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AB 438

Revises provisions relating to nonemergency medical transportation. (BDR 40-1042)

2025 Regular Session Introduced by Jill Dickman and 3 co-sponsors

NEMT regulation moves from the Nevada Transportation Authority to health authorities, requiring new permits, rate filings, and safety standards for private NEMT providers.

(Pursuant to Joint Standing Rule No. 14.3.1, no further action allowed.)
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Bill Summary · AB 438

Summary — AB 438 (BDR 40‑1042) — Nonemergency Medical Transportation (NEMT) oversight (Nevada)

Status: Enacted — Approved by Governor 10/01/2025; Chaptered by Secretary of State as Chapter 152, Statutes of 2025.
Introduced: 03/17/2025. Sponsor/Authors: Assemblymembers Dickman; Gallant, Gray, Gurr and O’Neill.

Main purpose

AB 438 transfers regulatory authority over private providers of nonemergency medical transportation (NEMT) from the Nevada Transportation Authority (NTA) to public health authorities — specifically, the Division of Public and Behavioral Health (DHHS Division) for most counties and the district board of health for counties with population ≥700,000 (currently Clark County). The change aligns oversight of NEMT with other ambulance/EMS public‑health regulation.

Key provisions and changes

  • Transfers regulation and permitting of private NEMT providers from the NTA to:
    • the district board of health in counties with population ≥700,000 (Clark County), and
    • the Division of Public and Behavioral Health in all other counties.
  • Removes requirement that private NEMT operators obtain a certificate or permit from the NTA; instead requires a permit from the applicable health authority.
  • Establishes/clarifies a definition and scope of “nonemergency medical transportation” and the applicability of health‑agency standards.
  • Limits the fee for a NEMT operator permit to not more than $200.
  • Clarifies scope and use of provisional permits for NEMT operators.
  • Requires private NEMT providers to file their schedule of rates with the Division or district board of health, as applicable.
  • Preserves existing exemptions:
    • governmental entities that provide NEMT remain exempt from permitting/regulation; and
    • a specific exemption for certain common motor carriers contracting with local governmental entities (retained under same conditions).
  • Requires drivers of NEMT vehicles to report suspected abuse, neglect, isolation or abandonment of elderly/vulnerable persons, and abuse/neglect or commercial sexual exploitation of children; willful failure to report may be a misdemeanor or gross misdemeanor.
  • Makes conforming statutory changes to reflect shifted authority and avoids creating new operational powers for providers.
  • Clarifies that issuance of a state permit does not relieve providers from local franchising or permitting requirements.

Who is affected

  • Private NEMT companies and their drivers (must obtain new permits, comply with health standards, file rates, and satisfy mandated‑reporter duties).
  • Nevada Department of Health and Human Services (Division), district boards of health (Clark County), which gain permitting, inspection and enforcement responsibilities.
  • Nevada Transportation Authority (NTA), which is relieved of most NEMT oversight responsibilities.
  • Passengers who use NEMT services, including elderly, vulnerable and behavioral‑health clients; rural providers and clients may see procedural changes.
  • Local governments — potential fiscal and administrative effects (bill contains identified unfunded mandates in specified sections).

Procedural/timeline notes

  • Legislative history shows committee referrals and amendments through spring–summer 2025; Senate amendments concurred in September 2025.
  • Enrolled 09/11/2025; approved and chaptered as law 10/01/2025.
  • Fiscal notes: bill indicates state impact and possible local fiscal impact; contains identified unfunded mandates (§§ 8, 9, 12).

Potential impacts and considerations

  • Administrative: Permitting and oversight functions move from a transportation regulator (NTA) to health agencies that already regulate EMS/ambulances — potentially speeding health‑based approvals and adding clinical/safety standards to NEMT regulation.
  • Operational/cost: Providers will face new permitting requirements, rate filing, and compliance with health‑agency standards; permit fee capped at $200 but other costs (inspections, staffing, compliance) may change.
  • Enforcement and safety: Drivers will be subject to mandated‑reporter obligations, and health agencies may apply vehicle/equipment/clinical standards different from previous NTA vehicle‑focused requirements.

For full text and statutory amendments consult Chapter 152, Statutes of 2025 (AB 438).

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

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