NEVADA LEGISLATURE
Sixty-ninth Session, 1997
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ASSEMBLY DAILY JOURNAL
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THE ONE HUNDRED AND THIRTY-NINTH DAY
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Carson City (Saturday), June 7, 1997
Assembly called to order at 8:28 a.m.
Mr. Speaker presiding.
Roll called.
All present except Assemblymen Amodei, Carpenter, Collins, de Braga, Ernaut, Mortenson and Nolan, who were excused.
Prayer by the Chaplain, The Reverend Lisa Schilbe.
All-knowing God, though we see only a portion of the picture, You know all the details that make up the full tapestry of our lives. As we serve You this day, may we pay attention to those details that are important to You: a kind word, a patient spirit, sound judgment and understanding. Help us to talk less and listen more. Teach us to do the right thing always though we may not receive accolades from those around us. We ask this in dependence upon You.
Amen.
Pledge of allegiance to the Flag.
Assemblyman Perkins moved that further reading of the Journal be dispensed with, and the Speaker and Chief Clerk be authorized to make the necessary corrections and additions.
Motion carried.
MESSAGES FROM THE SENATE
Senate Chamber, Carson City, June 6, 1997
To the Honorable the Assembly:
I have the honor to inform your honorable body that the Senate on this day passed Assembly Bill No. 463.
Also, I have the honor to inform your honorable body that the Senate on this day adopted Assembly Concurrent Resolution No. 39.
Also, I have the honor to inform your honorable body that the Senate on this day passed Senate Bill No. 145.
Also, I have the honor to inform your honorable body that the Senate on this day passed, as amended, Senate Bills Nos. 205, 254, 353.
Mary Jo Mongelli
Assistant Secretary of the Senate
MOTIONS, RESOLUTIONS AND NOTICES
Assembly Concurrent Resolution No. 28.
Assemblywoman Freeman moved the adoption of the resolution.
Remarks by Assemblywoman Freeman.
Resolution adopted.
INTRODUCTION, FIRST READING AND REFERENCE
By the Committee on Infrastructure:
Assembly Bill No. 570--An Act relating to governmental services; providing for the creation of assessment districts for the maintenance of landscaping, security walls and public lighting; and providing other matters properly relating thereto.
Assemblyman Goldwater moved that the bill be referred to the Committee on Infrastructure.
Motion carried.
By Assemblymen Gustavson, Cegavske, Tiffany, Von Tobel, Berman, Marvel, Carpenter and Hettrick:
Assembly Bill No. 571--An Act relating to education; providing in skeleton form for a temporary program of voucher schools; and providing other matters properly relating thereto.
Assemblyman Gustavson moved that the bill be referred to the Committee on Education.
Motion carried.
By Assemblymen Chowning, Price, Hettrick, Koivisto, Evans, Goldwater, Krenzer, Lambert, Segerblom, Tiffany, Ernaut, Neighbors, Bache, Herrera, Ohrenschall, Cegavske and Parks:
Assembly Bill No. 572--An Act relating to professions; permitting an ophthalmologist and an optometrist to cooperate in the formation of a professional corporation or a professional association; and providing other matters properly relating thereto.
Assemblywoman Chowning moved that the bill be referred to the Committee on Commerce.
Motion carried.
Senate Bill No. 145.
Assemblyman Perkins moved that the bill be referred to the Committee on Judiciary.
Motion carried.
Senate Bill No. 205.
Assemblyman Perkins moved that the bill be referred to the Committee on Health and Human Services.
Motion carried.
Senate Bill No. 254.
Assemblyman Perkins moved that the bill be referred to the Committee on Government Affairs.
Motion carried.
Senate Bill No. 353.
Assemblyman Perkins moved that the bill be referred to the Committee on Taxation.
Motion carried.
SECOND READING AND AMENDMENT
Assembly Bill No. 30.
Bill read second time.
The following amendment was proposed by the Committee on Health and Human Services:
Amendment No. 495.
