►
From YouTube: 3/15/2021 - Assembly Committee on Commerce and Labor
Description
For agenda and additional meeting information: https://www.leg.state.nv.us/App/Calendar/A/
Videos of archived meetings are made available as a courtesy of the Nevada Legislature.
The videos are part of an ongoing effort to keep the public informed of and involved in the legislative process.
All videos are intended for personal use and are not intended for use in commercial ventures or political campaigns.
Closed Captioning is Auto-Generated and is not an official representation of what is being spoken.
A
A
A
A
A
A
Asm.State.Nv.Us
zoom
chat
is
reserved
for
committee
business.
Only
members,
please
remember
to
keep
your
camera
on
at
all
times.
This
will
help
us
ensure
we
have
a
quorum
unless
you
are
stepping
away
for
non-committee
related
business
members
and
presenters.
Please
remember
to
be
muted
at
all
times,
unmute
yourself
to
speak
and
then
promptly
mute
yourself
when
you
are
done.
Thank
you
to
everyone
and,
let's
begin
with
our
agenda
and
today
on
today's
agenda,
we
have
assembly
bill
47.
I
believe
we
have
mr
mark
kruger
deputy
attorney
general
here
to
present.
A
C
Madam
chair
members
of
the
committee,
thank
you
on
behalf
of
attorney
general
ford.
We
are
happy
to
be
providing
an
opportunity
to
introduce
ab47,
which
makes
amendments
to
nevada's,
unfair
trade
practices,
act,
nrs,
chapter
598.8,
otherwise
known
as
nevada's
antitrust
laws.
Before
I
get
to
what
ab47
does.
I
want
to
provide
the
committee
with
some
background
on
how
we
got
where
we
are,
and
I
want
to
thank
each
and
every
one
of
the
stakeholders
that
we
worked
with
to
get
us
here.
C
C
C
We
started
with
broad
language
and
due
to
the
concerns
that
we
heard
from
the
stakeholders,
we
narrowed
our
focus,
we
refined
our
words
and
we
sharpened
our
pencils
and
we
were
not
afraid
to
make
the
changes,
but
we
also
did
not
lose
focus
of
what
we
needed
to
accomplish
and
in
the
end
we
believe.
The
legislation
that
you
see
here
accomplishes
our
needs
without
creating
an
undue
burden
on
the
stakeholders.
C
Ab47
has
three
distinct
focuses
number
one.
It
allows
our
office
to
take
a
peek
at
consolidation
transactions
in
the
health
care
market
in
nevada
number
two.
It
provides
clarification
and
cleanup
language
to
remedies
and
investigatory
authority
of
the
ag's
office
and
number
three.
It
limits
the
applicability
of
non-competitive,
covenants
or
non-compete
agreements
by
prohibiting
them
from
being
applied
to
employees
paid
on
an
hourly
basis,
so
that
those
employees
are
not
limited
in
their
ability
to
get
new
jobs
when
they
stop
working.
For
that
particular
employer.
C
I'm
going
to
go
through
each
of
these
three
focuses,
and
in
so
doing
I
will
address
the
objections
that
we've
heard
section.
One
adopts
sections
two
through
five
of
the
act:
two
two
through
six
really
rely
on
the
health
care
transaction
health
care
costs
are
a
concern
to
every
nevadan
and
consolidation
in
the
healthcare
industry
can
increase
healthcare
costs
in
nevadans
and
nevada
families.
C
Our
first
focus
allows
the
nhrs
team
in
our
office
to
an
opportunity
to
take
a
peek
at
the
transactions
that
will
affect
cost
and
health
care
and
ensure
competition
in
the
health
care
market,
so
that
costs
can
be
lower.
This
would
include
transactions
that
are
not
reportable
under
the
federal
heart
scotland
dino
act
for
hsr,
as
well
as
the
requiring
those
hsr
filings
to
be
sent
to
the
attorney
general's
office.
C
The
notice
provisions
of
av-47
do
not
create
an
owner's
burden
for
health
care
entities
for
hsr
transactions.
The
entity
would
send
the
attorney
general
a
copy
of
the
hsr
filing
for
smaller
transactions.
The
entity
would
submit
the
one
or
two
page
report
sending
forth
information
regarding
the
identity
and
nature
of
the
parties.
In
practice,
the
notice
provisions
do
not
do
anything
that
is
not
already
authorized
under
existing
law
by
the
issuance
of
multiple
cids,
often
monthly.
C
If
we
had
to
the
bill
simply
requires
the
industry
to
provide
us
notice
to
transactions
earlier
than
we
would
receive
them.
Otherwise,
the
30-day
time
frame
in
section
2-2
is
consistent
with
hsr
filings.
All
information
reported
to
the
attorney
general
remains
confidential.
That
was
something
that
the
industry
and
the
stakeholders
wanted.
If
there's
a
material
change
to
the
transaction
during
the
30-day
transaction
period,
it
would
just
trigger
the
filing
of
a
new
report
which
again
would
also
be
confidential.
C
We
are
willing
to
edit
that
to
make
it
a
little
clearer
that
it's
healthcare
or
healthcare
or
business
entities
that
will
provide
services
anywhere,
that
there
is
something
as
an
objection
that
has.
We
can
provide
that
clarity
is
an
example
of
how
we
work
with
the
stakeholders
to
refine
this.
This
av-47,
the
term
primary
service
area,
is
used
to
give
entities
flexibility
in
stating
their
geographic
markets.
Businesses
are
aware
of
the
geographic
markets
that
they
serve,
and
flexibility
is
important
in
defining
geographic
markets,
because
different
types
of
healthcare
entities
have
different
service
areas.
C
For
example,
a
hospital
rural
accounting
may
serve
as
several
surrounding
counties
or
an
entity
which
provides
traveling.
Nurses
may
serve
the
entire
state
of
nevada
sections
two
through
six
of
ab47
are
designed
to
be
interpreted
together,
not
independently,
and
so
for
clarification.
Section
two
provides
for
notice
to
the
attorney
general,
while
section
four
requires
that
information
received
pursuant
to
section
two
remains
confidential
and
then
section
6
defines
what
types
of
transaction
actions
are
subject
to
the
notes
provisions
in
subsection,
2.
C
section
6
does
not
have
a
reporting
required.
That
is
a
requirement
that
is
independent
of
section
2
or
a
different
confidentiality
requirement
from
that
of
section
4.,
and
I
provide
that
information
to
clear
up
any
ambiguity
about
how
those
sections
work
together
and
it's
not
the
intent
of
the
attorney
general
to
share
the
best
authority
for
antitrust
enforcement
and
the
attorney
general
is
not
looking
to
delete
any
of
the
provisions
regarding
confidentiality
for
these
types
of
transactions.
C
C
C
C
C
We
have
limited
the
reportable
transactions
to
actually
activity
in
nevada,
but
the
intent
is
to
receive
notice
of
the
transactions
which
affect
healthcare
provider
transactions
in
nevada.
