Senate Amendment to Assembly Bill No. 429 First Reprint (BDR 38-635)
Proposed by: Committee on Human Resources and Facilities
Amendment Box: Replaces Amendment No. 785. Resolves conflicts with A.B. No. 203, A.B. No. 249, A.B. No. 305, A.B. No. 483, A.B. No. 645, A.B. No. 649 and S.B. No. 398. Makes substantive changes.
Resolves Conflicts with: AB203, AB249, AB305, AB483, AB645, AB649, SB398
Amends: Summary: Title: Preamble: Joint Sponsorship:
ASSEMBLY ACTION
Initial and Date | SENATE ACTION Initial and DateAdopted Lost | Adopted Lost
Concurred In Not | Concurred In Not
Receded Not | Receded Not
Amend sec. 7, page 3, line 22, by deleting "
and" and inserting "and".Amend sec. 7, page 3, line 23, by deleting "
Amend sec. 22, page 11, line 41, by deleting "director" and inserting "administrator".
Amend sec. 22, page 12, line 20, by deleting "generally." and inserting:
"generally
(a) Is made from money received by the committee from a source other than the State of Nevada; and
(b) Is not inconsistent with any condition attached to the acceptance of that money.
".Amend sec. 22, page 12, line 22, by deleting "director" and inserting "administrator".
Amend sec. 22, page 12, line 24, by deleting "director" and inserting "administrator".
Amend sec. 22, page 12, between lines 26 and 27, by inserting:
"
(d) Apply for grants.(e) Accept and expend any money made available to the committee by gift, grant, donation or bequest.
".Amend sec. 22, page 12, line 29, by deleting the semicolon and inserting:
"of the department;
(b) Administrator;".
Amend sec. 22, page 12, line 30, by deleting "(b)" and inserting "(c)".
Amend sec. 22, page 12, line 31, by deleting "(c)" and inserting "(d)".
Amend sec. 22, page 12, by deleting line 33 and inserting:
"(a) "Administrator" means the administrator of the rehabilitation division of the department.".
Amend the bill as a whole by renumbering sec. 38 as sec. 39 and adding a new section designated sec. 38, following sec. 37, to read as follows:
"Sec. 38. Section 2 of chapter 442, Statutes of Nevada 1997, at page 1559, is hereby amended to read as follows:
(a) Is cost effective;
(b) Is the most convenient method of providing pharmaceutical services to the recipients of Medicaid; and
(c) Includes access to pharmacies licensed in this state to the maximum extent possible.
2. If the welfare division enters into a contract pursuant to subsection 1, except for any limitations on coverage provided pursuant to 42 U.S.C. § 1396r-8(d)(2) or (6), the contract must provide for reimbursement for the dispensing of a drug to a recipient of Medicaid, without requiring any prior or retroactive approval, if the drug:
(a) Has been approved or designated as safe and effective by the Food and Drug Administration; and
(b) Is prescribed by a physician who determines that the drug is appropriate for the diagnosis or treatment of the recipient of Medicaid.
3. The provisions of this section do not apply to a contract that provides services only to recipients who are eligible to receive benefits pursuant to:
(a) The program established to provide temporary assistance for needy families pursuant to Title IV of the Social Security Act
,(b) The child health assurance program established pursuant to 42 U.S.C. § 1396a(a)(10)(A)(i)(IV), (VI) or (VII).".
Amend sec. 38, page 20, line 17, after "5." by inserting:
"
Section 14.1 of this act expires by limitation on June 30, 1998.6.
".Amend the bill as a whole by renumbering sec. 39 as sec. 52 and adding new sections designated sections 40 through 51, following sec. 38, to read as follows:
"Sec. 40. Section 3 of Assembly Bill No. 249 of this session is hereby amended to read as follows:
Sec. 3. NRS 422.2935 is hereby amended to read as follows:
(a) Recover] , the welfare division shall recover benefits correctly paid for Medicaid from:
[(1)] (a) The undivided estate of the person who received those benefits; and
[(2)] (b) Any recipient of money or property from the undivided estate of the person who received those benefits.
[(b) Recover from the recipient of Medicaid or the person who signed the application for Medicaid on behalf of the recipient an amount not to exceed the benefits incorrectly paid to the recipient if the person who signed the application:
(1) Failed to report any required information to the welfare division which he knew at the time he signed the application; or
(2) Failed within the period allowed by the welfare division to report any required information to the welfare division which he obtained after he filed the application.]
2. The welfare division shall not recover benefits pursuant to
3. Except as otherwise provided by federal law, if a transfer of real or personal property by a recipient of Medicaid is made for less than fair market value, the welfare division may pursue any remedy available pursuant to chapter 112 of NRS with respect to the transfer.
