AB 15 — Revises provisions relating to Medicaid fraud. (BDR 18-446)

(ReprintedAssembly withBill amendmentsNo. adopted on May 19, 2025) FIRST REPRINT A.B.

1515–Committee ASSEMBLYon BILLGovernment NOAffairs .CHAPTER..........

15–COMMITTEE ON GOVERNMENT A FFAIRS (O NB EHALF OF THE ATTORNEY GENERAL ) P REFILED N OVEMBER 4, 2024 ____________ Referred to Committee on Government Affairs SUMMARY—Revises provisions relating to Medicaid fraud.

(BDR 18-446) FISCAL NOTE:

Effect on Local Government:

No.

Effect on the State:

No.

~ EXPLANATION – Matter in bolded italics is new;

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

Existing law establishes the Medicaid Fraud Control Unit within the Office of prosecutionthe Attorney General as the agency responsible for the investigation and 228.410) In carrying out those duties and responsibilities, existing law authorizes the Attorney General, acting through the chief executive of violationsthe Medicaid Fraud Control Unit or offenseshis relatingor her designee, to theissue Statea Plansubpoena for Medicaid.documents, records or materials.

(NRS 228.410) In carrying out those duties and responsibilities, existing law authorizes the Attorney General, acting through the chief executive of the Medicaid Fraud Control Unit or his or her designee, to issue a subpoena for documents, records or materials.

and (2) authorizedanswer towritten useinterrogatories anyunder documents,oath. records, materials, testimony or answerseneral is produced pursuant to such a subpoena in the course of a civil action involving Medicaid fraud, but prohibited from using those items in the course of a criminal action.

SectionUnder section 1 setsthe forthAttorney proceduresGeneral byis whichauthorized to use any documents, records, materials, testimony or answers produced pursuant to such a subpoena in the Attorneycourse Generalof maya petitioncivil action involving Medicaid fraud, but prohibited from using those items in the course of a criminal a court for the issuance of an order to compel compliance with such a subpoena.subpoena.ion Existing federal law provides financial incentives for states that enact laws establishing liability for false or fraudulent claims made to the State Plan for Medicaid.

Existing federal law provides financial incentives for states that enact laws Medicaid.

§ 1396h) To be eligible for these financial incentives, the - *AB15_R1* – 2 – laws of a state must contain provisions that are at least as effective at rewarding and facilitating certain qui tam actions for false or fraudulent claims as those described in the federal False Claims Act.

§§ 3729-3732) Existing federal law prohibits a private person from bringing a qui tam action against a person for false theor subjectfraudulent ofclaims aif civilthe suitaction oris anbased administrativeupon civilallegations moneyor penaltytransactions proceedingwhich in are which the Federal Government is already a party.

§ 3730(e)(3)) Existing state law contains similar provisions, but prohibits a private plaintiff from maintaining, rather than bringing, a qui tam action for false or fraudulent claims if the action is based upon allegations or transactions that are the subject of a civil action or administrative proceeding for a monetary penalty to which the State or thatpolitical prohibition,subdivision consistentis withalready federal law, to prohibit a personparty. from bringing,ises rather than maintaining, such an action under those circumstances.

Existing(NRS law357.080) makesSection it2 aof grossthis misdemeanorbill forrevises athat personprohibition, toconsistent intentionallywith failfederal tolaw, maintain certain records relating to prohibit a claimperson forfrom paymentbringing, forrather goodsthan ormaintaining, servicessuch pursuantan toaction theunder Statethose Plancircumstances. for Medicaid.

(NRSExisting 422.570)law Sectionmakes 3it ofa thisgross billmisdemeanor insteadfor makesa theperson punishmentto forintentionally suchfail anto offense:pursuant to the State Plan for Medicaid.

(1)(NRS a422.570) misdemeanorSection if3 theof amountthis claimbills wasinstead $650makes orthe more.hanpunishment $650;for such an offense:

and(1) (2) a gross misdemeanor if the amount of the THEclaim PEOPLEwas OFless THEthan STATE$650; OF NEVADA, REPRESENTED IN SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:

and (2) a gross misdemeanor if the amount of the claim was $650 or more.

- 83rd Session (2025) – 2 – 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:

The Attorney General may use any documents, records , [or] materials , testimony or answers produced pursuant to a subpoena issued under this section in the course of a civil action brought pursuant to NRS 228.410.

- *AB15_R1* – 3 – 4.

5.subpoena was served and upon a showing of good cause, modify the order issued pursuant to subsection 4 or issue any further order that justice may require to protect the person from - 83rd Session (2025) – 3 – unreasonable annoyance, embarrassment, oppression, burden or expense.

The court may, on motion by the person upon whom the subpoena was served and upon a showing of good cause, modify the order issued pursuant to subsection 4 or issue any further order that justice may require to protect the person from unreasonable annoyance, embarrassment, oppression, burden or expense.

7.it in NRS 228.410.

As used in this section, “Plan” has the meaning ascribed to itSec. in NRS 228.410.

Sec.

(a) Against a member of the Legislature or the Judiciary, an elected officer of the Executive Department of the State Government, or a member of the governing body of a political subdivision, if the action is based upon evidence or information - *AB15_R1* – 4 – known to the State or political subdivision at the time the action was brought.

On the date the private plaintiff files a complaint, he or she shall send a copy of the complaint to the Attorney General by mail - 83rd Session (2025) – 4 – with return receipt requested.

Sec.422.570 1.NRS 4A person [is guilty of a gross misdemeanor if,] who, upon submitting a claim for or upon receiving payment for goods or services pursuant to the Plan, [the person] intentionally fails to maintain such records as are necessary to disclose fully the nature of the goods or services for which a claim was submitted or payment was received, or such records as are necessary to disclose fully all income and expenditures upon which rates of payment were based, for at least 5 years after the date on which payment was received [.] is guilty of:

3.

NRS 422.570 is hereby amended to read as follows:

422.570 1.

A person [is guilty of a gross misdemeanor if,] who, upon submitting a claim for or upon receiving payment for goods or services pursuant to the Plan, [the person] intentionally fails to maintain such records as are necessary to disclose fully the nature of the goods or services for which a claim was submitted or payment was received, or such records as are necessary to disclose fully all income and expenditures upon which rates of payment were based, for at least 5 years after the date on which payment was received [.] is guilty of: