Nevada Revised Statutes
Chapter 439B - Restraining Costs of Health Care
NRS 439B.340 - Report on indigent patients treated; verification by Director; compensation for treatment provided in excess of obligation; assessment for failure to fulfill minimum obligation.


1. Before September 30 of each year, each county in which hospitals subject to the provisions of NRS 439B.300 to 439B.340, inclusive, are located shall provide to the Department a report showing:
(a) The total number of inpatients treated by each such hospital who are claimed by the hospital to be indigent;
(b) The number of such patients for whom no reimbursement was provided by the county because of the limitation imposed by subsection 3 of NRS 439B.320;
(c) The total amount paid to each such hospital for treatment of such patients; and
(d) The amount the hospital would have received for patients for whom no reimbursement was provided.
2. The Director shall verify the amount of treatment provided to indigent inpatients by each hospital to which no reimbursement was provided by:
(a) Determining the number of indigent inpatients who received treatment. For a hospital that has contracted with the Department pursuant to subsection 4 of NRS 428.030, the Director shall determine the number based upon the evaluations of eligibility made by the employee assigned to the hospital pursuant to the contract. For all other hospitals, the Director shall determine the number based upon the report submitted pursuant to subsection 1.
(b) Multiplying the number of indigent inpatients who received each type of treatment by the highest amount paid by the county for that treatment.
(c) Adding the products of the calculations made pursuant to paragraphs (a) and (b) for all treatment provided.
If the total amount of treatment provided to indigent inpatients in the previous fiscal year by the hospital was less than its minimum obligation for the year, the Director shall assess the hospital for the amount of the difference between the minimum obligation and the actual amount of treatment provided by the hospital to indigent inpatients. If a decision of a county regarding the indigent status of one or more inpatients is pending appeal before the Director or upon receiving satisfactory proof from a hospital that the decision is pending appeal before a court having general jurisdiction in the county pursuant to subsection 4 of NRS 439B.330, the Director shall defer assessing the hospital the amount that may be offset by the determination on appeal until a final determination of the matter is made.
3. If the Director determines that a hospital has met its obligation to provide treatment to indigent inpatients, the Director shall certify to the county in which the hospital is located that the hospital has met its obligation. The county is not required to pay the hospital for the costs of treating indigent inpatients until the certification is received from the Director. The county shall pay the hospital for such treatment within 30 days after receipt of the certification to the extent that money was available for payment pursuant to NRS 428.050, 428.285 and 450.425 at the time the treatment was provided.
4. The Director shall determine the amount of the assessment which a hospital must pay pursuant to this section and shall notify the hospital in writing of that amount on or before November 1 of each year. The notice must include, but is not limited to, a written statement for each claim which is denied indicating why the claim was denied. Payment is due 30 days after receipt of the notice, except for assessments deferred pursuant to subsection 2 which, if required, must be paid within 30 days after the court hearing the appeal renders its decision. If a hospital fails to pay the assessment when it is due the hospital shall pay, in addition to the assessment:
(a) Interest at a rate of 1 percent per month for each month after the assessment is due in which it remains unpaid; and
(b) Any court costs and fees required by the Director to obtain payment of the assessment and interest from the hospital.
5. Any money collected pursuant to this section must be paid to the county in which the hospital paying the assessment is located. The money received by a county from assessments made pursuant to this section does not constitute revenue from taxes ad valorem for the purposes of NRS 354.59811, 428.050, 428.285 and 450.425, and must be excluded in determining the maximum rate of tax authorized by those sections.
(Added to NRS by 1987, 869; A 1987, 1630; 1989, 1802, 2085; 1991, 1938, 2112; 1993, 587; 2013, 2884)

Structure Nevada Revised Statutes

Nevada Revised Statutes

Chapter 439B - Restraining Costs of Health Care

NRS 439B.010 - Definitions.

NRS 439B.030 - "Billed charge" defined.

NRS 439B.035 - "Children’s Health Insurance Program" defined.

NRS 439B.040 - "Committee" defined.

NRS 439B.050 - "Department" defined.

NRS 439B.060 - "Director" defined.

NRS 439B.070 - "Discharge form" defined.

NRS 439B.090 - "Fiscal year" defined.

NRS 439B.100 - "Health facility" defined.

NRS 439B.110 - "Hospital" defined.

NRS 439B.115 - "Major hospital" defined.

NRS 439B.120 - "Medicaid" defined.

NRS 439B.130 - "Medicare" defined.

