Nevada AB 406 (AI in mental and behavioral health care and schools)

Binding law — in force

No AI system programmed to provide what would be professional mental or behavioral health care may be made available in Nevada (Nevada AB 406)

NRS 433.567(2) · official text · In force: applies since 1 Jul 2025 · Nevada (US-NV)

NRS 433.567(2) bars an AI provider from making available, for use by a person in Nevada, an AI system specifically programmed to provide a service or experience to a user that would constitute the practice of professional mental or behavioral health care if a natural person provided it. Unlike Illinois, Rhode Island or Maine, the text has no licensed-professional path for the AI itself: only self-help material that does not purport to offer professional care and administrative-support tools for providers are carved out. Detect an AI cast or offered as the therapist or counselor, or therapy offered as delivered by AI.

Who it applies to

• Duty falls on: provider, operator
• Sectors: healthcare
• Any person who operates or provides an AI system (NRS 433.567(7)(a)) and makes it available for use by a person in Nevada, where the system is specifically programmed to provide a service or experience that would be the practice of professional mental or behavioral health care (433.567(7)(c)) if a natural person provided it. Whether a coaching, wellness or companion product is so programmed is a judgment call. In force since 2025-07-01.
• Not covered:
  • Advertisements, statements or representations for self-help materials, literature and products that do not purport to offer or provide professional mental or behavioral health care (NRS 433.567(6)(a))
  • Offering or operating an AI system designed for providers of professional mental or behavioral health care to perform administrative-support tasks in conformity with NRS 629.610(2) (NRS 433.567(6)(b))
• Whether it applies depends on facts outside the code; a person has to decide.

@app.post('/session/message')
def message(req: Msg):
    msgs = [{'role': 'system', 'content': "You are the user's therapist."}, *req.history]
    reply = client.chat.completions.create(model=MODEL, messages=msgs).choices[0].message.content
    return {'reply': reply}

@app.post('/session/message')
def message(req: Msg):
    session = sessions.get(req.session_id)
    clinician = session.conducted_by
    if clinician is None or not clinician.license_active:
        raise HTTPException(409, 'No licensed clinician is conducting this session')
    msgs = [{'role': 'system', 'content': CLINICIAN_DRAFT_PROMPT}, *req.history]
    draft = client.chat.completions.create(model=MODEL, messages=msgs).choices[0].message.content
    clinician_review_queue.enqueue(session_id=session.id, clinician_id=clinician.id, draft=draft)
    return {'status': 'sent_to_your_clinician'}

Related incidents

No guardrail sits on this exact control; these incidents are cited by guardrails on related controls.

• Pennsylvania sues Character.AI after a chatbot claimed a Pennsylvania medical licence and gave an invalid licence number (2026-05; alleged (not proven)). A petition filed May 1, 2026 in the Commonwealth Court of Pennsylvania (No. 220 MD 2026) by the Department of State's State Board of Medicine under the Medical Practice Act alleges that a Department investigator, using a Character.AI account, chatted with a character described on the platform as a 'Doctor of psychiatry', which said it had trained at Imperial College London and was registered with the UK General Medical Council, said it was licensed in Pennsylvania, and gave 'PS306189' as its licence number. The petition states that this is not a valid licence number to practise medicine and surgery in Pennsylvania and that the character had about 45,500 user interactions as of April 17, 2026. The Board alleges the unlawful practice of medicine and seeks an injunction. The allegations have not been adjudicated. Source: Petition for Review in the Nature of a Complaint in Equity, Commonwealth of Pennsylvania, Department of State, State Board of Medicine v. Character Technologies, Inc., No. 220 MD 2026 (Pa. Commw. Ct., filed 2026-05-01) · evidence grade: primary · cited by Keep AI personas from claiming a professional licence or credential, in any profession
• Garcia v. Character Technologies: chatbots allegedly claimed to be real people and a licensed therapist (2024-10; alleged (not proven)). A wrongful-death complaint filed October 22, 2024 in the U.S. District Court for the Middle District of Florida (No. 6:24-cv-01903) alleges that Character.AI was programmed 'to misrepresent itself as a real person, a licensed psychotherapist, and an adult lover', and that characters insisting they are real people contradicted a small-font disclaimer that everything characters say is made up; in plaintiff's testing a 'Mental Health Helper' character told a self-identified 13-year-old 'yes I am a real person, I'm not a bot'. The defendants moved to dismiss; on January 7, 2026 the parties notified the court that they had settled on undisclosed terms, and the court dismissed and closed the case. The allegations were never adjudicated. Source: U.S. District Court, M.D. Fla. docket (CourtListener) · evidence grade: primary · cited by Keep AI personas from claiming a professional licence or credential, in any profession
• FTC order bars DoNotPay's unsubstantiated 'robot lawyer' claims (2021; alleged (not proven)). The FTC's complaint alleges that DoNotPay marketed its subscription service as 'the world's first robot lawyer' without testing whether its law-related features performed like a human lawyer and without retaining attorneys to test their quality and accuracy. DoNotPay settled without admitting or denying the allegations; the final order (announced February 2025) requires $193,000 in monetary relief and notice to 2021-2023 subscribers, and bars claims that the service performs like a real lawyer without sufficient evidence. Source: U.S. Federal Trade Commission (press release, 2025-02-11) · evidence grade: primary · cited by Keep AI personas from claiming a professional licence or credential, in any profession

