[Rev. 3/13/2024 9:51:45 AM]
κ2023 Statutes of Nevada, Page 3385κ
Senate Bill No. 341Senators Cannizzaro, Lange, Dondero Loop; Daly, Donate, Neal, Ohrenschall and Pazina
CHAPTER 522
[Approved: June 15, 2023]
AN ACT relating to governmental financial administration; making appropriations for various purposes relating to health, education and employment and other community services; revising provisions relating to the titles and maximum salaries of the unclassified personnel of the Public Utilities Commission of Nevada; and providing other matters properly relating thereto.
EXPLANATION Matter in bolded italics is new; matter between
brackets [omitted material] is material to be
omitted.
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1. There is hereby appropriated from the State General Fund to the Food Bank of Northern Nevada the sum of $2,000,000 for the purpose of purchasing food for distribution to persons served by the Food Bank.
Sec. 2. There is hereby appropriated from the State General Fund to Three Square the sum of $2,000,000 for the purpose of purchasing food for distribution to persons served by Three Square Food Bank.
Sec. 3. There is hereby appropriated from the State General Fund to the Advisory Committee on Problem Gambling created by NRS 458A.060 the sum of $500,000 to conduct statewide seminars on problem gambling awareness.
Sec. 4. There is hereby appropriated from the State General Fund to the Boys & Girls Clubs of Southern Nevada the sum of $250,000 for its programs.
Sec. 5. There is hereby appropriated from the State General Fund to Boys Town Nevada the sum of $250,000 for its programs.
Sec. 6. There is hereby appropriated from the State General Fund to Candlelighters Childhood Cancer Foundation of Nevada the sum of $1,000,000 for the provision of assistance to children affected by cancer and their families.
Sec. 7. There is hereby appropriated from the State General Fund to Catholic Charities of Southern Nevada the sum of $3,000,000 for its Meals on Wheels Program.
Sec. 8. There is hereby appropriated from the State General Fund to the Cleveland Clinic Nevada the sum of $3,000,000 for medical services and research.
Sec. 9. There is hereby appropriated from the State General Fund to Communities in Schools of Nevada the sum of $1,000,000 for its programs.
Sec. 10. There is hereby appropriated from the State General Fund to the Culinary Academy of Las Vegas the sum of $6,000,000 for a capital improvement project.
Sec. 11. There is hereby appropriated from the State General Fund to the Culinary Academy of Las Vegas the sum of $4,000,000 for an outreach campaign to enroll persons into accredited hospitality programs with in-house support.
κ2023 Statutes of Nevada, Page 3386 (CHAPTER 522, SB 341)κ
Sec. 12. There is hereby appropriated from the State General Fund to the Department of Education the sum of $250,000 for Holocaust education programs.
Sec. 13. There is hereby appropriated from the State General Fund to the Division of State Library, Archives and Public Records of the Department of Administration the sum of $500,000 for books and other research materials.
Sec. 14. There is hereby appropriated from the State General Fund to the Domestic Violence Resource Center in Reno, Nevada the sum of $1,000,000 for its programs and services.
Sec. 15. There is hereby appropriated from the State General Fund to Friends of Gem Theater the sum of $1,000,000 for the restoration of the Gem Theater in Pioche, Nevada.
Sec. 16. There is hereby appropriated from the State General Fund to the Gay and Lesbian Community Center of Southern Nevada, Inc. the sum of $1,000,000 for its programs and services.
Sec. 17. There is hereby appropriated from the State General Fund to Green Our Planet the sum of $3,000,000 for its programs for school gardens.
Sec. 18. There is hereby appropriated from the State General Fund to the International Gaming Institute of the University of Nevada, Las Vegas, the sum of $500,000 for the Expanding the Leaderverse initiative to increase the diversity of the leadership of the gaming industry.
Sec. 19. There is hereby appropriated from the State General Fund to the Leadership Institute of Nevada the sum of $250,000 for educational training, support and programming for first-generation college students.
Sec. 20. There is hereby appropriated from the State General Fund to the Legal Aid Center of Southern Nevada the sum of $4,000,000 for a capital improvement project.
Sec. 21. There is hereby appropriated from the State General Fund to the Legal Aid Center of Southern Nevada the sum of $250,000 for programs and services relating to tenants rights.
Sec. 22. There is hereby appropriated from the State General Fund to The Neon Museum the sum of $1,000,000 for a capital improvement project.
Sec. 23. There is hereby appropriated from the State General Fund to the Nevada Arts Council created by NRS 233C.025 the sum of $500,000 for its programs and activities.
Sec. 24. There is hereby appropriated from the State General Fund to the Nevada Blind Childrens Foundation the sum of $1,000,000 for its programs and services.
Sec. 25. There is hereby appropriated from the State General Fund to the Nevada Clean Energy Fund formed pursuant to NRS 701B.985 the sum of $1,000,000 to use for obtaining federal money to assist with carrying out qualified clean energy projects and economic policies pursuant to NRS 701B.930 to 701B.995, inclusive.
Sec. 26. There is hereby appropriated from the State General Fund to the Pioneer Center for the Performing Arts the sum of $1,000,000 for a capital improvement project.
Sec. 27. There is hereby appropriated from the State General Fund to the Regional Transportation Commission of Southern Nevada the sum of $5,000,000 for activities to stabilize transit operations.
Sec. 28. There is hereby appropriated from the State General Fund to the Roseman University of Health Sciences the sum of $1,000,000 for recruitment of students.
κ2023 Statutes of Nevada, Page 3387 (CHAPTER 522, SB 341)κ
Sec. 29. There is hereby appropriated from the State General Fund to Special Olympics Nevada the sum of $250,000 for its programs.
Sec. 30. There is hereby appropriated from the State General Fund to the Tahoe-Douglas Visitors Authority the sum of $1,200,000 for providing microtransit service.
Sec. 31. There is hereby appropriated from the State General Fund to United Way of Northern Nevada and the Sierra the sum of $1,200,000 for its United Readers Program.
Sec. 32. There is hereby appropriated from the State General Fund to the Greenspun College of Urban Affairs of the University of Nevada, Las Vegas the sum of $1,000,000 for tourist safety initiatives.
Sec. 33. There is hereby appropriated from the State General Fund to Vegas PBS the sum of $4,000,000 for digital educational materials and activities related to the Outdoor Nevada television program.
Sec. 34. There is hereby appropriated from the State General Fund to the Interim Finance Committee the sum of $2,500,000 for allocation to the nonprofit corporation formed to establish an art museum in Las Vegas, Nevada, upon a showing to the Committee:
1. That the corporation has been incorporated under the laws of this State as a nonprofit corporation; and
2. That the purpose of the corporation is to establish an art museum in Las Vegas, Nevada.
Sec. 35. Except for a state agency, as defined in NRS 223.470, upon acceptance of the money appropriated by this act, the entity that accepts the money agrees to:
1. Prepare and transmit a report to the Interim Finance Committee on or before December 20, 2024, that describes each expenditure made from the money appropriated by this act from the date on which the money was received by the entity through December 1, 2024;
2. Prepare and transmit a final report to the Interim Finance Committee on or before September 19, 2025, that describes each expenditure made from the money appropriated by this act from the date on which the money was received by the entity through June 30, 2025; and
3. Upon request of the Legislative Commission, make available to the Legislative Auditor any of the books, accounts, claims, reports, vouchers or other records of information, confidential or otherwise, of the entity, regardless of their form or location, that the Legislative Auditor deems necessary to conduct an audit of the use of the money appropriated by this act.
Sec. 36. Any remaining balance of the appropriations made by sections 1 to 34, inclusive, of this act must not be committed for expenditure after June 30, 2025, by the entity to which the appropriation is made or any entity to which money from the appropriation is granted or otherwise transferred in any manner, and any portion of the appropriated money remaining must not be spent for any purpose after September 19, 2025, by either the entity to which the money was appropriated or the entity to which the money was subsequently granted or transferred, and must be reverted to the State General Fund on or before September 19, 2025.
κ2023 Statutes of Nevada, Page 3388 (CHAPTER 522, SB 341)κ
Sec. 37. Section 1 of Assembly Bill No. 522 of this session is hereby amended to read as follows:
Section 1. The following state officers, employees and medical and related positions are entitled to receive approximate annual salaries of not more than the maximum amounts set forth following their specified titles or positions:
Annual
Title or Position Salary
1. Office of the Attorney General:
Administrative Services Officer....................................... $84,241
Assistant Attorney General (each).................................... 159,930
Attorney General Counsel for Prosecuting Attorneys... 122,187
Bureau Chief (each)............................................................ 145,217
Chief Deputy Attorney General (each)............................ 134,342
Chief Financial Officer....................................................... 116,247
Chief Investigator................................................................ 121,515
Chief Personnel Manager..................................................... 99,797
Chief of Staff........................................................................ 159,930
Construction Law Counsel................................................. 150,765
Deputy Attorney General (each)....................................... 108,753
Engineer................................................................................... 93,618
Executive Assistant............................................................... 63,973
Financial Analyst (each)....................................................... 92,759
General Counsel................................................................... 150,765
Information Technology Chief.......................................... 113,926
Investigator (each)................................................................. 74,984
Legal Researcher (each)....................................................... 63,973
Ombudsman for Victims of Domestic Violence, Sexual Assault and Human Trafficking 88,765
Program Specialist, Technological Crimes....................... 63,973
Public Information Officer................................................... 80,605
Regulatory Manager............................................................ 103,920
Senior Deputy Attorney General (each).......................... 121,547
Senior Economist................................................................. 116,268
Senior Engineer.................................................................... 103,829
Senior Regulatory Analyst................................................... 97,027
Solicitor General.................................................................. 150,765
Special Assistant Attorney General, Military................. 122,187
Special Assistant Attorney General, Neighborhood...... 122,187
Special Counsel (each)....................................................... 150,765
Supervising Legal Researcher (each)................................. 67,171
Technical Staff Manager.................................................... 103,920
Victims Advocate (each)...................................................... 73,602
2. Office of the Controller:
Chief Deputy Controller.................................................. $122,187
Executive Assistant............................................................... 63,973
3. Office of the Governor, Agency for Nuclear Projects:
Executive Assistant............................................................. $63,973
Executive Director............................................................... 131,078
κ2023 Statutes of Nevada, Page 3389 (CHAPTER 522, SB 341)κ
Annual
Title or Position Salary
Planner/Researcher.............................................................. $94,594
Planning Division Administrator...................................... 119,321
Technical Programs Division Administrator.................. 119,321
4. Office of the Governor, Nevada Athletic Commission:
Chief Assistant..................................................................... $76,767
Division Administrator....................................................... 111,313
5. Office of the Governor, Office for New Americans:
Director................................................................................. $80,605
6. Office of the Governor, Office of Energy:
Deputy Director................................................................. $106,414
Director................................................................................. 121,547
7. Office of the Governor, Office of Finance:
Administrator, Office of Project Management, SMART 21 $127,780
Chief Assistant Budget Administrator............................. 101,138
Deputy Director................................................................... 133,060
Director, Office of Finance................................................ 145,217
Director, Office of Project Management, SMART 21.. 140,739
Division Administrator, Budget Division....................... 122,187
Division Administrator, Internal Audits.......................... 122,187
Executive Assistant............................................................... 63,973
Organizational Change Manager, Office of Project Management, SMART 21 116,677
8. Office of the Governor, Office of Federal Assistance:
Director................................................................................. $92,253
Executive Grants Analyst (each)......................................... 70,437
Senior Executive Grants Analyst........................................ 84,230
9. Office of the Governor, Office of Science, Innovation and Technology:
Director............................................................................... $101,163
10. Office of the Lieutenant Governor:
Administrative Secretary (each)....................................... $54,357
Assistant to the Lieutenant Governor (each)..................... 80,528
Chief of Staff.......................................................................... 84,553
Deputy Director, Office of Small Business Advocacy.... 67,802
Director, Office of Small Business Advocacy.................. 80,605
Executive Assistant............................................................... 63,973
11. Office of the Secretary of State:
Business Portal Administrator........................................ $116,607
Chief Deputy........................................................................ 133,060
Chief, Enforcement............................................................. 110,959
Deputy Secretary of State, Commercial Recordings..... 111,313
Deputy Secretary of State, Elections................................ 122,187
Deputy Secretary of State, Operations............................. 111,313
Deputy Secretary of State, Southern Nevada................. 111,313
Executive Assistant............................................................... 63,973
κ2023 Statutes of Nevada, Page 3390 (CHAPTER 522, SB 341)κ
Annual
Title or Position Salary
Public Information Officer................................................. $80,605
Securities Administrator..................................................... 116,247
12. Office of the State Treasurer:
Chief Deputy State Treasurer.......................................... $133,060
Chief of Staff........................................................................ 133,060
Deputy State Treasurer, Cash Management.................... 111,313
Deputy State Treasurer, Debt Management.................... 111,313
Deputy State Treasurer, Financial Literacy and Security 111,313
Deputy State Treasurer, Investments............................... 133,060
Deputy State Treasurer, Unclaimed Property................. 111,313
Executive Assistant............................................................... 63,973
Executive Director, Millennium Scholarship................. 111,313
Senior Deputy State Treasurer (each).............................. 122,187
13. Department of Administration:
Deputy Director................................................................. $133,060
Director................................................................................. 145,217
Executive Assistant............................................................... 63,973
(a) Administrative Services Division
Division Administrator..................................................... $122,187
(b) Division of Enterprise Information Technology Services
Chief Assistant, Planning................................................... $92,741
Chief, Planning, Research and Grant Management....... 101,138
Deputy Administrator......................................................... 122,187
Division Administrator....................................................... 133,060
Special Advisor.................................................................... 111,313
State Chief Information Officer........................................ 133,060
(c) Division of Human Resource Management
Administrator, Equal Employment Opportunity............ $92,760
Division Administrator....................................................... 122,187
Division Deputy Administrator (each)............................... 99,797
(d) Division of State Library, Archives and Public Records
Division Administrator..................................................... $111,313
(e) Fleet Services Division
Division Administrator....................................................... $92,760
(f) Hearings Division
Appeals Officer (each)..................................................... $121,547
Hearing Officer (each).......................................................... 80,605
Information Systems Specialist........................................... 70,492
Senior Appeals Officer....................................................... 134,342
(g) Mail Services Division
Division Administrator....................................................... $92,760
(h) Purchasing Division
Attorney.............................................................................. $108,753
Division Administrator....................................................... 111,313
(i) Public Employees Deferred Compensation Program
Deferred Compensation Executive Officer.................. $111,313
(j) Risk Management Division
Division Administrator....................................................... $99,797
κ2023 Statutes of Nevada, Page 3391 (CHAPTER 522, SB 341)κ
Annual
Title or Position Salary
(k) State Public Works Division
Administrator..................................................................... $140,739
Deputy Administrator, Buildings and Grounds.............. 122,187
Deputy Administrator, Code Compliance and Enforcement 133,060
Deputy Administrator, Professional Services................. 133,060
Project Manager II (each).................................................. 111,313
Project Manager III (each)................................................. 121,547
14. State Department of Agriculture:
Deputy Director................................................................. $122,187
Director................................................................................. 133,060
(a) Division of Administrative Services
Division Administrator..................................................... $111,313
(b) Division of Animal Industry
Deputy Administrator......................................................... $99,797
Division Administrator....................................................... 111,313
(c) Division of Food and Nutrition
Deputy Administrator......................................................... $99,797
Division Administrator....................................................... 111,313
(d) Division of Measurement Standards
Division Administrator..................................................... $111,313
(e) Division of Plant Health and Compliance
Deputy Administrator......................................................... $99,797
Division Administrator....................................................... 111,313
(f) Miscellaneous
Executive Assistant............................................................. $63,973
Industry and Global Trade Coordinator............................. 88,230
State Veterinarian................................................................ 124,705
Supervisor, Animal Disease Laboratory.......................... 110,302
Veterinary Diagnostician................................................... 102,197
15. Department of Business and Industry:
Deputy Director, Administration.................................... $111,313
Deputy Director, Programs................................................ 122,187
Director................................................................................. 145,217
(a) Attorney for Injured Workers
Deputy Attorney (each).................................................... $108,753
Division Administrator....................................................... 134,342
Senior Deputy Attorney (each)......................................... 121,547
(b) Division of Financial Institutions
Certified Public Accountant.............................................. $76,978
Deputy Division Administrator........................................... 92,759
Division Administrator....................................................... 111,313
(c) Division of Industrial Relations
Attorney (each).................................................................. $108,753
Chief Investigator.................................................................. 92,759
Deputy Division Administrator (each)............................... 99,797
Deputy Division Administrator, Mechanical Unit........... 92,759
Deputy Division Administrator, Mine Safety................... 92,759
κ2023 Statutes of Nevada, Page 3392 (CHAPTER 522, SB 341)κ
Annual
Title or Position Salary
Deputy Division Administrator, Safety Consultation... $92,759
Division Administrator....................................................... 122,187
Senior Attorney.................................................................... 121,547
(d) Division of Insurance
Deputy Division Administrator (each).......................... $111,313
Deputy Division Administrator, Captive Insurers......... 108,753
Division Administrator....................................................... 133,060
Insurance Counsel/Hearing Officer (each)...................... 111,313
Lead Actuary (each)............................................................ 143,353
Lead Insurance Counsel/Hearing Officer........................ 121,547
(e) Division of Mortgage Lending
Certified Public Accountant.............................................. $76,978
Deputy Division Administrator........................................... 92,759
Division Administrator....................................................... 111,313
(f) Employee-Management Relations Board
Division Administrator....................................................... $99,797
Executive Assistant............................................................... 63,973
(g) Housing Division
Affordable Housing Advocate.......................................... $80,605
Chief Assistant....................................................................... 76,767
Chief Financial Officer....................................................... 108,753
Deputy Administrator........................................................... 92,759
Deputy Division Administrator........................................... 92,759
Division Administrator....................................................... 111,313
(h) Nevada Transportation Authority
Attorney.............................................................................. $108,753
Chief Transportation Inspector......................................... 105,951
Commissioner (each).......................................................... 121,801
Deputy Division Administrator......................................... 108,753
Division Administrator....................................................... 129,899
Financial Analyst (each)....................................................... 92,868
Manager................................................................................. 100,621
(i) Office of the Labor Commissioner
Chief Assistant..................................................................... $59,697
Deputy Division Administrator........................................... 92,759
Division Administrator....................................................... 111,313
State Apprenticeship Director............................................. 83,591
(j) Real Estate Division
Deputy Division Administrator......................................... $92,759
Division Administrator....................................................... 111,313
Ombudsman............................................................................ 84,554
(k) Taxicab Authority
Attorney.............................................................................. $108,753
Division Administrator....................................................... 129,899
Deputy Division Administrator........................................... 99,797
(l) Miscellaneous
Administrative Law Judge............................................... $121,547
Executive Assistant............................................................... 63,973
κ2023 Statutes of Nevada, Page 3393 (CHAPTER 522, SB 341)κ
Annual
Title or Position Salary
Ombudsman of Consumer Affairs for Minorities.......... $84,554
16. State Department of Conservation and Natural Resources:
Deputy Director (each)..................................................... $122,187
Director................................................................................. 145,217
(a) Division of Environmental Protection
Division Administrator..................................................... $140,739
(b) Division of Forestry
Division Administrator..................................................... $122,187
(c) Division of Natural Heritage
Administrator..................................................................... $111,313
(d) Division of Outdoor Recreation
Deputy Division Administrator......................................... $92,759
Division Administrator......................................................... 99,797
(e) Division of State Lands
Division Administrator..................................................... $111,313
(f) Division of State Parks
Division Administrator..................................................... $122,187
(g) Division of Water Resources
Chief Administrative Law Judge (licensed attorney). $134,342
District Supervisor, Water Commissioner......................... 80,605
Division Administrator....................................................... 140,739
(h) Office of Historic Preservation
Administrator..................................................................... $111,313
(i) Miscellaneous
Executive Assistant............................................................. $63,973
17. Department of Corrections:
Assistant to the Director................................................... $101,133
Deputy Director, Industrial Programs.............................. 133,060
Deputy Director, Operations, Northern Region............. 133,060
Deputy Director, Operations, Southern Region............. 133,060
Deputy Director, Support Services................................... 133,060
Director................................................................................. 145,217
Executive Assistant............................................................... 63,973
Medical Director.................................................................. 217,595
Mental Health Director....................................................... 122,187
18. Department of Education:
Chief Strategy Officer...................................................... $105,951
Deputy Superintendent for Administrative and Fiscal Services 122,187
Deputy Superintendent of Instructional, Research and Evaluative Services (each) 122,187
Director, Safe and Respectful Learning Office................ 99,797
Executive Assistant............................................................... 63,973
Superintendent of Public Instruction................................ 145,217
κ2023 Statutes of Nevada, Page 3394 (CHAPTER 522, SB 341)κ
Annual
Title or Position Salary
19. Department of Employment, Training and Rehabilitation:
Deputy Director (each)..................................................... $133,060
Director................................................................................. 145,217
(a) Employment Security Division
Deputy Staff Attorney...................................................... $108,753
Division Administrator....................................................... 133,060
Senior Attorney.................................................................... 121,547
(b) Governors Office of Workforce Innovation
Executive Director............................................................ $110,949
(c) Information Development and Processing Division
Division Administrator..................................................... $122,187
(d) Nevada Equal Rights Commission
Division Administrator....................................................... $99,797
(e) Rehabilitation Division
Chief, Disability Employment Policy.............................. $92,760
Division Administrator....................................................... 122,187
(f) Miscellaneous
Chief Auditor..................................................................... $102,354
Executive Assistant............................................................... 63,973
Hearing Officer (each).......................................................... 80,605
20. Department of Health and Human Services:
(a) Aging and Disability Services Division
Chief, Elder Rights............................................................ $108,753
Deputy Division Administrator (each)............................ 122,187
Division Administrator....................................................... 133,060
Executive Director, Persons Who are Deaf and Hard of Hearing 74,648
Sign Language Interpreter (each)........................................ 84,636
Regional Coordinator (each)................................................ 88,765
(b) Directors Office
Administrative Assistant, Patient Protection Commission $54,127
Chief Biostatistician, Data Analytics............................... 111,313
Deputy Director, Administrative Services...................... 122,187
Deputy Director, Fiscal Services...................................... 122,187
Deputy Director, Programs................................................ 122,187
Director................................................................................. 145,217
Executive Director, Patient Protection Commission....... 99,797
Policy Analyst, Patient Protection Commission............... 84,241
(c) Division of Child and Family Services
Bureau Chief, Youth Parole Bureau.............................. $111,313
Deputy Division Administrator (each)............................ 122,187
Division Administrator....................................................... 133,060
Medical Epidemiologist..................................................... 176,943
Superintendent, Caliente Youth Center........................... 111,313
Superintendent, Nevada Youth Training Center............ 111,313
Superintendent, Summit View Youth Correctional Center 116,876
κ2023 Statutes of Nevada, Page 3395 (CHAPTER 522, SB 341)κ
Annual
Title or Position Salary
(d) Division of Health Care Financing and Policy
Actuary................................................................................ $111,313
Deputy Division Administrator (each)............................ 122,187
Division Administrator....................................................... 133,060
State Dental Health Officer............................................... 176,943
(e) Division of Public and Behavioral Health
Chief Medical Officer...................................................... $245,371
Deputy Division Administrator (each)............................ 122,187
Division Administrator....................................................... 140,739
Hospital Administrator....................................................... 121,547
Medical Epidemiologist..................................................... 176,943
Medical Program Coordinator, Mental Health Program 215,574
State Epidemiologist........................................................... 111,313
Statewide Psychiatric Medical Director.......................... 235,355
Statewide Suicide Prevention Coordinator........................ 80,605
Statewide Suicide Prevention Trainer/Networking Facilitator (each) 76,767
(f) Office for Consumer Health Assistance
Chief, Elder Rights.............................................................. $99,797
Governors Consumer Health Advocate.......................... 111,313
Ombudsman for Consumer Health Assistance (each)..... 88,765
(g) Office of Minority Health and Equity
Manager................................................................................. $80,605
(h) Welfare and Supportive Services
Deputy Division Administrator (each).......................... $122,187
Division Administrator....................................................... 133,060
(i) Miscellaneous
Agency Manager (each)................................................... $121,547
Executive Assistant (each)................................................... 63,973
21. Department of Indigent Defense Services:
Deputy Director (each)..................................................... $140,739
Deputy Public Defender, Appellate.................................. 108,753
Deputy Public Defender (each)......................................... 108,753
Executive Assistant............................................................... 63,973
Executive Director............................................................... 142,017
Investigator (each)................................................................. 74,984
State Public Defender......................................................... 134,342
Supervising Public Defender (appeals)........................... 121,547
Supervising Public Defender (office) (each).................. 121,547
Supervising Public Defender (trial).................................. 121,547
22. Department of Motor Vehicles:
(a) Administrative Services Division
Division Administrator..................................................... $111,313
(b) Division of Central Services and Records
Division Administrator..................................................... $111,313
(c) Division of Compliance Enforcement
Deputy Administrator....................................................... $111,313
Division Administrator....................................................... 122,187
κ2023 Statutes of Nevada, Page 3396 (CHAPTER 522, SB 341)κ
Annual
Title or Position Salary
(d) Division of Field Services
Deputy Administrator....................................................... $111,313
Division Administrator....................................................... 122,187
(e) Division of Information Technology
Division Administrator..................................................... $122,187
(f) Division of the Office of the Director
Deputy Director................................................................. $140,739
Director................................................................................. 145,217
Executive Assistant............................................................... 63,973
(g) Division of Research and Project Management
Division Administrator..................................................... $127,780
Deputy Administrator......................................................... 111,313
Organizational Change Manager...................................... 116,677
(h) Motor Carrier Division
Division Administrator..................................................... $111,313
(i) Office of Administrative Hearings
Administrative Law Judge (licensed attorney) (each) $121,547
Administrative Law Judge (other than licensed attorney) (each) 108,753
Chief Administrative Law Judge (licensed attorney).... 134,342
Chief Administrative Law Judge (other than licensed attorney) 121,547
23. Department of Public Safety:
Deputy Director................................................................. $140,739
Director................................................................................. 145,217
Executive Assistant............................................................... 63,973
(a) Capitol Police Division
Division Administrator..................................................... $111,313
(b) Division of Parole and Probation
Chair, State Board of Parole Commissioners............... $122,187
Division Administrator....................................................... 140,739
Executive Director, Parole Board....................................... 99,797
Executive Secretary, Parole Board..................................... 63,973
Parole Board Member (each)............................................... 99,797
(c) Investigation Division
Division Administrator..................................................... $133,060
(d) Nevada Highway Patrol Division
Chief.................................................................................... $140,739
Lieutenant Colonel.............................................................. 140,739
(e) Nevada Office of Cyber Defense Coordination
Division Administrator, Cyber Security........................ $118,604
(f) Office of Traffic Safety
Division Administrator, Highway Safety Planning and Administration $108,753
(g) Records, Communications and Compliance Division
Administrator, NCJIS Program...................................... $127,780
Division Administrator....................................................... 127,656
(h) State Fire Marshal Division
Division Administrator..................................................... $122,187
κ2023 Statutes of Nevada, Page 3397 (CHAPTER 522, SB 341)κ
Annual
Title or Position Salary
24. Department of Sentencing Policy:
Executive Director............................................................ $142,017
Deputy Director................................................................... 108,753
25. Department of Taxation:
Administrative Law Judge (licensed attorney)............ $121,547
Chief Administrative Law Judge (licensed attorney).... 134,342
Chief Deputy Director........................................................ 133,060
Deputy Director (each)....................................................... 122,187
Executive Assistant............................................................... 63,973
Executive Director............................................................... 145,217
State Demographer.............................................................. 108,753
26. Department of Tourism and Cultural Affairs:
Administrator, Nevada Arts Council............................. $111,313
Advertising Sales Representative........................................ 67,323
Art Director (each)................................................................. 65,630
Chief Deputy, Administration........................................... 111,313
Deputy Director, Division of Tourism............................. 111,313
Deputy Director, Marketing and Advertising................... 88,231
Deputy Director, Sales and Industry Partners................... 88,231
Development Specialist, Nevada Magazine (each).......... 73,385
Development Specialist, Tourism (each)........................... 82,841
Development Specialist II, Tourism (each)....................... 88,231
Director................................................................................. 133,060
Division Administrator, Museums and History............. 111,313
Editor Publisher, Nevada Magazine................................. 100,243
Executive Assistant............................................................... 63,973
Executive Director, Nevada Indian Commission........... 111,313
Managing Editor, Publications............................................ 77,056
Operations and Finance Manager....................................... 96,496
Production Manager.............................................................. 62,113
Project Analyst....................................................................... 63,551
Project Analyst II (each)....................................................... 74,100
Public Information Officer................................................... 90,931
Public Relations Specialist................................................... 82,842
27. Department of Transportation:
Administrator of External Civil Rights......................... $111,313
Assistant Director, Administrative Services................... 122,187
Assistant Director, Engineering........................................ 140,739
Assistant Director, Operations.......................................... 140,739
Assistant Director, Planning and Program Development 122,187
Chief Pilot............................................................................. 121,547
Communications Director.................................................... 99,797
Deputy Director (each)....................................................... 142,017
Director................................................................................. 145,217
κ2023 Statutes of Nevada, Page 3398 (CHAPTER 522, SB 341)κ
Annual
Title or Position Salary
Executive Assistant............................................................. $63,973
Executive Director, Nevada State Infrastructure Bank. 133,060
Hearings Officer..................................................................... 80,605
Pilot II (each).......................................................................... 99,797
Pilot III (each)...................................................................... 108,753
28. Department of Veterans Services:
Administrator, Veterans Home....................................... $122,187
Deputy Director, Health and Wellness............................... 92,760
Deputy Director, Programs and Services........................... 92,760
Director................................................................................. 108,753
Executive Assistant............................................................... 63,973
29. Department of Wildlife:
Chief Game Warden......................................................... $111,313
Deputy Director (each)....................................................... 122,187
Director................................................................................. 133,060
Division Administrator, Conservation Education............ 99,797
Division Administrator, Fisheries Management............... 99,797
Division Administrator, Game Management.................... 99,797
Division Administrator, Habitat.......................................... 99,797
Division Administrator, Data and Technology Services. 99,797
Division Administrator, Wildlife Diversity...................... 99,797
Executive Assistant............................................................... 63,973
30. Colorado River Commission of Nevada:
Administrative Services Officer..................................... $135,807
Assistant Director, Energy Information Systems........... 122,150
Assistant Director, Engineering and Operations............ 135,724
Assistant Hydropower Program Manager....................... 115,366
Assistant Power Supply Planner....................................... 105,950
Deputy Director................................................................... 142,510
Director................................................................................. 149,883
Division Head, Water......................................................... 135,807
Energy Accountant................................................................ 89,563
Energy Services Manager.................................................. 142,510
Environmental Program Manager.................................... 122,150
Hydropower Program Manager........................................ 128,939
Manager, Power Accounting............................................. 121,547
Manager, Power Planner.................................................... 121,547
Natural Resource Specialist (each)................................... 118,080
Network Administrator......................................................... 88,219
Office Manager...................................................................... 74,648
Power Facilities Communication Technician (each)....... 95,008
Power Facilities Electrician................................................. 88,219
Power Facilities Manager (each)...................................... 122,150
Power Supply Manager...................................................... 135,807
κ2023 Statutes of Nevada, Page 3399 (CHAPTER 522, SB 341)κ
Annual
Title or Position Salary
Power Supply Planner...................................................... $122,187
Senior Energy Accountant (each)..................................... 101,791
Senior Power Facilities Electrician (each)........................ 95,008
Senior Power Facilities Engineer...................................... 117,453
31. Commission on Ethics:
Associate Counsel............................................................. $108,753
Commission Counsel.......................................................... 121,547
Executive Assistant............................................................... 63,973
Executive Director............................................................... 121,547
Investigator............................................................................. 74,984
Senior Legal Researcher....................................................... 63,973
32. Commission on Judicial Discipline:
General Counsel................................................................ $159,930
33. Commission on Mineral Resources:
Administrator, Division of Minerals.............................. $119,335
Chief for Dangerous Mines.................................................. 85,862
Chief for Mine Regulation................................................... 85,862
Deputy Administrator, Division of Minerals.................... 95,466
Field Specialist, Minerals (each)......................................... 72,690
Program Manager, Oil, Gas and Geothermal................. 109,880
34. Nevada Gaming Control Board:
(a) Administration Division
Chief.................................................................................... $121,515
Chief Deputy........................................................................ 110,470
(b) Audit Division
Agent (each)......................................................................... $82,603
Chief...................................................................................... 121,515
Chief Deputy (each)............................................................ 110,470
Senior Agent (each)............................................................... 86,950
Special Agent (each)............................................................. 91,297
Supervisor (each)................................................................. 100,425
(c) Enforcement Division
Agent (each)......................................................................... $82,603
Chief...................................................................................... 121,515
Chief Deputy (each)............................................................ 110,470
Senior Agent (each)............................................................... 86,950
Special Agent (each)............................................................. 91,297
Supervisor (each)................................................................. 100,425
(d) Gaming Control Board
Chair.................................................................................... $170,240
Executive Secretary............................................................. 110,470
Member (each)..................................................................... 158,293
(e) Investigations Division
Agent (each)......................................................................... $82,603
Chief...................................................................................... 121,515
Chief Deputy (each)............................................................ 110,470
Investigative Services Manager (each)............................ 107,458
Senior Agent (each)............................................................... 86,950
Special Agent (each)............................................................. 91,297
Supervisor (each)................................................................. 100,425
κ2023 Statutes of Nevada, Page 3400 (CHAPTER 522, SB 341)κ
Annual
Title or Position Salary
(f) Tax and License Division
Agent (each)......................................................................... $82,603
Chief...................................................................................... 121,515
Chief Deputy........................................................................ 110,470
Senior Agent (each)............................................................... 86,950
Special Agent.......................................................................... 91,297
Supervisor (each)................................................................. 100,425
(g) Technology Division
Chief.................................................................................... $129,799
Chief Deputy, Technology................................................. 118,668
Engineer, Technology (each)............................................. 107,636
Information Security Officer............................................. 107,636
Senior Agent (each)............................................................... 86,950
Senior Engineer, Technology (each)................................ 113,016
Technician, Technology (each)........................................... 70,439
(h) Miscellaneous
Executive Assistant............................................................. $67,106
Financial Officer.................................................................... 95,609
Hearings Officer (each)...................................................... 106,414
Human Resources Manager............................................... 107,458
Information Management Coordinator.............................. 95,609
Information Technology Manager.................................... 118,392
Network Specialist I (each).................................................. 84,639
Network Specialist II (each)................................................ 93,472
Programming Manager....................................................... 111,395
Programming Supervisor................................................... 104,968
Senior Application Developer (each)................................. 94,238
Senior Economic Analyst................................................... 106,375
Senior Network Specialist.................................................. 101,482
Senior Policy Counsel......................................................... 106,375
Senior Research Specialist................................................. 106,375
Supervisor (each)................................................................. 100,425
Systems Administrator (each)........................................... 100,077
System Manager.................................................................. 111,395
35. Office of the Military:
Adjutant General............................................................... $145,217
Administrative Assistant, StarBase Program (each)........ 58,964
Administrator, Nevada National Guard Youth Challenge Program 99,236
Administrator, StarBase Program (each)........................... 92,760
Administrator, Youth Programs........................................ 122,187
Analyst Supervisor/NAIC Manager, Homeland Security 84,243
Deputy Administrator, Nevada National Guard Youth Challenge Program 92,759
Deputy Administrator, StarBase Program......................... 85,000
Division Administrator, Homeland Security.................. 133,060
Nevada National Guard Enlisted SAD (each)............... 98,940
κ2023 Statutes of Nevada, Page 3401 (CHAPTER 522, SB 341)κ
Annual
Title or Position Salary
Nevada National Guard Officer SAD (each)............ $162,846
Nevada National Guard Warrant Officer SAD (each) 111,314
Nevada National Guard, Cyber Security Specialist....... 106,744
Psychological Health Manager (each)................................ 84,229
Training Specialist (each)..................................................... 80,195
36. Peace Officers Standards and Training Commission:
Bureau Chief (each)............................................................ $87,858
Deputy Director...................................................................... 99,797
Director................................................................................. 111,313
Executive Assistant............................................................... 63,973
Training Specialist (each)..................................................... 80,195
37. Public Employees Benefits Program:
Chief Financial Officer.................................................... $108,753
Executive Assistant............................................................... 63,973
Executive Officer................................................................. 140,739
Lead Insurance Counsel..................................................... 121,547
Operations Officer............................................................... 119,628
Quality Control Officer...................................................... 108,753
38. Public Utilities Commission of Nevada:
Administrative Attorney (each)...................................... $108,753
Assistant Commission Secretary...................................... 108,753
Chair...................................................................................... 158,293
Chief Attorney (each)......................................................... 134,342
Commission Policy Adviser (each).................................. 118,080
Commission Secretary........................................................ 122,187
Consumer Outreach............................................................... 92,759
Director, Regulatory Operations....................................... 142,510
Executive Assistant (each)................................................... 63,973
Executive Director............................................................... 149,883
General Counsel................................................................... 150,765
Manager, Engineering......................................................... 135,724
Manager, Information Technology................................... 111,313
Manager, Policy Analysis.................................................. 135,807
Manager, Regulatory Accounting..................................... 122,187
Manager, Resource and Market Analysis........................ 122,187
Manager, Systems Operation............................................. 104,549
Public Education and Statistical Analysis Officer (each) 76,767
Public Utilities Commissioner (each).............................. 150,000
Regulatory Accountant (each)........................................... 101,791
Regulatory Economist (each)............................................ 106,375
Regulatory Engineer (each)............................................... 117,453
Senior Attorney (each)........................................................ 121,547
Senior Compliance Investigator.......................................... 83,221
Senior Utility Analyst (each)............................................... 83,221
Staff Counsel........................................................................ 150,765
κ2023 Statutes of Nevada, Page 3402 (CHAPTER 522, SB 341)κ
Annual
Title or Position Salary
39. Silver State Health Insurance Exchange:
Administrative Assistant (each)........................................ $54,127
Benefit Manager (each)........................................................ 69,029
Communications Officer...................................................... 84,222
Executive Assistant............................................................... 63,973
Executive Director, Silver State Health Insurance Exchange 133,060
Finance and Research Officer.............................................. 92,256
Grants and Projects Analyst................................................. 63,550
Information Systems Manager.......................................... 110,941
Information Technology Analyst........................................ 78,961
Operations Manager, Silver State Health Insurance Exchange 119,628
Quality Assurance Officer.................................................... 94,621
Training Specialist................................................................. 71,682
40. State Public Charter School Authority:
Deputy Director................................................................... $99,797
Director................................................................................. 111,313
Staff Attorney....................................................................... 108,753
41. Cannabis Compliance Board:
Administrative Law Judge............................................... $121,547
Chief of Administration...................................................... 107,458
Chief of Inspections/Audit................................................. 107,458
Chief of Investigations........................................................ 107,458
Deputy Director................................................................... 122,187
Executive Assistant............................................................... 63,973
Executive Director............................................................... 133,060
42. Medical and Related Positions:
Pharmacist 1 (each)........................................................... $113,201
Pharmacist 2 (each)............................................................. 124,520
Pharmacist 3 (each)............................................................. 136,973
Senior Institutional Dentist (Range B) (each)................ 157,422
Senior Physician (Range C) (each)................................... 176,943
Senior Psychiatrist (Range C) (each)............................... 201,133
Κ A Senior Psychiatrist (Range C) is a psychiatrist certified by the American Board of Psychiatry and Neurology, Inc.