NRS 439B.140 - "Net revenue" defined.

NRS 439B.150 - "Practitioner" defined.

NRS 439B.160 - Purposes of chapter.

NRS 439B.200 - Creation; appointment of and restrictions on members; officers; terms of members; vacancies; annual reports.

NRS 439B.210 - Meetings; quorum; compensation.

NRS 439B.220 - Powers.

NRS 439B.225 - Committee to review certain regulations proposed or adopted by licensing boards; recommendations to Legislature.

NRS 439B.227 - Committee to review certain new provisions of law; recommendations to Legislature concerning mandated reporters.

NRS 439B.260 - Reduction of billed charges for certain patients and services; notice; resolution of disputes. [Effective through December 31, 2025.] Reduction of billed charges for certain patients and services; notice; resolution of disputes. [Effec...

NRS 439B.265 - Collection of deductible or copayment from indigent patient covered by Medicare prohibited. [Effective upon confirmation by the Federal Government that the deductibles and copayments which a hospital is prohibited from collecting from...

NRS 439B.270 - Foundation for hospital nursing practice: Establishment; governing body.

NRS 439B.275 - Program for provision of technical assistance to rural hospitals.

NRS 439B.280 - Educational program to promote wellness, physical fitness and prevention of disease, accidents and motor vehicle crashes.

NRS 439B.300 - Legislative findings and declarations; applicability.

NRS 439B.310 - "Indigent" defined.

NRS 439B.320 - Hospital required to provide care for proportionate share of indigent patients; duties of Department and board of county commissioners; reimbursement for care.

NRS 439B.330 - Eligibility of indigent for assistance; payment of hospital for serving disproportionately large share of patients; discharge forms; appeal from determination of county regarding indigent status.

NRS 439B.340 - Report on indigent patients treated; verification by Director; compensation for treatment provided in excess of obligation; assessment for failure to fulfill minimum obligation.

NRS 439B.350 - Department to establish; purpose.

NRS 439B.360 - Evaluation: Recommendations; report to Interim Finance Committee.

NRS 439B.370 - Director authorized to contract for certain services.

NRS 439B.400 - Hospital must maintain and use uniform list of billed charges; exception.

NRS 439B.410 - Hospital required to provide emergency services and care; unlawful acts of hospital or physician working in hospital emergency room; treating hospital may recover penalty from transferring hospital; exceptions; administrative investiga...

NRS 439B.420 - Prohibited acts of hospitals and related entities; exceptions; submission of contracts to Director; civil penalty.

NRS 439B.425 - Prohibited referral of patients; exceptions; penalty.

NRS 439B.430 - Prohibited acts of hospitals; examination by Director; administrative fine; injunctive relief.

NRS 439B.440 - Director may require hospitals, health facilities and providers of health services to submit information; independent audit; examinations; penalty.

NRS 439B.450 - Powers and duties of Director.

NRS 439B.460 - Director authorized to delegate powers and duties.

NRS 439B.500 - Penalty for violation of provisions.

NRS 439B.600 - Definitions.

NRS 439B.605 - "Manufacturer" defined.

NRS 439B.607 - "National Drug Code" defined.

NRS 439B.610 - "Pharmacy" defined.

NRS 439B.615 - "Pharmacy benefit manager" defined.

NRS 439B.616 - "Rebate" defined.

NRS 439B.618 - "Third party" defined.

NRS 439B.619 - "Unit" defined.

NRS 439B.620 - "Wholesale acquisition cost" defined.

NRS 439B.622 - "Wholesaler" defined.

NRS 439B.625 - Organization representing interests of retail merchants to prepare and update list of most commonly prescribed drugs or generic equivalents.

NRS 439B.630 - Department to annually compile lists of certain prescription drugs.

NRS 439B.635 - Manufacturer of certain prescription drugs to prepare, submit and affirm accuracy of annual report; contents of report.

NRS 439B.640 - Manufacturer of drug that has undergone significant price increase to submit report describing reasons for increase; affirmation of accuracy of report; contents of report.

NRS 439B.642 - Wholesaler of certain prescription drugs to prepare, submit and affirm accuracy of annual report; contents of report.

NRS 439B.645 - Pharmacy benefit manager to submit and affirm accuracy of annual report concerning certain drugs; contents of report.

NRS 439B.650 - Department to compile annual report concerning price of certain drugs; contents of report; presentation of report at public hearing.

NRS 439B.655 - Pharmacies to provide to Department contact information, electronic mail address and address of Internet website; exceptions.

