REIMBURSEMENT, ANALYSIS AND PAYMENT
The Reimbursement, Analysis and Payment Unit provides expertise on medical rate setting and reimbursement policy. The primary functions of this unit include provider reimbursement rate setting, collection of Provider utilization and financial data, reporting on provider finances, and the management of supplemental payment programs. The Unit is divided into two teams:
- The Rate Setting Team is responsible for provider rate setting. They provide expertise on federally allowable reimbursement methodologies and industry standards. They perform research into rate setting methodologies used in other states. They conduct reimbursement workshops with providers and draft State Plan amendments pertaining to rate methodologies.
- The Supplemental Payment Program Team manages supplemental payment programs and draft State Plan amendments related to the supplemental payment programs pursuant to State Plan 4.19 A, B, and D. In addition staff coordinates the collection of data posted to the Nevada Compare Care Website and manages the collection of financial data from institutional providers. This includes collection of Medicare and Medicaid cost reports and the oversight of audit contractors.
- Rate Setting
- Supplemental Payment Programs
- Nevada Compare Care