Nevada Revised Statutes
Chapter 422 - Health Care Financing and Policy
NRS 422.29301 - Administration of provisions concerning recovery of amounts incorrectly paid for recipient of Medicaid; regulations; enforcement.

The Director:
1. Shall administer the provisions of NRS 422.29302, 422.29304 and 422.29306;
2. May adopt such regulations as are necessary for the administration of those provisions; and
3. May invoke any legal, equitable or special procedures for the enforcement of those provisions.
(Added to NRS by 2003, 872; A 2013, 1306)

Structure Nevada Revised Statutes

Nevada Revised Statutes

Chapter 422 - Health Care Financing and Policy

NRS 422.001 - Definitions.

NRS 422.003 - "Administrator" defined.

NRS 422.021 - "Children’s Health Insurance Program" defined.

NRS 422.030 - "Department" defined.

NRS 422.040 - "Director" defined.

NRS 422.041 - "Division" defined.

NRS 422.046 - "Medicaid" defined.

NRS 422.050 - "Public assistance" defined.

NRS 422.054 - "Undivided estate" defined.

NRS 422.061 - Purposes of Division.

NRS 422.063 - State plans for certain programs: Development, adoption and revision by Director; Division required to comply.

NRS 422.064 - State plans for certain programs: Priority access to treatment and services for certain parents.

NRS 422.065 - Eligibility of persons who are not citizens or nationals of United States for state or local public benefits.

NRS 422.075 - Division to submit certain information to Nevada Commission on Autism Spectrum Disorders.

NRS 422.151 - Creation; function.

NRS 422.153 - Composition; terms and compensation of members.

NRS 422.155 - Chair; Secretary; meetings; subcommittees.

NRS 422.162 - Creation; appointment of members; terms; Chair; members serve without additional compensation; member who is state employee must be relieved from duties to prepare for and attend meetings.

NRS 422.165 - Duties.

NRS 422.175 - "Reinvestment advisory committee" defined. [Effective January 1, 2022.]

NRS 422.185 - Establishment; membership; members serve without compensation; leave for members who are public employees. [Effective January 1, 2022.]

NRS 422.195 - Chair; meetings; subcommittees; quorum. [Effective January 1, 2022.]

NRS 422.205 - Duties; report. [Effective January 1, 2022.]

NRS 422.2354 - Qualifications.

NRS 422.2356 - Executive Officer of Division; administration and management of Division.

NRS 422.2357 - Administration of chapter.

NRS 422.2358 - Reports.

NRS 422.2362 - Fiscal duties.

NRS 422.2364 - Organization of Division; appointment of heads of sections; employees; standards of service.

NRS 422.2366 - Administration of oaths; testimony of witnesses; subpoenas.

NRS 422.2368 - Adoption of regulations.

NRS 422.23685 - Regulations required to include provision prohibiting certain actions relating to organ transplants for persons with disabilities.

NRS 422.2369 - Procedure for adopting, amending or repealing regulations.

NRS 422.2372 - General and miscellaneous powers and duties. [Effective through December 31, 2025.] General and miscellaneous powers and duties. [Effective January 1, 2026.]

NRS 422.2374 - Cooperation with Medicaid Fraud Control Unit; suspension or exclusion of provider of goods or services under State Plan for Medicaid.

NRS 422.239 - Appointment by Division in unclassified service or as contractor; qualifications; duties; restrictions on other employment.

NRS 422.240 - Legislative appropriations; disbursements.

NRS 422.242 - Gifts and grants of money to Division: Deposit in Gift and Cooperative Account of the Division of Health Care Financing and Policy; use; approval of claims by Administrator.

NRS 422.260 - Acceptance of Social Security Act and related federal money.

NRS 422.265 - Acceptance of increased benefits of future congressional legislation; regulations.

NRS 422.267 - Contract or agreement with Federal Government by Director.