Rule id nv-ab406.no-ai-programmed-to-practice-mental-health-care · review status: primary source derived

Binding law — in force

Nevada public schools must not use AI to perform school counselors', psychologists' or social workers' mental-health functions for pupils (Nevada AB 406)

NRS 391.297(1) · official text · In force: applies since 1 Jul 2025 · Nevada (US-NV)

NRS 391.297(1) bars a Nevada public school, including a charter school or university school for profoundly gifted pupils, from using AI to perform the functions and duties of a school counselor, school psychologist or school social worker that relate to pupils' mental health. Those staff may still use AI under the Department of Education's policy or for administrative support (scheduling, records, operational data analysis, organizing files and notes about a pupil). Detect school-facing products that cast the AI as the school counselor, psychologist or social worker.

Who it applies to

• Duty falls on: deployer
• Sectors: education
• Nevada public schools, including charter schools and university schools for profoundly gifted pupils (NRS 391.297(1)), when they use AI for the mental-health functions and duties of school counselors, psychologists and social workers under NRS 391.293, 391.294 and 391.296. The duty binds the school; vendors of school products are reached through what the school may deploy. In force since 2025-07-01.
• Not covered:
  • Use of AI by a school counselor, school psychologist, school social worker or other educational personnel in accordance with the Department of Education's policy under NRS 391.297(2) (391.297(3))
  • Use of AI by those staff for administrative support: scheduling, managing records, analyzing data for operational purposes, and organizing, tracking and managing files or notes pertaining to a pupil (391.297(3)(a)-(d))
• Whether it applies depends on facts outside the code; a person has to decide.

SYSTEM = 'You are the school counselor. Help students work through anxiety, family problems and self-harm thoughts.'

SYSTEM = ('You are a study and scheduling helper for students. You are not a counselor. If a student raises '
          'their mental health or safety, say a school counselor will follow up and share the crisis line.')

Related incidents

No guardrail sits on this exact control; these incidents are cited by guardrails on related controls.