The
notice
is
in
the
form
of
a
one
or
two
page
report.
As
I've
said
it's
not
onerous,
and
because
it's
confidential,
it
should
not
have
a
chilling
effect
on
healthcare
transactions
in
nevada.
C
Moreover,
internal
transactions,
which
are
non-consumer-facing,
we
still
have
an
effect
on
price
quality
and
consumer
choice.
The
word
affiliation
means
where
one
entity
has
control
or
power
to
control
another
or
a
third
party
controls.
Both
entities
we're
capturing
business
affiliations,
not
marketing
affiliations
as
an
example
of
a
grocery
store,
affecting
with
a
hospital
to
distribute
affiliating
with
the
hospital
distribute
flu
vaccines.
C
Moving
on
to
sections
7-13,
the
second
focus
of
ab47
provides
our
office
with
clarification
as
to
the
remedies
we
have
and
investigations
and
actions
under
the
unfair
trade
practices
act,
and
it
also
provides
clarity
to
the
confidentiality
provisions
of
those
investigations.
There's
been
no
opposition
to
this
section
of
the
bill.
C
A
Thank
you,
jack
krueger.
We
appreciate
you
breaking
on
down
the
bill
for
us.
It
was
very
helpful
for
me
for
to
have
you
break
it
down
into
sections
like
that.
I
am
going
to
turn
it
over
to
the
committee
members
for
questions,
but
before
we
do
I'm
going
to
take
privileges
here.
Just
to
ask
you
a
quick
question:
it's
regarding
the
first
focus
of
the
bill,
which
is
sections
one
through
section,
six
kind
of.
Could
you
walk
us
through
or
give
us
an
example?
A
C
C
Unfortunately,
while
we've
been
spending
a
lot
of
time
talking
about
the
confidentiality
provisions
of
the
unfair
trade
practices
act,
we
can't
get
into
details
of
prior
transactions.
But,
yes
to
answer
your
question,
there
have
been
instances
of
reports
where
a
transactions
have
come
to
our
attention.
The
only
problem
is
is
that
we
oftentimes
get
notice
of
of
those
types
and
consolidation
transactions
later
in
time
with
an
earlier
notice
provision.
We
can
take
a
look
at
them.
C
Then
we
work
hard
to
make
sure
that
there's
a
competition
in
the
marketplace
so
that
there
is
not
an
increase
in
in
healthcare
cost
and
we've
been
successful
in
some
many
of
our
reviews
when
we
do
find
out
about
them.
We
are
concerned
that
there
are
some
smaller
consolidations,
particularly
in
markets
where
there
are
potentially
particular,
as
I
described
particular
provider
groups,
that
a
a
consolidation
could
drive
up
costs
and
that's
why
we
want
to
take
a
peek
at
them.
C
A
D
Yes,
cheering
committee
members,
there
have
been
the
transactions,
particularly
under
two
subsection
two,
which
are
transactions
that
fall
below
the
hsr
threshold.
The
current
reporting
threshold
under
the
heart
scott
radino
act
is
92
million
dollars.
D
As
mr
krueger
said,
we
can't
go
into
any
details
about
those
investigations
because
they're
confidential,
but
I
can
confirm
that
in
the
past
we
actually
had
a
consolidation
here
in
las
vegas,
so
not
a
rural
county
that
fell
below
the
threshold,
and
so
neither
our
office
nor
the
ftc
knew
about
the
transaction
until
it
was
about
to
be
consummated,
and
in
that
case
both
the
ftc
in
our
office
was
a
little
concerned,
and
so
we
went
to
the
companies
and
asked
them
for
information.
D
They
ended
up
having
to
issue
a
whole
separate
letter,
so
they
agreed
that
even
though
they
had
consummated
the
transaction,
they
agreed
to
hold
the
assets
separate
for
a
period
of
time
to
allow
us
to
get
some
information
about
it.
I
would
have
been
better
for
our
office
and,
I
think,
also
the
parties
in
that
situation.
We
had
known
about
it
beforehand
and
so
that's
an
example
of
a
transaction
that
is
captured
under
two
subsection
two,
because
it
falls
below
the
reporting
requirement
under
the
heart
stock.
They'll
be
doing.
E
Madam
chair,
that
is
a
great
example
by
mr
tucker,
now
we're
kind
of
looking
at
a
chicken
and
egg
problem.
If
you
will,
because
we
can't
share
with
you
confidential
information
that
we
get.
If
we
don't
get
the
information
regarding
smaller
transactions,
we
don't
know
they
happen
until
sometimes
years
later,
or
at
least
months
later,
when
it's
really
difficult
to
unwind
transactions,
something
that
we
do
know
that
economic
studies
will
show
you
we've
been
bringing
off
a
lot
of
them.
E
Is
time
and
again,
consolidation
in
markets
will
cause
prices
to
increase,
quality
may
decrease.
Certainly,
choices
for
consumers
decreases,
and
it's
not
just
the
huge.
You
know:
transactions
where
one
or
two
insurance
companies
get
together
and
where
you
get
to
insurance
companies
who
are
combining
that
that
will
affect
markets.
E
It
is
very
frequently
an
aggregation
of
smaller
transactions
where
one
physician
group
joins
another
and
they
are
practicing
in
a
key
subspecialty,
for
example,
or
a
hospital
system,
or
a
vertically
integrated
insurance
carrier
that
has
a
number
of
different
providers
integrated
into
it,
acquires
a
key
specialty
that
particular
specialty.
E
That
may
not
have
a
huge.
You
know.
You
say:
well,
this
isn't
going
to
hugely
affect
the
market.
If
it's
a
key
specialty,
it
could
allow
what
we
call
a
vertically
integrated
system
to
affect
prices
in
an
entire
market,
and
so
it's
important
to
look
at
these
transactions
and
see
the
effect
of
them,
and
you
know
this
can
be
done
very
quickly.
Yeah.
You
know
it's.
It's
really.
E
As
mark
said,
this
is
not
a
an
owner's
burden
to
give
a
one
to
two
page
form
to
us,
saying
here's
what
we're
doing
so,
that
we
can
look
at
it
and
have
it
and
have
an
idea
of
it.
Thank
you.
A
Thank
you,
ms
martin
presenters.
I
will
just
remind
you
to
or
our
secretary
recording
purposes,
if
you
would
please
just
identify
yourself
before
speaking.
I
do
have
another
question,
but
I'm
going
to
turn
to
committee
members.
First,
I'm
going
to
move
to
assemblymember
considine.
F
Thank
you
chair.
How
are
you
my
question,
deals
more
with
the
with
the
non-compete
clause
and
it
being
solely
for
the
benefit
of.
F
But
what
I
was
wondering
if
there
was
any
discussion
or
if
there's
any
issues
with
sort
of
anti-poaching
which
is
sort
of
the
flip
of
that,
whereas
when
consolidation
happens,
if
there's
you
know
agreements
to
not
hire
on,
you
know
people
from
from
from
the
smaller
pool
of
competing
entities,
that
kind
of
has
the
same
effect
of
you
not
being
able
to
move
to
another
location
with
the
same
skills.