NRS 422.270 - Duties of Department regarding Medicaid and Children’s Health Insurance Program.

NRS 422.2703 - Department required to establish and maintain system for electronic submission of applications for Medicaid or Children’s Health Insurance Program.

NRS 422.2704 - Review of and recommendations concerning rates of reimbursement.

NRS 422.2712 - Reporting of certain rates of reimbursement for physicians.

NRS 422.2717 - State Plan for Medicaid: Inclusion of requirement that independent foster care adolescents are eligible for Medicaid.

NRS 422.27171 - State Plan for Medicaid: Inclusion of authorization for pregnant women determined to be presumptively eligible for Medicaid to enroll in Medicaid for prescribed period without submitting application for enrollment which includes addit...

NRS 422.27172 - State Plan for Medicaid: Inclusion of requirement for payment of certain costs related to family planning. [Effective through December 31, 2021.] State Plan for Medicaid: Inclusion of requirement for payment of certain costs related t...

NRS 422.27173 - State Plan for Medicaid: Inclusion of requirement for payment of certain costs for examination of pregnant women for discovery of chlamydia trachomatis, gonorrhea, hepatitis B, hepatitis C and syphilis.

NRS 422.27174 - State Plan for Medicaid: Inclusion of requirement for payment of certain costs for preventative care.

NRS 422.27175 - State Plan for Medicaid: Inclusion of requirement for payment of certain costs for screening, genetic counseling and testing for harmful mutations in the BRCA gene for women. [Effective January 1, 2022.]

NRS 422.27176 - State Plan for Medicaid: Inclusion of requirement for payment of certain costs for mammogram.

NRS 422.27177 - State Plan for Medicaid: Inclusion of requirement for payment of costs incurred for doula services provided by enrolled doula; application for waiver or amendment related to doula services; requirements for enrollment as doula. [Effec...

NRS 422.27178 - State Plan for Medicaid: Inclusion of requirement for payment of certain costs for breastfeeding supplies and prenatal screenings and tests.

NRS 422.27179 - State Plan for Medicaid: Inclusion of requirement for payment of certain costs for breastfeeding supplies for certain period, prenatal screenings and tests and lactation consultation and support. [Effective January 1, 2022.]

NRS 422.2718 - State Plan for Medicaid: Inclusion of requirement for payment of certain expenses related to testing for human papillomavirus and administration of human papillomavirus vaccine.

NRS 422.2719 - State Plan for Medicaid: Inclusion of requirement for payment of certain costs related to fetal alcohol spectrum disorders.

NRS 422.272 - State Plan for Medicaid: Inclusion of requirement for payment of certain costs for medical, administrative and transactional costs of certain persons admitted to certain medical facilities for more than 30 days.

NRS 422.2721 - State Plan for Medicaid: Inclusion of requirement for payment of certain costs for services provided through telehealth; inclusion of prohibition against certain practices related to such services. [Effective through 1 year after the d...

NRS 422.2722 - State Plan for Medicaid: Inclusion of requirement for payment of certain costs for services provided by community health worker.

NRS 422.2723 - State Plan for Medicaid: Inclusion of requirement for payment of certain costs related to dialysis and emergency care to treat kidney failure.

NRS 422.27234 - State Plan for Medicaid: Inclusion of requirement for payment of certain costs related to sickle cell disease and its variants.

NRS 422.27235 - State Plan for Medicaid: Inclusion of requirement for payment of certain costs related to preventing acquisition of human immunodeficiency virus.

NRS 422.27236 - State Plan for Medicaid: Inclusion of requirement for payment of certain costs for cognitive assessment and care planning services for persons who experience signs or symptoms of cognitive impairment.

NRS 422.27238 - State Plan for Medicaid: Reimbursement for crisis stabilization services.

NRS 422.27239 - State Plan for Medicaid: Reimbursement of supervising psychologist for services of psychological assistant, psychological intern or psychological trainee.