Amend the bill as a whole by deleting sections 1 through 22 and adding new sections designated sections 1 through 19, following the enacting clause, to read as follows:
"Section 1. Chapter 679B of NRS is hereby amended by adding thereto the provisions set forth as sections 2 to 16, inclusive, of this act.
Sec. 2. As used in sections 2 to 16, inclusive, of this act, unless the context otherwise requires, the words and terms defined in sections 3 to 8, inclusive, of this act have the meanings ascribed to them in those sections.
Sec. 3. "Bureau" means the bureau of protections for consumers of health care.
Sec. 4. "Chief" means the chief of the bureau.
Sec. 5. "Health care plan" means a policy, contract, certificate or agreement offered or issued by an insurer to provide, deliver, arrange for, pay for or reimburse any of the costs or health care services.
Sec. 6. "Insured" means a person covered by a policy of health insurance issued in the State of Nevada by an insurer.
Sec. 7. "Insurer" means any insurer or organization authorized pursuant to this Title to conduct business in this state that provides or arranges for the provision of health care services, including, without limitation, an insurer that issues a policy of health insurance, an insurer that issues a policy of group health insurance, a carrier serving small employers, a fraternal benefit society, a hospital or medical service corporation, a health maintenance organization, a plan for dental care and a prepaid limited health service organization.
Sec. 8. "Provider of health care" means a physician, dentist, licensed nurse, dispensing optician, optometrist, practitioner of respiratory care, registered physical therapist, podiatric physician, licensed psychologist, licensed marriage and family therapist, chiropractor, doctor of Oriental medicine in any form, medical laboratory director or technician, or pharmacist.
Sec. 9. 1. The bureau of protections for consumers of health care is hereby created within the division.
2. The commissioner shall appoint a chief of the bureau who is in the classified service of the state and is directly responsible to the commissioner. The chief must be selected on the basis of his education, training, experience and demonstrated abilities, and his interest in assisting insureds. The experience required pursuant to this subsection must include, without limitation, experience with and knowledge of:
(a) The field of health care;
(b) The provisions of this Title;
(c) Health insurance and administrators of health care plans;
(d) Managed care organizations, including, without limitation, health maintenance organizations; and
(e) The provisions of chapters 439, 439B, 441A, 442, 449, 450, 450B, 451, 457, 458 and 460 of NRS.
Sec. 10. The chief shall:
1. Establish procedures and policies for the management of the bureau;
2. Subject to the approval of the commissioner, appoint such personnel as are necessary for the proper and efficient performance of the functions of the bureau;
3. Prescribe the duties of the personnel of the bureau;
4. Submit to the director of the legislative counsel bureau a biennial report on January 31 of each odd-numbered year for distribution to the legislature summarizing the information collected pursuant to subsection 10 of section 11 of this act during the preceding biennium, including, without limitation, suggestions for any necessary legislation concerning the provision of health care services; and
5. Take such other action as may be necessary or appropriate to carry out the purposes of sections 2 to 16, inclusive, of this act.
Sec. 11. The bureau shall:
1. Establish a toll-free telephone service for receiving inquiries and complaints from insureds in this state;
2. Take such actions as are necessary to ensure public awareness of the existence and purpose of the bureau and to educate consumers of health care concerning the provision of health care services in this state;
3. Provide prompt answers to inquiries of insureds concerning the provision of health care services, or refer the insureds to the appropriate agency, department or other entity that is responsible for addressing the specific type of inquiry;
4. Refer insureds to the appropriate agency, department or other entity that is responsible for addressing the specific type of complaint of the insured;
5. Resolve complaints of insureds related to the provision of health care services, as provided in section 12 of this act;
6. Provide counseling and assistance to insureds concerning their health care plans, including, without limitation, assistance concerning coverage for health care services, filing complaints and accessing the complaint and appeal process;
7. Investigate reports of poor quality of health care services or improper treatment of insureds provided pursuant to the health care plan of an insured, and notify the appropriate agency, department or other entity that is responsible for addressing such cases of the findings of the investigation;
8. Advocate for the rights of consumers of health care in this state;
9. Enforce the provisions of this Title pursuant to any power delegated to the bureau by the commissioner pursuant to NRS 679B.110; and
10. Maintain a record of each inquiry and complaint received from an insured and a record of the action taken by the bureau concerning each such inquiry and complaint.
