[Rev. 11/21/2013 1:00:44 PM--2013]

CHAPTER 652 - MEDICAL LABORATORIES

GENERAL PROVISIONS

NRS 652.010           Short title.

NRS 652.020           Definitions.

NRS 652.030           “Board” defined.

NRS 652.035           “Division” defined.

NRS 652.040           “Laboratory” defined.

NRS 652.050           “Laboratory director” defined.

NRS 652.060           “Medical laboratory” defined.

NRS 652.070           Legislative declaration.

LICENSES

NRS 652.080           License required; term; renewal; inactive status; licensure of laboratory located outside state.

NRS 652.090           Application: Contents. [Effective through December 31, 2013.]

NRS 652.090           Application: Contents; regulations governing proof of identity. [Effective January 1, 2014.]

NRS 652.092           Division prohibited from issuing or renewing license without proof of compliance with certain guidelines with respect to safe and appropriate injection practices.

NRS 652.095           Payment of child support: Submission of certain information by applicant; grounds for denial of license or certificate; duty of Board. [Effective until the date of the repeal of 42 U.S.C. § 666, the federal law requiring each state to establish procedures for withholding, suspending and restricting the professional, occupational and recreational licenses for child support arrearages and for noncompliance with certain processes relating to paternity or child support proceedings.]

NRS 652.095           Payment of child support: Submission of certain information by applicant; grounds for denial of license or certificate; duty of Board. [Effective on the date of the repeal of 42 U.S.C. § 666, the federal law requiring each state to establish procedures for withholding, suspending and restricting the professional, occupational and recreational licenses for child support arrearages and for noncompliance with certain processes relating to paternity or child support proceedings and expires by limitation 2 years after that date.]

NRS 652.100           Fees; deposit in appropriate account; claims for expenses.

NRS 652.110           Validity and display of licenses.

POWERS AND DUTIES OF DIVISION OF PUBLIC AND BEHAVIORAL HEALTH OF DEPARTMENT OF HEALTH AND HUMAN SERVICES AND STATE BOARD OF HEALTH

NRS 652.120           Enforcement of chapter.

NRS 652.123           Limitations on stringency of regulations adopted by Board. [Effective through December 31, 2013.]

NRS 652.123           Limitations on stringency of regulations adopted by Board. [Effective January 1, 2014.]

NRS 652.125           Regulations for certification and licensure of laboratory directors and personnel; continuing education.

NRS 652.127           Requirements to qualify for certification as assistant in laboratory. [Effective through December 31, 2013.]

NRS 652.127           Board to adopt regulations establishing requirements to qualify for certification as assistant in medical laboratory; regulations. [Effective January 1, 2014.]

NRS 652.130           Regulations: Advice of Medical Laboratory Advisory Committee; subjects.

NRS 652.135           Regulations: Length of time records must be retained.

NRS 652.140           Inspections; proficiency tests; reports.

NRS 652.150           List of laboratories meeting minimum standards and qualifications.

NRS 652.155           Licensing of certain persons and laboratories without examination.

MEDICAL LABORATORY ADVISORY COMMITTEE

NRS 652.160           Creation; duties.

NRS 652.170           Appointment, terms and qualifications of members; compensation of members and employees.

REGULATION OF LABORATORIES AND LABORATORY DIRECTORS

NRS 652.180           Duties of laboratory director.

NRS 652.185           Requirements for conduct of certain laboratory tests for detection of human immunodeficiency virus.

NRS 652.190           Examination, review and referral of specimens; reporting of results; recommendation for review of results by physician.

NRS 652.193           Release of results of tests regarding patient of rural hospital.

NRS 652.195           Cytologic examination of gynecologic specimens: Direct billing required; unlawful practices; exceptions.

NRS 652.200           Limitation on contents of laboratory’s report.

NRS 652.210           Manipulation for collection of specimens; authorized practices of technical personnel. [Effective through December 31, 2013.]

NRS 652.210           Manipulation for collection of specimens; authorized practices of technical personnel. [Effective January 1, 2014.]

NRS 652.215           Licensed professional nurses: Performance of specific procedures under supervision of Chief Medical Officer; regulations governing performance of procedures.

NRS 652.217           Conditions under which licensed nurse or licensed or certified laboratory personnel may perform certain laboratory tests. [Effective through December 31, 2013.]

NRS 652.217           Conditions under which licensed nurse or licensed or certified laboratory personnel may perform certain laboratory tests. [Effective January 1, 2014.]

DISCIPLINARY PROCEEDINGS

NRS 652.220           Grounds for denial, suspension or revocation of license.

NRS 652.223           Suspension of license or certificate for failure to pay child support or comply with certain subpoenas or warrants; reinstatement of license or certificate. [Effective until 2 years after the date of the repeal of 42 U.S.C. § 666, the federal law requiring each state to establish procedures for withholding, suspending and restricting the professional, occupational and recreational licenses for child support arrearages and for noncompliance with certain processes relating to paternity or child support proceedings.]

NRS 652.225           Hearing after receipt of report of certain violations; regulations.

NRS 652.228           Certain records relating to investigation deemed confidential; certain records relating to disciplinary action and orders imposing discipline deemed public records.

APPLICABILITY OF CHAPTER

NRS 652.230           Applicability to public and private laboratories; exceptions.

NRS 652.235           Applicability to laboratory operated by licensed physician solely in connection with diagnosis or treatment of own patients; requirements.

NRS 652.240           Licensing of laboratories in operation on January 1, 1967; persons operating or employed in laboratories on January 1, 1967.