NRS 422.2724 - State Plan for Medicaid: Reimbursement of registered nurse for certain services provided to persons eligible for Medicaid.

NRS 422.272405 - State Plan for Medicaid: Reimbursement for services provided by advanced practice registered nurse to certain recipients. [Effective January 1, 2022.]

NRS 422.272407 - State Plan for Medicaid: Reimbursement of recipients for personal care services.

NRS 422.27241 - State Plan for Medicaid: Reimbursement for services for hospice care provided to persons eligible for Medicaid.

NRS 422.27242 - State Plan for Medicaid and Children’s Health Insurance Program: Inclusion of authorization for enrollment of certain children; authority to reduce or eliminate available benefits.

NRS 422.27243 - Program to provide medical assistance to certain persons who are employed and have disabilities.

NRS 422.27247 - Application for federal waiver to provide certain dental care for certain persons.

NRS 422.27248 - Application for federal waiver authorizing Department to receive federal funding for coverage for certain treatment for person in institution for mental diseases.

NRS 422.273 - Establishment, development and implementation of Medicaid managed care program. [Effective through December 31, 2025.] Establishment, development and implementation of statewide Medicaid managed care program; statewide procurement proce...

NRS 422.2734 - Plan to ensure provision of behavioral health services by certain managed care organizations in culturally competent manner: Preparation; contents; implementation; review; additional duties.

NRS 422.2735 - Program to provide increased capitation payments to Medicaid managed care plans for ground emergency medical transportation services provided by governmental provider. [Effective on the date that a program to provide increased capitati...

NRS 422.2748 - Cooperation with Medicaid Fraud Control Unit.

NRS 422.27482 - Report concerning provision of health benefits by large employers.

NRS 422.27485 - Enrollment of eligible Indian children in Children’s Health Insurance Program: Duty of Department to seek assistance of and cooperate with Indian tribes; immediate action required; certain contracts for provision of services required.

NRS 422.27487 - Eligibility for and coverage under Medicaid for persons who are incarcerated and persons released from incarceration; regulations. [Effective January 1, 2022.]

NRS 422.2749 - Custody, use, preservation and confidentiality of records, files and communications concerning applicants for and recipients of public assistance or assistance pursuant to Children’s Health Insurance Program; regulations.

NRS 422.27495 - Contracts for provision of certain transportation services for recipients of Medicaid and recipients of services pursuant to Children’s Health Insurance Program; regulations.

NRS 422.27497 - Establishment of certain rates of reimbursement and limitations on hours for provision of certain services for recipients of Medicaid by behavior analysts, assistant behavior analysts and registered behavior technicians; reporting of...

NRS 422.275 - Legal advisers for Division.

NRS 422.276 - Appeal to Division by applicant for or recipient of benefits from Medicaid or Children’s Health Insurance Program; notice of initial decision; hearing.

NRS 422.277 - Hearing: Rights of parties; informal disposition; record; transcribing of oral proceedings; findings of fact; certain employees or representatives of Division prohibited from participating in decision.

NRS 422.2775 - Hearing: Evidence.

NRS 422.278 - Hearing: Person with communications disability entitled to services of interpreter.

NRS 422.2785 - Contents and delivery of decision or order of hearing officer; petition for judicial review; filing of decision and record with court.

NRS 422.279 - Judicial review: Taking of additional evidence; limitations on review; grounds for reversal; appeal to appellate court.

NRS 422.280 - Forms of reports and records to be kept by persons subject to supervision or investigation by Division.

NRS 422.291 - Assistance not assignable or subject to process or bankruptcy law.

NRS 422.292 - Assistance subject to future amending and repealing acts.

NRS 422.293 - Subrogation: Department subrogated to rights of recipient of Medicaid or of insurance provided pursuant to Children’s Health Insurance Program; lien on proceeds of recovery.

NRS 422.293001 - Subrogation: Notice to Department of recipient’s claim; statute of limitations tolled until notice received.

