reglab/statecodes huggingface dataset:
Nevada Administrative Code › Chapter 439A - Planning for the Provision of Health Care › PROGRAMS TO INCREASE AWARENESS OF INFORMATION CONCERNING HOSPITALS AND SURGICAL CENTERS FOR AMBULATORY PATIENTS › Section 439A.815 - Information concerning surgical centers for ambulatory patients: Request for extension of time for submission of information

Current through June 11, 2024
1. A
			 surgical center for ambulatory patients may submit to the Director a written
			 request to submit the information required pursuant to NAC 439A.810 more than
			 45 days after the last day of a calendar month. Each request must be submitted
			 in the form and within the time period required by the Department.
2. The Director shall review each request
			 submitted pursuant to subsection 1 and determine whether to grant the
			 request.
3. If the Director
			 determines that an extension of the time for submission is appropriate, the
			 Director shall provide written notice to the surgical center, including the
			 date by which the information required pursuant to NAC 439A.810 must be
			 submitted.
Added to NAC by Dep't of
				Health & Human Services by R151-08, 12-17-2008, eff.
				5-20-2009
NRS
				  439A.250
Nevada Administrative Code › Chapter 439A - Planning for the Provision of Health Care › PROGRAMS TO INCREASE AWARENESS OF INFORMATION CONCERNING HOSPITALS AND SURGICAL CENTERS FOR AMBULATORY PATIENTS › Section 439A.820 - Information concerning surgical centers for ambulatory patients: Notification by Department that information is incomplete; effect of failure to submit complete information

Current through June 11, 2024
1. If a surgical
			 center fails to submit the information required pursuant to NAC 439A.810 or if
			 the Department determines that the information is incomplete or inaccurate, the
			 Department will notify the surgical center pursuant to subsection 3 of
			 NRS
			 439A.250.
2. If a surgical center is notified pursuant
			 to subsection 1, the surgical center shall submit the required information to
			 the Department within 30 days after receipt of the notice. If the surgical
			 center does not submit the required information within 30 days, the Department
			 may send to the Division of Public and Behavioral Health of the Department a
			 written notice of failure to comply and request that the Division take
			 appropriate disciplinary action against the surgical center, including, without
			 limitation, the imposition of an administrative penalty.
Added to NAC by Dep't of
				Health & Human Services by R151-08, 12-17-2008, eff.
				5-20-2009
NRS
				  439A.250
Nevada Administrative Code › Chapter 439A - Planning for the Provision of Health Care › PROGRAMS TO INCREASE AWARENESS OF INFORMATION CONCERNING HOSPITALS AND SURGICAL CENTERS FOR AMBULATORY PATIENTS › Section 439A.825 - Information concerning surgical centers for ambulatory patients: Department to determine and make publicly available list of 50 medical treatments for outpatients of surgical centers to be included in program

Current through June 11, 2024
1. For purposes of paragraph (d) of
			 subsection 2 of
			 NRS
			 439A.240, the Department will:
(a) Determine and make publicly available a
			 list of the 50 medical treatments for outpatients of surgical centers for
			 ambulatory patients that will be included in the program to increase public
			 awareness of health care information concerning surgical centers for ambulatory
			 patients; and
(b) Review the list
			 of 50 medical treatments once every 2 years and update the list as the
			 Department determines necessary.
Nevada Administrative Code › Chapter 439A - Planning for the Provision of Health Care › PROGRAMS TO INCREASE AWARENESS OF INFORMATION CONCERNING HOSPITALS AND SURGICAL CENTERS FOR AMBULATORY PATIENTS › Section 439A.830 - Information concerning hospitals: Department to determine and make publicly available lists of diagnosis-related groups for inpatients of hospitals and 50 medical treatments for outpatients of hospitals to be included in program

Current through June 11, 2024
1. For purposes of
			 paragraph (d) of subsection 2 of
			 NRS
			 439A.220, the Department will:
(a) Determine and make publicly available a
			 list of the diagnosis-related groups for inpatients of hospitals that will be
			 included in the program to increase public awareness of health care information
			 concerning hospitals;
(b) Determine
			 and make publicly available a list of the 50 medical treatments for outpatients
			 of hospitals that will be included in the program to increase public awareness
			 of health care information concerning hospitals; and
(c) Review each list once every 2 years and
			 update the list as the Department determines necessary.
Nevada Administrative Code › Chapter 439A - Planning for the Provision of Health Care › PROGRAMS TO INCREASE AWARENESS OF INFORMATION CONCERNING HOSPITALS AND SURGICAL CENTERS FOR AMBULATORY PATIENTS › Section 439A.840 - Request for information

Current through June 11, 2024
1. A person may
			 submit to the Department a written request for the review and release of
			 information collected and maintained by the Department pursuant to
			 NRS 439A.200 to
			 439A.290,
			 inclusive, and NAC 439A.800 to 439A.840, inclusive.
2. If the request is for the purpose of
			 research, the Department will grant the review and release of the
			 information.
3. If the request is
			 for purposes other than research, the Department will consider the request and
			 determine whether to grant the review and release of the information.
4. The Department will ensure that
			 information reviewed or released pursuant to this section does not disclose any
			 information which reveals the identity of a specific patient of a hospital or
			 surgical center for ambulatory patients.
Added to NAC by Dep't of
				Health & Human Services by R151-08, eff.
				12-17-2008
NRS
				  439A.290
Nevada Administrative Code › Chapter 439B - RESTRAINING COSTS OF HEALTH CARE › Section 439B.Sec. 2.1 - NEW

