In one paragraph
Nevada's AB 295 (2025) would have set prior authorization deadlines for health carriers (5 days non-urgent, 48 hours urgent, replacing 20 days) and required carriers using AI or automated decision tools for prior authorization to notify insureds in writing, and barred using AI to make adverse determinations or reduce or modify approved care unless a physician (or dentist) independently reviews the request. Carriers would report annually. Under Joint Standing Rule 14.3.1 no further action was allowed after April 12, 2025, so it died.
Plain-English summary, written with AI assistance. The official text controls.
What it means for business
None: the bill died and never became law. Had it passed, health carriers using AI for prior authorization would have needed written notice to insureds, physician review before AI-based denials, faster decisions and annual reports.
Key provisions
- Carriers using an AI system or automated decision tool for prior authorization must notify each insured in writing of that use, how it works generally and the data it uses
- AI could not be used to make an adverse determination or to terminate, reduce or modify previously approved care unless a physician (or dentist) with an unrestricted license, current board certification and relevant expertise independently reviews the request
- Prior authorization decisions within 5 days (non-urgent) or 48 hours (urgent), replacing the 20-day deadline; approvals for chronic conditions valid for 12 months
- By March 1 each year carriers would report to the Commissioner of Insurance and DHHS Director on requests, approvals, denials, appeals and decision times; published by April 1
- After a hearing, a civil penalty of 5 percent of the carrier's gross Nevada income for the quarter, for each violation of NRS 687B.225(2)(b) or (c) or the reporting section; extra sanctions by regulation for five or more violations in 18 months
- Parallel rules for Medicaid and CHIP (sections 15 to 19) and for public and employer plans; generally effective January 1, 2026
- Referred to Commerce and Labor February 25, 2025; 'no further action allowed' April 12, 2025; it did not pass
Latest legislative action
Apr 12, 2025. (Pursuant to Joint Standing Rule No. 14.3.1, no further action allowed.)
Sponsors
| Name | Role | District |
|---|---|---|
| Rebecca Edgeworth R | Sponsor | HD-035 |
| Thaddeus Yurek R | Sponsor | HD-019 |
| Tracy Brown-May D | Sponsor | HD-042 |
Topics and industries
Related topics
Affected industries
This page is general information, not legal advice. Summaries are AI-assisted and may contain errors; read the statute for the controlling text and talk to a lawyer about your situation. Full disclaimer · Report an error