Hearing to review action taken against provider of services under State Plan for Medicaid; regulations; appeal of final decision.

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1. Upon receipt of a request for a hearing from a provider of services under the State Plan for Medicaid, the Division shall appoint a hearing officer to conduct the hearing. Any employee or other representative of the Division who investigated or made the initial decision regarding the action taken against a provider of services may not be appointed as the hearing officer or participate in the making of any decision pursuant to the hearing.

2. The Division shall adopt regulations prescribing the procedures to be followed at the hearing.

3. The decision of the hearing officer is a final decision. Any party, including the Division, who is aggrieved by the decision of the hearing officer may appeal that decision to the District Court in and for Carson City by filing a petition for judicial review within 30 days after receiving the decision of the hearing officer.

4. A petition for judicial review filed pursuant to this section must be served upon every party within 30 days after the filing of the petition for judicial review.

5. Unless otherwise provided by the court:

(a) Within 90 days after the service of the petition for judicial review, the Division shall transmit to the court the original or a certified copy of the entire record of the proceeding under review, including, without limitation, a transcript of the evidence resulting in the final decision of the hearing officer;

(b) The petitioner who is seeking judicial review pursuant to this section shall serve and file an opening brief within 40 days after the Division gives written notice to the parties that the record of the proceeding under review has been filed with the court;

(c) The respondent shall serve and file an answering brief within 30 days after service of the opening brief; and

(d) The petitioner may serve and file a reply brief within 30 days after service of the answering brief.

6. Within 7 days after the expiration of the time within which the petitioner may reply, any party may request a hearing. Unless a request for hearing has been filed, the matter shall be deemed submitted.

7. The review of the court must be confined to the record. The court shall not substitute its judgment for that of the hearing officer as to the weight of the evidence on questions of fact. The court may affirm the decision of the hearing officer or remand the case for further proceedings. The court may reverse or modify the decision if substantial rights of the appellant have been prejudiced because the administrative findings, inferences, conclusions or decisions are:

(a) In violation of constitutional or statutory provisions;

(b) In excess of the statutory authority of the Division;

(c) Made upon unlawful procedure;

(d) Affected by other error of law;

(e) Clearly erroneous in view of the reliable, probative and substantial evidence on the whole record; or

(f) Arbitrary or capricious or characterized by abuse of discretion or clearly unwarranted exercise of discretion.

(Added to NRS by 1987, 1670; A 1997, 1243, 2628; 1999, 581, 2231, 2242; 2005, 22nd Special Session, 32)


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