AB 36 — Revises provisions relating to Medicaid. (BDR 38-291)

A.B.Assembly Bill No.

3636–Committee Aon SSEMBLYHealth BILLand NOHuman .Services CHAPTER..........

36–COMMITTEE ON H EALTH AND HUMAN SERVICES (O N BEHALF OF THE DIVISION OF HEALTH CARE F INANCING AND POLICY OF THE D EPARTMENT OF H EALTH AND HUMAN SERVICES ) PREFILED N OVEMBER 15, 2024 ____________ Referred to Committee on Health and Human Services SUMMARY—Revises provisions relating to Medicaid.

(BDR 38-291) FISCAL NOTE:

Effect on Local Government:

No.

Effect on the State:

Yes.

~ EXPLANATION – Matter in bolded italics is new;

matter between brackets [omitted material] is material to be omitted.

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.

(1) authorizes such a provider of services to request a hearing with the Division of Health Care Financing and Policy of the DivisionDepartment toconcerning adoptan regulationsaction prescribingtaken against the proceduresprovider; for such a hearing.

and (2) requires the Division to adopt regulations prescribing the procedures for such a hearing.

and (2) require, with certain exceptions, 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 ofofn 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 1vider,1 unless additionally requires the Division to adopt regulations prescribing:

(1) the actions onconstitute extenuating circumstances and which ajustify providerthe maysubmission of a request for a hearing;hearing later than 90 calendar days after the provider receives notice of an action against him or her.

andSection (2)2 theof circumstancesthis thatbill constituterequires extenuating circumstances and which justify the submissionprovisions of asection request1, -and *AB36*any –regulations 2adopted –pursuant forto asection hearing1, laterto thanapply 90prospectively calendaronly daysto afterhearings therequested provideron receivesor noticeafter ofJanuary an1, action2026. against him or her.

SectionEXPLANATION 2– ofMatter thisin billbolded requiresitalics theis provisionsnew; of section 1, hearings requested on or after January 1, 2026.

1,matter tobetween applybrackets prospectively[omitted onlymaterial] tois THEmaterial PEOPLEto OFbe THEomitted. STATE OF NEVADA, REPRESENTED IN SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:

THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:

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 - 83rd Session (2025) – 2 – the hearing officer or participate in the making of any decision pursuant to the hearing.

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.

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.

(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, - *AB36* – 3 – including, without limitation, a transcript of the evidence resulting in the final decision of the hearing officer;

(c) The respondent shall serve and file an answering brief within 30 days after service of the opening brief;

- 83rd Session (2025) – 3 – [7.] 8.

The court may affirm the decision of the hearing officer or remand the casedecision forif furthersubstantial proceedings.rights of the appellant have been prejudiced because the administrative findings, inferences, conclusions or decisions are:

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:

H~~~~~ 25 - *AB36*83rd Session (2025)