50-state desk · NV
Nevada
Process / partialMajor hospitals (typically Clark and Washoe) must reduce billed charges for uninsured Nevada residents — commonly a 30%+ haircut off billed charges, with additional charity policies on top. No statewide 200% write-off floor. Medicaid is expanded. Hospitals that skip federal price-transparency rules can lose collection rights.
NRS 439B.260; NRS 439B.320 · compiled September 2026
| Rule | This state |
|---|---|
| Free-care floor | — |
| Discount / eligibility floor | — |
| Covers insured patients | Uninsured-focused statute |
| Which hospitals | Some hospitals / programs only |
| Medicaid expansion | Yes — adults to 138% FPL |
| Screen before collections | Yes |
| Credit reports | No state ban |
| Debt sales | Not banned |
| Home liens | Restricted or banned |
| Wage garnishment | Tighter than the federal 25% cap |
| Interest on medical debt | No special cap located |
| Collection hold | No extra state waiting period |
| Lawsuit clock | 6 years · NRS 11.190 |
2026 poverty line here
Alaska and Hawaii use their own HHS tables. Everyone else uses the 48-state and D.C. figures, effective January 2026.
| Household | 100% | Free floor | Discount floor |
|---|---|---|---|
| 1 | $15,960 | — | — |
| 2 | $21,640 | — | — |
| 3 | $27,320 | — | — |
| 4 | $33,000 | — | — |
| 5 | $38,680 | — | — |
| 6 | $44,360 | — | — |
What to do
- 01 Uninsured at a Las Vegas or Reno major hospital: demand the NRS 439B uninsured discount in writing.
- 02 Then still apply for charity care — the 30% haircut is a floor, not the best number.
- 03 Home liens for medical debt are tightly limited. Do not sign a new lien.
- 04 If the hospital is not posting prices as required, collection leverage drops. Say so.
Appeals
Federal No Surprises Act.
Insurance: Nevada Division of Insurance — external review
Medicaid: DHHS / Medicaid fair hearing.
Medicare is federal regardless of state: redetermination, reconsideration, ALJ, Appeals Council, then district court.
Cite this in a letter
If this is a major hospital and I am an uninsured Nevada resident, I request the mandatory uninsured discount under NRS 439B.260, plus a FAP / charity-care review. Please also confirm price-transparency compliance before any collection action.
Put a Nevada bill in the machine.
The estimate will use this state’s floors. The letters will cite NRS 439B.260; NRS 439B.320.
Start a Nevada caseFederal overlay — every state
501(r)
501(c)(3) hospital organizations must publish a Financial Assistance Policy, a plain-language summary, and generally may not take extraordinary collection actions (selling the debt, reporting it, liens, lawsuits) until they have made reasonable efforts to determine FAP eligibility.
No Surprises Act
Emergency services, air ambulance, and many out-of-network clinicians at in-network facilities cannot balance-bill beyond in-network cost-sharing. Independent dispute resolution is between the plan and the provider — not a reason to pay the sticker rate.
FDCPA
15 U.S.C. § 1692g. Within 30 days of first collector contact, demand validation. Until validated, collection and credit reporting should stop. Partial payment can restart a state’s statute of limitations.
EMTALA
Emergency departments must screen and stabilize regardless of ability to pay. An ER bill is not an agreement that chargemaster rates are the cash price.
Medicare appeals
Five levels: redetermination (MAC, 120 days), reconsideration (QIC), ALJ at OMHA, Medicare Appeals Council, then federal district court. A remaining patient balance is often a claim the provider still needs to work.
Credit bureaus
The CFPB’s 2025 medical-debt reporting rule was vacated in July 2025. Industry practice still generally omits paid medical collections and unpaid balances under $500. Unpaid medical debt over $500 can appear after a delay unless a state ban applies. FCRA-preemption fights over those state bans are ongoing.