Nevada Assembly introduces AB36 to revise Medicaid provider hearing procedures

Assembly Bill 36, introduced by the Nevada State Legislature on March 25, 2025, aims to revise provisions related to Medicaid, specifically concerning the process for providers to request hearings regarding actions taken against them under the State Plan for Medicaid. The bill, which is backed by the Division of Health Care Financing and Policy of the Department of Health and Human Services, seeks to streamline the hearing process and clarify the circumstances under which providers can appeal decisions.

The key provision of Assembly Bill 36 mandates that providers must submit a request for a hearing within 90 calendar days of receiving notice of an action against them. However, the bill allows for exceptions if the Division determines that extenuating circumstances exist. This change is intended to ensure timely resolution of disputes and enhance the accountability of Medicaid providers.

Debate surrounding the bill has focused on the balance between protecting providers' rights and ensuring efficient oversight of Medicaid services. Some stakeholders argue that the 90-day limit may be too restrictive, potentially disadvantaging providers who face legitimate challenges in meeting this timeline. Others contend that the proposed regulations will help expedite the hearing process, ultimately benefiting both providers and recipients of Medicaid services.

The fiscal note accompanying the bill indicates that it will have an effect on the state budget but will not impact local governments. The implications of this legislation are significant, as it could lead to changes in how Medicaid services are administered in Nevada, potentially affecting the quality of care and the operational dynamics of healthcare providers.

As Assembly Bill 36 moves through the legislative process, its outcomes will be closely monitored by healthcare advocates and providers alike, as it may set a precedent for future Medicaid-related legislation in the state. The bill's progress will be a key indicator of Nevada's commitment to balancing provider accountability with the need for accessible healthcare services.