Sec. 38. This act becomes effective upon passage and approval.
________
κ2023 Statutes of Nevada, Page 3403κ
Senate Bill No. 310Senators Goicoechea, Hansen; and Stone
CHAPTER 523
[Approved: June 15, 2023]
AN ACT relating to dentistry; providing for the licensure and regulation of expanded function dental assistants; creating a special endorsement for dental hygienists to practice restorative dental hygiene; authorizing a dental hygienist who possesses certain qualifications to prescribe and dispense certain drugs that are not controlled substances and certain devices; authorizing a public health dental hygienist to authorize an expanded function dental assistant or dental assistant to perform certain tasks under certain circumstances; providing penalties; and providing other matters properly relating thereto.
Legislative Counsels Digest:
Existing law provides for the licensure and regulation of dentists, dental hygienists and dental therapists by the Board of Dental Examiners of Nevada. (Chapter 631 of NRS) Existing law authorizes a licensed dentist to assign certain tasks to a dental assistant, who is not required to have a license. (NRS 631.313, 631.317)
Sections 4-8 of this bill provide for the licensure and regulation of expanded function dental assistants. Sections 2, 3 and 3.5 of this bill define the terms expanded function dental assistance, expanded function dental assistant and restorative dental hygiene, respectively. Section 10 of this bill makes a conforming change to indicate the proper placement of sections 2, 3 and 3.5 in the Nevada Revised Statutes.
Section 4 requires a person to be over 18 years of age to be eligible to apply for a license to practice expanded function dental assistance. Section 5 of this bill requires an applicant for such a license to: (1) possess certain education and experience; (2) hold a current certification in the techniques of administering cardiopulmonary resuscitation; and (3) pass a written clinical examination and a written jurisprudence examination administered by the Board. Section 6 of this bill authorizes a person who is licensed in another state and possesses certain other qualifications to apply for a license by endorsement as an expanded function dental assistant. Section 6 authorizes the Board to require such an applicant to complete such additional training as is necessary for the applicant to be able to practice expanded function dental assistance with the same degree of competence as a person licensed pursuant to section 5. Section 6.5 of this bill requires the Board to issue a special endorsement to practice restorative dental hygiene to a dental hygienist who has an active license in good standing to practice dental hygiene in this State and has successfully completed a course on restorative dental hygiene. Section 7 of this bill requires an expanded function dental assistant or a dental hygienist with a special endorsement to practice restorative dental hygiene to work under the authorization of a dentist and prescribes certain requirements governing the supervision of an expanded function dental assistant. Section 8 of this bill prescribes the services and procedures an expanded function dental assistant or dental hygienist with a special endorsement to practice restorative dental hygiene is authorized to perform. Section 22 of this bill requires the Board to adopt regulations governing the practice of: (1) expanded function dental assistants; and (2) dental hygienists who hold a special endorsement to practice restorative dental hygiene. Section 25 of this bill requires the Board to adopt regulations governing continuing education in expanded function dental assistance. Section 26 of this bill prescribes certain fees relating to licensure as an expanded function dental assistant, which are equal to similar fees that apply to dental hygienists.
κ2023 Statutes of Nevada, Page 3404 (CHAPTER 523, SB 310)κ
Section 36 of this bill prescribes certain activities that constitute the illegal practice of expanded function dental assistance, and section 39 of this bill makes it a crime to practice expanded function dental assistance without a license. It is also a crime to practice restorative dental hygiene without the proper special endorsement. (NRS 631.400)
Sections 11-20, 21, 23, 24, 27-35, 37-40, 42-45, 47 and 48 of this bill make revisions to certain existing provisions so that expanded function dental assistants are treated in the same manner as similar providers of oral health care in various respects.
Existing law: (1) provides for the issuance of a special endorsement as a public health dental hygienist to a dental hygienist who possesses certain qualifications; and (2) authorizes the holder of such an endorsement to provide services without the authorization or supervision of a dentist under certain circumstances. (NRS 631.287) Sections 20.5 and 42 of this bill authorize a public health dental hygienist to authorize an expanded function dental assistant or a dental assistant to perform certain tasks as part of an approved program of public health dental hygiene.
Existing law authorizes a dental hygienist to perform only those services which are authorized by a dentist, unless otherwise provided by a regulation adopted by the Board. (NRS 631.310) Sections 9, 41 and 46 of this bill authorize a dental hygienist who possesses certain qualifications to prescribe and dispense only certain drugs that are not controlled substances and are used for preventative treatment and devices used for such treatment. Section 9 prohibits such a dental hygienist from prescribing or dispensing any controlled substance or any other drug or device that is not listed in section 9. Section 9 requires the Board to adopt regulations prescribing continuing education for a dental hygienist who prescribes and dispenses the drugs and devices listed in section 9. Section 40.5 of this bill: (1) requires a dental hygienist to obtain a certification from the State Board of Pharmacy to possess, prescribe and dispense dangerous drugs and devices pursuant to section 9; and (2) authorizes the State Board of Pharmacy to deny a dental hygienist application for such a certificate or grant the certificate but limit the ability of a dental hygienist to possess, prescribe and dispense dangerous drugs and devices.
EXPLANATION Matter in bolded italics is new; matter between
brackets [omitted material] is material to be
omitted.
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1. Chapter 631 of NRS is hereby amended by adding thereto the provisions set forth as sections 2 to 9.5, inclusive, of this act:
Sec. 2. Expanded function dental assistance means the performance of educational, preventative, therapeutic, palliative and restorative treatment of intraoral or extraoral procedures under the supervision of a dentist or as otherwise authorized pursuant to this chapter by a person licensed pursuant to section 5 or 6 of this act.
Sec. 3. Expanded function dental assistant means any person who practices the profession of expanded function dental assistance and is licensed pursuant to this chapter.
Sec. 3.5. Restorative dental hygiene means the performance of educational, preventative, therapeutic, palliative and restorative treatment of intraoral or extraoral procedures under the supervision of a dentist or as otherwise authorized pursuant to this chapter by a dental hygienist who holds a special endorsement issued pursuant to section 6.5 of this act.
Sec. 4. Any person is eligible to apply for a license to practice expanded function dental assistance in this State who is over 18 years of age.
κ2023 Statutes of Nevada, Page 3405 (CHAPTER 523, SB 310)κ
Sec. 5. Except as otherwise provided in section 6 of this act, an applicant for a license as an expanded function dental assistant must include in his or her application proof that he or she:
1. Possesses the following qualifications:
(a) Graduation from an accredited program for dental assisting with expanded functions; or
(b) Successful completion of a course of training for expanded function dental assistants and:
(1) Graduation from an accredited program for dental assisting without expanded functions; or
(2) Employment as a dental assistant working full-time for at least 2 years or part-time for at least 4 years and a passing score on the examination for Certified Dental Assistants administered by the Dental Assisting National Board, or its successor organization;
2. Holds a current certification in the techniques of administering cardiopulmonary resuscitation;
3. Has passed a written clinical examination given by the Board upon such subjects as the Board deems necessary for the practice of expanded function dental assistance; and
4. Has passed a written examination given by the Board concerning laws and regulations governing the practice of expanded function dental assistance in this State.
Sec. 6. 1. An applicant for a license by endorsement as an expanded function dental assistant must include in his or her application proof that he or she:
(a) Is currently licensed as an expanded function dental assistant in another state or territory of the United States, or the District of Columbia;
(b) Possesses the following qualifications:
(1) Graduation from an accredited program for dental assisting with expanded functions; or
(2) Employment as a dental assistant or an expanded function dental assistant working full-time for at least 2 years or part-time for at least 4 years; and
(c) Has passed a written examination given by the Board concerning laws and regulations governing the practice of expanded function dental assistance in this State.
2. The Board may require an applicant for licensure by endorsement as an expanded function dental assistant to complete any training that the Board deems necessary for the applicant to be able to practice expanded function dental assistance with the same degree of competence as a person who possesses the qualifications described in section 5 of this act.
Sec. 6.5. 1. The Board shall, upon application by a dental hygienist who has the qualifications prescribed by subsection 2, issue a special endorsement of the license allowing the dental hygienist to practice restorative dental hygiene. The special endorsement may be renewed biennially upon renewal of the license of the dental hygienist.
2. An applicant for a special endorsement allowing a dental hygienist to practice restorative dental hygiene must include in his or her application proof that he or she:
(a) Holds an active license in good standing as a dental hygienist in this State; and
(b) Has successfully completed a course on restorative dental hygiene.
κ2023 Statutes of Nevada, Page 3406 (CHAPTER 523, SB 310)κ
Sec. 7. 1. An expanded function dental assistant or dental hygienist with a special endorsement of his or her license issued pursuant to section 6.5 of this act may only practice expanded function dental assistance or restorative dental hygiene, as applicable, under the authorization of a dentist who is licensed in this State, unless otherwise authorized by NRS 631.287 or a regulation adopted by the Board.
2. Except as specifically authorized by NRS 631.287 or a regulation adopted by the Board, an expanded function dental assistant shall not practice expanded function dental assistance to a person unless that person is a patient of the authorizing dentist of the expanded function dental assistant.
3. Except as specifically required by a regulation adopted by the Board, the authorizing dentist of an expanded function dental assistant is not required to be present during the provision of services by the expanded function dental assistant.
4. If the expanded function dental assistance required or requested by a patient exceeds the scope of practice or the skill and training of an expanded function dental assistant, the expanded function dental assistant shall refer the patient to the authorizing dentist of the expanded function dental assistant.
Sec. 8. An expanded function dental assistant or dental hygienist with a special endorsement to practice restorative dental hygiene may perform the following acts under the conditions prescribed by section 7 of this act:
1. Any service that a dental assistant or dental hygienist, as applicable, is authorized to perform pursuant to this chapter or any regulation adopted pursuant thereto.
2. Placing, condensing, contouring, adjusting, curing and finishing restorations that are made of a direct restorative material, including, without limitation, amalgam, resin-based composite and glass ionomer.
3. Placing and removing matrices and interproximal wedge devices.
4. Placing desensitizers, liners and bases.
5. Taking final impressions for:
(a) Indirect restorations, including, without limitation, crowns, bridges and veneers; and
(b) Removable prostheses, including, without limitation, dentures.
6. Adjusting a removable prostheses extraorally.
7. Cementation of permanent restorations, including, without limitation, crowns, bridges and veneers, if the authorizing dentist:
(a) Evaluates and approves each permanent restoration before the cementation is final; and
(b) Inspects each permanent restoration before the patient leaves the premises where the cementation occurred.
8. Placing topical fluoride.
9. Administering a hemostatic agent.
10. Applying agents for bleaching teeth.
11. Using an ultrasonic scaling unit only for the removal of bonding agents. This subsection does not authorize an expanded function dental assistant to use an ultrasonic scaling unit on any natural tooth.
κ2023 Statutes of Nevada, Page 3407 (CHAPTER 523, SB 310)κ
Sec. 9. 1. A dental hygienist who meets the requirements prescribed by regulation of the Board pursuant to subsection 4 and is issued a certificate by the State Board of Pharmacy pursuant to section 40.5 of this act may prescribe and dispense only:
(a) Topical or systemic prescription drugs, other than controlled substances, for preventative care;
(b) Fluoride preparations for which a prescription is not required;
(c) Topical antimicrobial oral rinses; and
(d) Medicament trays or mouthguards.
2. A dental hygienist shall not prescribe or dispense:
(a) A controlled substance; or
(b) Any drug or device not listed in subsection 1 or authorized under the certificate issued pursuant to section 40.5 of this act.
3. A dental hygienist may only prescribe and dispense a drug or device pursuant to subsection 1:
(a) In compliance with any applicable regulations adopted by the Board; and
(b) In compliance with any applicable law governing the handling, prescribing and dispensing of a drug or device.
4. The Board shall adopt regulations prescribing the:
(a) Education and training that a dental hygienist must complete before prescribing and dispensing a drug or device pursuant to subsection 1; and
(b) Continuing education that a dental hygienist must complete to be authorized to continue prescribing and dispensing drugs or devices pursuant to subsection 1.
Sec. 9.5. (Deleted by amendment.)
Sec. 10. NRS 631.005 is hereby amended to read as follows:
631.005 As used in this chapter, unless the context otherwise requires, the words and terms defined in NRS 631.015 to 631.105, inclusive, and sections 2, 3 and 3.5 of this act have the meanings ascribed to them in those sections.
Sec. 11. NRS 631.070 is hereby amended to read as follows:
631.070 License means a certificate issued by the Board to any applicant upon completion of requirements for admission to practice expanded function dental assistance, dental hygiene, dental therapy or dentistry, or any of the special branches of dentistry, as provided by the license.
Sec. 12. NRS 631.115 is hereby amended to read as follows:
631.115 Except as otherwise provided in subsection [2] 3 of NRS 631.317, this chapter does not apply to:
1. A legally qualified physician or surgeon unless he or she practices dentistry as a specialty.
2. A dentist, dental hygienist , [or] dental therapist or expanded function dental assistant of the United States Army, Navy, Air Force, Public Health Service, Coast Guard or Department of Veterans Affairs in the discharge of his or her official duties, including, without limitation, providing medical care in a hospital in accordance with an agreement entered into pursuant to NRS 449.2455.
κ2023 Statutes of Nevada, Page 3408 (CHAPTER 523, SB 310)κ
Sec. 13. NRS 631.130 is hereby amended to read as follows:
631.130 The Governor shall appoint:
1. Six members who are graduates of accredited dental schools or colleges, are residents of Nevada and have ethically engaged in the practice of dentistry in Nevada for a period of at least 5 years.
2. One member who has resided in Nevada for at least 5 years and who represents the interests of persons or agencies that regularly provide health care to patients who are indigent, uninsured or unable to afford health care. This member may be licensed under the provisions of this chapter.
3. Three members who:
(a) Are graduates of accredited schools or colleges of dental hygiene or dental therapy;
(b) Are residents of Nevada; and
(c) Have been actively engaged in the practice of dental hygiene or dental therapy in Nevada for a period of at least 5 years before their appointment to the Board.
4. One member who is a representative of the general public. This member must not be:
(a) A dentist, dental hygienist , [or] dental therapist [;] or expanded function dental assistant; or
(b) The spouse or the parent or child, by blood, marriage or adoption, of a dentist, dental hygienist , [or] dental therapist [.] or expanded function dental assistant.
Sec. 14. NRS 631.190 is hereby amended to read as follows:
631.190 In addition to the powers and duties provided in this chapter, the Board shall:
1. Adopt rules and regulations necessary to carry out the provisions of this chapter.
2. Appoint such committees, review panels, examiners, officers, employees, agents, attorneys, investigators and other professional consultants and define their duties and incur such expense as it may deem proper or necessary to carry out the provisions of this chapter, the expense to be paid as provided in this chapter.
3. Fix the time and place for and conduct examinations for the granting of licenses to practice dentistry, dental hygiene , [and] dental therapy [.] and expanded function dental assistance.
4. Examine applicants for licenses to practice dentistry, dental hygiene , [and] dental therapy [.] and expanded function dental assistance.
5. Collect and apply fees as provided in this chapter.
6. Keep a register of all dentists, dental hygienists , [and] dental therapists and expanded function dental assistants licensed in this State, together with their addresses, license numbers and renewal certificate numbers.
7. Have and use a common seal.
8. Keep such records as may be necessary to report the acts and proceedings of the Board. Except as otherwise provided in NRS 631.368, the records must be open to public inspection.
9. Maintain offices in as many localities in the State as it finds necessary to carry out the provisions of this chapter.
10. Have discretion to examine work authorizations in dental offices or dental laboratories.
κ2023 Statutes of Nevada, Page 3409 (CHAPTER 523, SB 310)κ
Sec. 15. NRS 631.215 is hereby amended to read as follows:
631.215 1. Any person shall be deemed to be practicing dentistry who:
(a) Uses words or any letters or title in connection with his or her name which in any way represents the person as engaged in the practice of dentistry, or any branch thereof;
(b) Advertises or permits to be advertised by any medium that the person can or will attempt to perform dental operations of any kind;
(c) Evaluates or diagnoses, professes to evaluate or diagnose or treats or professes to treat, surgically or nonsurgically, any of the diseases, disorders, conditions or lesions of the oral cavity, maxillofacial area or the adjacent and associated structures and their impact on the human body;
(d) Extracts teeth;
(e) Corrects malpositions of the teeth or jaws;
(f) Takes impressions of the teeth, mouth or gums, unless the person is authorized by the regulations of the Board to engage in such activities without being a licensed dentist;
(g) Examines a person for, or supplies artificial teeth as substitutes for natural teeth;
(h) Places in the mouth and adjusts or alters artificial teeth;
(i) Does any practice included in the clinical dental curricula of accredited dental colleges or a residency program for those colleges;
(j) Administers or prescribes such remedies, medicinal or otherwise, as are needed in the treatment of dental or oral diseases;
(k) Uses X-ray radiation or laser radiation for dental treatment or dental diagnostic purposes, unless the person is authorized by the regulations of the Board to engage in such activities without being a licensed dentist;
(l) Determines:
(1) Whether a particular treatment is necessary or advisable; or
(2) Which particular treatment is necessary or advisable; or
(m) Dispenses tooth whitening agents or undertakes to whiten or bleach teeth by any means or method, unless the person is:
(1) Dispensing or using a product that may be purchased over the counter for a persons own use; or
(2) Authorized by the regulations of the Board to engage in such activities without being a licensed dentist.
2. Nothing in this section:
(a) Prevents a dental assistant, dental hygienist, dental therapist , expanded function dental assistant or qualified technician from making radiograms or X-ray exposures for dental treatment or dental diagnostic purposes upon the direction of a licensed dentist.
(b) Prevents a dental hygienist or dental therapist from administering local anesthesia for pain management during treatment or using X-ray radiation or laser radiation for dental treatment or dental diagnostic purposes, upon authorization of a licensed dentist.
(c) Prohibits the performance of mechanical work, on inanimate objects only, by any person employed in or operating a dental laboratory upon the written work authorization of a licensed dentist.
(d) Prevents students from performing dental procedures that are part of the curricula of an accredited dental school or college or an accredited school of dental hygiene or an accredited school of dental therapy or an accredited school of dental assisting.
κ2023 Statutes of Nevada, Page 3410 (CHAPTER 523, SB 310)κ
(e) Prevents a licensed dentist , [or] dental hygienist or expanded function dental assistant from another state or country from appearing as a clinician for demonstrating certain methods of technical procedures before a dental society or organization, convention or dental college or an accredited school of dental hygiene or an accredited school of dental assisting.
(f) Prohibits the manufacturing of artificial teeth upon receipt of a written authorization from a licensed dentist if the manufacturing does not require direct contact with the patient.
(g) Prohibits the following entities from owning or operating a dental office or clinic if the entity complies with the provisions of NRS 631.3452:
(1) A nonprofit corporation organized pursuant to the provisions of chapter 82 of NRS to provide dental services to rural areas and medically underserved populations of migrant or homeless persons or persons in rural communities pursuant to the provisions of 42 U.S.C. § 254b or 254c.
(2) A federally-qualified health center as defined in 42 U.S.C. § 1396d(l)(2)(B) operating in compliance with other applicable state and federal law.
(3) A nonprofit charitable corporation as described in section 501(c)(3) of the Internal Revenue Code and determined by the Board to be providing dental services by volunteer licensed dentists at no charge or at a substantially reduced charge to populations with limited access to dental care.
(h) Prevents a person who is actively licensed as a dentist in another jurisdiction from treating a patient if:
(1) The patient has previously been treated by the dentist in the jurisdiction in which the dentist is licensed;
(2) The dentist treats the patient only during a course of continuing education involving live patients which:
(I) Is conducted at an institute or organization with a permanent facility registered with the Board for the sole purpose of providing postgraduate continuing education in dentistry; and
(II) Meets all applicable requirements for approval as a course of continuing education; and
(3) The dentist treats the patient only under the supervision of a person licensed pursuant to NRS 631.2715.
(i) Prohibits a person from providing goods or services for the support of the business of a dental practice, office or clinic owned or operated by a licensed dentist or any entity not prohibited from owning or operating a dental practice, office or clinic if the person does not:
(1) Provide such goods or services in exchange for payments based on a percentage or share of revenues or profits of the dental practice, office or clinic; or
(2) Exercise any authority or control over the clinical practice of dentistry.
(j) Prohibits a dental hygienist, dental therapist or expanded function dental assistant from engaging in any activity authorized by this chapter or the regulations adopted pursuant thereto.
3. The Board shall adopt regulations identifying activities that constitute the exercise of authority or control over the clinical practice of dentistry, including, without limitation, activities which:
(a) Exert authority or control over the clinical judgment of a licensed dentist; or
κ2023 Statutes of Nevada, Page 3411 (CHAPTER 523, SB 310)κ
(b) Relieve a licensed dentist of responsibility for the clinical aspects of the dental practice.
Κ Such regulations must not prohibit or regulate aspects of the business relationship, other than the clinical practice of dentistry, between a licensed dentist or professional entity organized pursuant to the provisions of chapter 89 of NRS and the person or entity providing goods or services for the support of the business of a dental practice, office or clinic owned or operated by the licensed dentist or professional entity.
Sec. 16. NRS 631.220 is hereby amended to read as follows:
631.220 1. Every applicant for a license to practice dental hygiene, dental therapy , expanded function dental assistance or dentistry, or any of its special branches, must:
(a) File an application with the Board.
(b) Accompany the application with a recent photograph of the applicant together with the required fee and such other documentation as the Board may require by regulation.
(c) Submit with the application a complete set of fingerprints and written permission authorizing the Board to forward the fingerprints to the Central Repository for Nevada Records of Criminal History for submission to the Federal Bureau of Investigation for its report.
(d) If the applicant is required to take an examination pursuant to NRS 631.240, 631.300 or 631.3121 [,] or section 5 or 6 of this act, submit with the application proof satisfactory that the applicant passed the examination.
2. An application must include all information required to complete the application.
3. The Secretary-Treasurer may, in accordance with regulations adopted by the Board and if the Secretary-Treasurer determines that an application is:
(a) Sufficient, advise the Executive Director of the sufficiency of the application. Upon the advice of the Secretary-Treasurer, the Executive Director may issue a license to the applicant without further review by the Board.
(b) Insufficient, reject the application by sending written notice of the rejection to the applicant.
Sec. 17. NRS 631.225 is hereby amended to read as follows:
631.225 1. In addition to any other requirements set forth in this chapter:
(a) An applicant for the issuance of a license to practice dentistry, dental hygiene , [or] dental therapy or expanded function dental assistance 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 to practice dentistry, dental hygiene , [or] dental therapy or expanded function dental assistance 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
(b) A separate form prescribed by the Board.
κ2023 Statutes of Nevada, Page 3412 (CHAPTER 523, SB 310)κ
3. A license to practice dentistry, dental hygiene , [or] dental therapy or expanded function dental assistance may not be issued or renewed by the Board 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.
Sec. 18. NRS 631.260 is hereby amended to read as follows:
631.260 Except as otherwise provided in subsection 3 of NRS 631.220, as soon as possible after the examination has been given, the Board, under rules and regulations adopted by it, shall determine the qualifications of the applicant and shall issue to each person found by the Board to have the qualifications therefor a license which will entitle the person to practice dental hygiene, dental therapy , expanded function dental assistance or dentistry, or any special branch of dentistry, as in such license defined, subject to the provisions of this chapter.
Sec. 19. NRS 631.271 is hereby amended to read as follows:
631.271 1. The Board shall, without a clinical examination required by NRS 631.240, 631.300 or 631.3121, issue a limited license to practice dentistry, dental hygiene , [or] dental therapy or expanded function dental assistance to a person who:
(a) Is qualified for a license to practice dentistry, dental hygiene , [or] dental therapy or expanded function dental assistance in this State;
(b) Pays the required application fee;
(c) Has entered into a contract with:
(1) The Nevada System of Higher Education to provide services as a dental intern, dental resident or instructor of dentistry, dental hygiene , [or] dental therapy or expanded function dental assistance at an educational or outpatient clinic, hospital or other facility of the Nevada System of Higher Education; or
(2) An accredited program of dentistry, dental hygiene , [or] dental therapy or expanded function dental assistance of an institution which is accredited by a regional educational accrediting organization that is recognized by the United States Department of Education to provide services as a dental intern, dental resident or instructor of dentistry, dental hygiene , [or] dental therapy or expanded function dental assistance at an educational or outpatient clinic, hospital or other facility of the institution and accredited by the Commission on Dental Accreditation of the American Dental Association or its successor specialty accrediting organization;
(d) Satisfies the requirements of NRS 631.230, 631.290 or 631.312, as appropriate; and
(e) Satisfies at least one of the following requirements:
κ2023 Statutes of Nevada, Page 3413 (CHAPTER 523, SB 310)κ
(1) Has a license to practice dentistry, dental hygiene , [or] dental therapy or expanded function dental assistance issued pursuant to the laws of another state or territory of the United States, or the District of Columbia;
(2) Presents to the Board a certificate granted by the Western Regional Examining Board which contains a notation that the person has passed, within the 5 years immediately preceding the date of the application, a clinical examination administered by the Western Regional Examining Board;
(3) Successfully passes a clinical examination approved by the Board and the American Board of Dental Examiners; or
(4) Has the educational or outpatient clinic, hospital or other facility where the person will provide services as a dental intern or dental resident in an internship or residency program submit to the Board written confirmation that the person has been appointed to a position in the program. If a person qualifies for a limited license pursuant to this subparagraph, the limited license remains valid only while the person is actively providing services as a dental intern or dental resident in the internship or residency program and is in compliance with all other requirements for the limited license.
2. The Board shall not issue a limited license to a person:
(a) Who has been issued a license to practice dentistry, dental hygiene , [or] dental therapy or expanded function dental assistance if:
(1) The person is involved in a disciplinary action concerning the license; or
(2) The license has been revoked or suspended; or
(b) Who has been refused a license to practice dentistry, dental hygiene , [or] dental therapy [,] or expanded function dental assistance,
Κ in this State, another state or territory of the United States, or the District of Columbia.
3. Except as otherwise provided in subsection 4, a person to whom a limited license is issued pursuant to subsection 1:
(a) May practice dentistry, dental hygiene , [or] dental therapy or expanded function dental assistance in this State only:
(1) At the educational or outpatient clinic, hospital or other facility where the person is employed; and
(2) In accordance with the contract required by paragraph (c) of subsection 1.
(b) Shall not, for the duration of the limited license, engage in the private practice of dentistry, dental hygiene , [or] dental therapy or expanded function dental assistance in this State or accept compensation for the practice of dentistry, dental hygiene , [or] dental therapy or expanded function dental assistance except such compensation as may be paid to the person by the Nevada System of Higher Education or an accredited program of dentistry, dental hygiene , [or] dental therapy or expanded function dental assistance for services provided as a dental intern, dental resident or instructor of dentistry, dental hygiene , [or] dental therapy or expanded function dental assistance pursuant to paragraph (c) of subsection 1.
4. The Board may issue a permit authorizing a person who holds a limited license to engage in the practice of dentistry, dental hygiene , [or] dental therapy or expanded function dental assistance in this State and to accept compensation for such practice as may be paid to the person by entities other than the Nevada System of Higher Education or an accredited program of dentistry, dental hygiene , [or] dental therapy or expanded function dental assistance with whom the person is under contract pursuant to paragraph (c) of subsection 1.
κ2023 Statutes of Nevada, Page 3414 (CHAPTER 523, SB 310)κ
function dental assistance with whom the person is under contract pursuant to paragraph (c) of subsection 1. The Board shall, by regulation, prescribe the standards, conditions and other requirements for the issuance of a permit.
5. A limited license expires 1 year after its date of issuance and may be renewed on or before the date of its expiration, unless the holder no longer satisfies the requirements for the limited license. The holder of a limited license may, upon compliance with the applicable requirements set forth in NRS 631.330 and the completion of a review conducted at the discretion of the Board, be granted a renewal certificate that authorizes the continuation of practice pursuant to the limited license for 1 year.
6. A permit issued pursuant to subsection 4 expires on the date that the holders limited license expires and may be renewed when the limited license is renewed, unless the holder no longer satisfies the requirements for the permit.
7. Within 7 days after the termination of a contract required by paragraph (c) of subsection 1, the holder of a limited license shall notify the Board of the termination, in writing, and surrender the limited license and a permit issued pursuant to this section, if any, to the Board.
8. The Board may revoke a limited license and a permit issued pursuant to this section, if any, at any time if the Board finds, by a preponderance of the evidence, that the holder of the license violated any provision of this chapter or the regulations of the Board.
Sec. 20. NRS 631.274 is hereby amended to read as follows:
631.274 1. The Board shall, without a clinical examination required by NRS 631.240, 631.300 or 631.3121 [,] or section 5 of this act, issue a restricted geographical license to practice dentistry, dental hygiene , [or] dental therapy or expanded function dental assistance to a person if the person meets the requirements of subsection 2 and:
(a) A board of county commissioners submits a request that the Board of Dental Examiners of Nevada waive the requirements of NRS 631.240, 631.300 or 631.3121 or section 5 of this act for any applicant intending to practice dentistry, dental hygiene , [or] dental therapy or expanded function dental assistance in a rural area of a county in which dental, dental hygiene , [or] dental therapy or expanded function dental assistance needs are underserved , as that term is defined by the officer of rural health of the University of Nevada School of Medicine;
(b) Two or more boards of county commissioners submit a joint request that the Board of Dental Examiners of Nevada waive the requirements of NRS 631.240, 631.300 or 631.3121 or section 5 of this act for any applicant intending to practice dentistry, dental hygiene , [or] dental therapy or expanded function dental assistance in one or more rural areas within those counties in which dental, dental hygiene , [or] dental therapy or expanded function dental assistance needs are underserved , as that term is defined by the officer of rural health of the University of Nevada School of Medicine; or
(c) The director of a federally qualified health center or a nonprofit clinic submits a request that the Board waive the requirements of NRS 631.240, 631.300 or 631.3121 or section 5 of this act for any applicant who has entered into a contract with a federally qualified health center or nonprofit clinic which treats underserved populations in Washoe County or Clark County.
2. A person may apply for a restricted geographical license if the person:
κ2023 Statutes of Nevada, Page 3415 (CHAPTER 523, SB 310)κ
(a) Has a license to practice dentistry, dental hygiene , [or] dental therapy or expanded function dental assistance issued pursuant to the laws of another state or territory of the United States, or the District of Columbia;
(b) Is otherwise qualified for a license to practice dentistry, dental hygiene , [or] dental therapy or expanded function dental assistance in this State;
(c) Pays the application, examination and renewal fees in the same manner as a person licensed pursuant to NRS 631.240, 631.300 or 631.3121 [;] or section 5 of this act;
(d) Submits all information required to complete an application for a license; and
(e) Satisfies the requirements of NRS 631.230, 631.290 or 631.312 [,] or section 4 of this act, as appropriate.