NRS 652.245           Exemption of tests and examinations conducted by law enforcement agencies or ordered by court.

UNLAWFUL ACTS; PENALTIES

NRS 652.250           Public nuisance; injunctions.

NRS 652.260           Penalties. [Effective through December 31, 2013.]

NRS 652.260           Penalties. [Effective January 1, 2014.]

_________

 

GENERAL PROVISIONS

      NRS 652.010  Short title.  This chapter may be cited as the Medical Laboratory Certification and Improvement Law.

      (Added to NRS by 1967, 926)

      NRS 652.020  Definitions.  As used in this chapter, unless the context otherwise requires, the words and terms defined in NRS 652.030 to 652.060, inclusive, have the meanings ascribed to them in those sections.

      (Added to NRS by 1967, 926; A 1991, 650)

      NRS 652.030  “Board” defined.  “Board” means the State Board of Health.

      (Added to NRS by 1967, 926)

      NRS 652.035  “Division” defined.  “Division” means the Division of Public and Behavioral Health of the Department of Health and Human Services.

      (Added to NRS by 1995, 1590; A 2013, 3070)

      NRS 652.040  “Laboratory” defined.  “Laboratory” means any medical laboratory.

      (Added to NRS by 1967, 926)

      NRS 652.050  “Laboratory director” defined.  “Laboratory director” means a person responsible for the administration of the technical and scientific operation of a medical laboratory.

      (Added to NRS by 1967, 926; A 1973, 660)

      NRS 652.060  “Medical laboratory” defined.  “Medical laboratory” means any facility for microbiological, serological, immunohematological (blood banking), cytological, histological, chemical, hematological, biophysical, toxicological, or other methods of examination of tissues, secretions or excretions of the human body. The term does not include a forensic laboratory operated by a law enforcement agency.

      (Added to NRS by 1967, 926; A 1983, 599; 1993, 499)

      NRS 652.070  Legislative declaration.  The Legislature declares that:

      1.  The proper operation of medical laboratories within the State is a matter of vital concern affecting the public health, safety and welfare.

      2.  The purpose of this chapter is to promote public health, safety and welfare by developing, establishing and enforcing:

      (a) Minimum standards for the licensing of medical laboratories;

      (b) Minimum qualifications for laboratory directors and the certification of laboratory personnel;

      (c) Performance standards for laboratories; and

      (d) Requirements for the retention of the health care and other regularly maintained records of laboratories.

      (Added to NRS by 1967, 926; A 1997, 1123)

LICENSES

      NRS 652.080  License required; term; renewal; inactive status; licensure of laboratory located outside state.

      1.  Except as otherwise provided in NRS 652.217 and 652.235, no person may operate, conduct, issue a report from or maintain a medical laboratory without first obtaining a license to do so issued by the Division pursuant to the provisions of this chapter.

      2.  A license issued pursuant to the provisions of subsection 1 is valid for 24 months and is renewable biennially on or before the date of its expiration.

      3.  No license may be issued to a laboratory which does not have a laboratory director.

      4.  A license may be placed in an inactive status upon the approval of the Division and the payment of current fees.

      5.  The Division may require a laboratory that is located outside of this state to be licensed in accordance with the provisions of this chapter before the laboratory may examine any specimens collected within this state if the Division determines that the licensure is necessary to protect the public health, safety and welfare of the residents of this state.

      (Added to NRS by 1967, 926; A 1973, 660; 1975, 1162; 1995, 794, 1590; 1997, 1124)

      NRS 652.090  Application: Contents. [Effective through December 31, 2013.]  An application for a license must be made under oath on a form prescribed by the Division and must contain the following information:

      1.  The name and location of the laboratory;

      2.  The name of the laboratory director;

      3.  The name of the owner or owners of the laboratory or, if a corporation, the names of the officers, directors and beneficial owners of 10 percent or more of its shares;

      4.  A description of the program and services provided by the laboratory; and

      5.  Such other information as the Division may deem necessary or expedient to carry out its powers and duties under this chapter.

      (Added to NRS by 1967, 927; A 1995, 1590)

      NRS 652.090  Application: Contents; regulations governing proof of identity. [Effective January 1, 2014.]

      1.  An application for a license must be on a form prescribed by the Division and must contain the following information:

      (a) The name and location of the laboratory;

      (b) The name and proof of identity of the laboratory director;

      (c) The name of the owner or owners of the laboratory or, if a corporation, the names of the officers, directors and beneficial owners of 10 percent or more of its shares;

      (d) A description of the program and services provided by the laboratory; and

      (e) Such other information as the Division may deem necessary or expedient to carry out its powers and duties under this chapter.

      2.  The Board shall adopt regulations to carry out the provisions of subsection 1, including, without limitation, regulations setting forth the acceptable forms of proof of identity that a laboratory director must include in an application pursuant to paragraph (b) of subsection 1.

      (Added to NRS by 1967, 927; A 1995, 1590; 2013, 102, effective January 1, 2014)

      NRS 652.092  Division prohibited from issuing or renewing license without proof of compliance with certain guidelines with respect to safe and appropriate injection practices.  The Division shall not issue or renew a license to a medical laboratory whose licensed personnel have job duties that include the administration of injections unless the applicant for issuance or renewal of the license attests that the laboratory director and laboratory personnel whose job duties include the administration of injections have knowledge of and are in compliance with the guidelines of the Centers for Disease Control and Prevention concerning the prevention of transmission of infectious agents through safe and appropriate injection practices.