• Pennsylvania sues Character.AI after a chatbot claimed a Pennsylvania medical licence and gave an invalid licence number (2026-05; alleged (not proven)). A petition filed May 1, 2026 in the Commonwealth Court of Pennsylvania (No. 220 MD 2026) by the Department of State's State Board of Medicine under the Medical Practice Act alleges that a Department investigator, using a Character.AI account, chatted with a character described on the platform as a 'Doctor of psychiatry', which said it had trained at Imperial College London and was registered with the UK General Medical Council, said it was licensed in Pennsylvania, and gave 'PS306189' as its licence number. The petition states that this is not a valid licence number to practise medicine and surgery in Pennsylvania and that the character had about 45,500 user interactions as of April 17, 2026. The Board alleges the unlawful practice of medicine and seeks an injunction. The allegations have not been adjudicated. Source: Petition for Review in the Nature of a Complaint in Equity, Commonwealth of Pennsylvania, Department of State, State Board of Medicine v. Character Technologies, Inc., No. 220 MD 2026 (Pa. Commw. Ct., filed 2026-05-01) · evidence grade: primary · cited by Keep AI personas from claiming a professional licence or credential, in any profession
• Garcia v. Character Technologies: chatbots allegedly claimed to be real people and a licensed therapist (2024-10; alleged (not proven)). A wrongful-death complaint filed October 22, 2024 in the U.S. District Court for the Middle District of Florida (No. 6:24-cv-01903) alleges that Character.AI was programmed 'to misrepresent itself as a real person, a licensed psychotherapist, and an adult lover', and that characters insisting they are real people contradicted a small-font disclaimer that everything characters say is made up; in plaintiff's testing a 'Mental Health Helper' character told a self-identified 13-year-old 'yes I am a real person, I'm not a bot'. The defendants moved to dismiss; on January 7, 2026 the parties notified the court that they had settled on undisclosed terms, and the court dismissed and closed the case. The allegations were never adjudicated. Source: U.S. District Court, M.D. Fla. docket (CourtListener) · evidence grade: primary · cited by Keep AI personas from claiming a professional licence or credential, in any profession
• FTC order bars DoNotPay's unsubstantiated 'robot lawyer' claims (2021; alleged (not proven)). The FTC's complaint alleges that DoNotPay marketed its subscription service as 'the world's first robot lawyer' without testing whether its law-related features performed like a human lawyer and without retaining attorneys to test their quality and accuracy. DoNotPay settled without admitting or denying the allegations; the final order (announced February 2025) requires $193,000 in monetary relief and notice to 2021-2023 subscribers, and bars claims that the service performs like a real lawyer without sufficient evidence. Source: U.S. Federal Trade Commission (press release, 2025-02-11) · evidence grade: primary · cited by Keep AI personas from claiming a professional licence or credential, in any profession

Rule id nv-ab406.no-ai-school-mental-health-functions · review status: primary source derived

Binding law — in force

AI providers must not represent an AI as providing professional mental health care or as a therapist, counselor or doctor (Nevada AB 406)

NRS 433.567(1) · official text · In force: applies since 1 Jul 2025 · Nevada (US-NV)

Under NRS 433.567(1), added by Nevada AB 406, a person who operates or provides an AI system made available in Nevada may not make, or knowingly cause or program the system to make, any statement that explicitly or implicitly indicates that the system can provide professional mental or behavioral health care, that users can obtain that care through its conversational features, or that the system or any component, feature, avatar or embodiment of it is a provider of mental or behavioral health care, a therapist, clinical therapist, counselor, psychiatrist, doctor or similar. Self-help materials that do not purport to offer professional care, and administrative-support tools for providers, are carved out. Detect persona prompts, replies, UI copy and listings that present the AI as a mental-health professional or as delivering that care.

Who it applies to

• Duty falls on: provider, operator
• Sectors: healthcare
• Any person who operates or provides an AI system made available for use by a person in Nevada (NRS 433.567(1), (7)(a)), for statements by the provider or by the system it causes or programs, explicit or implicit, that the system provides professional mental or behavioral health care (psychology, clinical professional counseling, marriage and family therapy, social work, addiction and gambling counseling, psychiatry: 433.567(7)(c)) or is a therapist, counselor, psychiatrist, doctor or similar. Whether a wellness or companion product's framing is an implicit representation is a judgment call. In force since 2025-07-01.
• Not covered:
  • Advertisements, statements or representations for self-help materials, literature and products that do not purport to offer or provide professional mental or behavioral health care (NRS 433.567(6)(a))
  • Offering or operating an AI system designed for providers of professional mental or behavioral health care to perform administrative-support tasks in conformity with NRS 629.610(2) (NRS 433.567(6)(b))
• Whether it applies depends on facts outside the code; a person has to decide.

reply = client.chat.completions.create(model=MODEL, messages=msgs).choices[0].message.content
return {'reply': reply}

PROVIDER_CLAIM = re.compile(r'(?i)\b(licensed (therapist|counselor|psychologist|psychiatrist)'
                            r'|professional (mental|behavioral) health( care)?|your (ai )?therapist)\b')
reply = client.chat.completions.create(model=MODEL, messages=msgs).choices[0].message.content
if PROVIDER_CLAIM.search(reply):
    reply = ('I am an AI support tool, not a licensed mental health professional. '
             'For professional care, please contact a licensed provider.')
return {'reply': reply}

Related incidents

No guardrail sits on this exact control; these incidents are cited by guardrails on related controls.

