• Nursing Laws

  • Nevada should adopt the same policies as California in regards to nurse-to-patient ratios. This will increase nurse salaries, increase the number of nurses in hospitals, improve patient care and satisfaction and will help nurses perform all of the tasks they have been assigned by the patients' physicians.

• Insurance Plan Access

  • Health insurance plans in Nevada should be open to any willing provider. This will help patients get care more quickly and prevent insurance companies from creating delays by having deliberately narrow networks.

  • Nevada should create a centralized credentialing service for insurance companies. This will allow the new providers Nevada needs to become more rapidly available to the patients who need them.

• State Payment Issues

  • In Nevada, no insurance company should be allowed to pay less than Medicare rates. This will help us recruit more healthcare providers to Nevada since it will make reimbursements on par with the rest of the nation.

  • Medicaid payments should be increased. Up to 20% of Nevadans rely on Medicaid as their primary form of insurance and payments are so low, many hospitals and providers reduced offered services because they lose money treating their Medicaid patients. Medicaid should provide at least adequate healthcare. Increasing Medicaid reimbursements allows all healthcare workers a chance to make more income and will increase access to healthcare.

  • Increase state incentives to create Federally Qualified Health Centers. These center receive millions of dollars of federal funding to provide primary care to patients who can't afford insurance. We need to incentivize creation of these centers. This will improve access to healthcare for Nevadans and create more healthcare jobs without increasing healthcare costs for Nevadans.

• Improvements to Care

  • A state-backed self-funded central system for housing all patient images should be created in Nevada. If patient's consent, this gives emergency rooms immediate access to all of a patient's imaging regardless of where in the state the prior images were performed. With current laws this is not possible.

  • Healthcare providers should be allowed to own hospitals. Hospitals can employ healthcare providers and create standards of care, but healthcare providers are forbidden from starting their own hospitals to establish their own, potentially better standards of care. This is anticompetitive and should be changed in Nevada.

• Resolutions in favor of changes to national laws

  • It is possible for the state legislature to pass resolutions to request our federal representatives make efforts to change federal laws. We should do this.

  • A resolution should be passed advocating that part of Medicare reimbursements should be increased for maintenance of excellent office staff. Office staff with years of experience more often perform their job duties better than new hires. This allows healthcare office workers to see their job as a career with increased earning opportunities, instead of fearing being fired every year as Medicare reimbursements are annually reduced.

  • Medicare payments should be revised to allow for surgeons training multiple residents to supervise multiple surgeries at once. Otherwise, the new surgeons will not learn to function independently and there will be no experienced surgeons willing to take on the task of assisting/teaching as every slow resident in training gradually learn how to operate.

• For Debate

  • Should healthcare vendors (hospitals, insurance plans, pharmacy benefit managers) be required to offer services/products from at least 10 separate providers/vendors? This increases choice and reduces supply chain delays if one provider/vendor goes out of business. This one is directed at pharmacy benefit managers, forcing them to increase vendors so there will be less drug shortages, and at HMO's forcing them to expand networks. This will increase the number of equipment vendors, medical supply vendors and pharmaceutical vendors in NV. It will also increase consumer choice and care options.

  • Should Assistant Physicians be allowed in NV to increase the number of providers? Assistant Physicians are medical school graduates who have not yet completed a residency. Under current NV law they cannot treat patients in Nevada. They have 4-5 years of training after college, as compared to the 3 years of training physician assistants have. Mississippi is the only state to allow APs and is inundated with applicants. According to the President of their Board of Medical Examiners, they have not had significant problems with APs supervised by physicians. Given the healthcare provider shortage in Nevada, should we allow APs to practice like PAs here?

  • Should laws be put into place to further relax licensing requirements? The Governor has required all licensing entities in the state to remove unnecessary requirements and remove requirements that are not present in at least half of all states in the US. In a year we will see if this has sped up the licensing processes. Should the state provide funding for an audit/operations research evaluation of these processes?

  • Should a study be performed to evaluate the role of AI in medicine and should NV reach out the big 3 software companies? They are already developing AI to help with diagnoses and care management. Should Nevada try to lead the nation in development of these advanced platforms?

  • Are for-profit health insurance companies unethical and should they be banned? 80% of private health insurance in America is obtained through an employer. Health insurance companies compete with each other by offering low prices to companies. The companies don't have a way of following up on the quality of the coverage or the outcomes of the care, so they only pay attention to price. It is the job of the for-profit company to charge the maximum than market will bear. It is the job of the company managers to minimize company expenses. They achieve this by negotiating to reduce the prices they pay to healthcare providers, facilities and healthcare product suppliers. They can also achieve this by reducing the amount of care they provide, by reducing the number of providers in there network and thus delaying care (saving them money) or by denying authorization for needed care (saving them money. Since manager salaries are tied to profits and not patient outcomes, there are perverse incentives to provide no or limited care. If only mutual health insurance companies were allowed (insurance companies owned by the members of the insurance plan) then the people for whom the insurance is for (the potential patients) would determine the salaries and compensation of the managers and would force them to focus on the quality of the care, not only on the price.

Legislative Agenda