      (Added to NRS by 2011, 2055)

      NRS 652.095  Payment of child support: Submission of certain information by applicant; grounds for denial of license or certificate; duty of Board. [Effective until the date of the repeal of 42 U.S.C. § 666, the federal law requiring each state to establish procedures for withholding, suspending and restricting the professional, occupational and recreational licenses for child support arrearages and for noncompliance with certain processes relating to paternity or child support proceedings.]

      1.  In addition to any other requirements set forth in this chapter:

      (a) An applicant for the issuance of a license or certificate issued pursuant to NRS 652.125 shall include the social security number of the applicant in the application submitted to the Board.

      (b) An applicant for the issuance or renewal of a license or certificate issued pursuant to NRS 652.125 shall submit to the Board the statement prescribed by the Division of Welfare and Supportive Services of the Department of Health and Human Services pursuant to NRS 425.520. The statement must be completed and signed by the applicant.

      2.  The Board shall include the statement required pursuant to subsection 1 in:

      (a) The application or any other forms that must be submitted for the issuance or renewal of the license or certificate; or

      (b) A separate form prescribed by the Board.

      3.  A license or certificate may not be issued or renewed by the Board pursuant to NRS 652.125 if the applicant:

      (a) Fails to submit the statement required pursuant to subsection 1; or

      (b) Indicates on the statement submitted pursuant to subsection 1 that the applicant is subject to a court order for the support of a child and is not in compliance with the order or a plan approved by the district attorney or other public agency enforcing the order for the repayment of the amount owed pursuant to the order.

      4.  If an applicant indicates on the statement submitted pursuant to subsection 1 that the applicant is subject to a court order for the support of a child and is not in compliance with the order or a plan approved by the district attorney or other public agency enforcing the order for the repayment of the amount owed pursuant to the order, the Board shall advise the applicant to contact the district attorney or other public agency enforcing the order to determine the actions that the applicant may take to satisfy the arrearage.

      (Added to NRS by 1997, 2180; A 2005, 2796, 2807)

      NRS 652.095  Payment of child support: Submission of certain information by applicant; grounds for denial of license or certificate; duty of Board. [Effective on the date of the repeal of 42 U.S.C. § 666, the federal law requiring each state to establish procedures for withholding, suspending and restricting the professional, occupational and recreational licenses for child support arrearages and for noncompliance with certain processes relating to paternity or child support proceedings and expires by limitation 2 years after that date.]

      1.  In addition to any other requirements set forth in this chapter, an applicant for the issuance or renewal of a license or certificate issued pursuant to NRS 652.125 shall submit to the Board the statement prescribed by the Division of Welfare and Supportive Services of the Department of Health and Human Services pursuant to NRS 425.520. The statement must be completed and signed by the applicant.

      2.  The Board shall include the statement required pursuant to subsection 1 in:

      (a) The application or any other forms that must be submitted for the issuance or renewal of the license or certificate; or

      (b) A separate form prescribed by the Board.

      3.  A license or certificate may not be issued or renewed by the Board pursuant to NRS 652.125 if the applicant:

      (a) Fails to submit the statement required pursuant to subsection 1; or

      (b) Indicates on the statement submitted pursuant to subsection 1 that the applicant is subject to a court order for the support of a child and is not in compliance with the order or a plan approved by the district attorney or other public agency enforcing the order for the repayment of the amount owed pursuant to the order.

      4.  If an applicant indicates on the statement submitted pursuant to subsection 1 that the applicant is subject to a court order for the support of a child and is not in compliance with the order or a plan approved by the district attorney or other public agency enforcing the order for the repayment of the amount owed pursuant to the order, the Board shall advise the applicant to contact the district attorney or other public agency enforcing the order to determine the actions that the applicant may take to satisfy the arrearage.

      (Added to NRS by 1997, 2180; A 2005, 2796, 2797, 2807, effective on the date of the repeal of 42 U.S.C. § 666, the federal law requiring each state to establish procedures for withholding, suspending and restricting the professional, occupational and recreational licenses for child support arrearages and for noncompliance with certain processes relating to paternity or child support proceedings)

      NRS 652.100  Fees; deposit in appropriate account; claims for expenses.

      1.  All applications for a license or renewal thereof must be accompanied by a reasonable fee in an amount prescribed by the Board. All fees must be paid to the Division and must be deposited with the State Treasurer for credit to the appropriate account of the State Board of Health.

      2.  Claims for per diem and travel expenses and for other expenses of administration of this chapter must be paid as other claims against the State are paid.

      (Added to NRS by 1967, 927; A 1975, 1163; 1983, 405; 1985, 446; 1995, 1590)

      NRS 652.110  Validity and display of licenses.

      1.  A license issued pursuant to the provisions of this chapter is valid only for the laboratory premises for which it is issued and shall be prominently displayed in such laboratory.

      2.  Any such license shall become void 30 days after a change of laboratory directors or in the ownership or location of the laboratory.

      (Added to NRS by 1967, 927)

POWERS AND DUTIES OF DIVISION OF PUBLIC AND BEHAVIORAL HEALTH OF DEPARTMENT OF HEALTH AND HUMAN SERVICES AND STATE BOARD OF HEALTH

      NRS 652.120  Enforcement of chapter.  The Division shall enforce the provisions of this chapter.