Sec. 12. 1. If an insured has exhausted all of his available remedies, including, without limitation, any procedure for the filing of a complaint or appeal that is available through his insurer, he may request the chief to assist him to resolve a dispute with his insurer. Except as otherwise provided in subsection 4, upon receiving such a request, the chief or his designated representation shall hear, mediate, arbitrate or resolve by any other alternative means of dispute resolution the dispute between the insured and his insurer if the dispute concerns the provision of health care services or the denial of coverage for treatment. The chief may provide such assistance in any other matter he deems appropriate.
2. The decision of the chief or his designated representative pursuant to subsection 1 is a final decision for the purpose of judicial review.
3. The chief or his designated representative may subpoena witnesses, compel their attendance, administer oaths, examine any person under oath relative to the subject of a hearing conducted pursuant to this section, and compel any person to subscribe to his testimony after it has been correctly reduced to writing, and in connection therewith, require the production of books, papers, records, correspondence or other documents that he deems relevant to the inquiry.
4. The chief may decline to resolve a case that he determines to be trivial, without merit or beyond the scope of his jurisdiction.
5. Any medical information concerning an insured obtained pursuant to this section must be kept confidential.
Sec. 13. 1. The chief or his designated representative may, if authorized by the commissioner, examine an insurer in the manner provided in NRS 679B.230 to 679B.300, inclusive.
2. Any information obtained pursuant to this section must be kept confidential as provided in NRS 679B.190.
Sec. 14. Each insurer shall include on each health insurance card or evidence of coverage issued to an insured:
1. The toll-free telephone number established pursuant to subsection 1 of section 11 of this act, printed in at least 12-point type; and
2. The name of the bureau and its hours of operation, printed in at least 10-point type.
Sec. 15. 1. The bureau shall establish, and revise annually, a list of providers of health care who do not have a contract with an insurer for the provision of services, to assist and advise the bureau concerning the appropriateness of health care delivered by an insurer, the denial of health care services or coverage by an insurer, and any other issue that affects insureds.
2. The bureau may assign two persons with relevant training and experience from the list established pursuant to subsection 1 to assist with each complaint received pursuant to section 11 of this act and each dispute resolved pursuant to section 12 of this act.
3. While engaged in assisting the bureau with a complaint, each person assigned pursuant to subsection 2 is entitled to receive the per diem allowance and travel expenses provided for state officers and employees generally.
4. A person assigned to assist the bureau pursuant to this section is not liable for any damage or injury to any person, including, without limitation, death, as a result of any advice or assistance provided to the bureau pursuant to this section.
5. For the purposes of this section, "provider of health care" includes a provider of health care who is or was licensed, certified or otherwise authorized to practice pursuant to the laws of any state.
Sec. 16. 1. Each insurer authorized to transact health insurance in this state shall pay to the division an annual fee on or before March 1 of each year in an amount determined by the division pursuant to this section, but not to exceed $500, to cover the costs of the bureau for the administration and enforcement of sections 2 to 15, inclusive, of this act.
2. The commissioner shall annually determine the amount of the fee by determining the costs of the bureau for the administration and enforcement of sections 2 to 15, inclusive, of this act, including, without limitation, any expenses incident to or associated with the requirements of those sections, and equally dividing the cost among insurers.
3. The division shall mail to each insurer a notice of the amount of the fee on or before January 15 of each year.
Sec. 17. NRS 695A.555 is hereby amended to read as follows:
695A.555Societies are not exempt from the provisions of NRS 679B.158 [.] or section 16 of this act. If a society is an admitted health insurer, as that term is defined in NRS 449.450, it is not exempt from the fees imposed pursuant to NRS 449.465.
