2-30 the words and terms defined in NRS 422.010 to 422.055, inclusive, and

2-34 [1.] (a) State supplementary assistance;

2-35 [2.] (b) Temporary assistance for needy families;

2-36 [3.] (c) Medicaid;

2-37 [4.] (d) Food stamp assistance;

2-38 [5.] (e) Low-income home energy assistance;

2-39 [6.] (f) The program for child care and development; and

2-40 [7.] (g) Benefits provided pursuant to any other public welfare program

2-41 administered by the welfare division or the division of health care

2-42 financing and policy pursuant to such additional federal legislation as is

3-5 section 3 of this act, 422.301 to 422.306, inclusive, and 422.380 to

3-6 422.390, inclusive, [and 422.580,] unless the context otherwise requires,

3-7 "administrator" means the administrator of the division of health care

3-11 administer oaths and take testimony thereunder and issue subpoenas

3-12 requiring the attendance of witnesses before the division of health care

3-13 financing and policy at a designated time and place and the production of

3-14 books, papers and records relative to:

3-15 (a) Eligibility or continued eligibility to provide medical care, remedial

3-16 care or other services pursuant to the state plan for Medicaid [;] or the

3-17 children’s health insurance program; and

3-18 (b) Verification of treatment and payments to a provider of medical

3-19 care, remedial care or other services pursuant to the state plan for Medicaid

3-20 [.] or the children’s health insurance program.

3-21 2. If a witness fails to appear or refuses to give testimony or to

3-22 produce books, papers and records as required by the subpoena, the district

3-23 court of the county in which the investigation is being conducted may

3-24 compel the attendance of the witness, the giving of testimony and the

3-28 concerning applicants for and recipients of public assistance or assistance

3-29 pursuant to the children’s health insurance program to purposes directly

3-30 connected to the administration of this chapter, and to provide safeguards

3-31 therefor, under the applicable provisions of the Social Security Act, the

3-32 welfare division and the division of health care financing and policy shall

3-33 establish and enforce reasonable regulations governing the custody, use

3-34 and preservation of any records, files and communications filed with the

3-35 welfare division or the division of health care financing and policy.

3-36 2. If, pursuant to a specific statute or a regulation of the welfare

3-37 division or the division of health care financing and policy, names and

3-38 addresses of, or information concerning, applicants for and recipients of

3-39 assistance , including, without limitation, assistance pursuant to the

3-40 children’s health insurance program, are furnished to or held by any

4-12 provided pursuant to the children’s health insurance program incurs an

4-13 illness or injury for which medical services are payable [under the state

4-14 plan] by the department and which is incurred under circumstances

4-15 creating a legal liability in some person other than the recipient or a

4-16 division of the department to pay all or part of the costs of such services,

4-17 the department is subrogated to the right of the recipient to the extent of all

4-18 such costs and may join or intervene in any action by the recipient or his

4-19 successors in interest to enforce such legal liability.

4-20 2. If a recipient or his successors in interest fail or refuse to commence

4-21 an action to enforce the legal liability, the department may commence an

4-22 independent action, after notice to the recipient or his successors in

4-23 interest, to recover all costs to which it is entitled. In any such action by the

4-24 department, the recipient or his successors in interest may be joined as

4-25 third-party defendants.

4-26 3. In any case where the department is subrogated to the rights of the

4-27 recipient or his successors in interest as provided in subsection 1, the

4-28 department has a lien upon the proceeds of any recovery from the persons

4-29 liable, whether the proceeds of the recovery are by way of judgment,

4-30 settlement or otherwise. Such a lien must be satisfied in full, unless

4-31 reduced pursuant to subsection 5, at such time as:

4-32 (a) The proceeds of any recovery or settlement are distributed to or on

4-33 behalf of the recipient, his successors in interest or his attorney; and

4-34 (b) A dismissal by any court of any action brought to enforce the legal

4-35 liability established by subsection 1.

4-36 No such lien is enforceable unless written notice is first given to the person

4-37 against whom the lien is asserted.

