Nevada SB 248 / Medical Debt Law

What is SB 248?

Senate Bill 248 was passed by the Nevada Legislature in 2021 to add consumer protections to medical debt collection in Nevada. It's codified in NRS 649.366, NRS 649.367, and NRS 649.368. SB 248 fundamentally changed how medical debt can be collected in Nevada and added specific requirements that healthcare providers must understand before placing medical accounts.

Three Core Requirements

1. NRS 649.366 — 60-Day Written Notification

Before any collection activity begins on a medical debt, the collection agency must send the patient a written notification. The patient then has 60 days from receipt of the notification before active collection (phone calls, dunning letters, credit reporting) can commence. During this 60-day window:

• No collection activity occurs
• No credit bureau reporting
• The patient has time to verify the debt, work directly with the provider, or set up payment arrangements

2. NRS 649.367 — Voluntary Payment Treatment

Any payment received from a patient during the 60-day notification period is treated as voluntary — not a collection action. This is significant: payments during the notification window aren't treated as collection successes for fee-calculation or reporting purposes, which is intended to encourage patients to resolve balances directly with providers during the window without escalating to formal collection.

3. NRS 649.368 — 5% Fee Cap

Collection fees added to medical debt in Nevada are capped at 5% of the underlying balance. This applies regardless of the agency's standard contingency rate for non-medical accounts.

What Healthcare Providers Must Do

Before Placement

• Confirm your collection agency understands and implements the SB 248 / NRS 649.366 60-day notification workflow
• Confirm fee structures comply with the 5% cap under NRS 649.368
• Ensure your patient statements reflect the post-notification timeline so patients aren't surprised by the process
• Execute a Business Associate Agreement (BAA) with your collection agency if PHI is being shared

During Placement

• Transmit accurate balance information — the 5% cap is calculated on the balance you place
• Include any prior patient communication history (statements sent, payment offers extended, financial assistance applications)
• Tag accounts where the patient has already engaged with a financial assistance application or charity care review

Common Misconceptions

"SB 248 only applies to hospitals."

Incorrect. SB 248 applies to medical debt broadly — hospital accounts, physician group accounts, dental accounts, ambulance services, behavioral health, and any other healthcare-related receivables placed for collection.

"The 60 days runs from the original service date."

Incorrect. The 60 days runs from the patient's receipt of the written notification from the collection agency — not from the date of service, the date of billing, or the placement date.

"The 5% cap doesn't apply if we're outside Nevada."

Incorrect for accounts collected in Nevada. The fee cap applies to medical debt collected from Nevada residents under Nevada collection agency law, regardless of where the healthcare provider is located.

"Voluntary payment treatment means the patient pays nothing."

Incorrect. Voluntary payments during the notification window are still payments — the underlying balance is still owed. The "voluntary" designation affects how the payment is treated for collection fee calculation and reporting purposes; it doesn't reduce the patient's obligation.

How Vegas Valley Implements SB 248

Every medical account placed with Vegas Valley Collection Service runs through our SB 248-compliant workflow:

1. Intake & validation — Account is loaded; placement metadata is verified; BAA confirmed.
2. Notification generated — Within standard intake timelines, the required NRS 649.366 written notification is sent to the patient.
3. 60-day hold — Active collection (calls, letters beyond the notification, credit reporting) is held during the window. Inbound contact and voluntary payments are accepted.
4. Window expires — Active collection begins. Outreach is HIPAA-aware, professional, and patient-sensitive.
5. Resolution or escalation — Payment plans, settlements, or — for unresolved accounts with sufficient documentation — referral to counsel for legal action.

All fees are calculated within the 5% cap.

For More Information

Read the statutes directly: NRS Chapter 649 on the Nevada Legislature website.