1. Except as otherwise provided in subsection 2, the Department shall directly manage, direct and coordinate all payments and rebates for prescription drugs and all other services and payments relating to the provision of prescription drugs under the State Plan for Medicaid and the Children’s Health Insurance Program.
2. The Department may enter into a contract with:
(a) A pharmacy benefit manager for the provision of any services described in subsection 1.
(b) A health maintenance organization pursuant to NRS 422.273 for the provision of any of the services described in subsection 1 for recipients of Medicaid or recipients of insurance through the Children’s Health Insurance Program who receive coverage through a Medicaid managed care program.
(c) One or more public or private entities from this State, the District of Columbia or other states or territories of the United States for the collaborative purchasing of prescription drugs in accordance with subsection 3 of NRS 277.110.
3. A contract entered into pursuant to paragraph (a) or (b) of subsection 2 must:
(a) Include the provisions required by NRS 422.4056; and
(b) Require the pharmacy benefit manager or health maintenance organization, as applicable, to disclose to the Department any information relating to the services covered by the contract, including, without limitation, information concerning dispensing fees, measures for the control of costs, rebates collected and paid and any fees and charges imposed by the pharmacy benefit manager or health maintenance organization pursuant to the contract.
4. In addition to meeting the requirements of subsection 3, a contract entered into pursuant to:
(a) Paragraph (a) of subsection 2 may require the pharmacy benefit manager to provide the entire amount of any rebates received for the purchase of prescription drugs, including, without limitation, rebates for the purchase of prescription drugs by an entity other than the Department, to the Department.
(b) Paragraph (b) of subsection 2 must require the health maintenance organization to provide to the Department the entire amount of any rebates received for the purchase of prescription drugs, including, without limitation, rebates for the purchase of prescription drugs by an entity other than the Department, less an administrative fee in an amount prescribed by the contract. The Department shall adopt policies prescribing the maximum amount of such an administrative fee.
(Added to NRS by 2019, 4027; A 2021, 1752)
Structure Nevada Revised Statutes
Chapter 422 - Health Care Financing and Policy
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 422.151 - Creation; function.
NRS 422.153 - Composition; terms and compensation of members.
NRS 422.155 - Chair; Secretary; meetings; subcommittees.
NRS 422.175 - "Reinvestment advisory committee" defined. [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 422.2366 - Administration of oaths; testimony of witnesses; subpoenas.
NRS 422.2368 - Adoption of regulations.
NRS 422.2369 - Procedure for adopting, amending or repealing regulations.
NRS 422.240 - Legislative appropriations; disbursements.
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 422.2704 - Review of and recommendations concerning rates of reimbursement.
NRS 422.2712 - Reporting of certain rates of reimbursement for physicians.
NRS 422.27238 - State Plan for Medicaid: Reimbursement for crisis stabilization services.
NRS 422.272407 - State Plan for Medicaid: Reimbursement of recipients for personal care services.
NRS 422.27247 - Application for federal waiver to provide certain dental care for certain persons.
NRS 422.2748 - Cooperation with Medicaid Fraud Control Unit.
NRS 422.27482 - Report concerning provision of health benefits by large employers.
NRS 422.275 - Legal advisers for Division.
NRS 422.2775 - Hearing: Evidence.
NRS 422.278 - Hearing: Person with communications disability entitled to services of interpreter.
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 422.293005 - Subrogation: Liability for failure to comply with provisions.
NRS 422.29306 - Imposition and release of lien on property of recipient of Medicaid.
NRS 422.308 - Family planning service; birth control.
NRS 422.362 - "Cardholder" defined.
NRS 422.363 - "Medicaid card" defined.
NRS 422.365 - "Receives" defined.
NRS 422.369 - Unlawful acts: Fraud by person authorized to provide care to holder of card; penalty.
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 422.37915 - "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 422.3805 - Federal waivers: Duties of Administrator.
NRS 422.390 - Regulations; quarterly report.
NRS 422.3964 - State Plan for Medicaid: Inclusion of certain home and community-based services.
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 422.4035 - Silver State Scripts Board: Creation; membership.
NRS 422.404 - Silver State Scripts Board: Chair; terms; vacancies; meetings; quorum.
NRS 422.405 - Silver State Scripts Board: Duties and powers.
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 422.460 - "Benefit" defined.
NRS 422.470 - "Claim" defined.
NRS 422.490 - "Provider" defined.
NRS 422.500 - "Recipient" defined.
NRS 422.510 - "Records" 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.