians or dentists with relevant expertise, requiring health carriers to publish their prior authorization procedures and criteria online, and setting specific timelines for responding to authorization requests. For non-urgent care, carriers must respond within 7 days, and for urgent care, within 48 hours. The bill prohibits carriers from requiring prior authorization for emergency services and establishes an appeals process for denied requests. Additionally, the bill requires health carriers to annually report detailed statistics about their prior authorization processes, including approval rates and common reasons for denial. The changes aim to increase transparency, speed up medical care approvals, and ensure that authorization decisions are made by qualified medical professionals. The bill will take effect on January 1, 2026, giving health insurers time to adjust their procedures to comply with the new requirements.

Budget and Finance, Business and Industry

https://www.leg.state.nv.us/App/NELIS/REL/83rd2025/Bill/12346/Overview