Current through June 11, 2024
1. To request a list of randomly selected
		  arbitrators pursuant to subsection 3 of NRS 439B.754  to arbitrate a dispute
		  over a claim of less than $5,000, an out-of-network provider must submit a
		  request to the Department. If the out-of-network provider submits the request
		  because the third party has refused or failed to pay the additional amount
		  requested by the out-of-network-provider pursuant to subsection 2 of NRS 439B.754, the out-of-network provider must submit the request by:
(a) If the third party refused to pay the
		  additional amount, not later than 30 business days after the date on which the
		  third party notifies the out-of-network provider of the refusal.
(b) If the third party failed to pay the
		  additional amount for 30 business days after receiving a request for the
		  additional amount, not later than 30 business days after that date.
Nevada Administrative Code › Chapter 439B - RESTRAINING COSTS OF HEALTH CARE › Section 439B.Sec. 3.1 - NEW

Current through June 11, 2024
1. Not later than 10 business days after the
		  Department provides a written list of arbitrators to an out-of-network provider
		  and a third party pursuant to subsection 5 of section 2, the out-of-network
		  provider and third party shall strike arbitrators from the list in the manner
		  required by subsection 4 of NRS 439B.754  and provide the name or names of any
		  remaining arbitrators on the list in writing to the Department.
2. Not later than 10 business days after
		  receiving the name of any remaining arbitrator on the list pursuant to
		  subsection 1, the Department shall:
(a) If one
		  arbitrator who does not have a conflict of interest remains, notify the
		  out-ofnetwork provider and the third party in writing of the name of that
		  arbitrator.
(b) If more than one
		  arbitrator who does not have a conflict of interest remains, randomly select an
		  arbitrator from the remaining arbitrators as required by subsection 4 of NRS 439B.754  and notify the out-of-network provider and the third party in writing
		  of the name of that arbitrator.
Nevada Administrative Code › Chapter 439B - RESTRAINING COSTS OF HEALTH CARE › Section 439B.Sec. 4.1 - NEW

Current through June 11, 2024
An out-of-network provider that wishes to request a list of
			 randomly selected arbitrators pursuant to subsection 3 of NRS 439B.754  to
			 arbitrate a dispute over a claim of $5,000 or more must request a list of five
			 randomly selected arbitrators from:
1.
		  The American Arbitration Association or its successor organization;
		  or
2. JAMS or its successor
		  organization.
Added
			 to NAC by Dept of Human Resources, by
			 R101-19A,
			 eff. 9/19/2022;	Added
			 to NAC by Dept of Human Resources, by
			 R101-19A,
			 eff. 9/19/2022
NRS 439B.754
Nevada Administrative Code › Chapter 439B - RESTRAINING COSTS OF HEALTH CARE › Section 439B.Sec. 5.1 - NEW

Current through June 11, 2024
1. To elect to have the provisions of NRS 439B.700  to 439B.760, inclusive, apply to an entity or organization that is not
		  otherwise subject to those provisions as authorized pursuant to NRS 439B.757,
		  the entity or organization must apply to the Department in the form prescribed
		  by the Department. The application must include, without limitation:
(a) The name of and contact information for
		  the entity or organization; and
(b)
		  A description of the type of entity or organization, as applicable, that it
		  is.
Nevada Administrative Code › Chapter 439B - RESTRAINING COSTS OF HEALTH CARE › Section 439B.Sec. 6.1 - NEW

Current through June 11, 2024
1. On or before December 31 of each year,
		  each provider of health care who provides medically necessary emergency
		  services in this State shall submit to the Department in the form prescribed by
		  the Department:
(a) The name of and contact
		  information for the provider of health care;
(b) A description of the type of provider of
		  health care that it is;
(c) Whether
		  there was an increase or decrease in the number of contracts with third parties
		  entered into by the provider of health care during the immediately preceding 12
		  months and the amount of the increase or decrease, stated as a percentage;
		  and
(d) For each new contract with
		  a third party entered into by the provider of health care during the
		  immediately preceding 12 months, the type of the third party.
Nevada Administrative Code › Chapter 439B - RESTRAINING COSTS OF HEALTH CARE › GENERAL PROVISIONS › Section 439B.010 - Definitions

Current through June 11, 2024
As used in this chapter, unless the context otherwise
				requires, the words and terms defined in NAC 439B.030 to 439B.190, inclusive,
				have the meanings ascribed to them in those sections.
Added to NAC by Dep't of
				Human Resources, eff. 4-13-88; A 1-2-90; 12-31-91;
				10-20-93
Nevada Administrative Code › Chapter 439B - RESTRAINING COSTS OF HEALTH CARE › GENERAL PROVISIONS › Section 439B.110 - "Hospital fiscal year" defined

Current through June 11, 2024
"Hospital fiscal year" has the meaning ascribed to it in
				subsection 2 of
				NRS
				439B.090.
Added to NAC by Dep't of
				Human Resources, eff. 4-13-88
Nevada Administrative Code › Chapter 439B - RESTRAINING COSTS OF HEALTH CARE › GENERAL PROVISIONS › Section 439B.130 - "Inpatient" defined

Current through June 11, 2024
"Inpatient" means a patient who:
1. Is formally admitted to a
			 hospital;
2. Is assigned to a
			 regularly maintained inpatient bed; and
3. Has an inpatient medical chart initiated
			 by the hospital.
Added to NAC by Dep't of
				Human Resources, eff. 4-13-88
Nevada Administrative Code › Chapter 439B - RESTRAINING COSTS OF HEALTH CARE › GENERAL PROVISIONS › Section 439B.140 - "Inpatient billed charges" defined

Current through June 11, 2024
"Inpatient billed charges" means those billed charges which are
				attributable to the provision of inpatient care by a hospital.
Added to NAC by Dep't of
				Human Resources, eff. 4-13-88
Nevada Administrative Code › Chapter 439B - RESTRAINING COSTS OF HEALTH CARE › GENERAL PROVISIONS › Section 439B.150 - "Inpatient net revenue" defined