3. The Board shall not issue a restricted geographical license to a person:
(a) Whose license to practice dentistry, dental hygiene , [or] dental therapy or expanded function dental assistance has been revoked or suspended;
(b) Who has been refused a license to practice dentistry, dental hygiene , [or] dental therapy [;] or expanded function dental assistance; or
(c) Who is involved in or has pending a disciplinary action concerning a license to practice dentistry, dental hygiene , [or] dental therapy [,] or expanded function dental assistance,
Κ in this State, another state or territory of the United States, or the District of Columbia.
4. The Board shall examine each applicant in writing on the contents and interpretation of this chapter and the regulations of the Board.
5. A person to whom a restricted geographical license is issued pursuant to this section:
(a) May practice dentistry, dental hygiene , [or] dental therapy or expanded function dental assistance only in the county or counties which requested the restricted geographical licensure pursuant to paragraph (a) or (b) of subsection 1.
(b) Shall not, for the duration of the restricted geographical license, engage in the private practice of dentistry, dental hygiene , [or] dental therapy or expanded function dental assistance in this State or accept compensation for the practice of dentistry, dental hygiene , [or] dental therapy or expanded function dental assistance except such compensation as may be paid to the person by a federally qualified health center or nonprofit clinic pursuant to paragraph (c) of subsection 1.
6. Within 7 days after the termination of a contract pursuant to paragraph (c) of subsection 1, the holder of a restricted geographical license shall notify the Board of the termination, in writing, and surrender the restricted geographical license.
7. A person to whom a restricted geographical license was issued pursuant to this section may petition the Board for an unrestricted license without a clinical examination required by NRS 631.240, 631.300 or 631.3121 or section 5 of this act if the person:
(a) Has not had a license to practice dentistry, dental hygiene , [or] dental therapy or expanded function dental assistance revoked or suspended in this State, another state or territory of the United States, or the District of Columbia;
κ2023 Statutes of Nevada, Page 3416 (CHAPTER 523, SB 310)κ
(b) Has not been refused a license to practice dentistry, dental hygiene , [or] dental therapy or expanded function dental assistance in this State, another state or territory of the United States, or the District of Columbia;
(c) Is not involved in or does not have pending a disciplinary action concerning a license to practice dentistry, dental hygiene , [or] dental therapy or expanded function dental assistance in this State, another state or territory of the United States, or the District of Columbia; and
(d) Has:
(1) Actively practiced dentistry, dental hygiene , [or] dental therapy or expanded function dental assistance for 3 years at a minimum of 30 hours per week in the county or counties which requested the restricted geographical licensure pursuant to paragraph (a) or (b) of subsection 1; or
(2) Been under contract with a federally qualified health center or nonprofit clinic for a minimum of 3 years.
8. The Board may revoke a restricted geographical license at any time if the Board finds, by a preponderance of the evidence, that the holder of the license violated any provision of this chapter or the regulations of the Board.
Sec. 20.5. NRS 631.287 is hereby amended to read as follows:
631.287 1. The Board shall, upon application by a dental hygienist who is licensed pursuant to this chapter and has such qualifications as the Board specifies by regulation, issue a special endorsement of the license allowing the dental hygienist to practice public health dental hygiene. The special endorsement may be renewed biennially upon the renewal of the license of the dental hygienist.
2. A dental hygienist who holds a special endorsement issued pursuant to subsection 1 may provide services without the authorization or supervision of a dentist only as specified by regulations adopted by the Board.
3. As part of a program for the provision of public health dental hygiene approved by the Board, a dental hygienist with a special endorsement to practice public health dental hygiene may authorize a dental assistant or expanded function dental assistant under his or her direct supervision to:
(a) Apply dental sealants;
(b) Apply topical fluoride;
(c) Perform coronal polishing;
(d) Take radiographs; and
(e) Provide oral health education.
Sec. 21. NRS 631.313 is hereby amended to read as follows:
631.313 1. Except as otherwise provided in NRS 454.217 and 629.086, a licensed dentist may assign to a person in his or her employ who is a dental hygienist, a dental therapist, a dental assistant , an expanded function dental assistant or other person directly or indirectly involved in the provision of dental care only such intraoral tasks as may be permitted by a regulation of the Board or by the provisions of this chapter.
2. The performance of these tasks must be:
(a) If performed by a dental assistant or a person, other than a dental hygienist or dental therapist, who is directly or indirectly involved in the provision of dental care, under the supervision of the licensed dentist who made the assignment.
κ2023 Statutes of Nevada, Page 3417 (CHAPTER 523, SB 310)κ
(b) If performed by a dental hygienist , [or] dental therapist [,] or expanded function dental assistant, authorized by the licensed dentist of the patient for whom the tasks will be performed, except as otherwise provided in NRS 631.287.
3. No such assignment is permitted that requires:
(a) [The] Except as otherwise provided in sections 8 and 9 of this act, the diagnosis, treatment planning, prescribing of drugs or medicaments, or authorizing the use of restorative, prosthodontic or orthodontic appliances.
(b) Surgery on hard or soft tissues within the oral cavity or any other intraoral procedure that may contribute to or result in an irremediable alteration of the oral anatomy.
(c) The administration of general anesthesia, minimal sedation, moderate sedation or deep sedation except as otherwise authorized by regulations adopted by the Board.
(d) The performance of a task outside the authorized scope of practice of the employee who is being assigned the task.
4. A dental hygienist may, pursuant to regulations adopted by the Board, administer local anesthesia or nitrous oxide in a health care facility, as defined in NRS 162A.740, if:
(a) The dental hygienist is so authorized by the licensed dentist of the patient to whom the local anesthesia or nitrous oxide is administered; and
(b) The health care facility has licensed medical personnel and necessary emergency supplies and equipment available when the local anesthesia or nitrous oxide is administered.
Sec. 22. NRS 631.317 is hereby amended to read as follows:
631.317 The Board shall adopt rules or regulations:
1. Specifying the intraoral tasks that may be assigned by a licensed dentist to a dental hygienist, dental therapist or dental assistant in his or her employ or that may be performed by a dental hygienist or dental therapist engaged in school health activities or employed by a public health agency.
2. Specifying the intraoral tasks, in addition to those prescribed by section 8 of this act, that may be assigned by a licensed dentist to an expanded function dental assistant or dental hygienist with a special endorsement to practice restorative dental hygiene in his or her employ or that may be performed by an expanded function dental assistant or dental hygienist with a special endorsement to practice restorative dental hygiene engaged in school health activities or employed by a public health agency.
3. Governing the practice of dentists, dental hygienists , [and] dental therapists and expanded function dental assistants in full-time employment with the State of Nevada.
Sec. 23. NRS 631.330 is hereby amended to read as follows:
631.330 1. Licenses issued pursuant to NRS 631.271, 631.2715 and 631.275 must be renewed annually. All other licenses must be renewed biennially.
2. Except as otherwise provided in NRS 631.271, 631.2715 and 631.275:
(a) Each holder of a license to practice dentistry, dental hygiene , [or] dental therapy or expanded function dental assistance must, upon:
(1) Payment of the required fee;
(2) Submission of proof of completion of the required continuing education; and
(3) Submission of all information required to complete the renewal,
κ2023 Statutes of Nevada, Page 3418 (CHAPTER 523, SB 310)κ
Κ be granted a renewal certificate which will authorize continuation of the practice for 2 years.
(b) A licensee must comply with the provisions of this subsection and subsection 1 on or before June 30. Failure to comply with those provisions by June 30 every 2 years automatically suspends the license, and it may be reinstated only upon payment of the fee for reinstatement and compliance with the requirements of this subsection.
3. If a license suspended pursuant to this section is not reinstated within 12 months after suspension, it is automatically revoked.
Sec. 24. NRS 631.340 is hereby amended to read as follows:
631.340 1. Any person who has obtained from the Board a license certificate to practice dental hygiene, dental therapy , expanded function dental assistance or dentistry or any special branch of dentistry in this State, and who fails to obtain a renewal certificate, must, before resuming the practice in which he or she was licensed, make application to the Secretary-Treasurer, under such rules as the Board may prescribe, for the restoration of the license to practice.
2. Upon application being made, the Secretary-Treasurer shall determine whether the applicant possesses the qualifications prescribed for the granting of a license to practice in his or her particular profession, and whether the applicant continues to possess a good moral character and is not otherwise disqualified to practice in this State. If the Secretary-Treasurer so determines, the Secretary-Treasurer shall thereupon issue the license, and thereafter the person may make application annually for a renewal certificate, as provided in this chapter.
Sec. 25. NRS 631.342 is hereby amended to read as follows:
631.342 1. The Board shall adopt regulations concerning continuing education in dentistry, dental hygiene , [and] dental therapy [.] and expanded function dental assistance. The regulations must include:
(a) Except as provided in NRS 631.3425, the number of hours of credit required annually;
(b) The criteria used to accredit each course; and
(c) The requirements for submission of proof of attendance at courses.
2. Except as otherwise provided in subsection 3, as part of continuing education, each licensee must complete a course of instruction, within 2 years after initial licensure, relating to the medical consequences of an act of terrorism that involves the use of a weapon of mass destruction. The course must provide at least 4 hours of instruction that includes instruction in the following subjects:
(a) An overview of acts of terrorism and weapons of mass destruction;
(b) Personal protective equipment required for acts of terrorism;
(c) Common symptoms and methods of treatment associated with exposure to, or injuries caused by, chemical, biological, radioactive and nuclear agents;
(d) Syndromic surveillance and reporting procedures for acts of terrorism that involve biological agents; and
(e) An overview of the information available on, and the use of, the Health Alert Network.
3. Instead of the course described in subsection 2, a licensee may complete:
κ2023 Statutes of Nevada, Page 3419 (CHAPTER 523, SB 310)κ
(a) A course in Basic Disaster Life Support or a course in Core Disaster Life Support if the course is offered by a provider of continuing education accredited by the National Disaster Life Support Foundation; or
(b) Any other course that the Board determines to be the equivalent of a course specified in paragraph (a).
4. Notwithstanding the provisions of subsections 2 and 3, the Board may determine whether to include in a program of continuing education additional courses of instruction relating to the medical consequences of an act of terrorism that involves the use of a weapon of mass destruction.
5. Each licensee must complete, as part of continuing education, at least 2 hours of training in the screening, brief intervention and referral to treatment approach to substance use disorder within 2 years after initial licensure.
6. As used in this section:
(a) Act of terrorism has the meaning ascribed to it in NRS 202.4415.
(b) Biological agent has the meaning ascribed to it in NRS 202.442.
(c) Chemical agent has the meaning ascribed to it in NRS 202.4425.
(d) Radioactive agent has the meaning ascribed to it in NRS 202.4437.
(e) Weapon of mass destruction has the meaning ascribed to it in NRS 202.4445.
Sec. 26. NRS 631.345 is hereby amended to read as follows:
631.345 1. Except as otherwise provided in NRS 631.2715, the Board shall by regulation establish fees for the performance of the duties imposed upon it by this chapter which must not exceed the following amounts:
Application fee for an initial license to practice dentistry........... $1,500
Application fee for an initial license to practice dental hygiene or expanded function dental assistance 750
Application fee for an initial license to practice dental therapy.... 1,000
Application fee for a specialists license to practice dentistry......... 300
Application fee for a limited license or restricted license to practice dentistry, dental hygiene , [or] dental therapy or expanded function dental assistance....................................... 300
Fee for administering a clinical examination in dentistry.............. 2,500
Fee for administering a clinical examination in dental hygiene , [or] dental therapy or expanded function dental assistance......................................................................................... 1,500
Application and examination fee for a permit to administer general anesthesia, minimal sedation, moderate sedation or deep sedation................................................................................. 750
Fee for any reinspection required by the Board to maintain a permit to administer general anesthesia, minimal sedation, moderate sedation or deep sedation............................... 500
Biennial renewal fee for a permit to administer general anesthesia, minimal sedation, moderate sedation or deep sedation................................................................................................ 600
Fee for the inspection of a facility required by the Board to renew a permit to administer general anesthesia, minimal sedation, moderate sedation or deep sedation............................... 350
κ2023 Statutes of Nevada, Page 3420 (CHAPTER 523, SB 310)κ
Fee for the inspection of a facility required by the Board to ensure compliance with infection control guidelines............................................................................................................ $500
Biennial license renewal fee for a general license, specialists license, temporary license or restricted geographical license to practice dentistry.......................................................... 1,000
Annual license renewal fee for a limited license or restricted license to practice dentistry 300
Biennial license renewal fee for a general license, temporary license or restricted geographical license to practice dental hygiene , [or] dental therapy or expanded function dental assistance 600
Annual license renewal fee for a limited license to practice dental hygiene , [or] dental therapy or expanded function dental assistance................................................................................ 300
Biennial license renewal fee for an inactive dentist........................... 400
Biennial license renewal fee for a dentist who is retired or has a disability 100
Biennial license renewal fee for an inactive dental hygienist , [or] dental therapist or expanded function dental assistant............................................................................................... 200
Biennial license renewal fee for a dental hygienist , [or] dental therapist or expanded function dental assistant who is retired or has a disability.............................................................. 100
Reinstatement fee for a suspended license to practice dentistry, dental hygiene , [or] dental therapy or expanded function dental assistance............................................................... 500
Reinstatement fee for a revoked license to practice dentistry, dental hygiene , [or] dental therapy or expanded function dental assistance............................................................... 500
Reinstatement fee to return a dentist, dental hygienist , [or] dental therapist or expanded function dental assistant who is inactive, retired or has a disability to active status.......... 500
Fee for the certification of a license........................................................ 50
2. Except as otherwise provided in this subsection, the Board shall charge a fee to review a course of continuing education for accreditation. The fee must not exceed $150 per credit hour of the proposed course. The Board shall not charge a nonprofit organization or an agency of the State or of a political subdivision of the State a fee to review a course of continuing education.
3. All fees prescribed in this section are payable in advance and must not be refunded.
Sec. 27. NRS 631.3452 is hereby amended to read as follows:
631.3452 Except as otherwise provided in NRS 631.3453, an entity that owns or operates a dental office or clinic as described in paragraph (g) of subsection 2 of NRS 631.215 must:
1. Designate an actively licensed dentist as the dental director of the dental office or clinic. The dental director shall have responsibility for the clinical practice of dentistry at the dental office or clinic, including, without limitation:
κ2023 Statutes of Nevada, Page 3421 (CHAPTER 523, SB 310)κ
(a) Diagnosing or treating any of the diseases or lesions of the oral cavity, teeth, gingiva or the supporting structures thereof.
(b) Administering or prescribing such remedies, medicinal or otherwise, as are needed in the treatment of dental or oral diseases.
(c) Determining:
(1) Whether a particular treatment is necessary or advisable; or
(2) Which particular treatment is necessary or advisable.
(d) The overall quality of patient care that is rendered or performed in the clinical practice of dentistry.
(e) Supervising dental hygienists, dental therapists, dental assistants , expanded function dental assistants and other personnel involved in direct patient care and authorizing procedures performed by the dental hygienists, dental therapists, dental assistants , expanded function dental assistants and other personnel in accordance with the standards of supervision established by law or regulations adopted pursuant thereto.
(f) Providing any other specific services that are within the scope of clinical dental practice.
(g) Retaining patient dental records as required by law and regulations adopted by the Board.
(h) Ensuring that each patient receiving services from the dental office or clinic has a dentist of record.
2. Maintain current records of the names of licensed dentists who supervise the clinical activities of dental hygienists, dental therapists, dental assistants , expanded function dental assistants or other personnel involved in direct patient care. The records must be available to the Board upon written request.
Sec. 28. NRS 631.3455 is hereby amended to read as follows:
631.3455 Nothing in this chapter precludes a person or entity not licensed by the Board from providing goods or services for the support of the business of a dental practice, office or clinic if the person or entity does not manage or control the clinical practice of dentistry. Such goods and services may include, without limitation, transactions involving:
1. Real and personal property, other than the ownership of the clinical records of patients; and
2. Personnel, other than licensed dentists, dental hygienists , [and] dental therapists [.] and expanded function dental assistants.
Sec. 29. NRS 631.346 is hereby amended to read as follows:
631.346 The following acts, among others, constitute unprofessional conduct:
1. Employing, directly or indirectly, any student or any suspended or unlicensed dentist, dental hygienist , [or] dental therapist or expanded function dental assistant to perform operations of any kind to treat or correct the teeth or jaws, except as provided in this chapter;
2. Except as otherwise provided in NRS 631.287 or 631.3453, giving a public demonstration of methods of practice any place other than the office where the licensee is known to be regularly engaged in this practice;
3. Employing, procuring, inducing, aiding or abetting a person not licensed or registered as a dentist to engage in the practice of dentistry, but a patient shall not be deemed to be an accomplice, employer, procurer, inducer, aider or abettor;
4. For a dental hygienist or dental therapist, practicing in any place not authorized pursuant to this chapter; or
κ2023 Statutes of Nevada, Page 3422 (CHAPTER 523, SB 310)κ
5. Practicing while a license is suspended or without a renewal certificate.
Sec. 30. NRS 631.3465 is hereby amended to read as follows:
631.3465 The following acts, among others, constitute unprofessional conduct:
1. Dividing fees or agreeing to divide fees received for services with any person for bringing or referring a patient, without the knowledge of the patient or his or her legal representative, but licensed dentists are not prohibited from:
(a) Practicing in a partnership and sharing professional fees;
(b) Employing another licensed dentist, dental hygienist , [or] dental therapist [;] or expanded function dental assistant; or
(c) Rendering services as a member of a nonprofit professional service corporation.
2. Associating with or lending his or her name to any person engaged in the illegal practice of dentistry or associating with any person, firm or corporation holding himself, herself or itself out in any manner contrary to the provisions of this chapter.
3. Associating with or being employed by a person not licensed pursuant to this chapter if that person exercises control over the services offered by the dentist, owns all or part of the dentists practice or receives or shares the fees received by the dentist. The provisions of this subsection do not apply to a dentist who associates with or is employed by a person who owns or controls a dental practice pursuant to NRS 631.385.
4. Using the name clinic, institute, referral services or other title or designation that may suggest a public or semipublic activity.
5. Practicing under the name of a dentist who has not been in active practice for more than 1 year.
Sec. 31. NRS 631.3475 is hereby amended to read as follows:
631.3475 The following acts, among others, constitute unprofessional conduct:
1. Malpractice;
2. Professional incompetence;
3. Suspension or revocation of a license to practice dentistry, the imposition of a fine or other disciplinary action by any agency of another state authorized to regulate the practice of dentistry in that state;
4. More than one act by the dentist, dental hygienist , [or] dental therapist or expanded function dental assistant constituting substandard care in the practice of dentistry, dental hygiene , [or] dental therapy [;] or expanded function dental assistance, as applicable;
5. Administering, dispensing or prescribing any controlled substance or any dangerous drug as defined in chapter 454 of NRS, if it is not required to treat the dentists patient;
6. Knowingly procuring or administering a controlled substance or a dangerous drug as defined in chapter 454 of NRS that is not approved by the United States Food and Drug Administration, unless the unapproved controlled substance or dangerous drug:
(a) Was procured through a retail pharmacy licensed pursuant to chapter 639 of NRS;
(b) Was procured through a Canadian pharmacy which is licensed pursuant to chapter 639 of NRS and which has been recommended by the State Board of Pharmacy pursuant to subsection 4 of NRS 639.2328; or
κ2023 Statutes of Nevada, Page 3423 (CHAPTER 523, SB 310)κ
(c) Is cannabis being used for medical purposes in accordance with chapter 678C of NRS;
7. Having an alcohol or other substance use disorder to such an extent as to render the person unsafe or unreliable as a practitioner, or such gross immorality as tends to bring reproach upon the dental profession;
8. Conviction of a felony or misdemeanor involving moral turpitude or which relates to the practice of dentistry in this State, or conviction of any criminal violation of this chapter;
9. Conviction of violating any of the provisions of NRS 616D.200, 616D.220, 616D.240 or 616D.300 to 616D.440, inclusive;
10. Failure to comply with the provisions of NRS 453.163, 453.164, 453.226, 639.23507, 639.23535 and 639.2391 to 639.23916, inclusive, and any regulations adopted by the State Board of Pharmacy pursuant thereto.
11. Fraudulent, illegal, unauthorized or otherwise inappropriate prescribing, administering or dispensing of a controlled substance listed in schedule II, III or IV;
12. Failure to comply with the provisions of NRS 454.217 or 629.086;
13. Failure to obtain any training required by the Board pursuant to NRS 631.344;
14. The performance or supervision of the performance of a pelvic examination in violation of NRS 629.085; or
15. Operation of a medical facility, as defined in NRS 449.0151, at any time during which:
(a) The license of the facility is suspended or revoked; or
(b) An act or omission occurs which results in the suspension or revocation of the license pursuant to NRS 449.160.
Κ This subsection applies to an owner or other principal responsible for the operation of the facility.
Sec. 32. NRS 631.3485 is hereby amended to read as follows:
631.3485 1. The following acts, among others, constitute unprofessional conduct:
(a) Willful or repeated violations of the provisions of this chapter;
(b) Willful or repeated violations of the regulations of the State Board of Health, the State Board of Pharmacy or the Board of Dental Examiners of Nevada;
(c) Failure to pay the fees for a license; or
(d) Failure to make the health care records of a patient available for inspection and copying as provided in NRS 629.061, if the dentist, dental hygienist , [or] dental therapist or expanded function dental assistant is the custodian of health care records with respect to those records.
2. As used in this section, custodian of health care records has the meaning ascribed to it in NRS 629.016.
Sec. 33. NRS 631.3487 is hereby amended to read as follows:
631.3487 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 to practice dentistry, dental hygiene , [or] dental therapy [,] or expanded function dental assistance the Board shall deem the license 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 by the district attorney or other public agency pursuant to NRS 425.550 stating that the holder of the license has complied with the subpoena or warrant or has satisfied the arrearage pursuant to NRS 425.560.
κ2023 Statutes of Nevada, Page 3424 (CHAPTER 523, SB 310)κ
other public agency pursuant to NRS 425.550 stating that the holder of the license has complied with the subpoena or warrant or has satisfied the arrearage pursuant to NRS 425.560.
2. The Board shall reinstate a license to practice dentistry, dental hygiene , [or] dental therapy or expanded function dental assistance that has been suspended by a district court pursuant to NRS 425.540 if:
(a) The Board receives a letter issued by the district attorney or other public agency pursuant to NRS 425.550 to the person whose license was suspended stating that the person whose license was suspended has complied with the subpoena or warrant or has satisfied the arrearage pursuant to NRS 425.560; and
(b) The person whose license was suspended pays the fee imposed pursuant to NRS 631.345 for the reinstatement of a suspended license.
Sec. 34. NRS 631.350 is hereby amended to read as follows:
631.350 1. Except as otherwise provided in NRS 631.271, 631.2715 and 631.347, the Board may:
(a) Refuse to issue a license to any person;
(b) Revoke or suspend the license or renewal certificate issued by it to any person;
(c) Fine a person it has licensed;
(d) Place a person on probation for a specified period on any conditions the Board may order;
(e) Issue a public reprimand to a person;
(f) Limit a persons practice to certain branches of dentistry;
(g) Require a person to participate in a program relating to an alcohol or other substance use disorder or any other impairment;
(h) Require that a persons practice be supervised;
(i) Require a person to perform community service without compensation;
(j) Require a person to take a physical or mental examination or an examination of his or her competence;
(k) Require a person to fulfill certain training or educational requirements;
(l) Require a person to reimburse a patient; or
(m) Any combination thereof,
Κ if the Board finds, by a preponderance of the evidence, that the person has engaged in any of the activities listed in subsection 2.
2. The following activities may be punished as provided in subsection 1:
(a) Engaging in the illegal practice of dentistry, dental hygiene , [or] dental therapy [;] or expanded function dental assistance;
(b) Engaging in unprofessional conduct; or
(c) Violating any regulations adopted by the Board or the provisions of this chapter.
3. The Board may delegate to a hearing officer or panel its authority to take any disciplinary action pursuant to this chapter, impose and collect fines therefor and deposit the money therefrom in banks, credit unions, savings and loan associations or savings banks in this State.
4. If a hearing officer or panel is not authorized to take disciplinary action pursuant to subsection 3 and the Board deposits the money collected from the imposition of fines with the State Treasurer for credit to the State General Fund, it may present a claim to the State Board of Examiners for recommendation to the Interim Finance Committee if money is needed to pay attorneys fees or the costs of an investigation, or both.
κ2023 Statutes of Nevada, Page 3425 (CHAPTER 523, SB 310)κ
recommendation to the Interim Finance Committee if money is needed to pay attorneys fees or the costs of an investigation, or both.
5. The Board shall not administer a private reprimand.
6. An order that imposes discipline and the findings of fact and conclusions of law supporting that order are public records.
Sec. 35. NRS 631.360 is hereby amended to read as follows:
631.360 1. Except as otherwise provided in NRS 631.364, the Board may, upon its own motion, and shall, upon the verified complaint in writing of any person setting forth facts which, if proven, would constitute grounds for initiating disciplinary action, investigate the actions of any person who practices dentistry, dental hygiene , [or] dental therapy or expanded function dental assistance in this State. A complaint may be filed anonymously. If a complaint is filed anonymously, the Board may accept the complaint but may refuse to consider the complaint if anonymity of the complainant makes processing the complaint impossible or unfair to the person who is the subject of the complaint.
2. The Board shall, before initiating disciplinary action, at least 10 days before the date set for the hearing, notify the accused person in writing of any charges made. The notice may be served by delivery of it personally to the accused person or by mailing it by registered or certified mail to the place of business last specified by the accused person, as registered with the Board.
3. At the time and place fixed in the notice, the Board shall proceed to hear the charges. If the Board receives a report pursuant to subsection 5 of NRS 228.420, a hearing must be held within 30 days after receiving the report.
4. The Board may compel the attendance of witnesses or the production of documents or objects by subpoena. The Board may adopt regulations that set forth a procedure pursuant to which the Executive Director may issue subpoenas on behalf of the Board. Any person who is subpoenaed pursuant to this subsection may request the Board to modify the terms of the subpoena or grant additional time for compliance.
5. The Board may obtain a search warrant from a magistrate upon a showing that the warrant is needed for an investigation or hearing being conducted by the Board and that reasonable cause exists to issue the warrant.
6. If the Board is not sitting at the time and place fixed in the notice, or at the time and place to which the hearing has been continued, the Board shall continue the hearing for a period not to exceed 30 days.
7. The Board shall retain all complaints received by the Board pursuant to this section for at least 10 years, including, without limitation, any complaints not acted upon.
Sec. 36. NRS 631.395 is hereby amended to read as follows:
631.395 A person is guilty of the illegal practice of dentistry, dental hygiene , [or] dental therapy or expanded function dental assistance who:
1. Sells or barters, or offers to sell or barter, any diploma or document conferring or purporting to confer any dental degree, or any certificate or transcript made or purporting to be made pursuant to the laws regulating the licensing and registration of dentists, dental hygienists , [or] dental therapists [;] or expanded function dental assistants;
2. Purchases or procures by barter any such diploma, certificate or transcript, with the intent that it be used as evidence of the holders qualifications to practice dentistry, or in fraud of the laws regulating that practice;
κ2023 Statutes of Nevada, Page 3426 (CHAPTER 523, SB 310)κ
3. With fraudulent intent, alters in a material regard any such diploma, certificate or transcript;
4. Uses or attempts to use any diploma, certificate or transcript, which has been purchased, fraudulently issued, counterfeited or materially altered, either as a license or color of license to practice dentistry, or in order to procure registration as a dentist, dental hygienist , [or] dental therapist [;] or expanded function dental assistant;
5. Practices dentistry under a false or assumed name;
6. Assumes the degree of Doctor of Dental Surgery or Doctor of Dental Medicine or appends the letters D.D.S. or D.M.D. or R.D.H. to his or her name, not having conferred upon him or her, by diploma from an accredited dental or dental hygiene college or school legally empowered to confer the title, the right to assume the title, or assumes any title or appends any letters to his or her name with the intent to represent falsely that he or she has received a dental degree or license;
7. Willfully makes, as an applicant for examination, license or registration under this chapter, a false statement in a material regard in an affidavit required by this chapter;
8. Within 10 days after a demand is made by the Secretary-Treasurer, fails to furnish to the Board the names and addresses of all persons practicing or assisting in the practice of dentistry in the office of the person at any time within 60 days before the notice, together with a sworn statement showing under and by what license or authority the person and his or her employee are and have been practicing dentistry, but the affidavit must not be used as evidence against the person in any proceeding under this chapter;
9. Except as otherwise provided in NRS 629.091, practices dentistry, dental hygiene , [or] dental therapy or expanded function dental assistance in this State without a license;
10. Except as otherwise provided in NRS 631.385, owns or controls a dental practice, shares in the fees received by a dentist or controls or attempts to control the services offered by a dentist if the person is not himself or herself licensed pursuant to this chapter; or
11. Aids or abets another in violating any of the provisions of this chapter.
Sec. 37. NRS 631.396 is hereby amended to read as follows:
631.396 Any member or agent of the Board may enter any premises in this State where a person who holds a license or certificate issued pursuant to the provisions of this chapter practices dentistry, dental hygiene , [or] dental therapy or expanded function dental assistance and inspect it to determine whether a violation of any provision of this chapter has occurred, including, without limitation, an inspection to determine whether any person at the premises is practicing dentistry, dental hygiene , [or] dental therapy or expanded function dental assistance without the appropriate license or certificate issued pursuant to the provisions of this chapter.
Sec. 38. NRS 631.397 is hereby amended to read as follows:
631.397 Unless the Board determines that extenuating circumstances exist, the Board shall forward to the appropriate law enforcement agency any substantiated information submitted to the Board concerning a person who practices or offers to practice dentistry, dental hygiene , [or] dental therapy or expanded function dental assistance without the appropriate license or certificate issued pursuant to the provisions of this chapter.
κ2023 Statutes of Nevada, Page 3427 (CHAPTER 523, SB 310)κ
Sec. 39. NRS 631.400 is hereby amended to read as follows:
631.400 1. A person who engages in the illegal practice of dentistry in this State is guilty of a category D felony and shall be punished as provided in NRS 193.130, unless a greater penalty is provided pursuant to NRS 200.830 or 200.840.
2. Unless a greater penalty is provided pursuant to NRS 200.830 or 200.840, a person who practices or offers to practice dental hygiene , [or] dental therapy or expanded function dental assistance in this State without a license, or who, having a license, practices dental hygiene , [or] dental therapy or expanded function dental assistance in a manner or place not permitted by the provisions of this chapter:
(a) If it is his or her first or second offense, is guilty of a gross misdemeanor.
(b) If it is his or her third or subsequent offense, is guilty of a category D felony and shall be punished as provided in NRS 193.130.
3. Unless a greater penalty is provided by specific statute, a person who is licensed to practice dentistry who practices dentistry in a manner or place not permitted by the provisions of this chapter:
(a) If it is his or her first or second offense, is guilty of a gross misdemeanor.
(b) If it is his or her third or subsequent offense, is guilty of a category D felony and shall be punished as provided in NRS 193.130.
4. The Board may assign a person described in subsection 1, 2 or 3 specific duties as a condition of renewing a license.
5. If a person has engaged or is about to engage in any acts or practices which constitute or will constitute an offense against this chapter, the district court of any county, on application of the Board, may issue an injunction or other appropriate order restraining the conduct. Proceedings under this subsection are governed by Rule 65 of the Nevada Rules of Civil Procedure, except that no bond or undertaking is required in any action commenced by the Board.
6. In addition to any other penalty prescribed by law, if the Board determines that a person has committed any act described in subsection 1, 2 or 3, the Board may:
(a) Issue and serve on the person an order to cease and desist until the person obtains from the Board the proper license or certificate or otherwise demonstrates that he or she is no longer in violation of subsection 1, 2 or 3. An order to cease and desist must include a telephone number with which the person may contact the Board.
(b) Issue a citation to the person. A citation issued pursuant to this paragraph must be in writing, describe with particularity the nature of the violation and inform the person of the provisions of this paragraph. Each activity in which the person is engaged constitutes a separate offense for which a separate citation may be issued. To appeal a citation, the person must submit a written request for a hearing to the Board not later than 30 days after the date of issuance of the citation.
(c) Assess against the person an administrative fine of not more than $5,000.
(d) Impose any combination of the penalties set forth in paragraphs (a), (b) and (c).
κ2023 Statutes of Nevada, Page 3428 (CHAPTER 523, SB 310)κ
Sec. 40. NRS 632.472 is hereby amended to read as follows:
632.472 1. The following persons shall report in writing to the Executive Director of the Board any conduct of a licensee or holder of a certificate which constitutes a violation of the provisions of this chapter:
(a) Any physician, dentist, dental hygienist, expanded function dental assistant, chiropractic physician, optometrist, podiatric physician, medical examiner, resident, intern, professional or practical nurse, nursing assistant, medication aide - certified, perfusionist, physician assistant licensed pursuant to chapter 630 or 633 of NRS, psychiatrist, psychologist, marriage and family therapist, clinical professional counselor, alcohol or drug counselor, peer recovery support specialist, peer recovery support specialist supervisor, music therapist, holder of a license or limited license issued pursuant to chapter 653 of NRS, driver of an ambulance, paramedic or other person providing medical services licensed or certified to practice in this State.
(b) Any personnel of a medical facility or facility for the dependent engaged in the admission, examination, care or treatment of persons or an administrator, manager or other person in charge of a medical facility or facility for the dependent upon notification by a member of the staff of the facility.
(c) A coroner.
(d) Any person who maintains or is employed by an agency to provide personal care services in the home.
(e) Any person who operates, who is employed by or who contracts to provide services for an intermediary service organization as defined in NRS 449.4304.
(f) Any person who maintains or is employed by an agency to provide nursing in the home.
(g) Any employee of the Department of Health and Human Services.
(h) Any employee of a law enforcement agency or a countys office for protective services or an adult or juvenile probation officer.
(i) Any person who maintains or is employed by a facility or establishment that provides care for older persons.
(j) Any person who maintains, is employed by or serves as a volunteer for an agency or service which advises persons regarding the abuse, neglect or exploitation of an older person and refers them to persons and agencies where their requests and needs can be met.
(k) Any social worker.
(l) Any person who operates or is employed by a community health worker pool or with whom a community health worker pool contracts to provide the services of a community health worker, as defined in NRS 449.0027.
2. Every physician who, as a member of the staff of a medical facility or facility for the dependent, has reason to believe that a nursing assistant or medication aide - certified has engaged in conduct which constitutes grounds for the denial, suspension or revocation of a certificate shall notify the superintendent, manager or other person in charge of the facility. The superintendent, manager or other person in charge shall make a report as required in subsection 1.
