Nevada Medicaid and Nevada Check Up News (Second Quarter 2020 Provider Newsletter) [Read]

Attention Behavioral Health Providers: Monthly Behavioral Health Training Assistance (BHTA) Webinar Scheduled [See Web Announcement 2009]

Attention All Providers: Requirements on When to Use the National Provider Identifier (NPI) of an Ordering, Prescribing or Referring (OPR) Provider on Claims [Announcement 850]

If you are a Medicaid provider whose revalidation application has not been processed by your termination due date, you will be ineligible to provide services to any Nevada Medicaid or Nevada Check Up recipients, including both Fee-for-Service and Managed Care Organization (MCO) enrolled recipients. See Web Announcement 1265

Enrollment Termination Frequently Asked Questions (FAQs) [Review]


Nevada Medicaid COVID-19

Nevada Health Response

Known Modernization System Issues-Click HERE

Urgent Updates Regarding Professional Crossover and Outpatient Crossover Claims Payment Issue. See Web Announcement 2174.

Paper claims are no longer accepted by Nevada Medicaid. Please refer to Web Announcement 1733 and Web Announcement 1829 for additional information.

Top 10 Claim Denial Reasons and Resolutions/Workarounds for May 2020 Claims. See Web Announcement 2221.

Top Prior Authorization Denial Reasons for the First Quarter of 2020. See Web Announcement 2188.

Top 10 Enrollment Return Reasons and Resolutions for May 2020 Submissions. See Web Announcement 2220.

Attention Providers Using the Authorization Criteria Function: Results that return prior authorization (PA) requirements are accurate. For results that return “There are no records found based on the search criteria,” there may be a PA requirement if limits have been exceeded. To verify PA requirements, please refer to the Medicaid Services Manual (MSM) Chapter for your service type at and the Billing Guide for your provider type at

Scheduled Site Maintenance

During the scheduled site maintenance window the Provider Web Portal will be unavailable. The table below shows the regularly scheduled maintenance window. All times will be in the Pacific time zone.

Monday - Friday
12:00AM - 12:30AM

8:00PM - 12:00AM


Silver State Scripts Board Replaces Pharmacy and Therapeutics (P&T) Committee

On June 14, 2019, Governor Steve Sisolak signed into law Nevada Senate Bill 378. This bill indicates new provisions to the Pharmacy and Therapeutics (P&T) Committee as listed below:

  • Effective June 30, 2019, the P&T Committee has been removed, and the terms of its members expired.

  • The Silver State Scripts Board has been established to replace the P&T Committee and holds the same responsibilities, which include development of the Preferred Drug List (PDL).

  • The Nevada Department of Health and Human Services (DHHS) Director has appointed the following members to the Silver State Scripts Board:

    ‐ Mark Decerbo, PharmD (Chairman)

    ‐ Kate Ward, PharmD (Vice Chairman)

    ‐ Joseph Adashek, MD

    ‐ Sapandeep Khurana, MD

    ‐ Brian Passalacqua, MD

    ‐ Steven Zuchowski, MD

    ‐ Michael Hautekeet, RPh

    ‐ Evelyn Chu, PharmD

    ‐ Mark Crumby, PharmD

    ‐ Aditi Singh, MD

The Pharmacy webpages on the Nevada Medicaid website at will be updated to incorporate the changes listed above. Please note: If you have P&T webpages saved to your internet favorites, those hyperlinks will no longer connect you to the website when the website changes are complete, and you will receive the error “404 – Page Not Found.” When the changes are complete, please visit the Pharmacy webpages at and reset your internet favorites. A future web announcement will be published when the website has been updated.

Upcoming Meetings

March 28, 2019

June 27, 2019

September 26, 2019

December 5, 2019

P&T Meeting Binder

P&T Past Meeting Material

P&T Clinical Meeting Information

P&T Board Member List

Meeting agendas are on the DHCFP’s Public Notices webpage.