Nevada Public Welfare

Sec. § 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 Services of United States Department of Health and Human Services.


1.

The State Plan for Medicaid must provide the methodology for:

(a)

Calculating the initial distribution of the disproportionate share payments in accordance with the regulations adopted pursuant to NRS 422.390;

(b)

Adjusting the disproportionate share payment to a hospital if the annual audit of the hospital demonstrates that the disproportionate share payment made to the hospital was greater than the amount of money which the hospital was eligible to receive; and

(c)

Redistributing any amount of disproportionate share payments which are returned to the Division as a result of the adjustments made in accordance with paragraph (b).

2.

The State Plan for Medicaid or, if the Division deems necessary, the Division may require a hospital to submit any documentation or other information to verify eligibility for a disproportionate share payment or compliance with the requirements of NRS 422.380 to 422.390, inclusive. A disproportionate share payment may not be calculated for or made to a hospital which fails to provide the Division with documentation or other information that is required by the State Plan for Medicaid or the Division.

3.

Except as otherwise provided in subsection 4, the State Plan for Medicaid must be consistent with the provisions of NRS 422.380 to 422.390, inclusive, and the regulations adopted pursuant thereto, and Title XIX of the Social Security Act, 42 U.S.C. §§ 1396 et seq., and the regulations adopted pursuant to those provisions.

4.

If the Centers for Medicare and Medicaid Services of the United States Department of Health and Human Services denies an amendment to the State Plan for Medicaid, the Director may negotiate terms which are acceptable to the Centers for Medicare and Medicaid Services which are inconsistent with the provisions of NRS 422.380 to 422.390, inclusive, and the regulations adopted pursuant thereto if:

(a)

Negotiating such terms is necessary to ensure that the State Plan for Medicaid is consistent with the provisions of Title XIX of the Social Security Act, 42 U.S.C. §§ 1396 et seq., and the regulations adopted pursuant to those provisions; and

(b)

Before finalizing such an amendment to the State Plan for Medicaid, the Director obtains the approval of the Interim Finance Committee.
Source

Last accessed
Feb. 5, 2021