      (Added to NRS by 1967, 927; A 1995, 1590)

      NRS 652.123  Limitations on stringency of regulations adopted by Board. [Effective through December 31, 2013.]  Regulations adopted by the Board pursuant to this chapter may not be more stringent than the provisions of Part 493 of Title 42 of the Code of Federal Regulations, except that the Board may adopt regulations which are more stringent relating to:

      1.  Any laboratory test, other than a test for the detection of the human immunodeficiency virus, classified as a waived test pursuant to the provisions of Part 493 of Title 42 of the Code of Federal Regulations; and

      2.  The qualifications and duties of the personnel of a medical laboratory.

      (Added to NRS by 1997, 1123; A 2009, 308)

      NRS 652.123  Limitations on stringency of regulations adopted by Board. [Effective January 1, 2014.]  Regulations adopted by the Board pursuant to this chapter may not be more stringent than the provisions of Part 493 of Title 42 of the Code of Federal Regulations, except that the Board may adopt regulations which are more stringent relating to:

      1.  Any laboratory test, other than a test for the detection of the human immunodeficiency virus, classified as a waived test pursuant to the provisions of Part 493 of Title 42 of the Code of Federal Regulations;

      2.  The qualifications and duties of the personnel of a medical laboratory; and

      3.  The administrative penalties that may be imposed for violating any of the provisions of this chapter or regulations adopted pursuant thereto.

      (Added to NRS by 1997, 1123; A 2009, 308; 2013, 103, effective January 1, 2014)

      NRS 652.125  Regulations for certification and licensure of laboratory directors and personnel; continuing education.

      1.  The Board shall adopt regulations for the certification and licensure of laboratory directors and laboratory personnel who perform technical duties other than the collection of blood.

      2.  The Division shall, as a prerequisite for the renewal of a certificate or license, require the laboratory director and any laboratory personnel certified by the Division pursuant to this chapter to comply with the requirements for continuing education adopted by the Board.

      (Added to NRS by 1985, 549; A 1995, 1590)

      NRS 652.127  Requirements to qualify for certification as assistant in laboratory. [Effective through December 31, 2013.]  To qualify for certification as an assistant in a medical laboratory, a person must be a high school graduate or have a general equivalency diploma or an equivalent document and:

      1.  Must complete at least 6 months of training approved by the Board and demonstrate an ability to perform laboratory procedures in the medical laboratory where he or she receives the training; or

      2.  Must:

      (a) Complete a course of instruction that qualifies him or her to take an examination for certification in phlebotomy that is administered by:

             (1) The American Medical Technologists;

             (2) The American Society of Clinical Pathologists; or

             (3) The National Certification Agency; and

      (b) Pass an examination specified in paragraph (a).

      (Added to NRS by 1999, 172; A 2013, 3294)

      NRS 652.127  Board to adopt regulations establishing requirements to qualify for certification as assistant in medical laboratory; regulations. [Effective January 1, 2014.]

      1.  To qualify for certification as an assistant in a medical laboratory, a person must meet the qualifications established by the Board by regulation.

      2.  The Board shall adopt such regulations as necessary to carry out the provisions of this section.

      (Added to NRS by 1999, 172; A 2013, 103, 3294, effective January 1, 2014)

      NRS 652.130  Regulations: Advice of Medical Laboratory Advisory Committee; subjects.  Except as otherwise provided in NRS 652.127, the Board, with the advice of the Medical Laboratory Advisory Committee, may prescribe and publish rules and regulations relating to:

      1.  The education, training and experience qualifications of laboratory directors and technical personnel.

      2.  The location and construction of laboratories, including plumbing, heating, lighting, ventilation, electrical services and similar conditions, to ensure the conduct and operation of the laboratory in a manner which will protect the public health.

      3.  Sanitary conditions within the laboratory and its surroundings, including the water supply, sewage, the handling of specimens and matters of general hygiene, to ensure the protection of the public health.

      4.  The equipment essential to the proper conduct and operation of a laboratory.

      5.  The determination of the accuracy of test results produced by a laboratory and the establishment of minimum qualifications therefor.

      (Added to NRS by 1967, 927; A 1999, 173)

      NRS 652.135  Regulations: Length of time records must be retained.  The Board shall adopt regulations establishing the length of time that the health care and other regularly maintained records of a medical laboratory must be retained. The regulations must be consistent with the provisions of Part 493 of Title 42 of the Code of Federal Regulations.

      (Added to NRS by 1997, 1123)

      NRS 652.140  Inspections; proficiency tests; reports.  The Division may:

      1.  Inspect the premises and operations of laboratories;

      2.  Conduct proficiency tests to determine the accuracy of the test results of laboratories;

      3.  Require laboratories to submit reports to determine compliance with the provisions of this chapter; and

      4.  Require that the reports submitted by a laboratory be:

      (a) Made under oath;

      (b) Signed by the laboratory director; or

      (c) Made under oath and signed by the laboratory director.

      (Added to NRS by 1967, 927; A 1995, 1591)

      NRS 652.150  List of laboratories meeting minimum standards and qualifications.  The Division shall maintain a registration list of all laboratories meeting the minimum standards and qualifications of this chapter.

      (Added to NRS by 1967, 927; A 1995, 1591)

      NRS 652.155  Licensing of certain persons and laboratories without examination.  Notwithstanding the provisions of NRS 652.130 and 652.150, and without requiring any examination or any other qualification than is provided in this section, the Division shall, upon application and the payment of any appropriate fee before January 1, 1972:

      1.  Issue a director’s license to any person who operated a laboratory in this state for at least 3 years immediately preceding January 1, 1967;

      2.  Issue a medical laboratory technologist’s certificate to any person who was a medical laboratory technologist in this state for at least 1 year immediately preceding January 1, 1967;

      3.  Issue a license to, and include in the registration list of laboratories meeting the minimum standards and qualifications of this chapter, any laboratory which was in operation in this state on January 1, 1967, which has a director meeting the qualifications provided in subsection 1; and

      4.  Keep on inactive status any licensee under this section who notifies the Division that he or she desires such a status and pays the current fees.