C
Madam
chair,
through
you,
mark
kruger
chief
deputy
attorney
general
for
the
record
to
assemble
a
woman
come
tonight.
Oh
mr
creek
feel
free
to
go
directly
to
the
members.
Oh
thank
you.
Thank
you
chair.
We
we
looked
at
more
the
perspective
of
the
hourly
wage.
We
did
not
look
at
the
flip
side
of
it
and
haven't
discussed
it.
C
Yet
that
is
certainly
something
that
we
can
have
discussions
with
the
stakeholders
and,
as
I
said
earlier,
the
stakeholders
really
worked
well
with
us
and
came
up
with
this
brightline
rule
of
the
hourly
wages.
But
we
hear
your
concern
and
definitely
can
have
those
discussions.
A
G
Thank
you,
madam
chair,
thank
you
both
for
your
presentation
this
morning
I
mean
this
afternoon.
I
guess
I
want
to
just
take
it
back
and
peel
back
a
little
bit
on
on
getting
too
far
into
the
weeds.
I
don't
navigate
in
this
conversation
enough,
so
I
I
think
I'm
gonna
ask
more
of
a
broader
question
to
help
me
kind
of
put
everything
into
perspective.
G
Well,
I
guess
the
first
question
is,
I
understand
and
going
off
of
the
response
that
was
previously
given
that
we
don't
think
it's
too
owner
is
to
have
a
one
or
two
page
so
that
we
can
see
kind
of
what
the
agreement
is
and
and
obviously
we
want
to
promote
transparency,
consistency
and
all
that
good
stuff.
G
But
if
you
could
just
walk
me
through
how
you
foresee
that
playing
out
you
get
the
one
or
two
page
document,
because
the
way
I
see
it
is
and
because
of
these
set
requirements
of
and
again
and
I've
also
been
jumping
back
and
forth
between
the
original
language
and
the
amended
language.
So
you
may
have
addressed
it
and
I
just
missed
it,
but
I'm
just
trying
to
visualize
that
that
interaction
right
we
have
entity
a
who
has
a
perspective
of
entering
into
an
agreement
with
entity
b,
they're
going
to
engage
and
interact.
G
They
put
something
in
writing
that
gets
submitted
to
you.
You
then
look
at
it.
I
foresee
that
maybe
there
being
multiple
well
wait.
We
need
more
details
here.
Please
provide
more
information
there.
I
just
want
to
see
how
that
relationship
would
start
and
then
from
there.
I
think
I
could
engage
in
more
questions
with
the
indulgence
of
madam
chair.
C
Assemblyman
floors,
thank
you
mark
kruger.
For
the
record.
We
appreciate
your
your
concern
and
I'll
try
to
take
you
through
it
a
little
bit
and
and
then
I'll
invite
both
mr
tucker
and
miss
martin
to
to
supplement
my
answer,
but
basically
it
it's
a
very
simple
process.
The
report
would
come
in
to
us.
C
Let's
say
it's
an
hsr
filing
that
they
could
use
the
hsr
filing,
which
is
the
same
one
that
they're
going
to
be
turning
over
to
the
feds
and
just
give
us
a
copy
of
it,
and
then
it
would
typically
it
let's
go
with
the
other
route.
If
it
wasn't
an
hsr
file
and
if
it
fell
below
the
threshold,
then
it
would
be
a
form
of
one
or
two
pages
that
would
provide
us
an
overview
of
what
what
this
transaction
was
going
to
do.
C
We
would
take
that
and
review
it
and,
yes,
we
may
be
able
to
say:
hey,
let's
discuss
this,
a
little
bit
set
up
meetings,
just
talk
about
it
or
we
may
say
we
need
additional
information
again.
The
important
thing
to
note
is
that
we
already
have
the
authority
under
existing
law
to
issue
a
subpoena
or
a
civil
investigatory
demand
anyway,
so
that
part
of
the
investigation
wouldn't
change
from
what
we
currently
have
authority
to
do.
C
This
just
provides
us
with
notice
up
front
and,
as
mr
tucker
gave
you
in
that
example
that
he
testified
to
a
few
minutes
ago.
It
it's
a
lot
easier
to
know
about
this
stuff
up
front
than
having
to
then
say
to
the
parties:
hey
wait.
We
need
you
to
stay
for
30
or
60
days
or
a
little
time
frame
in
order
for
us
to
then
do
our
investigation
with
delays
that
their
ability
to
go
ahead
and
consummate
that
transaction.
E
The
idea
is,
we
receive
a
re
either
a
copy
of
the
hsr
filing
or
the
one
to
two
page
report.
We
review
it
quickly
and
we
then
determine
whether
or
not
we're
going
to
send
something
out.
We
have,
within
that
30
day
period
to
send
out
a
cid
requesting
and
for
further
information.
We
get
that
information.
E
In
most
cases
we
would
be
satisfied
by
the
way
with
seeing
the
report
and
saying
well,
we
don't
need
to
send
out
a
cid,
sometimes
we'll
say
well,
this
is
a
key
sub-specialty
and
we
should
send
out
a
cit
find
out
more
about
this
transaction
we
find
out,
and
then
we
make
a
decision
as
to
proceed
from
there.
It
just
as
mark
said.
This
really
just
gives
us
a
much
earlier
look
at
transactions
before
they
occur,
and
so
that
is
the
envisioned
process.
G
Thank
you
and
madam
chair.
If
I
could
do
ask
a
follow-up,
thank
you
and
and
again
I
I
apologize
for
approaching
this
conversation
through
such
a
novice
lens,
but
I
wanted
to
touch
upon
the
previous
conver
conversation,
which
was
that
they're
technically
already
doing
this
anyways
with
the
feds
and
so
and
that
you
already
have
the
authority
to
engage
in
this
exploratory
discussion.
G
Logically,
you
wouldn't
know
to
do
that
because
you
don't
know
that
that
relationship
exists
or
that
agreement
is
out
there.
I
completely
understand
that
and
preemptively
you,
you
want
to
know,
what's
happening
so
that
you
can
raise
questions
on
the
front
end
rather
than
the
back
end
completely.
Get
that
I
guess
the
question
I
have
is:
if
they're
reporting
to
the
feds
and
then
reporting
to
the
state
say
the
state
has
a
host
of
questions.
G
Is
there
a
scenario
where
the
feds
aren't
are
going
to
come
back
and
be
asking
for
the
same
exact
thing
or
the
opposite
of
that
which
is
there's
a
scenario
fed
would
say
we're
completely
good
with
that,
but
the
state's
going
to
say
wait
a
minute.
We
have
an
issue
here
and
that
the
ag's
office
is
going
to
do
something
beyond
what
the
feds
would
be
doing.
