- New freestanding Clark County ERs must accept Medicare, Medicaid (reviewjournal.com)
New hospitals or medical centers that offer or advertise emergency services in Clark County will need to accept Medicare and Medicaid, starting this summer...Hospitals that obtain a business license after June 1 will be subject to the new rule. They must also be certified by the Centers for Medicare and Medicaid Services and be in compliance with federal law that requires emergency departments to treat patients without regard for insurance or ability to pay...The new stipulations...come amid concerns over the emergence of freestanding ERs, or microhospitals, that are not part of existing hospital networks. Those medical facilities are licensed through the state, but lack accreditation, do not accept Medicare and Medicaid and are not subject to the same reporting requirements and other standards...READ MORE
- 2-Minute Preview: Drug pricing board, public record changes and automatic voting rights restoration on deck (thenevadaindependent.com)
SB262: Asthma drug pricing transparency
...Democratic Sen. Yvanna Cancela...has introduced a bill that would apply the same standards toward drugs that treat asthma...SB262 largely copies provisions of Cancela’s 2017 legislation on diabetes drug transparency, which requires the drug manufacturer to submit information to the state related to the cost of the pricing of the drug, and explain to the state whether the drug has undergone a substantial price increase in the past two years...SB262
SB378: Drug pricing boardProposed by Democratic Sen. Yvanna Cancela, this measure would establish a statewide Prescription Drug Affordability Board, charged with identifying certain prescription drugs with pricing that creates challenges for insurers and patients and that would recommend an upper price and payment limit on the drug...The bill lays out the structure, make-up and abilities of the board, funded by taxes on prescription drug manufacturers based on their market share and the required costs of the board. It also lays out a process for setting upper recommendations on prescription drug prices, including requiring the suggested limits become mandatory after 2024...SB378
AB303: Regulation of kratom products
Sponsored by Assembly Republican Leader Jim Wheeler, this bill would require the state pharmacy board to regulate and oversee the sale of kratom, a Southeast Asian tropical tree with leaves that contain psychotropic effects...The bill would also prohibit the sale of kratom products to children under the age of 18, or to sell any kratom products that have been altered to become “injurious” to a consumer. It sets a $1,000 fine and separate civil penalty up to $1,000 for violations...AB303
AB239: Opioid clarification bill
...this bill would make changes to the opioid prescribing law passed in the 2017 legislative session that prompted complaints by physicians in the interim. The legislation would, among other things:
- Codify certain definitions from pharmacy board regulations, including course of treatment and acute pain
- Allow providers to still prescribe a controlled substance after reviewing a patient utilization report if they determine the prescription is medically necessary
- Allow providers to prescribe a longer initial prescription for a controlled substance for the treatment of acute pain than normally allowed by law if medically necessary
- Remove a requirement that a provider make a good faith effort to attempt to review a patient’s medical records before issuing an initial prescription of a controlled substance for the treatment of pain unless the initial prescription is for more than 30 days or the medical records are relevant to the prescription
- Repeal requirements that providers consider certain factors — including whether there is reason to believe the patient is not using drugs as prescribed, the number of attempts by a patient to obtain an early refill of a prescription and the number of times a patient claims a prescription has been lost or stolen — before prescribing a controlled substance...AB239 - Assemblywoman presents bills to require health insurers to apply certain payments to deductibles, out-of-pocket maximums (thenevadaindependent.com)
Democratic Assemblywoman Ellen Spiegel presented two bills...that would allow patients to apply cash payments on drugs and the costs of out-of-network emergency bills to their insurance plan deductibles or annual out-of-pocket maximums...The two bills aim to reduce the financial burden of meeting high deductibles and annual out-of-pocket maximums, which have become increasingly common in recent years, by allowing patients to contribute payments made outside the scope of his or her insurance plan to them. But health insurers, at a hearing on the bills during a meeting of the Assembly Commerce and Labor Committee...expressed concerns that the requirements as written could be technically difficult to accomplish and overly burdensome...READ MORE
- Cancela to introduce trio of pharmaceutical bills to rein in high drug costs (thenevadaindependent.com)
After taking on the pharmaceutical industry two years ago with an insulin pricing transparency bill, Democratic state Sen. Yvanna Cancela plans to continue...A suite of three bills, which Cancela plans to introduce next week, will establish a prescription drug review board, create additional pharmaceutical pricing transparency requirements and mandate that savings in the drug pricing process are passed along to patients. Like the legislation last session, the bills will address the roles that both pharmaceutical manufacturers and the middlemen in the drug pricing process, called pharmacy benefit managers, play in determining drug costs...The pharmaceutical industry has challenged a host of recent state legislation, including bills in California and Maryland, attempting to rein in drug costs by arguing that they violate the Commerce Clause, which restricts the power of states to regulate interstate commerce...READ MORE
- Democrats reject Republican amendment to restore state trade secret protections for drug pricing information (thenevadaindependent.com)