      (Added to NRS by 1971, 1315; A 1975, 1163; 1995, 1591)

MEDICAL LABORATORY ADVISORY COMMITTEE

      NRS 652.160  Creation; duties.  A Medical Laboratory Advisory Committee to advise the Board on matters of policy concerning medical laboratories, qualifications of laboratory directors and personnel and other matters pursuant to the provisions of this chapter is hereby created.

      (Added to NRS by 1967, 928)

      NRS 652.170  Appointment, terms and qualifications of members; compensation of members and employees.

      1.  The Board shall appoint the members of the Medical Laboratory Advisory Committee.

      2.  After the initial terms, members shall serve for 3-year terms.

      3.  A member may not serve for more than two consecutive terms. Service of 2 or more years in filling an unexpired term constitutes a term.

      4.  The Advisory Committee is composed of:

      (a) Two pathologists, certified in clinical pathology by the American Board of Pathology.

      (b) Two medical technologists.

      (c) One bioanalyst who is a laboratory director.

      (d) One qualified biochemist from the Nevada System of Higher Education.

      (e) One licensed physician actively engaged in the practice of clinical medicine in this State.

      5.  No member of the Advisory Committee may have any financial or business arrangement with any other member which pertains to the business of laboratory analysis.

      6.  The Chief Medical Officer or a designated representative of the Chief Medical Officer is an ex officio member of the Advisory Committee.

      7.  Each member of the Advisory Committee is entitled to receive:

      (a) A salary of not more than $60, as fixed by the Board, for each day’s attendance at a meeting of the Committee; and

      (b) A per diem allowance and travel expenses at a rate fixed by the Board, while engaged in the business of the Committee. The rate must not exceed the rate provided for state officers and employees generally.

      8.  While engaged in the business of the Committee, each employee of the Committee is entitled to receive a per diem allowance and travel expenses at a rate fixed by the Board. The rate must not exceed the rate provided for state officers and employees generally.

      (Added to NRS by 1967, 928; A 1973, 269; 1977, 1260; 1981, 1996; 1985, 446; 1989, 1706; 1993, 421)

REGULATION OF LABORATORIES AND LABORATORY DIRECTORS

      NRS 652.180  Duties of laboratory director.  A laboratory director shall:

      1.  Select and supervise all laboratory procedures;

      2.  Report the findings or results of laboratory tests;

      3.  Actively participate in the operation of the laboratory to the extent necessary to assure compliance with the provisions of this chapter;

      4.  Be responsible for the proper performance of all work in the laboratory and of all subordinates; and

      5.  Retain the health care and other regularly maintained records of the laboratory in accordance with regulations adopted by the Board pursuant to NRS 652.135.

      (Added to NRS by 1967, 927; A 1997, 1124)

      NRS 652.185  Requirements for conduct of certain laboratory tests for detection of human immunodeficiency virus.  A laboratory which conducts a laboratory test for the detection of the human immunodeficiency virus that is classified as a waived test pursuant to the provisions of Part 493 of Title 42 of the Code of Federal Regulations shall:

      1.  Conduct the test in accordance with the quality assurance guidelines relating to testing using rapid human immunodeficiency virus antibody tests established by the Centers for Disease Control and Prevention of the United States Department of Health and Human Services; and

      2.  Comply with the provisions of NRS 441A.150 and any regulations adopted pursuant to chapter 441A of NRS relating to the reporting of communicable diseases.

      (Added to NRS by 2009, 308)

      NRS 652.190  Examination, review and referral of specimens; reporting of results; recommendation for review of results by physician.

      1.  A laboratory may examine specimens only at the request of:

      (a) A licensed physician;

      (b) Any other person authorized by law to use the findings of laboratory tests and examinations; or

      (c) If the examination can be made with a testing device or kit which is approved by the Food and Drug Administration for use in the home and which is available to the public without a prescription, any person.

      2.  Except as otherwise provided in NRS 441A.150, 442.325 and 652.193, the laboratory may report the results of the examination only to:

      (a) The person requesting the test or procedure;

      (b) A provider of health care who is treating or providing assistance in the treatment of the patient;

      (c) A provider of health care to whom the patient has been referred; and

      (d) The patient for whom the testing or procedure was performed.

      3.  The laboratory report must contain the name of the laboratory. If a specimen is accepted by a laboratory and is referred to another laboratory, the name and address of the other laboratory must be clearly shown by the referring laboratory on the report to the person requesting the test or procedure.

      4.  Whenever an examination is made pursuant to paragraph (c) of subsection 1, the laboratory report must contain a provision which recommends that the results of the examination be reviewed and interpreted by a physician or other licensed provider of health care.

      (Added to NRS by 1967, 928; A 1989, 59; 1993, 499; 1995, 1602; 1997, 1124; 1999, 3516; 2003, 1333)

      NRS 652.193  Release of results of tests regarding patient of rural hospital.

      1.  Except as otherwise provided in NRS 442.325, a licensed laboratory may release the results of tests performed at the laboratory regarding a patient of a rural hospital only to:

      (a) The patient;

      (b) The physician who ordered the tests; and

      (c) A provider of health care who is currently treating or providing assistance in the treatment of the patient.

