reglab/statecodes huggingface dataset:
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › PROVISION OF NEONATAL CARE BY HOSPITAL › Levels of Care › Section 442.380 - Level I basic care facilities: General requirements

Current through June 11, 2024
1. A level I basic care facility must be able to provide:
(a) A newborn nursery for the routine care of apparently normal neonates who have demonstrated successful adaptation to extrauterine life.
(b) Resuscitation and stabilization of all neonates born in the hospital.
(c) Evaluation and continuing care of healthy neonates.
(d) Identification, stabilization and preparation of neonates for transport to a level II specialty care facility or level III subspecialty care facility, as appropriate.
(e) A policy that clearly delineates when consultation with a level II specialty care facility or level III subspecialty care facility is required to prevent rapid or further deterioration of a neonate and prevent delay in treatment at a higher level of care.
(f) Visitation between the neonate and the parents and siblings of the neonate.
(g) Collection and retrieval of data as required pursuant to the
Guidelines for Perinatal Care
adopted by reference pursuant to NAC 442.370.
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › PROVISION OF NEONATAL CARE BY HOSPITAL › Levels of Care › Section 442.390 - Level II specialty care facilities: General requirements

Current through June 11, 2024
1. A level II specialty care facility must be able to provide:
(a) The basic care services as described under subsection 1 of NAC 442.380.
(b) Intermediate care for a minimum of six neonates.
(c) Stabilization of severely ill neonates before transfer to a level III subspecialty care facility.
(d) Treatment for moderately ill neonates that were carried to term and larger preterm neonates.
(e) Collection and retrieval of data as required pursuant to the
Guidelines for Perinatal Care
adopted by reference pursuant to NAC 442.370.
(f) Continuing care of neonates who have a low weight at birth and are not ill but require frequent feeding or require more hours of nursing than normal neonates.
(g) Intermediate care of sick neonates who do not require intensive care but require 6 to 12 hours of nursing care each day. Neonates who require complex care, such as assisted ventilation for more than several hours, will be moved to a level III subspecialty care facility.
(h) Cardiopulmonary resuscitative services and continuous monitoring of cardiopulmonary status.
(i) Care in excess of its designated level for a neonate for not more than 24 hours, while identifying, stabilizing and preparing a high-risk or critically ill neonate for transport to a level III subspecialty care facility.
(j) Continuing care for convalescing neonates transported from level III subspecialty care facilities.
(k) Gavage feeding.
(l) Pharmacy services, including parenteral nutritional solutions, 24 hours per day.
(m) Laboratory consultation services 24 hours per day.
(n) Radiological services, such as X-ray, diagnostic imaging procedures and consultation services, 24 hours per day.
(o) Certified or registered respiratory therapists trained in neonatology on staff 24 hours per day.
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › PROVISION OF NEONATAL CARE BY HOSPITAL › Levels of Care › Section 442.401 - Level III subspecialty care facilities: General requirements

Current through June 11, 2024
1. A level III subspecialty care facility must:
(a) Be able to care for neonates as provided by NAC 442.390;
(b) Provide nine or more beds for the intensive care of neonates;
(c) Provide and adhere to a formal, written plan for in-house coverage of the level III subspecialty care facility by neonatologists, pediatricians, qualified physicians and advanced practice registered nurses, taking into consideration the condition and medical needs of the neonates requiring level III subspecialty care; and
(d) Have formal, written agreements with each level I basic care facility and level II specialty care facility from which it receives neonates. The agreement must include provisions for:
(1) Education in perinatal care, including neonatal resuscitation, for the staff of the level I basic care facilities and level II specialty care facilities, on at least an annual basis; and
(2) Technical assistance in the development of a program of quality assurance for the care provided to neonates by the level I basic care facilities and level II specialty care facilities.
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › PROVISION OF NEONATAL CARE BY HOSPITAL › Levels of Care › Section 442.405 - Level II specialty care facilities and level III subspecialty care facilities: Additional requirements

Current through June 11, 2024
In addition to the requirements set forth in NAC 442.390 and 442.401, level II specialty care facilities and level III subspecialty care facilities must meet the following requirements:
1. The following support personnel must be available in level II specialty care facilities and level III subspecialty care facilities:
(a) At least one full-time social worker, licensed pursuant to chapter 641B of NRS, for every 30 beds in the facility. The social worker must have experience with the socioeconomic and psychosocial problems of high-risk women and fetuses, as defined in the
Guidelines for Perinatal Care
adopted by reference pursuant to NAC 442.370, ill neonates and the families of ill neonates.
(b) At least one occupational therapist or physical therapist with experience in the care of neonates.
(c) At least one licensed dietitian who has special training in perinatal nutrition and can plan diets that meet the special needs of high-risk women and neonates.
(d) Personnel in the pharmacy, including, but not limited to, pharmacists and technicians, who will work to review continually their systems and process of administering medication to ensure that policies relating to the care of patients are maintained.
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › PROVISION OF NEONATAL CARE BY HOSPITAL › Designation of Hospital as Neonatal Facility › Section 442.411 - Application; fee; requirements for provision of obstetrical services