NRS 422.293003 - Subrogation: Department required to provide notice of amount of lien; enforceability of lien.

NRS 422.293005 - Subrogation: Liability for failure to comply with provisions.

NRS 422.29301 - Administration of provisions concerning recovery of amounts incorrectly paid for recipient of Medicaid; regulations; enforcement.

NRS 422.29302 - Recovery of benefits paid for Medicaid: Powers and duties of Department; claim against estate of recipient; regulations; distribution of money recovered; payment in cash.

NRS 422.29304 - Recovery of amounts paid for Medicaid under certain circumstances; powers and duties of Department; duty to reimburse Department; waiver of repayment; regulations.

NRS 422.29306 - Imposition and release of lien on property of recipient of Medicaid.

NRS 422.305 - Confidentiality of information obtained in investigation of provider of services under State Plan for Medicaid.

NRS 422.306 - Hearing to review action taken against provider of services under State Plan for Medicaid; regulations; appeal of final decision.

NRS 422.308 - Family planning service; birth control.

NRS 422.3085 - Development of Sexual Trauma Services Guide; provision of information about Guide to public; regulations.

NRS 422.309 - Provision of prenatal care to pregnant women who are indigent; provision of information concerning availability of prenatal care; regulations.

NRS 422.361 - Definitions.

NRS 422.362 - "Cardholder" defined.

NRS 422.363 - "Medicaid card" defined.

NRS 422.364 - "Plan" defined.

NRS 422.365 - "Receives" defined.

NRS 422.366 - Unlawful acts: Obtaining or possessing card without consent of holder of card; presumption from possession of card; penalty.

NRS 422.367 - Unlawful acts: Sale or purchase of card; authorization by holder of card for use by person not entitled to use card; penalty.

NRS 422.368 - Unlawful acts: Use of forged, expired or revoked card to obtain benefits; receipt of benefits by misrepresentation; penalty.

NRS 422.369 - Unlawful acts: Fraud by person authorized to provide care to holder of card; penalty.

NRS 422.3755 - Definitions.

NRS 422.376 - "Facility for intermediate care" defined.

NRS 422.3765 - "Facility for skilled nursing" defined.

NRS 422.3771 - "Nursing facility" defined.

NRS 422.3775 - Fee: Payment; amount; due date; allowable cost for Medicaid reimbursement purposes.

NRS 422.378 - Report by nursing facility to Division.

NRS 422.3785 - Account to Increase the Quality of Nursing Care: Creation; deposit of money; expenditures; consequence of federal law prohibiting certain expenditures from Account.

NRS 422.379 - Administrative penalties for late payment of fee; recoupment of fees and administrative penalties; repayment plan.

NRS 422.3791 - Definitions.

NRS 422.37915 - "Account" defined.

NRS 422.3792 - "Agency to provide personal care services in the home" defined.

NRS 422.37925 - "Medical facility" defined.

NRS 422.3793 - "Operator" defined.

NRS 422.37935 - "Operator group" defined.

NRS 422.3794 - Imposition of assessment; vote; amount of assessment; regulations; deposit of revenue; compliance with federal law; submission of information to Division.

NRS 422.37945 - Account to Improve Health Care Quality and Access: Creation; administration; separate accounting; uses; nonreversion.

NRS 422.3795 - Administrative penalties; deduction from future Medicaid payments; notification; payment plans.

NRS 422.380 - Definitions.

NRS 422.3805 - Federal waivers: Duties of Administrator.

NRS 422.382 - Intergovernmental transfers of money from counties to Division; deposit in Intergovernmental Transfer Account in State General Fund; administration by Division.

NRS 422.385 - Disproportionate share payments from Medicaid Budget Account; transfer of money from Intergovernmental Transfer Account.

NRS 422.387 - Calculation of disproportionate share payments; verification of eligibility for disproportionate share payments; Director authorized to negotiate terms of amendment to State Plan for Medicaid with Centers for Medicare and Medicaid Servi...