3. A report may be filed by any other person.
4. Any person who in good faith reports any violation of the provisions of this chapter to the Executive Director of the Board pursuant to this section is immune from civil liability for reporting the violation.
κ2023 Statutes of Nevada, Page 3429 (CHAPTER 523, SB 310)κ
5. As used in this section:
(a) Agency to provide personal care services in the home has the meaning ascribed to it in NRS 449.0021.
(b) Community health worker pool has the meaning ascribed to it in NRS 449.0028.
(c) Peer recovery support specialist has the meaning ascribed to it in NRS 433.627.
(d) Peer recovery support specialist supervisor has the meaning ascribed to it in NRS 433.629.
Sec. 40.5. Chapter 639 of NRS is hereby amended by adding thereto a new section to read as follows:
1. Except as otherwise provided in subsection 5, a dental hygienist licensed pursuant to chapter 631 of NRS may, if authorized by the Board, possess, prescribe or dispense dangerous drugs and devices only to the extent and subject to the limitations specified in section 9 of this act and the certificate issued to the dental hygienist by the Board pursuant to this section.
2. If a dental hygienist wishes to possess, prescribe or dispense dangerous drugs and devices and is authorized to do so by section 9 of this act and the regulations adopted pursuant thereto, the dental hygienist must apply to the Board for a certificate to possess, prescribe or dispense dangerous drugs and devices and pay the applicable fee for authorization of a practitioner to dispense dangerous drugs pursuant to NRS 639.170.
3. The Board shall consider each application separately and, except as otherwise provided in subsection 5, may, even though the dental hygienist is otherwise authorized by section 9 of this act to possess, prescribe or dispense dangerous drugs and devices:
(a) Refuse to issue a certificate;
(b) Issue a certificate limiting the authority of the dental hygienist to possess, prescribe or dispense dangerous drugs and devices, the area in which the dental hygienist may possess dangerous drugs and devices or the kind and amount of dangerous drugs or devices; or
(c) Issue a certificate imposing other limitations or restrictions which the Board feels are necessary and required to protect the health, safety and welfare of the public.
4. The Board may adopt regulations controlling the maximum amount to be possessed, prescribed or dispensed and the storage, security, recordkeeping and transportation of dangerous drugs or devices by a dental hygienist licensed pursuant to chapter 631 of NRS.
5. The provisions of this section do not limit or authorize the Board to limit the authority of a dental hygienist to possess dangerous drugs under the circumstances authorized by paragraph (b) of subsection 1 of NRS 454.213, regardless of whether the dental hygienist holds a certificate issued pursuant to this section.
Sec. 41. NRS 639.0125 is hereby amended to read as follows:
639.0125 Practitioner means:
1. A physician, dentist, veterinarian or podiatric physician who holds a license to practice his or her profession in this State;
2. A hospital, pharmacy or other institution licensed, registered or otherwise permitted to distribute, dispense, conduct research with respect to or administer drugs in the course of professional practice or research in this State;
κ2023 Statutes of Nevada, Page 3430 (CHAPTER 523, SB 310)κ
3. An advanced practice registered nurse who has been authorized to prescribe controlled substances, poisons, dangerous drugs and devices;
4. A physician assistant who:
(a) Holds a license issued by the Board of Medical Examiners; and
(b) Is authorized by the Board to possess, administer, prescribe or dispense controlled substances, poisons, dangerous drugs or devices under the supervision of a physician as required by chapter 630 of NRS;
5. A physician assistant who:
(a) Holds a license issued by the State Board of Osteopathic Medicine; and
(b) Is authorized by the Board to possess, administer, prescribe or dispense controlled substances, poisons, dangerous drugs or devices under the supervision of an osteopathic physician as required by chapter 633 of NRS; [or]
6. An optometrist who is certified by the Nevada State Board of Optometry to prescribe and administer pharmaceutical agents pursuant to NRS 636.288, when the optometrist prescribes or administers pharmaceutical agents within the scope of his or her certification [.] ; or
7. A dental hygienist who:
(a) Holds a valid license to practice dental hygiene in this State;
(b) Is authorized to prescribe and dispense the dangerous drugs and devices listed in section 9 of this act in accordance with the provisions of that section and the regulations adopted pursuant thereto; and
(c) Holds a certificate issued pursuant to section 40.5 of this act by the State Board of Pharmacy authorizing him or her to so prescribe.
Sec. 42. NRS 653.430 is hereby amended to read as follows:
653.430 The provisions of this chapter do not apply to:
1. A physician or physician assistant licensed pursuant to chapter 630 or 633 of NRS.
2. A dentist, dental hygienist , [or] dental therapist or expanded function dental assistant licensed pursuant to chapter 631 of NRS or a dental assistant working within the scope of his or her employment under the direct supervision of [a] :
(a) A dentist [.] ; or
(b) Where authorized by NRS 631.287, a dental hygienist who holds a special endorsement to practice public health dental hygiene.
3. A chiropractic physician or chiropractic assistant licensed pursuant to chapter 634 of NRS.
4. A person training to become a chiropractic assistant or a student practicing in the preceptor program established by the Chiropractic Physicians Board of Nevada pursuant to NRS 634.1375.
5. A podiatric physician or podiatry hygienist licensed pursuant to chapter 635 of NRS, or a person training to be a podiatry hygienist.
6. A veterinarian or veterinary technician licensed pursuant to chapter 638 of NRS or any other person performing tasks under the supervision of a veterinarian or veterinary technician as authorized by regulation of the Nevada State Board of Veterinary Medical Examiners.
7. The performance of mammography in accordance with NRS 457.182 to 457.187, inclusive.
κ2023 Statutes of Nevada, Page 3431 (CHAPTER 523, SB 310)κ
Sec. 43. NRS 200.471 is hereby amended to read as follows:
200.471 1. As used in this section:
(a) Assault means:
(1) Unlawfully attempting to use physical force against another person; or
(2) Intentionally placing another person in reasonable apprehension of immediate bodily harm.
(b) Fire-fighting agency has the meaning ascribed to it in NRS 239B.020.
(c) Officer means:
(1) A person who possesses some or all of the powers of a peace officer;
(2) A person employed in a full-time salaried occupation of fire fighting for the benefit or safety of the public;
(3) A member of a volunteer fire department;
(4) A jailer, guard or other correctional officer of a city or county jail;
(5) A prosecuting attorney of an agency or political subdivision of the United States or of this State;
(6) A justice of the Supreme Court, judge of the Court of Appeals, district judge, justice of the peace, municipal judge, magistrate, court commissioner, master or referee, including a person acting pro tempore in a capacity listed in this subparagraph;
(7) An employee of this State or a political subdivision of this State whose official duties require the employee to make home visits;
(8) A civilian employee or a volunteer of a law enforcement agency whose official duties require the employee or volunteer to:
(I) Interact with the public;
(II) Perform tasks related to law enforcement; and
(III) Wear identification, clothing or a uniform that identifies the employee or volunteer as working or volunteering for the law enforcement agency;
(9) A civilian employee or a volunteer of a fire-fighting agency whose official duties require the employee or volunteer to:
(I) Interact with the public;
(II) Perform tasks related to fire fighting or fire prevention; and
(III) Wear identification, clothing or a uniform that identifies the employee or volunteer as working or volunteering for the fire-fighting agency; or
(10) A civilian employee or volunteer of this State or a political subdivision of this State whose official duties require the employee or volunteer to:
(I) Interact with the public;
(II) Perform tasks related to code enforcement; and
(III) Wear identification, clothing or a uniform that identifies the employee or volunteer as working or volunteering for this State or a political subdivision of this State.
(d) Provider of health care means a physician, a medical student, a perfusionist or a physician assistant licensed pursuant to chapter 630 of NRS, a practitioner of respiratory care, a homeopathic physician, an advanced practitioner of homeopathy, a homeopathic assistant, an osteopathic physician, a physician assistant licensed pursuant to chapter 633 of NRS, a podiatric physician, a podiatry hygienist, a physical therapist, a medical laboratory technician, an optometrist, a chiropractic physician, a chiropractic assistant, a doctor of Oriental medicine, a nurse, a student nurse, a certified nursing assistant, a nursing assistant trainee, a medication aide - certified, a dentist, a dental student, a dental hygienist, a dental hygienist student, an expanded
κ2023 Statutes of Nevada, Page 3432 (CHAPTER 523, SB 310)κ
podiatric physician, a podiatry hygienist, a physical therapist, a medical laboratory technician, an optometrist, a chiropractic physician, a chiropractic assistant, a doctor of Oriental medicine, a nurse, a student nurse, a certified nursing assistant, a nursing assistant trainee, a medication aide - certified, a dentist, a dental student, a dental hygienist, a dental hygienist student, an expanded function dental assistant, an expanded function dental assistant student, a pharmacist, a pharmacy student, an intern pharmacist, an attendant on an ambulance or air ambulance, a psychologist, a social worker, a marriage and family therapist, a marriage and family therapist intern, a clinical professional counselor, a clinical professional counselor intern, a licensed dietitian, the holder of a license or a limited license issued under the provisions of chapter 653 of NRS, an emergency medical technician, an advanced emergency medical technician and a paramedic.
(e) School employee means a licensed or unlicensed person employed by a board of trustees of a school district pursuant to NRS 391.100 or 391.281.
(f) Sporting event has the meaning ascribed to it in NRS 41.630.
(g) Sports official has the meaning ascribed to it in NRS 41.630.
(h) Taxicab has the meaning ascribed to it in NRS 706.8816.
(i) Taxicab driver means a person who operates a taxicab.
(j) Transit operator means a person who operates a bus or other vehicle as part of a public mass transportation system.
2. A person convicted of an assault shall be punished:
(a) If paragraph (c) or (d) does not apply to the circumstances of the crime and the assault is not made with the use of a deadly weapon or the present ability to use a deadly weapon, for a misdemeanor.
(b) If the assault is made with the use of a deadly weapon or the present ability to use a deadly weapon, for a category B felony by imprisonment in the state prison for a minimum term of not less than 1 year and a maximum term of not more than 6 years, or by a fine of not more than $5,000, or by both fine and imprisonment.
(c) If paragraph (d) does not apply to the circumstances of the crime and if the assault is committed upon an officer, a provider of health care, a school employee, a taxicab driver or a transit operator who is performing his or her duty or upon a sports official based on the performance of his or her duties at a sporting event and the person charged knew or should have known that the victim was an officer, a provider of health care, a school employee, a taxicab driver, a transit operator or a sports official, for a gross misdemeanor, unless the assault is made with the use of a deadly weapon or the present ability to use a deadly weapon, then for a category B felony by imprisonment in the state prison for a minimum term of not less than 1 year and a maximum term of not more than 6 years, or by a fine of not more than $5,000, or by both fine and imprisonment.
(d) If the assault is committed upon an officer, a provider of health care, a school employee, a taxicab driver or a transit operator who is performing his or her duty or upon a sports official based on the performance of his or her duties at a sporting event by a probationer, a prisoner who is in lawful custody or confinement or a parolee, and the probationer, prisoner or parolee charged knew or should have known that the victim was an officer, a provider of health care, a school employee, a taxicab driver, a transit operator or a sports official, for a category D felony as provided in NRS 193.130, unless the assault is made with the use of a deadly weapon or the present ability to use a deadly weapon, then for a category B felony by imprisonment in the state prison for a minimum term of not less than 1 year and a maximum term of not more than 6 years, or by a fine of not more than $5,000, or by both fine and imprisonment.
κ2023 Statutes of Nevada, Page 3433 (CHAPTER 523, SB 310)κ
ability to use a deadly weapon, then for a category B felony by imprisonment in the state prison for a minimum term of not less than 1 year and a maximum term of not more than 6 years, or by a fine of not more than $5,000, or by both fine and imprisonment.
Sec. 44. NRS 200.5093 is hereby amended to read as follows:
200.5093 1. Any person who is described in subsection 4 and who, in a professional or occupational capacity, knows or has reasonable cause to believe that an older person or vulnerable person has been abused, neglected, exploited, isolated or abandoned shall:
(a) Except as otherwise provided in subsection 2, report the abuse, neglect, exploitation, isolation or abandonment of the older person or vulnerable person to:
(1) The local office of the Aging and Disability Services Division of the Department of Health and Human Services;
(2) A police department or sheriffs office; or
(3) A toll-free telephone service designated by the Aging and Disability Services Division of the Department of Health and Human Services; and
(b) Make such a report as soon as reasonably practicable but not later than 24 hours after the person knows or has reasonable cause to believe that the older person or vulnerable person has been abused, neglected, exploited, isolated or abandoned.
2. If a person who is required to make a report pursuant to subsection 1 knows or has reasonable cause to believe that the abuse, neglect, exploitation, isolation or abandonment of the older person or vulnerable person involves an act or omission of the Aging and Disability Services Division, another division of the Department of Health and Human Services or a law enforcement agency, the person shall make the report to an agency other than the one alleged to have committed the act or omission.
3. Each agency, after reducing a report to writing, shall forward a copy of the report to the Aging and Disability Services Division of the Department of Health and Human Services and the Unit for the Investigation and Prosecution of Crimes.
4. A report must be made pursuant to subsection 1 by the following persons:
(a) Every physician, dentist, dental hygienist, expanded function dental assistant, chiropractic physician, optometrist, podiatric physician, medical examiner, resident, intern, professional or practical nurse, physician assistant licensed pursuant to chapter 630 or 633 of NRS, perfusionist, psychiatrist, psychologist, marriage and family therapist, clinical professional counselor, clinical alcohol and drug counselor, alcohol and drug counselor, music therapist, athletic trainer, driver of an ambulance, paramedic, licensed dietitian, holder of a license or a limited license issued under the provisions of chapter 653 of NRS, behavior analyst, assistant behavior analyst, registered behavior technician, peer recovery support specialist, as defined in NRS 433.627, peer recovery support specialist supervisor, as defined in NRS 433.629, or other person providing medical services licensed or certified to practice in this State, who examines, attends or treats an older person or vulnerable person who appears to have been abused, neglected, exploited, isolated or abandoned.
(b) Any personnel of a hospital or similar institution engaged in the admission, examination, care or treatment of persons or an administrator, manager or other person in charge of a hospital or similar institution upon notification of the suspected abuse, neglect, exploitation, isolation or abandonment of an older person or vulnerable person by a member of the staff of the hospital.
κ2023 Statutes of Nevada, Page 3434 (CHAPTER 523, SB 310)κ
manager or other person in charge of a hospital or similar institution upon notification of the suspected abuse, neglect, exploitation, isolation or abandonment of an older person or vulnerable person by a member of the staff of the hospital.
(c) A coroner.
(d) Every person who maintains or is employed by an agency to provide personal care services in the home.
(e) Every person who maintains or is employed by an agency to provide nursing in the home.
(f) Every person who operates, who is employed by or who contracts to provide services for an intermediary service organization as defined in NRS 449.4304.
(g) Any employee of the Department of Health and Human Services, except the State Long-Term Care Ombudsman appointed pursuant to NRS 427A.125 and any of his or her advocates or volunteers where prohibited from making such a report pursuant to 45 C.F.R. § 1321.11.
(h) Any employee of a law enforcement agency or a countys office for protective services or an adult or juvenile probation officer.
(i) Any person who maintains or is employed by a facility or establishment that provides care for older persons or vulnerable persons.
(j) Any person who maintains, is employed by or serves as a volunteer for an agency or service which advises persons regarding the abuse, neglect, exploitation, isolation or abandonment of an older person or vulnerable person and refers them to persons and agencies where their requests and needs can be met.
(k) Every social worker.
(l) Any person who owns or is employed by a funeral home or mortuary.
(m) Every person who operates or is employed by a community health worker pool, as defined in NRS 449.0028, or with whom a community health worker pool contracts to provide the services of a community health worker, as defined in NRS 449.0027.
(n) Every person who is enrolled with the Division of Health Care Financing and Policy of the Department of Health and Human Services to provide doula services to recipients of Medicaid pursuant to NRS 422.27177.
5. A report may be made by any other person.
6. If a person who is required to make a report pursuant to subsection 1 knows or has reasonable cause to believe that an older person or vulnerable person has died as a result of abuse, neglect, isolation or abandonment, the person shall, as soon as reasonably practicable, report this belief to the appropriate medical examiner or coroner, who shall investigate the cause of death of the older person or vulnerable person and submit to the appropriate local law enforcement agencies, the appropriate prosecuting attorney, the Aging and Disability Services Division of the Department of Health and Human Services and the Unit for the Investigation and Prosecution of Crimes his or her written findings. The written findings must include the information required pursuant to the provisions of NRS 200.5094, when possible.
7. A division, office or department which receives a report pursuant to this section shall cause the investigation of the report to commence within 3 working days. A copy of the final report of the investigation conducted by a division, office or department, other than the Aging and Disability Services Division of the Department of Health and Human Services, must be forwarded within 30 days after the completion of the report to the:
κ2023 Statutes of Nevada, Page 3435 (CHAPTER 523, SB 310)κ
(a) Aging and Disability Services Division;
(b) Repository for Information Concerning Crimes Against Older Persons or Vulnerable Persons created by NRS 179A.450; and
(c) Unit for the Investigation and Prosecution of Crimes.
8. If the investigation of a report results in the belief that an older person or vulnerable person is abused, neglected, exploited, isolated or abandoned, the Aging and Disability Services Division of the Department of Health and Human Services or the countys office for protective services may provide protective services to the older person or vulnerable person if the older person or vulnerable person is able and willing to accept them.
9. A person who knowingly and willfully violates any of the provisions of this section is guilty of a misdemeanor.
10. As used in this section, Unit for the Investigation and Prosecution of Crimes means the Unit for the Investigation and Prosecution of Crimes Against Older Persons or Vulnerable Persons in the Office of the Attorney General created pursuant to NRS 228.265.
Sec. 45. NRS 439.2713 is hereby amended to read as follows:
439.2713 Provider of oral health care means a dentist , [or] dental hygienist or expanded function dental assistant licensed pursuant to the provisions of chapter 631 of NRS.
Sec. 46. NRS 454.00958 is hereby amended to read as follows:
454.00958 Practitioner means:
1. A physician, dentist, veterinarian or podiatric physician who holds a valid license to practice his or her profession in this State.
2. A pharmacy, hospital or other institution licensed or registered to distribute, dispense, conduct research with respect to or to administer a dangerous drug in the course of professional practice in this State.
3. When relating to the prescription of poisons, dangerous drugs and devices:
(a) An advanced practice registered nurse who holds a certificate from the State Board of Pharmacy permitting him or her so to prescribe; or
(b) A physician assistant who holds a license from the Board of Medical Examiners and a certificate from the State Board of Pharmacy permitting him or her so to prescribe.
4. An optometrist who is certified to prescribe and administer pharmaceutical agents pursuant to NRS 636.288 when the optometrist prescribes or administers dangerous drugs which are within the scope of his or her certification.
5. A dental hygienist who holds a valid license to practice dental hygiene in this State and:
(a) Is authorized to prescribe and dispense the dangerous drugs listed in section 9 of this act in accordance with the provisions of that section and the regulations adopted pursuant thereto; and
(b) Holds a certificate issued by the State Board of Pharmacy pursuant to section 40.5 of this act authorizing him or her to so prescribe.
Sec. 47. NRS 454.213 is hereby amended to read as follows:
454.213 1. Except as otherwise provided in NRS 454.217, a drug or medicine referred to in NRS 454.181 to 454.371, inclusive, may be possessed and administered by:
(a) A practitioner.
(b) A physician assistant licensed pursuant to chapter 630 or 633 of NRS, at the direction of his or her supervising physician or a licensed dental hygienist or expanded function dental assistant acting in the office of and under the supervision of a dentist.
κ2023 Statutes of Nevada, Page 3436 (CHAPTER 523, SB 310)κ
dental hygienist or expanded function dental assistant acting in the office of and under the supervision of a dentist.
(c) Except as otherwise provided in paragraph (d), a registered nurse licensed to practice professional nursing or licensed practical nurse, at the direction of a prescribing physician, physician assistant licensed pursuant to chapter 630 or 633 of NRS, dentist, podiatric physician or advanced practice registered nurse, or pursuant to a chart order, for administration to a patient at another location.
(d) In accordance with applicable regulations of the Board, a registered nurse licensed to practice professional nursing or licensed practical nurse who is:
(1) Employed by a health care agency or health care facility that is authorized to provide emergency care, or to respond to the immediate needs of a patient, in the residence of the patient; and
(2) Acting under the direction of the medical director of that agency or facility who works in this State.
(e) A medication aide - certified at a designated facility under the supervision of an advanced practice registered nurse or registered nurse and in accordance with standard protocols developed by the State Board of Nursing. As used in this paragraph, designated facility has the meaning ascribed to it in NRS 632.0145.
(f) Except as otherwise provided in paragraph (g), an advanced emergency medical technician or a paramedic, as authorized by regulation of the State Board of Pharmacy and in accordance with any applicable regulations of:
(1) The State Board of Health in a county whose population is less than 100,000;
(2) A county board of health in a county whose population is 100,000 or more; or
(3) A district board of health created pursuant to NRS 439.362 or 439.370 in any county.
(g) An advanced emergency medical technician or a paramedic who holds an endorsement issued pursuant to NRS 450B.1975, under the direct supervision of a local health officer or a designee of the local health officer pursuant to that section.
(h) A respiratory therapist employed in a health care facility. The therapist may possess and administer respiratory products only at the direction of a physician.
(i) A dialysis technician, under the direction or supervision of a physician or registered nurse only if the drug or medicine is used for the process of renal dialysis.
(j) A medical student or student nurse in the course of his or her studies at an accredited college of medicine or approved school of professional or practical nursing, at the direction of a physician and:
(1) In the presence of a physician or a registered nurse; or
(2) Under the supervision of a physician or a registered nurse if the student is authorized by the college or school to administer the drug or medicine outside the presence of a physician or nurse.
Κ A medical student or student nurse may administer a dangerous drug in the presence or under the supervision of a registered nurse alone only if the circumstances are such that the registered nurse would be authorized to administer it personally.
κ2023 Statutes of Nevada, Page 3437 (CHAPTER 523, SB 310)κ
(k) Any person designated by the head of a correctional institution.
(l) An ultimate user or any person designated by the ultimate user pursuant to a written agreement.
(m) A holder of a license to engage in radiation therapy and radiologic imaging issued pursuant to chapter 653 of NRS, at the direction of a physician and in accordance with any conditions established by regulation of the Board.
(n) A chiropractic physician, but only if the drug or medicine is a topical drug used for cooling and stretching external tissue during therapeutic treatments.
(o) A physical therapist, but only if the drug or medicine is a topical drug which is:
(1) Used for cooling and stretching external tissue during therapeutic treatments; and
(2) Prescribed by a licensed physician for:
(I) Iontophoresis; or
(II) The transmission of drugs through the skin using ultrasound.
(p) In accordance with applicable regulations of the State Board of Health, an employee of a residential facility for groups, as defined in NRS 449.017, pursuant to a written agreement entered into by the ultimate user.
(q) A veterinary technician or a veterinary assistant at the direction of his or her supervising veterinarian.
(r) In accordance with applicable regulations of the Board, a registered pharmacist who:
(1) Is trained in and certified to carry out standards and practices for immunization programs;
(2) Is authorized to administer immunizations pursuant to written protocols from a physician; and
(3) Administers immunizations in compliance with the Standards for Immunization Practices recommended and approved by the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention.
(s) A registered pharmacist pursuant to written guidelines and protocols developed pursuant to NRS 639.2629 or a collaborative practice agreement, as defined in NRS 639.0052.
(t) A person who is enrolled in a training program to become a physician assistant licensed pursuant to chapter 630 or 633 of NRS, dental hygienist, advanced emergency medical technician, paramedic, respiratory therapist, dialysis technician, physical therapist or veterinary technician or to obtain a license to engage in radiation therapy and radiologic imaging pursuant to chapter 653 of NRS if the person possesses and administers the drug or medicine in the same manner and under the same conditions that apply, respectively, to a physician assistant licensed pursuant to chapter 630 or 633 of NRS, dental hygienist, advanced emergency medical technician, paramedic, respiratory therapist, dialysis technician, physical therapist, veterinary technician or person licensed to engage in radiation therapy and radiologic imaging who may possess and administer the drug or medicine, and under the direct supervision of a person licensed or registered to perform the respective medical art or a supervisor of such a person.
(u) A medical assistant, in accordance with applicable regulations of the:
(1) Board of Medical Examiners, at the direction of the prescribing physician and under the supervision of a physician or physician assistant.
κ2023 Statutes of Nevada, Page 3438 (CHAPTER 523, SB 310)κ
(2) State Board of Osteopathic Medicine, at the direction of the prescribing physician and under the supervision of a physician or physician assistant.
2. As used in this section, accredited college of medicine has the meaning ascribed to it in NRS 453.375.
Sec. 48. NRS 695D.040 is hereby amended to read as follows:
695D.040 Dentist includes a dental hygienist [.] and an expanded function dental assistant.
Sec. 49. 1. Not later than January 1, 2025, the Board of Dental Examiners of Nevada shall submit a report to the Director of the Legislative Counsel Bureau for transmittal to the 83rd Session of the Legislature that includes, without limitation:
(a) The number of persons that applied for licensure as an expanded function dental assistant pursuant to sections 5 and 6 of this act during the 2024 calendar year and the number of such licenses issued during the 2024 calendar year;
(b) The number of persons that applied for a special endorsement to practice restorative dental hygiene pursuant to section 6.5 of this act during the 2024 calendar year and the number of such special endorsements issued during the 2024 calendar year;
(c) The number of dental hygienists currently authorized to prescribe and dispense drugs or devices pursuant to section 9 of this act; and
(d) A description of the impact of authorizing the practice of expanded function dental assistance and restorative dental hygiene and the prescription and dispensing of drugs by dental hygienists on the quality and availability of dental services in this State.
2. As used in this section:
(a) Dental hygienist has the meaning ascribed to it in NRS 631.040.
(b) Expanded function dental assistance has the meaning ascribed to it in section 2 of this act.
(c) Expanded function dental assistant has the meaning ascribed to it in section 3 of this act.
(d) Restorative dental hygiene has the meaning ascribed to it in section 3.5 of this act.
Sec. 50. 1. This section becomes effective upon passage and approval.
2. Sections 1 to 49, inclusive, of this act become effective:
(a) Upon passage and approval for the purpose of adopting any regulations and performing any other preparatory administrative tasks that are necessary to carry out the provisions of this act; and
(b) On January 1, 2024, for all other purposes.
________
κ2023 Statutes of Nevada, Page 3439κ
Senate Bill No. 385Senator Neal
CHAPTER 524
[Approved: June 15, 2023]
AN ACT relating to health care; requiring a hospital to ensure that a patient or his or her primary caregiver meets or knows how to contact a dietician assigned to a care team for the patient in certain circumstances; requiring certain entities that provide care to a patient in his or her residence to consult with a dietician in certain circumstances; requiring Medicaid to provide coverage for certain dental procedures and certain corrective lenses; making appropriations to and authorizing certain expenditures by the Division of Health Care Financing and Policy of the Department of Health and Human Services; and providing other matters properly relating thereto.
Legislative Counsels Digest:
Existing law requires the State Board of Health to adopt regulations governing the licensing and operation of medical facilities, including hospitals. (NRS 449.0302) Section 1 of this bill requires a hospital that discharges a patient to ensure that the patient or the person with primary responsibility for the care of the patient meets or knows how to contact any dietician assigned to a care team for the patient while the patient rehabilitates. Section 1 requires certain licensed entities that provide care to a patient discharged from a hospital in his or her residence to consult with a dietician to ensure that the patient or the person with primary responsibility for the care of the patient understands the dietary needs of the patient. Sections 2-7 and 10 of this bill make conforming changes to provide for the administration and enforcement of the requirements of section 1 in the same manner as other requirements imposed on medical facilities by existing law.
Existing law requires the Department of Health and Human Services to administer Medicaid. (NRS 422.270) Section 9.4 of this bill requires the Director of the Department to include under Medicaid coverage for: (1) the filling of cavities; (2) the fabrication, preparation and placement of temporary and permanent crowns; and (3) removable dentures. Section 9.8 of this bill: (1) requires the Director to include under Medicaid coverage for polycarbonate lenses; and (2) prohibits Medicaid from placing certain conditions on such coverage. Sections 9.4 and 9.8 require the Department to apply for certain federal approval, as necessary to obtain federal funding to provide such coverage. Section 8 of this bill makes a conforming change to indicate that the provisions of sections 9.4 and 9.8 will be administered in the same manner as the provisions of existing law governing the State Plan for Medicaid. Section 11.5 of this bill makes appropriations to and authorizes expenditures by the Division of Health Care Financing and Policy of the Department for administrative and medical service costs of providing Medicaid coverage for certain dental services.
EXPLANATION Matter in bolded italics is new; matter between
brackets [omitted material] is material to be
omitted.
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1. Chapter 449 of NRS is hereby amended by adding thereto a new section to read as follows:
1. If a patient will be released from a hospital to his or her residence or a rehabilitation center and a dietician is assigned to a team of persons formed by the hospital to care for the patient while the patient rehabilitates, the hospital shall ensure that the patient or the person with primary responsibility for the care of the patient meets or knows how to contact the dietician.
κ2023 Statutes of Nevada, Page 3440 (CHAPTER 524, SB 385)κ
formed by the hospital to care for the patient while the patient rehabilitates, the hospital shall ensure that the patient or the person with primary responsibility for the care of the patient meets or knows how to contact the dietician.
2. If a patient is released by a hospital to his or her residence to receive care from an agency to provide personal care services in the home or any other entity licensed pursuant to this chapter that provides care to the patient in his or her residence, the agency to provide personal care services in the home or other entity shall consult with a dietician, as appropriate, to ensure that the patient or the person with primary responsibility for the care of the patient understands the dietary needs of the patient.
Sec. 2. NRS 449.029 is hereby amended to read as follows:
449.029 As used in NRS 449.029 to 449.240, inclusive, and section 1 of this act, unless the context otherwise requires, medical facility has the meaning ascribed to it in NRS 449.0151 and includes a program of hospice care described in NRS 449.196.
Sec. 3. NRS 449.0301 is hereby amended to read as follows:
449.0301 The provisions of NRS 449.029 to 449.2428, inclusive, and section 1 of this act do not apply to:
1. Any facility conducted by and for the adherents of any church or religious denomination for the purpose of providing facilities for the care and treatment of the sick who depend solely upon spiritual means through prayer for healing in the practice of the religion of the church or denomination, except that such a facility shall comply with all regulations relative to sanitation and safety applicable to other facilities of a similar category.
2. Foster homes as defined in NRS 424.014.
3. Any medical facility, facility for the dependent or facility which is otherwise required by the regulations adopted by the Board pursuant to NRS 449.0303 to be licensed that is operated and maintained by the United States Government or an agency thereof.
Sec. 4. NRS 449.0302 is hereby amended to read as follows:
449.0302 1. The Board shall adopt:
(a) Licensing standards for each class of medical facility or facility for the dependent covered by NRS 449.029 to 449.2428, inclusive, and section 1 of this act and for programs of hospice care.
(b) Regulations governing the licensing of such facilities and programs.
(c) Regulations governing the procedure and standards for granting an extension of the time for which a natural person may provide certain care in his or her home without being considered a residential facility for groups pursuant to NRS 449.017. The regulations must require that such grants are effective only if made in writing.
(d) Regulations establishing a procedure for the indemnification by the Division, from the amount of any surety bond or other obligation filed or deposited by a facility for refractive surgery pursuant to NRS 449.068 or 449.069, of a patient of the facility who has sustained any damages as a result of the bankruptcy of or any breach of contract by the facility.
(e) Regulations that prescribe the specific types of discrimination prohibited by NRS 449.101.
(f) Regulations requiring a hospital or independent center for emergency medical care to provide training to each employee who provides care to victims of sexual assault or attempted sexual assault concerning appropriate care for such persons, including, without limitation, training concerning the requirements of NRS 449.1885.
κ2023 Statutes of Nevada, Page 3441 (CHAPTER 524, SB 385)κ
victims of sexual assault or attempted sexual assault concerning appropriate care for such persons, including, without limitation, training concerning the requirements of NRS 449.1885.
(g) Any other regulations as it deems necessary or convenient to carry out the provisions of NRS 449.029 to 449.2428, inclusive [.] , and section 1 of this act.
2. The Board shall adopt separate regulations governing the licensing and operation of:
(a) Facilities for the care of adults during the day; and
(b) Residential facilities for groups,
Κ which provide care to persons with Alzheimers disease or other severe dementia, as described in paragraph (a) of subsection 2 of NRS 449.1845.
3. The Board shall adopt separate regulations for:
(a) The licensure of rural hospitals which take into consideration the unique problems of operating such a facility in a rural area.
(b) The licensure of facilities for refractive surgery which take into consideration the unique factors of operating such a facility.
(c) The licensure of mobile units which take into consideration the unique factors of operating a facility that is not in a fixed location.
4. The Board shall require that the practices and policies of each medical facility or facility for the dependent provide adequately for the protection of the health, safety and physical, moral and mental well-being of each person accommodated in the facility.
5. In addition to the training requirements prescribed pursuant to NRS 449.093, the Board shall establish minimum qualifications for administrators and employees of residential facilities for groups. In establishing the qualifications, the Board shall consider the related standards set by nationally recognized organizations which accredit such facilities.
6. The Board shall adopt separate regulations regarding the assistance which may be given pursuant to NRS 453.375 and 454.213 to an ultimate user of controlled substances or dangerous drugs by employees of residential facilities for groups. The regulations must require at least the following conditions before such assistance may be given:
(a) The ultimate users physical and mental condition is stable and is following a predictable course.
(b) The amount of the medication prescribed is at a maintenance level and does not require a daily assessment.
(c) A written plan of care by a physician or registered nurse has been established that:
(1) Addresses possession and assistance in the administration of the medication; and
(2) Includes a plan, which has been prepared under the supervision of a registered nurse or licensed pharmacist, for emergency intervention if an adverse condition results.
(d) Except as otherwise authorized by the regulations adopted pursuant to NRS 449.0304, the prescribed medication is not administered by injection or intravenously.
(e) The employee has successfully completed training and examination approved by the Division regarding the authorized manner of assistance.
κ2023 Statutes of Nevada, Page 3442 (CHAPTER 524, SB 385)κ
7. The Board shall adopt separate regulations governing the licensing and operation of residential facilities for groups which provide assisted living services. The Board shall not allow the licensing of a facility as a residential facility for groups which provides assisted living services and a residential facility for groups shall not claim that it provides assisted living services unless:
(a) Before authorizing a person to move into the facility, the facility makes a full written disclosure to the person regarding what services of personalized care will be available to the person and the amount that will be charged for those services throughout the residents stay at the facility.
(b) The residents of the facility reside in their own living units which:
(1) Except as otherwise provided in subsection 8, contain toilet facilities;
(2) Contain a sleeping area or bedroom; and
(3) Are shared with another occupant only upon consent of both occupants.
