Nevada Administrative Code
Chapter 439B - RESTRAINING COSTS OF HEALTH CARE
Section 439B.Sec. 22 - NEW

Universal Citation: NV Admin Code 439B.Sec. 22

Current through December 12, 2024

1. A data submitter may request an extension of time to submit historical data to the all-payer claims database for a period of time for which the data submitter is unable to comply with the deadline prescribed by section 17.

2. A request for an extension made pursuant to this section must be submitted to the Department and include:

(a) A detailed explanation of the reason the data submitter is unable to comply with the requirement to submit historical data to the all-payer claims database by the deadline prescribed by section 17 for the submission of historical data to be accepted for that calendar quarter; and

(b) The period of time for which the data submitter is requesting an extension, not to exceed 1 calendar quarter.

3. Except as otherwise provided in this subsection, a request for an extension made pursuant to this section must be submitted to the Department not less than 30 calendar days before the first deadline to submit historical data to the all-payer claims database to which the extension would apply. If a data submitter is unable to submit a request for an extension to the Department on or before that date, the data submitter must notify the Department in writing as soon as the data submitter determines that an extension is necessary.

4. Upon receipt of a request for an extension submitted pursuant to this section not less than 30 calendar days before the first deadline to submit historical data to the all-payer claims database to which the extension would apply, the Department will suspend the requirement for the data submitter to submit historical data to the all-payer claims database while the Department determines whether to approve or deny the request. The Department may refuse to suspend that requirement if the request is submitted after that date.

5. Not later than 15 days after receipt of a request for an extension submitted pursuant to this section, the Department will issue a written determination to the data submitter notifying the data submitter whether the Department has approved or denied the request.

6. If the Department grants an extension, the written determination issued pursuant to subsection 5 must specify the period of time for which the extension has been granted.

7. If the Department denies a request for an extension made pursuant to this section:

(a) The data submitter that submitted the request shall comply with all applicable requirements to submit historical data to the all-payer claims database. If the denial is issued after the first deadline to submit historical data to the all-payer claims database to which the requested extension would have applied, the data submitter shall comply with all applicable requirements to submit historical data to the all-payer claims database within 15 calendar days after the date on which the written determination of denial was issued.

(b) Neither the data submitter nor any entity on whose behalf the data submitter was required to submit historical data to the all-payer claims database is entitled to a hearing on the denial. The provisions of this paragraph do not affect the right of any person or entity to a hearing pursuant to section 24 on a decision to impose an administrative penalty for any attendant failure to comply with the provisions of NRS 439B.800 to 439B.875, inclusive, and sections 2 to 24, inclusive.

Added to NAC by Dep't of Human Resources by R104-23A, eff. 11/15/2024

NRS 439B.875

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