Nevada Revised Statutes
Chapter 439B - Restraining Costs of Health Care
NRS 439B.410 - Hospital required to provide emergency services and care; unlawful acts of hospital or physician working in hospital emergency room; treating hospital may recover penalty from transferring hospital; exceptions; administrative investiga...


1. Except as otherwise provided in subsection 4, each hospital in this State has an obligation to provide emergency services and care, including care provided by physicians and nurses, and to admit a patient where appropriate, regardless of the financial status of the patient.
2. Except as otherwise provided in subsection 4, it is unlawful for a hospital or a physician working in a hospital emergency room to:
(a) Refuse to accept or treat a patient in need of emergency services and care; or
(b) Except when medically necessary in the judgment of the attending physician:
(1) Transfer a patient to another hospital or health facility unless, as documented in the patient’s records:
(I) A determination has been made that the patient is medically fit for transfer;
(II) Consent to the transfer has been given by the receiving physician, hospital or health facility;
(III) The patient has been provided with an explanation of the need for the transfer; and
(IV) Consent to the transfer has been given by the patient or the patient’s legal representative; or
(2) Provide a patient with orders for testing at another hospital or health facility when the hospital from which the orders are issued is capable of providing that testing.
3. A physician, hospital or other health facility which treats a patient as a result of a violation of subsection 2 by a hospital or a physician working in the hospital is entitled to recover from that hospital an amount equal to three times the charges for the treatment provided that was billed by the physician, hospital or other health facility which provided the treatment, plus reasonable attorney’s fees and costs.
4. This section does not prohibit the transfer of a patient from one hospital to another:
(a) When the patient is covered by an insurance policy or other contractual arrangement which provides for payment at the receiving hospital;
(b) After the county responsible for payment for the care of an indigent patient has exhausted the money which may be appropriated for that purpose pursuant to NRS 428.050, 428.285 and 450.425; or
(c) When the hospital cannot provide the services needed by the patient.
No transfer may be made pursuant to this subsection until the patient’s condition has been stabilized to a degree that allows the transfer without an additional risk to the patient.
5. As used in this section:
(a) "Emergency services and care" means medical screening, examination and evaluation by a physician or, to the extent permitted by a specific statute, by a person under the supervision of a physician, to determine if an emergency medical condition or active labor exists and, if it does, the care, treatment and surgery by a physician necessary to relieve or eliminate the emergency medical condition or active labor, within the capability of the hospital. As used in this paragraph:
(1) "Active labor" means, in relation to childbirth, labor that occurs when:
(I) There is inadequate time before delivery to transfer the patient safely to another hospital; or
(II) A transfer may pose a threat to the health and safety of the patient or the unborn child.
(2) "Emergency medical condition" means the presence of acute symptoms of sufficient severity, including severe pain, such that the absence of immediate medical attention could reasonably be expected to result in:
(I) Placing the health of the patient in serious jeopardy;
(II) Serious impairment of bodily functions; or
(III) Serious dysfunction of any bodily organ or part.
(b) "Medically fit" means that the condition of the patient has been sufficiently stabilized so that the patient may be safely transported to another hospital, or is such that, in the determination of the attending physician, the transfer of the patient constitutes an acceptable risk. Such a determination must be based upon the condition of the patient, the expected benefits, if any, to the patient resulting from the transfer and whether the risks to the patient’s health are outweighed by the expected benefits, and must be documented in the patient’s records before the transfer.
6. If an allegation of a violation of the provisions of subsection 2 is made against a hospital licensed pursuant to the provisions of chapter 449 of NRS, the Division of Public and Behavioral Health of the Department shall conduct an investigation of the alleged violation. Such a violation, in addition to any criminal penalties that may be imposed, constitutes grounds for the denial, suspension or revocation of such a license, or for the imposition of any sanction prescribed by NRS 449.163.
7. If an allegation of a violation of the provisions of subsection 2 is made against:
(a) A physician licensed to practice medicine pursuant to the provisions of chapter 630 of NRS, the Board of Medical Examiners shall conduct an investigation of the alleged violation. Such a violation, in addition to any criminal penalties that may be imposed, constitutes grounds for initiating disciplinary action or denying licensure pursuant to the provisions of subsection 3 of NRS 630.3065.
(b) An osteopathic physician licensed to practice osteopathic medicine pursuant to the provisions of chapter 633 of NRS, the State Board of Osteopathic Medicine shall conduct an investigation of the alleged violation. Such a violation, in addition to any criminal penalties that may be imposed, constitutes grounds for initiating disciplinary action pursuant to the provisions of subsection 1 of NRS 633.131.
(Added to NRS by 1987, 867; A 1989, 1660; 2003, 1178; 2013, 3045)

Structure Nevada Revised Statutes

Nevada Revised Statutes

Chapter 439B - Restraining Costs of Health Care

NRS 439B.010 - Definitions.