Current through June 11, 2024
1. The Division shall provide a uniform application form for hospitals to apply for a designation as a level II specialty care facility or level III subspecialty care facility.
2. The application must include a statement:
(a) Describing the qualifications of the hospital's personnel to provide level II specialty care or level III subspecialty care for neonates;
(b) Describing the facilities and equipment to be used to provide level II specialty care or level III subspecialty care for neonates;
(c) Describing how the hospital's facilities and personnel meet or exceed the standards established in NAC 442.250 to 442.550, inclusive, for the level of neonatal care requested;
(d) From the medical director of the proposed neonatal facility that the hospital has adequate facilities, equipment, personnel and policies and procedures to provide neonatal care at the level requested; and
(e) From the chief operating officer of the hospital that the hospital is committed to maintaining sufficient support personnel and equipment to provide neonatal care at the level requested.
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › PROVISION OF NEONATAL CARE BY HOSPITAL › Designation of Hospital as Neonatal Facility › Section 442.415 - Accompaniment of application with letter of approval

Current through June 11, 2024
If a hospital is required to obtain the approval of the Director of the Department of Health and Human Services pursuant to NRS 439A.100 in order to provide intensive care for neonates, the hospital's application for approval to be designated as a level II specialty care facility or level III subspecialty care facility must be accompanied by a letter of approval received from the Director.
Added to NAC by Bd. of Health, eff. 9-1-89; A by R064-04, 8-4-2004
NRS 442.007, 449.0302
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › PROVISION OF NEONATAL CARE BY HOSPITAL › Designation of Hospital as Neonatal Facility › Section 442.430 - Level III subspecialty care facilities: Requirements for designation

Current through June 11, 2024
A hospital seeking designation as a level III subspecialty care facility must:
1. Demonstrate its capability to provide all required services and equipment, which include:
(a) The following services and equipment for the transportation of a neonate:
(1) A portable incubator;
(2) Resuscitation equipment;
(3) Oxygen, a means of application and a means to monitor levels of saturation;
(4) Portable cardiac and temperature monitoring equipment;
(5) A ventilator; and
(6) Continuous intravenous infusion equipment.
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › PROVISION OF NEONATAL CARE BY HOSPITAL › Designation of Hospital as Neonatal Facility › Section 442.440 - Level III subspecialty care facilities: System required for education, consultation, referral and continuing care

Current through June 11, 2024
A hospital seeking designation as a level III subspecialty care facility must comply with the requirements set forth in NAC 442.430, as appropriate, and must develop and maintain a system which includes:
1. The education of personnel providing neonatal services in hospitals which make referrals to that level III subspecialty care facility;
2. A service by telephone, for 24 hours per day, for consultation and referral;
3. The education of personnel at all usual sources of referrals concerning the identification and stabilization of a neonate at a stage which is considered a high risk; and
4. A program for the continuing analysis of and care for each neonate.
Added to NAC by Bd. of Health, 7-16-85, eff. 8-1-85; A 9-1-89; R064-04, 8-4-2004
NRS 442.007, 449.0302
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › PROVISION OF NEONATAL CARE BY HOSPITAL › Designation of Hospital as Neonatal Facility › Section 442.461 - Reporting requirements; provision of access for inspection

Current through June 11, 2024
A level II specialty care facility or level III subspecialty care facility shall:
1. Comply with the reporting requirements established by the Division;
2. Provide access to its facilities and records for inspection by the Division; and
3. Annually submit to the Division reports concerning the birth weight, survival, transfer and incidence of certain conditions of neonates in a format approved by the Division.
Added to NAC by Bd. of Health, 7-16-85, eff. 8-1-85; A 9-1-89; 9-16-92; R064-04, 8-4-2004
NRS 442.007, 449.0302
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › PROVISION OF NEONATAL CARE BY HOSPITAL › Designation of Hospital as Neonatal Facility › Section 442.471 - Periodic examination of sites and review of performance

Current through June 11, 2024
The Division shall conduct an examination on the site of each facility designated at each level and review its performance at least once every 5 years.
Added to NAC by Bd. of Health, 7-16-85, eff. 8-1-85; A 9-1-89; R064-04, 8-4-2004
NRS 442.007, 449.0302
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › PROVISION OF NEONATAL CARE BY HOSPITAL › Designation of Hospital as Neonatal Facility › Section 442.480 - Provision of certain new services: Requirements for approval; period of approval