(c) The facility provides personalized care to the residents of the facility and the general approach to operating the facility incorporates these core principles:
(1) The facility is designed to create a residential environment that actively supports and promotes each residents quality of life and right to privacy;
(2) The facility is committed to offering high-quality supportive services that are developed by the facility in collaboration with the resident to meet the residents individual needs;
(3) The facility provides a variety of creative and innovative services that emphasize the particular needs of each individual resident and the residents personal choice of lifestyle;
(4) The operation of the facility and its interaction with its residents supports, to the maximum extent possible, each residents need for autonomy and the right to make decisions regarding his or her own life;
(5) The operation of the facility is designed to foster a social climate that allows the resident to develop and maintain personal relationships with fellow residents and with persons in the general community;
(6) The facility is designed to minimize and is operated in a manner which minimizes the need for its residents to move out of the facility as their respective physical and mental conditions change over time; and
(7) The facility is operated in such a manner as to foster a culture that provides a high-quality environment for the residents, their families, the staff, any volunteers and the community at large.
8. The Division may grant an exception from the requirement of subparagraph (1) of paragraph (b) of subsection 7 to a facility which is licensed as a residential facility for groups on or before July 1, 2005, and which is authorized to have 10 or fewer beds and was originally constructed as a single-family dwelling if the Division finds that:
(a) Strict application of that requirement would result in economic hardship to the facility requesting the exception; and
(b) The exception, if granted, would not:
(1) Cause substantial detriment to the health or welfare of any resident of the facility;
κ2023 Statutes of Nevada, Page 3443 (CHAPTER 524, SB 385)κ
(2) Result in more than two residents sharing a toilet facility; or
(3) Otherwise impair substantially the purpose of that requirement.
9. The Board shall, if it determines necessary, adopt regulations and requirements to ensure that each residential facility for groups and its staff are prepared to respond to an emergency, including, without limitation:
(a) The adoption of plans to respond to a natural disaster and other types of emergency situations, including, without limitation, an emergency involving fire;
(b) The adoption of plans to provide for the evacuation of a residential facility for groups in an emergency, including, without limitation, plans to ensure that nonambulatory patients may be evacuated;
(c) Educating the residents of residential facilities for groups concerning the plans adopted pursuant to paragraphs (a) and (b); and
(d) Posting the plans or a summary of the plans adopted pursuant to paragraphs (a) and (b) in a conspicuous place in each residential facility for groups.
10. The regulations governing the licensing and operation of facilities for transitional living for released offenders must provide for the licensure of at least three different types of facilities, including, without limitation:
(a) Facilities that only provide a housing and living environment;
(b) Facilities that provide or arrange for the provision of supportive services for residents of the facility to assist the residents with reintegration into the community, in addition to providing a housing and living environment; and
(c) Facilities that provide or arrange for the provision of programs for alcohol and other substance use disorders, in addition to providing a housing and living environment and providing or arranging for the provision of other supportive services.
Κ The regulations must provide that if a facility was originally constructed as a single-family dwelling, the facility must not be authorized for more than eight beds.
11. The Board shall adopt regulations applicable to providers of community-based living arrangement services which:
(a) Except as otherwise provided in paragraph (b), require a natural person responsible for the operation of a provider of community-based living arrangement services and each employee of a provider of community-based living arrangement services who supervises or provides support to recipients of community-based living arrangement services to complete training concerning the provision of community-based living arrangement services to persons with mental illness and continuing education concerning the particular population served by the provider;
(b) Exempt a person licensed or certified pursuant to title 54 of NRS from the requirements prescribed pursuant to paragraph (a) if the Board determines that the person is required to receive training and continuing education substantially equivalent to that prescribed pursuant to that paragraph;
(c) Require a natural person responsible for the operation of a provider of community-based living arrangement services to receive training concerning the provisions of title 53 of NRS applicable to the provision of community-based living arrangement services; and
κ2023 Statutes of Nevada, Page 3444 (CHAPTER 524, SB 385)κ
(d) Require an applicant for a license to provide community-based living arrangement services to post a surety bond in an amount equal to the operating expenses of the applicant for 2 months, place that amount in escrow or take another action prescribed by the Division to ensure that, if the applicant becomes insolvent, recipients of community-based living arrangement services from the applicant may continue to receive community-based living arrangement services for 2 months at the expense of the applicant.
12. The Board shall adopt separate regulations governing the licensing and operation of freestanding birthing centers. Such regulations must:
(a) Align with the standards established by the American Association of Birth Centers, or its successor organization, the accrediting body of the Commission for the Accreditation of Birth Centers, or its successor organization, or another nationally recognized organization for accrediting freestanding birthing centers; and
(b) Allow the provision of supervised training to providers of health care, as appropriate, at a freestanding birthing center.
13. As used in this section, living unit means an individual private accommodation designated for a resident within the facility.
Sec. 5. NRS 449.160 is hereby amended to read as follows:
449.160 1. The Division may deny an application for a license or may suspend or revoke any license issued under the provisions of NRS 449.029 to 449.2428, inclusive, and section 1 of this act upon any of the following grounds:
(a) Violation by the applicant or the licensee of any of the provisions of NRS 439B.410 or 449.029 to 449.245, inclusive, and section 1 of this act or of any other law of this State or of the standards, rules and regulations adopted thereunder.
(b) Aiding, abetting or permitting the commission of any illegal act.
(c) Conduct inimical to the public health, morals, welfare and safety of the people of the State of Nevada in the maintenance and operation of the premises for which a license is issued.
(d) Conduct or practice detrimental to the health or safety of the occupants or employees of the facility.
(e) Failure of the applicant to obtain written approval from the Director of the Department of Health and Human Services as required by NRS 439A.100 or as provided in any regulation adopted pursuant to NRS 449.001 to 449.430, inclusive, and section 1 of this act and 449.435 to 449.531, inclusive, and chapter 449A of NRS if such approval is required.
(f) Failure to comply with the provisions of NRS 441A.315 and any regulations adopted pursuant thereto or NRS 449.2486.
(g) Violation of the provisions of NRS 458.112.
2. In addition to the provisions of subsection 1, the Division may revoke a license to operate a facility for the dependent if, with respect to that facility, the licensee that operates the facility, or an agent or employee of the licensee:
(a) Is convicted of violating any of the provisions of NRS 202.470;
(b) Is ordered to but fails to abate a nuisance pursuant to NRS 244.360, 244.3603 or 268.4124; or
κ2023 Statutes of Nevada, Page 3445 (CHAPTER 524, SB 385)κ
(c) Is ordered by the appropriate governmental agency to correct a violation of a building, safety or health code or regulation but fails to correct the violation.
3. The Division shall maintain a log of any complaints that it receives relating to activities for which the Division may revoke the license to operate a facility for the dependent pursuant to subsection 2. The Division shall provide to a facility for the care of adults during the day:
(a) A summary of a complaint against the facility if the investigation of the complaint by the Division either substantiates the complaint or is inconclusive;
(b) A report of any investigation conducted with respect to the complaint; and
(c) A report of any disciplinary action taken against the facility.
Κ The facility shall make the information available to the public pursuant to NRS 449.2486.
4. On or before February 1 of each odd-numbered year, the Division shall submit to the Director of the Legislative Counsel Bureau a written report setting forth, for the previous biennium:
(a) Any complaints included in the log maintained by the Division pursuant to subsection 3; and
(b) Any disciplinary actions taken by the Division pursuant to subsection 2.
Sec. 6. NRS 449.163 is hereby amended to read as follows:
449.163 1. In addition to the payment of the amount required by NRS 449.0308, if a medical facility, facility for the dependent or facility which is required by the regulations adopted by the Board pursuant to NRS 449.0303 to be licensed violates any provision related to its licensure, including any provision of NRS 439B.410 or 449.029 to 449.2428, inclusive, and section 1 of this act or any condition, standard or regulation adopted by the Board, the Division, in accordance with the regulations adopted pursuant to NRS 449.165, may:
(a) Prohibit the facility from admitting any patient until it determines that the facility has corrected the violation;
(b) Limit the occupancy of the facility to the number of beds occupied when the violation occurred, until it determines that the facility has corrected the violation;
(c) If the license of the facility limits the occupancy of the facility and the facility has exceeded the approved occupancy, require the facility, at its own expense, to move patients to another facility that is licensed;
(d) Impose an administrative penalty of not more than $5,000 per day for each violation, together with interest thereon at a rate not to exceed 10 percent per annum; and
(e) Appoint temporary management to oversee the operation of the facility and to ensure the health and safety of the patients of the facility, until:
(1) It determines that the facility has corrected the violation and has management which is capable of ensuring continued compliance with the applicable statutes, conditions, standards and regulations; or
(2) Improvements are made to correct the violation.
2. If the facility fails to pay any administrative penalty imposed pursuant to paragraph (d) of subsection 1, the Division may:
κ2023 Statutes of Nevada, Page 3446 (CHAPTER 524, SB 385)κ
(a) Suspend the license of the facility until the administrative penalty is paid; and
(b) Collect court costs, reasonable attorneys fees and other costs incurred to collect the administrative penalty.
3. The Division may require any facility that violates any provision of NRS 439B.410 or 449.029 to 449.2428, inclusive, and section 1 of this act or any condition, standard or regulation adopted by the Board to make any improvements necessary to correct the violation.
4. Any money collected as administrative penalties pursuant to paragraph (d) of subsection 1 must be accounted for separately and used to administer and carry out the provisions of NRS 449.001 to 449.430, inclusive, and section 1 of this act, 449.435 to 449.531, inclusive, and chapter 449A of NRS to protect the health, safety, well-being and property of the patients and residents of facilities in accordance with applicable state and federal standards or for any other purpose authorized by the Legislature.
Sec. 7. NRS 449.240 is hereby amended to read as follows:
449.240 The district attorney of the county in which the facility is located shall, upon application by the Division, institute and conduct the prosecution of any action for violation of any provisions of NRS 449.029 to 449.245, inclusive [.] , and section 1 of this act.
Sec. 8. NRS 232.320 is hereby amended to read as follows:
232.320 1. The Director:
(a) Shall appoint, with the consent of the Governor, administrators of the divisions of the Department, who are respectively designated as follows:
(1) The Administrator of the Aging and Disability Services Division;
(2) The Administrator of the Division of Welfare and Supportive Services;
(3) The Administrator of the Division of Child and Family Services;
(4) The Administrator of the Division of Health Care Financing and Policy; and
(5) The Administrator of the Division of Public and Behavioral Health.
(b) Shall administer, through the divisions of the Department, the provisions of chapters 63, 424, 425, 427A, 432A to 442, inclusive, 446 to 450, inclusive, 458A and 656A of NRS, NRS 127.220 to 127.310, inclusive, 422.001 to 422.410, inclusive, and sections 9.4 and 9.8 of this act, 422.580, 432.010 to 432.133, inclusive, 432B.6201 to 432B.626, inclusive, 444.002 to 444.430, inclusive, and 445A.010 to 445A.055, inclusive, and all other provisions of law relating to the functions of the divisions of the Department, but is not responsible for the clinical activities of the Division of Public and Behavioral Health or the professional line activities of the other divisions.
(c) Shall administer any state program for persons with developmental disabilities established pursuant to the Developmental Disabilities Assistance and Bill of Rights Act of 2000, 42 U.S.C. §§ 15001 et seq.
(d) Shall, after considering advice from agencies of local governments and nonprofit organizations which provide social services, adopt a master plan for the provision of human services in this State. The Director shall revise the plan biennially and deliver a copy of the plan to the Governor and the Legislature at the beginning of each regular session. The plan must:
κ2023 Statutes of Nevada, Page 3447 (CHAPTER 524, SB 385)κ
(1) Identify and assess the plans and programs of the Department for the provision of human services, and any duplication of those services by federal, state and local agencies;
(2) Set forth priorities for the provision of those services;
(3) Provide for communication and the coordination of those services among nonprofit organizations, agencies of local government, the State and the Federal Government;
(4) Identify the sources of funding for services provided by the Department and the allocation of that funding;
(5) Set forth sufficient information to assist the Department in providing those services and in the planning and budgeting for the future provision of those services; and
(6) Contain any other information necessary for the Department to communicate effectively with the Federal Government concerning demographic trends, formulas for the distribution of federal money and any need for the modification of programs administered by the Department.
(e) May, by regulation, require nonprofit organizations and state and local governmental agencies to provide information regarding the programs of those organizations and agencies, excluding detailed information relating to their budgets and payrolls, which the Director deems necessary for the performance of the duties imposed upon him or her pursuant to this section.
(f) Has such other powers and duties as are provided by law.
2. Notwithstanding any other provision of law, the Director, or the Directors designee, is responsible for appointing and removing subordinate officers and employees of the Department.
Sec. 9. Chapter 422 of NRS is hereby amended by adding thereto the provisions set forth as sections 9.4 and 9.8 of this act.
Sec. 9.4. 1. To the extent that federal financial participation is available, the Director shall include under Medicaid coverage for:
(a) The filling of cavities;
(b) The fabrication, preparation and placement of temporary and permanent crowns; and
(c) Removable dentures to improve chewing, phonetics and aesthetics.
2. The Department shall:
(a) Apply to the Secretary of Health and Human Services for any waiver of federal law or apply for any amendment of the State Plan for Medicaid that is necessary for the Department to receive federal funding to provide the coverage described in subsection 1.
(b) Fully cooperate in good faith with the Federal Government during the application process to satisfy the requirements of the Federal Government for obtaining a waiver or amendment pursuant to paragraph (a).
Sec. 9.8. 1. To the extent that federal financial participation is available, the Director shall include under Medicaid coverage for polycarbonate lenses. Medicaid must not require, as a condition precedent to such coverage:
(a) A provider of health care to provide documentation concerning the reasons for using a polycarbonate lens instead of another type of lens; or
(b) The recipient of Medicaid to try another type of lens.
κ2023 Statutes of Nevada, Page 3448 (CHAPTER 524, SB 385)κ
2. The Department shall:
(a) Apply to the Secretary of Health and Human Services for any waiver of federal law or apply for any amendment of the State Plan for Medicaid that is necessary for the Department to receive federal funding to provide the coverage described in subsection 1.
(b) Fully cooperate in good faith with the Federal Government during the application process to satisfy the requirements of the Federal Government for obtaining a waiver or amendment pursuant to paragraph (a).
Sec. 10. NRS 654.190 is hereby amended to read as follows:
654.190 1. The Board may, after notice and an opportunity for a hearing as required by law, impose an administrative fine of not more than $10,000 for each violation on, recover reasonable investigative fees and costs incurred from, suspend, revoke, deny the issuance or renewal of or place conditions on the license of, and place on probation or impose any combination of the foregoing on any licensee who:
(a) Is convicted of a felony relating to the practice of administering a nursing facility or residential facility or of any offense involving moral turpitude.
(b) Has obtained his or her license by the use of fraud or deceit.
(c) Violates any of the provisions of this chapter.
(d) Aids or abets any person in the violation of any of the provisions of NRS 449.029 to 449.2428, inclusive, and section 1 of this act, as those provisions pertain to a facility for skilled nursing, facility for intermediate care or residential facility for groups.
(e) Violates any regulation of the Board prescribing additional standards of conduct for licensees, including, without limitation, a code of ethics.
(f) Engages in conduct that violates the trust of a patient or resident or exploits the relationship between the licensee and the patient or resident for the financial or other gain of the licensee.
2. If a licensee requests a hearing pursuant to subsection 1, the Board shall give the licensee written notice of a hearing pursuant to NRS 233B.121 and 241.034. A licensee may waive, in writing, his or her right to attend the hearing.
3. The Board may compel the attendance of witnesses or the production of documents or objects by subpoena. The Board may adopt regulations that set forth a procedure pursuant to which the Chair of the Board may issue subpoenas on behalf of the Board. Any person who is subpoenaed pursuant to this subsection may request the Board to modify the terms of the subpoena or grant additional time for compliance.
4. An order that imposes discipline and the findings of fact and conclusions of law supporting that order are public records.
5. The expiration of a license by operation of law or by order or decision of the Board or a court, or the voluntary surrender of a license, does not deprive the Board of jurisdiction to proceed with any investigation of, or action or disciplinary proceeding against, the licensee or to render a decision suspending or revoking the license.
κ2023 Statutes of Nevada, Page 3449 (CHAPTER 524, SB 385)κ
Sec. 11. (Deleted by amendment.)
Sec. 11.5. 1. There is hereby appropriated from the State General Fund to the Division of Health Care Financing and Policy of the Department of Health and Human Services for the administrative and medical services costs of providing Medicaid coverage for certain dental services the following sums:
For the Fiscal Year 2023-2024................................................. $1,165,121
For the Fiscal Year 2024-2025................................................. $1,410,808
2. Expenditure of the following sums not appropriated from the State General Fund or the State Highway Fund is hereby authorized by Division of Health Care Financing and Policy of the Department of Health and Human Services for the same purpose as set forth in subsection 1:
For the Fiscal Year 2023-2024................................................. $5,194,695
For the Fiscal Year 2024-2025................................................. $5,867,076
3. Any balance of the sums appropriated by subsection 1 remaining at the end of the respective fiscal years must not be committed for expenditure after June 30 of the respective fiscal years by the entity to which the appropriation is made or any entity to which money from the appropriation is granted or otherwise transferred in any manner, and any portion of the appropriated money remaining must not be spent for any purpose after September 20, 2024, and September 19, 2025, respectively, by either the entity to which the money was appropriated or the entity to which the money was subsequently granted or transferred, and must be reverted to the State General Fund on or before September 20, 2024, and September 19, 2025, respectively.
Sec. 12. 1. This section becomes effective upon passage and approval.
2. Section 11.5 of this act becomes effective on July 1, 2023.
3. Sections 1 to 7, inclusive, 10 and 11 of this act become effective on October 1, 2023.
4. Sections 8 to 9.8, inclusive, of this act become effective:
(a) Upon passage and approval for the purpose of performing any other preparatory administrative tasks that are necessary to carry out the provisions of this act; and
(b) On January 1, 2024, for all other purposes.
________
κ2023 Statutes of Nevada, Page 3450κ
Senate Bill No. 370Senators Cannizzaro, Nguyen, Donate; Daly, D. Harris, Lange, Neal, Pazina and Scheible
CHAPTER 525
[Approved: June 15, 2023]
AN ACT relating to data privacy; requiring certain entities to develop, maintain and make available on the Internet a policy concerning the privacy of consumer health data; prohibiting such an entity from collecting or sharing consumer health data without the affirmative, voluntary consent of a consumer in certain circumstances; requiring such an entity to perform certain actions upon the request of a consumer; requiring such an entity to establish a process to appeal the denial of such a request; requiring such an entity to take certain actions to protect the security of consumer health data; limiting the circumstances under which a processor is authorized to process consumer health data; requiring a processor to assist certain entities in complying with certain requirements; prohibiting a person from selling or offering to sell consumer health data under certain circumstances; prohibiting the implementation of a geofence under certain circumstances; prohibiting discrimination against a consumer for certain reasons; authorizing certain civil enforcement; providing penalties; and providing other matters properly relating thereto.
Legislative Counsels Digest:
Existing federal law and regulations contain various protections for health information maintained or used: (1) by a person or entity that provides health care, an insurer or a business associate of a person or entity that provides health care or an insurer; or (2) for scientific research. (42 U.S.C. §§ 11101 et seq.; Pub. L. No. 104-191, 100 Stat. 2548; 21 C.F.R. Parts 46, 50 and 56, 42 C.F.R. Parts 2 and 3, 45 C.F.R. Parts 160 and 164) Sections 2-34 of this bill prescribe various protections for consumer health data that is maintained and used by other persons and nongovernmental entities and for other purposes. Section 7 of this bill defines the term consumer to mean a natural person who has requested a product or service from a regulated entity and who resides in this State or whose consumer health data is collected in this State, except for a natural person acting in an employment context or as an agent of a governmental entity. Section 8 of this bill defines the term consumer health data to mean personally identifiable information that is linked or reasonably capable of being linked to a consumer and is used by a regulated entity to identify the health status of the consumer. Section 15 of this bill defines the term regulated entity to refer to a person who: (1) conducts business in this State or produces or provides products or services that are targeted to consumers in this State; and (2) determines the purpose and means of processing, sharing or selling consumer health data. Sections 3-6, 9-14 and 16-19 of this bill define certain other terms. Section 20 of this bill provides that the provisions of sections 2-34 do not apply to certain persons, entities and data, including: (1) certain persons and entities whose collection and disclosure of data is specifically regulated by federal law; and (2) certain data that is collected or disclosed under certain provisions of federal law or regulations or state law.
κ2023 Statutes of Nevada, Page 3451 (CHAPTER 525, SB 370)κ
Section 21 of this bill requires a regulated entity to develop, maintain and make available a policy concerning the privacy of consumer health data. Section 21 also prohibits a regulated entity from: (1) taking certain actions with regard to consumer health data that are inconsistent with the policy without the affirmative, voluntary consent of the consumer; or (2) entering into a contract for the processing of consumer health data that is inconsistent with the policy. Section 22 of this bill generally prohibits a regulated entity from collecting or sharing consumer health data without the affirmative, voluntary consent of the consumer to whom the data relates, except to the extent necessary to provide a product or service that the consumer has requested from the regulated entity. Section 22 of this bill prescribes certain requirements governing such consent.
Section 24 of this bill requires a regulated entity, upon the request of a consumer, to: (1) confirm whether the regulated entity is collecting, sharing or selling consumer health data concerning the consumer; (2) provide the consumer with a list of all third parties with whom the regulated entity has shared or to whom the regulated entity has sold consumer health data relating to the consumer; (3) cease collecting or sharing consumer health data relating to the consumer; or (4) delete consumer health data concerning the consumer. Section 24 also requires a regulated entity to establish a secure and reliable means of making such a request. Section 25 of this bill prescribes requirements governing the response to such a request, including a requirement that a regulated entity provide information in response to such a request free of charge in most circumstances. However, if a consumer submits more than two requests in a year and those requests are manifestly unfounded, excessive or repetitive, section 25 authorizes the regulated entity to charge a reasonable fee to provide such information. Section 26 of this bill prescribes requirements governing the time within which a regulated entity or an affiliate, processor or other third party with which a regulated entity has shared data must delete consumer health data in response to a request for such deletion. Section 27 of this bill requires a regulated entity to establish a process to appeal the refusal of the regulated entity to act on a request made pursuant to section 24.
Section 28 of this bill requires a regulated entity to limit access to and establish, implement and maintain policies and procedures to protect the security of consumer health data. Section 29 of this bill requires a processor who processes consumer health data on behalf of a regulated entity to only process such data in accordance with a written contract between the processor and the regulated entity. Section 29 also requires such a processor to assist the regulated entity in complying with the provisions of sections 2-34.
Section 30 of this bill prohibits a person from selling or offering to sell consumer health data without the written authorization of the consumer to whom the data pertains or beyond the scope of such authorization, with certain exceptions. Section 30 also prohibits a person from conditioning the provision of goods or services on a consumer providing such authorization. Section 30 requires a person who sells consumer health data to: (1) establish a means by which a consumer may revoke such written authorization; and (2) provide a copy of such written authorization to the consumer and purchaser. Section 30 also requires both a seller and a purchaser of consumer health data to maintain such written authorization for at least 6 years after the expiration of the written authorization. Section 17 of this bill exempts certain activity from the definition of the term sell, thereby exempting such activity from the requirements of section 30.
Section 31 of this bill prohibits a person from implementing a geofence within 1,750 feet of any person or entity that provides in-person health care services or products for certain purposes. Section 33 of this bill prohibits a regulated entity from discriminating against a consumer for taking any action authorized by sections 2-34 or to enforce those provisions.
κ2023 Statutes of Nevada, Page 3452 (CHAPTER 525, SB 370)κ
Existing law provides that a variety of actions constitute deceptive trade practices. (NRS 118A.275, 205.377, 228.620, 370.695, 597.997, 603.170, 604B.910, 676A.770; chapter 598 of NRS) Existing law authorizes a court to impose a civil penalty of not more than $12,500 for each violation upon a person whom the court finds has engaged in a deceptive trade practice directed toward an elderly person or a person with a disability. (NRS 598.0973) Additionally, existing law authorizes a court to make such additional orders or judgments as may be necessary to restore to any person in interest any money or property which may have been acquired by means of any deceptive trade practice. (NRS 598.0993) In addition to these enforcement mechanisms, existing law provides that when the Commissioner of Consumer Affairs or the Director of the Department of Business and Industry has cause to believe that a person has engaged or is engaging in any deceptive trade practice, the Commissioner or Director may request that the Attorney General represent him or her in instituting an appropriate legal proceeding, including an application for an injunction or temporary restraining order. (NRS 598.0979) Existing law provides that if a person violates a court order or injunction resulting from a complaint brought by the Commissioner, the Director, the district attorney of any county of this State or the Attorney General, the person is required to pay a civil penalty of not more than $10,000 for each violation. Furthermore, if a court finds that a person has willfully engaged in a deceptive trade practice, the person who committed the violation: (1) may be required to pay an additional civil penalty not more than $5,000 for each violation; and (2) is guilty of a felony or misdemeanor, depending on the value of the property or services lost as a result of the deceptive trade practice. (NRS 598.0999) With certain exceptions, section 34 of this bill provides that a person who violates any provision of sections 2-34 is guilty of a deceptive trade practice. Sections 1 and 34 of this bill provide that a person injured by such a violation does not have a private right of action. Section 34 additionally provides that the provisions of sections 2-34 must not be construed to affect any other provision of law.
Section 35 of this bill exempts consumer health data from provisions of existing law governing information collected on the Internet from consumers because those provisions are less stringent than the provisions of sections 2-34.
EXPLANATION Matter in bolded italics is new; matter between
brackets [omitted material] is material to be
omitted.
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1. NRS 598.0977 is hereby amended to read as follows:
598.0977 [If] Except as otherwise provided in section 34 of this act, an elderly person or a person with a disability suffers damage or injury as a result of a deceptive trade practice, he or she or his or her legal representative, if any, may commence a civil action against any person who engaged in the practice to recover the actual damages suffered by the elderly person or person with a disability, punitive damages, if appropriate, and reasonable attorneys fees. The collection of any restitution awarded pursuant to this section has a priority over the collection of any civil penalty imposed pursuant to NRS 598.0973.
Sec. 1.5. Chapter 603A of NRS is hereby amended by adding thereto the provisions set forth as sections 2 to 34.9, inclusive, of this act.
Sec. 2. As used in sections 2 to 34, inclusive, of this act, unless the context otherwise requires, the words and terms defined in sections 3 to 19, inclusive, of this act have the meanings ascribed to them in those sections.
Sec. 3. Affiliate means an entity that shares common branding with another entity and controls, is controlled by or is under common control with the other entity.
κ2023 Statutes of Nevada, Page 3453 (CHAPTER 525, SB 370)κ
control with the other entity. For the purposes of this section, an entity shall be deemed to control another entity if the entity:
1. Owns or has the power to vote at least half of the outstanding shares of any class of voting security in the other entity;
2. Controls in any manner the election of a majority of the directors or persons exercising similar functions to directors of the other entity; or
3. Has the power to exercise controlling influence over the management of the other entity.
Sec. 4. Authenticate means to ascertain the identity of the originator of an electronic or physical document and establish a link between the document and the originator.
Sec. 5. Biometric data means data which is generated from the measurement or technical processing of the physiological, biological or behavioral characteristics of a person and, alone or in combination with other data, is capable of being used to identify the person. The term includes, without limitation:
1. Imagery of the fingerprint, palm print, hand print, scar, bodily mark, tattoo, voiceprint, face, retina, iris or vein pattern of a person; and
2. Keystroke patterns or rhythms and gait patterns or rhythms that contain identifying information.
Sec. 6. Collect means to buy, rent, access, retain, receive, acquire, infer, derive or otherwise process consumer health data in any manner.
Sec. 7. Consumer means a natural person who has requested a product or service from a regulated entity and who resides in this State or whose consumer health data is collected in this State. The term does not include a natural person acting in an employment context or as an agent of a governmental entity.
Sec. 8. Consumer health data means personally identifiable information that is linked or reasonably capable of being linked to a consumer and that a regulated entity uses to identify the past, present or future health status of the consumer. The term:
1. Includes, without limitation:
(a) Information relating to:
(1) Any health condition or status, disease or diagnosis;
(2) Social, psychological, behavioral or medical interventions;
(3) Surgeries or other health-related procedures;
(4) The use or acquisition of medication;
(5) Bodily functions, vital signs or symptoms;
(6) Reproductive or sexual health care; and
(7) Gender-affirming care;
(b) Biometric data or genetic data related to information described in paragraph (a);
(c) Information related to the precise geolocation information of a consumer that a regulated entity uses to indicate an attempt by a consumer to receive health care services or products; and
(d) Any information described in paragraph (a), (b) or (c) that is derived or extrapolated from information that is not consumer health data, including, without limitation, proxy, derivative, inferred or emergent data derived through an algorithm, machine learning or any other means.
2. Does not include information that is used to:
(a) Provide access to or enable gameplay by a person on a video game platform; or
κ2023 Statutes of Nevada, Page 3454 (CHAPTER 525, SB 370)κ
(b) Identify the shopping habits or interests of a consumer, if that information is not used to identify the specific past, present or future health status of the consumer.
Sec. 9. Gender-affirming care means health services or products that support and affirm the gender identity of a person, including, without limitation:
1. Treatments for gender dysphoria;
2. Gender-affirming hormone therapy; and
3. Gender-affirming surgery.
Sec. 10. Genetic data means any data that concerns the genetic characteristics of a person. The term includes, without limitation:
1. Data directly resulting from the sequencing of all or a portion of the deoxyribonucleic acid of a person;
2. Genotypic and phenotypic information that results from analyzing the information described in subsection 1; and
3. Data concerning the health of a person that is analyzed in connection with the information described in subsection 1.
Sec. 11. Health care services or products means any service or product provided to a person to assess, measure, improve or learn about the health of a person. The term includes, without limitation:
1. Services relating to any health condition or status, disease or diagnosis;
2. Social, psychological, behavioral or medical interventions;
3. Surgeries or other health-related procedures;
4. Medication or services related to the use or acquisition of medication; or
5. Monitoring or measurement related to bodily functions, vital signs or symptoms.
Sec. 12. (Deleted by amendment.)
Sec. 12.5. Precise geolocation information means information derived from technology, including, without limitation, latitude and longitude coordinates at the level of detail typically provided by a global positioning system, that directly identifies the specific location of a natural person with precision and accuracy within a radius of 1,750 feet. The term does not include:
1. The content of any communication; or
2. Any data generated by or connected to advanced metering infrastructure for utilities or other equipment used by a utility.
Sec. 13. Process means any operation or set of operations performed on consumer health data.
Sec. 14. Processor means a person who processes consumer health data on behalf of a regulated entity.
Sec. 15. Regulated entity means any person who:
1. Conducts business in this State or produces or provides products or services that are targeted to consumers in this State; and
2. Alone or with other persons, determines the purpose and means of processing, sharing or selling consumer health data.
Sec. 16. Reproductive or sexual health care means health care services or products that support or relate to the reproductive system or sexual well-being of a person. The term includes, without limitation, abortion, the provision of medication to induce an abortion and any medical or nonmedical services associated with an abortion.
κ2023 Statutes of Nevada, Page 3455 (CHAPTER 525, SB 370)κ
Sec. 17. Sell means to exchange consumer health data for money or other valuable consideration. The term does not include the exchange of consumer health data for money or other valuable consideration:
1. With a processor in a manner consistent with the purpose for which the consumer health data was collected, as disclosed to the consumer to whom the consumer health data pertains pursuant to section 22 of this act.
2. With a third party as an asset that is part of a merger, acquisition, bankruptcy or other transaction through which the third party assumes control of all or part of the assets of the regulated entity.
3. With a third party for the purpose of providing a product or service requested by the consumer to whom the consumer health data pertains.
4. With an affiliate of the person who is providing or disclosing the consumer health data.
5. As directed by the consumer to whom the consumer health data pertains or where the consumer to whom the consumer health data pertains intentionally uses the person who is providing or disclosing the consumer health data to interact with the third party to whom the consumer health data is provided or disclosed.
6. Where the consumer has intentionally made the consumer health data available to the general public through mass media that was not restricted to a specific audience.
Sec. 18. Share means to release, disclose, disseminate, divulge, make available, provide access to, license or otherwise communicate consumer health data orally, in writing or by electronic or other means.
Sec. 19. Third party means a person who is not a consumer, regulated entity, processor or affiliate of a regulated entity.
Sec. 20. 1. The provisions of sections 2 to 34, inclusive, of this act do not apply to:
(a) Any person or entity that is subject to the Health Insurance Portability and Accountability Act of 1996, Public Law 104-191, and the regulations adopted pursuant thereto.
(b) A financial institution or an affiliate of a financial institution that is subject to the provisions of the Gramm-Leach-Bliley Act, 15 U.S.C. §§ 6801 et seq., or any personally identifiable information regulated by that Act which is collected, maintained or sold as provided in that Act.
(c) Patient identifying information, as defined in 42 C.F.R. § 2.11, that is collected, used or disclosed in accordance with 42 C.F.R. Part 2.
(d) Patient safety work product, as defined in 42 C.F.R. § 3.20, that is collected, used or disclosed in accordance with 42 C.F.R. Part 3.
(e) Identifiable private information, as defined in 45 C.F.R. § 46.102, that is collected, used or disclosed in accordance with 45 C.F.R. Part 46.
(f) Information used or shared as part of research conducted pursuant to 45 C.F.R. Part 46 or 21 C.F.R. Parts 50 and 56 or in accordance with the version of the Guideline for Good Clinical Practice prescribed by the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use published on November 9, 2016.
(g) Information used only for public health activities and purposes, as described in 45 C.F.R. § 164.512(b), regardless of whether such information is subject to the Health Insurance Portability and Accountability Act of 1996, Public Law 104-191, and the regulations adopted pursuant thereto.
κ2023 Statutes of Nevada, Page 3456 (CHAPTER 525, SB 370)κ
(h) Personally identifiable information that is governed by and collected, used or disclosed pursuant to:
(1) Part C of Title XI of the Social Security Act, 42 U.S.C. §§ 1320d et seq.;
(2) The Fair Credit Reporting Act, 15 U.S.C. §§ 1681 et seq.; or
(3) The Family Educational Rights and Privacy Act of 1974, 20 U.S.C. § 1232g, and the regulations adopted pursuant thereto.
(i) Information and documents created for the purposes of compliance with the federal Health Care Quality Improvement Act of 1986, 42 U.S.C. §§ 11101 et seq., and any regulations adopted pursuant thereto.
(j) The collection or sharing of consumer health data where expressly authorized by any provision of federal or state law.
(k) Information processed by or for any governmental or tribal entity for civic or governmental purposes and operations or related services and operations.
(l) Any person who holds a nonrestricted license, as defined in NRS 463.0177, or an affiliate, as defined in NRS 463.0133, of such a person.
(m) Law enforcement agencies, contractors of law enforcement agencies and law enforcement activities.
(n) Information that has been de-identified in accordance with the requirements for de-identification set forth in 45 C.F.R. § 164.514.
2. A third party that obtains consumer health data from a regulated entity through a merger, acquisition, bankruptcy or other transaction through which the third party assumes control of all or part of the assets of the regulated entity is deemed to assume all obligations of the regulated entity to comply with the provisions of sections 2 to 34, inclusive, of this act.