4-38 4. The recipient or his successors in interest shall notify the

4-39 department in writing before entering any settlement agreement or

4-40 commencing any action to enforce the legal liability referred to in

4-41 subsection 1. Except if extraordinary circumstances exist, a person who

4-42 fails to comply with the provisions of this subsection shall be deemed to

5-20 pursuant to:

5-21 (a) The program established to provide temporary assistance for needy

5-22 families;

5-23 (b) [The program for assistance to the medically indigent;] Medicaid; or

5-24 (c) Any program for which a grant has been provided to this state

5-25 pursuant to 42 U.S.C. §§ 1397 et seq.,

5-26 to a qualified alien who complies with the requirements established by the

5-27 welfare division pursuant to federal law and this chapter for the receipt of

5-28 benefits pursuant to that program.

5-29 2. As used in this section, "qualified alien" has the meaning ascribed

5-33 services under the state plan for Medicaid, the division of health care

5-34 financing and policy shall appoint a hearing officer to conduct the hearing.

5-35 Any employee or other representative of the division of health care

5-36 financing and policy who investigated or made the initial decision

5-37 regarding the action taken against a provider of services may not be

5-38 appointed as the hearing officer or participate in the making of any

5-39 decision pursuant to the hearing.

5-40 2. The division of health care financing and policy shall adopt

5-41 regulations prescribing the procedures to be followed at the hearing.

7-3 financing and policy to furnish the types of medical and remedial care for

7-4 which assistance may be provided under the plan, or an agent or employee

7-5 of the authorized person, who, with the intent to defraud, furnishes such

7-6 care upon presentation of a Medicaid card which he knows was obtained or

7-7 retained in violation of any of the provisions of NRS 422.361 to 422.367,

7-8 inclusive, or is forged, expired or revoked, is guilty of a category D felony

7-9 and shall be punished as provided in NRS 193.130. In addition to any other

7-13 of a household pursuant to NRS 422.3724 includes a provision providing

7-14 for the payment of transitional assistance to the head of the household, the

7-15 welfare division may provide transitional assistance to the head of the

7-16 household if the household becomes ineligible for benefits for one or more

7-17 of the reasons described in 42 U.S.C. § 608(a)(11). The welfare division

7-18 shall not provide transitional assistance pursuant to this section for more

7-19 than 12 consecutive months.

7-20 2. As used in this section, "transitional assistance" means:

7-21 (a) Assistance provided by the welfare division to low-income families

7-22 to pay for the costs of child care; or

7-23 (b) Medicaid provided pursuant to the plan administered by the [welfare

7-27 422.387 must be made, to the extent allowed by the state plan for

7-28 Medicaid, from the Medicaid budget account.

7-29 2. Except as otherwise provided in subsection 3, the money in the

7-30 intergovernmental transfer account must be transferred from that account

7-31 to the Medicaid budget account to the extent that money is available from

7-32 the Federal Government for proposed expenditures, including expenditures

7-33 for administrative costs. If the amount in the account exceeds the amount

7-34 authorized for expenditure by the division of health care financing and

7-35 policy for the purposes specified in NRS 422.387, the division of health

7-36 care financing and policy is authorized to expend the additional revenue in

7-37 accordance with the provisions of the state plan for Medicaid.

7-38 3. If enough money is available to support Medicaid, money in the

7-39 intergovernmental transfer account may be transferred to an account

7-40 established for the provision of health care services to uninsured children

7-41 [who are under the age of 13 years] pursuant to a federal program in which

8-7 422.361 to 422.369, inclusive, or 422.450 to 422.590, inclusive, a person

8-8 who knowingly and designedly, by any false pretense, false or misleading

8-9 statement, impersonation or misrepresentation, obtains or attempts to

8-10 obtain monetary or any other public assistance , or money, property,

8-11 medical or remedial care or any other service provided pursuant to the

8-12 children’s health insurance program, having a value of $100 or more,

8-13 whether by one act or a series of acts, with the intent to cheat, defraud or

8-14 defeat the purposes of this chapter is guilty of a category E felony and shall

8-15 be punished as provided in NRS 193.130. In addition to any other penalty,

8-16 the court shall order the person to pay restitution.

8-17 2. For the purposes of subsection 1, whenever a recipient of temporary

8-18 assistance for needy families pursuant to the provisions of this chapter

8-19 receives an overpayment of benefits for the third time and the

8-20 overpayments have resulted from a false statement or representation by the

8-21 recipient or from the failure of the recipient to notify the welfare division

8-22 of a change in his circumstances which would affect the amount of

8-23 assistance he receives, a rebuttable presumption arises that the payment

8-24 was fraudulently received.

