A.B. 15
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ASSEMBLY BILL NO. 15–COMMITTEE
ON GOVERNMENT AFFAIRS
(ON BEHALF OF THE ATTORNEY GENERAL)
PREFILED NOVEMBER 4, 2024
____________
Referred to Committee on Government Affairs
SUMMARY—Revises provisions relating to Medicaid fraud.
(BDR 18-446)
FISCAL NOTE: Effect on Local Government: No.
Effect on the State: No.
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EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted.
AN ACT relating to Medicaid fraud; revising the authority of the
Attorney General, acting through the Medicaid Fraud
Control Unit, to issue subpoenas; setting forth procedures
for the enforcement of such a subpoena; revising
provisions governing certain actions for false or
fraudulent claims; revising the penalties for failing to
maintain certain records relating to Medicaid claims; and
providing other matters properly relating thereto.
Legislative Counsel’s Digest:
Existing law establishes the Medicaid Fraud Control Unit within the Office of 1
the Attorney General as the agency responsible for the investigation and 2
prosecution of violations or offenses relating to the State Plan for Medicaid. (NRS 3
228.410) In carrying out those duties and responsibilities, existing law authorizes 4
the Attorney General, acting through the chief executive of the Medicaid Fraud 5
Control Unit or his or her designee, to issue a subpoena for documents, records or 6
materials. (NRS 228.411) Section 1 of this bill additionally authorizes such a 7
subpoena to compel a person to: (1) appear and be examined under oath; and (2) 8
answer written interrogatories under oath. Section 1 sets forth procedures by which 9
the Attorney General may petition a court for the issuance of an order to compel 10
compliance with such a subpoena. 11
Existing federal law provides financial incentives for states that enact laws 12
establishing liability for false or fraudulent claims made to the State Plan for 13
Medicaid. (42 U.S.C. § 1396h) To be eligible for these financial incentives, the 14
laws of a state must contain provisions that are at least as effective at rewarding and 15
facilitating certain qui tam actions for false or fraudulent claims as those described 16
in the federal False Claims Act. (31 U.S.C. §§ 3729-3732) Existing federal law 17
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prohibits a private person from bringing a qui tam action against a person for false 18
or fraudulent claims if the action is based upon allegations or transactions which are 19
the subject of a civil suit or an administrative civil money penalty proceeding in 20
which the Federal Government is already a party. (31 U.S.C. § 3730(e)(3)) Existing 21
state law contains similar provisions, but prohibits a private plaintiff from 22
maintaining, rather than bringing, a qui tam action for false or fraudulent claims if 23
the action is based upon allegations or transactions that are the subject of a civil 24
action or administrative proceeding for a monetary penalty to which the State or 25
political subdivision is already a party. (NRS 357.080) Section 2 of this bill revises 26
that prohibition, consistent with federal law, to prohibit a person from bringing, 27
rather than maintaining, such an action under those circumstances. 28
Existing law makes it a gross misdemeanor for a person to intentionally fail to 29
maintain certain records relating to a claim for payment for goods or services 30
pursuant to the State Plan for Medicaid. (NRS 422.570) Section 3 of this bill 31
instead makes the punishment for such an offense: (1) a misdemeanor if the amount 32
of the claim was less than $650; and (2) a gross misdemeanor if the amount of the 33
claim was $650 or more. 34
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1. NRS 228.411 is hereby amended to read as follows: 1
228.411 1. In carrying out the duties and responsibilities 2
under NRS 228.410, the Attorney General, acting through the chief 3
executive of the Medicaid Fraud Control Unit or his or her designee, 4
may issue a subpoena [for] to compel a person to: 5
(a) Produce documents, records or materials [.] ; 6
(b) Appear and be examined under oath; 7
(c) Answer written interrogatories under oath; or 8
(d) Perform any combination of the actions described in 9
paragraphs (a), (b) and (c). 10
2. The Attorney General may use any documents, records , [or] 11
materials , testimony or answers produced pursuant to a subpoena 12
issued under this section in the course of a civil action brought 13
pursuant to NRS 228.410. 14
3. [Any] If a person [who willfully] fails or refuses to comply 15
with a subpoena issued pursuant to this section [is guilty of a 16
misdemeanor.] , the Attorney General may petition the district 17
court in the county in which the person resides or has his or her 18
principal place of business. Upon the filing of such a petition, the 19
court shall set a time for a hearing on the petition and provide 20
notice of the petition and hearing to the parties. 21
4. Except as otherwise provided in subsection 5, the court 22
shall enter an order compelling compliance with the subpoena if, 23
