Makes changes related to health care. (BDR 57-87)
SB128 makes two broad sets of changes to Nevada health care law. First, it limits how health insurers and certain public/self-insured plans may use artificial intelligence and automated decision tools in the prior authorization process. The bill bars insurers from relying solely on AI or automated tools to deny, modify, reduce, or terminate prior authorization requests or previously approved care, and requires that covered requests be approved unless a licensed health care professional with the appropriate expertise determines the care is not medically necessary or is experimental or investigational. The bill also allows AI tools to be used to automatically approve requests, but not as the sole basis for adverse utilization-management decisions.
Second, SB128 adds legislative findings and policy statements encouraging health care providers to discuss stem cell therapy with patients diagnosed with arthritis, osteoarthritis, or other conditions commonly treated with stem cell therapy. It also encourages primary care providers, at a first visit with a new patient, to inform patients about options to donate, bank, or store stem cells for future use by the patient or a donee. These provisions are framed as public policy encouragements rather than direct mandates for treatment.
The bill affects Nevada’s insurance code and public employee/self-insured health coverage provisions, including NRS 687B.225 and related chapters governing local government and state employee plans. It creates a new standard requiring human clinical review for adverse prior authorization decisions in most private and public plans, while expressly excluding Medicaid managed care organizations and CHIP coverage under certain DHHS contracts. It also adds new sections to the medical licensing chapters for physicians, advanced practice registered nurses, and osteopathic physicians, establishing the state’s findings on stem cell therapy and provider counseling expectations.
The overall sentiment reflected in the bill’s passage was favorable but divided. SB128 passed the Senate 15-6 and the Assembly 23-16, indicating meaningful support but also substantial opposition. The vote pattern suggests the AI prior authorization restrictions and the stem cell counseling provisions were both significant enough to draw debate, even though no committee transcript excerpts are available here.
The main point of contention is likely the restriction on insurer use of AI in utilization review. Supporters would view the bill as a patient-protection measure ensuring medical decisions are made by licensed clinicians rather than algorithms, while opponents may see it as limiting insurer efficiency, increasing administrative costs, or constraining tools used to manage care. The stem cell provisions may also raise concern for some observers because they encourage discussion of a therapy that remains evolving and condition-specific, though the bill stops short of requiring treatment or coverage.
SB128 amends Nevada insurance and public-employee health coverage statutes to prohibit most insurers and self-insured public plans from using AI or automated decision tools as the sole basis for adverse prior authorization decisions, and to require review by an appropriately qualified licensed health care professional before denying or reducing covered care. It also adds policy declarations to the licensing chapters for physicians, APRNs, and osteopathic physicians encouraging patient counseling about stem cell therapy and stem cell banking/donation. The bill takes effect January 1, 2026, with immediate effectiveness only for rulemaking and preparatory administration.
The bill appears to have received mixed but ultimately sufficient support. Final passage votes in both chambers were positive, but the margins were not overwhelming, suggesting broad agreement on the need for human oversight in prior authorization while still reflecting concern about the scope of the AI restrictions and the policy statements on stem cell therapy. The absence of committee transcript material limits more granular sentiment analysis, but the recorded votes indicate the measure was controversial enough to split both chambers.
The most notable controversy is the prohibition on relying solely on AI or automated decision tools to deny or alter prior authorization requests. Supporters likely argue this protects patients from opaque or overly rigid algorithmic denials and ensures medically trained review; critics may argue it could slow approvals, increase costs, and reduce insurers’ ability to manage utilization efficiently. A secondary point of discussion is the stem cell therapy language, which encourages providers to discuss a treatment area that is promising but still medically and scientifically evolving. Because those provisions are framed as encouragements rather than mandates, they are less likely to be the primary source of opposition than the AI/utilization-management provisions.