Sec. 21. 1. A regulated entity shall develop and maintain a policy concerning the privacy of consumer health data that clearly and conspicuously establishes:
(a) The categories of consumer health data being collected by the regulated entity and the manner in which the consumer health data will be used;
(b) The categories of sources from which consumer health data is collected;
(c) The categories of consumer health data that are shared by the regulated entity;
(d) The categories of third parties and affiliates with whom the regulated entity shares consumer health data;
(e) The purposes of collecting, using and sharing consumer health data;
(f) The manner in which consumer health data will be processed;
(g) The procedure for submitting a request pursuant to section 24 of this act;
(h) The process, if any such process exists, for a consumer to review and request changes to any of his or her consumer health data that is collected by the regulated entity;
(i) The process by which the regulated entity notifies consumers whose consumer health data is collected by the regulated entity of material changes to the privacy policy;
κ2023 Statutes of Nevada, Page 3457 (CHAPTER 525, SB 370)κ
(j) Whether a third party may collect consumer health data over time and across different Internet websites or online services when the consumer uses any Internet website or online service of the regulated entity; and
(k) The effective date of the privacy policy.
2. A regulated entity shall post conspicuously on the main Internet website maintained by the regulated entity a hyperlink to the policy developed pursuant to subsection 1 or otherwise provide that policy to consumers in a manner that is clear and conspicuous.
3. A regulated entity shall not:
(a) Collect, use or share categories of consumer health data, other than those included in the privacy policy pursuant to paragraph (c) of subsection 1, without disclosing those additional categories to each consumer whose data will be collected, used or shared and obtaining the affirmative, voluntary consent of the consumer;
(b) Share consumer health data with a third party or affiliate, other than those included in the privacy policy pursuant to paragraph (d) of subsection 1, without disclosing those additional third parties or affiliates to each consumer whose data will be shared and obtaining the affirmative, voluntary consent of the consumer;
(c) Collect, use or share consumer health data for purposes other than those included in the privacy policy pursuant to paragraph (e) of subsection 1 without disclosing those additional purposes to each consumer whose data will be collected, used or shared and obtaining the affirmative, voluntary consent of the consumer; or
(d) Enter into a contract pursuant to section 29 of this act with a processer to process consumer health data that is inconsistent with the privacy policy.
Sec. 22. 1. A regulated entity shall not collect consumer health data except:
(a) With the affirmative, voluntary consent of the consumer; or
(b) To the extent necessary to provide a product or service that the consumer to whom the consumer health data relates has requested from the regulated entity.
2. A regulated entity shall not share consumer health data except:
(a) With the affirmative, voluntary consent of the consumer to whom the consumer health data relates, which must be separate and distinct from the consent provided pursuant to subsection 1 for the collection of the data;
(b) To the extent necessary to provide a product or service that the consumer to whom the consumer health data relates has requested from the regulated entity; or
(c) Where required or authorized by another provision of law.
3. Any consent required by this section must be obtained before the collection or sharing, as applicable, of consumer health data. The request for such consent must clearly and conspicuously disclose:
(a) The categories of consumer health data to be collected or shared, as applicable;
(b) The purpose for collecting or sharing, as applicable, the consumer health data including, without limitation, the manner in which the consumer health data will be used;
κ2023 Statutes of Nevada, Page 3458 (CHAPTER 525, SB 370)κ
(c) If the consumer health data will be shared, the categories of persons and entities with whom the consumer health data will be shared; and
(d) The manner in which the consumer may withdraw consent for the collection or sharing, as applicable, of consumer health data relating to the consumer and request that the regulated entity cease such collection or sharing pursuant to section 24 of this act.
Sec. 23. (Deleted by amendment.)
Sec. 24. 1. Except as otherwise provided in section 25 of this act, upon the request of a consumer, a regulated entity shall:
(a) Confirm whether the regulated entity is collecting, sharing or selling consumer health data relating to the consumer.
(b) Provide the consumer with a list of all third parties with whom the regulated entity has shared consumer health data relating to the consumer or to whom the regulated entity has sold such consumer health data.
(c) Cease collecting, sharing or selling consumer health data relating to the consumer.
(d) Delete consumer health data concerning the consumer.
2. A regulated entity shall establish a secure and reliable means of making a request pursuant to this section. When establishing the means for making such a request, the regulated entity must consider:
(a) The need for the safe and reliable communication of such requests; and
(b) The ability of the regulated entity to authenticate the identity of the consumer making the request.
Sec. 25. 1. Except as otherwise provided in this section, a regulated entity shall respond to a request made pursuant to section 24 of this act without undue delay and not later than 45 days after authenticating the request. If reasonably necessary based on the complexity and number of requests from the same consumer, the regulated entity may extend the period prescribed by this section not more than an additional 45 days. A regulated entity that grants itself such an extension must, not later than 45 days after authenticating the request, provide the consumer with notice of the extension and the reasons therefor.
2. If a regulated entity is not able to authenticate a request made pursuant to section 24 of this act after making commercially reasonable efforts, the regulated entity:
(a) Is not required to comply with the request; and
(b) May request that the consumer provide such additional information as is reasonably necessary to authenticate the request.
3. A regulated entity:
(a) Shall provide information free of charge to a consumer in response to:
(1) Requests made pursuant to section 24 of this act at least twice each year; and
(2) Additional requests that are not manifestly unfounded, excessive or repetitive.
(b) Except as otherwise provided in paragraph (a), may charge a reasonable fee to provide information to a consumer in response to requests made pursuant to section 24 of this act that are manifestly unfounded, excessive or repetitive.
κ2023 Statutes of Nevada, Page 3459 (CHAPTER 525, SB 370)κ
4. In any civil proceeding challenging the validity of a fee charged pursuant to paragraph (b) of subsection 3, the regulated entity has the burden of demonstrating by a preponderance of the evidence that the request to which the fee pertained was manifestly unfounded, excessive or repetitive.
Sec. 26. 1. Not later than 30 days after authenticating a request made pursuant to paragraph (d) of subsection 1 of section 24 of this act for the deletion of consumer health data, a regulated entity shall, except as otherwise provided in subsection 3:
(a) Delete all consumer health data described in the request from the records and network of the regulated entity; and
(b) Notify each affiliate, processor, contractor or other third party with which the regulated entity has shared consumer health data of the deletion request.
2. Not later than 30 days after receiving notification of a deletion request pursuant to paragraph (b) of subsection 1, an affiliate, processor, contractor or other third party shall, except as otherwise provided in subsection 3, delete the consumer health data described in the request from the records and network of the affiliate, processor, contractor or other third party.
3. If data described in a deletion request made pursuant to paragraph (d) of subsection 1 of section 24 of this act is stored or archived on backup systems, a regulated entity or an affiliate, processor, contractor or other third party may delay the deletion of the data for not more than 2 years after the request is authenticated, as necessary to restore the archived or backup system.
Sec. 27. 1. A regulated entity shall establish a process by which a consumer may appeal the refusal of the regulated entity to act on a request made pursuant to section 24 of this act. The process must be:
(a) Conspicuously available on the Internet website of the regulated entity; and
(b) Similar to the process for making a request pursuant to section 24 of this act.
2. Not later than 45 days after receiving an appeal pursuant to subsection 1, a regulated entity shall inform the consumer in writing of:
(a) Any action taken in response to the appeal or any decision not to take such action;
(b) The reasons for any such action or decision; and
(c) If the regulated entity decided not to take the action requested in the appeal, the contact information for the Office of the Attorney General.
Sec. 28. 1. A regulated entity shall only authorize the employees and processors of the regulated entity to access consumer health data where reasonably necessary to:
(a) Further the purpose for which the consumer consented to the collection or sharing of the consumer data pursuant to section 22 of this act; or
(b) Provide a product or service that the consumer to whom the consumer health data relates has requested from the regulated entity.
2. A regulated entity shall establish, implement and maintain policies and practices for the administrative, technical and physical security of consumer health data. The policies must:
κ2023 Statutes of Nevada, Page 3460 (CHAPTER 525, SB 370)κ
(a) Satisfy the standard of care in the industry in which the regulated entity operates to protect the confidentiality, integrity and accessibility of consumer health data;
(b) Comply with the provisions of NRS 603A.010 to 603A.290, inclusive, where applicable; and
(c) Be reasonable, taking into account the volume and nature of the consumer health data at issue.
Sec. 29. 1. A processor shall only process consumer health data pursuant to a contract between the processor and a regulated entity. Such a contract must set forth the applicable processing instructions and the specific actions that the processor is authorized to take with regard to the consumer health data it possesses on behalf of the regulated entity.
2. To the extent practicable, a processor shall assist the regulated entity with which the processor has entered into a contract pursuant to subsection 1 in complying with the provisions of sections 2 to 34, inclusive, of this act.
3. If a processor processes consumer health data outside the scope of a contract described in subsection 1 or in a manner inconsistent with any provision of such a contract, the processor:
(a) Is not guilty of a deceptive trade practice pursuant to section 34 of this act solely because the processor violated the requirements of this section; and
(b) Shall be deemed a regulated entity for the purposes of sections 2 to 34, inclusive, of this act, for actions and omissions with regard to such consumer health data.
Sec. 30. 1. A person shall not sell or offer to sell consumer health data:
(a) Without the written authorization of the consumer to whom the data pertains; or
(b) If the consumer provides such written authorization, in a manner that is outside the scope of or inconsistent with the written authorization.
2. A person shall not condition the provision of goods or services on a consumer authorizing the sale of consumer health data pursuant to subsection 1.
3. Written authorization pursuant to subsection 1 must be provided in a form written in plain language which includes, without limitation:
(a) The name and contact information of the person selling the consumer health data;
(b) A description of the specific consumer health data that the person intends to sell;
(c) The name and contact information of the person purchasing the consumer health data;
(d) A description of the purpose of the sale, including, without limitation, the manner in which the consumer health data will be gathered and the manner in which the person described in paragraph (c) intends to use the consumer health data;
(e) A statement of the provisions of subsection 2;
(f) A statement that the consumer may revoke the written authorization at any time and a description of the means established pursuant to subsection 4 for revoking the authorization;
κ2023 Statutes of Nevada, Page 3461 (CHAPTER 525, SB 370)κ
(g) A statement that any consumer health data sold pursuant to the written authorization may be disclosed to additional persons and entities by the person described in paragraph (c) and, after such disclosure, is no longer subject to the protections of this section;
(h) The date on which the written authorization expires pursuant to subsection 5; and
(i) The signature of the consumer to which the consumer health data pertains.
4. A person who sells consumer health data shall establish a means by which a consumer may revoke a written authorization made pursuant to subsection 1.
5. Written authorization provided pursuant to subsection 1 expires 1 year after the date on which the authorization is given.
6. A written authorization provided pursuant to subsection 1 is not valid if the written authorization:
(a) Was a condition for the provision of goods or services to the consumer in violation of subsection 2;
(b) Does not comply with the requirements of subsection 3;
(c) Has been revoked pursuant to subsection 4; or
(d) Has expired pursuant to subsection 5.
7. A person who sells consumer health data shall provide a copy of the written authorization provided pursuant to subsection 1 to the consumer who signed the written authorization and the purchaser of the consumer health data.
8. A seller and purchaser of consumer health data shall each retain a copy of the written authorization provided pursuant to subsection 1 for at least 6 years after the date on which the written authorization expired pursuant to subsection 5.
Sec. 31. 1. A person shall not implement a geofence within 1,750 feet of any medical facility, facility for the dependent or any other person or entity that provides in-person health care services or products for the purpose of:
(a) Identifying or tracking consumers seeking in-person health care services or products;
(b) Collecting consumer health data; or
(c) Sending notifications, messages or advertisements to consumers related to their consumer health data or health care services or products.
2. As used in this section:
(a) Facility for the dependent has the meaning ascribed to it in NRS 449.0045.
(b) Geofence means technology that uses coordinates for global positioning, connectivity to cellular towers, cellular data, radio frequency identification, wireless Internet data or any other form of detecting the physical location of a person to establish a virtual boundary with a radius of 1,750 feet or less around a specific physical location.
(c) Medical facility has the meaning ascribed to it in NRS 449.0151.
Sec. 32. (Deleted by amendment.)
Sec. 33. A regulated entity shall not discriminate against a consumer for taking:
1. Any action authorized by sections 2 to 34, inclusive, of this act; or
2. Any action to enforce the provisions of sections 2 to 34, inclusive, of this act.
κ2023 Statutes of Nevada, Page 3462 (CHAPTER 525, SB 370)κ
Sec. 34. 1. Except as otherwise provided in this section and section 29 of this act, a violation of sections 2 to 34, inclusive, of this act constitutes a deceptive trade practice for the purposes of NRS 598.0903 to 598.0999, inclusive.
2. The provisions of sections 2 to 34, inclusive, of this act:
(a) Do not create a private right of action; and
(b) Must not be construed to affect any other provision of law.
Secs. 34.1, 34.2, 34.3, 34.35, 34.4, 34.45, 34.5, 34.6, 34.7, 34.8 and 34.9. (Deleted by amendment.)
Sec. 35. NRS 603A.338 is hereby amended to read as follows:
603A.338 The provisions of NRS 603A.300 to 603A.360, inclusive, do not apply to:
1. A consumer reporting agency, as defined in 15 U.S.C. § 1681a(f);
2. Any personally identifiable information regulated by the Fair Credit Reporting Act, 15 U.S.C. §§ 1681 et seq., and the regulations adopted pursuant thereto, which is collected, maintained or sold as provided in that Act;
3. A person who collects, maintains or makes sales of personally identifiable information for the purposes of fraud prevention;
4. Any personally identifiable information that is publicly available;
5. Any personally identifiable information protected from disclosure under the federal Drivers Privacy Protection Act of 1994, 18 U.S.C. §§ 2721 et seq., which is collected, maintained or sold as provided in that Act; [or]
6. Any consumer health data subject to the provisions of sections 2 to 34, inclusive, of this act; or
7. A financial institution or an affiliate of a financial institution that is subject to the provisions of the Gramm-Leach-Bliley Act, 15 U.S.C. §§ 6801 et seq., or any personally identifiable information regulated by that Act which is collected, maintained or sold as provided in that Act.
Sec. 36. This act becomes effective on March 31, 2024.
________
κ2023 Statutes of Nevada, Page 3463κ
Senate Bill No. 363Senators Spearman, Daly; D. Harris, Neal, Ohrenschall, Pazina and Scheible
Joint Sponsor: Assemblyman DSilva
CHAPTER 526
[Approved: June 15, 2023]
AN ACT relating to affordable housing; authorizing the Housing Division of the Department of Business and Industry to prioritize funding for projects related to affordable housing that give preference to certain persons; and providing other matters properly relating thereto.
Legislative Counsels Digest:
Existing law creates the Account for Affordable Housing in the State General Fund and prescribes the distribution and use of money in the Account. (NRS 319.500, 319.510) Existing law also authorizes the Housing Division of the Department of Business and Industry to distribute a certain portion of money in the Account to public or private nonprofit charitable organizations for projects that meet certain criteria. (NRS 319.510) This bill authorizes the Division to give priority to projects that provide a preference for: (1) women who are veterans; (2) women who were previously incarcerated; (3) survivors of domestic violence; (4) elderly women who do not have stable or adequate living arrangements; and (5) unmarried persons with primary physical custody of a child.
EXPLANATION Matter in bolded italics is new; matter between
brackets [omitted material] is material to be
omitted.
Whereas, The shortage of affordable housing is affecting communities across the State of Nevada and the nation, and particularly impacts certain populations of women in Nevada; and
Whereas, Women who are veterans face many challenges when returning to civilian life, including, without limitation, raising children on their own and dealing with the psychological repercussions related to events such as military service or sexual trauma, which can put women who are veterans at a high risk of experiencing housing insecurity or homelessness; and
Whereas, Women who were formerly incarcerated experience barriers to employment as well as distrust and discrimination which create significant obstacles for formerly incarcerated women to obtain and maintain safe, stable housing for themselves and their families after release; and
Whereas, Survivors of domestic violence are also hampered in finding safe, affordable housing as a result of certain barriers such as a history of financial abuse, discrimination based on the violent or criminal actions of perpetrators and the unique safety and confidentiality needs of survivors of domestic violence; and
Whereas, Elderly women are more likely to live in poverty than men as a result of historical wage disparities and having to take time away from the workforce for caregiving; and
Whereas, Expansion of the inventory of affordable housing that provides a preference for these disadvantaged female populations will address many of the significant obstacles that such women face in obtaining safe, stable and affordable housing; and
κ2023 Statutes of Nevada, Page 3464 (CHAPTER 526, SB 363)κ
Whereas, Federal and state funding for housing in Nevada should be prioritized for projects that provide a preference for such disadvantaged women; now, therefore,
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1. NRS 319.510 is hereby amended to read as follows:
319.510 1. Except as otherwise provided in subsection 2, money deposited in the Account for Affordable Housing must be used:
(a) For the acquisition, construction or rehabilitation of affordable housing for eligible families by public or private nonprofit charitable organizations, housing authorities or local governments through loans, grants or subsidies;
(b) To provide technical and financial assistance to public or private nonprofit charitable organizations, housing authorities and local governments for the acquisition, construction or rehabilitation of affordable housing for eligible families;
(c) To provide funding for projects of public or private nonprofit charitable organizations, housing authorities or local governments that provide assistance to or guarantee the payment of rent or deposits as security for rent for eligible families, including homeless persons;
(d) To reimburse the Division for the costs of administering the Account;
(e) To assist eligible persons by supplementing their monthly rent for the manufactured home lots, as defined by NRS 118B.016, on which their manufactured homes, as defined by NRS 118B.015, are located; and
(f) In any other manner consistent with this section to assist eligible families in obtaining or keeping affordable housing, including use as the States contribution to facilitate the receipt of related federal money.
2. Except as otherwise provided in this subsection, the Division may expend money from the Account as reimbursement for the necessary costs of efficiently administering the Account and any money received pursuant to 42 U.S.C. §§ 12701 et seq. In no case may the Division expend more than $40,000 per year or an amount equal to 6 percent of any money made available to the State pursuant to 42 U.S.C. §§ 12701 et seq., whichever is greater. In addition, the Division may expend not more than $175,000 per year from the Account to create and maintain the statewide low-income housing database required by NRS 319.143. The Division may expend not more than $75,000 per year of the money deposited in the Account pursuant to NRS 375.070 for the purpose set forth in paragraph (e) of subsection 1. Of the remaining money allocated from the Account:
(a) Except as otherwise provided in subsection 3, 15 percent must be distributed to the Division of Welfare and Supportive Services of the Department of Health and Human Services for use in its program developed pursuant to 45 C.F.R. § 233.120, as that section existed on December 4, 1997, to provide emergency assistance to needy families with children, subject to the following:
(1) The Division of Welfare and Supportive Services shall adopt regulations governing the use of the money that are consistent with the provisions of this section.
κ2023 Statutes of Nevada, Page 3465 (CHAPTER 526, SB 363)κ
(2) The money must be used solely for activities relating to affordable housing that are consistent with the provisions of this section.
(3) The money must be made available to families that have children and whose income is at or below the federally designated level signifying poverty.
(4) All money provided by the Federal Government to match the money distributed to the Division of Welfare and Supportive Services pursuant to this section must be expended for activities consistent with the provisions of this section.
(b) Eighty-five percent must be distributed to public or private nonprofit charitable organizations, housing authorities and local governments for the acquisition, construction and rehabilitation of affordable housing for eligible families, subject to the following:
(1) Priority may be given to those projects that provide a preference for:
(I) Women who are veterans;
(II) Women who were previously incarcerated;
(III) Survivors of domestic violence;
(IV) Elderly women who do not have stable or adequate living arrangements; and
(V) Unmarried persons with primary physical custody of a child.
(2) Priority must be given to those projects that qualify for the federal tax credit relating to low-income housing.
[(2)] (3) Priority must be given to those projects that anticipate receiving federal money to match the state money distributed to them.
[(3)] (4) Priority must be given to those projects that have the commitment of a local government to provide assistance to them.
[(4)] (5) All money must be used to benefit families whose income does not exceed 120 percent of the median income for families residing in the same county, as defined by the United States Department of Housing and Urban Development.
[(5)] (6) Not less than 15 percent of the units acquired, constructed or rehabilitated must be affordable to persons whose income is at or below the federally designated level signifying poverty. For the purposes of this subparagraph, a unit is affordable if a family does not have to pay more than 30 percent of its gross income for housing costs, including both utility and mortgage or rental costs.
[(6)] (7) To be eligible to receive money pursuant to this paragraph, a project must be sponsored by a local government.
3. The Division may, pursuant to contract and in lieu of distributing money to the Division of Welfare and Supportive Services pursuant to paragraph (a) of subsection 2, distribute any amount of that money to private or public nonprofit entities for use consistent with the provisions of this section.
________
κ2023 Statutes of Nevada, Page 3466κ
Senate Bill No. 355Senators Lange and Hammond
CHAPTER 527
[Approved: June 15, 2023]
AN ACT relating to commerce; prohibiting the Commissioner of Financial Institutions from requiring an applicant for a license to establish a new depository institution to identify the physical address of the proposed depository institution in the application for the license; authorizing certain persons employed by financial institutions to temporarily delay certain financial transactions involving the suspected exploitation of an older person or vulnerable person; exempting certain persons from liability for certain actions relating to the suspected exploitation of an older person or vulnerable person; authorizing certain persons to perform certain work from a remote location under certain circumstances; setting forth various requirements concerning such work performed at a remote location; requiring a person licensed to engage in the business of lending in this State to provide notice to the Attorney General and certain other persons of certain breaches of security involving personal information; revising the circumstances under which a person is not required to accept an acknowledged power of attorney; prohibiting certain deceptive service agreements between an owner of residential property and a service provider; revising provisions governing persons who hold a permit to engage in property management; revising the method by which a collection agency must notify a medical debtor before taking any action to collect a medical debt; providing penalties; and providing other matters properly relating thereto.
Legislative Counsels Digest:
Existing law provides for the licensure and regulation of various types of financial institutions, including, without limitation, depository institutions, by the Commissioner of Financial Institutions. (Title 55 of NRS) Existing law requires the Commissioner, during the process for the organization and licensing of a banking corporation or company, to examine all the facts connected with the formation of the proposed banking corporation or company, including its location. (NRS 659.045) Similarly, existing law requires a person who desires to organize a savings bank to submit to the Commissioner an application that contains, among other things, the location of the proposed main office of the savings bank. (NRS 673.080) Section 1 of this bill prohibits the Commissioner from requiring an applicant for a license to establish a new depository institution to identify in the application for the license the physical address where the main office of the proposed depository institution will be located. Section 1 authorizes the Commissioner to require such an applicant to: (1) identify the location of the proposed main office, described in general terms, in the application; and (2) provide the physical address of the proposed main office before the depository institution commences business. Section 2 of this bill makes a conforming change to indicate the proper placement of section 1 in the Nevada Revised Statutes.
κ2023 Statutes of Nevada, Page 3467 (CHAPTER 527, SB 355)κ
Existing law prohibits a person from engaging in the business of lending in this State without having first obtained a license from the Commissioner for each office or other place of business in which the person engages in the business of lending. (NRS 675.060) Section 5 of this bill authorizes an employee of a licensee to engage in the business of lending in this State at a remote location if authorized by the licensee. Section 5 requires a licensee: (1) to enter into a written agreement with an employee before authorizing the employee to work at a remote location; and (2) to ensure that the employee and the remote location meet certain requirements. Section 6 of this bill requires a licensee who authorizes an employee to engage in the business of lending in this State at a remote location to develop and adhere to a written data security policy meeting certain requirements. Section 7 of this bill sets forth certain prohibited acts with respect to an employee who engages in the business of lending in this State at a remote location. Section 8 of this bill requires a licensee who authorizes any employee to engage in the business of lending in this State at a remote location to conduct an annual review and evaluation of the operations of the licensee which are conducted by employees working at remote locations. Section 11 of this bill defines words and terms for the purposes of this bill. Sections 12-16 of this bill make certain changes to provisions governing the licensing of persons engaged in the business of lending to account for the provisions of sections 5-8 which authorize an employee of a licensee to engage in the business of lending in this State at a remote location.
Existing law requires a data collector that owns, licenses or maintains computerized data which includes personal information to, after discovery or notification of a breach of security in which personal information maintained by the data collector was, or is reasonably believed to have been, acquired by an unauthorized person, notify each affected resident of this State and certain other persons. (NRS 603A.220) Section 17 of this bill exempts a person licensed to engage in the business of lending in this State from those requirements. Section 9 of this bill instead sets forth similar provisions which require a licensee, after discovery or notification of a breach of security in which personal information maintained by the licensee was, or is reasonably believed to have been, acquired by an unauthorized person, to notify each affected resident if the breach is reasonably likely to subject the resident to a risk of harm and certain other conditions are met. Section 9 sets forth certain requirements for such a notification. Section 10 of this bill requires a licensee who is required to notify more than 500 residents of this State pursuant to section 9 as the result of a single breach also to notify the Attorney General.
Existing law requires certain financial institutions to designate a person to whom an officer or employee of the financial institution must report known or suspected exploitation of an older person or vulnerable person. (NRS 657.290) Section 3 of this bill authorizes a designated reporter to delay a requested disbursement or transaction involving an older person or vulnerable person if the designated reporter knows or has reasonable cause to believe that the older person or vulnerable person has been exploited. Section 3 sets forth procedures and requirements for the imposition of such a delay. Additionally, section 3 provides that a financial institution and its officers, employees and designated reporters are immune from criminal, civil and administrative liability for: (1) making a report concerning the known or suspected exploitation of an older person or vulnerable person; (2) delaying a requested disbursement or transaction involving such exploitation pursuant to section 3; and (3) taking certain other actions relating to known or suspected exploitation of an older person or vulnerable person.
Under existing law, a person who refuses to accept an acknowledged power of attorney, with certain exceptions, is subject to: (1) a court order mandating acceptance of the power of attorney; and (2) liability for reasonable attorneys fees and costs incurred in any action or proceeding that confirms the validity of the power of attorney or mandates acceptance of the power of attorney. (NRS 162A.370) Section 16.5 of this bill provides that a designated reporter who delays a requested disbursement or transaction pursuant to section 3 or certain other persons who make a report concerning the exploitation of an older person or vulnerable person are not required to accept an acknowledged power of attorney under certain circumstances.
κ2023 Statutes of Nevada, Page 3468 (CHAPTER 527, SB 355)κ
Section 16.3 of this bill prohibits a service provider from entering into or recording a service agreement with an owner of residential property that provides for the performance of the agreement more than 1 year from the date of the execution of the agreement if the service agreement: (1) purports to run with the land or bind future owners; (2) allows for the assignment of the right to provide service without requiring notice to and the agreement of the owner; or (3) purports to create a security interest in residential property. Section 16.3 provides that such a service agreement is void and unenforceable. Section 16.3 also: (1) provides that a county recorder may refuse to record such an agreement; (2) provides that any person who attempts to record such an agreement is guilty of a misdemeanor; and (3) authorizes a person with an interest in residential property subject to such a service agreement to bring a civil action. Additionally, section 16.3 requires a service provider that has entered into a service agreement on or before the passage and approval of this bill to record a notice of the service agreement with the county recorder of the county in which the real property that is subject to the service agreement is located. Finally, section 16.3 provides that a service provider who enters into or records a service agreement prohibited by section 16.3 is engaged in a deceptive trade practice.
Existing law authorizes a person licensed as a real estate broker, real estate broker-salesperson or real estate salesperson to apply to the Real Estate Division of the Department of Business and Industry for a permit to engage in property management. (NRS 645.6052) A real estate broker who holds a permit to engage in property management is prohibited from acting as a property manager unless the broker has first obtained a property management agreement signed by the broker and the client for whom the broker will manage the property. (NRS 645.6056) Section 18 of this bill sets forth certain duties of a person who acts as a property manager when entering into a property management agreement and performing his or her duties pursuant to such agreement. Section 22 of this bill prohibits a property manager from waiving any of those duties. Section 23 of this bill authorizes a person who has suffered damages as the proximate result of a property managers failure to perform any of those duties to bring an action against the property manager.
Section 19 of this bill revises the definition of the term agency to include a relationship arising out of a property management agreement. Section 20 of this bill requires the Division to prepare and distribute certain forms to property managers.
Existing law provides that if a real estate broker assigns different licensees affiliated with his or her brokerage to separate parties to a real estate transaction, the licensees are not required to obtain the written consent of each party to the transaction. (NRS 645.252, 645.253) Section 21 of this bill provides that property managers affiliated with a brokerage who are assigned to separate parties to a property management agreement are also not required to obtain such written consent.
Existing law requires an applicant for a license as a mortgage company to state in the application: (1) for an applicant who is not a wholesale lender, the location of each principal office and branch office at which the mortgage company will conduct business in this State; and (2) the location of any principal office, office or other place of business located outside this State from which the mortgage company will conduct business in this State. Existing law also requires a mortgage company that will conduct business at one or more branch offices to apply for a license for each branch office. (NRS 645B.020)
Section 24 of this bill authorizes an employee of a mortgage company, including, without limitation, a mortgage loan originator employed by or associated with the mortgage company, to conduct the business of the mortgage company at a remote location if authorized by the mortgage company. Section 24 defines remote location to mean, in general, any location, including the residence of an employee, that is not a location for which a license as a mortgage company has been issued. Section 24 sets forth certain requirements for a mortgage company to authorize an employee to conduct the business of the mortgage company at a remote location. Additionally, section 24 prohibits: (1) an employee from interacting with a customer in person at the residence of the employee; and (2) the maintenance of physical records at a remote location. Finally, section 24 requires: (1) a mortgage company to maintain certain records relating to business conducted at a remote location at its principal office or a branch office; and (2) the Commissioner of Mortgage Lending to adopt regulations governing the conducting of the business of a mortgage company at a remote location.
κ2023 Statutes of Nevada, Page 3469 (CHAPTER 527, SB 355)κ
business conducted at a remote location at its principal office or a branch office; and (2) the Commissioner of Mortgage Lending to adopt regulations governing the conducting of the business of a mortgage company at a remote location.
Existing law requires each mortgage company to keep and maintain at each location where the mortgage company conducts business in this State records of all mortgage transactions made by the mortgage company at that location. (NRS 645B.080) Section 25 of this bill exempts a remote location from that requirement and instead requires a mortgage company to keep and maintain records of all mortgage transactions made by an employee at a remote location in accordance with the requirements established by the Commissioner of Mortgage Lending by regulation.
Existing law requires a collection agency, not less than 60 days before taking any action to collect a medical debt, to send by registered or certified mail to the medical debtor written notification setting forth certain information. (NRS 649.366) Section 26 of this bill removes the requirement that the written notification be sent by mail that is registered or certified.
EXPLANATION Matter in bolded italics is new; matter between
brackets [omitted material] is material to be
omitted.
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1. Chapter 657 of NRS is hereby amended by adding thereto a new section to read as follows:
1. The Commissioner shall not require an applicant for a license to establish a new depository institution to identify in the application for the license the physical address where the main office of the proposed depository institution will be located.
2. The Commissioner may require an applicant for a license to establish a new depository institution to:
(a) Identify in the application for the license the location, described in general terms, where the main office of the proposed depository institution will be located; and
(b) Provide to the Commissioner the physical address of the main office of the proposed depository institution before the depository institution commences business.
Sec. 2. NRS 657.150 is hereby amended to read as follows:
657.150 As used in NRS 657.150 to 657.290, inclusive, and section 1 of this act, unless the context otherwise requires, the words and terms defined in NRS 657.160 and 657.170 have the meanings ascribed to them in those sections.
Sec. 3. NRS 657.290 is hereby amended to read as follows:
657.290 1. Each financial institution shall designate a person or persons to whom an officer or employee of the financial institution must report known or suspected exploitation of an older person or vulnerable person.
2. If an officer or employee reports known or suspected exploitation of an older person or vulnerable person to a designated reporter and, based on such a report or based on his or her own observations or knowledge, the designated reporter knows or has reasonable cause to believe that an older person or vulnerable person has been exploited, the designated reporter : [shall:]
(a) Except as otherwise provided in subsection 3, shall report the known or suspected exploitation of the older person or vulnerable person to:
(1) The local office of the Aging and Disability Services Division of the Department of Health and Human Services;
(2) A police department or sheriffs office;
κ2023 Statutes of Nevada, Page 3470 (CHAPTER 527, SB 355)κ
(3) The countys office for protective services, if one exists in the county where the suspected action occurred; or
(4) A toll-free telephone service designated by the Aging and Disability Services Division of the Department of Health and Human Services; [and]
(b) [Make] Shall make such a report as soon as reasonably practicable [.] ; and
(c) May temporarily delay a requested disbursement from, or a requested transaction involving, an account of an older person or vulnerable person or an account to which an older person or vulnerable person is a beneficiary if the designated reporter:
(1) Not later than 2 business days after the date on which the requested disbursement or transaction is delayed:
(I) Provides written notification of the delay and the reason for the delay to all parties authorized to transact business on the account, except a party who is reasonably believed to have engaged in the suspected exploitation; and
(II) Notifies the local office of the Aging and Disability Services Division of the Department of Health and Human Services and a local law enforcement agency of the delay; and
(2) Notifies the local office of the Aging and Disability Services Division of the Department of Health and Human Services and the appropriate local law enforcement agency of any new information that is relevant to the delay within a reasonable time after becoming aware of the information.
3. If the designated reporter knows or has reasonable cause to believe that the exploitation of the older person or vulnerable person involves an act or omission of the Aging and Disability Services Division, another division of the Department of Health and Human Services or a law enforcement agency, the designated reporter shall make the report to an agency other than the one alleged to have committed the act or omission.
4. In accordance with the provisions of subsection 3 of NRS 239A.070, in making a report pursuant to this section, a designated reporter may:
(a) Disclose any facts or information that form the basis of the determination that the designated reporter knows or has reasonable cause to believe that an older person or vulnerable person has been exploited, including, without limitation, the identity of any person believed to be involved in the exploitation of the older person or vulnerable person; and
(b) Provide any financial records or other documentation relating to the exploitation of the older person or vulnerable person.
5. [An officer, employee] A financial institution and any of its officers, employees and [the] designated [reporter] reporters are [entitled to the immunity] immune from civil, criminal and administrative liability [set forth in NRS 200.5096 for making a report in good faith.] arising from:
(a) Making a report in good faith pursuant to this section;
(b) Delaying a requested disbursement or transaction involving the known or suspected exploitation of an older person or vulnerable person pursuant to this section; or
(c) Taking any reasonable action which is:
(1) Performed in furtherance of a duty or authorization created by subsection 2, 3 or 4; and
(2) Based upon a reasonable belief that an older person or vulnerable person has been exploited.