Current through June 11, 2024
"Inpatient net revenue" means the net revenue which is
				attributable to the provision of inpatient care by a hospital.
Added to NAC by Dep't of
				Human Resources, eff. 4-13-88
Nevada Administrative Code › Chapter 439B - RESTRAINING COSTS OF HEALTH CARE › GENERAL PROVISIONS › Section 439B.185 - "Operating budget" defined

Current through June 11, 2024
"Operating budget" means a plan of financial operations
				embodying an estimate of proposed expenditures for a given period and the
				proposed means of financing such expenditures, and generally including at least
				the following information:
1. The
			 period of the budget (inclusive dates);
2. Forecasted patient days;
3. Percentage of rate increase to be
			 implemented;
4. Forecasted gross
			 revenues;
5. Forecasted contractual
			 allowances, bad debt and discounts;
6. Forecasted operating expense;
7. Forecasted income from hospital
			 operations;
8. Forecasted
			 nonoperating revenues;
9.
			 Forecasted nonoperating expense; and
10. Forecasted total income or
			 loss.
Added to NAC by Dep't of
				Human Resources, eff. 10-20-93
Nevada Administrative Code › Chapter 439B - RESTRAINING COSTS OF HEALTH CARE › FINANCIAL PRACTICES OF HOSPITALS › Section 439B.220 - Submission of quarterly reports

Current through June 11, 2024
1. Each hospital
			 shall submit the following information not later than 30 days after each
			 quarter:
(a) Financial reports in the form
			 prescribed by the department;
(b)
			 Utilization reports in the form prescribed by the department; and
(c) A statement of all substantial changes in
			 the services provided by the hospital in the quarter.
Nevada Administrative Code › Chapter 439B - RESTRAINING COSTS OF HEALTH CARE › FINANCIAL PRACTICES OF HOSPITALS › Section 439B.230 - Submission of annual financial reports

Current through June 11, 2024
Each year a hospital shall file with the department:
1. A copy of the report required to be
			 submitted by the hospital to the Health Care Financing Administration for the
			 purpose of Medicare payments, commonly known as the Medicare Cost Report within
			 120 days after the end of the hospital's Medicare fiscal year.
2. At least 30 days after the beginning of
			 each hospital fiscal year, a proposed operating budget for the hospital for the
			 hospital's fiscal year.
3. Within
			 30 days of receipt by the hospital, a copy of any report by an independent
			 auditor concerning a financial audit of the hospital's operations.
Added to NAC by Dep't of
				Human Resources, eff. 4-13-88; A 10-20-93
Nevada Administrative Code › Chapter 439B - RESTRAINING COSTS OF HEALTH CARE › FINANCIAL PRACTICES OF HOSPITALS › Section 439B.240 - Certification of financial reports; penalty for failure to submit information; request for extension of time

Current through June 11, 2024
1. The officers of
			 a hospital shall certify that the financial reports required to be submitted by
			 a hospital to the department are, to the best of their knowledge and belief,
			 accurate and complete.
2. Except as
			 otherwise provided in subsection 3, any person who fails to submit information
			 required pursuant to this chapter on the date for submission is subject to an
			 administrative fine of up to $1,000 for each day the information is not
			 submitted. The fine will be imposed after notice and a hearing pursuant to NAC
			 439B.520.
3. A person may request
			 an extension to submit information required by this chapter if the request:
(a) Is received by the department before the
			 information is due; and
(b) Sets
			 forth an adequate justification of the reasons for the delay and a proposed
			 submission date.
Nevada Administrative Code › Chapter 439B - RESTRAINING COSTS OF HEALTH CARE › FINANCIAL PRACTICES OF HOSPITALS › Section 439B.250 - Submission of copy of audit

Current through June 11, 2024
Each hospital in this state with not more than 200 beds or
				which is subject to the provisions of chapter 450 of NRS shall submit to the
				department a copy of its audit. The audit must be conducted by an independent
				auditor at least annually. The hospital shall submit a copy of the audit within
				30 days after receipt by the hospital of the audit from its auditor.
Added to NAC by Dep't of
				Human Resources, eff. 4-13-88
Nevada Administrative Code › Chapter 439B - RESTRAINING COSTS OF HEALTH CARE › FINANCIAL PRACTICES OF HOSPITALS › Section 439B.260 - Independent audits; penalty for failure to cooperate

Current through June 11, 2024
1.
			 The director shall contract at least biennially with an independent auditing
			 firm to conduct an examination of each hospital in this state with more than
			 200 beds which is not subject to the provisions of chapter 450 of NRS to ensure
			 compliance with this chapter. The director shall determine the scope of the
			 examination for each hospital.
2.
			 The auditor shall conduct the examination to determine whether the hospital is
			 in full compliance with this chapter.
3. The auditor shall maintain separate
			 accounts of the costs of the audit for each hospital. Each hospital subject to
			 the audit shall pay the costs of the audit.
4. A hospital may contract with the auditing
			 firm appointed by the department for other work in the hospital in connection
			 with the audit.
5. Any person who
			 fails to submit information to the auditor upon request or who fails to submit
			 to the audit is subject to an administrative fine of up to $1,000 for each day
			 the person fails to submit the information or submit to the audit. The director
			 may impose the fine after notice and a hearing pursuant to NAC
			 439B.520.
Added to NAC by Dep't of
				Human Resources, eff. 4-13-88; A 10-20-93
Nevada Administrative Code › Chapter 439B - RESTRAINING COSTS OF HEALTH CARE › MAJOR HOSPITALS › Section 439B.325 - Major hospital to provide disclosure to patient who does not have medical insurance; effect of discount on prior arrangement to pay; circumstances entitling hospital to recover discount

