Nevada Administrative Code Chapter 428 - Hospital Care for Indigent Persons
Here’s a comprehensive overview of Nevada Administrative Code (NAC) Chapter 428 – Hospital Care for Indigent Persons, including its structure, key provisions, and operational processes:
📚 1. Scope & Structure
NAC Chapter 428 governs the procedures for hospitals to obtain reimbursement when treating indigent persons. It comprises:
§ 428.010 — Severability
§ 428.020 — Definitions
§ 428.030 — Eligibility for reimbursement
§ 428.040 — Investigation of contractual liability
§ 428.050 — Patient's income
§ 428.060 — Patient's assets
§ 428.070 — Application for reimbursement
§ 428.080 — Preliminary review (physician and ambulance charges)
§ 428.090 — Board review and hospital reimbursement (law.cornell.edu)
2. Definitions (428.020)
This section defines terms critical to the chapter, such as:
“Hospital”, “Board”, “Indigent person”, etc.
3. Eligibility & Investigation (§ 428.030–.040)
Eligibility is established via county certification of indigency (§ 428.030).
Investigation (§ 428.040) determines third-party responsibility—e.g., insurers or liable individuals—to ensure reimbursement efforts before applying to the Fund. (nvnaco.org)
4. Means Testing (§ 428.050–.060)
The patient’s:
Income (§ 428.050), and
Assets (§ 428.060),
are evaluated to determine eligibility, aligning with definitions in NAC and NRS standards. (law.cornell.edu)
5. Application for Reimbursement (§ 428.070)
Hospitals must submit a properly documented application including:
Completed application and indigency certification
Itemized hospital charges
AMA’s Current Procedural Terminology (CPT)–coded physician services (law.cornell.edu)
Documentation of attempts to recover from responsible third parties
Accident report from the first responder
Patient release of medical/financial info and assignment of claim
Diagnosis summary (law.cornell.edu)
Additional details:
The latest CPT edition is adopted by reference, unless Nevada Association of Counties objects within 30 days (law.cornell.edu).
6. Preliminary Review (§ 428.080)
A preliminary assessment is conducted to confirm inclusion of physician and ambulance charges with respect to CPT coding and documentation. (law.cornell.edu)
7. Final Review & Payment (§ 428.090)
The Board of Trustees of the Fund for Hospital Care for Indigent Persons conducts a final review of the application and authorizes payment to the hospital. The Fund is a state-designated pool financed by county taxation and reimburses hospitals through the Board. (law.cornell.edu)
🔁 Interaction with NRS
Parallel provisions exist in NRS Chapter 428 (Indigent Persons), including:
Definitions of “hospital care” and “fund”
Establishment of the Fund and Board structure
Levying county taxes to finance the Fund
Application and payment procedures (law.justia.com, nvnaco.org)
✅ Summary
NAC 428 provides a clear statutory pathway for hospitals to receive payment when treating indigent patients:
Defines eligibility and means testing
Requires hospitals to exhaust third-party recovery
Mandates detailed applications with CPT-coded charges
Empowers a state Board to evaluate and reimburse from a county-funded pool
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