8-25 3. For the purposes of subsection 1, "public assistance" includes any

8-26 money, property, medical or remedial care or any other service provided

8-30 entitled by reason of a violation of NRS 422.540, 422.550, 422.560 or

8-31 422.570 is liable for:

8-32 (a) An amount equal to three times the amount unlawfully obtained;

8-33 (b) Not less than $5,000 for each false claim, statement or

8-34 representation;

8-35 (c) An amount equal to three times the total of the reasonable expenses

8-36 incurred by the state in enforcing this section; and

8-37 (d) Payment of interest on the amount of the excess payment at the rate

8-38 fixed pursuant to NRS 99.040 for the period from the date upon which

8-39 payment was made to the date upon which repayment is made pursuant to

8-40 the plan.

8-41 2. A criminal action need not be brought against the provider before

9-14 consisting of 11 members, is hereby created.

9-15 2. The director shall appoint to the committee:

9-16 (a) One member who is an employee of the rehabilitation division of the

9-17 department.

9-18 (b) One member who is an employee of the [welfare] division of health

9-19 care financing and policy of the department of human resources and

9-20 participates in the administration of the state program providing Medicaid.

9-21 (c) One member who is a licensed insurer in this state.

9-22 (d) One member who represents the interests of educators in this state.

9-23 (e) One member who is a person professionally qualified in the field of

9-24 psychiatric mental health.

9-25 (f) Two members who are employees of private providers of

9-26 rehabilitative health care located in this state.

9-27 (g) One member who represents persons who operate community-based

9-28 programs for head injuries in this state.

9-29 (h) One member who represents hospitals in this state.

9-30 (i) Two members who represent the recipients of health care in this

9-31 state.

9-32 3. After the initial appointments, each member of the committee serves

9-33 a term of 3 years.

9-34 4. The committee shall elect one of its members to serve as chairman.

9-35 5. Members of the committee serve without compensation and are not

9-36 entitled to receive the per diem allowance or travel expenses provided for

9-37 state officers and employees generally.

9-38 6. The committee may:

9-39 (a) Make recommendations to the director relating to the establishment

9-40 and operation of any program for persons with traumatic brain injuries.

9-41 (b) Make recommendations to the director concerning proposed

9-42 legislation relating to traumatic brain injuries.

10-14 uniform standards of eligibility prescribed by the board of county

10-15 commissioners or by NRS 439B.310, if applicable, falls sick in the county,

10-16 not having money or property to pay his board, nursing or medical aid, the

10-17 board of county commissioners of the proper county shall, on complaint

10-18 being made, give or order to be given such assistance to the poor person as

10-19 is in accordance with the policies and standards established and approved

10-20 by the board of county commissioners and within the limits of money

10-21 which may be lawfully appropriated for this purpose pursuant to NRS

10-22 428.050, 428.285 and 450.425.

10-23 2. If the sick person dies, the board of county commissioners shall give

10-24 or order to be given to the person a decent burial or cremation.

10-25 3. Except as otherwise provided in NRS 422.382, the board of county

10-26 commissioners shall make such allowance for the person’s board, nursing,

10-27 medical aid, burial or cremation as the board deems just and equitable, and

10-28 order it paid out of the county treasury.

10-29 4. The responsibility of the board of county commissioners to provide

10-30 medical aid or any other type of remedial aid under this section is relieved

10-31 to the extent provided in NRS 422.382 and to the extent of the amount of

10-32 money or the value of services provided by:

10-33 (a) The [welfare division of the] department of human resources to or

10-34 for such persons for medical care or any type of remedial care under the

10-35 state plan for Medicaid; and

10-36 (b) The fund for hospital care to indigent persons under the provisions

10-40 investigate and prosecute violations of NRS 422.540 to 422.570, inclusive,

10-41 and any fraud in the administration of the plan or in the provision of

12-5 1. To ensure that the Medicaid provided by this state [is] and the

12-6 insurance provided pursuant to the children’s health insurance program

12-7 in this state are provided in the manner that is most efficient to this state.

12-8 2. To evaluate alternative methods of providing Medicaid [.] and

12-9 providing insurance pursuant to the children’s health insurance

12-10 program.

12-11 3. To review Medicaid , the children’s health insurance program and

12-12 other health programs of this state to determine the maximum amount of

12-13 money that is available from the Federal Government for such programs.

12-14 4. To promote access to quality health care for all residents of this

12-15 state.