Current through June 11, 2024
1. A hospital may request the Division's approval to provide a new service for the level II specialty care of neonates after the hospital has operated a level I basic care facility for at least 6 months. A hospital may request the Division's approval to provide a new service for the level III subspecialty care of neonates after the hospital has operated a level II specialty care facility for at least 6 months. The hospital may not provide a new service for the level II specialty care or level III subspecialty care of neonates before it has received written approval for the service from the Division.
2. The Division shall send written notification to the hospital within 45 working days after receiving the application. The notice must state:
(a) Whether the application is complete; and
(b) If the application is not complete, what is needed for completion.
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › PROVISION OF NEONATAL CARE BY HOSPITAL › Designation of Hospital as Neonatal Facility › Section 442.501 - Denial, suspension or revocation of right to provide care: Grounds

Current through June 11, 2024
The Division may deny, suspend or revoke the right of a hospital to provide level II specialty care or level III subspecialty care for neonates for the failure of the hospital to:
1. Comply with the provisions of NAC 442.250 to 442.550, inclusive; or
2. Pay the costs associated with an inspection made by a site-inspection team.
Added to NAC by Bd. of Health, eff. 9-1-89; A 9-16-92; 10-30-97; R064-04, 8-4-2004
NRS 442.007, 449.0302
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › PROVISION OF NEONATAL CARE BY HOSPITAL › Designation of Hospital as Neonatal Facility › Section 442.511 - Denial, suspension or revocation of right to provide care: Notice; appeal

Current through June 11, 2024
1. The Division shall give a hospital written notice in the manner prescribed in chapter 439 of NAC before it:
(a) Denies an application of a hospital to provide level II specialty care or level III subspecialty care for neonates;
(b) Revokes its approval of a hospital to provide level II specialty care or level III subspecialty care for neonates; or
(c) Suspends its approval of a hospital to provide level II specialty care or level III subspecialty care for neonates.
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › PROVISION OF NEONATAL CARE BY HOSPITAL › Designation of Hospital as Neonatal Facility › Section 442.520 - Revocation of designation: Grounds

Current through June 11, 2024
The Division may revoke a hospital's designation as a level II specialty care facility or level III subspecialty care facility if the hospital:
1. Uses unlicensed beds in its level II specialty care facility or level III subspecialty care facility;
2. Fails to provide the services required for a level II specialty care facility or level III subspecialty care facility at its designated level or provides care in excess of its designated level;
3. Fails to comply with the criteria and standards for a level II specialty care facility or level III subspecialty care facility at its designated level;
4. Maintains a policy for admission to the level II specialty care facility or level III subspecialty care facility which discriminates on the basis of financial resources, race, color, religion or national origin;
5. Fails to correct the deficiencies specified by the Division within the time set;
6. Fails to provide the required continuing analysis in accordance with the criteria set by the Division;
7. Fails to provide systems for continuing care and consultation with the referral facility, if applicable; or
8. Holds itself out to the public as anything other than as designated by the Division.
Added to NAC by Bd. of Health, 7-16-85, eff. 8-1-85; A 9-1-89; 9-16-92; R064-04, 8-4-2004
NRS 442.007, 449.0302
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › PROVISION OF NEONATAL CARE BY HOSPITAL › Designation of Hospital as Neonatal Facility › Section 442.530 - Revocation of designation: Procedure

Current through June 11, 2024
1. The Division shall give written notice to a hospital of its intention to revoke the hospital's designation. The notice must contain the reasons for the Division's action.
2. Within 30 days after the hospital receives such notice, it may respond in writing and submit evidence to the Division opposing the proposed action.
3. The Division shall revoke the hospital's designation if the hospital fails to:
(a) Respond in writing pursuant to subsection 2;
(b) Submit evidence which is sufficient to refute the Division's reasons; or
(c) Correct the deficiencies specified by the Division within the time set by the Division.
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › PROVISION OF NEONATAL CARE BY HOSPITAL › Miscellaneous Provisions › Section 442.540 - Acceptance of neonate without regard to ability of parents or guardian to pay

Current through June 11, 2024
A level I basic care facility, level II specialty care facility or level III subspecialty care facility shall accept any neonate transported to or back to that facility, as appropriate, without regard to the ability of the parents or guardian of the neonate to pay for the care to be provided to the neonate.
Added to NAC by Bd. of Health, 7-16-85, eff. 8-1-85; A 9-1-89; R064-04, 8-4-2004
NRS 442.007, 449.0302
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › PROVISION OF NEONATAL CARE BY HOSPITAL › Miscellaneous Provisions › Section 442.550 - System of cooperation among facilities; records of problems and solutions discussed

Current through June 11, 2024
A system of cooperation to ensure the quality of care provided must be established between a level III subspecialty care facility and facilities that refer neonates to it. Records must be kept by each facility of any problems and solutions discussed among the facilities in order to maintain a minimum standard for the quality of the care provided. The records are part of the quality assurance program records of the hospital.
Added to NAC by Bd. of Health, 7-16-85, eff. 8-1-85; A 9-1-89; R064-04, 8-4-2004
NRS 442.007, 449.0302
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › SERVICES UNDER SOCIAL SECURITY ACT › General Provisions › Section 442.600 - Definitions

