NRS 422.306
Hearing to review action taken against provider of services under State Plan for Medicaid

  • regulations
  • appeal of final decision.

1. Upon receipt of a request for a hearing 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 representative of the Division who investigated or made the initial decision regarding the action taken against a provider of services may not be appointed as the hearing officer or participate in the making of any decision pursuant to the hearing.

2.

The Division shall adopt regulations prescribing the procedures to be followed at the hearing.

3.

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.

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.

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.

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.

7.

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.
Health and Welfare Programs

Source: Section 422.306 — Hearing to review action taken against provider of services under State Plan for Medicaid; regulations; appeal of final decision., https://www.­leg.­state.­nv.­us/NRS/NRS-422.­html#NRS422Sec306.

422.001
Definitions.
422.003
“Administrator” defined.
422.021
“Children’s Health Insurance Program” defined.
422.030
“Department” defined.
422.040
“Director” defined.
422.041
“Division” defined.
422.046
“Medicaid” defined.
422.050
“Public assistance” defined.
422.054
“Undivided estate” defined.
422.061
Purposes of Division.
422.063
State plans for certain programs: Development, adoption and revision by Director
422.064
State plans for certain programs: Priority access to treatment and services for certain parents.
422.065
Eligibility of persons who are not citizens or nationals of United States for state or local public benefits.
422.075
Division to submit certain information to Nevada Commission on Autism Spectrum Disorders.
422.151
Creation
422.153
Composition
422.155
Chair
422.162
Creation
422.165
Duties.
422.240
Legislative appropriations
422.242
Gifts and grants of money to Division: Deposit in Gift and Cooperative Account of the Division of Health Care Financing and Policy
422.260
Acceptance of Social Security Act and federal money.
422.265
Acceptance of increased benefits of future congressional legislation
422.267
Contract or agreement with Federal Government by Director.
422.270
Duties of Department regarding Medicaid and Children’s Health Insurance Program.
422.272
State Plan for Medicaid: Inclusion of requirement for payment of certain costs.
422.273
Establishment, development and implementation of Medicaid managed care program.
422.275
Legal advisers for Division.
422.276
Appeal to Division by applicant for or recipient of benefits from Medicaid or Children’s Health Insurance Program
422.277
Hearing: Rights of parties
422.278
Hearing: Person with communications disability entitled to services of interpreter.
422.279
Judicial review: Taking of additional evidence
422.280
Forms of reports and records to be kept by persons subject to supervision or investigation by Division.
422.291
Assistance not assignable or subject to process or bankruptcy law.
422.292
Assistance subject to future amending and repealing acts.
422.293
Subrogation: Department subrogated to rights of recipient of Medicaid or of insurance provided pursuant to Children’s Health Insurance Program
422.305
Confidentiality of information obtained in investigation of provider of services under State Plan for Medicaid.
422.306
Hearing to review action taken against provider of services under State Plan for Medicaid
422.308
Family planning service
422.309
Provision of prenatal care to pregnant women who are indigent
422.361
Definitions.
422.362
“Cardholder” defined.
422.363
“Medicaid card” defined.
422.364
“Plan” defined.
422.365
“Receives” defined.
422.366
Unlawful acts: Obtaining or possessing card without consent of holder of card
422.367
Unlawful acts: Sale or purchase of card
422.368
Unlawful acts: Use of forged, expired or revoked card to obtain benefits
422.369
Unlawful acts: Fraud by person authorized to provide care to holder of card
422.376
“Facility for intermediate care” defined.
422.378
Report by nursing facility to Division.
422.379
Administrative penalties for late payment of fee
422.380
Definitions.
422.382
Intergovernmental transfers of money from counties to Division
422.385
Disproportionate share payments from Medicaid Budget Account
422.387
Calculation of disproportionate share payments
422.390
Regulations
422.396
Establishment and administration of program to provide community-based services
422.401
Definitions.
422.402
“Drug Use Review Board” defined.
422.403
Establishment and management of use by Medicaid program of step therapy and prior authorization
422.404
Silver State Scripts Board: Chair
422.405
Silver State Scripts Board: Duties and powers.
422.406
Regulations
422.410
Fraudulent acts
422.450
Definitions.
422.460
“Benefit” defined.
422.470
“Claim” defined.
422.480
“Plan” defined.
422.490
“Provider” defined.
422.500
“Recipient” defined.
422.510
“Records” defined.
422.520
“Sign” defined.
422.525
“Statement or representation” defined.
422.530
Responsibility for false claim, statement or representation.
422.540
Offenses regarding false claims, statements or representations
422.550
Statement regarding truth and accuracy of applications, reports and invoices
422.560
Offenses regarding sale, purchase or lease of goods, services, materials or supplies
422.570
Intentional failure to maintain adequate records