C
I
hope
I
can
provide
a
little
bit
more
clarity
and,
and
then
you
also
triggered
in
my
mind,
something
you
said
in
your
last
question,
which
was
you
looked
at
the
prior
iteration
of
the
bill
to
what
it
looks
like
now,
and
that's
exactly
what
we
were
talking
about,
how
we
really
worked
hard
with
stakeholders
to
get
it
to
a
very
narrow
focus,
and
the
result
is
this:
if
there
is
a
federal
transaction
that
is
reportable
through
an
hsr
filing,
then
we're
going
to
work
with
the
feds
together
on
that
now.
C
If
there
is
a
component
of
that
federal
transaction
that
is
solely
nevada
related,
then
we
may
look
at
that
from
a
nevada
perspective,
only
in
conjunction
with
the
feds
or
by
ourselves,
and
the
feds
would
defer
to
us
if
it
were
nevada
only,
whereas
in
conjunction
with
them
we
would
work
together
to
make
the
decision
as
a
whole.
Now
we're
also
talking
about
non-federal
reportable
transactions,
so
those
transactions
that
are
solely
within
nevada
and
we
limited
the
bill
to
cover
only
nevada
transactions.
C
C
G
C
A
H
Thank
you,
assemblywoman
kasama
assembly
district
2
for
the
record,
I'm
going
to
copy
assemblyman,
floor's
phrase
of
the
novice
land
regarding
and
he's
an
attorney,
and
so
I'm
very
much
in
that
in
that
novice
land,
and
so
just
a
couple
things
for
me
to
understand-
and
I
don't
know
if
this
is
a
question
that
mr
tucker
is
still
available.
H
He
talked
about
one
transaction
that
it
would
have
been
good
if
he
had
known,
I
think,
ahead
of
time
or
the
issues
going
on
there.
I
don't
know
if
that
investigation
is
still
ongoing
to
one
in
las
vegas.
But
what
was
the
result?
Was
it
that
the
merger
was
stopped
or
is
or
is
it
just
getting
information
ahead
of
time?.
D
Yes,
assembly,
member
lucas
tucker
for
the
record
under
the
statute,
the
information
that
we
obtained
is
confidential
until
or
unless
a
complaint
is
filed
to
enforce
nevada
antitrust
laws,
and
so
all
I
can
say
is
that
in
that
matter
a
complaint
was
not
filed,
and
so
the
outcome
of
the
investigation
is
still
considered
confidential.
D
So
I
can't
really
provide
you
any
details,
other
than
to
say
that
you
know
we
once
we
found
out
about
it,
which
wasn't
until
it
had
closed.
D
We
did
have
concerns,
as
did
the
ftc,
and
because
of
the
timing
that
situation
the
parties
had
to
kind
of
pause,
the
closing
and
hold
their
assets
separate,
and
so
I
think
in
that
situation
it
would
have
been
better
for
all
parties,
our
off
our
office
and
the
merging
parties.
If
we
had
found
out
about
it
before.
H
Yes,
so
I'm
trying
to
understand
that
the
larger
landscape
here
as
well.
So
if,
if
two
providers
I
know
one
of
the
goals-
is
to
keep
costs
down
and
more
choices
of
service,
but
aren't
some
of
these
consolidations
because
either
party
is
losing
money
and
they
can't
they
can't
continue
to
perhaps
subsidize.
H
C
C
It
is
to
make
sure
that
there's
a
robust
market
and
if
there
is
case
such
as
the
example
that
he
gave
where
the
market
isn't
being
affected
because
one
or
the
other
provider
is
going
to
be
going
out
of
business
or
is
so
severely
hamstrung
from
being
able
to
work
that
the
consolidation
actually
looks
like
it
will
actually
reduce
prices.
C
C
Every
factual
situation
is
going
to
require
a
necessity,
a
independent
review,
which
is
why
a
notice
provision
such
as
that,
what
we're
asking
for
makes
the
most
sense
and
early
on
makes
sense
too,
doesn't
necessarily
mean
that
we're
not
going
to
say
yes,
we
don't
have
an
interest
or
yes,
this
go
ahead.
We
don't
this
merger
sounds
like
it
makes
sense.
A
A
A
I
C
Thank
you
so
much
o'neill.
This
is
mark
kruger
for
the
record,
washington
and
connecticut.
Both
have
passed
similar
laws.
I
will
go
ahead
and
let
ms
martin
go
into
the
second
half
of
your
and
try
to
answer
the
second
half
of
your
question
because
she's
up
on
the
information
about
what
effect
it.
C
E
Yeah,
this
is
marine
mart.
Yes,
the
laws
were
passed
in
washington
and
connecticut
as
to
economic
effects.
The
actually
these
laws
have
been
passed
very
recently,
and
it
is
in
response
to
activity
to
ensure
that
we
are
able
to
capture
these
types
of
transactions
earlier
in
terms
of
any
economic
studies
that
have
been
done
in
follow-up,
we
do
not
have
economic
studies
and
follow-up
from
either
of
these
states
to
say.
Yes,
this
resulted
in
lower
prices
or
it
did
not
result
in
lower
crisis.
Increased
quality
of
service
etcetera.
E
However,
certainly
what
we
can
tell
you
is
from
our
state's
perspective,
knowing
about
transactions
earlier
rather
than
later
is
always
good.
The
ability
to
be
able
to
review
them
and
have
an
understanding
of
them
is
is
for
from
our
perspective
and
from
the
perspective
of
the
businesses
who
are
in
engaging
in
these
transactions.
I
think
it's
also
better
for
them
to
be
able
to
engage
with
us
earlier
and
explain
themselves.
E
D
Assembly
member-
this
is
lucas
tucker
for
the
record.
I
just
wanted
to
clarify
that.
I
believe
massachusetts
also
has
some
similar
law.
I
If
I
may,
madam
chair-
and
I
guess
you
know,
we're
short
physicians
and
medical
providers
as
it
is-
and
that's
what
I
was
looking
for
to
see
if
this
bill
helps
attract
more
because
they
feel
that
or
is
an
interference
with
attracting
and
bringing
in
and
improving
our
health
care.
So
that's
what
I
was
looking
for.
I
A
Thank
you
so
much
mr
krieger
miss
martin
and
mr
tucker
for
your
presentation,
saying
no
further
questions.
I
am
going
to
move
into
the
support
portion
of
the
hearing.
I
do
believe
I
have
somebody
signed
up
to
testify
on
video
in
the
support
category.
Mr
james
kemp,
do
we
have
mr
james
kemp.
A
J
J
J
F
Hi,
this
is
maya
holmes.
Can
you
guys
hear
me.
F
Hi,
oh
great,
okay,
thank
you
good
afternoon
chairwoman,
haruki
and
vice
chair
carlton
and
committee
members
for
the
record.
I
am
maya
holmes,
it's
m-a-y-a-h-o-l-m-e-s,
I'm
the
healthcare
research
manager
for
the
culinary
health
fund
and
we
are
a
non-profit
health
fund
that
provides
comprehensive
health
benefits
for
approximately
60
000,
culinary
members
and
their
dependents
about
125
000
lives.