12-19 by a business pursuant to NRS 274.260, and if it finds that the business is

12-20 qualified by financial responsibility and business experience to create and

12-21 preserve employment opportunities in the specially benefited zone and

12-22 improve the economic climate of the municipality and finds further that the

12-23 business did not relocate from a depressed area in this state or reduce

12-24 employment elsewhere in Nevada in order to expand in the specially

12-25 benefited zone, the governing body may, on behalf of the municipality,

12-26 enter into an agreement with the business, for a period of not more than 20

12-27 years, under which the business agrees in return for one or more of the

12-28 benefits authorized in this chapter and NRS 374.643 for qualified

12-29 businesses, as specified in the agreement, to establish, expand, renovate or

12-30 occupy a place of business within the specially benefited zone and hire

12-31 new employees at least 35 percent of whom at the time they are employed

12-32 are at least one of the following:

12-33 (a) Unemployed persons who have resided at least 6 months in the

12-34 municipality.

12-35 (b) Persons eligible for employment or job training under any federal

12-36 program for employment and training who have resided at least 6 months

12-37 in the municipality.

12-38 (c) Recipients of benefits under any state or county program of public

12-39 assistance, including , without limitation, temporary assistance for needy

12-40 families, [aid to the medically indigent] Medicaid and unemployment

12-41 compensation who have resided at least 6 months in the municipality.

12-42 (d) Persons with a physical or mental handicap who have resided at

13-27 requires, the words and terms defined in NRS 439B.030 to 439B.150,

13-28 inclusive, and section 24 of this act have the meanings ascribed to them in

13-32 "indigent" means those persons:

13-33 1. Who are not covered by any policy of health insurance;

13-34 2. Who are ineligible for Medicare, Medicaid, the children’s health

13-35 insurance program, the benefits provided pursuant to NRS 428.115 to

13-36 428.255, inclusive, or any other federal or state program of public

13-37 assistance covering the provision of health care;

13-38 3. Who meet the limitations imposed by the county upon assets and

13-39 other resources or potential resources; and

13-40 4. Whose income is less than:

13-41 (a) For one person living without another member of a household,

13-42 $438.

13-43 (b) For two persons, $588.

14-9 provided by any other person reporting a case or suspected case of a

14-10 communicable disease, or by any person who has a communicable disease,

14-11 or as determined by investigation of the health authority, is confidential

14-12 medical information and must not be disclosed to any person under any

14-13 circumstances, including pursuant to any subpoena, search warrant or

14-14 discovery proceeding, except as follows:

14-15 1. For statistical purposes, provided that the identity of the person is

14-16 not discernible from the information disclosed.

14-17 2. In a prosecution for a violation of this chapter.

14-18 3. In a proceeding for an injunction brought pursuant to this chapter.

14-19 4. In reporting the actual or suspected abuse or neglect of a child or

14-20 elderly person.

14-21 5. To any person who has a medical need to know the information for

14-22 his own protection or for the well-being of a patient or dependent person,

14-23 as determined by the health authority in accordance with regulations of the

14-24 board.

14-25 6. If the person who is the subject of the information consents in

14-26 writing to the disclosure.

14-27 7. Pursuant to subsection 2 of NRS 441A.320.

14-28 8. If the disclosure is made to [the welfare division of] the department

14-29 of human resources and the person about whom the disclosure is made has

14-30 been diagnosed as having acquired immunodeficiency syndrome or an

14-31 illness related to the human immunodeficiency virus and is a recipient of

14-32 or an applicant for Medicaid.

14-33 9. To a fireman, police officer or person providing emergency medical

14-34 services if the board has determined that the information relates to a

14-35 communicable disease significantly related to that occupation. The

14-36 information must be disclosed in the manner prescribed by the board.

14-40 of 10 members appointed by the board, is hereby created.