Current through June 11, 2024
1. A major hospital
			 which is required to reduce or discount the total billed charge for hospital
			 services provided to an inpatient pursuant to
			 NRS
			 439B.260 shall provide each patient who
			 informs the hospital that he does not have medical insurance or other coverage
			 to pay for inpatient services with a written disclosure approved by the
			 director explaining:
(a) That the patient may
			 be entitled to receive a reduction or discount on his total billed charge; and
(b) How to apply for such a
			 reduction or discount.
Nevada Administrative Code › Chapter 439B - RESTRAINING COSTS OF HEALTH CARE › MAJOR HOSPITALS › Section 439B.330 - Determination of reasonableness of arrangement for payment; hospital to provide written notice of terms of arrangement and respective rights and obligations to patient; adjustment of monthly payments

Current through June 11, 2024
1.
			 Except as otherwise provided in subsection 2, to be deemed reasonable, the
			 arrangement for payment required pursuant to paragraph (c) of subsection 1 of
			 NRS
			 439B.260 must include at least a monthly
			 payment which is the greater of:
(a)
			 Twenty-five dollars; or
(b) Five
			 percent of the monthly gross income of the patient's household, exclusive of
			 income which is not paid in cash, or 25 percent of the monthly gross income of
			 the patient's household which exceeds 200 percent of the federal poverty level,
			 whichever is less.
Nevada Administrative Code › Chapter 439B - RESTRAINING COSTS OF HEALTH CARE › MAJOR HOSPITALS › Section 439B.335 - Initial payment from patient upon admittance to hospital

Current through June 11, 2024
1. A major hospital may require an initial
			 payment from a patient who is admitted to the hospital.
2. If a patient elects to be admitted to a
			 major hospital, the hospital may require an initial payment in addition to any
			 other preadmission deposits or payments.
3. A major hospital shall not require an
			 initial payment towards the total billed charge which exceeds:
(a) Two and one-half times the monthly
			 payment determined pursuant to subsection 1 of NAC 439B.330; or
(b) Fifty percent of the unencumbered liquid
			 assets of the household of the patient.
Nevada Administrative Code › Chapter 439B - RESTRAINING COSTS OF HEALTH CARE › MAJOR HOSPITALS › Section 439B.340 - Determination of annual rate of interest on unpaid balance of total billed charge; effect of delinquent account; sale, assignment or transfer of right to balance due on account

Current through June 11, 2024
1. If a major
			 hospital charges interest on the unpaid balance of the total billed charge of a
			 patient, the annual rate of interest must be based on the balance due after any
			 reductions or discounts. The interest rate must not exceed the statutory
			 interest rate in effect on the date that the arrangement for payment is agreed
			 upon.
2. If the account of a
			 patient becomes delinquent by 30 days or more:
(a) Upon the first and second occurrences,
			 the hospital shall provide written notice of the delinquency to the patient. If
			 the delinquency is not cured within 10 days after the patient receives the
			 notice, the hospital may revoke any discount that was provided to the patient
			 and seek to accelerate payment on the account.
(b) Upon the third and subsequent
			 occurrences, the hospital may revoke the discount and seek to accelerate
			 payment without allowing the patient 10 days to cure the delinquency.
Nevada Administrative Code › Chapter 439B - RESTRAINING COSTS OF HEALTH CARE › CARE OF INDIGENT PATIENTS › General Requirements › Section 439B.390 - Applicability of certain provisions of NRS and NAC

Current through June 11, 2024
1. The
				provisions of
				NRS
				439B.300 to
				439B.340,
				inclusive, and NAC 439B.410 apply to any hospital with 100 or more
				beds.
2. If the number of licensed
				beds of a hospital expands to 100 or more, it becomes subject to the provisions
				of
				NRS
				439B.300 to
				439B.340,
				inclusive, and NAC 439B.410.
3. As
				of July 1, 1992, the provisions of
				NRS
				439B.300 to
				439B.340,
				inclusive, and NAC 439B.410 apply to the following hospitals:
(a) In Clark County:
(1) Desert Springs Hospital;
(2) Sunrise Hospital and Medical Center;
(3) Lake Mead Hospital and Medical
				Center;
(4) University Medical
				Center;
(5) Valley Hospital
				Medical Center; and
(6) Saint Rose
				Dominican Hospital; and
Nevada Administrative Code › Chapter 439B - RESTRAINING COSTS OF HEALTH CARE › CARE OF INDIGENT PATIENTS › General Requirements › Section 439B.410 - Submission of copy of Medicare Cost Report and estimate of inpatient net revenue

Current through June 11, 2024
1. Each hospital
				shall, within 120 days after the end of the hospital's Medicare fiscal year,
				submit to the department a copy of the report required to be submitted to the
				Health Care Financing Administration for the purpose of Medicare payments,
				commonly known as the Medicare Cost Report, for each hospital fiscal
				year.
2. Each such hospital whose
				hospital fiscal year ends June 30, shall submit to the department an estimate
				of its inpatient net revenue for its current hospital fiscal year not later
				than June 30 of each year.
Added to NAC by Dep't
				  of Human Resources, eff. 4-13-88; A
				  10-20-93
Nevada Administrative Code › Chapter 439B - RESTRAINING COSTS OF HEALTH CARE › CARE OF INDIGENT PATIENTS › General Requirements › Section 439B.420 - Determination of minimum obligation

