Bill > AB463

This bill revises provisions relating to prior authorization for health insurance in Nevada, focusing on reducing waiting times and eliminating prior authorization requirements for certain medical services. Specifically, the bill requires health carriers (including insurance companies and dental care organizations) to respond to prior authorization requests within 2 business days, with a maximum response time of 7 calendar days. The bill prohibits health carriers from requiring prior authorization for several types of medical services, including preventive care services with high-quality ratings, hospice care for pediatric patients, substance use disorder outpatient services, neonatal abstinence syndrome treatment, and blood glucose test strips for diabetics. If a health carrier fails to respond to a prior authorization request within the specified timeframe, the request is automatically deemed approved. The bill applies to private health insurers and Medicaid/Children's Health Insurance Program providers, with implementation set to begin on January 1, 2026. The legislation aims to streamline medical care access by reducing administrative barriers and ensuring timely responses to medical service requests.

Budget and Finance, Business and Industry, Health and Social Services

https://www.leg.state.nv.us/App/NELIS/REL/83rd2025/Bill/12708/Overview