422.580
Civil penalties for certain violations
422.590
Limitation and accrual of actions.
422.2354
Qualifications.
422.2356
Executive Officer of Division
422.2357
Administration of chapter.
422.2358
Reports.
422.2362
Fiscal duties.
422.2364
Organization of Division
422.2366
Administration of oaths
422.2368
Adoption of regulations.
422.2369
Procedure for adopting, amending or repealing regulations.
422.2372
General and miscellaneous powers and duties.
422.2374
Cooperation with Medicaid Fraud Control Unit
422.2703
Department required to establish and maintain system for electronic submission of applications for Medicaid or Children’s Health Insurance Program.
422.2704
Review of rates of reimbursement.
422.2712
Reporting of certain rates of reimbursement for physicians.
422.2717
State Plan for Medicaid: Inclusion of requirement that independent foster care adolescents are eligible for Medicaid.
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.
422.2719
State Plan for Medicaid: Inclusion of requirement for payment of certain costs related to fetal alcohol spectrum disorders.
422.2721
State Plan for Medicaid: Payment for services provided through telehealth.
422.2723
State Plan for Medicaid: Inclusion of requirement for payment of certain costs relating to dialysis and emergency care to treat kidney failure.
422.2724
State Plan for Medicaid: Reimbursement of registered nurse for certain services provided to persons eligible for Medicaid.
422.2735
Program to provide increased capitation payments to Medicaid managed care plans for ground emergency medical transportation services provided by governmental provider.
422.2748
Cooperation with Medicaid Fraud Control Unit.
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.
422.2775
Hearing: Evidence.
422.2785
Contents and delivery of decision or order of hearing officer
422.3085
Development of Sexual Trauma Services Guide
422.3755
Definitions.
422.3765
“Facility for skilled nursing” defined.
422.3771
“Nursing facility” defined.
422.3775
Payment of fee
422.3785
Creation of Account to Increase the Quality of Nursing Care
422.3791
Definitions.
422.3792
“Agency to provide personal care services in the home” defined.
422.3793
“Operator” defined.
422.3794
Imposition of assessment
422.3795
Administrative penalties
422.3805
Federal waivers: Duties of Administrator.
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.
422.3964
State Plan for Medicaid: Inclusion of certain home and community-based services.
422.4015
“Board” defined.
422.4021
“Health benefit plan” defined.
422.4022
“Health maintenance organization” defined.
422.4023
“Pharmacy benefit manager” defined.
422.4024
“Sickle cell disease and its variants” defined.
422.4025
List of preferred prescription drugs used for Medicaid program and Children’s Health Insurance Program
422.4026
Coverage of certain supplements for treating sickle cell disease and its variants.
422.4035
Silver State Scripts Board: Creation
422.4045
Silver State Scripts Board: Members serve without compensation
422.4053
Department to manage payments and rebates for prescription drugs
422.4056
Audits of certain contracts.
422.27172
State Plan for Medicaid: Inclusion of requirement for payment of certain costs related to family planning.
422.27174
State Plan for Medicaid: Inclusion of requirement for payment of certain costs for preventative care.
422.27176
State Plan for Medicaid: Inclusion of requirement for payment of certain costs for mammogram.
422.27178
State Plan for Medicaid: Inclusion of requirement for payment of certain costs for breastfeeding supplies and prenatal screenings and tests.
422.27234
State Plan for Medicaid: Inclusion of requirement for payment of certain costs related to sickle cell disease and its variants.
422.27238
State Plan for Medicaid: Reimbursement for crisis stabilization services.
422.27239
State Plan for Medicaid: Reimbursement for services of psychological assistant, psychological intern or psychological trainee.
422.27241
State Plan for Medicaid: Reimbursement for services for hospice care provided to persons eligible for Medicaid.
422.27242
State Plan for Medicaid and Children’s Health Insurance Program: Inclusion of authorization for enrollment of certain children.
422.27243
Program to provide medical assistance to certain persons who are employed and have disabilities.
422.27247
Application for federal waiver to provide certain dental care for certain persons.
422.27482
Report concerning provision of health benefits by large employers.
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
422.27495
Contracts for provision of certain transportation services for recipients of Medicaid and recipients of services pursuant to Children’s Health Insurance Program.
422.29301
Administration of provisions concerning recovery of amounts incorrectly paid for recipient of Medicaid.
422.29302
Recovery of benefits paid for Medicaid: Powers and duties of Department
422.29304
Recovery of amounts paid for Medicaid under certain circumstances
422.29306
Imposition and release of lien on property of recipient of Medicaid.
422.37915
“Account” defined.
422.37925
“Medical facility” defined.
422.37935
“Operator group” defined.
422.37945
Creation of Account
422.293001
Subrogation: Notice to Department of recipient’s claim
422.293003
Subrogation: Department required to provide notice of amount of lien
422.293005
Subrogation: Liability for failure to comply with provisions.
Last Updated

Feb. 5, 2021

§ 422.306’s source at nv​.us