κ2023 Statutes of Nevada, Page 3471 (CHAPTER 527, SB 355)κ
6. Except as otherwise provided in this subsection and subsections 7 and 8, a delay in a requested disbursement or transaction authorized by paragraph (c) of subsection 2 expires 15 business days after the date on which the requested disbursement or transaction was delayed. If the local office of the Aging and Disability Services Division of the Department of Health and Human Services or a local law enforcement agency requests in writing that the designated reporter extend the delay, the delay expires upon the earlier of:
(a) Twenty-five business days after the date on which the requested disbursement or transaction was delayed; or
(b) Upon the written request of the local office of the Aging and Disability Services Division of the Department of Health and Human Services or the local law enforcement agency that requested the extension of the delay or upon the order of a court of competent jurisdiction.
7. A delay in a requested disbursement or transaction authorized by paragraph (c) of subsection 2 may expire before the period set forth in subsection 6 and the designated reporter may proceed with the requested disbursement or transaction if the designated reporter reasonably believes that the requested disbursement or transaction will not result in exploitation of the older person or vulnerable person.
8. A court of competent jurisdiction may issue an order extending a delay of a requested disbursement or transaction authorized by paragraph (c) of subsection 2 based on the petition of the local office of the Aging and Disability Services Division of the Department of Health and Human Services, a local law enforcement agency or any other interested party.
9. When determining whether an older person or vulnerable person has been exploited, a designated reporter may consider any of the following circumstances, if applicable and without limitation:
(a) A requested disbursement from, or a requested transaction involving, an account of an older person or vulnerable person or an account to which an older person or vulnerable person is a beneficiary that the older person or vulnerable person cannot explain;
(b) A request to close a certificate of deposit of an older person or vulnerable person that is made:
(1) Before the date of maturity of the certificate of deposit; and
(2) With apparent disregard for any penalty associated with closing the certificate of deposit before the date of maturity of the certificate of deposit;
(c) A check written by an older person or vulnerable person under suspicious circumstances;
(d) An uncharacteristic attempt by an older person or vulnerable person to initiate a wire transfer of a significant sum of money;
(e) A suspicious signature on documentation relating to an account of an older person or vulnerable person;
(f) A suspicious alteration to a:
(1) Trust to which an older person or vulnerable person is a beneficiary; or
(2) Will or trust for which an older person or vulnerable person is a testator or trustee;
(g) A suspicious alteration in a power of attorney relating to an older person or a vulnerable person; and
(h) A person attempting to initiate a financial transaction on behalf of an older person or vulnerable person without proper documentation.
κ2023 Statutes of Nevada, Page 3472 (CHAPTER 527, SB 355)κ
Sec. 4. Chapter 675 of NRS is hereby amended by adding thereto the provisions set forth as sections 5 to 10, inclusive, of this act.
Sec. 5. 1. An employee of a licensee may engage in the business of lending in this State at a remote location in accordance with sections 5 to 8, inclusive, of this act if authorized by the licensee.
2. Before authorizing an employee to engage in the business of lending in this State at a remote location, a licensee must enter into a written agreement with the employee that is signed by the employee in which the employee:
(a) Agrees to:
(1) Maintain the confidentiality of data concerning borrowers and potential borrowers while working at the remote location;
(2) Maintain all data of the licensee electronically while working at the remote location;
(3) Read and comply with the data security policy adopted by the licensee pursuant to section 6 of this act; and
(4) Keep any equipment provided to the employee by the licensee for use at the remote location safe and secure in the manner prescribed by the licensee;
(b) Agrees not to:
(1) Print or otherwise reproduce physical documents containing any data of the licensee at the remote location;
(2) Except as authorized by section 7 of this act, disclose to a borrower or potential borrower that the employee is working at a remote location;
(3) Convey to a borrower or potential borrower that the remote location at which the licensee is working is the place of business of the licensee; and
(4) Conduct any interactions with a borrower or potential borrower in person at the remote location.
3. A licensee shall not authorize an employee to engage in the business of lending in this State at a remote location unless the remote location:
(a) Is located in the United States;
(b) Is secure and sufficiently closed off from the public to enable the employee to maintain the confidentiality of borrowers and potential borrowers; and
(c) Contains all the equipment necessary for the employee to perform his or her work for the licensee, which must:
(1) Be sufficiently connected to the systems used by the licensee, including, without limitation, telephone systems, computerized data systems and other computer systems, to allow the licensee to monitor and oversee the work of the employee as though the employee were performing the same work at the place of business of the licensee; and
(2) Require the employee to enter unique credentials, passwords or similar information to access the computerized data system of the licensee and other computer systems used by the licensee to conduct business.
4. A licensee shall ensure that each employee of the licensee who engages in the business of lending at a remote location:
(a) Before beginning work at a remote location, completes a training program at the place of business of the licensee that includes, without limitation, instruction on privacy, confidentiality, monitoring and security in the context of remote work and compliance with applicable laws and the policies of the licensee;
κ2023 Statutes of Nevada, Page 3473 (CHAPTER 527, SB 355)κ
(b) Receives the same level of communication, management, oversight and monitoring he or she would receive while working at the place of business of the licensee; and
(c) Complies with the provisions of this chapter and the regulations adopted pursuant thereto.
5. As used in this section, place of business means an office or place of business for which a license has been issued pursuant to this chapter.
Sec. 6. A licensee who authorizes any employee to engage in the business of lending in this State at a remote location shall develop and adhere to a written data security policy. The data security policy must set forth procedures and requirements to ensure that:
1. Data of the licensee that is stored at or accessible from a remote location is protected against unauthorized or accidental disclosure, access, use, modification, duplication or destruction;
2. An employee working at a remote location is able to access the computerized data system of the licensee and other computer systems of the licensee only through the use of a virtual private network or other system that:
(a) Requires the use of a username and password, frequent password changes, multifactor authentication, a system that automatically prevents a person from accessing an account upon the failure of the person to enter the appropriate credentials after a set number of attempts or any combination thereof; and
(b) Uses data encryption;
3. Any updates or repairs necessary to keep data and equipment secure are installed or implemented immediately;
4. All data of the licensee is stored in a safe and secure manner and the computerized data system of the licensee is capable of being modified to accommodate the storage of data necessary for an employee working at a remote location to perform his or her work;
5. Each remote location at which an employee works contains computers or other electronic devices which make use of reasonable security measures, such as antivirus software and firewalls;
6. The computerized data system of the licensee and other computer systems of the licensee may only be accessed through computers or other electronic devices which:
(a) Are issued by the licensee; and
(b) May only be used by an employee while performing activities approved by the licensee;
7. An internal or external risk assessment is performed annually on the protection of the data of the licensee from reasonably foreseeable internal or external risks;
8. After the performance of a risk assessment pursuant to subsection 7, the data security policy is updated to correct any deficiencies identified in the risk assessment;
9. The licensee has procedures in place which establish the actions that must be taken upon the:
(a) Discovery of a breach of the security of the computerized data system, including, without limitation, any actions that must be taken concerning the disclosure of the breach as required by section 9 of this act or other applicable law; and
κ2023 Statutes of Nevada, Page 3474 (CHAPTER 527, SB 355)κ
(b) Occurrence of an emergency, including, without limitation, a fire or natural disaster, that has the potential to impact the storage of or access to data of the licensee;
10. The data of the licensee is disposed of in a timely and secure manner as required by applicable law and contractual requirements; and
11. The licensee is able, without the licensee or an agent of the licensee being physically present at a remote location, to disconnect any computer or device provided to an employee at a remote location from the computerized data system of the licensee or other computer systems of the licensee and disable and erase any data from such a computer or device upon termination of the employees employment with the licensee.
Sec. 7. 1. An employee who engages in the business of lending in this State at a remote location shall not print or store physical records containing any data of the licensee at the remote location.
2. Except as otherwise provided in subsection 3, an employee who engages in the business of lending in this State at a remote location or the licensee who employs such an employee shall not represent in any manner to a borrower, potential borrower or any other person that the employee is working at a remote location, including, without limitation, by:
(a) Advertising in any form the address of the remote location where the employee works or a personal telephone number or facsimile number associated with the remote location;
(b) Meeting a borrower or potential borrower at, or inviting a borrower or potential borrower to, the remote location; or
(c) Directly or indirectly suggesting or holding out in any manner that the address of the remote location is the address of the place of business of the licensee, including, without limitation, by receiving mail intended for the licensee at the remote location or storing physical records of the licensee at the remote location.
3. An employee may respond to an inquiry concerning his or her location by stating that he or she is working remotely or working at a remote location.
4. As used in this section, place of business has the meaning ascribed to it in section 5 of this act.
Sec. 8. A licensee who authorizes any employee to engage in the business of lending in this State at a remote location shall, at least once each year, conduct a review and evaluation of the operations of the licensee which are conducted by employees working at remote locations to determine whether such operations comply with the provisions of sections 5 to 8, inclusive, of this act. The Commissioner may require a licensee to conduct such a review and evaluation at such other times as the Commissioner deems necessary.
Sec. 9. 1. If a licensee that owns or licenses computerized data that includes personal information discovers or is notified of a breach of the security of the computerized data system of the licensee, the licensee shall notify any resident of this State whose personal information was, or is reasonably believed to have been, acquired by an unauthorized person if:
(a) The breach is reasonably likely to subject the resident to a risk of harm; and
(b) Either:
(1) The personal information acquired or believed to have been acquired was not encrypted; or
κ2023 Statutes of Nevada, Page 3475 (CHAPTER 527, SB 355)κ
(2) The breach resulted in, or is reasonably believed to have resulted in, an unauthorized person acquiring an encryption key or other means of converting encrypted personal information acquired by the person into an unencrypted or otherwise intelligible form.
2. Except as otherwise provided in this subsection and subsection 4, the notification required by subsection 1 must be made in the most expedient time possible and not more than 30 days after the date on which the licensee discovered or was notified of the breach. A licensee may delay providing the notification beyond the period required by this subsection, as authorized by subsection 4 or if the delay is caused by any measures necessary to determine the scope of the breach and restore the reasonable integrity of the computerized data system of the licensee.
3. Except as otherwise provided in subsection 4, a licensee that maintains data which includes personal information that the licensee does not own shall notify the owner of the information of any breach of the security of the computerized data system of the licensee immediately following discovery if the personal information was, or is reasonably believed to have been, acquired by an unauthorized person.
4. A notification required by this section may be delayed if a law enforcement agency determines that the notification will impede a criminal investigation. The notification must be made after the law enforcement agency determines that the notification will not impede a criminal investigation.
5. Except as otherwise provided in subsections 6 and 8, a notification required by this section may be provided by any of the following methods:
(a) Written notification.
(b) Electronic notification, if the notification provided is consistent with the provisions of the Electronic Signatures in Global and National Commerce Act, 15 U.S.C. §§ 7001 et seq.
(c) Substitute notification, if the licensee demonstrates that the cost of providing notification would exceed $250,000, the affected class of subject persons to be notified exceeds 500,000 or the licensee does not have sufficient contact information. Substitute notification must consist of all the following:
(1) Notification by electronic mail when the licensee has electronic mail addresses for the subject persons.
(2) Conspicuous posting of the notification on the Internet website of the licensee, if the licensee maintains an Internet website.
(3) Notification to major statewide media.
6. If a breach involves a username, password or other login credentials to an electronic mail account furnished by the licensee, the licensee shall not provide the notification required pursuant to this section to that electronic mail account.
7. A notification provided by a licensee pursuant to this section must be written in plain language and contain, at a minimum, the following information:
(a) The name and contact information of the licensee;
(b) A list of the types of personal information that were or are reasonably believed to have been subject to the breach;
(c) The period of time, if known, in which personal information was potentially subject to acquisition by unauthorized persons as a result of the breach, including, without limitation, the date of the breach and the date upon which the licensee discovered or was notified of the breach;
κ2023 Statutes of Nevada, Page 3476 (CHAPTER 527, SB 355)κ
(d) The toll-free telephone numbers and addresses of the major credit reporting agencies; and
(e) If the breach involved personal information that includes a username, password or other login credentials to an online account, an advisement to the person whose personal information was, or is reasonably believed to have been, acquired by an unauthorized person to promptly change any relevant passwords or security questions or answers associated with the online account and to take any other appropriate steps to protect the online account and any other online account for which the person uses any of the same information to access.
8. A licensee who maintains his or her own notification procedures as part of a data security policy for the treatment of personal information that are otherwise consistent with the timing requirements of this section shall be deemed to be in compliance with the notification requirements of this section if the licensee notifies subject persons in accordance with its policies and procedures in the event of a breach of the security of the computerized data system of the licensee.
Sec. 10. 1. A licensee who is required to notify more than 500 residents of this State pursuant to section 9 of this act as the result of a single breach shall notify the Attorney General of the breach not more than 30 days after the date on which the licensee discovered or was notified of the breach. The notification must include, without limitation:
(a) The number of residents of this State affected or estimated to be affected by the breach.
(b) A list of the types of personal information that were or are reasonably believed to have been subject to the breach.
(c) The period of time, if known, in which personal information was potentially subject to acquisition by unauthorized persons as a result of the breach, including, without limitation, the date of the breach and the date upon which the licensee discovered or was notified of the breach.
(d) A summary of the actions taken to contain the breach.
(e) A sample copy of the notification the licensee provided to persons affected or reasonably believed to be affected by the breach which excludes any personally identifiable information.
2. If any of the information described in subsection 1 is unavailable to a licensee at the time the licensee submits the notification to the Attorney General, the licensee shall promptly provide the information to the Attorney General after the information becomes available to the licensee.
Sec. 11. NRS 675.020 is hereby amended to read as follows:
675.020 As used in this chapter, unless the context otherwise requires:
1. Amount of cash advance means the amount of cash or its equivalent actually received by a borrower or paid out at his or her direction or on his or her behalf.
2. Amount of loan obligation means the amount of cash advance plus the aggregate of charges added thereto pursuant to authority of this chapter.
3. Breach of the security of the computerized data system or breach means the unauthorized acquisition of computerized data from the computerized data system of the licensee that compromises the security, confidentiality or integrity of personal information maintained by the licensee. The term does not include the good faith acquisition of personal information by an employee or agent of a licensee for a legitimate purpose of the licensee, so long as the personal information is not used for a purpose unrelated to the licensee or subject to further authorized disclosure.
κ2023 Statutes of Nevada, Page 3477 (CHAPTER 527, SB 355)κ
4. Business of lending in this State means that a person:
(a) Solicits loans in this State or makes loans to persons in this State, unless these are isolated, incidental or occasional transactions; or
(b) Is located in this State and solicits loans outside of this State or makes loans to persons located outside of this State, unless these are isolated, incidental or occasional transactions.
5. Commissioner means the Commissioner of Financial Institutions.
[4.] 6. Community means a contiguous area of the same economic unit or metropolitan area as determined by the Commissioner, and may include all or part of a city or several towns or cities.
[5.] 7. Computerized data system means a system of software, hardware or firmware, including, without limitation, a system of web-based applications, that:
(a) Is owned, leased or licensed by a licensee;
(b) Is located at the place of business of the licensee or hosted remotely; and
(c) Stores or provides access to personal information, financial information or other data related to borrowers or potential borrowers.
8. Consumer credit has the meaning ascribed to it in NRS 604A.036.
[6.] 9. Covered service member has the meaning ascribed to it in NRS 604A.038.
[7.] 10. Dependent has the meaning ascribed to it in NRS 604A.057.
[8.] 11. Internet business lender means a person who makes business loans exclusively through the Internet.
[9.] 12. License means a license, issued under the authority of this chapter, to make loans in accordance with the provisions of this chapter, at a single place of business.
[10.] 13. Licensee means a person to whom one or more licenses have been issued.
[11.] 14. Nationwide Multistate Licensing System and Registry or Registry has the meaning ascribed to it in NRS 604A.083.
15. Personal information has the meaning ascribed to it in NRS 603A.040.
16. Remote location means a location other than an office or place of business for which a license has been issued pursuant to this chapter and at which the employee of a licensee engages in the business of lending in this State pursuant to sections 5 to 8, inclusive, of this act.
Sec. 12. NRS 675.060 is hereby amended to read as follows:
675.060 [1.] No person may engage in the business of lending in this State without first having obtained a license from the Commissioner pursuant to this chapter for each office or other place of business at which the person engages in such business, except that [if] :
1. If a person intends to engage in the business of lending in this State as a deferred deposit loan service, high-interest loan service or title loan service, as those terms are defined in chapter 604A of NRS, the person must obtain a license from the Commissioner pursuant to chapter 604A of NRS before the person may engage in any such business.
2. [For the purpose of this section, a person engages in the business of lending in this State if he or she:
(a) Solicits loans in this State or makes loans to persons in this State, unless these are isolated, incidental or occasional transactions; or
(b) Is located in this State and solicits loans outside of this State or makes loans to persons located outside of this State, unless these are isolated, incidental or occasional transactions.]
κ2023 Statutes of Nevada, Page 3478 (CHAPTER 527, SB 355)κ
incidental or occasional transactions.] An employee of a licensee may engage in the business of lending in this State at a remote location in accordance with sections 5 to 8, inclusive, of this act.
Sec. 13. NRS 675.120 is hereby amended to read as follows:
675.120 If the Commissioner finds:
1. That the financial responsibility, experience, character and general fitness of the applicant are such as to command the confidence of the public and to warrant belief that the business will be operated lawfully, honestly, fairly and efficiently, within the purposes of this chapter; and
2. That the applicant, unless he or she will function solely as a loan broker, has available for the operation of the business at the specified location identified in the application liquid assets of at least $50,000,
Κ he or she shall thereupon enter an order granting the application, and file his or her findings of fact together with the transcript of any hearing held under this chapter, and forthwith issue and deliver a license to the applicant.
Sec. 14. NRS 675.130 is hereby amended to read as follows:
675.130 Each license shall:
1. State the address at which the business is to be conducted [;] , not including any remote location; and
2. State fully the name of the licensee, and if the licensee is a copartnership or association, the names of its members, and if a corporation, the date and place of its incorporation.
Sec. 15. NRS 675.210 is hereby amended to read as follows:
675.210 Not more than one place of business may be maintained under the same license. The Commissioner may issue additional licenses to the same licensee for other business locations upon compliance with all the provisions of this chapter governing issuance of a single license. Nothing herein requires a license for [any] :
1. Any place of business devoted to accounting, recordkeeping or administrative purposes only [.] ; or
2. A remote location.
Sec. 16. NRS 675.240 is hereby amended to read as follows:
675.240 No licensee shall conduct the business of making loans provided for by this chapter under any name or at any place other than that stated in the license. Nothing herein shall prevent [the] :
1. The making of loans by mail nor prohibit accommodations to individual borrowers when necessitated by hours of employment, sickness or other emergency situations [.] ; or
2. A licensee from authorizing an employee to engage in the business of lending in this State at a remote location in accordance with sections 5 to 8, inclusive, of this act.
Sec. 16.3. Chapter 111 of NRS is hereby amended by adding thereto a new section to read as follows:
1. A service provider shall not enter into or record a service agreement with an owner of residential property that provides for performance of the service agreement more than 1 year from the date of execution of the service agreement if the service agreement:
(a) Purports to run with the land or bind future owners of interests in the residential property;
(b) Allows for the assignment of the right to provide service without requiring notice to and agreement of the owner of the residential property; or
κ2023 Statutes of Nevada, Page 3479 (CHAPTER 527, SB 355)κ
(c) Purports to create a security interest in the residential property, including, without limitation, a lien or encumbrance.
2. The provisions of this section do not apply to:
(a) A home warranty or similar product that covers the cost of maintenance of a major housing system, including, without limitation, a plumbing or electrical system, for a set period of time;
(b) An insurance contract;
(c) An option to purchase or right of refusal;
(d) A maintenance or repair agreement entered into by a homeowners association in a common interest community;
(e) A mechanics lien;
(f) A mortgage loan or a commitment to make or receive a mortgage loan;
(g) A security agreement relating to the sale or rental of personal property or fixtures;
(h) Any utility service provided by a public utility, including, without limitation, water, sewer, electrical, telephone or cable; or
(i) A declaration created in the formation of a common-interest community or an amendment thereto.
3. A service agreement prohibited pursuant to this section that is recorded on or after the effective date of this act is void and unenforceable. A county recorder may refuse to record any written instrument that contains a service agreement that is prohibited pursuant to this section. A person who submits a written instrument for recordation to the county recorder that contains such a service agreement is guilty of a misdemeanor.
4. The recording of a service agreement prohibited pursuant to this section does not provide actual or constructive notice to a bona fide purchaser or creditor of residential property.
5. A violation of subsection 1 constitutes a deceptive trade practice for the purposes of NRS 598.0903 to 598.0999, inclusive. Any person with an interest in a residential property for which a service agreement prohibited pursuant to this section is recorded may bring a civil action in any court of competent jurisdiction for such a violation. If a person brings such an action, the court may award the person:
(a) Any equitable relief that the court deems appropriate;
(b) Actual damages; and
(c) Actual costs and attorneys fees.
6. On or before July 31, 2023, a service provider that has entered into a service agreement on or before the effective date of this act shall record a notice of service agreement with the county recorder of the county in which the real property that is the subject of the service agreement is located, which must include, without limitation:
(a) The title Notice of Service Agreement in not less than 14-point boldface type;
(b) A legal description of the real property;
(c) The amount of the fee provided in the service agreement or the method by which the fee must be calculated;
(d) The date or circumstances under which the obligation set forth in the service agreement expires;
(e) The name, address and telephone number of the service provider; and
(f) If the service provider is:
κ2023 Statutes of Nevada, Page 3480 (CHAPTER 527, SB 355)κ
(1) A natural person, the notarized signature of the service provider; or
(2) A business entity, the notarized signature of an authorized officer or employee of the business entity.
7. If a service provider fails to record the notice required pursuant to subsection 6 on or before July 31, 2023, the service agreement is hereby declared void and unenforceable and any interest in the real property that is subject to the service agreement may be conveyed free and clear of the service agreement.
8. As used in this section:
(a) Residential property means any land in this State which is primarily used for personal, family or household purposes to which is affixed not less than one nor more than four dwelling units.
(b) Service agreement means a contract under which a person agrees to provide services in connection with the maintenance, purchase or sale of residential property.
(c) Service provider means a person who provides services to another party.
Sec. 16.5. NRS 162A.370 is hereby amended to read as follows:
162A.370 1. Except as otherwise provided in subsection 2:
(a) A person shall either accept an acknowledged power of attorney, or request a certification, a translation or an opinion of counsel pursuant to NRS 162A.360, not later than 10 business days after presentation of the power of attorney for acceptance;
(b) If a person requests a certification, a translation or an opinion of counsel pursuant to NRS 162A.360, the person shall accept the power of attorney not later than 5 business days after receipt of the certification, translation or opinion of counsel; and
(c) A person may not require an additional or different form of power of attorney for authority granted in the power of attorney presented.
2. A person is not required to accept an acknowledged power of attorney if:
(a) The person is not otherwise required to engage in a transaction with the principal in the same circumstances;
(b) Engaging in a transaction with the agent or the principal in the same circumstances would be inconsistent with federal law;
(c) The person has actual knowledge of the termination of the agents authority or of the power of attorney before exercise of the power;
(d) A request for a certification, a translation or an opinion of counsel pursuant to NRS 162A.360 is refused;
(e) The person in good faith believes that the power is not valid or that the agent does not have the authority to perform the act requested, whether or not a certification, a translation or an opinion of counsel has been requested or provided pursuant to NRS 162A.360; [or]
(f) The person makes, or has actual knowledge that another person has made, a report pursuant to NRS 200.5093 stating a good faith belief that the principal may be subject to abuse, neglect, exploitation, isolation or abandonment by the agent or a person acting for or with the agent [.] ; or
(g) The person:
(1) Makes, or has actual knowledge that another person has made, a report pursuant to NRS 657.290 of the known or suspected exploitation by the agent, or a person acting for or with the agent, of the principal who is an older person or vulnerable person; or
κ2023 Statutes of Nevada, Page 3481 (CHAPTER 527, SB 355)κ
(2) Is a designated reporter of a financial institution who, pursuant to NRS 657.290, delays a requested disbursement or transaction involving a principal who is an older person or vulnerable person whom the designated reporter knows or has reasonable cause to believe is being exploited.
3. A person that refuses in violation of this section to accept an acknowledged power of attorney is subject to:
(a) A court order mandating acceptance of the power of attorney; and
(b) Liability for reasonable attorneys fees and costs incurred in any action or proceeding that confirms the validity of the power of attorney or mandates acceptance of the power of attorney.
4. As used in this section:
(a) Designated reporter has the meaning ascribed to it in NRS 657.230.
(b) Older person has the meaning ascribed to it in NRS 657.250.
(c) Vulnerable person has the meaning ascribed to it in NRS 657.270.
Sec. 17. NRS 603A.220 is hereby amended to read as follows:
603A.220 1. [Any] Except as otherwise provided in subsection 7, a data collector that owns or licenses computerized data which includes personal information shall disclose any breach of the security of the system data following discovery or notification of the breach to any resident of this State whose unencrypted personal information was, or is reasonably believed to have been, acquired by an unauthorized person. The disclosure must be made in the most expedient time possible and without unreasonable delay, consistent with the legitimate needs of law enforcement, as provided in subsection 3, or any measures necessary to determine the scope of the breach and restore the reasonable integrity of the system data.
2. Any data collector that maintains computerized data which includes personal information that the data collector does not own shall notify the owner or licensee of the information of any breach of the security of the system data immediately following discovery if the personal information was, or is reasonably believed to have been, acquired by an unauthorized person.
3. The notification required by this section may be delayed if a law enforcement agency determines that the notification will impede a criminal investigation. The notification required by this section must be made after the law enforcement agency determines that the notification will not compromise the investigation.
4. For purposes of this section, except as otherwise provided in subsection 5, the notification required by this section may be provided by one of the following methods:
(a) Written notification.
(b) Electronic notification, if the notification provided is consistent with the provisions of the Electronic Signatures in Global and National Commerce Act, 15 U.S.C. §§ 7001 et seq.
(c) Substitute notification, if the data collector demonstrates that the cost of providing notification would exceed $250,000, the affected class of subject persons to be notified exceeds 500,000 or the data collector does not have sufficient contact information. Substitute notification must consist of all the following:
(1) Notification by electronic mail when the data collector has electronic mail addresses for the subject persons.
(2) Conspicuous posting of the notification on the Internet website of the data collector, if the data collector maintains an Internet website.
(3) Notification to major statewide media.
κ2023 Statutes of Nevada, Page 3482 (CHAPTER 527, SB 355)κ
5. A data collector which:
(a) Maintains its own notification policies and procedures as part of an information security policy for the treatment of personal information that is otherwise consistent with the timing requirements of this section shall be deemed to be in compliance with the notification requirements of this section if the data collector notifies subject persons in accordance with its policies and procedures in the event of a breach of the security of the system data.
(b) Is subject to and complies with the privacy and security provisions of the Gramm-Leach-Bliley Act, 15 U.S.C. §§ 6801 et seq., shall be deemed to be in compliance with the notification requirements of this section.
6. If a data collector determines that notification is required to be given pursuant to the provisions of this section to more than 1,000 persons at any one time, the data collector shall also notify, without unreasonable delay, any consumer reporting agency that compiles and maintains files on consumers on a nationwide basis, as that term is defined in 15 U.S.C. § 1681a(p), of the time the notification is distributed and the content of the notification.
7. The provisions of this section do not apply to a person licensed pursuant to chapter 675 of NRS.
Sec. 18. Chapter 645 of NRS is hereby amended by adding thereto a new section to read as follows:
A person who holds a permit to engage in property management when entering into a property management agreement and performing his or her duties pursuant to such property management agreement, as applicable:
1. Shall disclose to each party to the property management agreement as soon as practicable:
(a) Any material and relevant facts, data or information which the property manager knows, or which by the exercise of reasonable care and diligence should have known, relating to the property which is the subject of the property management agreement.
(b) Each source from which the property manager will receive compensation as a result of the agreement.
(c) That the property manager is a principal to the agreement or has an interest in a principal to the agreement.
(d) That the property manager is acting for more than one party to the agreement. If a property manager makes such a disclosure, he or she must obtain the written consent of each party to the agreement for whom the property manager is acting before he or she may continue to act in his or her capacity as an agent. The written consent must include:
(1) A description of the property management agreement.
(2) A statement that the property manager is acting for two or more parties to the agreement who have an adverse interest and that in acting for these parties, the property manager has a conflict of interest.
(3) A statement that the property manager will not disclose any confidential information for 1 year after the revocation or termination of any property management agreement entered into with a party to the agreement, unless he or she is required to do so by a court of competent jurisdiction or is given written permission to do so by that party.
(4) A statement that a party is not required to consent to the property manager acting on behalf of the party.
(5) A statement that the party is giving consent without coercion and understands the terms of the consent given.
(6) Any changes in the property managers relationship to a party to the agreement or activity.
κ2023 Statutes of Nevada, Page 3483 (CHAPTER 527, SB 355)κ
2. Shall exercise reasonable skill and care with respect to all parties to the property management agreement in carrying out the terms of the property management agreement and performing his or her duties.
3. Shall provide the appropriate form prepared by the Division pursuant to NRS 645.193 to:
(a) Each party for whom the property manager is acting as a property manager in the property management agreement; and
(b) Each unrepresented party to the property management agreement, if any.
4. Shall seek a rental or lease of real property at the price and terms stated in the property management agreement or at a price acceptable to the client.
5. Shall advise the client to obtain advice from an expert relating to matters which are beyond the expertise of the property manager.
6. Shall account for all money and property the property manager receives in which the client may have an interest as soon as is practicable.
7. Unless otherwise agreed upon in writing, owes no duty to:
(a) Independently verify the accuracy of a statement made by an inspector certified pursuant to chapter 645D of NRS or another appropriate licensed or certified expert.
(b) Conduct an independent inspection of the financial condition of a party to the property management agreement.
(c) Conduct an investigation of the condition of the property which is the subject of the property management agreement.
Sec. 19. NRS 645.0045 is hereby amended to read as follows:
645.0045 1. Agency means a relationship between a principal and an agent arising out of a brokerage agreement or property management agreement whereby the agent is engaged to do certain acts on behalf of the principal in dealings with a third party.
2. The term does not include a relationship arising solely from negotiations or communications with a client of another broker with the written permission of the broker in accordance with the provisions of subsection 2 of NRS 645.635.
Sec. 20. NRS 645.193 is hereby amended to read as follows:
645.193 The Division shall prepare and distribute to licensees [:] and property managers:
1. A form which sets forth the duties owed by a licensee or property manager who is acting for only one party to a real estate transaction [.] or property management agreement, as applicable.
2. A form which sets forth the duties owed by a licensee or property manager who is acting for more than one party to a real estate transaction [.] or property management agreement, as applicable.
3. A form which sets forth the duties owed by a real estate broker who assigns different licensees or property managers affiliated with his or her brokerage to separate parties to a real estate transaction [.] or property management agreement, as applicable.
Sec. 21. NRS 645.253 is hereby amended to read as follows:
645.253 If a real estate broker assigns different [licensees] :
1. Licensees affiliated with his or her brokerage to separate parties to a real estate transaction, the licensees are not required to obtain the written consent required pursuant to paragraph (d) of subsection 1 of NRS 645.252. Each licensee shall not disclose, except to the real estate broker, confidential information relating to a client in violation of NRS 645.254.
κ2023 Statutes of Nevada, Page 3484 (CHAPTER 527, SB 355)κ
2. Licensees affiliated with his or her brokerage who hold permits to engage in property management to separate parties to a property management agreement, the property managers are not required to obtain the written consent required pursuant to paragraph (d) of subsection 1 of section 18 of this act. Each property manager shall not disclose, except to the real estate broker, confidential information relating to a client in violation of section 18 of this act.
Sec. 22. NRS 645.255 is hereby amended to read as follows:
645.255 Except as otherwise provided in subsection 4 of NRS 645.254, no duty of a licensee set forth in NRS 645.252 or 645.254 or a property manager set forth in section 18 of this act may be waived.
Sec. 23. NRS 645.257 is hereby amended to read as follows:
645.257 1. A person who has suffered damages as the proximate result of a licensees or property managers failure to perform any duties required by NRS 645.252, 645.253 or 645.254 or section 18 of this act or the regulations adopted to carry out those sections may bring an action against the licensee or property manager for the recovery of the persons actual damages.
2. In such an action, any knowledge of the client [of] :
(a) Of the licensee of material facts, data or information relating to the real property which is the subject of the real estate transaction may not be imputed to the licensee [.] ; and
(b) Of the property manager of material facts, data or information relating to the real property which is the subject of the property management agreement may not be imputed to the property manager.
3. In an action brought by a person [against a licensee] pursuant to subsection 1 [, the] :
(a) The standard of care owed by a licensee is the degree of care that a reasonably prudent real estate licensee would exercise and is measured by the degree of knowledge required to be obtained by a real estate licensee pursuant to NRS 645.343 and 645.345 [.] ; and
(b) The standard of care owed by a property manager is the degree of care that a reasonably prudent property manager would exercise and is measured by the degree of knowledge required to be obtained by a permit to engage in property management pursuant to NRS 645.6052.
Sec. 24. Chapter 645B of NRS is hereby amended by adding thereto a new section to read as follows:
1. An employee of a mortgage company may conduct the business of the mortgage company at a remote location if authorized by the mortgage company.
2. A mortgage company may authorize an employee to conduct the business of the mortgage company at a remote location if the mortgage company:
(a) Has adopted written policies and procedures for the supervision of employees working at a remote location to ensure that:
(1) Each employee working from a remote location complies with the provisions of this section and the regulations adopted pursuant thereto; and
(2) The mortgage company exercises reasonable supervision and control over the activities of his or her mortgage loan originators pursuant to NRS 645B.460;
(b) Has adopted a comprehensive written plan for the security of the information systems of the mortgage company and any customer information collected and maintained by the mortgage company, which must contain specific provisions regarding cybersecurity and the use of a virtual private network or other secure connection at the remote location that requires:
κ2023 Statutes of Nevada, Page 3485 (CHAPTER 527, SB 355)κ
contain specific provisions regarding cybersecurity and the use of a virtual private network or other secure connection at the remote location that requires:
(1) Multifactor authentication;
(2) A backup system and data recovery system; and
(3) Protocols in the event of a cybersecurity incident; and
(c) Ensures that the information systems of the mortgage company and any customer information collected and maintained by the mortgage company are accessed by employees working at a remote location only in accordance with the security plan adopted pursuant to paragraph (b).
3. An employee of a mortgage company shall not interact with a customer of the mortgage company in person at the residence of the employee unless a license has been issued for that residence pursuant to NRS 645B.020.
4. Any physical records of a mortgage company must not be maintained at a remote location. Any underlying origination records obtained through the conduct of the business of a mortgage company at a remote location must be maintained at the principal office or a branch office of the mortgage company.
5. The Commissioner shall adopt regulations governing the conducting of the business of a mortgage company at a remote location. The regulations:
(a) Must include, without limitation, requirements for the keeping and maintenance of complete and suitable records of all mortgage transactions made by an employee of a mortgage company at a remote location; and
(b) May include, without limitation, any additional requirements for an employee of a mortgage company to conduct the business of a mortgage company from a remote location.
6. As used in this section:
(a) Business of a mortgage company includes, without limitation, any activity for which a license is required pursuant to this chapter that is conducted by an employee who is a mortgage loan originator employed by or associated with a mortgage company.