Current through June 11, 2024
1. The department
				shall:
(a) For the purposes of determining 0.6
				percent of a hospital's inpatient net revenue for the hospital's previous
				fiscal year pursuant to
				NRS
				439B.320, use the report required to be
				submitted by the hospital pursuant to NAC 439B.410 for the most recent hospital
				fiscal year ending before July 1 in any year.
(b) Determine the amount of the hospital's
				minimum obligation by:
(1) Dividing the amount
				shown as inpatient total patient revenues on line 25 of Worksheet G-2 of the
				2552-89 Medicare Cost Report or comparable line on a subsequent Medicare Cost
				Report by the amount shown as the total of all total patient revenues on the
				same line;
(2) Multiplying the
				result of paragraph (a) by the amount reported as Net Patient Revenues on line
				3 of Worksheet G-3 of that report to determine the hospital's total inpatient
				net revenue; and
(3) Multiplying
				the result of paragraph (b) by 0.006.
Nevada Administrative Code › Chapter 439B - RESTRAINING COSTS OF HEALTH CARE › CARE OF INDIGENT PATIENTS › General Requirements › Section 439B.430 - Reports on actual and estimated minimum obligation; notification to board of county commissioners

Current through June 11, 2024
1. On or before
				July 31 of each fiscal year, the department shall report to the affected
				hospitals and the boards of county commissioners of Clark and Washoe counties:
(a) The actual minimum obligation for
				indigent care for each hospital located in the county with a hospital fiscal
				year ending on a date other than June 30; and
(b) The estimated minimum obligation for
				indigent care for each hospital located in the county with a hospital fiscal
				year ending on June 30.
Nevada Administrative Code › Chapter 439B - RESTRAINING COSTS OF HEALTH CARE › CARE OF INDIGENT PATIENTS › General Requirements › Section 439B.435 - Delivery to hospitals of reports on indigent patients treated

Current through June 11, 2024
Each county that is subject to the provisions of
				  NRS
				  439B.340 shall, at the time it provides the
				  department with the report required by that section, deliver a copy of the
				  report to each hospital affected thereby.
Added to NAC by Dep't
				  of Human Resources, eff. 1-9-89; A
				  10-20-93
Nevada Administrative Code › Chapter 439B - RESTRAINING COSTS OF HEALTH CARE › CARE OF INDIGENT PATIENTS › Appeal of Determination of Indigent Status › Section 439B.441 - Applicability

Current through June 11, 2024
A hospital appealing a determination of a county regarding
				  the indigent status of an inpatient pursuant to subsection 4 of
				  NRS
				  439B.330 shall comply with the provisions of
				  NAC 439B.441 to 439B.449, inclusive.
Added to NAC by Dep't
				  of Human Resources, eff. 9-16-92
Nevada Administrative Code › Chapter 439B - RESTRAINING COSTS OF HEALTH CARE › CARE OF INDIGENT PATIENTS › Appeal of Determination of Indigent Status › Section 439B.442 - Exhaustion of administrative procedures

Current through June 11, 2024
A hospital must exhaust all available administrative
				  procedures with a county before filing an appeal of a determination of a county
				  regarding the indigent status of an inpatient with the director or the person
				  designated by the director to hear such an appeal.
Added to NAC by Dep't
				  of Human Resources, eff. 9-16-92
Nevada Administrative Code › Chapter 439B - RESTRAINING COSTS OF HEALTH CARE › CARE OF INDIGENT PATIENTS › Appeal of Determination of Indigent Status › Section 439B.443 - Filing and contents of appeal; submission of additional material upon request

Current through June 11, 2024
1. An appeal of a
				determination of a county regarding the indigent status of an inpatient must be
				in writing and must be filed with the director within 30 calendar days after
				the date the hospital receives written notification of the county's final
				determination.
2. An appeal must
				include the following information and documentation:
(a) The name of the patient;
(b) The date or dates of service;
(c) The amount billed;
(d) A listing of all determinations made by
				the county regarding the claim, including the date and the reason for
				rejection;
(e) All correspondence
				between the hospital and the county regarding the application for verification
				of indigent status of the patient;
(f) Any other information submitted by the
				hospital to the county for consideration in making its determination;
				and
(g) A written explanation of
				the basis for believing that the county's decision was clearly erroneous,
				arbitrary, capricious or an abuse of discretion.
Nevada Administrative Code › Chapter 439B - RESTRAINING COSTS OF HEALTH CARE › CARE OF INDIGENT PATIENTS › Appeal of Determination of Indigent Status › Section 439B.444 - Determination to hold hearing or to issue decision denying appeal without hearing

Current through June 11, 2024
After considering the information and documentation specified
				  in NAC 439B.443, the director or his designee will:
1. Hold a hearing; or
2. Based upon a finding that the county acted
				properly in rejecting the application, render a written decision that the
				appeal is without merit.
Added to NAC by Dep't
				  of Human Resources, eff. 9-16-92
Nevada Administrative Code › Chapter 439B - RESTRAINING COSTS OF HEALTH CARE › CARE OF INDIGENT PATIENTS › Appeal of Determination of Indigent Status › Section 439B.446 - Scheduling and notice of hearing

Current through June 11, 2024
If the director or his designee determines that a hearing on
				  the indigent status of an inpatient is necessary, he will set a time and place
				  for the hearing and send notice of the hearing to the hospital and the county
				  by registered or certified mail. Unless all parties otherwise stipulate, the
				  hearing must be held not less than 30 calendar days nor more than 60 calendar
				  days after the date the appeal was received by the director or his
				  designee.
Added to NAC by Dep't
				  of Human Resources, eff. 9-16-92
Nevada Administrative Code › Chapter 439B - RESTRAINING COSTS OF HEALTH CARE › CARE OF INDIGENT PATIENTS › Appeal of Determination of Indigent Status › Section 439B.447 - Presentation of evidence at hearing