Current through June 11, 2024
As used in NAC 442.600 to 442.788, inclusive, unless the context otherwise requires, the words and terms defined in NAC 442.602 to 442.708, inclusive, have the meanings ascribed to them in those sections.
Added to NAC by Bd. of Health, eff. 11-27-89; A 1-18-94; 10-30-97; R212-97, 7-23-98; R095-99, 11-29-99; R024-06, 7-14-2006
NRS 442.140, 442.190
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › SERVICES UNDER SOCIAL SECURITY ACT › General Provisions › Section 442.602 - "Activities of daily living" defined

Current through June 11, 2024
"Activities of daily living" means activities that a person performs independently to care for his or her personal needs, including, but not limited to, bathing, grooming, using the toilet, eating, brushing his or her teeth, transferring from a bed to a chair or ambulating.
Added to NAC by Bd. of Health, eff. 1-18-94
NRS 442.140, 442.190
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › SERVICES UNDER SOCIAL SECURITY ACT › General Provisions › Section 442.603 - "Acute care" defined

Current through June 11, 2024
"Acute care" means a level of medical services provided in a hospital.
Added to NAC by Bd. of Health, eff. 1-18-94
NRS 442.190
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › SERVICES UNDER SOCIAL SECURITY ACT › General Provisions › Section 442.614 - "Ambulatory or outpatient services" defined

Current through June 11, 2024
"Ambulatory or outpatient services" means limited medical services provided for the diagnosis or treatment of a client who does not require care in a medical facility for more than 24 hours.
Added to NAC by Bd. of Health, eff. 1-18-94
NRS 442.190
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › SERVICES UNDER SOCIAL SECURITY ACT › General Provisions › Section 442.616 - "Annually" defined

Current through June 11, 2024
"Annually" means for each continuous period of 12 months of participation in the program.
Added to NAC by Bd. of Health by R212-97, eff. 7-23-98
NRS 442.140, 442.190
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › SERVICES UNDER SOCIAL SECURITY ACT › General Provisions › Section 442.617 - "Bureau" defined

Current through June 11, 2024
"Bureau" means the Bureau of Family Health Services of the Division.
Added to NAC by Bd. of Health, eff. 10-30-97
NRS 442.140, 442.190
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › SERVICES UNDER SOCIAL SECURITY ACT › General Provisions › Section 442.619 - "Chief" defined

Current through June 11, 2024
"Chief" means the Chief of the Bureau.
Added to NAC by Bd. of Health by R212-97, eff. 7-23-98
NRS 442.140, 442.190
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › SERVICES UNDER SOCIAL SECURITY ACT › General Provisions › Section 442.620 - "Chronic" defined

Current through June 11, 2024
"Chronic" means a medical condition persisting for more than 12 weeks.
Added to NAC by Bd. of Health, eff. 11-27-89
NRS 442.190
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › SERVICES UNDER SOCIAL SECURITY ACT › General Provisions › Section 442.625 - "Client" defined

Current through June 11, 2024
"Client" means a person who is eligible to participate in the program pursuant to NAC 442.600 to 442.788, inclusive.
Added to NAC by Bd. of Health, eff. 11-27-89; A 1-18-94; R212-97, 7-23-98; R095-99, 11-29-99; R024-06, 7-14-2006
NRS 442.140, 442.190
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › SERVICES UNDER SOCIAL SECURITY ACT › General Provisions › Section 442.635 - "Diagnostic evaluation" defined

Current through June 11, 2024
"Diagnostic evaluation" means the performance of a medical history, a physical examination, laboratory tests, radiological procedures, sonography, magnetic resonance imaging, or specific, limited surgical procedures necessary for the definition of pathology.
Added to NAC by Bd. of Health, eff. 11-27-89; A 1-18-94
NRS 442.190
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › SERVICES UNDER SOCIAL SECURITY ACT › General Provisions › Section 442.637 - "Disabling condition" defined

Current through June 11, 2024
"Disabling condition" means an anatomical, physiological or other physical deficiency which inhibits normal growth or the ability to perform the activities of daily living.
Added to NAC by Bd. of Health, eff. 11-27-89; A 1-18-94-Substituted in revision for NAC 442.650
NRS 442.140, 442.190
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › SERVICES UNDER SOCIAL SECURITY ACT › General Provisions › Section 442.638 - "Division" defined

Current through June 11, 2024
"Division" means the Division of Public and Behavioral Health of the Department of Health and Human Services.
Added to NAC by Bd. of Health, eff. 11-27-89-Substituted in revision for NAC 442.655
NRS 442.140, 442.190
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › SERVICES UNDER SOCIAL SECURITY ACT › General Provisions › Section 442.639 - "Eligible condition" defined

Current through June 11, 2024
"Eligible condition" means an eligible medical condition or another condition for which coverage is provided under the program pursuant to NAC 442.600 to 442.788, inclusive.
Added to NAC by Bd. of Health by R212-97, eff. 7-23-98; A by R095-99, 11-29-99; R024-06, 7-14-2006
NRS 442.140, 442.190
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › SERVICES UNDER SOCIAL SECURITY ACT › General Provisions › Section 442.640 - "Eligible medical condition" defined

