On March 4, 2025, the Nevada State Legislature introduced Assembly Bill 186, a significant piece of legislation aimed at enhancing healthcare access and equity in the state. The bill primarily focuses on expanding the scope of services that advanced practice registered nurses (APRNs) and physician assistants (PAs) can provide, particularly in the testing, prevention, and treatment of human immunodeficiency virus (HIV) and hepatitis C.

One of the key provisions of AB186 mandates that the Nevada Medicaid State Plan include a requirement for reimbursement rates for APRNs and PAs that are equal to those provided to physicians for similar services. This change is expected to encourage more healthcare providers to offer essential services related to these critical health issues, thereby improving patient access to care.

The bill also clarifies the definition of "primary care," encompassing various medical practices, including family medicine, pediatrics, internal medicine, obstetrics and gynecology, and midwifery. By doing so, it aims to streamline the healthcare delivery process and ensure that patients receive comprehensive care from qualified professionals.

The introduction of AB186 has sparked notable discussions among lawmakers and healthcare advocates. Proponents argue that the bill addresses significant gaps in healthcare access, particularly for underserved populations who may face barriers in receiving timely treatment for HIV and hepatitis C. They emphasize that empowering APRNs and PAs to provide these services can alleviate the burden on physicians and improve overall public health outcomes.

However, the bill has also faced some opposition. Critics express concerns about the adequacy of training and oversight for APRNs and PAs in managing complex health conditions. They argue that while expanding the scope of practice is beneficial, it must be accompanied by stringent guidelines to ensure patient safety and quality of care.

The implications of AB186 extend beyond healthcare access; they touch on broader social and economic issues. By potentially increasing the number of healthcare providers available to treat HIV and hepatitis C, the bill could lead to reduced healthcare costs in the long term, as early intervention often prevents more severe health complications. Additionally, it aligns with national efforts to combat these diseases, reflecting a growing recognition of the importance of comprehensive healthcare strategies.

As the legislative process unfolds, stakeholders will be closely monitoring the bill's progress and any amendments that may arise. The outcome of AB186 could set a precedent for future healthcare legislation in Nevada, influencing how care is delivered and reimbursed across the state. Ultimately, the bill represents a critical step toward enhancing healthcare equity and improving health outcomes for vulnerable populations in Nevada.