A Democratic-controlled Senate rejected...an amendment backed by their Republican colleagues that would have removed a carveout in state trade secret law long opposed by the national drug lobby...Senate Republican Leader James Settelmeyer framed the amendment as an attempt to codify an agreement reached between drug companies and the state following a lawsuit over Nevada’s first-in-the-nation diabetes drug pricing transparency law...As part of that agreement, the state mapped out a process in regulation to protect information that drug companies believe to be trade secret protected from public disclosure...“The framework for protection of trade secrets in the regulations adopted for diabetes transparency reporting applies to disclosures under statute but were written by referencing the specific bill that created those sections,”...Pharmaceutical Research and Manufacturers of America said in a statement opposing the asthma bill. “The confidentiality language in the regulations for the diabetes transparency bill should be adopted in SB 262 to clarify that the requirements and considerations apply to disclosures required by those sections of statute generally and not just pursuant to any specific bill.”...Sen. Yvanna Cancela, who sponsored both the diabetes and asthma drug pricing bills, said on the floor that she believed the proposed amendment would weaken the state’s drug pricing transparency statute and pointed to the existing regulatory framework in place...READ MORE
- Lawmakers hear bill to require tourist-focused microhospital to accept Medicare, Medicaid (thenevadaindependent.com)
Elite Medical Center...Since it opened...its business model has been based on providing emergency care to tourists...The federally-run Medicare program for the elderly and the state-run Medicaid program for low-income residents just isn’t lucrative and therefore isn’t part of its business model...The rest of Nevada’s hospitals use their privately insured patients to subsidize the cost of treating those covered under Medicare and Medicaid. Hospitals argue that the rates paid by government insurance programs don’t come close to the actual costs of providing care, so they must carefully balance the number of patients they take under each type of insurance in order to stay financially solvent....the other hospitals believe that Elite is siphoning off the well-insured patients at their expense and without shouldering any of the burden for treating those on Medicare or Medicaid. That’s why the state hospital association is pushing for lawmakers to pass AB232, which would require essentially all Nevada hospitals to accept Medicare and Medicaid...READ MORE
- First diabetes drug transparency report reveals profits, costs associated with treating the disease (thenevadaindependent.com)Supplemental Report 2017 Essential Diabetes Drugs (dhhs.nv.gov)
Drug manufacturers earned an average of $1.58 in profit for every $1 they spent on the production and administration of diabetes drugs in 2017, according to a report released by the Nevada Department of Health and Human Services...But the diabetes drug report...found wide variations in the profitability of drugs used to treat diabetes based on data provided by manufacturers to the state. Although some drug companies reported losses, 69 percent reported of manufacturer reports indicated profits greater than the combined cost of production and administrative expenditures, including some with profits more than 20 times combined costs...The long-awaited report comes nearly two years after lawmakers passed a bill requiring manufacturers of diabetes drugs and PBMs to submit annual reports to the state detailing the costs associated with those drugs and explaining any price increases. The first report based on that information was initially slated to be released in September...READ MORE
- Nevada proposal could curtail surprise medical bills (reviewjournal.com)
No one loved a bill heard in committee...that would keep emergency room patients from getting socked with surprise medical bills from an out-of-network provider that treats them...But no one hated the bill enough to oppose it...The bill...would bar an out-of-network provider treating an ER patient with “medically necessary emergency services” from charging more than the patient’s insurance co-payment, co-insurance or deductible. It also establishes procedures for insurers and third-party providers to work out payments between them, without putting the patient in the middle, and for transferring patients from an out-of-network facility where they were initially treated to one within their network within 24 hours of becoming stable...READ MORE
- Dispensaries respond to critical audit, say they want more training on marijuana tracking software (thenevadaindependent.com)
The Nevada Dispensary Association is responding to a recent state audit that was critical of the seed-to-sale tracking system the marijuana industry uses, noting that auditors did not find cannabis was diverted to or from the black market and suggesting that confusion over new software led to reporting errors...State auditors found frequent discrepancies between the amount of sales that are logged into the seed-to-sale tracking software METRC, and those reported on state tax returns. The association, which represents numerous marijuana businesses, did not comment...but provided a statement to The Nevada Independent about the findings this week...The audit suggested that with data incongruencies between the tax returns and the software, the state could have been losing out on $500,000 in tax revenue in a six-month period...READ MORE
- Bills would protect health care benefits in Nevada (reviewjournal.com)
Two bills introduced in a Senate health committee...in the Legislature would protect health care benefits in Nevada...Senate Bill 235 would extend pre-existing condition protections created by the federal Affordable Care Act to state law...If SB235 is approved, those with chronic conditions would continue to be protected from discrimination by insurers...A second bill, SB192, introduced in the committee...would require employers to offer comprehensive health coverage that covers all of the ACA’s 10 essential health benefits, including prescription and maternity coverage, if they pay employees at the lower end of a two-tiered minimum wage system...READ MORE