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  • Technical Bulletin
  • Syphilis

Updates to NRS 442.010, Rapid Point-of-Care Syphilis Testing During Pregnancy

Summary

Assembly Bill (AB) 360, introduced by Assemblymember Heather Goulding, was approved and signed by Governor Lombardo May 30, 2025, as part of the 83rd Nevada Legislative Session. The amendments include the following:

Who Orders Tests

  • This amendment expands the provider types to include physician assistants and advance practice registered nurses, in addition to physicians.

Timing and Test Types

  • These providers shall test for syphilis if evaluating a woman of childbearing age for any reason to determine if a) she is pregnant; and, b) whether she had received any prenatal screenings and tests; and, c) if pregnant, to test for syphilis if there is no history of syphilis and the patient has not been tested for syphilis in the prior 3 months.
  • The amendments expand the types of testing that should be conducting to include a rapid or point-of-care test, if there is no history of syphilis, unless a serological test result will be made available prior to the patient being discharged or otherwise leaving the facility.
    • If there is a prior history of syphilis, a serological test may be performed.
  • The health care provider shall ensure any refusal for testing be documented in medical records.

Facilities and Exemptions

  • Non-hospital settings are required to develop a policy to comply with the documentation of refusal for services including testing offered and ensuring practices are in alignment with American College of Obstetricians and Gynecologists prenatal screening recommendations.
  • Rural clinics owned, operated or administered by DHHS, including a city, county, city board of health, county board of health or district board of health are exempt from the requirements in paragraph c of subsection 1 and subsection 8.

Enforcement

  • The Division of Public and Behavioral health may investigate and fine up to $5,000 per day or suspend those in violation of NRS 442.010.

Medicaid Reimbursement

  • Permitting federal match, Medicaid must reimburse for rapid syphilis testing, separate from bundled prenatal care payments.

While AB 360 has not yet been codified, amendments to existing code can be viewed in the enrolled version here.

Agencies may begin to make changes to policies and procedures; however, all sections 1-4 go into effect January 1, 2026.

Screenings During Pregnancy

Currently, NRS 442.010 indicates syphilis testing must be conducted during first visit to a healthcare provider during pregnancy and during the third trimester between the 27th and 36th week of gestation or as soon as possible. Additionally, syphilis testing should occur at time of delivery for those living in a high syphilis morbidity region, or if there was no prenatal care, or if the infant was stillborn 20 weeks after gestation.

NRS 442 outlines Nevada regulations related to testing for HIV, chlamydia, gonorrhea, hepatitis B and C as well as congenital heart disease and blood lead levels.

Questions

For updated guidance, review the Division of Public and Behavioral Health Technical Bulletin web page regularly. Email stateepi@health.nv.gov for other questions regarding syphilis testing during pregnancy.