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AB 36

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

2025 Regular Session

Requires Medicaid providers to request a hearing within 90 days of notice, with regulations defining extenuating circumstances; applies to hearings requested after Jan 1, 2026.

Approved by the Governor. Chapter 66.
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Bill Summary · AB 36

AB 36 — Revises provisions relating to Medicaid (BDR 38‑291) — Summary

Status: Enacted — Approved by Governor; Chapter 66 (2025).
Introduced: December 2, 2024.
Sponsor: Assembly Committee on Health and Human Services (on behalf of the Division of Health Care Financing and Policy, Department of Health and Human Services, Nevada).

Purpose / intent

To clarify and standardize timelines and procedures for administrative hearings when the Division of Health Care Financing and Policy (DHCFP) takes an action against a provider under Nevada’s Medicaid State Plan. The bill establishes a firm request‑for‑hearing deadline, requires the Division to adopt implementing regulations (including what constitutes “extenuating circumstances”), and makes those rules apply prospectively.

Key provisions

  • Amends NRS 422.306 to require a provider of services under the Medicaid State Plan to request an administrative hearing no later than 90 calendar days after the date of the notice of the action being challenged, unless the Division determines extenuating circumstances justify a later request.
  • Directs the Division to adopt regulations that:
    • Prescribe hearing procedures;
    • Enumerate the actions for which a provider may request a hearing; and
    • Define the circumstances that qualify as “extenuating circumstances” permitting a late hearing request.
  • Retains existing safeguards: the hearing officer must not be an employee or representative who investigated or made the original decision; the hearing officer’s decision is final and may be appealed by filing for judicial review in the District Court in Carson City within 30 days.
  • Specifies procedural timelines for judicial review (e.g., Division must file the record within 90 days; briefing schedules).
  • Prospectivity: the 90‑day requirement and related regulations apply only to hearings requested on or after January 1, 2026. The act is effective upon passage and approval for the purpose of adopting regulations and administrative preparation, and January 1, 2026, for all other purposes.

Who is affected

  • Primary: Providers of services under Nevada’s Medicaid (State Plan) who may be subject to Division actions (e.g., enrollment sanctions, payment denials, terminations).
  • Administrative: The DHCFP (Division) — required to develop and publish regulations and to apply the new timing rules.
  • Judicial: District Court in Carson City as the forum for judicial review of hearing officer decisions.

Practical impact and timeline

  • Providers must generally request hearings within 90 days of notice beginning for requests made on/after January 1, 2026, or risk forfeiture absent Division‑approved extenuating circumstances.
  • The Division must adopt implementing regulations prior to the Jan. 1, 2026 prospective effective date; those regulations will (1) identify which Division actions are appealable and (2) define allowable extenuating circumstances.
  • The change aims to create clearer, uniform deadlines and procedural definitions, which may reduce uncertainty and administrative delay but could also narrow the window for providers to preserve appeal rights without an approved exception.

Fiscal note / administrative

  • Fiscal effect: State — Yes; Local government — No (per committee analyses).
  • The Division will incur administrative work to promulgate regulations and implement the new procedures.

Compiled from official sources — confirm details with the bill’s official record.

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