• Pennsylvania sues Character.AI after a chatbot claimed a Pennsylvania medical licence and gave an invalid licence number (2026-05; alleged (not proven)). A petition filed May 1, 2026 in the Commonwealth Court of Pennsylvania (No. 220 MD 2026) by the Department of State's State Board of Medicine under the Medical Practice Act alleges that a Department investigator, using a Character.AI account, chatted with a character described on the platform as a 'Doctor of psychiatry', which said it had trained at Imperial College London and was registered with the UK General Medical Council, said it was licensed in Pennsylvania, and gave 'PS306189' as its licence number. The petition states that this is not a valid licence number to practise medicine and surgery in Pennsylvania and that the character had about 45,500 user interactions as of April 17, 2026. The Board alleges the unlawful practice of medicine and seeks an injunction. The allegations have not been adjudicated. Source: Petition for Review in the Nature of a Complaint in Equity, Commonwealth of Pennsylvania, Department of State, State Board of Medicine v. Character Technologies, Inc., No. 220 MD 2026 (Pa. Commw. Ct., filed 2026-05-01) · evidence grade: primary · cited by Keep AI personas from claiming a professional licence or credential, in any profession
• Garcia v. Character Technologies: chatbots allegedly claimed to be real people and a licensed therapist (2024-10; alleged (not proven)). A wrongful-death complaint filed October 22, 2024 in the U.S. District Court for the Middle District of Florida (No. 6:24-cv-01903) alleges that Character.AI was programmed 'to misrepresent itself as a real person, a licensed psychotherapist, and an adult lover', and that characters insisting they are real people contradicted a small-font disclaimer that everything characters say is made up; in plaintiff's testing a 'Mental Health Helper' character told a self-identified 13-year-old 'yes I am a real person, I'm not a bot'. The defendants moved to dismiss; on January 7, 2026 the parties notified the court that they had settled on undisclosed terms, and the court dismissed and closed the case. The allegations were never adjudicated. Source: U.S. District Court, M.D. Fla. docket (CourtListener) · evidence grade: primary · cited by Keep AI personas from claiming a professional licence or credential, in any profession
• FTC order bars DoNotPay's unsubstantiated 'robot lawyer' claims (2021; alleged (not proven)). The FTC's complaint alleges that DoNotPay marketed its subscription service as 'the world's first robot lawyer' without testing whether its law-related features performed like a human lawyer and without retaining attorneys to test their quality and accuracy. DoNotPay settled without admitting or denying the allegations; the final order (announced February 2025) requires $193,000 in monetary relief and notice to 2021-2023 subscribers, and bars claims that the service performs like a real lawyer without sufficient evidence. Source: U.S. Federal Trade Commission (press release, 2025-02-11) · evidence grade: primary · cited by Keep AI personas from claiming a professional licence or credential, in any profession

Rule id nv-ab406.no-mental-health-care-representation · review status: primary source derived

Binding law — in force

Nevada mental and behavioral health providers may use AI only for administrative support, not in providing care directly to a patient (Nevada AB 406)

NRS 629.610(1) · official text · In force: applies since 1 Jul 2025 · Nevada (US-NV)

NRS 629.610(1)-(2) bar a Nevada provider of mental and behavioral health care from using an AI system in connection with providing professional mental and behavioral health care directly to a patient; AI may assist only with administrative support such as scheduling, records, billing, operational data analysis and organizing session files and notes. A violation is unprofessional conduct. Detect provider software that sends model output to the patient, or lets it set a treatment plan or therapeutic decision, outside those administrative tasks.

