NRS 232.49935 Plan for certain persons to purchase certain coverage; duties of Authority. [Effective until the effective date of the initial contract entered into between the Nevada Health Authority and the state pharmacy benefit manager pursuant to NRS 422.4053, as amended by section 12 of chapter 514, Statutes of Nevada 2025, at page 3591.]
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NRS 232.49935 Plan for certain persons to purchase certain coverage; duties of Authority. [Effective until the effective date of the initial contract entered into between the Nevada Health Authority and the state pharmacy benefit manager pursuant to NRS 422.4053 , as amended by section 12 of chapter 514, Statutes of Nevada 2025, at page 3591 .]
1. The Director shall:
(a)Enter into a contract with one or more qualified experts to develop and implement a plan to allow persons who are eligible for coverage under the Public Employees’ Benefits Program, Medicaid, the Children’s Health Insurance Program, the Silver State Health Insurance Exchange and the Public Option to select and, where applicable, purchase such coverage in a manner that improves access to affordable, quality health care and minimizes the cost of health care to the State. The plan must include, without limitation, strategies for:
(1)Purchasing coverage for the programs described in this subsection; and
(2)Strengthening networks of providers established for the programs described in this section.
(b)Periodically present the plan described in paragraph
(a)to the Board of the Public Employees’ Benefits Program, solicit input from the Board and make such adjustments as the Director deems appropriate in response to such input.
(c)Within the limits of available resources, utilize the experts contracted pursuant to paragraph
(a)to:
(1)Assess and monitor the value, quality and accessibility of services provided by the Public Employees’ Benefits Program to participants;
(2)Review national best practices applicable to insurance for current and retired public employees and dependents thereof;
(3)Make recommendations to the Board of the Public Employees’ Benefits Program concerning ways to improve the value, quality and accessibility of services provided to participants, including, without limitation:
(I)Ways to provide additional support to participants in accessing and utilizing benefits;
(II)Measures to improve the health literacy of participants, including, without limitation, participants who have retired and have coverage through Medicare; and
(4)Provide such additional assessments and recommendations as requested by the Board of the Public Employees’ Benefits Program.
(d)On or before February 1 of each odd-numbered year:
(1)Compile a report concerning the development and implementation of the plan described in paragraph (a), which must include, without limitation, a summary of:
(I)The input received from the Board of the Public Employees’ Benefits Program pursuant to paragraph (b); and
(II)Any actions taken by the Director in response to such input; and
(2)Submit the report to the Governor and the Director of the Legislative Counsel Bureau for transmittal to the next regular session of the Legislature.
(e)Develop and implement a plan to facilitate real-time final determinations of eligibility for and enrollment in applicable state health subsidy programs through the Silver State Health Insurance Exchange in a manner that includes the ability to make the comparisons described in paragraph
(a)of subsection 8 of NRS 422.273 , where applicable.
2. The Authority shall:
(a)Apply to the Secretary of Health and Human Services for any waiver of federal law or apply for any amendment to the State Plan for Medicaid or other federal authority that is necessary for the Authority to carry out the provisions of paragraph
(e)of subsection 1.
(b)Fully cooperate in good faith with the Federal Government during the application process to satisfy the requirements of the Federal Government for obtaining a waiver, amendment or other federal authority pursuant to paragraph (a).
3. As used in this section:
(a)“Applicable state health subsidy program” has the meaning ascribed to it in 42 U.S.C. § 18083(e).
(b)“Network” means a defined set of providers of health care who are under contract with the Authority to provide health care services pursuant to the Public Employees’ Benefits Program, Medicaid, the Children’s Health Insurance Program, the Silver State Health Insurance Exchange or the Public Option.