A.B. 36
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ASSEMBLY BILL NO. 36–COMMITTEE ON
HEALTH AND HUMAN SERVICES
(ON BEHALF OF THE DIVISION OF HEALTH CARE
FINANCING AND POLICY OF THE DEPARTMENT
OF HEALTH AND HUMAN SERVICES)
PREFILED NOVEMBER 15, 2024
____________
Referred to Committee on Health and Human Services
SUMMARY—Revises provisions relating to Medicaid.
(BDR 38-291)
FISCAL NOTE: Effect on Local Government: No.
Effect on the State: Yes.
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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; revising provisions relating to certain
hearings concerning actions taken against a provider of
services under the State Plan for Medicaid; and providing
other matters properly relating thereto.
Legislative Counsel’s Digest:
Existing federal and state law requires the Department of Health and Human 1
Services to develop and administer a State Plan for Medicaid. (42 U.S.C. § 1396a; 2
NRS 422.063, 422.270) Existing federal law requires a State Plan to include 3
provisions for the oversight of providers of services under the State Plan. (42 4
U.S.C. § 1396a) Existing state law: (1) authorizes such a provider of services to 5
request a hearing with the Division of Health Care Financing and Policy of the 6
Department concerning an action taken against the provider; and (2) requires the 7
Division to adopt regulations prescribing the procedures for such a hearing. (NRS 8
422.306) Existing regulations: (1) establish the actions taken against a provider for 9
which the provider may request a hearing; and (2) require, with certain exceptions, 10
that a provider submit a request for a hearing to the Division such that the Division 11
receives the request not later than 90 calendar days after the date of the notice of 12
the action for which a hearing is requested. (Medicaid Services Manual 3105.1) 13
Section 1 of this bill requires a provider to request a hearing not later than 90 14
calendar days after the date of the notice of an action against the provider, unless 15
the Division determines that extenuating circumstances exist. Section 1 16
additionally requires the Division to adopt regulations prescribing: (1) the actions 17
on which a provider may request a hearing; and (2) the circumstances that 18
constitute extenuating circumstances and which justify the submission of a request 19
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for a hearing later than 90 calendar days after the provider receives notice of an 20
action against him or her. Section 2 of this bill requires the provisions of section 1, 21
and any regulations adopted pursuant to section 1, to apply prospectively only to 22
hearings requested on or after January 1, 2026. 23
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1. NRS 422.306 is hereby amended to read as follows: 1
422.306 1. Upon receipt of a request for a hearing that 2
complies with the provisions of this section and any regulations 3
adopted pursuant thereto, from a provider of services under the 4
State Plan for Medicaid, the Division shall appoint a hearing officer 5
to conduct the hearing. Any employee or other representative of the 6
Division who investigated or made the initial decision regarding the 7
action taken against a provider of services may not be appointed as 8
the hearing officer or participate in the making of any decision 9
pursuant to the hearing. 10
2. Unless the Division determines that extenuating 11
circumstances exist pursuant to the regulations adopted pursuant 12
to subsection 3, a provider of services must request a hearing 13
pursuant to subsection 1 not later than 90 calendar days after the 14
date of the notice of the action being taken against the provider 15
that is the subject of the hearing. 16
3. The Division shall adopt regulations prescribing the 17
[procedures] : 18
(a) Procedures to be followed at the hearing [.] ; 19
(b) Actions on which a provider of services may request a 20
hearing; and 21
(c) Circumstances that constitute extenuating circumstances 22
and which justify the submission of a request for a hearing after 23
the expiration of the time period prescribed by subsection 2. 24
[3.] 4. The decision of the hearing officer is a final decision. 25
Any party, including the Division, who is aggrieved by the decision 26
of the hearing officer may appeal that decision to the District Court 27
in and for Carson City by filing a petition for judicial review within 28
30 days after receiving the decision of the hearing officer. 29
[4.] 5. A petition for judicial review filed pursuant to this 30
section must be served upon every party within 30 days after the 31
filing of the petition for judicial review. 32
[5.] 6. Unless otherwise provided by the court: 33
(a) Within 90 days after the service of the petition for judicial 34
review, the Division shall transmit to the court the original or a 35
certified copy of the entire record of the proceeding under review, 36
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including, without limitation, a transcript of the evidence resulting 1
in the final decision of the hearing officer; 2
(b) The petitioner who is seeking judicial review pursuant to this 3
section shall serve and file an opening brief within 40 days after the 4
Division gives written notice to the parties that the record of the 5
proceeding under review has been filed with the court; 6
(c) The respondent shall serve and file an answering brief within 7
30 days after service of the opening brief; and 8
(d) The petitioner may serve and file a reply brief within 30 days 9
after service of the answering brief. 10
[6.] 7. Within 7 days after the expiration of the time within 11
which the petitioner may reply, any party may request a hearing. 12
Unless a request for hearing has been filed, the matter shall be 13
deemed submitted. 14
[7.] 8. The review of the court must be confined to the record. 15
The court shall not substitute its judgment for that of the hearing 16
officer as to the weight of the evidence on questions of fact. The 17
court may affirm the decision of the hearing officer or remand the 18
case for further proceedings. The court may reverse or modify the 19
decision if substantial rights of the appellant have been prejudiced 20
because the administrative findings, inferences, conclusions or 21
decisions are: 22
(a) In violation of constitutional or statutory provisions; 23
(b) In excess of the statutory authority of the Division; 24
(c) Made upon unlawful procedure; 25
(d) Affected by other error of law; 26
(e) Clearly erroneous in view of the reliable, probative and 27
substantial evidence on the whole record; or 28
(f) Arbitrary or capricious or characterized by abuse of 29
discretion or clearly unwarranted exercise of discretion. 30
Sec. 2. The amendatory provisions of section 1 of this act do 31
not apply to a hearing requested pursuant to subsection 1 of NRS 32
422.306 before January 1, 2026. 33
Sec. 3. 1. This section becomes effective upon passage and 34
approval. 35
2. Sections 1 and 2 of this act become effective: 36
(a) Upon passage and approval for the purpose of adopting any 37
regulations and performing any other preparatory administrative 38
tasks that are necessary to carry out the provisions of this act; and 39
(b) On January 1, 2026, for all other purposes. 40
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