at the hearing, the court finds that: 24
(a) The subpoena was properly issued; 25
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(b) There is reasonable cause to believe that a violation of 1
NRS 422.540 to 422.570, inclusive, or any fraud in the 2
administration of the Plan or in the provision of medical 3
assistance pursuant to the Plan has occurred or is occurring; and 4
(c) The document, record, material, testimony or answer is 5
relevant to the investigation of the Attorney General. 6
5. The court may, on motion by the person upon whom the 7
subpoena was served and upon a showing of good cause, modify 8
the order issued pursuant to subsection 4 or issue any further 9
order that justice may require to protect the person from 10
unreasonable annoyance, embarrassment, oppression, burden or 11
expense. 12
[4.] 6. A subpoena issued pursuant to this section must include 13
a copy of the provisions of subsections 1 [, 2 and 3.] to 5, inclusive. 14
7. As used in this section, “Plan” has the meaning ascribed to 15
it in NRS 228.410. 16
Sec. 2. NRS 357.080 is hereby amended to read as follows: 17
357.080 1. Except as otherwise provided in this section and 18
NRS 357.100, a private plaintiff may bring an action pursuant to 19
this chapter for a violation of NRS 357.040 on his or her own 20
account and that of the State or a political subdivision, or both the 21
State and a political subdivision. The action must be brought in the 22
name of the State or the political subdivision, or both. After such an 23
action is commenced, it may be dismissed only with written consent 24
of the court and the Attorney General. The court and the Attorney 25
General shall take into account the public purposes of this chapter 26
and the best interests of the parties in dismissing the action or 27
consenting to the dismissal, as applicable, and provide the reasons 28
for dismissing the action or consenting to the dismissal, as 29
applicable. 30
2. If a private plaintiff brings an action pursuant to this chapter, 31
no person other than the Attorney General or the Attorney General’s 32
designee may intervene or bring a related action pursuant to this 33
chapter based on the facts underlying the first action. 34
3. An action may not be [maintained] brought by a private 35
plaintiff pursuant to this chapter: 36
(a) Against a member of the Legislature or the Judiciary, an 37
elected officer of the Executive Department of the State 38
Government, or a member of the governing body of a political 39
subdivision, if the action is based upon evidence or information 40
known to the State or political subdivision at the time the action was 41
brought. 42
(b) If the action is based upon allegations or transactions that are 43
the subject of a civil action or an administrative proceeding for a 44
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monetary penalty to which the State or political subdivision is 1
already a party. 2
4. A complaint filed pursuant to this section must be placed 3
under seal and so remain for at least 60 days or until the Attorney 4
General or a designee of the Attorney General pursuant to NRS 5
357.070 has elected whether to intervene. No service may be made 6
upon the defendant until so ordered by the court. 7
5. On the date the private plaintiff files a complaint, he or she 8
shall send a copy of the complaint to the Attorney General by mail 9
with return receipt requested. The private plaintiff shall send with 10
each copy of the complaint a written disclosure of substantially all 11
material evidence and information he or she possesses. If a district 12
attorney or city attorney has accepted a designation from the 13
Attorney General pursuant to NRS 357.070, the Attorney General 14
shall forward a copy of the complaint to the district attorney or city 15
attorney, as applicable. 16
6. An action pursuant to this chapter may be brought in any 17
judicial district in this State in which the defendant can be found, 18
resides, transacts business or in which any of the alleged fraudulent 19
activities occurred. 20
Sec. 3. NRS 422.570 is hereby amended to read as follows: 21
422.570 1. A person [is guilty of a gross misdemeanor if,] 22
who, upon submitting a claim for or upon receiving payment for 23
goods or services pursuant to the Plan, [the person] intentionally 24
fails to maintain such records as are necessary to disclose fully the 25
nature of the goods or services for which a claim was submitted or 26
payment was received, or such records as are necessary to disclose 27
fully all income and expenditures upon which rates of payment were 28
based, for at least 5 years after the date on which payment was 29
received [.] is guilty of: 30
(a) If the amount of the claim is less than $650, a 31
misdemeanor. 32
(b) If the amount of the claim is $650 or more, a gross 33
misdemeanor. 34
2. A person who intentionally destroys such records within 5 35
years after the date payment was received is guilty of a category D 36
felony and shall be punished as provided in NRS 193.130. 37
Sec. 4. This act becomes effective upon passage and approval. 38
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