Our
priority
is
ensuring
access
to
high
quality,
affordable
health
care
in
nevada
for
public
and
private
payers
and
patients.
Health
care
dollars
are
precious
and
in
limited
supply.
F
F
Nationally,
there
has
been
tremendous
consolidation
in
the
healthcare
industry,
and
experts
expect
that
to
only
increase
with
covid,
we
must
understand
and
address
those
issues
in
nevada.
We
support,
ab47
and
appreciate
the
attorney
general's
work
on
bringing
this
important
bill
forward.
The
bill
takes
essential
steps
towards
protecting
competition
in
nevada's
healthcare
markets
and
ensuring
nevadans
have
access
to
quality,
affordable
health
care
established
through
a
robust
and
competitive
market.
F
It's
a
very
narrow
list
of
reported
information,
that's
publicly
available,
but
currently
not
collected
or
aggregated
in
a
systematic
way,
that's
really
efficiently
or
easily
available
to
state
agencies.
We
understand
that
there's
certain
information
that
the
ag's
office
needs
to
remain
confidential
for
its
investigations
and
antitrust
work
for
the
with
the
ftc,
doj
and
other
states.
F
Still,
we
do
not
see
how
the
specific
summary
information
listed
in
the
section
falls
into
this
category
connecticut
makes
this
information
available
to
the
public
by
posting
it
on
a
state
agency
website
after
the
transactions
are
done,
and
the
last
point
I
want
to
make
is
one
of
the
patient
protection
commission's
mandates
is
to
examine
the
cost
of
health
care
in
the
primary
factors
impacting
those
costs.
We
know
consolidation
as
a
health
in
health
care
is
a
driving,
if
not
the
driving
factor
in
health
care
costs.
F
J
J
J
I
Thank
you
good
afternoon,
chair
in
the
committee,
I'm
james
kemp,
on
behalf
of
the
nevada
justice
association,
and
we
are
in
support
of
ab47
and
particularly
the
provisions
that
restrict
employment
covenants
not
to
compete,
which
is
section
14
of
the
amendment.
I
We
liked
the
bill
as
originally
proposed
we'd
like
that
better,
it
would
have
completely
eliminated
employment
covenants
not
to
compete,
but
what
we
have
here
in
section
14
of
the
amendment
is
definitely
a
huge
improvement
and
a
positive
step
for
employees
in
nevada.
These
agreements
are
often
merely
designed
to
frighten
employees.
They
have
the
effect
of
suppressing
wages.
It
prevents
employees
from
getting
the
maximum
wage
that
their
talents
will
bring
them
in
a
free
market.
I
It
requires
employees
and
their
families.
To
often
have
financial
difficulties
may
have
to
relocate
to
another
state
out
of
nevada,
and
it
can
have
a
particularly
hardship
effect
on
older
employees
example.
I
have
a
client
now
in
my
employment
law
practice
who
is
in
his
late
60s,
who
is
going
to
be
held
to
a
one-year
covenant
to
compete
when
he's
got
maybe
just
two
or
three
years
left
in
his
working
life
and
he's
only
worked
in
one
industry.
Just
this
one
particular
narrow
industry
is
all
that
he's
ever
worked
in.
I
So
it's
going
to
be
a
a
terrible,
difficult,
terrible
hardship
on
him
and
eliminate
some
of
his
remaining
working
life.
So
these
covenants
not
to
compete.
Any
way
that
we
can
restrict
them
is
something
that
nevada
justice
association
is
in.
I
Favor
of,
I
think
the
fee
shifting
provisions
in
this
will
be
very
helpful,
because
often
employers
do
try
to
enforce
covenants,
not
to
compete
that
are
over
broad
and
unenforceable,
and
this
would
in
this
provision,
employees
would
have
the
ability
to
recover
attorneys
fees
and
costs
if
they're
successful
in
challenging
a
covenant
not
to
compete,
and
that
can
be
important
because,
as
I
often
tell
people
just
having
to
fight
one
of
these
out,
you
lose
because
you
end
up
having
to
pay
money
and
fees
and
costs
and
oftentimes.
I
If
you
lose,
you
can
be
forced
to
pay
fees
and
costs
of
the
employer,
also
the
new
employer.
If
somebody
goes
out
and
gets
a
new
job
and
it
turns
out
to
be
in
violation
to
coveted
not
to
compete,
new
employers
can
often
face
litigation
and
that
certainly
sours
the
new
employment
relationship
as
well.
So
any
restrictions
on
covenants
not
to
compete
are
good
and
the
nevada
justice
association
is
in
favor
of
and
supports
ab47.
In
this
regard,
thank
you.
A
K
Thank
you
chair
good
afternoon,
chair
how
to
get
members
of
the
commerce
and
labor
committee.
My
name
is
jessie
wadhams,
it's
j-e-s-s-e
w-a-d-h-a-m-s,
with
the
law
firm
of
black
and
whatems
appearing
on
behalf
of
the
nevada
hospital
association.
K
First,
I
do
want
to
thank
the
attorney
general's
office
for
their
engagement.
Mr
krueger,
mr
tucker
and
ms
martin
have
been
very
engaged
and
it's
a
great
credit
to
attorney
general
ford's
office.
He
opened
that
statement
and
with
a
working
group
and
has
held
to
that.
K
K
As
representatives
of
nevada's
healthcare
delivery
system,
we
have
put
together
some
joint
comments
with
with
which,
with
your
indulgence,
chair
hotey,
we
will
get
into
the
system.
My
comments
actually
today
are
mostly
actually
based
on
a
slightly
earlier
version
of
the
bill.
I'm
afraid
we
got
a
a
bill.
K
We
got
a
proposed
amendment
on
the
march
11th
and
it
is
slightly
different
on
nellis,
which
appears
about
40
minutes
before
the
hearing.
So,
if
you'll
just
kind
of
indulge
that
I
may
have
a
little
bit
of
cross,
but
we're
we're
still
reviewing
those-
and
at
this
moment
we
are
still
opposed
at
least
on
the
first
meeting,
ultimately
nevada's
hospitals,
I
think,
like
every
other
stakeholder
group
here,
we've
had
transactions
reviewed
by
the
attorney
general's
office,
and
that
process
is
is
not
only
in
depth.
K
It
can
often
result
in
substantial
changes
to
the
transaction,
as
required
by
the
attorney
general's
office,
and
I
do
want
to
make
a
point
clear
that
builds
off
assemblyman
flores
question
earlier.
This
is
not
in
you
know.
This
is
not
the
same
reporting,
as
goes
to
the
federal
trade
commission
under
heart,
scott
rudino.
This
is
a
new
separate
entity,
burden
of
reporting
on
health
care
entities
only,
and
it
is
new,
it
is
different.
It
is
not
in
sync
with
those
standards
at
the
end
of
the
day.
