NRS422.276. Appeal to Division by applicant for or recipient of benefits from Medicaid or Children’s Health Insurance Program; notice of initial decision; hearing.

      1.  Subject to the provisions of subsection 2, if an application for Medicaid or the Children’s Health Insurance Program or a claim for benefits from either program is not acted upon by the Division within a reasonable time after the filing of the application or claim for benefits, or is denied in whole or in part, or if any claim for benefits is reduced, suspended or terminated, the applicant or recipient may appeal to the Division and may be represented in the appeal by counsel or other representative chosen by the applicant or recipient.

      2.  Upon the initial decision to deny, reduce, suspend or terminate benefits, the Division shall notify that applicant or recipient of its decision, the regulations involved and the right to request a hearing within a certain period. If a request for a hearing is received within that period, the Division shall notify that person of the time, place and nature of the hearing. The Division shall provide an opportunity for a hearing of that appeal and shall review the case regarding all matters alleged in that appeal.

      3.  The Division is not required to grant a hearing pursuant to this section if the request for the hearing is based solely upon the provisions of a federal law or a law of this State that requires an automatic adjustment to the benefits that may be received by an applicant or recipient.

      (Added to NRS by 1981, 1908; A 1985, 857; 1993, 2064; 1997, 2238; 1999, 2229; 2013, 1305)