Current through June 11, 2024
"Eligible medical condition" means a medical condition of a client described in NAC 442.784.
Added to NAC by Bd. of Health, eff. 11-27-89; A 1-18-94; R212-97, 7-23-98
NRS 442.140, 442.190
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › SERVICES UNDER SOCIAL SECURITY ACT › General Provisions › Section 442.660 - "High-risk pregnancy" defined

Current through June 11, 2024
"High-risk pregnancy" means a pregnancy which, on the basis of age or genetic, medical, nutritional or environmental factors, can be considered likely to require more than standard, routine obstetric care.
Added to NAC by Bd. of Health, eff. 11-27-89; A 1-18-94
NRS 442.190
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › SERVICES UNDER SOCIAL SECURITY ACT › General Provisions › Section 442.662 - "Hospital" defined

Current through June 11, 2024
"Hospital" has the meaning ascribed to it in NRS 449.012.
Added to NAC by Bd. of Health, eff. 1-18-94
NRS 442.140, 442.190
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › SERVICES UNDER SOCIAL SECURITY ACT › General Provisions › Section 442.663 - "Household" defined

Current through June 11, 2024
"Household" means an association of persons who live together as a single economic unit, regardless of whether they are related.
Added to NAC by Bd. of Health, eff. 1-18-94; A by R212-97, 7-23-98
NRS 442.140, 442.190
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › SERVICES UNDER SOCIAL SECURITY ACT › General Provisions › Section 442.665 - "Inpatient" defined

Current through June 11, 2024
"Inpatient" means a client who requires a stay of more than 24 hours in a hospital for treatment or a diagnostic evaluation.
Added to NAC by Bd. of Health, eff. 11-27-89; A 1-18-94
NRS 442.190
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › SERVICES UNDER SOCIAL SECURITY ACT › General Provisions › Section 442.670 - "Medicaid" defined

Current through June 11, 2024
"Medicaid" means the program established pursuant to Title XIX of the Social Security Act, 42 U.S.C. §§
										1396 et seq., to provide assistance for part or all of the cost of medical care for indigent persons.
Added to NAC by Bd. of Health, eff. 11-27-89; A 1-18-94; R212-97, 7-23-98
NRS 442.140, 442.190
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › SERVICES UNDER SOCIAL SECURITY ACT › General Provisions › Section 442.676 - "Medical facility" defined

Current through June 11, 2024
"Medical facility" means an establishment that provides treatment and services directed toward the habilitation and rehabilitation of a client to a reasonable level of health and ability to perform the activities of daily living.
Added to NAC by Bd. of Health, eff. 1-18-94
NRS 442.140, 442.190
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › SERVICES UNDER SOCIAL SECURITY ACT › General Provisions › Section 442.680 - "Medical review" defined

Current through June 11, 2024
"Medical review" means the review of a provider's medical records by, or in consultation with, a medical staff composed of persons who are employed by the Division or have a contract with the Division for the performance of those services.
Added to NAC by Bd. of Health, eff. 11-27-89; A 1-18-94; R212-97, 7-23-98
NRS 442.190
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › SERVICES UNDER SOCIAL SECURITY ACT › General Provisions › Section 442.685 - "Medical services" defined

Current through June 11, 2024
"Medical services" means services rendered by a provider and other treatment, services and necessary appliances directed toward the habilitation and rehabilitation of a client to a reasonable level of health and ability to perform the activities of daily living.
Added to NAC by Bd. of Health, eff. 11-27-89; A 1-18-94
NRS 442.140, 442.190
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › SERVICES UNDER SOCIAL SECURITY ACT › General Provisions › Section 442.687 - "Memorandum of understanding" defined

Current through June 11, 2024
"Memorandum of understanding" means an agreement that defines the type of services a provider will provide to clients and the method by which the provider will be reimbursed for those services under the program.
Added to NAC by Bd. of Health by R212-97, eff. 7-23-98
NRS 442.140, 442.190
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › SERVICES UNDER SOCIAL SECURITY ACT › General Provisions › Section 442.688 - "Nevada Check Up" defined

Current through June 11, 2024
"Nevada Check Up" means the program established pursuant to 42 U.S.C. §§
										1397 aa to 1397jj, inclusive, to provide health insurance for uninsured children from low-income families in this State.
Added to NAC by Bd. of Health by R095-99, eff. 11-29-99
NRS 442.140, 442.190
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › SERVICES UNDER SOCIAL SECURITY ACT › General Provisions › Section 442.690 - "Physician" defined

