Nevada regulates PBM conduct but does not protect pharmacy reimbursement directly. Its PBM statutes (NRS 683A.178–.179) impose a fiduciary duty to the plan, require conflict-of-interest disclosure, bar gag clauses on cheaper alternatives, and prevent a copay larger than what the PBM pays the pharmacy — but there is no MAC pricing or appeal mechanism and no reimbursement floor.
The only major 2025 reform enacted, SB 389, requires Nevada Medicaid to use a single PBM (prohibited from spread pricing) by 2030. That restructures Medicaid procurement; it is not a pharmacy reimbursement floor.