Lombardo’s bill seeks to fix what ails Nevada health care 

Gov. Joe Lombardo is predicting success for his Nevada Health Care Access Act, which was introduced at the Legislature on Thursday. The measure is designed to increase Nevada’s health care workforce, reduce disparities in care for rural residents, and cut red tape. 

“I have an agreement and cooperation with (legislative) leadership,” Lombardo said Thursday at an event where he introduced the measure to medical students and others at UNLV’s Kirk Kerkorian Medical School in Las Vegas. “We anticipate success here.”

‘Not personal’

Lombardo has expressed frustration with legislative delays in bringing his bills forth for hearings. The governor said that frustration has not been alleviated but added he’s not taking it personally. 

“I’m confident we still have enough time. And, you know, sometimes you think it’s personal as the governor and whether it’s a partisan issue. It’s not the case. The legislative session is very cumbersome short term, and you continually want to remove the need for a special session,” he said.  “What we experienced in this session is unique, because we’ve had a lot of federal funding in previous years and a lot of ability to act on funds that are available. This session, we don’t have that luxury.”

President Donald Trump, Elon Musk’s Department of Government Efficiency, and the Republican-controlled Congress have proposed or executed cuts at a hectic pace since Trump took office in January. 

“We’re having grants cut weekly,” UNLV Interim President Chris Heavey told the Current. 

The governor said his legislative priorities remain constant – health care, education and housing – but noted the timing of the Economic Forum’s reduced budget forecasts late in the session “makes it difficult to make decisions, especially in your budgetary hearings.”

“It seems like it’s personal, but it’s not,” Lombardo reiterated of legislative delays in bringing his bills forward for hearings, adding he wanted to “dispel the rumor out there that I’m not communicating with leadership. I have constant communication with leadership.”

System failures

The state’s health care “weaknesses have gone unaddressed for many years,”  Stacie Weeks, an administrator of Nevada’s Department of Health and Human Services, told the gathering. “They have exacerbated the state’s health care workforce challenges and stymied our efforts at the state to contain costs and improve quality in our system.”

Weeks noted Nevada ranks “in the bottom in just about every health score nationally. We must do better.” 

Increasing the state’s healthcare workforce is among the bill’s priorities.

“As our state’s Medicaid director, I’ve seen first hand that improving access to coverage does help with healthier communities,” Weeks said. “However, what good is health insurance or coverage, even in Medicaid, if someone can’t get to see a doctor when they need to, unless they are in an emergency?”

Weeks say the current system leads to higher costs and poor outcomes. 

Lombardo’s bill seeks to increase the state’s health care workforce by establishing a $25 million annual fund to address workforce shortages, particularly in underserved communities and high-demand specialties, by “driving innovation through public-private partnerships, competitive grants,” and targeting infrastructure investments, says a handout from the governor’s office. The fund will be managed by the newly-created Nevada Health Authority, which will be led by Weeks. 

Of the medical school’s 60 graduates this semester, 42% are remaining in Nevada for residency programs. 

“If you don’t have the residency programs here in the state of Nevada, where are these graduates going to end up?” Lombardo asked rhetorically, noting physicians tend to remain in the state where they complete their residency.  

The legislation would also reform the process of obtaining prior authorizations from health insurers in an effort to speed up treatment and get bills paid faster, Weeks said. 

All health care plans will be required to use a standardized electronic process for prior authorization. No prior authorization will be required for emergencies, and insurance companies will be required to respond within two business days. 

The legislation calls for graduate medical education programs that would incentivize training in high-demand specialties. The legislation would provide liability protections for clinical staff to encourage greater participation. 

The bill intends to streamline and accelerate the state’s licensing and credentialing process, the governor said. The state is currently 48th in the nation for practicing doctors per capita, according to Weeks. 

The bill also seeks to increase access to dental care by expanding training programs for dental hygienists and assistants, especially in underserved areas. 

Under the legislation, Nevada’s Patient Protection Commission would be called on to conduct a feasibility study for an academic medical center to further increase the healthcare workforce. 

A newly-created Office of Mental Health would be housed under the Nevada Health Authority, with the goal of expanding access to mental health care statewide while addressing workforce shortages.

Finally, the legislation would simplify and speed up the eligibility process for Medicaid applicants.

The outlook for Medicaid funding for Nevada in the wake of the Trump administration’s budget proposals “does not look as damaging to the state of Nevada” as anticipated, said Weeks, noting the department is examining how work requirements will affect the program. “But overall, it’s not as big in terms of cuts that we expected for the state.” 

The legislation, Senate Bill 495, contains an unfunded mandate, according to the legislative website, and was referred to the Senate Committee on Health and Human Services.