Current through June 11, 2024
"Physician" means a provider who:
1. Is licensed by the state where he or she practices;
2. Is certified by or eligible to take an examination for certification from a specialty board that is a member of the American Board of Medical Specialties; and
3. Has a memorandum of understanding with the Division.
Added to NAC by Bd. of Health, eff. 11-27-89; A 1-18-94; 10-30-97; R212-97, 7-23-98
NRS 442.140, 442.190
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › SERVICES UNDER SOCIAL SECURITY ACT › General Provisions › Section 442.694 - "Primary care" defined

Current through June 11, 2024
"Primary care" means a full range of comprehensive, integrated and longitudinal health services that are based in the community of a client, centered on the family of a client and provided on an ambulatory basis, including, but not limited to, services for prevention, diagnosis, treatment, consultation and referral.
Added to NAC by Bd. of Health by R212-97, eff. 7-23-98
NRS 442.190
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › SERVICES UNDER SOCIAL SECURITY ACT › General Provisions › Section 442.696 - "Prognosis" defined

Current through June 11, 2024
"Prognosis" means the prospects of a client reaching a reasonable level of health and an ability to perform the activities of daily living.
Added to NAC by Bd. of Health, eff. 1-18-94
NRS 442.140, 442.190
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › SERVICES UNDER SOCIAL SECURITY ACT › General Provisions › Section 442.700 - "Program" defined

Current through June 11, 2024
"Program" means the program of the Division that provides reimbursement for the specialized medical services required for the maximum alleviation or rehabilitation of the eligible conditions of clients.
Added to NAC by Bd. of Health, eff. 11-27-89; A 1-18-94; R212-97, 7-23-98; R095-99, 11-29-99
NRS 442.140, 442.190
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › SERVICES UNDER SOCIAL SECURITY ACT › General Provisions › Section 442.702 - "Program specialist" defined

Current through June 11, 2024
"Program specialist" means an employee of the Division who is designated by the Administrator to determine:
1. Eligibility for the receipt of services under the program;
2. Whether to authorize the provision of services under the program before those services are rendered; and
3. Whether to approve claims for compensation submitted by providers under the program.
Added to NAC by Bd. of Health by R212-97, eff. 7-23-98
NRS 442.140, 442.190
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › SERVICES UNDER SOCIAL SECURITY ACT › General Provisions › Section 442.705 - "Provider" defined

Current through June 11, 2024
"Provider" means a person authorized to provide a health care service or product pursuant to NAC 442.600 to 442.788, inclusive, through a signed memorandum of understanding with the Division.
Added to NAC by Bd. of Health, eff. 11-27-89; A 1-18-94; R212-97, 7-23-98; R095-99, 11-29-99; R024-06, 7-14-2006
NRS 442.140, 442.190
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › SERVICES UNDER SOCIAL SECURITY ACT › General Provisions › Section 442.707 - "Residence" defined

Current through June 11, 2024
"Residence" means a place where a person remains when not called elsewhere for labor or other special temporary purposes, and to which the person returns.
Added to NAC by Bd. of Health, eff. 1-18-94
NRS 442.140, 442.190
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › SERVICES UNDER SOCIAL SECURITY ACT › General Provisions › Section 442.708 - "Resident" defined

Current through June 11, 2024
"Resident" means a person who lives in this State and:
1. Intends to make this State his or her home permanently or for an indefinite period; or
2. Is employed or seeking employment in this State.
This term includes a person who does not have a fixed place of residence in this State, is temporarily absent from the State but intends to return to this State when he or she has accomplished the purpose of the absence, or is a dependent of military personnel for the duration of the tour of duty of his or her parent or guardian in this State.
Added to NAC by Bd. of Health, eff. 1-18-94; A by R212-97, 7-23-98
NRS 442.140, 442.190
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › SERVICES UNDER SOCIAL SECURITY ACT › General Provisions › Section 442.710 - Eligibility of clients under program

Current through June 11, 2024
1. To be eligible for participation in the program, a person must:
(a) Have an eligible condition;
(b) Be financially eligible pursuant to this section;
(c) Be a resident of this State and:
(1) A citizen of the United States;
(2) A qualified alien, as defined in 8 U.S.C. §
												1641; or
(3) An alien who is otherwise eligible for participation in the program pursuant to federal regulations regarding the eligibility of aliens for public assistance; and
(d) Not be eligible for medical services pursuant to any other program, including, without limitation, Medicaid and Nevada Check Up. The person must provide proof of denial to the Division.
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › SERVICES UNDER SOCIAL SECURITY ACT › General Provisions › Section 442.711 - Report by applicant of receipt of child support; application for assistance in obtaining child support

Current through June 11, 2024
1. An applicant for participation in the program or a client shall report to the Division of Public and Behavioral Health any payments of child support received for his or her support.
2. Except as otherwise provided in this subsection, an applicant or client who is not receiving all payments of child support to which he or she is entitled for his or her support shall file with the Division of Welfare and Supportive Services of the Department of Health and Human Services or the district attorney of the county in which he or she resides an application for assistance in obtaining that support. The Chief may, because of exceptional circumstances, excuse an applicant or client from compliance with the requirements of this subsection.
Added to NAC by Bd. of Health by R212-97, eff. 7-23-98
NRS 442.140, 442.190
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › SERVICES UNDER SOCIAL SECURITY ACT › General Provisions › Section 442.712 - Receipt of donations, judgments or settlements