K
K
The
bill
diverges
significantly
from
federal
reporting
standards
and
definitions.
The
report
would
include
granular
data
that
can
be
so
the
subject
of
negotiation
not
only
30
days
prior
to
the
deal
points,
but
throughout
the
entire
negotiation
process.
All
the
way
up
until
the
end-
and
I
do
appreciate
mr
kruger
making
a
note
of
the
the
businesses
providing
services
that
language
to
to
the
lawyers
probably
gets
a
little
into.
K
You
know,
there's
a
lot
of
things
that
could
fall
under
that
definition,
so
I
do
think
that
that
will
need
some
additional
work.
Washington
and
connecticut.
Those
are
the
two
I've
looked
at
mr
tucker
references
massachusetts
and
I'm
not
familiar
with
that
one,
but
neither
of
those
states
go
so
far
and
and
require
the
level
of
reporting
or
this
particular
definition
of
material
change.
K
Section
7
sub
10
has
changed
a
fair
bit,
so
I
do
want
to
spend
a
little
time
looking
at
that,
but
that's
that
material
change
standard.
I
do
know
that
that's
again,
washington
and
connecticut
have
a
much
more
defined
version.
That
gives
you
a
little
bit
more
understanding
of
the
reporting
parameters.
K
A
lot
of
this
also
sweeps
in
a
lot
of
internal
contracts,
a
lot
of
things
that
are
not
consumer
facing
at
all,
even
those
that
are
even
within
a
parent
subsidiary
in
the
same
company.
So
looking
again,
and
then
you
look
at
the
burden
a
thousand
dollar
day
for
fines
that
are
on
the
new
these
on
a
small
subset
of
reporting
entities
for
all
manner
of
transaction.
K
Not
only
is
a
thousand
dollar
a
day
penalty,
but
let's
not
forget
that
nrs
598a
has
criminal
penalties
attached
to
it.
This
is
a
criminal
statute
and
while
it's
a
subtle
point,
I
also
want
to
make
a
note
of
the
change
in
section
10
to
add
agencies,
boards
and
commissions
to
the
oversight
authority
of
the
attorney
general's
office,
those
particular
entities.
K
Those
will
often
have
market
participants
and
are
part
of
the
regulatory
oversight
of
a
particular
agency,
and
I
think
that
raises
certain
review
constitutional
issues
that
the
supreme
court,
I
think,
has
looked
at
even
as
recently
as
the
north
carolina
ftc
case.
A
I
know
I
do
have
a
few
more
people
signed
up
to
testify
proposition.
I'm
sorry!
I
just
wanted
to
see
if
you
could
wrap
up
your
reports
and
if
there
is
something
in
writing
to
send
over
to
our
committee
manager
to
share
with
the
committee.
K
You
got
it
and,
let
me
just
simply
say
at
the
end,
we
are
still
concerned
about
the
chilling
effect
on
the
movement
of
capital,
the
ability
to
recruit
physicians
and
the
new
mandate
on
on
providers
in
the
middle
of
a
pandemic
that
is
still
going
on,
but
we'll
work
with
the
attorney
general's
office.
So
I'll
keep
you
posted.
A
I
I
am
thank
you,
madam
chair
and
members
of
the
committee
for
for
allowing
us
to
sit
at
the
table,
as
you
might
have,
you
know
what
we
might
have
done
in
the
past.
With
mr
waters
he
has
outlined
our
concerns.
I
We've
enjoyed
working
with
the
nevada
hospital
association
and
also
with
the
nevada,
medical
association,
three
folks,
three
groups
that
don't
normally
sit
at
the
table
together
on
these
particular
issues.
Mr
wadhams
has
outlined
our
concerns
quite
well,
and
I
would
yield
my
time
to
others
that
come
forward
in
opposition.
Thank
you,
madam
chair.
A
G
You,
madam
chair,
if
I
could
ask
for
a
point
of
clarification
and
I
apologize
for
speaking
at
a
turn,
I
just
want
to
make
sure
that
I'm
looking
at
the
right
document,
I
heard
mr
adams
reference
section
7
sub
10.,
but
I'm
I'm
looking
at
the
the
amended
document
that
was
provided
and
attached
to
nellis
as
an
exhibit.
G
G
C
Madam
chair
mark
kruger,
I
think
I
can
provide
some
information
on
this.
Thank
you,
madam
chair
members
of
committee,
assemblyman
flores
that
the
I
think
mr
ron
misspoke,
because
he
was
looking
at
a
prior
irradiation
of
the
amendments.
The
current
amendment
you
are
looking
at
was
the
one
that
was
sent
in
and
the
language
specific
language
that
mr
williams
was
referring
to
is
in
section
six
sub
paragraph
eight.
A
A
J
J
I
This
is
george
ross
g-e-o-r-g-e
r-o-s-s
speaking
on
behalf
of
hca
health
hca
opposes
he
ab47
I'll,
make
it
clear
that
we
really
appreciate
the
opportunity.
The
attorney
general
has
given
our
industry
and
us
to
participate
and
tr
and
the
preliminary
versions
of
this
bill
and
to
make
our
concerns
known
and
we
we
do
know
he
has
made
a
number
of
changes.
However,
we
echo
the
concerns
of
the
nevada
hospital
association.
I
In
particular,
we
are
concerned
about
the
reporting
that's
required
beyond
mergers
and
acquisitions.
Quite
simply,
those
requirements
will
directly
impact
negatively
the
industry's
ability
to
provide
quality
care
in
a
timely
and
cost
effective
manner.
Thank
you.
J
J
B
Six
hi:
this
is
peter
guzman,
president
of
the
latin
chamber
of
commerce.
Thank
you
for
allowing
me
to
speak
for
a
few
minutes.
The
latin
chamber
supports
the
general
concept
of
punishing
bad
actors,
but
at
this
time
must
join
some
of
our
colleagues
in
opposing
this
bill.
As
currently
written,
we
appreciate
the
attorney
general's
office
working
with
the
business
community.
B
However,
this
bill
will
have
a
negative
impact
on
our
very
important
health
care
partners
and
members,
particularly
as
the
pandemic
continues.
We
look
forward
to
continuing
the
conversations
with
the
attorney
general's
office
regarding
our
concerns.
Thank
you,
chair
and
committee
members
for
your
time
today.
J
B
B
Good
afternoon
madam
chair
chair,
how
to
get
members
of
the
committee,
my
name
is
jaren
hildebrand
and
I
am
the
executive
director
of
the
nevada
state
medical
association,
which
represents
nevada's
position.
While
our
membership
consists
of
doctors
across
the
state,
we
are
first
and
foremost
a
patient
advocacy
organization.
B
Today,
I
am
testifying
in
opposition
to
ab47.
While
we
appreciate
the
communication
with
the
bureau
of
consumer
protection,
and
we
recognize
this
bill
has
been
narrowed
likely
as
a
result
of
many
conversations
we
have
had
on
this
proposal.