14-41 2. The board shall appoint to the advisory committee:

14-42 (a) One representative of facilities for long-term care;

15-17 health benefits or coverage provided pursuant to:

15-18 1. A group health plan;

15-19 2. A health benefit plan;

15-20 3. Part A or Part B of Title XVIII of the Social Security Act, also

15-21 known as Medicare;

15-22 4. Title XIX of the Social Security Act, also known as Medicaid, other

15-23 than coverage consisting solely of benefits under section 1928 of that Title;

15-24 5. Chapter 55 of Title 10, United States Code (Civilian Health and

15-25 Medical Program of Uniformed Services (CHAMPUS));

15-26 6. A medical care program of the Indian Health Service or of a tribal

15-27 organization;

15-28 7. A state health benefit risk pool;

15-29 8. A health plan offered pursuant to chapter 89 of Title 5, United

15-30 States Code (Federal Employees Health Benefits Program (FEHBP));

15-31 9. A public health plan as defined in [federal regulations] 45 C.F.R. §

15-32 146.113, authorized by the Public Health Service Act, section

15-33 2701(c)(1)(I), as amended by Public Law 104-191 [; or] , 42 U.S.C. §

15-34 300gg(c)(1)(I);

15-35 10. A health benefit plan under section 5(e) of the Peace Corps Act ,

15-36 [(] 22 U.S.C. § 2504(e) [).] ; or

15-37 11. The children’s health insurance program established pursuant to

15-41 provided to a person pursuant to:

15-42 1. A group health plan;

16-22 provided to a person pursuant to:

16-23 1. A group health plan;

16-24 2. A health benefit plan;

16-25 3. Part A or Part B of Title XVIII of the Social Security Act, also

16-26 known as Medicare;

16-27 4. Title XIX of the Social Security Act, also known as Medicaid, other

16-28 than coverage consisting solely of benefits under section 1928 of that Title;

16-29 5. Chapter 55 of Title 10, United States Code (Civilian Health and

16-30 Medical Program of Uniformed Services (CHAMPUS));

16-31 6. A medical care program of the Indian Health Service or of a tribal

16-32 organization;

16-33 7. A state health benefit risk pool;

16-34 8. A health plan offered pursuant to chapter 89 of Title 5, United

16-35 States Code (Federal Employees Health Benefits Program (FEHBP));

16-36 9. A public health plan as defined in federal regulations authorized by

16-37 the Public Health Service Act, section 2701(c)(1)(I), as amended by Public

16-38 Law 104-191; [or]

16-39 10. A health benefit plan under section 5(e) of the Peace Corps Act ,

16-40 [(] 22 U.S.C. § 2504(e) [).] ; or

16-41 11. The children’s health insurance program established pursuant to

17-3 specific provisions of this Title, the provisions of this Title are not

17-4 applicable to any health maintenance organization granted a certificate of

17-5 authority under this chapter. This provision does not apply to an insurer

17-6 licensed and regulated pursuant to this Title except with respect to its

17-7 activities as a health maintenance organization authorized and regulated

17-8 pursuant to this chapter.

17-9 2. Solicitation of enrollees by a health maintenance organization

17-10 granted a certificate of authority, or its representatives, must not be

17-11 construed to violate any provision of law relating to solicitation or

17-12 advertising by practitioners of a healing art.

17-13 3. Any health maintenance organization authorized under this chapter

17-14 shall not be deemed to be practicing medicine and is exempt from the

17-15 provisions of chapter 630 of NRS.

17-16 4. The provisions of NRS 695C.110, 695C.170 to 695C.200,

17-17 inclusive, 695C.250 and 695C.265 do not apply to a health maintenance

17-18 organization that provides health care services through managed care to

17-19 recipients of Medicaid or insurance pursuant to the children’s health

17-20 insurance program pursuant to a contract with the [welfare] division of

17-21 health care financing and policy of the department of human resources.

17-22 This subsection does not exempt a health maintenance organization from

17-23 any provision of this chapter for services provided pursuant to any other

17-28 14.3 to 29, inclusive, 32 to 43, inclusive, 45, 47, 49 to 54,

17-29 inclusive, 56, 57, 59, 63, 64, 67 to 71, inclusive, and 74 to 88,

17-30 inclusive, of this act become effective on July 1, 1997.

17-31 2. Sections 1, 30, 30.5, 44, 46, 48, 54.5, 58, 60, 61, 62, 65, 66,

17-32 72 and 73 of this act become effective at 12:01 a.m. on July 1,

17-33 1997.

17-34 3. Sections 31 and 55 of this act become effective at 12:02 a.m.

17-35 on July 1, 1997.

17-36 4. Section 14.2 of this act becomes effective on July 1, 1998.

17-37 [5. Sections 1 to 14.4, inclusive, 15 to 30, inclusive, 31 to 54,

17-38 inclusive, 55 to 80.3, inclusive, and 84 of this act, and subsection 1