Existing federal and state law requires the Department of Health and Human Services to develop and administer a State Plan for Medicaid. (42 U.S.C. § 1396a; NRS 422.063, 422.270) Existing federal law requires a State Plan to include provisions for the oversight of providers of services under the State Plan. (42 U.S.C. § 1396a) Existing state law: (1) authorizes such a provider of services to request a hearing with the Division of Health Care Financing and Policy of the Department concerning an action taken against the provider; and (2) requires the Division to adopt regulations prescribing the procedures for such a hearing. (NRS 422.306) Existing regulations: (1) establish the actions taken against a provider for which the provider may request a hearing; and (2) require, with certain exceptions, that a provider submit a request for a hearing to the Division such that the Division receives the request not later than 90 calendar days after the date of the notice of the action for which a hearing is requested. (Medicaid Services Manual 3105.1) Section 1 of this bill requires a provider to request a hearing not later than 90 calendar days after the date of the notice of an action against the provider, unless the Division determines that extenuating circumstances exist. Section 1 additionally requires the Division to adopt regulations prescribing: (1) the actions on which a provider may request a hearing; and (2) the circumstances that constitute extenuating circumstances and which justify the submission of a request for a hearing later than 90 calendar days after the provider receives notice of an action against him or her. Section 2 of this bill requires the provisions of section 1, and any regulations adopted pursuant to section 1, to apply prospectively only to hearings requested on or after January 1, 2026.

Statutes affected:
As Introduced: 422.306
BDR: 422.306