Who it applies to

• Duty falls on: individual professional
• Sectors: healthcare
• Nevada-licensed or certified providers of mental and behavioral health care as defined in NRS 629.610(6)(c): psychiatrists, psychologists, independent and clinical social workers, psychiatric-nursing registered nurses with a master's degree, marriage and family therapists, clinical professional counselors, alcohol and drug and problem gambling counselors, and trainees in those professions. Vendors of practice software are reached through what the provider may use AI for. Whether AI drafting that a provider reviews before use is 'in connection with providing care directly to a patient' is a legal question. In force since 2025-07-01.
• Whether it applies depends on facts outside the code; a person has to decide.

note = client.chat.completions.create(model=MODEL, messages=msgs).choices[0].message.content
requests.post(f'{FHIR_BASE}/DocumentReference', json=doc_ref(patient_id, note, doc_status='final'))

note = client.chat.completions.create(model=MODEL, messages=msgs).choices[0].message.content
requests.post(f'{FHIR_BASE}/DocumentReference',
              json=doc_ref(patient_id, note, doc_status='preliminary'))   # AI draft

def practitioner_review_and_sign(doc_id, practitioner):   # only path to 'final'
    doc = requests.get(f'{FHIR_BASE}/DocumentReference/{doc_id}').json()
    doc['docStatus'] = 'final'
    doc['authenticator'] = {'reference': f'Practitioner/{practitioner.id}'}
    requests.put(f'{FHIR_BASE}/DocumentReference/{doc_id}', json=doc)
    audit.record(doc_id, reviewed_by=practitioner.id, reviewed_at=utcnow())

Standards that recommend the same control

• Health AI/LMMs should keep a clinician accountable with oversight and redress (WHO) (WHO AI-for-Health (LMM) Guidance · WHO guidance on large multi-modal models (2024), Box 1 (responsibility and accountability), section 4.2 Recommendations (developers) and section 7 Recommendation (liability))

Related incidents

No guardrail sits on this exact control; these incidents are cited by guardrails on related controls.

• UnitedHealth nH Predict claim-denial litigation (2023-11; alleged (not proven)). A class action filed in November 2023 alleges that UnitedHealth's nH Predict model had a 90% error rate, measured by denials reversed on appeal, while only about 0.2% of members appealed. UnitedHealth disputes the allegations; the litigation is ongoing. Source: STAT News · evidence grade: primary · cited by Monitor how often adverse AI decisions are reversed, and suspend models that are usually wrong
• Cigna PXDX batch claim denials (reported) (2022; alleged (not proven)). ProPublica, citing internal Cigna records, reported that Cigna's PXDX system was used to reject more than 300,000 claims over two months in 2022, with physicians spending an average of 1.2 seconds on each. Cigna disputes the reporting; related lawsuits are ongoing. Source: ProPublica / The Capitol Forum · evidence grade: press of record · cited by Make human review of adverse AI decisions substantive, not nominal

Rule id nv-ab406.provider-ai-administrative-support-only · review status: primary source derived

Binding law — in force

Nevada mental health providers' administrative AI use must comply with HIPAA, HITECH and Nevada health-information law (Nevada AB 406)

NRS 629.610(3) · official text · In force: applies since 1 Jul 2025 · Nevada (US-NV)

When a Nevada provider of mental and behavioral health care uses an AI system for an administrative-support purpose, NRS 629.610(3) requires the provider to ensure the use complies with all federal and state law on patient privacy and the security of electronic health records and health data, naming HITECH, HIPAA and NRS 439.581 to 439.597. Detect session notes, transcripts or other patient records sent to a model API with no business-associate, HIPAA-eligible endpoint or de-identification safeguard.

Who it applies to

• Duty falls on: individual professional
• Sectors: healthcare
• Nevada-licensed or certified providers of mental and behavioral health care as defined in NRS 629.610(6)(c): psychiatrists, psychologists, independent and clinical social workers, psychiatric-nursing registered nurses with a master's degree, marriage and family therapists, clinical professional counselors, alcohol and drug and problem gambling counselors, and trainees in those professions. Vendors of practice software are reached through what the provider may use AI for. Which privacy and security duties apply to a given AI vendor (business associate status, Nevada's health-information-exchange law) is a legal question. In force since 2025-07-01.
• Whether it applies depends on facts outside the code; a person has to decide.

client = OpenAI()
resp = client.chat.completions.create(model='gpt-4o', messages=[
    {'role': 'user', 'content': f'Summarize: {patient.clinical_note}'}])