NRS 439B.030 - "Billed charge" defined.

NRS 439B.035 - "Children’s Health Insurance Program" defined.

NRS 439B.040 - "Committee" defined.

NRS 439B.050 - "Department" defined.

NRS 439B.060 - "Director" defined.

NRS 439B.070 - "Discharge form" defined.

NRS 439B.090 - "Fiscal year" defined.

NRS 439B.100 - "Health facility" defined.

NRS 439B.110 - "Hospital" defined.

NRS 439B.115 - "Major hospital" defined.

NRS 439B.120 - "Medicaid" defined.

NRS 439B.130 - "Medicare" defined.

NRS 439B.140 - "Net revenue" defined.

NRS 439B.150 - "Practitioner" defined.

NRS 439B.160 - Purposes of chapter.

NRS 439B.200 - Creation; appointment of and restrictions on members; officers; terms of members; vacancies; annual reports.

NRS 439B.210 - Meetings; quorum; compensation.

NRS 439B.220 - Powers.

NRS 439B.225 - Committee to review certain regulations proposed or adopted by licensing boards; recommendations to Legislature.

NRS 439B.227 - Committee to review certain new provisions of law; recommendations to Legislature concerning mandated reporters.

NRS 439B.260 - Reduction of billed charges for certain patients and services; notice; resolution of disputes. [Effective through December 31, 2025.] Reduction of billed charges for certain patients and services; notice; resolution of disputes. [Effec...

NRS 439B.265 - Collection of deductible or copayment from indigent patient covered by Medicare prohibited. [Effective upon confirmation by the Federal Government that the deductibles and copayments which a hospital is prohibited from collecting from...

NRS 439B.270 - Foundation for hospital nursing practice: Establishment; governing body.

NRS 439B.275 - Program for provision of technical assistance to rural hospitals.

NRS 439B.280 - Educational program to promote wellness, physical fitness and prevention of disease, accidents and motor vehicle crashes.

NRS 439B.300 - Legislative findings and declarations; applicability.

NRS 439B.310 - "Indigent" defined.

NRS 439B.320 - Hospital required to provide care for proportionate share of indigent patients; duties of Department and board of county commissioners; reimbursement for care.

NRS 439B.330 - Eligibility of indigent for assistance; payment of hospital for serving disproportionately large share of patients; discharge forms; appeal from determination of county regarding indigent status.

NRS 439B.340 - Report on indigent patients treated; verification by Director; compensation for treatment provided in excess of obligation; assessment for failure to fulfill minimum obligation.

NRS 439B.350 - Department to establish; purpose.

NRS 439B.360 - Evaluation: Recommendations; report to Interim Finance Committee.

NRS 439B.370 - Director authorized to contract for certain services.

NRS 439B.400 - Hospital must maintain and use uniform list of billed charges; exception.

NRS 439B.410 - Hospital required to provide emergency services and care; unlawful acts of hospital or physician working in hospital emergency room; treating hospital may recover penalty from transferring hospital; exceptions; administrative investiga...

NRS 439B.420 - Prohibited acts of hospitals and related entities; exceptions; submission of contracts to Director; civil penalty.

NRS 439B.425 - Prohibited referral of patients; exceptions; penalty.

NRS 439B.430 - Prohibited acts of hospitals; examination by Director; administrative fine; injunctive relief.

NRS 439B.440 - Director may require hospitals, health facilities and providers of health services to submit information; independent audit; examinations; penalty.

NRS 439B.450 - Powers and duties of Director.

NRS 439B.460 - Director authorized to delegate powers and duties.

NRS 439B.500 - Penalty for violation of provisions.

NRS 439B.600 - Definitions.

NRS 439B.605 - "Manufacturer" defined.

NRS 439B.607 - "National Drug Code" defined.

NRS 439B.610 - "Pharmacy" defined.

NRS 439B.615 - "Pharmacy benefit manager" defined.

NRS 439B.616 - "Rebate" defined.

NRS 439B.618 - "Third party" defined.

NRS 439B.619 - "Unit" defined.

NRS 439B.620 - "Wholesale acquisition cost" defined.

NRS 439B.622 - "Wholesaler" defined.

NRS 439B.625 - Organization representing interests of retail merchants to prepare and update list of most commonly prescribed drugs or generic equivalents.

NRS 439B.630 - Department to annually compile lists of certain prescription drugs.

NRS 439B.635 - Manufacturer of certain prescription drugs to prepare, submit and affirm accuracy of annual report; contents of report.

NRS 439B.640 - Manufacturer of drug that has undergone significant price increase to submit report describing reasons for increase; affirmation of accuracy of report; contents of report.

NRS 439B.642 - Wholesaler of certain prescription drugs to prepare, submit and affirm accuracy of annual report; contents of report.

