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Nevada’s Division of Insurance said its latest assessment of mental health and addiction coverage found likely violations of the federal parity law by at least 16 insurers, documenting barriers that the state said made it harder for people to get mental health care than physical health care.
In a report published Dec. 31, 2025, the division said carriers operating in Nevada appeared to fall out of compliance with requirements that plans treat mental health and substance-use benefits the same way as medical benefits. Since 2008, federal law has required parity in how plans cover mental health and substance-use treatment, and the Affordable Care Act also includes mental health and substance abuse disorders as one of the 10 essential health benefits that many plans must offer.
According to the report, the problems it documented included requirements for prior authorization for benefits that were not publicly listed as needing it, and denial patterns where insurers rejected mental health and addiction claims at higher rates than medical claims. The report also said carriers used less robust credentialing standards for mental health and addiction providers and documented lower reimbursement rates for mental health claims than for physical health claims.
The division described the findings as the first part of a longer process, saying additional steps must occur before a carrier is determined to have violated the law and faces penalties. State Sen. Fabian Doñate, a Democrat who chairs the Senate Committee on Health and Wellness, called the report a disturbing finding about access in Nevada’s insurance market and said it starves provider networks and pushes families to seek out more expensive out-of-network care.
In a statement, Doñate said the report showed a system that “by burying mental health patients under double the paperwork and denying their preauthorization more often than medical patients, insurance companies have created a second-class tier of health care that violates the law.” He said the compliance issues in the report would make it harder for families to obtain timely help, including through services that require authorization.
The report also identified specific insurers flagged for violations, including UnitedHealthcare Insurance Co., Aetna Health Inc., SilverSummit Health Plan, Health Plan of Nevada Inc. and Sierra Health and Life Ins Co. It said three of the plans on the list—Health Plan of Nevada, Molina Healthcare of Nevada and SilverSummit Health Plan—have managed care contracts with the state, meaning they also provide Medicaid coverage.
Some carriers disputed or emphasized their response to the findings. In a statement to The Nevada Independent, the Nevada Association of Health Plans, which represents 10 companies, said it affirmed the importance of mental health and substance use disorder treatment and said it was not aware of the report’s conclusions until the outlet reached out. The association said some carriers were setting up meetings with regulators to discuss the report, and it said it would review the state’s analysis.
Consumer advocates pointed to practical effects of the barriers described in the report. Katrina Green, a single mother in North Las Vegas, said she faced frequent rejections and delays in mental health care for years, estimating that about 80% of the problems came from insurance. Green said she believed access to trained, neutral help could have made it easier to work through issues ranging from interpersonal barriers to the death of one of her children, and she said, “Had I been able to receive the help that I needed and or needed for my kids when I needed it, I probably wouldn’t hold so much resentment today and my load wouldn’t be so heavy,” adding, “I don’t even need solutions half the time. I just need to get it out loud and say it so that it’s heard.”
Regulators and lawmakers also discussed how the report and the names of insurers became public. The report, published Dec. 31, 2025, was not initially available on the Division of Insurance’s website, and it did not include the names of insurance violators at first. State law enacted in 2025, AB207, ended earlier confidentiality protections and allowed carrier names to be disclosed, with the details uploaded online Feb. 6 after questions from The Nevada Independent. State Assemblywoman Lisa Cole, a Republican, said the delay in publishing carrier information likely reflected a misunderstanding related to the new law.
Nevada’s Insurance Commissioner Ned Gaines said insurers contributed to access problems but were not the sole driver, citing Nevada’s provider shortage and behavioral health system strain. Gaines said the key takeaway for consumers was the report’s empirical confirmation of access challenges many people had already described, and he said the state’s ideal would be comparable convenience, appointment availability and wait times across medical, mental and substance disorder care.
David Lloyd, chief policy officer at the mental health organization Inseparable, said the market had not reached that standard and pointed to data he said showed Nevada patients in 2021 had to go 20 times more often for acute inpatient behavioral health services than for inpatient physical health services. Lloyd said denying more routine mental health care can lead to life-threatening consequences and contribute to emergency department visits, hospitalizations and higher overall costs, and he said low reimbursement can worsen provider shortages by making it difficult for clinicians to contract with insurers.
The process ahead depends on regulatory scrutiny. While state law says the parity report identified likely issues, it does not prescribe initial penalties in the first stage and requires additional investigation through a market conduct examination. State officials estimated that the parity examinations could extend into 2027, after which regulators could pursue enforcement actions such as fines that can max out at $50,000. Gaines said the examinations are intended to determine underlying reasons for the issues and to let regulators implement targeted solutions to prevent future parity violations.
For customers struggling with access, the division said people can file complaints. Nevada’s Health Authority also said it would be developing a similar mental health parity report for Medicaid programs under its oversight, while officials said parity issues across the state’s insurance landscape can connect—raising concerns that families may face barriers that push them toward taxpayer-funded Medicaid if provider networks and coverage gaps persist.