Current through June 11, 2024
At a hearing held pursuant to NAC 439B.446:
1. Except as otherwise provided in subsection
				3, the hospital and the county may present evidence in support of their
				positions.
2. The director or his
				designee may request any information or documentation that he deems necessary
				to render a decision on the appeal.
3. Except as otherwise provided in subsection
				2, the hospital shall not present evidence other than the information and
				documentation specified in NAC 439B.443, unless it has shown to the
				satisfaction of the director or his designee that the evidence is material and
				there is good cause for its failure to present the evidence to the county. The
				director or his designee may consider the additional evidence or may order the
				hospital to submit the additional evidence to the county and remand the
				application to the county.
Added to NAC by Dep't
				  of Human Resources, eff. 9-16-92
Nevada Administrative Code › Chapter 439B - RESTRAINING COSTS OF HEALTH CARE › CARE OF INDIGENT PATIENTS › Appeal of Determination of Indigent Status › Section 439B.448 - Issuance of decision after hearing

Current through June 11, 2024
If a hearing is held pursuant to NAC 439B.446, the director
				  or his designee will render a written decision within 30 calendar days after
				  the date of the hearing, or if additional information or documentation is
				  requested at the hearing, the director or his designee will render a written
				  decision within 30 calendar days after receipt of such information.
Added to NAC by Dep't
				  of Human Resources, eff. 9-16-92
Nevada Administrative Code › Chapter 439B - RESTRAINING COSTS OF HEALTH CARE › CARE OF INDIGENT PATIENTS › Appeal of Determination of Indigent Status › Section 439B.449 - Contents of decision issued after hearing; effect of decision issued without or after hearing

Current through June 11, 2024
1. The written
				decision of the director or his designee rendered pursuant to NAC 439B.448
				must:
(a) Affirm the county's decision;
				or
(b) Reverse or remand the
				county's decision, in whole or in part, if substantial rights of a hospital
				have been prejudiced because the county's decision was:
(1) Clearly erroneous;
(2) Arbitrary;
(3) Capricious; or
(4) An abuse of discretion.
Nevada Administrative Code › Chapter 439B - RESTRAINING COSTS OF HEALTH CARE › PROHIBITED CONTRACTS AND TRANSACTIONS › Section 439B.455 - Disclosure required of financial interest in facility or service to which patient referred

Current through June 11, 2024
A health facility shall not refer a patient to a health
				facility or service in which the referring party has a financial interest
				unless the health facility first provides the patient with a written statement
				disclosing that interest.
Added to NAC by Dep't of
				Human Resources, eff. 1-2-90; A 3-9-94
Nevada Administrative Code › Chapter 439B - RESTRAINING COSTS OF HEALTH CARE › PROHIBITED CONTRACTS AND TRANSACTIONS › Section 439B.470 - Procedure to determine whether prohibited contract between hospital and practitioner exists

Current through June 11, 2024
1. The department
			 shall:
(a) Establish a schedule for the
			 submission of a listing of all contracts between a hospital or a related entity
			 and a practitioner. The listing must indicate with respect to each contract:
(1) The type of contract, such as for rent,
			 for services as a medical director, or for some other purpose;
(2) The practitioner's name and
			 address;
(3) The effective date of
			 the contract; and
(4) The term of
			 the contract.
Nevada Administrative Code › Chapter 439B - RESTRAINING COSTS OF HEALTH CARE › PROHIBITED CONTRACTS AND TRANSACTIONS › Section 439B.480 - Contracts and agreements which must be listed and submitted to department

Current through June 11, 2024
1. The following contracts and agreements
			 must be included in the listing submitted to the department by a hospital
			 pursuant to NAC 439B.470:
(a) All rental
			 agreements between the hospital or a related entity and a physician or entity
			 which employs physicians;
(b) All
			 agreements between the hospital or related entity and a physician or entity
			 which employs physicians concerning the subsidization of rent by the hospital
			 or related entity;
(c) All
			 agreements between the hospital or a related entity and a practitioner for the
			 hospital or a related entity acting as the billing agent of the
			 practitioner;
(d) All agreements
			 for the selling of goods or services from the hospital or related entity to a
			 physician; and
(e) Such other
			 agreements and information as the director determines may be necessary to
			 determine if a violation of
			 NRS
			 439B.420 has occurred.
Nevada Administrative Code › Chapter 439B - RESTRAINING COSTS OF HEALTH CARE › PROHIBITED CONTRACTS AND TRANSACTIONS › Section 439B.490 - Preliminary procedure to determine whether prohibited transaction between hospital and related entity has occurred

Current through June 11, 2024
1. The department
			 shall:
(a) Establish a schedule for the
			 submission of a listing of all contracts and agreements between the hospitals
			 and related entities pursuant to
			 NRS
			 439B.430. The schedule must require the
			 submission of the listing from each hospital at least biennially.
(b) Notify each hospital in writing at least
			 30 days before the date for submission of the listing of contracts and
			 agreements between the hospital and its related entities. The department shall
			 specify in its notice the beginning and ending of the period for which the
			 contracts and agreements will be reviewed.
Nevada Administrative Code › Chapter 439B - RESTRAINING COSTS OF HEALTH CARE › PROHIBITED CONTRACTS AND TRANSACTIONS › Section 439B.500 - Determination by director of whether prohibited transaction between hospital and related entity has occurred