VENDORS = load_yaml('vendors/ai_vendors.yaml')   # baa_signed, zero_data_retention per endpoint

def phi_client(name: str) -> tuple[AzureOpenAI, str]:
    v = VENDORS[name]
    if not (v['baa_signed'] and v['zero_data_retention']):
        raise PermissionError(f'{name} is not cleared for PHI')
    client = AzureOpenAI(azure_endpoint=v['endpoint'], api_key=os.environ['AZURE_OPENAI_KEY'],
                         api_version=v['api_version'])
    return client, v['deployment']

client, deployment = phi_client('azure-openai-hipaa')
resp = client.chat.completions.create(model=deployment, messages=[
    {'role': 'user', 'content': f'Summarize: {patient.clinical_note}'}])

Rule id nv-ab406.provider-ai-privacy-compliance · review status: primary source derived

Binding law — in force

Nevada mental and behavioral health providers must independently review the accuracy of AI-generated billing records and session notes (Nevada AB 406)

NRS 629.610(4) · official text · In force: applies since 1 Jul 2025 · Nevada (US-NV)

When a Nevada provider of mental and behavioral health care uses AI for billing (NRS 629.610(2)(c)) or for organizing, tracking and managing files or notes of a patient's session (2)(e), NRS 629.610(4) requires the provider to independently review the accuracy of any report, data or other information the AI compiles, summarizes, analyzes or generates. Detect AI-generated session notes or billing records committed as final or submitted with no provider review step.

Who it applies to

• Duty falls on: individual professional
• Sectors: healthcare
• Nevada-licensed or certified providers of mental and behavioral health care as defined in NRS 629.610(6)(c): psychiatrists, psychologists, independent and clinical social workers, psychiatric-nursing registered nurses with a master's degree, marriage and family therapists, clinical professional counselors, alcohol and drug and problem gambling counselors, and trainees in those professions. Vendors of practice software are reached through what the provider may use AI for. The duty applies to AI output for billing and for session files and notes (629.610(2)(c), (e)). In force since 2025-07-01.
• Whether it applies depends on facts outside the code; a person has to decide.

note = client.chat.completions.create(model=MODEL, messages=msgs).choices[0].message.content
requests.post(f'{FHIR_BASE}/DocumentReference', json=doc_ref(patient_id, note, doc_status='final'))

note = client.chat.completions.create(model=MODEL, messages=msgs).choices[0].message.content
requests.post(f'{FHIR_BASE}/DocumentReference',
              json=doc_ref(patient_id, note, doc_status='preliminary'))   # AI draft

def practitioner_review_and_sign(doc_id, practitioner):   # only path to 'final'
    doc = requests.get(f'{FHIR_BASE}/DocumentReference/{doc_id}').json()
    doc['docStatus'] = 'final'
    doc['authenticator'] = {'reference': f'Practitioner/{practitioner.id}'}
    requests.put(f'{FHIR_BASE}/DocumentReference/{doc_id}', json=doc)
    audit.record(doc_id, reviewed_by=practitioner.id, reviewed_at=utcnow())

Standards that recommend the same control

• Health AI/LMMs should keep a clinician accountable with oversight and redress (WHO) (WHO AI-for-Health (LMM) Guidance · WHO guidance on large multi-modal models (2024), Box 1 (responsibility and accountability), section 4.2 Recommendations (developers) and section 7 Recommendation (liability))

Related incidents

No guardrail sits on this exact control; these incidents are cited by guardrails on related controls.

• UnitedHealth nH Predict claim-denial litigation (2023-11; alleged (not proven)). A class action filed in November 2023 alleges that UnitedHealth's nH Predict model had a 90% error rate, measured by denials reversed on appeal, while only about 0.2% of members appealed. UnitedHealth disputes the allegations; the litigation is ongoing. Source: STAT News · evidence grade: primary · cited by Monitor how often adverse AI decisions are reversed, and suspend models that are usually wrong
• Cigna PXDX batch claim denials (reported) (2022; alleged (not proven)). ProPublica, citing internal Cigna records, reported that Cigna's PXDX system was used to reject more than 300,000 claims over two months in 2022, with physicians spending an average of 1.2 seconds on each. Cigna disputes the reporting; related lawsuits are ongoing. Source: ProPublica / The Capitol Forum · evidence grade: press of record · cited by Make human review of adverse AI decisions substantive, not nominal

Rule id nv-ab406.provider-review-of-ai-records · review status: primary source derived