4. The amount of Medicaid paid to or on behalf of a person is a claim against the estate in any probate proceeding only at a time when there is no surviving spouse or surviving child who is under 21 years of age or is blind or permanently and totally disabled.
5. The state welfare administrator may elect not to file a claim against the estate of a recipient of Medicaid or his spouse if he determines that the filing of the claim will cause an undue hardship for the spouse or other survivors of the recipient. The administrator shall adopt regulations defining the circumstances that constitute an undue hardship.
6. Any recovery of money obtained pursuant to this section must be applied first to the cost of recovering the money. Any remaining money must be divided among the Federal Government, the department and the county in the proportion that the amount of assistance each contributed to the recipient bears to the total amount of the assistance contributed.
7.
(a) The death of the recipient of Medicaid;
(b) The death of the surviving spouse of the recipient of Medicaid;
(c) The death of all children of the recipient of Medicaid who are blind or permanently and totally disabled as determined in accordance with 42 U.S.C. § 1382c; and
(d) The arrival of all other children of the recipient of Medicaid at the age of 21 years.] Any recovery by the welfare division from the undivided estate of a recipient pursuant to this section must be paid in cash to the extent of:
(a) The amount of Medicaid paid to or on behalf of the recipient after October 1, 1993; or
(b) The value of the remaining assets in the undivided estate,
whichever is less.Sec. 41.
Section 4 of Assembly Bill No. 249 of this session is hereby amended to read as follows:Sec. 4. NRS 422.29355 is hereby amended to read as follows:
422.29355 1. The welfare division may, to the extent not prohibited by federal law, petition for the imposition of a lien pursuant to the provisions of NRS 108.850 against real or personal property of a recipient of Medicaid as follows:
(a) The welfare division may obtain a lien against a recipient’s property, both real or personal, before or after his death in the amount of assistance paid or to be paid on his behalf if the court determines that assistance was incorrectly paid for the recipient.
(b) The welfare division may seek a lien against the real property of a recipient at any age before his death in the amount of assistance paid or to be paid for him if he is an inpatient in a nursing facility, intermediate care facility for the mentally retarded or other medical institution and the welfare division determines, after notice and opportunity for a hearing in accordance with its regulations, that he cannot reasonably be expected to be discharged and return home.
2. No lien may be placed on a recipient’s home pursuant to paragraph (b) of subsection 1 for assistance correctly paid if:
(a) His spouse;
(b) His child who is under 21 years of age or blind or permanently and totally disabled as determined in accordance with 42 U.S.C. § 1382c; or
(c) His brother or sister who is an owner or part owner of the home and who was residing in the home for at least 1 year immediately before the date the recipient was admitted to the medical institution,
is lawfully residing in the home.
3. Upon the death of a recipient the welfare division may seek a lien upon his undivided estate as defined in NRS 422.054.
4. The state welfare administrator shall release a lien pursuant to this section:
(a) Upon notice by the recipient or his representative to the administrator that the recipient has been discharged from the medical institution and has returned home;
(b) If the lien was incorrectly determined; or
(c) Upon satisfaction of the claim of the welfare division.
Sec. 42. Assembly Bill No. 305 of this session is hereby amended by deleting sec. 33 and adding:
Sec. 33. (Deleted by amendment.)
Sec. 43. Assembly Bill No. 305 of this session is hereby amended by deleting sec. 37 and adding:
Sec. 37. (Deleted by amendment.)
Sec. 44. Section 45 of Assembly Bill No. 305 of this session is hereby amended to read as follows:
Sec. 45. [1. This section and sections 1 to 32, inclusive, 34, 35, 36, 38 to 44, inclusive, and 46 of this act become] This act becomes effective upon passage and approval.
[2. Sections 33 and 37 of this act become effective at 12:01 a.m. on July 1, 1999.
3. Sections 32 and 36 of this act expire by limitation on July 1, 1999.]
Sec. 45. Section 2 of Assembly Bill No. 483 of this session is hereby amended to read as follows:
Sec. 2. NRS 441A.220 is hereby amended to read as follows:
1. For statistical purposes, provided that the identity of the person is not discernible from the information disclosed.
2. In a prosecution for a violation of this chapter.
3. In a proceeding for an injunction brought pursuant to this chapter.
4. In reporting the actual or suspected abuse or neglect of a child or elderly person.
5. To any person who has a medical need to know the information for his own protection or for the well-being of a patient or dependent person, as determined by the health authority in accordance with regulations of the board.
6. If the person who is the subject of the information consents in writing to the disclosure.
7. Pursuant to subsection 2 of NRS 441A.320
8. If the disclosure is made to the department of human resources and the person about whom the disclosure is made has been diagnosed as having acquired immunodeficiency syndrome or an illness related to the human immunodeficiency virus and is a recipient of or an applicant for Medicaid.