Sec. 18. NRS 695C.055 is hereby amended to read as follows:
695C.0551. The provisions of NRS 449.465, 679B.158 and 680B.025 to 680B.060, inclusive, subsections 2, 4, 18, 19 and 32 of NRS 680B.010 and NRS 689C.015 to 689C.350, inclusive, and section 16 of this act, apply to a health maintenance organization.
2. For the purposes of subsection 1, unless the context requires that a provision apply only to insurers, any reference in those sections to "insurer" must be replaced by "health maintenance organization."
Sec. 19. This act becomes effective on July 1, 1997.".
Amend the title of the bill to read as follows:
- "AN ACT relating to health care; creating the bureau of protections for consumers of health care within the division of insurance of the department of business and industry; setting forth the duties of the bureau; providing for an annual fee to be paid by insurers to cover the costs of the bureau; and providing other matters properly relating thereto.".
- Amend the summary of the bill to read as follows:
- "SUMMARY--Creates bureau of protections for consumers of health care. (BDR 57-997)".
Assemblywoman Freeman moved the adoption of the amendment.
Remarks by Assemblywoman Freeman.
Amendment adopted.
Assemblywoman Freeman moved that Assembly Bill No. 30 be re-referred to the Committee on Health and Human Services.
Motion carried.
Bill ordered reprinted, engrossed and to the Committee on Health and Human Services.
Assembly Bill No. 151.
Bill read second time.
Assemblyman Anderson moved that Assembly Bill No. 151 be re-referred to the Committee on Ways and Means.
Motion carried.
Assembly Bill No. 355.
Bill read second time.
The following amendment was proposed by the Committee on Natural Resources, Agriculture, and Mining:
Amendment No. 491.
Amend sec. 8, page 2, line 22, by deleting:
"subsections 2 and" and inserting "subsection".
Amend sec. 8, page 2, line 31, by deleting "without limitation," and inserting:
"but not limited to,".
Amend sec. 8, page 3, by deleting lines 1 through 11 and inserting:
"(d) The regulated person or regulated facility has not been issued a citation for a violation of the environmental requirement in the immediately preceding 3 years;
(e) The regulated person did not obtain an actual economic benefit or advantage as a result of the violation; and
(f) The regulated person entered into an enforceable agreement with the appropriate regulatory agency to:
(1) Comply, as soon as practicable after the violation, with the environmental requirement;
(2) Remedy any damage or other harm caused by the violation; and
(3) Take action to prevent a recurrence of the violation.
2. A written agreement that prescribes the scope, methods and schedule for conducting an environmental audit may be reasonably modified if the regulated person and the regulatory agency specifically agree to the modification.".
Amend sec. 8, page 3, line 12, by deleting "requires" and inserting "provides for".
Amend sec. 9, page 3, line 22, by deleting:
"subsection 2 and".
Amend sec. 9, page 3, line 31, by deleting "without limitation," and inserting:
"but not limited to,".
Amend sec. 9, page 3, by deleting lines 37 through 44 and inserting:
"(c) The regulated person or regulated facility has not been issued a citation for a violation of the environmental requirement in the immediately preceding 3 years;
(d) The regulated person entered into an enforceable agreement with the appropriate regulatory agency to:
(1) Comply, as soon as practicable after the violation, with the environmental requirement;
(2) Remedy any damage or other harm caused by the violation; and
(3) Take action to prevent a recurrence of the violation; and
(e) The environmental requirement that was violated is not a requirement for which the regulated person or regulatory facility was specifically required to comply pursuant to a judicial or administrative order or consent agreement.
2. A written agreement that prescribes the scope, methods and schedule for conducting an environmental audit may be reasonably modified if the regulated person and the regulatory agency specifically agree to the modification.".
Amend sec. 9, page 4, line 1, by deleting "requires" and inserting "provides for".
Amend sec. 10, page 4, by deleting lines 22 through 26 and inserting:
"3. The violation resulted in serious actual harm or presented an imminent or substantial danger to the public health or the environment;
4. The environmental audit was conducted for a fraudulent purpose;
5. The regulated person obtained an actual economic benefit or advantage as a result of the violation; or
6. The regulated person conducted a previous environmental audit that disclosed the violation and he intentionally failed to report that violation to the appropriate regulatory agency.".