Current through June 11, 2024
1. The department
			 shall forward to the director any information which would support a
			 determination that a violation of
			 NRS
			 439B.430 has occurred.
2. Upon receipt of the information from any
			 source which provides reason to believe that a violation of
			 NRS
			 439B.430 has occurred, the director shall
			 allow the hospital to submit additional information from the hospital or
			 related entity or any other party to an agreement with the hospital or related
			 entity being investigated.
3. If
			 the director determines that there is:
(a)
			 Reason to believe a violation of
			 NRS
			 439B.430 has occurred, he shall schedule and
			 hold a hearing pursuant to NAC 439B.520; or
(b) Not sufficient reason to believe that a
			 violation of
			 NRS
			 439B.430 has occurred, he shall notify the
			 hospital of his determination in writing.
Nevada Administrative Code › Chapter 439B - RESTRAINING COSTS OF HEALTH CARE › PROHIBITED CONTRACTS AND TRANSACTIONS › Section 439B.510 - Reasonable cause to believe that prohibited transaction between hospital and related entity has occurred

Current through June 11, 2024
Reasonable cause to believe that a violation of subsection 2 of
				NRS
				439B.430 has occurred includes, but is not
				limited to:
1. The failure of a
			 hospital or related entity to submit the copies required by NAC 439B.490
			 concerning an agreement, contract or transaction between the hospital and a
			 related entity.
2. One or more
			 related agreements, contracts or transactions between the hospital and its
			 related entities resulting in:
(a) An increase
			 in the hospital's operating expenses;
(b) A decrease in the hospital's net patient
			 revenue; or
(c) A combination of
			 paragraphs (a) and (b), of more than 1 percent from the previous fiscal
			 year.
Nevada Administrative Code › Chapter 439B - RESTRAINING COSTS OF HEALTH CARE › PROHIBITED CONTRACTS AND TRANSACTIONS › Section 439B.520 - Hearing required before imposition of penalty

Current through June 11, 2024
1. Before
			 imposing any financial penalty or other penalty pursuant to this chapter, the
			 director shall hold a hearing concerning the penalty.
2. The proceedings conducted pursuant to this
			 section must be conducted pursuant to chapter 233B of NRS.
Added to NAC by Dep't of
				Human Resources, eff. 4-13-88; A 10-20-93
Nevada Administrative Code › Chapter 439B - RESTRAINING COSTS OF HEALTH CARE › REFERRALS BY PRACTITIONERS › Section 439B.5205 - Definitions

Current through June 11, 2024
As used in NAC 439B.5205 to 439B.5408, inclusive, and for the
				purpose of enforcing the provisions of
				NRS
				439B.425, unless the context otherwise
				requires, the words and terms defined in NAC 439B.5207 to 439B.540, inclusive,
				have the meanings ascribed to them in those sections.
Added to NAC by Dep't of
				Human Resources, eff. 3-9-94
Nevada Administrative Code › Chapter 439B - RESTRAINING COSTS OF HEALTH CARE › REFERRALS BY PRACTITIONERS › Section 439B.5207 - "Commercial establishment" defined

Current through June 11, 2024
"Commercial establishment" means any business entity that
				provides goods or services other than a medical laboratory or a health
				facility.
Added to NAC by Dep't of
				Human Resources, eff. 3-9-94
Nevada Administrative Code › Chapter 439B - RESTRAINING COSTS OF HEALTH CARE › REFERRALS BY PRACTITIONERS › Section 439B.530 - "Financial interest" defined

Current through June 11, 2024
1. Except as
			 otherwise provided in paragraph (f) of subsection 2 of
			 NRS
			 439B.425, "financial interest" means an
			 ownership or other interest:
(a) That provides
			 compensation based, in whole or in part, upon the volume or value of goods or
			 services provided as a result of referrals; and
(b) Which a practitioner or a person related
			 to the practitioner within two degrees of consanguinity or affinity:
(1) Owns, in whole or in part; or
(2) Holds as a beneficiary of a
			 trust.
Nevada Administrative Code › Chapter 439B - RESTRAINING COSTS OF HEALTH CARE › REFERRALS BY PRACTITIONERS › Section 439B.5302 - "Group practice" defined

Current through June 11, 2024
"Group practice" has the meaning ascribed to it in paragraph
				(a) of subsection 4 of
				NRS
				439B.425.
Added to NAC by Dep't of
				Human Resources, eff. 3-9-94
Nevada Administrative Code › Chapter 439B - RESTRAINING COSTS OF HEALTH CARE › REFERRALS BY PRACTITIONERS › Section 439B.5306 - "One parcel of land" defined

Current through June 11, 2024
"One parcel of land" means one conveyable lot or parcel of land
				or multiple conveyable lots or parcels of land which are contiguous.
Added to NAC by Dep't of
				Human Resources, eff. 3-9-94
Nevada Administrative Code › Chapter 439B - RESTRAINING COSTS OF HEALTH CARE › REFERRALS BY PRACTITIONERS › Section 439B.5308 - "Patient" defined

Current through June 11, 2024
"Patient" has the meaning ascribed to it in paragraph (b) of
				subsection 4 of
				NRS
				439B.425.
Added to NAC by Dep't of
				Human Resources, eff. 3-9-94
Nevada Administrative Code › Chapter 439B - RESTRAINING COSTS OF HEALTH CARE › REFERRALS BY PRACTITIONERS › Section 439B.540 - "Refer" defined

Current through June 11, 2024
"Refer" means sending or directing any person to another person
				or business entity for the purpose of obtaining, consuming or purchasing, for
				consideration, goods or services related to health care.
Added to NAC by Dep't of
				Human Resources, eff. 3-9-94
Nevada Administrative Code › Chapter 439B - RESTRAINING COSTS OF HEALTH CARE › REFERRALS BY PRACTITIONERS › Section 439B.5402 - Prohibited referral of patients by agent, employee or independent contractor of practitioner

