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AB 31

Provides for certain Medicaid reimbursement of providers of nonemergency secure behavioral health transport services. (BDR 38-368)

2025 Regular Session

AB 31 would reimburse Nevada's Medicaid NESBHT for empty miles and raise rates (15% rural, 10% otherwise) to expand trauma-informed transport access.

(No further action taken.)
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Bill Summary · AB 31

Summary — AB 31 (BDR 38-368)

Provides for certain Medicaid reimbursement of providers of nonemergency secure behavioral health transport services.

Status: Introduced December 2024; amended in committee; passed the Assembly (May 2025); referred to the Senate (no further action taken as of June 3, 2025). Sponsored by the Southern Regional Behavioral Health Policy Board / Assembly Committee on Health and Human Services.

Purpose / intent

AB 31 is designed to improve access to safe, trauma‑informed transportation for Medicaid beneficiaries experiencing behavioral‑health crises, especially in rural, frontier, and tribal areas. The bill aims to incentivize private and public providers to offer Non‑Emergency Secure Behavioral Health Transport (NESBHT) by (1) reimbursing for “empty miles” (distance traveled to pick up or after drop‑off), and (2) increasing Medicaid reimbursement rates for these services.

Key provisions

  • Requires the Director of the Department of Health and Human Services (DHHS) — to the extent federal financial participation is available — to include under Nevada Medicaid reimbursement that covers:
    • Distance traveled from a provider’s base to the patient pickup location, and
    • Distance traveled from the patient drop‑off back to the provider’s base (i.e., “empty” or round‑trip miles).
  • Directs the Director to apply to the U.S. Secretary of Health and Human Services for any federal waiver or State Plan amendment needed to obtain federal funding for these reimbursements and to cooperate in the federal approval process.
  • Establishes increased reimbursement rates to be requested in the State Plan amendment or waiver:
    • At least a 15% increase for transports when pickup, drop‑off, or both occur in a county with population under 100,000 (i.e., rural/frontier counties — currently all counties other than Clark and Washoe), and
    • At least a 10% increase for all other NESBHT services.
  • Uses the statutory definition of “nonemergency secure behavioral health transport services” from NRS 433.3317.

Affected parties

  • Medicaid beneficiaries requiring behavioral‑health transport.
  • NESBHT providers (public and private), who would be eligible for additional reimbursement including empty miles.
  • Rural and frontier counties (counties <100,000 population) stand to receive the larger (15%) rate increase.
  • Local law enforcement and EMS (potentially reduced transport burden).
  • Nevada DHHS / Division of Health Care Financing and Policy (administration, federal application, and implementation).

Fiscal and operational impact

  • Fiscal note (presented to committees) estimates an increase in Medicaid expenditures of about $1.26 million in FY 2026–27.
  • Implementation depends on securing federal authority (waiver or State Plan amendment) for federal matching funds.
  • Expected indirect benefits cited by proponents: reduced law‑enforcement/EMS overtime and out‑of‑service time, fewer ER visits, and improved trauma‑informed care beginning at pick‑up. Those savings were not captured in the fiscal note.

Timeline / procedural notes

  • Original deadline for the federal submission was October 1, 2025 (as introduced); committee amendment (first reprint) moved the DHHS submission deadline to on or before January 1, 2026.
  • The bill was amended in committee (Amendment No. 18) to clarify provisions and timing.
  • Although it passed the Assembly, the Senate did not take further action as of the latest status provided.

Context / rationale

Advocates and sponsors argue Nevada’s current Medicaid reimbursement practices (which reimburse only for loaded miles) have discouraged providers from offering NESBHT, particularly in rural/tribal areas where distances and “empty” travel time are substantial. AB 31 intends to create financial incentives to expand access to trauma‑informed, non‑law‑enforcement transport options for individuals in behavioral‑health crisis.

Compiled from official sources — confirm details with the bill’s official record.

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