Current through June 11, 2024
Any money received by or on behalf of a client from any donations, judgments or settlements relating to an eligible condition for which the client receives services from a provider under the program must be applied to pay for the cost of those services and related costs before money may be expended under the program for that purpose. If money is expended under the program for that purpose before a client receives money from such a source, the client shall reimburse the program for that expenditure. A client shall inform the Division of all actions taken to obtain such a judgment or settlement, including, without limitation, the name of any attorney retained for that purpose and the dates of any court hearings scheduled for that purpose.
Added to NAC by Bd. of Health by R212-97, eff. 7-23-98
NRS 442.140, 442.190
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › SERVICES UNDER SOCIAL SECURITY ACT › General Provisions › Section 442.715 - Eligibility of providers under program

Current through June 11, 2024
1. To provide services to clients, physicians and other regular providers of services under the program must have executed a memorandum of understanding with the Division, except that providers who provide services one time or on a sporadic basis are not required to have executed a memorandum of understanding if they agree to accept reimbursement provided under the program as payment in full for those services. The memorandum of understanding must:
(a) Require the physician or other provider to accept the rates of reimbursement set forth in NAC 442.751; and
(b) Provide that households will not be billed by the provider for the remaining balance.
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › SERVICES UNDER SOCIAL SECURITY ACT › General Provisions › Section 442.718 - Prohibition against discrimination

Current through June 11, 2024
No person may exclude from, deny the benefits of or otherwise discriminate against a person who wishes to participate in the program because of that person's race, creed, color, national origin or sex.
Added to NAC by Bd. of Health, eff. 1-18-94
NRS 442.140, 442.190
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › SERVICES UNDER SOCIAL SECURITY ACT › General Provisions › Section 442.720 - Format of forms to be used

Current through June 11, 2024
Forms used for application, financial eligibility, authorization and payment must be in a format satisfactory to the program.
Added to NAC by Bd. of Health, eff. 11-27-89
NRS 442.140, 442.190
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › SERVICES UNDER SOCIAL SECURITY ACT › General Provisions › Section 442.725 - Date of eligibility for participation; submission of application; annual updates

Current through June 11, 2024
1. Except as otherwise provided in subsection 2, an applicant's eligibility for participation in the program begins:
(a) On the date on which the applicant contacts a program specialist;
(b) On the date on which a medical facility notifies a program specialist regarding the applicant; or
(c) Within 72 hours after admission to a medical facility if the applicant was admitted on a weekend,
if, within 30 days after that date, the applicant submits an application to a program specialist.
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › SERVICES UNDER SOCIAL SECURITY ACT › General Provisions › Section 442.751 - Limitations of program

Current through June 11, 2024
The program will:
1. Not provide for the total care of a client.
2. Provide only services that are related to treating a client's condition.
3. Cover conditions with a poor or variable prognosis only as funding for the program allows.
4. Pay not more than $10,000 annually for each client unless, subject to budgetary limitations, the Chief Medical Officer or a person designated by the Administrator authorizes the expenditure of an additional amount in an extraordinary situation.
5. Reimburse providers at Medicaid rates for the costs of the services provided to clients. For the costs incurred for orthotic and prosthetic devices provided by medical prescription to enhance a client's ability to perform the activities of daily living, the program will reimburse:
(a) At Medicaid rates; or
(b) At 80 percent of the usual and customary charge if no Medicaid rate is available.
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › SERVICES UNDER SOCIAL SECURITY ACT › General Provisions › Section 442.765 - Grounds for terminating eligibility of client

Current through June 11, 2024
A program specialist shall terminate the eligibility of a client for the following reasons:
1. The client reaches the limitation on age set forth in NAC 442.782.
2. The client has achieved maximum alleviation or rehabilitation of his or her eligible condition.
3. The income of the client's household no longer meets the requirements of the program for financial eligibility.
4. The client's household chooses not to continue to participate in the program.
5. Failure by the client to cooperate in carrying out recommended treatment or to apply for third-party assistance, including, without limitation, assistance provided through Medicaid or Nevada Check Up.
6. A lack of money for the program for the continuation of the services required by the client.
7. Denial of other third-party coverage based on failure to cooperate.
8. Misrepresentation of material facts in the application.
9. Failure by the client to cooperate in seeking to obtain any applicable payments of child support, unless excused by the Chief because of exceptional circumstances.
Added to NAC by Bd. of Health, eff. 11-27-89; A 1-18-94; 10-30-97; R212-97, 7-23-98; R095-99, 11-29-99
NRS 442.140, 442.190
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › SERVICES UNDER SOCIAL SECURITY ACT › General Provisions › Section 442.770 - Submission and contents of claims