Amend the bill as a whole by deleting sec. 12 and adding a new section designated sec. 12, following sec. 11, to read as follows:
"Sec. 12. 1. Except as otherwise provided in this section, an environmental audit conducted pursuant to the provisions of this chapter shall be deemed privileged and is not admissible in an administrative proceeding or civil action against the regulated person who conducted the audit or the regulated facility which is owned or operated by the regulated person.
2. The privilege provided by subsection 1 does not apply if:
(a) An administrative proceeding or civil action is commenced by a regulatory agency;
(b) The regulated person expressly waives the privilege; or
(c) A court or administrative hearing officer determines in camera that the presumption against administrative or civil liability is rebutted pursuant to section 10 of this act.
3. For the purposes of paragraph (b) of subsection 2, a regulated person does not waive the privilege if he voluntarily discloses, pursuant to sections 2 to 13, inclusive, of this act, the results of an environmental audit or a violation of an environmental requirement discovered as a result of an environmental audit to a regulatory agency.
4. This section does not prohibit a person or entity from:
(a) Obtaining information concerning a violation of an environmental requirement from a source independent of an environmental audit.
(b) Commencing an administrative proceeding or civil or criminal action against a regulated person or a regulated facility which is owned or operated by a regulated person based upon information that was obtained from a source independent of an environmental audit.
(c) Intervening in a proceeding or action filed against a regulated person or regulated facility if the intervention is specifically authorized by statute or regulation.".
Amend sec. 13, page 4, line 40, by deleting "A" and inserting "1. A".
Amend sec. 13, page 4, between lines 41 and 42, by inserting:
"2. The fact that a regulated person does not conduct an environmental audit pursuant to the provisions of sections 2 to 13, inclusive, of this act, must not be considered by a court or administrative hearing officer in determining whether to impose administrative, civil or criminal liability for a violation of an environmental requirement by the regulated person.".
Amend the title of the bill by deleting the fifth and sixth lines and inserting:
"disclosure is made; providing a limited evidentiary privilege for an environmental audit under certain circumstances; and providing other matters properly relating".
Assemblyman Sandoval moved the adoption of the amendment.
Remarks by Assemblyman Sandoval.
Amendment adopted.
Bill ordered reprinted, engrossed and to third reading.
Assembly Bill No. 468.
Bill read second time.
The following amendment was proposed by the Committee on Education:
Amendment No. 569.
Amend section 1, page 1, by deleting lines 3 through 6 and inserting:
"All credits earned by a student in a course at a community college within the system must be accepted and applied toward the coursework required of the student in his major, if applicable, or other coursework required of the student, for the award of a baccalaureate degree upon graduation of the student from any university within the system if the catalog for the community college:
1. Designates the course as transferable by the system;
2. Identifies the course by the same title as the equivalent required course offered at a university; and
3. Contains the same description for the course as the equivalent required course offered at a university.".
Assemblyman Williams moved the adoption of the amendment.
Remarks by Assemblyman Williams.
Amendment adopted.
Bill ordered reprinted, engrossed and to third reading.
Assembly Bill No. 475.
Bill read second time and ordered to third reading.
GENERAL FILE AND THIRD READING
Assembly Bill No. 433.
Bill read third time.
Remarks by Assemblywoman Evans.
Roll call on Assembly Bill No. 433:
Yeas -- 35.
Nays -- None.
Excused -- Amodei, Carpenter, Collins, de Braga, Ernaut, Mortenson, Nolan--7.
Assembly Bill No. 433 having received a constitutional majority, Mr. Speaker declared it passed, as amended.
Bill ordered transmitted to the Senate.
Assembly Bill No. 448.
Bill read third time.
Remarks by Assemblywoman Evans.
Roll call on Assembly Bill No. 448:
Yeas -- 35.
Nays -- None.
Excused -- Amodei, Carpenter, Collins, de Braga, Ernaut, Mortenson, Nolan--7.
Assembly Bill No. 448 having received a constitutional majority, Mr. Speaker declared it passed, as amended.
Bill ordered transmitted to the Senate.
Assembly Bill No. 529.
Bill read third time.
Remarks by Assemblymen Chowning, Anderson, Price and Segerblom.
Roll call on Assembly Bill No. 529:
Yeas -- 35.
Nays -- None.
Excused -- Amodei, Carpenter, Collins, de Braga, Ernaut, Mortenson, Nolan--7.
Assembly Bill No. 529 having received a constitutional majority, Mr. Speaker declared it passed.
Bill ordered transmitted to the Senate.
UNFINISHED BUSINESS
Consideration of Senate Amendments
Assembly Bill No. 100.
The following Senate amendment was read:
Amendment No. 485.
Amend the bill as a whole by deleting sec. 2 and renumbering sec. 3 as sec. 2.
Assemblyman Herrera moved that the Assembly concur in the Senate amendment to Assembly Bill No. 100.
Remarks by Assemblyman Herrera.
Motion carried.
Bill ordered enrolled.
Assembly Bill No. 133.
The following Senate amendment was read:
Amendment No. 358.
Amend sec. 3, page 1, by deleting line 17 and inserting:
"operates the vehicle pursuant to that lease may apply to the department for a".
Amend sec. 6, page 2, by deleting line 39 and inserting:
"leases it to a carrier and operates the vehicle pursuant to that lease, or a new or used".
Assemblywoman Chowning moved that the Assembly concur in the Senate amendment to Assembly Bill No. 133.
Remarks by Assemblywoman Chowning.
Motion carried.
Bill ordered enrolled.
Assembly Bill No. 215.
The following Senate amendment was read:
Amendment No. 476.
Amend section 1, page 1, by deleting lines 9 and 10 and inserting:
"vehicle of a person if the requester submits a [notarized] written release from the person who holds a lien on the vehicle , or an agent of that person, or the person about whom the".
Amend section 1, page 1, line 12, after "request." by inserting:
"The written release must be in a form required by the director.".
Amend section 1, page 1, by deleting line 16 and inserting:
"imposed for parking violations, [or] who is not conducting an investigation pursuant to NRS 253.0415, 253.044 or 253.220 [:] , or who is not authorized to transact insurance pursuant to chapter 680A of NRS:".
Amend section 1, page 3, line 23, by deleting "(i)" and inserting:
"(i) In connection with an investigation conducted pursuant to NRS 253.0415, 253.044 or 253.220.
(j)".
Amend section 1, page 3, line 26, by deleting "(j)" and inserting "(k)".
Amend section 1, page 3, line 35, by deleting "(i)" and inserting "(j)".
Amend section 1, page 3, line 39, by deleting "[which] whom" and inserting "whom".
Amend the title of the bill, fourth line, after "distributions;" by inserting:
"authorizing the director of the department to release additional personal information to insurers;".
Amend the summary of the bill to read as follows:
- "SUMMARY--Expands circumstances under which personal information contained in files and records of department of motor vehicles and public safety may be released. (BDR 43-177)".
Assemblywoman Chowning moved that the Assembly concur in the Senate amendment to Assembly Bill No. 215.
Remarks by Assemblywoman Chowning.
Motion carried.
Bill ordered enrolled.
Signing of Bills and Resolutions
There being no objections, the Speaker and Chief Clerk signed Assembly Bill No. 156; Assembly Concurrent Resolutions Nos. 34, 35; Senate Bill No. 91.
MOTIONS, RESOLUTIONS AND NOTICES
Mr. Speaker announced the appointment of Assemblymen Herrera and Cegavske as a Committee to review the status of the Conference Committees.
Assemblyman Perkins moved that the Assembly adjourn until Monday, June 9, 1997 at 11 a.m.
Motion carried.
Assembly adjourned at 9:07 a.m.
Approved:
Joseph E. Dini, Jr.
Speaker of the Assembly
Attest: Linda B. Alden
Chief Clerk of the Assembly