MedicaidAdministrativeMedium impact
Attention All Providers: Clinical Records Procurement for Encounter Data Validation
Nevada Medicaid·NV·Provider Announcement
Effective date
Jun 12, 2025
We identified it
Jun 21, 2026
Summary
Nevada Medicaid's External Quality Review Organization (HSAG) is conducting an Encounter Data Validation Study requiring providers to promptly provide clinical records documentation for specified Medicaid recipients at no cost when requested by Managed Care Entities. This is a mandatory compliance requirement under existing Provider Participation Agreements.
Action Required
Immediately: All providers must comply with requests from Managed Care Entities (MCEs) to provide clinical records documentation for specified Nevada Medicaid recipients within the timeframes specified by each MCE. Ensure staff are prepared to promptly furnish requested records at no cost as required by Provider Participation Agreements. Non-compliance may violate contractual obligations with DHCFP.