Current through June 11, 2024
The provision of subsection 1 of
				NRS
				439B.425 prohibiting a practitioner from
				referring a patient, for a service or for goods related to health care, to a
				health facility, medical laboratory or commercial establishment in which the
				practitioner has a financial interest, must be construed as prohibiting any
				agent, employee or independent contractor of a practitioner from referring a
				patient of the practitioner, for a service or for goods related to health care,
				to a health facility, medical laboratory or commercial establishment in which
				the practitioner has a financial interest.
Added to NAC by Dep't of
				Human Resources, eff. 3-9-94
Nevada Administrative Code › Chapter 439B - RESTRAINING COSTS OF HEALTH CARE › REFERRALS BY PRACTITIONERS › Section 439B.5404 - Authorized referrals

Current through June 11, 2024
The following referrals do not present a perception of a
				conflict of interest, are consistent with the overall purpose of chapter 439B
				of NRS and are not prohibited by the provisions of
				NRS
				439B.425:
1. Any referral within one or more locations
			 of a business entity if:
(a) The goods or
			 services provided as a result of the referral are routinely provided to all
			 patients of the referring practitioner based on their needs;
(b) The referring practitioner has the right
			 to see regular patients for personal medical care, consultations, diagnoses and
			 treatment at the same site and general location where the goods or services
			 will be provided as a result of the referral;
(c) The goods and services provided as a
			 result of the referral are billed as part of the bill provided by the referring
			 practitioner or the business entity;
(d) The goods or services provided as a
			 result of the referral are not provided at a facility operating under a
			 different name; and
(e) The
			 referral is not a referral by a licensed physician to a medical laboratory:
(1) In which the physician has a financial
			 interest; and
(2) That is not
			 operated solely in connection with the diagnosis or treatment of the
			 physician's patients.
Nevada Administrative Code › Chapter 439B - RESTRAINING COSTS OF HEALTH CARE › REFERRALS BY PRACTITIONERS › Section 439B.5406 - Authorized referrals to facilities in which practitioner has financial interest

Current through June 11, 2024
1. The provisions
			 of
			 NRS
			 439B.425 do not prohibit a practitioner from
			 referring a patient, for a service or for goods related to health care, to a
			 health facility, medical laboratory or commercial establishment in which the
			 practitioner has a financial interest if the referral is made on or before June
			 30, 1994, and:
(a) The financial interest
			 existed on or before June 30, 1993;
(b) The practitioner files with the director,
			 on or before December 31, 1993, a form provided by the department for the
			 purpose of declaring a financial interest and requesting the authority to make
			 the referral until June 30, 1994;
(c) The practitioner cures any defect in the
			 form filed pursuant to paragraph (b) within 15 days from the date of postage of
			 the notice of that defect provided by the director pursuant to subsection 4;
			 and
(d) The practitioner provides
			 to each referred patient a written notice of his financial interest in any
			 goods or services to be provided as a result of the referral.
Nevada Administrative Code › Chapter 439B - RESTRAINING COSTS OF HEALTH CARE › REFERRALS BY PRACTITIONERS › Section 439B.5408 - Investigation of possible prohibited referral by practitioner; determination by director after investigation

Current through June 11, 2024
1. If the
			 department becomes aware of a possible violation of subsection 1 of
			 NRS
			 439B.425, it may investigate the violation or
			 forward the information to the applicable licensing board of the
			 practitioner.
2. If, after an
			 investigation is conducted pursuant to subsection 1, the director determines
			 that there is:
(a) Sufficient reason to
			 believe a violation of subsection 1 of
			 NRS
			 439B.425 has occurred, he will schedule and
			 hold a hearing pursuant to chapter 233B of NRS. If, at the hearing, it is found
			 that a violation of subsection 1 of
			 NRS
			 439B.425 has occurred, the director may
			 impose a fine pursuant to subsection 2 of
			 NRS
			 439B.450.
(b) Not sufficient reason to believe that a
			 violation of subsection 1 of
			 NRS
			 439B.425 has occurred, he will notify the
			 practitioner of his determination in writing.
Nevada Administrative Code › Chapter 439B - RESTRAINING COSTS OF HEALTH CARE › EDUCATIONAL PROGRAM TO PROMOTE WELLNESS, PHYSICAL FITNESS AND PREVENTION OF DISEASE AND ACCIDENTS › Section 439B.550 - Development and implementation of program

Current through June 11, 2024
An educational program developed pursuant to
				NRS
				439B.280 must be designed to address problems
				or objectives related to health that are identified in
National Health
				Promotion and Disease Prevention Objectives for the Year 2000
,
				published by the United States Public Health Service. The major hospitals must
				determine the form and content of each program, but a program must be approved
				by the director before it is implemented.
Added to NAC by Dep't of
				Human Resources, eff. 12-31-91
Nevada Administrative Code › Chapter 439B - RESTRAINING COSTS OF HEALTH CARE › EDUCATIONAL PROGRAM TO PROMOTE WELLNESS, PHYSICAL FITNESS AND PREVENTION OF DISEASE AND ACCIDENTS › Section 439B.555 - Description of program: Submission to director; contents

Current through June 11, 2024
At least 30 days before initiating an educational program
				pursuant to
				NRS
				439B.280, the major hospitals shall submit to
				the director a description of the program, including:
1. The name of the person responsible for
			 liaison with the director regarding the program;
2. Each problem or objective identified in
National Health Promotion and Disease Prevention Objectives for the
			 Year 2000
that the program is intended to address;
3. A syllabus or outline of the content of
			 the program, indicating the major points to be conveyed, other significant
			 points to be conveyed and the organization or sequence of presentation;
			 and
4. Biographical sketches of the
			 instructors, facilitators or leaders, indicating their professional competence
			 to instruct in the relevant subject areas. If the instructors, facilitators or
			 leaders for the program have not been selected at the time the plan is
			 submitted to the director, a brief statement of required professional
			 qualifications must be included.
Added to NAC by Dep't of
				Human Resources, eff. 12-31-91