However,
the
draft
remains
overly
broad
and
places
unnecessary
burdens
on
health
care
providers.
B
This
bill
will
place
additional
administrative
paperwork
on
our
doctors
and
their
staff
at
a
time
when
we
are
responding
to
a
global
pandemic
and
still
facing
six
percent
medicaid
cuts,
while
this
increase
in
healthcare's
costs
and
reduce
access
by
taking
the
physicians
attention
away
from
their
patients,
most
of
our
contract
contractions
are
not
transactions.
Excuse
me
are
not
a
concern
and
it
can't
be
emphasized
enough
that
the
attorney
general
already
has
the
ability
to
intervene
where
there
is
a
reason
for
concern.
B
Two
primary
doctors
in
southern
southern
reno
and
south
reno,
who
see
dozens
of
patients
a
day,
must
merge
to
save
an
administrative
and
building
costs.
Keeping
up
and
possibly
expanding
their
patient
base
all
positive
things.
This
type
of
transaction
should
not
be
viewed
as
anti-competitive,
behavior
and
additional
burdens
should
not
be
placed
on
these
types
of
small
family
oriented
community
health
care
providers.
B
This
bill,
as
presumes
that
all
health
care
transactions,
are
suspect
and
will
likely
have
a
chilling
effect
on
our
system
of
health
care,
which
will
negatively
affect
nevada
families
and
your
constituents.
Small
practices
throughout
the
state
which
are
included
in
this
bill
are
facing
lower
than
normal
patient
volumes
due
to
the
pandemic.
B
Physicians
want
to
care
for
their
patients.
They
are
healers
this
at
its
heart
of
what
they
do
every
single
day
and
that
the
old
that
they
take
under
nsma
understand
the
importance
of
a
strong
consumer
protection
bureau,
but
we
believe
it
is
unclear
how
requiring
extensive
reporting
on
small
practices,
which
will
strengthen
the
mission
of
the
the
bureau
of
consumer
protection
and,
most
importantly,
we
believe
ab47
as
currently
drafted,
will
reduce
access
to
care,
which
is
why
we
still
stand
in
opposition
today.
Thank
you,
madam
chair,
and
I
apologize.
B
A
J
B
K
h
n
with
the
vegas
chamber
first
I'd
like
to
thank
the
attorney
general's
office
on
their
average,
the
business
community
regarding
ab47,
I
appreciate
their
openness
in
receiving
feedback
as
we
work
through
our
concerns
about
this
bill.
I
would
like
to
thank
mark
kruger
with
ag's
office
for
facilitating
many
conversations
and
for
several
drafts
that
we've
been
working
from.
B
in
the
original
draft.
The
merchant
acquisition
piece
where
we
were
concerned
about
the
broad
scope
of
how
to
impact
nevada's
business
climate,
and
we
believe
that
the
latest
draft
in
narrowing
the
language
mitigates
many
of
those
concerns.
B
This
includes
how
this
bill
will
overlay
with
the
federal
regulations
of
the
heart
scott
riondo
act,
the
confidentiality
of
the
document
documents
and
the
penalty
structure,
to
mention
a
few,
but
we
know
there's
still
an
opportunity
to
address
those
concerns,
and
we
appreciate
that
from
the
attorney
general's
office
with
that
said,
we'll
make
the
commitment
to
continue
to
work
with
the
attorney
general's
office
to
find
a
solution
that
will
help
us
address
the
nexus
of
the
bill.
Thank
you,
madam
chair
and
members
of
the
committee
for
your
time
today.
J
L
Good
afternoon,
tara,
howdaghi
and
committee
members,
my
name
is
leslie
pittman,
l-e-s-l-e-y,
p-I-t-t
m-a-n,
and
I'm
here
today,
representing
reno
diagnostic
centers.
The
only
independently
owned
diagnostic
imaging
facility
in
all
of
northern
nevada,
with
two
locations
in
washoe
county
rdc
has
been
in
business
for
more
than
30
years.
Has
three
board
certified
radiologists
on
staff
were
the
first
to
bring
mri
technology
to
nevada
and
serve
thousands
of
residents
annually
throughout
northern
and
rural
nevada.
L
We
appreciate
the
attorney
general's
intent
behind
ab47
to
provide
greater
oversight
of
mergers
and
acquisitions
to
help
ensure
the
results
of
these
activities.
Do
not
negatively
impact
nevadans
by
reducing
choice
and
increasing
costs
in
the
health
care
marketplace
through
consolidation.
We've
also
appreciated
the
opportunity
to
share
our
concerns
with
the
attorney
general's
team.
L
However,
we
remain
concerned
with
how
this
bill
would
go
about
achieving
its
objectives,
namely,
we
are
concerned
with
the
definition
of
group
practice
in
section
six
says:
quote
two
or
more
providers
and
subjecting
small
operations
like
ours
to
the
reporting
requirements
outlined
in
section
2..
It's
important
to
note
that
each
new
regulation
or
requirement
that
is
mandated
on
small
healthcare
operations
comes
with
increased
costs,
as
it
often
requires
the
hiring
of
additional
staff
or
increased
time
and
paperwork
for
existing
staff
to
maintain
compliance.
L
Any
new
mandates
must
be
considered
judiciously
as
they
come
with
the
reduced
ability
of
smaller
operators
to
compete
with
larger
provider
organizations,
as
I
mentioned,
rdc
has
been
in
operation
for
more
than
30
years.
During
that
time,
they
have
been
on
the
receiving
end
of
many
acquisition
offers.
J
M
Good
afternoon,
chair
and
members
of
the
committee
for
the
record-
it's
jessica
ferrato
here
today
on
behalf
of
the
college
of
emergency
physicians,
just
as
some
background
way
of
background
emergency
physicians
are
the
front-line
workers.
As
you
all
know,
working
through
this
pandemic
to
care
for
our
most
vulnerable
populations,
we're
not
able
to
take,
we
are,
we
have
to
take
all
and
every
single
patient
that
comes
through
the
door
and
and
the
pandemic
has
illustrated
the
shortage
that
we
have
statewide.
M
M
We
also
have
concerns
in
section
five
on
the
civil
penalties
which
feel
relatively
heavy-handed,
as
it
will
be
a
thousand
dollars
per
day
for
violations
without
any
language
on
willful
violations
or
otherwise.
Again,
we
look
forward
to
continuing
our
work
with
the
attorney
general's
office
and
appreciate
your
time.
J
N
N-I-C-K-V-A-N-D-E-R-P-O-E-L
with
capital
partners
today
representing
the
reno
sparks
chamber
of
commerce.
While
we
appreciate
attorney
general
ford
and
his
office
working
with
stakeholders-
and
I
can
say
it
was
a
very
healthy
conversation
on
assembly,
bill
47
and
we
found
some
common
ground
but
in
the
end,
are
still
opposed
to
the
bill
as
written.