      2.  As used in this section:

      (a) “Provider of health care” has the meaning ascribed to it in NRS 629.031.

      (b) “Rural hospital” has the meaning ascribed to it in NRS 449.0177.

      (Added to NRS by 1995, 1602; A 1999, 3516)

      NRS 652.195  Cytologic examination of gynecologic specimens: Direct billing required; unlawful practices; exceptions.

      1.  A laboratory which performs a cytologic examination of gynecologic specimens for a patient residing in this State shall submit any bill for those services to:

      (a) The patient directly;

      (b) The responsible insurer or other third-party payor; or

      (c) The hospital, public health clinic or nonprofit health clinic.

Ę Except as otherwise provided in subsection 3, the laboratory shall not submit the bill for those services to the physician who directed the examination.

      2.  Except as otherwise provided in subsection 3, it is unlawful for a physician to charge, bill or otherwise solicit payment from a person for cytologic services relating to the examination of gynecologic specimens.

      3.  The provisions of this section do not apply to cytologic services:

      (a) Rendered by the physician himself or herself or in a laboratory operated solely in connection with the diagnosis or treatment of the physician’s own patients; or

      (b) Provided to an enrollee pursuant to a health care plan authorized pursuant to chapter 695C of NRS.

      (Added to NRS by 1991, 650)

      NRS 652.200  Limitation on contents of laboratory’s report.  No interpretation of test results, diagnosis, prognosis or suggested treatment may appear on the laboratory report form, unless the report is made by a physician licensed to practice in this state.

      (Added to NRS by 1967, 928)

      NRS 652.210  Manipulation for collection of specimens; authorized practices of technical personnel. [Effective through December 31, 2013.]

      1.  Except as otherwise provided in subsection 2 and NRS 126.121, no person other than a licensed physician, a licensed optometrist, a licensed practical nurse, a registered nurse, a perfusionist, a physician assistant licensed pursuant to chapter 630 or 633 of NRS, a certified intermediate emergency medical technician, a certified advanced emergency medical technician, a practitioner of respiratory care licensed pursuant to chapter 630 of NRS or a licensed dentist may manipulate a person for the collection of specimens.

      2.  The technical personnel of a laboratory may collect blood, remove stomach contents, perform certain diagnostic skin tests or field blood tests or collect material for smears and cultures.

      (Added to NRS by 1967, 928; A 1991, 375; 1993, 2842; 1997, 689; 1999, 1916; 2001, 776; 2005, 2517; 2007, 1530, 1847; 2009, 2990)

      NRS 652.210  Manipulation for collection of specimens; authorized practices of technical personnel. [Effective January 1, 2014.]

      1.  Except as otherwise provided in subsection 2 and NRS 126.121, no person other than a licensed physician, a licensed optometrist, a licensed practical nurse, a registered nurse, a perfusionist, a physician assistant licensed pursuant to chapter 630 or 633 of NRS, a certified advanced emergency medical technician, a certified paramedic, a practitioner of respiratory care licensed pursuant to chapter 630 of NRS or a licensed dentist may manipulate a person for the collection of specimens. The persons described in this subsection may perform any laboratory test which is classified as a waived test pursuant to Subpart A of Part 493 of Title 42 of the Code of Federal Regulations without obtaining certification as an assistant in a medical laboratory pursuant to NRS 652.127.

      2.  The technical personnel of a laboratory may collect blood, remove stomach contents, perform certain diagnostic skin tests or field blood tests or collect material for smears and cultures.

      (Added to NRS by 1967, 928; A 1991, 375; 1993, 2842; 1997, 689; 1999, 1916; 2001, 776; 2005, 2517; 2007, 1530, 1847; 2009, 2990; 2013, 103, 968, effective January 1, 2014)

      NRS 652.215  Licensed professional nurses: Performance of specific procedures under supervision of Chief Medical Officer; regulations governing performance of procedures.  A licensed professional nurse who is employed by the Division to work in the field of community health may perform specific laboratory procedures prescribed by the Board under the supervision of the Chief Medical Officer. The Board shall adopt regulations governing the performance of these procedures.

      (Added to NRS by 1983, 279; A 1995, 1591)

      NRS 652.217  Conditions under which licensed nurse or licensed or certified laboratory personnel may perform certain laboratory tests. [Effective through December 31, 2013.]

      1.  A licensed nurse who is employed by a medical facility which is licensed pursuant to chapter 449 of NRS may perform any laboratory test which is classified as a waived test pursuant to Subpart A of Part 493 of Title 42 of the Code of Federal Regulations if the laboratory director or a person designated by the laboratory director:

      (a) Verifies that the nurse is competent to perform the test;

      (b) Ensures that the test is performed in accordance with any manufacturer’s instructions; and

      (c) Validates and verifies the manner in which the test is performed through the use of controls which ensure accurate and reliable results of the test.

      2.  Licensed or certified personnel of a laboratory licensed pursuant to this chapter may perform any laboratory test which is classified as a waived test pursuant to Subpart A of Part 493 of Title 42 of the Code of Federal Regulations on the premises of an outpatient center of the laboratory or at a patient’s residence if the laboratory director or a person designated by the laboratory director:

      (a) Verifies that the person is competent to perform the test;

      (b) Ensures that the test is performed in accordance with any manufacturer’s instructions;

      (c) Validates and verifies the manner in which the test is performed through the use of controls which ensure accurate and reliable results of the test; and

      (d) Ensures compliance with any requirements for safety adopted by the Board.