Current through June 11, 2024
1. Except as otherwise provided in subsections 2 and 3, a provider shall submit a claim for the payment of services provided to a client to third-party payers before submitting the claim to the Division under the program.
2. Except as otherwise provided in subsection 3, the provider may submit the claim directly to the Division under the program if:
(a) The client does not have any third-party payers;
(b) The provider has exhausted the resources of all third-party payers; or
(c) All third-party payers deny the claim.
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › SERVICES UNDER SOCIAL SECURITY ACT › General Provisions › Section 442.775 - Payment or denial of claim for medical services: Notification of denial to provider; procedure for review of denial and appeal of decision of Bureau

Current through June 11, 2024
1. A program specialist shall determine whether to pay a claim for services furnished by a provider.
2. If the program specialist determines that the claim will not be paid, he or she shall notify the provider, in writing, of the reason why the claim will not be paid.
3. The provider may request a review of the decision denying payment of the claim.
4. The provider must submit a written request to the Bureau within 30 days after receiving notice that the claim has been denied.
5. If the Bureau receives a request for a review pursuant to subsection 4, it shall issue a written decision and notify the provider, in writing, of its decision.
6. The provider may appeal the decision of the Bureau in the manner prescribed in NAC 439.190 to 439.395, inclusive.
Added to NAC by Bd. of Health, eff. 11-27-89; A 1-18-94; 10-30-97; R212-97, 7-23-98
NRS 442.140, 442.190
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › SERVICES UNDER SOCIAL SECURITY ACT › General Provisions › Section 442.780 - Denial of medical services: Notification of applicant or client; procedure for review of denial and appeal of decision of Bureau

Current through June 11, 2024
1. If a program specialist determines that:
(a) An applicant for services under the program does not meet the requirements for eligibility;
(b) A client receiving services under the program no longer meets those requirements; or
(c) The eligibility of a client must be terminated in accordance with NAC 442.765,
the program specialist shall notify the applicant or client in writing of the reason why the services will not be provided.
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › SERVICES UNDER SOCIAL SECURITY ACT › Services for Children With Special Health Care Needs › Section 442.782 - Eligibility for medical services

Current through June 11, 2024
To be eligible for medical services for an eligible medical condition under the program, a person must:
1. Be below the age of 19 years;
2. Have a suspected or confirmed eligible medical condition; and
3. Meet the requirements for eligibility specified in NAC 442.710.
Added to NAC by Bd. of Health by R212-97, eff. 7-23-98; A by R095-99, 11-29-99
NRS 442.190
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › SERVICES UNDER SOCIAL SECURITY ACT › Services for Children With Special Health Care Needs › Section 442.784 - Eligible medical conditions: Categories; identification

Current through June 11, 2024
1. A client's eligible medical condition will be assigned to one of the following categories to determine the extent of medical services that will be provided under the program:
(a) Category 1 includes conditions:
(1) Which require ambulatory or outpatient services only; and
(2) For which an excellent prognosis is anticipated.
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › SERVICES UNDER SOCIAL SECURITY ACT › Services for Children With Special Health Care Needs › Section 442.786 - Ineligible conditions and services

Current through June 11, 2024
The program does not cover the following conditions and services:
1. Acute infectious diseases.
2. Learning disabilities, intellectual disabilities and problems related to behavior.
3. Allergies.
4. The alteration of a construction or dwelling.
5. Benign inflammatory conditions.
6. Blood and plasma, except for processing and administrative fees.
7. Chronic sinusitis, except in cases of severe respiratory impairment.
8. Cosmetic surgery as an isolated indication.
9. Custodial care.
10. Diagnostic or therapeutic procedures, techniques, instrumentalities or agents that:
(a) Have not been approved by the Food and Drug Administration; or
(b) Are experimental.
Nevada Administrative Code › Chapter 442 - Maternal and Child Health; Abortion › SERVICES UNDER SOCIAL SECURITY ACT › Services for Children With Special Health Care Needs › Section 442.788 - Payment for dietary supplements and medications; additional covered services

Current through June 11, 2024
1. The program does not pay for dietary supplements or medications relating to eligible medical conditions except as otherwise provided in subsection 2 and in the circumstances specified for the following eligible medical conditions:
(a) Cystic fibrosis, medications related to the eligible medical condition or its complications.
(b) Epilepsy, subject to individual case and medical review.
(c) Juvenile diabetes, subject to individual case and medical review.
(d) Inborn errors of metabolism, including those detected through the program for screening newborn babies conducted pursuant to NRS 442.008 and NAC 442.020 to 442.050, inclusive, dietary supplements as prescribed.
(e) Asthma that requires daily medication for a client to perform the activities of daily living, subject to individual case and medical review.
(f) Cardiac conditions that require ongoing medication for a client to perform the activities of daily living, subject to individual case and medical review.
(g) Thyroid conditions that require ongoing medication, subject to individual case and medical review.