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Nevada Administrative Register (Daily Updates) · October 17, 2026 · Primary source

R179-26I

Score 85PRIMARYregulatoryState registerNV

Summary

Nevada's Division of Health Care Financing and Policy has proposed a regulation (LCB File No. R179-26I) that substantially revises the methodology for calculating and distributing Medicaid Disproportionate Share Hospital payments under NRS 422.390 and 42 U.S.C. section 1396r-4. The proposed rule restructures DSH pool allocations, sharply reducing Pool A (large public hospitals) from 87.97 percent to 32.46 percent of total computable DSH supplemental payments, while significantly increasing shares for Pools B, C, D, and E covering private and rural hospitals. The regulation applies retroactively to Fiscal Years 2022-2023 and 2023-2024 and prospectively thereafter, and repeals NAC 422.105 governing prior intergovernmental transfer requirements from counties.

What this may mean

Public hospitals in Nevada counties with populations of 700,000 or more face a reduction in DSH pool allocation from 87.97 percent to 32.46 percent, a shift that materially reduces supplemental Medicaid payments for those facilities retroactive to FY 2022-2023. Private hospitals in the same large counties (Pool B) see their allocation rise from 1.69 percent to 9.49 percent, and rural private hospitals (Pool E) rise from 3.14 percent to 19.25 percent, representing a significant redistribution of DSH funds across Nevada's hospital sector.

Informational only. Not legal, medical, financial, or other professional advice. Always consult a qualified professional familiar with your specific facts before relying on any item.

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