NRS 439B.645 - Pharmacy benefit manager to submit and affirm accuracy of annual report concerning certain drugs; contents of report.

NRS 439B.650 - Department to compile annual report concerning price of certain drugs; contents of report; presentation of report at public hearing.

NRS 439B.655 - Pharmacies to provide to Department contact information, electronic mail address and address of Internet website; exceptions.

NRS 439B.660 - Manufacturer required to provide list of its pharmaceutical sales representatives; electronic access to list; prohibition against unlisted person marketing prescription drugs; reports.

NRS 439B.665 - Report by certain nonprofit organizations that receive items of value from manufacturer. [Effective through December 31, 2025.] Report by certain nonprofit organizations that receive items of value from manufacturer. [Effective January...

NRS 439B.670 - Department to place on Internet website certain information concerning pharmacies, nonprofit organizations and prescription drugs and certain reports by Department; additional or alternative procedures for obtaining information concern...

NRS 439B.675 - Manner of presentation of information.

NRS 439B.680 - Immunity from civil and criminal liability.

NRS 439B.685 - Regulations.

NRS 439B.690 - Suspension of components of program or duties of Department if sufficient money not available; acceptance of gifts and grants.

NRS 439B.695 - Administrative penalty for failure to provide information to Department; use of money collected by Department.

NRS 439B.700 - Definitions.

NRS 439B.703 - "Covered person" defined.

NRS 439B.706 - "Independent center for emergency medical care" defined.

NRS 439B.709 - "In-network emergency facility" defined.

NRS 439B.712 - "In-network provider" defined.

NRS 439B.715 - "Medically necessary emergency services" defined.

NRS 439B.718 - "Out-of-network emergency facility" defined.

NRS 439B.721 - "Out-of-network provider" defined.

NRS 439B.724 - "Provider contract" defined.

NRS 439B.727 - "Provider of health care" defined.

NRS 439B.730 - "Prudent person" defined.

NRS 439B.733 - "Screen" defined.

NRS 439B.736 - "Third party" defined. [Effective through December 31, 2025.] "Third party" defined. [Effective January 1, 2026.]

NRS 439B.739 - "To stabilize" and "stabilized" defined.

NRS 439B.742 - Inapplicability of provisions to certain hospitals, persons and health care services.

NRS 439B.745 - Limitation on amount out-of-network provider may collect from covered person; duties of out-of-network emergency facility upon providing services.

NRS 439B.748 - Payment to out-of-network emergency facility by third party.

NRS 439B.751 - Payment to out-of-network provider, other than emergency facility, by third party.

NRS 439B.754 - Determination of amount owed when no recent contract exists between out-of-network provider and third party; arbitration to resolve dispute; no interest pending resolution of dispute; confidentiality of arbitration.

NRS 439B.757 - Election by certain entities and organizations not otherwise covered to submit to provisions; regulations.

NRS 439B.760 - Reports; confidentiality of information.

NRS 439B.800 - Definitions. [Effective January 1, 2022.]

NRS 439B.805 - "All-payer claims database" defined. [Effective January 1, 2022.]

NRS 439B.810 - "Covered entity" defined. [Effective January 1, 2022.]

NRS 439B.815 - "Direct patient identifier" defined. [Effective January 1, 2022.]

NRS 439B.820 - "Proprietary financial information" defined. [Effective January 1, 2022.]

NRS 439B.825 - "Provider of health care" defined. [Effective January 1, 2022.]

NRS 439B.830 - "Unique identifier" defined. [Effective January 1, 2022.]

NRS 439B.835 - Establishment of database; duties of Department; advisory committees. [Effective January 1, 2022.]

NRS 439B.840 - Entities required and authorized to submit data to database; removal of direct patient identifiers and assignment of unique identifiers. [Effective January 1, 2022.]

NRS 439B.845 - Confidentiality of data; compliance with certain federal law; use of data in enforcement proceedings. [Effective January 1, 2022.]

NRS 439B.850 - Data requests. [Effective January 1, 2022.]

NRS 439B.855 - Access to and use of data; prohibition on release of data to certain entities; duties of recipient of data; requirement to include certain information in report which contains or uses data. [Effective January 1, 2022.]

NRS 439B.860 - Report concerning quality, efficiency and cost of health care based on data; publication of list of reports Department intends to publish in next calendar year. [Effective January 1, 2022.]

NRS 439B.865 - Reports concerning cost, performance and effectiveness of database and information concerning grants. [Effective January 1, 2022.]

NRS 439B.870 - Immunity from certain civil or criminal liability. [Effective January 1, 2022.]

NRS 439B.875 - Regulations; administrative penalties; contracts and agreements; gifts, grants and donations; accounting and use of administrative penalties by Department. [Effective January 1, 2022.]