NRS 439B.660 - Manufacturer required to provide list of its pharmaceutical sales representatives; electronic access to list; prohibition against unlisted person marketing prescription drugs; reports.

NRS 439B.665 - Report by certain nonprofit organizations that receive items of value from manufacturer. [Effective through December 31, 2025.] Report by certain nonprofit organizations that receive items of value from manufacturer. [Effective January...

NRS 439B.670 - Department to place on Internet website certain information concerning pharmacies, nonprofit organizations and prescription drugs and certain reports by Department; additional or alternative procedures for obtaining information concern...

NRS 439B.675 - Manner of presentation of information.

NRS 439B.680 - Immunity from civil and criminal liability.

NRS 439B.685 - Regulations.

NRS 439B.690 - Suspension of components of program or duties of Department if sufficient money not available; acceptance of gifts and grants.

NRS 439B.695 - Administrative penalty for failure to provide information to Department; use of money collected by Department.

NRS 439B.700 - Definitions.

NRS 439B.703 - "Covered person" defined.

NRS 439B.706 - "Independent center for emergency medical care" defined.

NRS 439B.709 - "In-network emergency facility" defined.

NRS 439B.712 - "In-network provider" defined.

NRS 439B.715 - "Medically necessary emergency services" defined.

NRS 439B.718 - "Out-of-network emergency facility" defined.

NRS 439B.721 - "Out-of-network provider" defined.

NRS 439B.724 - "Provider contract" defined.

NRS 439B.727 - "Provider of health care" defined.

NRS 439B.730 - "Prudent person" defined.

NRS 439B.733 - "Screen" defined.

NRS 439B.736 - "Third party" defined. [Effective through December 31, 2025.] "Third party" defined. [Effective January 1, 2026.]

NRS 439B.739 - "To stabilize" and "stabilized" defined.

NRS 439B.742 - Inapplicability of provisions to certain hospitals, persons and health care services.

NRS 439B.745 - Limitation on amount out-of-network provider may collect from covered person; duties of out-of-network emergency facility upon providing services.

NRS 439B.748 - Payment to out-of-network emergency facility by third party.

NRS 439B.751 - Payment to out-of-network provider, other than emergency facility, by third party.

NRS 439B.754 - Determination of amount owed when no recent contract exists between out-of-network provider and third party; arbitration to resolve dispute; no interest pending resolution of dispute; confidentiality of arbitration.

NRS 439B.757 - Election by certain entities and organizations not otherwise covered to submit to provisions; regulations.

NRS 439B.760 - Reports; confidentiality of information.

NRS 439B.800 - Definitions. [Effective January 1, 2022.]

NRS 439B.805 - "All-payer claims database" defined. [Effective January 1, 2022.]

NRS 439B.810 - "Covered entity" defined. [Effective January 1, 2022.]

NRS 439B.815 - "Direct patient identifier" defined. [Effective January 1, 2022.]

NRS 439B.820 - "Proprietary financial information" defined. [Effective January 1, 2022.]

NRS 439B.825 - "Provider of health care" defined. [Effective January 1, 2022.]

NRS 439B.830 - "Unique identifier" defined. [Effective January 1, 2022.]

NRS 439B.835 - Establishment of database; duties of Department; advisory committees. [Effective January 1, 2022.]

NRS 439B.840 - Entities required and authorized to submit data to database; removal of direct patient identifiers and assignment of unique identifiers. [Effective January 1, 2022.]

NRS 439B.845 - Confidentiality of data; compliance with certain federal law; use of data in enforcement proceedings. [Effective January 1, 2022.]

NRS 439B.850 - Data requests. [Effective January 1, 2022.]

NRS 439B.855 - Access to and use of data; prohibition on release of data to certain entities; duties of recipient of data; requirement to include certain information in report which contains or uses data. [Effective January 1, 2022.]

NRS 439B.860 - Report concerning quality, efficiency and cost of health care based on data; publication of list of reports Department intends to publish in next calendar year. [Effective January 1, 2022.]

NRS 439B.865 - Reports concerning cost, performance and effectiveness of database and information concerning grants. [Effective January 1, 2022.]

NRS 439B.870 - Immunity from certain civil or criminal liability. [Effective January 1, 2022.]

NRS 439B.875 - Regulations; administrative penalties; contracts and agreements; gifts, grants and donations; accounting and use of administrative penalties by Department. [Effective January 1, 2022.]