NRS 422.390 - Regulations; quarterly report.

NRS 422.396 - Establishment and administration of program to provide community-based services; application for federal waiver to amend State Plan for Medicaid; contracting for services; adoption of regulations.

NRS 422.3962 - Amendment of home and community-based services waiver to include as medical assistance under Medicaid funding of assisted living supportive services for senior citizens who reside in certain assisted living facilities.

NRS 422.3964 - State Plan for Medicaid: Inclusion of certain home and community-based services.

NRS 422.398 - Prohibition against considering money deposited in individual development account by recipient of Medicaid to be income for certain purposes. [Effective January 1, 2022.]

NRS 422.399 - Instruction in financial literacy for certain recipients of Medicaid. [Effective January 1, 2022.]

NRS 422.401 - Definitions.

NRS 422.4015 - "Board" defined.

NRS 422.402 - "Drug Use Review Board" defined.

NRS 422.4021 - Health benefit plan" defined.

NRS 422.4022 - "Health maintenance organization" defined.

NRS 422.4023 - "Pharmacy benefit manager" defined.

NRS 422.4024 - "Sickle cell disease and its variants" defined.

NRS 422.4025 - List of preferred prescription drugs used for Medicaid program and Children’s Health Insurance Program; list of drugs excluded from restrictions; role of Pharmacy and Therapeutics Committee; availability of new pharmaceutical products...

NRS 422.4026 - Coverage of certain supplements for treating sickle cell disease and its variants: Adoption of list by regulation; periodic review of list.

NRS 422.403 - Establishment and management of use by Medicaid program of step therapy and prior authorization; duties of Drug Use Review Board; acceptance of recommendations from Board; regulations.

NRS 422.4032 - Exemption from required step therapy for certain drugs: Application process; form; approval; payment of cost of drug for which exemption applies. [Effective January 1, 2022.]

NRS 422.4035 - Silver State Scripts Board: Creation; membership.

NRS 422.404 - Silver State Scripts Board: Chair; terms; vacancies; meetings; quorum.

NRS 422.4045 - Silver State Scripts Board: Members serve without compensation; members entitled to per diem; members holding public office or employed by governmental entity.

NRS 422.405 - Silver State Scripts Board: Duties and powers.

NRS 422.4052 - Department to take certain actions relating to acquisition of prescription drugs for recipient of Medicaid who resides in area for which declared disaster or emergency is in effect.

NRS 422.4053 - Department to manage payments and rebates for prescription drugs; contract for provision of certain services.

NRS 422.4056 - Audits of certain contracts; posting of audit results on Internet website.

NRS 422.406 - Regulations; contracts for services.

NRS 422.410 - Fraudulent acts; penalties.

NRS 422.450 - Definitions.

NRS 422.460 - "Benefit" defined.

NRS 422.470 - "Claim" defined.

NRS 422.480 - "Plan" defined.

NRS 422.490 - "Provider" defined.

NRS 422.500 - "Recipient" defined.

NRS 422.510 - "Records" defined.

NRS 422.520 - "Sign" defined.

NRS 422.525 - "Statement or representation" defined.

NRS 422.530 - Responsibility for false claim, statement or representation.

NRS 422.540 - Offenses regarding false claims, statements or representations; penalties.

NRS 422.550 - Statement regarding truth and accuracy of applications, reports and invoices; perjury; presumption concerning person who signs statement on behalf of provider.

NRS 422.560 - Offenses regarding sale, purchase or lease of goods, services, materials or supplies; penalty.

NRS 422.570 - Intentional failure to maintain adequate records; intentional destruction of records; penalties.

NRS 422.580 - Civil penalties for certain violations; liability of provider for excess amount unknowingly accepted; enforcement; use of money collected as penalty or repayment.

NRS 422.590 - Limitation and accrual of actions.