9. To a fireman, police officer or person providing emergency medical services if the board has determined that the information relates to a communicable disease significantly related to that occupation. The information must be disclosed in the manner prescribed by the board.
10. If the disclosure is authorized or required by specific statute.
Sec. 46. Section 1 of Assembly Bill No. 649 of this session is hereby amended to read as follows:
Section 1. NRS 200.5093 is hereby amended to read as follows:
(a) The local office of the aging services division of the department of human resources;
(b) A police department or sheriff’s office;
(c) The county’s office for protective services, if one exists in the county where the suspected action occurred; or
(d) A toll-free telephone service designated by the aging services division of the department of human resources.
If the report of abuse, neglect, exploitation or isolation of an older person involves an act or omission of the aging services division, another division of the department of human resources or a law enforcement agency, the report must be made to an agency other than the one alleged to have committed the act or omission. Each agency, after reducing the report to writing, shall forward a copy of the report to the aging services division of the department of human resources.
2. Reports must be made by the following persons who, in their professional or occupational capacities, know or have reason to believe that an older person is being or has been abused, neglected, exploited or isolated:
(a) Every physician, dentist, dental hygienist, chiropractor, optometrist, podiatric physician, medical examiner, resident, intern, professional or practical nurse, physician’s assistant, psychiatrist, psychologist, marriage and family therapist, alcohol or drug abuse counselor, driver of an ambulance, advanced emergency medical technician or other person providing medical services licensed or certified to practice in this state, who examines, attends or treats an older person who appears to have been abused, neglected, exploited or isolated.
(b) Any personnel of a hospital or similar institution engaged in the admission, examination, care or treatment of persons or an administrator, manager or other person in charge of a hospital or similar institution upon notification of the suspected abuse, neglect, exploitation or isolation of an older person by a member of the staff of the hospital.
(c) A coroner.
(d) Every clergyman, practitioner of Christian Science or religious healer, unless he acquired the knowledge of abuse, neglect, exploitation or isolation of the older person from the offender during a confession.
(e) Every person who maintains or is employed by an agency to provide nursing in the home.
(f) Every attorney, unless he has acquired the knowledge of abuse, neglect, exploitation or isolation of the older person from a client who has been or may be accused of such abuse, neglect, exploitation or isolation.
(g) Any employee of the department of human resources.
(h) Any employee of a law enforcement agency or a county’s office for protective services or an adult or juvenile probation officer.
(i) Any person who maintains or is employed by a facility or establishment that provides care for older persons.
(j) Any person who maintains, is employed by or serves as a volunteer for an agency or service which advises persons regarding the abuse, neglect, exploitation or isolation of an older person and refers them to persons and agencies where their requests and needs can be met.
(k) Every social worker.
(l) Any person who owns or is employed by a funeral home or mortuary.
3. A report may be filed by any other person.
4. A person required to make a report pursuant to this section who has reasonable cause to believe that an older person has died as a result of abuse, neglect or isolation shall report this belief to the appropriate medical examiner or coroner, who shall investigate the cause of death of the older person and submit to the appropriate local law enforcement agencies, the appropriate prosecuting attorney and the aging services division of the department of human resources his written findings. The written findings must include the information required pursuant to the provisions of NRS 200.5094, when possible.
5. A division, office or department which receives a report pursuant to this section shall cause the investigation of the report to commence within 3 working days. A copy of the final report of the investigation conducted by a division, office or department, other than the aging services division of the department of human resources, must be forwarded to the aging services division within 90 days after the completion of the report.
6. If the investigation of the report results in the belief that the older person is abused, neglected, exploited or isolated, the
7. A person who knowingly and willfully violates any of the provisions of this section is guilty of a misdemeanor.
Sec. 47. Section 2 of Assembly Bill No. 649 of this session is hereby amended to read as follows:
Sec. 2. NRS 200.50984 is hereby amended to read as follows:
200.50984 1. Notwithstanding any other statute to the contrary, the
2. Except as otherwise provided in this subsection, if a guardian has not been appointed for the older person, the
Sec. 48. Section 3 of Assembly Bill No. 649 of this session is hereby amended to read as follows:
Sec. 3. NRS 200.50986 is hereby amended to read as follows:
Sec. 49. Section 4 of Assembly Bill No. 649 of this session is hereby amended to read as follows:
Sec. 50. Section 1 of Senate Bill No. 398 of this session is hereby amended to read as follows:
Section 1. NRS 422.245 is hereby amended to read as follows:
Sec. 51. Section 4 of Senate Bill No. 398 of this session is hereby amended to read as follows:
Sec. 4. This act becomes effective on July 1, 1999.".