      (Added to NRS by 1995, 794; A 1997, 1125; 1999, 173)

      NRS 652.217  Conditions under which licensed nurse or licensed or certified laboratory personnel may perform certain laboratory tests. [Effective January 1, 2014.]

      1.  A licensed nurse who is employed by a medical facility which is licensed pursuant to chapter 449 of NRS may perform any laboratory test which is classified as a waived test pursuant to Subpart A of Part 493 of Title 42 of the Code of Federal Regulations if the laboratory director or a person designated by the laboratory director:

      (a) Verifies that the nurse is competent to perform the test;

      (b) Ensures that the test is performed in accordance with any manufacturer’s instructions; and

      (c) Validates and verifies the manner in which the test is performed through the use of controls which ensure accurate and reliable results of the test.

      2.  A licensed nurse described in subsection 1 may perform any laboratory test which is classified a waived test pursuant to Subpart A of Part 493 of Title 42 of the Code of Federal Regulations without obtaining certification as an assistant in a medical laboratory pursuant to NRS 652.127.

      3.  Licensed or certified personnel of a laboratory licensed pursuant to this chapter may perform any laboratory test which is classified as a waived test pursuant to Subpart A of Part 493 of Title 42 of the Code of Federal Regulations on the premises of an outpatient center of the laboratory or at a patient’s residence if the laboratory director or a person designated by the laboratory director:

      (a) Verifies that the person is competent to perform the test;

      (b) Ensures that the test is performed in accordance with any manufacturer’s instructions;

      (c) Validates and verifies the manner in which the test is performed through the use of controls which ensure accurate and reliable results of the test; and

      (d) Ensures compliance with any requirements for safety adopted by the Board.

      (Added to NRS by 1995, 794; A 1997, 1125; 1999, 173; 2013, 103, effective January 1, 2014)

DISCIPLINARY PROCEEDINGS

      NRS 652.220  Grounds for denial, suspension or revocation of license.  A license may be denied, suspended or revoked if the laboratory, laboratory director or any technical employee of the laboratory:

      1.  Violates any provision of this chapter;

      2.  Makes any misrepresentation in obtaining a license;

      3.  Has been convicted of a felony relating to the position for which the applicant has applied or the licensee has been licensed pursuant to this chapter;

      4.  Has been convicted of violating any of the provisions of NRS 616D.200, 616D.220, 616D.240 or 616D.300 to 616D.440, inclusive;

      5.  Is guilty of unprofessional conduct;

      6.  Knowingly permits the use of the name of a licensed laboratory or its director by an unlicensed laboratory; or

      7.  Fails to meet the minimum standards prescribed by the Board.

      (Added to NRS by 1967, 928; A 1993, 796; 2003, 2731; 2011, 860)

      NRS 652.223  Suspension of license or certificate for failure to pay child support or comply with certain subpoenas or warrants; reinstatement of license or certificate. [Effective until 2 years after the date of the repeal of 42 U.S.C. § 666, the federal law requiring each state to establish procedures for withholding, suspending and restricting the professional, occupational and recreational licenses for child support arrearages and for noncompliance with certain processes relating to paternity or child support proceedings.]

      1.  If the Board receives a copy of a court order issued pursuant to NRS 425.540 that provides for the suspension of all professional, occupational and recreational licenses, certificates and permits issued to a person who is the holder of a license or certificate issued pursuant to NRS 652.125, the Board shall deem the license or certificate issued to that person to be suspended at the end of the 30th day after the date on which the court order was issued unless the Board receives a letter issued to the holder of the license or certificate by the district attorney or other public agency pursuant to NRS 425.550 stating that the holder of the license or certificate has complied with the subpoena or warrant or has satisfied the arrearage pursuant to NRS 425.560.

      2.  The Board shall reinstate a license or certificate issued pursuant to NRS 652.125 that has been suspended by a district court pursuant to NRS 425.540 if the Board receives a letter issued by the district attorney or other public agency pursuant to NRS 425.550 to the person whose license or certificate was suspended stating that the person whose license or certificate was suspended has complied with the subpoena or warrant or has satisfied the arrearage pursuant to NRS 425.560.

      (Added to NRS by 1997, 2180; A 2005, 2807)

      NRS 652.225  Hearing after receipt of report of certain violations; regulations.  If the Board receives a report pursuant to subsection 5 of NRS 228.420, a hearing must be held pursuant to regulations adopted by the Board to consider the contents of the report. The Board shall adopt such regulations as are necessary to carry out the provisions of this section.

      (Added to NRS by 1993, 796; A 1995, 1591)

      NRS 652.228  Certain records relating to investigation deemed confidential; certain records relating to disciplinary action and orders imposing discipline deemed public records.

      1.  Except as otherwise provided in this section and NRS 239.0115, a complaint filed with the Board, all documents and other information filed with the complaint and all documents and other information compiled as a result of an investigation conducted to determine whether to initiate disciplinary action are confidential.

      2.  The complaint or other document filed by the Board to initiate disciplinary action and all documents and information considered by the Board when determining whether to impose discipline are public records.

      3.  An order that imposes discipline and the findings of fact and conclusions of law supporting that order are public records.

      (Added to NRS by 2003, 3476; A 2007, 2149)

APPLICABILITY OF CHAPTER

      NRS 652.230  Applicability to public and private laboratories; exceptions.  The provisions of this chapter apply to all public and private medical laboratories except:

      1.  A laboratory of any college, university or school which is conducted for the training of its students, actively engaged in research and approved by the State Department of Education.