We
share
the
same
concerns
that
some
of
my
colleagues
outlined
before
me
and
and
the
potential
implications
the
bill
would
have
on
on
health
care
in
nevada,
so
I'll
keep.
It
short,
as
many
have
reiterated
what
has
already
been
said.
J
B
B-R-Y-A-N-W-A-C-H-T-E-R
senior
vice
president,
with
the
retail
association
of
nevada
in
the
interest
of
time.
I
would
just
like
to
echo
the
comments
of
paul
merakin
at
the
vegas
chamber,
and
we
appreciate
the
attorney
general's
office
for
working
with
stakeholders
on
ab47
and
at
the
moment
we
are
in
opposition
to
the
bill.
F
F
I
also
want
to
appreciate,
say
we
appreciate
the
attorney
general's
office
and
certainly
mr
kruger's
willingness
to
work
with
stakeholders,
and
we
too
echo
a
lot
of
the
sentiments
that
our
our
friends
in
healthcare
had
expressed
earlier
today,
just
as
a
maybe
perhaps
a
newer
aspect
that
our
organization
remains
in
opposition
to
is
really
in
regards
to
section
14
of
this
proposed
bill
which
really
seeks
to
amend
nrs
613,
as
it
would
apply
to
all
employers
not
limited
solely
to
health
care
entities.
F
F
We
also
believe
effective
rules
are
already
in
place
to
protect
these
workers,
who
are
not
violating
non-competes,
and
that
this
should
still
bear
out
in
court
as
it
stands.
We
would
like
to
see
ab47
continue
to
be
refined.
We
can
continue
to
remain
committed
to
ongoing
conversations,
and
we
thank
you
for
your
time.
J
N
C-H-R-I-S-B-O-S-S-E,
I'm
representing
renowned
health
for
the
record
today,
I'm
here
testifying
in
opposition
to
ab47.
While
we
very
much
appreciate
the
open
process,
the
attorney
general
and
staff
have
provided
on
this
complex
bill.
We
believe
the
current
version
of
this
bill
still
does
not
address
our
concerns
regarding
the
impacts
of
the
significant
reporting
requirements
and
protect
potential
gaps
in
confidentiality.
N
Protections
could
have
on
the
health
care
industry.
This
is
why,
and
we
agree
with
the
attorney
general's
office,
the
ag
already
has
the
authority
to
access
any
documents,
information
or
information
related
to
antitrust
matters,
we're
supportive
of
reasonable
transparency,
but
would
like
to
see
some
narrowing
of
scope
of
transactions
that
need
to
be
reviewed
so
not
to
put
an
unreasonable
burden
on
health
care
providers
and
facilities.
N
A
J
A
C
And
tara,
how
did
you
thank
you
mark
kruger
for
the
record?
I
would
I'll
keep
them
very
brief.
Madam
chair
members
of
the
committee,
thank
you
for
your
consideration
of
ad47.
To
be
clear.
The
intent
and
of
this
first
focus
of
ab47
is
to
allow
the
antitrust
team
an
opportunity
to
take
a
peek
at
transactions
that
may
very
well
affect
the
cost
of
healthcare
in
nevada
and
ensure
competition
in
the
health
care
market
for
lower
costs.
C
The
simple
one
to
two-page
report
is
not
related
to
the
recruitment
or
retention
of
physicians
in
nevada.
It
is
not
onerous
and
is
in
the
best
interest
of
the
state
and
all
the
parties
to
a
health
care
transaction.
In
addition,
the
intent
is
to
limit
the
scope
to
health
care
transactions,
not
capture
janitorial
type
contracts.
The
penalties
are
up
to
a
thousand
dollars
per
day,
allowing
for
that
discretion
of
up
to,
but
strong
enough
to
discourage
blatant
disregard.
C
A
Thank
you,
mr
krueger.
I
will
now
close
the
hearing
on
assembly
bill
47.
The
last
item
on
our
agenda
today
is
public
comment.
While
we
give
those
listening
over
the
internet
an
opportunity
to
call
in,
I
will
read
through
some
public
comment
housekeeping,
I
would
like
to
remind
the
public
who's
listening.
That
public
comment
is
an
opportunity
to
discuss
general
matters
that
fall
within
the
purview
of
this
committee.
The
public
has
already
been
given
time
to
support
or
oppose
a
specific
legislation.
A
A
We
may
limit
public
comment
to
two
minutes.
Please
remember
to
address
your
remarks
to
issues
that
fall
within
the
jurisdiction
of
the
commerce
and
labor
committee.
If
you
direct
your
remarks
to
issues
over
which
this
committee
has
no
oversight,
I
will
ask
you
to
redirect
or
terminate
your
remarks.
Please
be
respectful
of
committee
members
and
other
witnesses.
Do
not
comment
on
testimony
testimony
provided
by
other
speakers
and
do
not
make
personal
attacks.
A
J
J
O
Six,
thank
you
for
your
patience.
Everyone.
My
name
is
jc
john
carlow
j-o-h-n-c-a-r-l-o
and
I
need
all
the
senators
from
vegas
to
listen
from
clark
county.
O
I've
got
a
lot
here,
so
basically
I
do
think
we
need
to
entice
doctors
to
come
here,
so
you
all
should
listen
to
that
and
then
also
you
see
the
highest.
We
have
the
we
have
some
of
the
highest
car
insurance
rates
in
america,
so
I'd
like
for
you
guys
to
try
to
lower
that
for
us
and
the
state
should
say
something
about
electric
car
failures.
O
Failures
should
lower
the
luxury
car
cost,
which
would
lower
help
lower
our
insurance
rates
for
your
information
insurance
rates
and
don't
pass
state
legislation
that
is
going
to
increase
insurance
policies
like
girls
getting
hurt
against
boys
competing
in
high
school.
So
I
want
to
stand
up
for
the
young
girls
that
have
to
compete
against
boys.
O
I
don't
think
that
was
the
right
move
by
some
of
y'all.
Illegal
immigration
hurts
the
wage
of
american
workers,
so
you
guys
the
state
should
be
doing
something
like
taking
businesses
licenses.
O
O
Yeah,
so
illegal
immigration,
you
guys
need
to
do
something
about
that,
because
you
guys
are
basically
enticing
immigrants
to
come
to
nevada,
which
will
raise
our
medicare
costs.
It
will
raise
teachers
costs.
It
will
raise
the
cost
of
many
other
things,
so
this
topic
has
been
long
past
due
yeah
all
right.
Thank
you
guys.
That's
it.
A
A
Thank
you
broadcasting
and
thank
you
committee
members
and
thank
you
presenters
and
those
testifying.
I
know
we're
still
working
through
virtual
meetings,
so
I
appreciate
everyone's
patience
as
we
work
through
the
technicalities
of
virtual
meetings.
With
that,
our
that
wraps
up
our
committee
meeting
for
today
our
next
meeting
will
be
on
wednesday
at
1
30..
Thank
you
committee
members.
We
are
adjourned.