Recovery of amounts paid for Medicaid under certain circumstances; powers and duties of Department; duty to reimburse Department; waiver of repayment.

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1. Except as otherwise provided in this section, the Department shall, to the extent that it is not prohibited by federal law, recover from a recipient of Medicaid the undivided estate of a recipient of Medicaid or a person who signed the application for Medicaid or for admission to a nursing facility on behalf of the recipient an amount not to exceed the amount incorrectly paid on behalf of the recipient, if the person who signed the application:

(a) Failed to report any required information to the Department or the nursing facility that the person knew at the time the person signed the application;

(b) Refused to provide financial information regarding the recipient’s income and assets, including, without limitation, information regarding any transfers or assignments of income or assets;

(c) Concealed information regarding the existence, transfer or disposition of the recipient’s income and assets with the intent of enabling a recipient to meet any eligibility requirement for Medicaid;

(d) Made any false representation regarding the recipient’s income and assets, including, without limitation, any information regarding any transfers or assignments of income or assets; or

(e) Failed to report to the Department or the nursing facility within the period allowed by the Department any required information that the person obtained after the person filed the application.

2. Except as otherwise provided in this section, a recipient of Medicaid, the undivided estate of a recipient of Medicaid or a person who signed the application for Medicaid or for admission to a nursing facility on behalf of the recipient shall reimburse the Department or appropriate state agency for the value of the amount incorrectly paid on behalf of the recipient.

3. The Director or a person designated by the Director may, to the extent that it is not prohibited by federal law, determine the amount of, and settle, adjust, compromise or deny a claim against a recipient of Medicaid, the undivided estate of a recipient of Medicaid or a person who signed the application for Medicaid or for admission to a nursing facility on behalf of the recipient.

4. The Director may, to the extent that it is not prohibited by federal law, waive the repayment of amounts incorrectly paid on behalf of a recipient of Medicaid if the incorrect payment was not the result of an intentional misrepresentation or omission by the recipient and if repayment would cause an undue hardship to the recipient. The Director shall, by regulation, establish the terms and conditions of such a waiver, including, without limitation, the circumstances that constitute undue hardship.

(Added to NRS by 1999, 876; A 2001, 65; 2003, 875; 2007, 2391; 2013, 1306)


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