Nevada Administrative Code

NAC 439A.815 Information concerning surgical centers for ambulatory patients: Request for extension of time for submission of information. (NRS 439A.250) 1. A surgical center for ambulatory patients may submit to the Director a written request to submit the information required p…

NAC 439A.820 Information concerning surgical centers for ambulatory patients: Notification by Department that information is incomplete; effect of failure to submit complete information. (NRS 439A.250) 1. If a surgical center fails to submit the information required pursuant to N…

NAC 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. (NRS 439A.250) 1. For purposes of paragraph (d) of subsec…

NAC 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. (NRS 439A.220, 439A.230) 1. For purpo…

NAC 439A.835 Internet website for information concerning hospitals and surgical centers for ambulatory patients: Duties of Department. (NRS 439A.270, 439A.290) The Department will: 1. Update the information contained on the Internet website established and maintained pursuant to …

NAC 439A.840 Request for information. (NRS 439A.290) 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, incl…

NAC 439B.010 Definitions. As used in this chapter, unless the context otherwise requires, the words and terms defined in NAC 439B.110 to 439B.185, 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; 1…

NAC 439B.030 “Billed charge” defined. “Billed charge” has the meaning ascribed to it in NRS 439B.030. (Added to NAC by Dep’t of Human Resources, eff. 4-13-88)

NAC 439B.040 “Department” defined. “Department” has the meaning ascribed to it in NRS 439B.050. (Added to NAC by Dep’t of Human Resources, eff. 4-13-88)

NAC 439B.050 “Director” defined. “Director” has the meaning ascribed to it in NRS 439B.060. (Added to NAC by Dep’t of Human Resources, eff. 4-13-88)

NAC 439B.080 “Fiscal year” defined. “Fiscal year” has the meaning ascribed to it in NRS 439B.090. (Added to NAC by Dep’t of Human Resources, eff. 4-13-88)

NAC 439B.090 “Health facility” defined. “Health facility” has the meaning ascribed to it in NRS 439A.015. (Added to NAC by Dep’t of Human Resources, eff. 4-13-88)

NAC 439B.100 “Hospital” defined. “Hospital” has the meaning ascribed to it in NRS 439B.110. (Added to NAC by Dep’t of Human Resources, eff. 4-13-88)

NAC 439B.110 “Hospital fiscal year” defined. “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)

NAC 439B.120 “Indigent” defined. “Indigent” has the meaning ascribed to it in NRS 439B.310. (Added to NAC by Dep’t of Human Resources, eff. 4-13-88)

NAC 439B.130 “Inpatient” defined. “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-…

NAC 439B.140 “Inpatient billed charges” defined. “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)

NAC 439B.150 “Inpatient net revenue” defined. “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)

NAC 439B.155 “Major hospital” defined. “Major hospital” has the meaning ascribed to it in NRS 439B.115. (Added to NAC by Dep’t of Human Resources, eff. 12-31-91)

NAC 439B.160 “Medicaid” defined. “Medicaid” has the meaning ascribed to it in NRS 439B.120. (Added to NAC by Dep’t of Human Resources, eff. 4-13-88)

NAC 439B.170 “Medicare” defined. “Medicare” has the meaning ascribed to it in NRS 439B.130. (Added to NAC by Dep’t of Human Resources, eff. 4-13-88)

NAC 439B.180 “Net revenue” defined. “Net revenue” has the meaning ascribed to it in NRS 439B.140. (Added to NAC by Dep’t of Human Resources, eff. 4-13-88)

NAC 439B.185 “Operating budget” defined. “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.…

NAC 439B.190 “Practitioner” defined. “Practitioner” has the meaning ascribed to it in NRS 439B.150. (Added to NAC by Dep’t of Human Resources, eff. 4-13-88) FINANCIAL PRACTICES OF HOSPITALS

NAC 439B.220 Submission of quarterly reports. 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 (…

NAC 439B.230 Submission of annual financial reports. 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 Medic…

NAC 439B.240 Certification of financial reports; penalty for failure to submit information; request for extension of time. 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 kno…

NAC 439B.250 Submission of copy of audit. 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 annuall…

NAC 439B.260 Independent audits; penalty for failure to cooperate. 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 chapt…

NAC 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. 1. A major hospital which is required to reduce or discount the total billed cha…

NAC 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. 1. Except as otherwise provided in subsection 2, to be deemed reas…

NAC 439B.335 Initial payment from patient upon admittance to hospital. 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 addi…

NAC 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. 1. If a major hospital charges interest on the unpaid balance of the total billed charge …

NAC 439B.390 Applicability of certain provisions of NRS and NAC. 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 t…

NAC 439B.410 Submission of copy of Medicare Cost Report and estimate of inpatient net revenue. 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 F…

NAC 439B.420 Determination of minimum obligation. 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 hospit…

NAC 439B.430 Reports on actual and estimated minimum obligation; notification to board of county commissioners. 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: …

NAC 439B.435 Delivery to hospitals of reports on indigent patients treated. 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…

NAC 439B.441 Applicability. 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, …

NAC 439B.442 Exhaustion of administrative procedures. 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 t…

NAC 439B.443 Filing and contents of appeal; submission of additional material upon request. 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 …

NAC 439B.444 Determination to hold hearing or to issue decision denying appeal without hearing. After considering the information and documentation specified in NAC 439B.443, the Director or the designee will: 1. Hold a hearing; or 2. Based upon a finding that the county acted pr…

NAC 439B.446 Scheduling and notice of hearing. If the Director or the designee determines that a hearing on the indigent status of an inpatient is necessary, he or she will set a time and place for the hearing and send notice of the hearing to the hospital and the county by regis…

NAC 439B.447 Presentation of evidence at hearing. 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 the designee may request any informati…

NAC 439B.448 Issuance of decision after hearing. If a hearing is held pursuant to NAC 439B.446, the Director or the 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 hea…

NAC 439B.449 Contents of decision issued after hearing; effect of decision issued without or after hearing. 1. The written decision of the Director or the designee rendered pursuant to NAC 439B.448 must: (a) Affirm the county’s decision; or (b) Reverse or remand the county’s deci…

NAC 439B.455 Disclosure required of financial interest in facility or service to which patient referred. 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…