Nevada Revised Statutes Title 53. Labor and Industrial Relations § 616D.440. False claim for payment: Withholding by insurer of payment to provider of health care; procedure for withholding; appeal

(a) Set forth the factual basis for the withholding, but need not disclose specific information regarding the insurer's investigation;

(b) Indicate that the payment is being withheld pursuant to the provisions of this section;

(c) Indicate that the payment is being withheld temporarily, as set forth in subsection 4, and describe the circumstances under which the withholding will be terminated;

(d) Specify the charge submitted by the provider of health care for which the payment is being withheld; and

(e) Notify the provider of health care of the right of the provider of health care to appeal the withholding.

(a) The insurer or the Attorney General determines that there is insufficient evidence to prove that the provider of health care knowingly made a false statement or representation or knowingly concealed a material fact to obtain the payment; or

(b) A final judgment or decree was rendered in favor of the provider of health care in a criminal proceeding arising out of the alleged misconduct.