Who needs to submit data?

Under state regulation R104-23, most health insurers that cover 1,000 or more Nevada residents are required to submit data to the Nevada APCD (NRS 439B.840). Participating plans span a wide variety of insurance providers, including:

• Commercial plans
• Self-insured employer plans
• Marketplace/exchange plans
• Public employee benefits plans
• Medicaid (both fee-for-service and managed care)
• Medicare (both fee-for-service and managed care)

What types of data are required?

Health insurers that participate in the Nevada APCD must provide data that includes the following (when applicable):

• Eligibility information
• Provider information
• Dental claims
• Medical claims
• Pharmacy claims

To protect patient privacy, all data submitted to the Nevada APCD must have any personal health information removed before submission. Prior to submission, insurers use a state-approved tool to transform sensitive data into encrypted, non-reversible codes that cannot be decrypted (either by the plans themselves or by the APCD administrator). All files are checked for this security step prior to being processed.

How does the process work?

Participation in the Nevada APCD is overseen by the Nevada Department of Health and Human Services (DHHS) and follows requirements outlined in state law. As noted above, most health insurers that cover 1,000 or more Nevada residents are required to participate using a two-step process: (1) registration and (2) data submission.

How to Register

Under Nevada law, insurers must register with the APCD each year by February 1. This process ensures that DHHS has the latest contact information, member counts, and other key details to verify an insurer’s participation.

To inquire about registering as a qualifying health insurer, please contact the APCD administrator using their dedicated email address here.

How to Submit Data

Once successfully registered with the Nevada APCD, insurers can submit their required data securely to the APCD. Submitted files must follow predetermined layouts, formatting rules, and strict security measures to ensure compliance with privacy laws like HIPAA. Data must be submitted at least quarterly to ensure that the APCD includes the latest available data.

Registered insurers can access data submission tools and technical specifications here.

How to Get Training & Support

The APCD administrator offers training, support, and resources to help insurers understand the submission process and stay on track with the State’s data submission requirements.

For questions or support, insurers can easily contact the APCD administrator using their dedicated email address here.