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- 83rd Session (2025)
Assembly Bill No. 36–Committee on
Health and Human Services
CHAPTER..........
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
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 exc eptions,
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.
EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted.
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:
422.306 1. Upon receipt of a request for a hearing that
complies with the provisions of this section and any regulations
adopted pursuant thereto, from a provider of services under the
State Plan for Medicaid, the Division shall appoint a hearing officer
to conduct the hearing. Any employee or other represe ntative of the
Division who investigated or made the initial decision regarding the
action taken against a provider of services may not be appointed as
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- 83rd Session (2025)
the hearing officer or participate in the making of any decision
pursuant to the hearing.
2. Unless the Division determines that extenuating
circumstances exist pursuant to the regulations adopted pursuant
to subsection 3 , a provider of services must request a hearing
pursuant to subsection 1 not later than 90 calendar days after the
date of the notice of the action being taken against the provider
that is the subject of the hearing.
3. The Division shall adopt regulations prescribing the
[procedures] :
(a) Procedures to be followed at the hearing [.] ;
(b) Actions on which a provider of services may request a
hearing; and
(c) Circumstances that constitute extenuating circumstances
and which justify the submission of a request for a hearing after
the expiration of the time period prescribed by subsection 2.
[3.] 4. The decision of the hearing officer is a final decision.
Any party, including the Division , who is aggrieved by the decision
of the hearing officer may appeal that decision to the District Court
in and for Carson City by filing a petition for judicial review within
30 days after receiving the decision of the hearing officer.
[4.] 5. A petition for judicial review filed pursuant to this
section must be served upon every party within 30 days after the
filing of the petition for judicial review.
[5.] 6. Unless otherwise provided by the court:
(a) Within 90 days after the service of the petition for judicial
review, the Division shall transmit to the court the original or a
certified copy of the entire record of the proceeding under review,
including, without limitation, a transcript of the evidence resulting
in the final decision of the hearing officer;
(b) The petitioner who is seeking judicial review pursuant to this
section shall serve and file an opening brief within 40 days after the
Division gives written notice to the parties that the record of the
proceeding under review has been filed with the court;
(c) The respondent shall serve and file an answering brief within
30 days after service of the opening brief; and
(d) The petitioner may serve and file a reply brief within 30 days
after service of the answering brief.
[6.] 7. Within 7 days after the expiration of the time within
which the petitioner may reply, any party may request a hearing.
Unless a request for hearing has been filed, the matter shall be
deemed submitted.
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[7.] 8. The review of the court must be confined to the record.
The court shall not substitute its judgment for that of the hearing
officer as to the weight of the evidence on questions of fact. The
court may affirm the decision of the hearing officer or remand the
case for further proceedings. The court may reverse or modify the
decision if substantial rights of the appellant have been prejudiced
because the administrative findings, inferences, conclusions or
decisions are:
(a) In violation of constitutional or statutory provisions;
(b) In excess of the statutory authority of the Division;
(c) Made upon unlawful procedure;
(d) Affected by other error of law;
(e) Clearly erroneous in view of the reliable, probative and
substantial evidence on the whole record; or
(f) Arbitrary or capricious or characterized by abuse of
discretion or clearly unwarranted exercise of discretion.
Sec. 2. The amendatory provisions of section 1 of this act do
not apply to a hearing requested pursuant to subsection 1 of NRS
422.306 before January 1, 2026.
Sec. 3. 1. This section becomes effective upon passage and
approval.
2. Sections 1 and 2 of this act become effective:
(a) Upon passage and approval for the purpose of adopting any
regulations and performing any other preparatory administrative
tasks that are necessary to carry out the provisions of this act; and
(b) On January 1, 2026, for all other purposes.
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