      2.  Laboratories operated by the Federal Government.

      3.  Laboratories operated by the State Department of Agriculture.

      (Added to NRS by 1967, 926; A 1967, 1206; 1973, 660; 1993, 1894; 1999, 3740)

      NRS 652.235  Applicability to laboratory operated by licensed physician solely in connection with diagnosis or treatment of own patients; requirements.

      1.  A licensed physician may operate a medical laboratory solely in connection with the diagnosis or treatment of the physician’s own patients if the medical laboratory complies with the provisions of this section.

      2.  Each such medical laboratory shall:

      (a) Register with the Division.

      (b) Comply with the rules and regulations adopted by the Board pursuant to NRS 652.130.

      (c) Submit to the inspections and tests provided for in subsections 1 and 2 of NRS 652.140.

      (Added to NRS by 1973, 661, 1406; A 1989, 1115; 1993, 2598; 1995, 1592)

      NRS 652.240  Licensing of laboratories in operation on January 1, 1967; persons operating or employed in laboratories on January 1, 1967.

      1.  A laboratory which was in operation in this state on January 1, 1967, is not required to be licensed pursuant to this chapter before January 1, 1972, but may apply for a license before that date. Unless such a laboratory is so licensed, the Division shall not include it in the registration list of laboratories meeting the minimum standards and qualifications of this chapter.

      2.  A person who was operating a laboratory in this state on January 1, 1967, may continue to do so or may be employed in a laboratory before, on or after July 1, 1972, without qualifying as a laboratory director or pursuant to any rules pertaining to technical personnel. A person who was employed in a laboratory in this state on January 1, 1967, may be employed in a laboratory before, on or after January 1, 1972, without qualifying pursuant to any rules pertaining to technical personnel.

      (Added to NRS by 1967, 929; A 1995, 1592; 1997, 1622)

      NRS 652.245  Exemption of tests and examinations conducted by law enforcement agencies or ordered by court.  The provisions of this chapter do not apply to any test or examination:

      1.  Conducted by a law enforcement officer or agency; or

      2.  Required by a court as a part of or in addition to a program of treatment and rehabilitation pursuant to NRS 453.580.

      (Added to NRS by 1993, 499; A 2007, 49)

UNLAWFUL ACTS; PENALTIES

      NRS 652.250  Public nuisance; injunctions.  The operation or maintenance of a laboratory in violation of this chapter is declared to be a public nuisance, and the Board may, in addition to other remedies, initiate an action to enjoin such violations or to enjoin the future operation of the laboratory until compliance with the provisions of this chapter is obtained.

      (Added to NRS by 1967, 929)

      NRS 652.260  Penalties. [Effective through December 31, 2013.]  Any person or laboratory violating any of the provisions of this chapter shall be punished by a fine of not more than $250 for the first offense and not more than $500 for any subsequent offense. Each act in violation of this chapter constitutes a separate offense.

      (Added to NRS by 1967, 929; A 1979, 1491)

      NRS 652.260  Penalties. [Effective January 1, 2014.]

      1.  If a person or laboratory violates any of the provisions of this chapter or the regulations adopted pursuant thereto, the Division may, after giving notice and opportunity to be heard:

      (a) Impose an administrative penalty of not more than $10,000; and

      (b) Require the person or laboratory to take any action necessary to correct the violation.

      2.  Each act in violation of this chapter or the regulations adopted pursuant thereto constitutes a separate offense.

      3.  In determining the amount of an administrative penalty to be imposed pursuant to this section, the Division shall consider:

      (a) The severity of the violation, including, without limitation:

             (1) The probability that death or serious harm to the health or safety of a person may occur as a result of the violation;

             (2) The severity of the potential or actual harm that may occur to any person as a result of the violation; and

             (3) The extent to which the provisions of this chapter or the regulations adopted pursuant thereto were violated;

      (b) Whether the person or laboratory has previously violated the provisions of this chapter or the regulations adopted pursuant thereto; and

      (c) Any other facts or circumstances that the Division determines are relevant.

      4.  If the person or laboratory fails to pay the administrative penalty imposed pursuant to this section after the time for an appeal has expired, the Division may:

      (a) Suspend the license of the person or laboratory;

      (b) Impose interest on the unpaid administrative penalty at a rate of 10 percent from the date on which the time for an appeal expired until the date the administrative penalty is paid; and

      (c) Collect court costs, reasonable attorney’s fees, the costs of an investigation and other costs incurred to collect the administrative penalty.

      5.  Except as otherwise provided in this section, all money collected from administrative penalties imposed pursuant to this section must be deposited in the State General Fund.

      6.  The money collected from such administrative penalties may be accounted for separately and used by the Division to administer and carry out the provisions of this chapter and to protect the health, safety and well-being of patients in accordance with applicable state and federal standards if:

      (a) The person or laboratory pays the administrative penalty without exercising the right to a hearing to contest the penalty; or

      (b) The administrative penalty is imposed in a hearing conducted by a hearing officer or panel appointed by the Division.

      7.  The Division may appoint one or more hearing officers or panels and may delegate to those hearing officers or panels the power of the Division to conduct hearings, determine violations and impose the administrative penalties authorized by this section.

      8.  If money collected from an administrative penalty is deposited in the State General Fund, the Division may present a claim to the State Board of Examiners for recommendation to the Interim Finance Committee if money is needed to pay court costs, attorney’s fees, the costs of an investigation or other costs incurred to collect the administrative penalty.

      9.  The Board may adopt regulations to carry out the provisions of this section.

      (Added to NRS by 1967, 929; A 1979, 1491; 2013, 104, effective January 1, 2014)