(b) Employee includes, without limitation, a mortgage loan originator who is employed by or associated with a mortgage company.
(c) Remote location means a location, other than a principal office, branch office or other office or place of business for which a license has been issued pursuant to NRS 645B.020, at which an employee of a mortgage company conducts the business of the mortgage company pursuant to this section. The term includes, without limitation, the residence of an employee.
Sec. 25. NRS 645B.080 is hereby amended to read as follows:
645B.080 1. Each mortgage company shall keep and maintain at all times at each location , other than a remote location, where the mortgage company conducts business in this state complete and suitable records of all mortgage transactions made by the mortgage company at that location. Each mortgage company shall also keep and maintain at all times at each such location all original books, papers and data, or copies thereof, clearly reflecting the financial condition of the business of the mortgage company. Each mortgage company shall keep and maintain complete and suitable records of all mortgage transactions made by an employee of the mortgage company at a remote location in accordance with the requirements established by the Commissioner by regulation pursuant to section 24 of this act.
κ2023 Statutes of Nevada, Page 3486 (CHAPTER 527, SB 355)κ
2. Except as otherwise provided in subsection 3, each mortgage company shall submit to the Commissioner each month a report of the mortgage companys activity for the previous month. The report must:
(a) Specify the volume of loans arranged and loans made by the mortgage company for the month or state that no loans were arranged or made in that month;
(b) Include any information required pursuant to NRS 645B.260 or pursuant to the regulations adopted by the Commissioner; and
(c) Be submitted to the Commissioner by the 15th day of the month following the month for which the report is made.
3. The Commissioner may waive the requirement to submit a report pursuant to subsection 2 if substantially similar information is available to the Commissioner from another source.
4. The Commissioner may adopt regulations prescribing accounting procedures for mortgage companies handling trust accounts and the requirements for keeping records relating to such accounts.
5. Each mortgage company who is required to register or voluntarily registers with the Registry shall submit to the Registry and the Commissioner a report of condition or any other report required by the Registry in the form and at the time required by the Registry.
6. As used in this section, remote location has the meaning ascribed to it in section 24 of this act.
Sec. 26. NRS 649.366 is hereby amended to read as follows:
649.366 1. Not less than 60 days before taking any action to collect a medical debt, a collection agency shall send by [registered or certified] mail to the medical debtor written notification that sets forth:
(a) The name of the medical facility, provider of health care or provider of emergency medical services that provided the goods or services for which the medical debt is owed;
(b) The date on which those goods or services were provided; and
(c) The principal amount of the medical debt.
2. The written notification required by subsection 1 must:
(a) Identify the name of the collection agency; and
(b) Inform the medical debtor that, as applicable:
(1) The medical debt has been assigned to the collection agency for collection; or
(2) The collection agency has otherwise obtained the medical debt for collection.
Sec. 27. 1. This section and section 16.3 of this act become effective upon passage and approval.
2. Sections 1 to 16, inclusive, 16.5 to 23, inclusive, and 26 of this act become effective:
(a) Upon passage and approval for the purpose of adopting any regulations and performing any other preparatory administrative tasks that are necessary to carry out the provisions of this act; and
(b) On October 1, 2023, for all other purposes.
3. Sections 24 and 25 of this act become effective:
(a) Upon passage and approval for the purpose of adopting any regulations and performing any other preparatory administrative tasks that are necessary to carry out the provisions of this act; and
(b) On January 1, 2024, for all other purposes.
________
κ2023 Statutes of Nevada, Page 3487κ
Senate Bill No. 439Senators D. Harris, Scheible and Donate
Joint Sponsors: Assemblywomen Gonzαlez, Peters and Taylor
CHAPTER 528
[Approved: June 15, 2023]
AN ACT relating to communicable diseases; requiring certain state and local agencies to develop policies to provide uninterrupted services during a public health emergency to certain persons; requiring a public or private detention facility to take certain measures to ensure the access of prisoners to treatment for and methods to prevent the acquisition of human immunodeficiency virus; revising provisions governing certain crimes committed by prisoners; requiring certain public and private health insurers to provide certain coverage; requiring such an insurer to reimburse an advanced practice registered nurse or physician assistant at the same rate as a physician for certain services; authorizing providers of health care to receive credit toward requirements for continuing education for certain training relating to the human immunodeficiency virus; requiring certain providers of health care to complete such training; providing that the repeal or revision of certain crimes applies retroactively; and providing other matters properly relating thereto.
Legislative Counsels Digest:
Existing law requires the Division of Public and Behavioral Health of the Department of Health and Human Services and district, county and city health departments to perform certain functions relating to public health in this State, including certain duties relating to the control of communicable diseases. (NRS 439.150-439.265, 439.340, 439.350, 439.360, 439.366, 439.367, 439.3675, 439.405, 439.410, 439.460, 439.470) Existing law also requires a district health officer or the Chief Medical Officer to perform certain duties relating to the control of communicable diseases. (Chapter 441A of NRS) Existing law prescribes certain responsibilities of the Division of Health Care Financing and Policy of the Department concerning the administration of the Medicaid program. (NRS 422.061, 422.063) Section 1 of this bill requires the Department and all district, county and city boards of health to develop policies to provide uninterrupted services during a public health emergency to persons who have been diagnosed with the human immunodeficiency virus or persons who are at a high risk of acquiring the human immunodeficiency virus. Section 2 of this bill makes a conforming change to indicate the proper placement of section 1 in the Nevada Revised Statutes.
Existing law requires the Director of the Department of Corrections to establish standards for the medical and dental services of each institution or facility under the control of the Department. (NRS 209.381) Existing law also requires a sheriff, chief of police or town marshal to arrange for the administration of medical care required by prisoners while in his or her custody. (NRS 211.140) Sections 11 and 12 of this bill impose certain requirements on the operators of public and private prisons, jails and detention facilities to ensure the access of prisoners to treatment for human immunodeficiency virus and methods of preventing the acquisition of human immunodeficiency virus.
Existing law prohibits a prisoner from using, propelling, discharging, spreading or concealing human excrement or bodily fluid with intent or under circumstances where it is reasonably likely that the excrement or fluid will come in contact with another person. Under most circumstances, a violation is a gross misdemeanor, a category D felony or a category B felony, depending on the circumstances of the prisoners confinement.
κ2023 Statutes of Nevada, Page 3488 (CHAPTER 528, SB 439)κ
category D felony or a category B felony, depending on the circumstances of the prisoners confinement. However, if the prisoner knew at the time of the offense that any portion of the excrement or bodily fluid contained a communicable disease that causes or is reasonably likely to cause substantial bodily harm, the violation is a category A felony, regardless of whether the communicable disease was transmitted. (NRS 212.189) Section 13 of this bill instead provides that such a violation is only a category A felony where: (1) the communicable disease was likely to be transmitted by his or her conduct; and (2) the communicable disease was actually transmitted as a result of the conduct. Section 78 of this bill provides that the provisions of section 13 apply retroactively to violations that occurred before the effective date of that section, if the person who committed the violation has not been convicted before that date.
Existing law requires public and private health plans, including Medicaid and health plans for state government employees, to cover an examination and testing of a pregnant woman for Chlamydia trachomatis, gonorrhea, hepatitis B, hepatitis C and syphilis. (NRS 287.04335, 422.27173, 689A.0412, 689B.0315, 689C.1675, 695A.1856, 695B.1913, 695C.1737, 695G.1714) Sections 16, 22, 34, 42, 47, 52, 55, 60, 65, 67 and 72 of this bill additionally require such insurance plans to cover: (1) testing for, treatment of and prevention of sexually transmitted diseases; and (2) condoms for certain covered persons.
Existing law requires certain public and private health plans, including health plans for state government employees, to cover drugs that prevent the acquisition of human immunodeficiency virus and any related laboratory or diagnostic procedures. (NRS 287.010, 287.04335, 689A.0437, 689B.0312, 689C.1671, 695A.1843, 695B.1924, 695C.1743, 695G.1705) Sections 31, 37, 44, 51, 57, 62, 68 and 74 of this bill require such insurance plans to cover all such drugs approved by the United States Food and Drug Administration and all drugs approved by the Food and Drug Administration for treating human immunodeficiency virus or hepatitis C without restrictions, other than step therapy. Sections 23, 37, 44, 51, 57, 62, 68 and 74 of this bill require such insurance plans to: (1) cover any service to test for, prevent or treat those diseases provided by a provider of primary care if the service is covered when provided by a specialist and certain other requirements are met; and (2) reimburse an advanced practice registered nurse or a physician assistant for such services at a rate equal to that provided to a physician. Sections 16, 20, 31, 33, 41, 46, 52, 54, 59, 64, 67 and 71 impose similar requirements regarding: (1) coverage of certain drugs approved by the Food and Drug Administration to treat substance use disorder; (2) coverage of services for the treatment of substance use disorder provided by a provider of primary care; and (3) reimbursement for such services provided by an advanced practice registered nurse. Sections 14.5-15.5 of this bill make conforming changes to exempt local governmental agencies that provide health insurance to employees through a plan of self-insurance from the amendatory provisions of section 44 while maintaining existing requirements that apply to such insurance. Sections 36, 38, 49 and 50 of this bill make conforming changes to indicate that the coverage required by sections 33 and 46 is in addition to certain coverage of services for the treatment of substance use disorder that certain insurers are required by existing law to provide. Sections 14 and 39 of this bill make conforming changes to indicate the proper placement of sections 20, 22, 33 and 34 in the Nevada Revised Statutes. Section 69 of this bill authorizes the Commissioner of Insurance to suspend or revoke the certificate of a health maintenance organization that fails to comply with the requirements of section 64 or 65. The Commissioner would also be authorized to take such action against any health insurer who fails to comply with the requirements of sections 33, 34, 37, 41-44, 46, 47, 50, 54-57, 59-62, 67, 68 or 71-74 of this bill. (NRS 680A.200, 695C.330)
Existing law requires the Department of Health and Human Services to develop a list of preferred prescription drugs to be used for the Medicaid program. Existing law requires the Department to: (1) include on that list drugs for the prevention of human immunodeficiency virus; and (2) include drugs prescribed to treat the human immunodeficiency virus on a list of drugs that are excluded from the restrictions imposed on drugs that are on the list of preferred prescription drugs. (NRS 422.4025) Section 25 of this bill requires the Medicaid program to cover a prescription drug that is not on the list of preferred prescription drugs if the drug is: (1) used to treat hepatitis C, used to provide medication-assisted treatment for opioid use disorder, used to support safe withdrawal from substance use disorder or is in the same class as a prescription drug on the list of preferred prescription drugs; and (2) is unsuitable for a recipient of Medicaid for certain reasons.
κ2023 Statutes of Nevada, Page 3489 (CHAPTER 528, SB 439)κ
Section 25 of this bill requires the Medicaid program to cover a prescription drug that is not on the list of preferred prescription drugs if the drug is: (1) used to treat hepatitis C, used to provide medication-assisted treatment for opioid use disorder, used to support safe withdrawal from substance use disorder or is in the same class as a prescription drug on the list of preferred prescription drugs; and (2) is unsuitable for a recipient of Medicaid for certain reasons.
Existing law requires physicians, osteopathic physicians, physician assistants and nurses to complete certain continuing education in order to renew their licenses. (NRS 630.253, 632.343, 633.471) Sections 28-30 and 75 of this bill require such a provider of health care who provides or supervises the provision of emergency medical care or primary care in a hospital to complete before the first renewal of their license or, for currently practicing providers, the next renewal of their license, at least 2 hours of training in stigma, discrimination and unrecognized bias toward persons who have acquired or are at a high risk of acquiring human immunodeficiency virus. Section 27 of this bill authorizes any provider of health care to use training in that subject in place of not more than 2 hours of any other training that the provider is required to complete, other than continuing education relating to ethics.
Senate Bill No. 275 of the 2021 Legislative Session repealed certain criminal offenses for which an element of the offense was having the human immunodeficiency virus. (Section 24, chapter 491, Statutes of Nevada 2021, at page 3199) Section 77 of this bill provides that the repeal of those offenses applies retroactively to violations that occurred before the effective date of Senate Bill No. 275.
EXPLANATION Matter in bolded italics is new; matter between
brackets [omitted material] is material to be
omitted.
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1. Chapter 441A of NRS is hereby amended by adding thereto a new section to read as follows:
1. The Department of Health and Human Services and all district, county and city boards of health shall develop policies to provide uninterrupted services during a public health emergency to persons who have been diagnosed with the human immunodeficiency virus or who are at a high risk of acquiring the human immunodeficiency virus and who are receiving services from the Department or any division thereof or the district, county or city health department, as applicable. Such policies may provide, without limitation, for the delivery of such services during a public health emergency:
(a) Over the Internet;
(b) Using an application for a mobile device; or
(c) By calling or sending text messages from a telephone number that is not generally blocked or identified as a source of unwanted calls or messages.
2. As used in this section:
(a) Mobile device includes, without limitation, a smartphone or a tablet computer.
(b) Public health emergency means:
(1) A public health emergency or other health event identified by a health authority pursuant to NRS 439.970; or
(2) A state of emergency or declaration of disaster proclaimed pursuant to NRS 414.070 that relates to or affects public health.
κ2023 Statutes of Nevada, Page 3490 (CHAPTER 528, SB 439)κ
Sec. 2. NRS 441A.334 is hereby amended to read as follows:
441A.334 As used in this section and NRS 441A.335 and 441A.336, and section 1 of this act, provider of health care means a physician, nurse or physician assistant licensed in accordance with state law.
Secs. 3-10. (Deleted by amendment.)
Sec. 11. Chapter 209 of NRS is hereby amended by adding thereto a new section to read as follows:
1. The Department or the operator of a private facility or institution shall not enter into a contract or other agreement with any person or entity to provide medical services to offenders who are diagnosed with human immunodeficiency virus unless the person or entity demonstrates that at least 95 percent of the patients who are diagnosed with human immunodeficiency virus to whom the person or entity provides medical services:
(a) Are offered treatment on the same day as the diagnosis; and
(b) Are able to begin such treatment not later than 7 days after diagnosis.
2. Except as otherwise provided in subsection 3, an institution, facility or private facility or institution shall take reasonable measures to ensure the availability of:
(a) Any drug prescribed for treating the human immunodeficiency virus in the form recommended by the prescribing practitioner to each offender who has been diagnosed with human immunodeficiency virus to the same extent and under the same conditions as other medical care for offenders.
(b) Methods of preventing the acquisition of human immunodeficiency virus, including, without limitation, drugs approved by the United States Food and Drug Administration for that purpose, to all offenders free of charge.
3. An institution, facility or private facility or institution:
(a) Is not required to make available a drug described in subsection 2 for which a prescription is required to an offender for whom such a prescription has not been issued.
(b) Shall take reasonable measures to make available to all offenders a provider of health care who is authorized to issue a prescription for a drug described in subsection 2.
(c) Shall not demand, request or suggest that a provider of health care refrain from issuing a prescription for a drug described in subsection 2 to an offender or take any other measure to prevent a provider of health care from issuing such a prescription.
4. As used in this section, provider of health care has the meaning ascribed to it in NRS 629.031.
Sec. 12. Chapter 211 of NRS is hereby amended by adding thereto a new section to read as follows:
1. A sheriff, chief of police or town marshal who is responsible for a county, city or town jail or detention facility shall not enter into a contract or other agreement with any person or entity to provide medical services to prisoners who are diagnosed with human immunodeficiency virus unless the person or entity demonstrates that at least 95 percent of the patients who are diagnosed with human immunodeficiency virus to whom the person or entity provides medical services:
κ2023 Statutes of Nevada, Page 3491 (CHAPTER 528, SB 439)κ
(a) Are offered treatment on the same day as the diagnosis; and
(b) Are able to begin such treatment not later than 7 days after diagnosis.
2. Except as otherwise provided in subsection 3, a county, city or town jail or detention facility shall take reasonable measures to ensure the availability of:
(a) Any drug prescribed for treating the human immunodeficiency virus in the form recommended by the prescribing practitioner to each prisoner who has been diagnosed with human immunodeficiency virus to the same extent and under the same conditions as other medical care for prisoners.
(b) Methods of preventing the acquisition of human immunodeficiency virus, including, without limitation, drugs approved by the United States Food and Drug Administration for that purpose, to all prisoners free of charge.
3. A county, city or town jail or detention facility:
(a) Is not required to make available a drug described in subsection 2 for which a prescription is required to a prisoner for whom such a prescription has not been issued.
(b) Shall take reasonable measures to make available to all prisoners a provider of health care who is authorized to issue a prescription for a drug described in subsection 2.
(c) Shall not demand, request or suggest that a provider of health care refrain from issuing a prescription for a drug described in subsection 2 to an offender or take any other measure to prevent a provider of health care from issuing such a prescription.
4. As used in this section, provider of health care has the meaning ascribed to it in NRS 629.031.
Sec. 13. NRS 212.189 is hereby amended to read as follows:
212.189 1. Except as otherwise provided in subsection 10, a prisoner who is under lawful arrest, in lawful custody or in lawful confinement shall not knowingly:
(a) Store or stockpile any human excrement or bodily fluid;
(b) Sell, supply or provide any human excrement or bodily fluid to any other person;
(c) Buy, receive or acquire any human excrement or bodily fluid from any other person; or
(d) Use, propel, discharge, spread or conceal, or cause to be used, propelled, discharged, spread or concealed, any human excrement or bodily fluid:
(1) With the intent to have the excrement or bodily fluid come into physical contact with any portion of the body of another person, including, without limitation, an officer or employee of a prison or law enforcement agency, whether or not such physical contact actually occurs; or
(2) Under circumstances in which the excrement or bodily fluid is reasonably likely to come into physical contact with any portion of the body of another person, including, without limitation, an officer or employee of a prison or law enforcement agency, whether or not such physical contact actually occurs.
2. Except as otherwise provided in subsection 4, if a prisoner who is under lawful arrest or in lawful custody violates any provision of subsection 1, the prisoner is guilty of:
κ2023 Statutes of Nevada, Page 3492 (CHAPTER 528, SB 439)κ
(a) For a first offense, a gross misdemeanor.
(b) For a second offense or any subsequent offense, a category D felony and shall be punished as provided in NRS 193.130.
3. Except as otherwise provided in subsection 4, if a prisoner who is in lawful confinement, other than residential confinement, violates any provision of subsection 1, the prisoner is guilty of a category B felony and shall be punished by imprisonment in the state prison for a minimum term of not less than 2 years and a maximum term of not more than 10 years, and may be further punished by a fine of not more than $10,000.
4. If a prisoner who is under lawful arrest, in lawful custody or in lawful confinement violates any provision of paragraph (d) of subsection 1 and, at the time of the offense, the prisoner knew that any portion of the excrement or bodily fluid involved in the offense contained a communicable disease that causes or is reasonably likely to cause substantial bodily harm, [whether or not] the communicable disease is likely to be transmitted as a result of the offense and the communicable disease was actually transmitted to a victim as a result of the offense, the prisoner is guilty of a category A felony and shall be punished by imprisonment in the state prison:
(a) For life with the possibility of parole, with eligibility for parole beginning when a minimum of 10 years has been served; or
(b) For a definite term of 25 years, with eligibility for parole beginning when a minimum of 10 years has been served,
Κ and may be further punished by a fine of not more than $50,000.
5. A sentence imposed upon a prisoner pursuant to subsection 2, 3 or 4:
(a) Is not subject to suspension or the granting of probation; and
(b) Must run consecutively after the prisoner has served any sentences imposed upon the prisoner for the offense or offenses for which the prisoner was under lawful arrest, in lawful custody or in lawful confinement when the prisoner violated the provisions of subsection 1.
6. In addition to any other penalty, the court shall order a prisoner who violates any provision of paragraph (d) of subsection 1 to reimburse the appropriate person or governmental body for the cost of any examinations or testing:
(a) Conducted pursuant to paragraphs (a) and (b) of subsection 8; or
(b) Paid for pursuant to subparagraph (2) of paragraph (c) of subsection 8.
7. The warden, sheriff, administrator or other person responsible for administering a prison shall immediately and fully investigate any act described in subsection 1 that is reported or suspected to have been committed in the prison.
8. If there is probable cause to believe that an act described in paragraph (d) of subsection 1 has been committed in a prison:
(a) Each prisoner believed to have committed the act or to have been the bodily source of any portion of the excrement or bodily fluid involved in the act shall submit to any appropriate examinations and testing to determine whether each such prisoner has any communicable disease.
(b) If possible, a sample of the excrement or bodily fluid involved in the act must be recovered and tested to determine whether any communicable disease is present in the excrement or bodily fluid.
(c) If the excrement or bodily fluid involved in the act came into physical contact with any portion of the body of an officer or employee of a prison or law enforcement agency:
κ2023 Statutes of Nevada, Page 3493 (CHAPTER 528, SB 439)κ
(1) The results of any examinations or testing conducted pursuant to paragraphs (a) and (b) must be provided to each such officer, employee or other person; and
(2) For each such officer or employee:
(I) Of a prison, the person or governmental body operating the prison where the act was committed shall pay for any appropriate examinations and testing requested by the officer or employee to determine whether a communicable disease was transmitted to the officer or employee as a result of the act; and
(II) Of any law enforcement agency, the law enforcement agency that employs the officer or employee shall pay for any appropriate examinations and testing requested by the officer or employee to determine whether a communicable disease was transmitted to the officer or employee as a result of the act.
(d) The results of the investigation conducted pursuant to subsection 7 and the results of any examinations or testing conducted pursuant to paragraphs (a) and (b) must be submitted to the district attorney of the county in which the act was committed or to the Office of the Attorney General for possible prosecution of each prisoner who committed the act.
9. If a prisoner is charged with committing an act described in paragraph (d) of subsection 1 and a victim or an intended victim of the act was an officer or employee of a prison or law enforcement agency, the prosecuting attorney shall not dismiss the charge in exchange for a plea of guilty, guilty but mentally ill or nolo contendere to a lesser charge or for any other reason unless the prosecuting attorney knows or it is obvious that the charge is not supported by probable cause or cannot be proved at the time of trial.
10. The provisions of this section do not apply to a prisoner who is in residential confinement or to a prisoner who commits an act described in subsection 1 if the act:
(a) Is otherwise lawful and is authorized by the warden, sheriff, administrator or other person responsible for administering the prison, or his or her designee, and the prisoner performs the act in accordance with the directions or instructions given to the prisoner by that person;
(b) Involves the discharge of human excrement or bodily fluid directly from the body of the prisoner and the discharge is the direct result of a temporary or permanent injury, disease or medical condition afflicting the prisoner that prevents the prisoner from having physical control over the discharge of his or her own excrement or bodily fluid; or
(c) Constitutes voluntary sexual conduct with another person in violation of the provisions of NRS 212.187.
Sec. 14. NRS 232.320 is hereby amended to read as follows:
232.320 1. The Director:
(a) Shall appoint, with the consent of the Governor, administrators of the divisions of the Department, who are respectively designated as follows:
(1) The Administrator of the Aging and Disability Services Division;
(2) The Administrator of the Division of Welfare and Supportive Services;
(3) The Administrator of the Division of Child and Family Services;
(4) The Administrator of the Division of Health Care Financing and Policy; and
(5) The Administrator of the Division of Public and Behavioral Health.
κ2023 Statutes of Nevada, Page 3494 (CHAPTER 528, SB 439)κ
(b) Shall administer, through the divisions of the Department, the provisions of chapters 63, 424, 425, 427A, 432A to 442, inclusive, 446 to 450, inclusive, 458A and 656A of NRS, NRS 127.220 to 127.310, inclusive, 422.001 to 422.410, inclusive, and section 20 of this act, 422.580, 432.010 to 432.133, inclusive, 432B.6201 to 432B.626, inclusive, 444.002 to 444.430, inclusive, and 445A.010 to 445A.055, inclusive, and all other provisions of law relating to the functions of the divisions of the Department, but is not responsible for the clinical activities of the Division of Public and Behavioral Health or the professional line activities of the other divisions.
(c) Shall administer any state program for persons with developmental disabilities established pursuant to the Developmental Disabilities Assistance and Bill of Rights Act of 2000, 42 U.S.C. §§ 15001 et seq.
(d) Shall, after considering advice from agencies of local governments and nonprofit organizations which provide social services, adopt a master plan for the provision of human services in this State. The Director shall revise the plan biennially and deliver a copy of the plan to the Governor and the Legislature at the beginning of each regular session. The plan must:
(1) Identify and assess the plans and programs of the Department for the provision of human services, and any duplication of those services by federal, state and local agencies;
(2) Set forth priorities for the provision of those services;
(3) Provide for communication and the coordination of those services among nonprofit organizations, agencies of local government, the State and the Federal Government;
(4) Identify the sources of funding for services provided by the Department and the allocation of that funding;
(5) Set forth sufficient information to assist the Department in providing those services and in the planning and budgeting for the future provision of those services; and
(6) Contain any other information necessary for the Department to communicate effectively with the Federal Government concerning demographic trends, formulas for the distribution of federal money and any need for the modification of programs administered by the Department.
(e) May, by regulation, require nonprofit organizations and state and local governmental agencies to provide information regarding the programs of those organizations and agencies, excluding detailed information relating to their budgets and payrolls, which the Director deems necessary for the performance of the duties imposed upon him or her pursuant to this section.
(f) Has such other powers and duties as are provided by law.
2. Notwithstanding any other provision of law, the Director, or the Directors designee, is responsible for appointing and removing subordinate officers and employees of the Department.
Sec. 14.5. Chapter 287 of NRS is hereby amended by adding thereto a new section to read as follows:
1. The governing body of any county, school district, municipal corporation, political subdivision, public corporation or other local governmental agency of the State of Nevada that provides health insurance through a plan of self-insurance shall provide coverage for:
(a) Drugs approved by the United States Food and Drug Administration for preventing the acquisition of human immunodeficiency virus;
(b) Laboratory testing that is necessary for therapy that uses such a drug; and
κ2023 Statutes of Nevada, Page 3495 (CHAPTER 528, SB 439)κ
(c) The services described in NRS 639.28085, when provided by a pharmacist who participates in the network plan of the governing body.
2. The governing body of any county, school district, municipal corporation, political subdivision, public corporation or other local governmental agency of the State of Nevada that provides health insurance through a plan of self-insurance shall reimburse a pharmacist who participates in the network plan of the governing body for the services described in NRS 639.28085 at a rate equal to the rate of reimbursement provided to a physician, physician assistant or advanced practice registered nurse for similar services.
3. The governing body of any county, school district, municipal corporation, political subdivision, public corporation or other local governmental agency of the State of Nevada that provides health insurance through a plan of self-insurance may subject the benefits required by subsection 1 to reasonable medical management techniques.
4. The governing body of any county, school district, municipal corporation, political subdivision, public corporation or other local governmental agency of the State of Nevada that provides health insurance through a plan of self-insurance shall ensure that the benefits required by subsection 1 are made available to an insured through a provider of health care who participates in the network plan of the governing body.
5. A plan of self-insurance described in subsection 1 that is delivered, issued for delivery or renewed on or after January 1, 2024, has the legal effect of including the coverage required by subsection 1, and any provision of the plan that conflicts with the provisions of this section is void.
6. As used in this section:
(a) Medical management technique means a practice which is used to control the cost or use of health care services or prescription drugs. The term includes, without limitation, the use of step therapy, prior authorization and categorizing drugs and devices based on cost, type or method of administration.
(b) Network plan means a plan of self-insurance provided by the governing body of a local governmental agency under which the financing and delivery of medical care, including items and services paid for as medical care, are provided, in whole or in part, through a defined set of providers under contract with the governing body. The term does not include an arrangement for the financing of premiums.
(c) Provider of health care has the meaning ascribed to it in NRS 629.031.
Sec. 15. NRS 287.010 is hereby amended to read as follows:
287.010 1. The governing body of any county, school district, municipal corporation, political subdivision, public corporation or other local governmental agency of the State of Nevada may:
(a) Adopt and carry into effect a system of group life, accident or health insurance, or any combination thereof, for the benefit of its officers and employees, and the dependents of officers and employees who elect to accept the insurance and who, where necessary, have authorized the governing body to make deductions from their compensation for the payment of premiums on the insurance.
(b) Purchase group policies of life, accident or health insurance, or any combination thereof, for the benefit of such officers and employees, and the dependents of such officers and employees, as have authorized the purchase, from insurance companies authorized to transact the business of such insurance in the State of Nevada, and, where necessary, deduct from the compensation of officers and employees the premiums upon insurance and pay the deductions upon the premiums.
κ2023 Statutes of Nevada, Page 3496 (CHAPTER 528, SB 439)κ
from insurance companies authorized to transact the business of such insurance in the State of Nevada, and, where necessary, deduct from the compensation of officers and employees the premiums upon insurance and pay the deductions upon the premiums.
(c) Provide group life, accident or health coverage through a self-insurance reserve fund and, where necessary, deduct contributions to the maintenance of the fund from the compensation of officers and employees and pay the deductions into the fund. The money accumulated for this purpose through deductions from the compensation of officers and employees and contributions of the governing body must be maintained as an internal service fund as defined by NRS 354.543. The money must be deposited in a state or national bank or credit union authorized to transact business in the State of Nevada. Any independent administrator of a fund created under this section is subject to the licensing requirements of chapter 683A of NRS, and must be a resident of this State. Any contract with an independent administrator must be approved by the Commissioner of Insurance as to the reasonableness of administrative charges in relation to contributions collected and benefits provided. The provisions of NRS 686A.135, 687B.352, 687B.408, 687B.723, 687B.725, 689B.030 to 689B.031, inclusive, 689B.0313 to 689B.050, inclusive, 689B.265, 689B.287 and 689B.500 apply to coverage provided pursuant to this paragraph, except that the provisions of NRS 689B.0378, 689B.03785 and 689B.500 only apply to coverage for active officers and employees of the governing body, or the dependents of such officers and employees.
(d) Defray part or all of the cost of maintenance of a self-insurance fund or of the premiums upon insurance. The money for contributions must be budgeted for in accordance with the laws governing the county, school district, municipal corporation, political subdivision, public corporation or other local governmental agency of the State of Nevada.
2. If a school district offers group insurance to its officers and employees pursuant to this section, members of the board of trustees of the school district must not be excluded from participating in the group insurance. If the amount of the deductions from compensation required to pay for the group insurance exceeds the compensation to which a trustee is entitled, the difference must be paid by the trustee.
3. In any county in which a legal services organization exists, the governing body of the county, or of any school district, municipal corporation, political subdivision, public corporation or other local governmental agency of the State of Nevada in the county, may enter into a contract with the legal services organization pursuant to which the officers and employees of the legal services organization, and the dependents of those officers and employees, are eligible for any life, accident or health insurance provided pursuant to this section to the officers and employees, and the dependents of the officers and employees, of the county, school district, municipal corporation, political subdivision, public corporation or other local governmental agency.
4. If a contract is entered into pursuant to subsection 3, the officers and employees of the legal services organization:
(a) Shall be deemed, solely for the purposes of this section, to be officers and employees of the county, school district, municipal corporation, political subdivision, public corporation or other local governmental agency with which the legal services organization has contracted; and
κ2023 Statutes of Nevada, Page 3497 (CHAPTER 528, SB 439)κ
(b) Must be required by the contract to pay the premiums or contributions for all insurance which they elect to accept or of which they authorize the purchase.
5. A contract that is entered into pursuant to subsection 3:
(a) Must be submitted to the Commissioner of Insurance for approval not less than 30 days before the date on which the contract is to become effective.
(b) Does not become effective unless approved by the Commissioner.
(c) Shall be deemed to be approved if not disapproved by the Commissioner within 30 days after its submission.
6. As used in this section, legal services organization means an organization that operates a program for legal aid and receives money pursuant to NRS 19.031.
Sec. 15.5. NRS 287.040 is hereby amended to read as follows:
287.040 The provisions of NRS 287.010 to 287.040, inclusive, and section 14.5 of this act do not make it compulsory upon any governing body of any county, school district, municipal corporation, political subdivision, public corporation or other local governmental agency of the State of Nevada, except as otherwise provided in NRS 287.021 or subsection 4 of NRS 287.023 or in an agreement entered into pursuant to subsection 3 of NRS 287.015, to pay any premiums, contributions or other costs for group insurance, a plan of benefits or medical or hospital services established pursuant to NRS 287.010, 287.015, 287.020 or paragraph (b), (c) or (d) of subsection 1 of NRS 287.025, for coverage under the Public Employees Benefits Program, or to make any contributions to a trust fund established pursuant to NRS 287.017, or upon any officer or employee of any county, school district, municipal corporation, political subdivision, public corporation or other local governmental agency of this State to accept any such coverage or to assign his or her wages or salary in payment of premiums or contributions therefor.
Sec. 16. NRS 287.04335 is hereby amended to read as follows:
287.04335 If the Board provides health insurance through a plan of self-insurance, it shall comply with the provisions of NRS 686A.135, 687B.352, 687B.409, 687B.723, 687B.725, 689B.0353, 689B.255, 695C.1723, 695G.150, 695G.155, 695G.160, 695G.162, 695G.1635, 695G.164, 695G.1645, 695G.1665, 695G.167, 695G.1675, 695G.170 to 695G.174, inclusive, and sections 71 and 72 of this act, 695G.176, 695G.177, 695G.200 to 695G.230, inclusive, 695G.241 to 695G.310, inclusive, and 695G.405, in the same manner as an insurer that is licensed pursuant to title 57 of NRS is required to comply with those provisions.
Secs. 17 and 18. (Deleted by amendment.)
Sec. 19. Chapter 422 of NRS is hereby amended by adding thereto the provisions set forth as sections 20 and 21 of this act.
Sec. 20. 1. The Director shall include in the State Plan for Medicaid a requirement that the State pay the nonfederal share of expenses for any service for the treatment of substance use disorder provided by a provider of primary care if the service is included in the State Plan when provided by a specialist and:
(a) The service is within the scope of practice of the provider of primary care; or
(b) The provider of primary care is capable of providing the service safely and effectively in consultation with a specialist and the provider engages in such consultation.
κ2023 Statutes of Nevada, Page 3498 (CHAPTER 528, SB 439)κ
2. As used in this section, primary care means the practice of family medicine, pediatrics, internal medicine, obstetrics and gynecology and midwifery.
Sec. 21. (Deleted by amendment.)
Sec. 22. NRS 422.27173 is hereby amended to read as follows:
422.27173 The Director shall include in the State Plan for Medicaid a requirement that the State must pay the nonfederal share of expenditures incurred for :
1. Testing for and the treatment and prevention of sexually transmitted diseases, including, without limitation, Chlamydia trachomatis, gonorrhea, syphilis, human immunodeficiency virus and hepatitis B and C, for all recipients of Medicaid, regardless of age. Services covered pursuant to this section must include, without limitation, the examination of a pregnant woman for the discovery of:
[1.] (a) Chlamydia trachomatis, gonorrhea, hepatitis B and hepatitis C in accordance with NRS 442.013.
[2.] (b) Syphilis in accordance with NRS 442.010.
2. Condoms for recipients of Medicaid.
Sec. 23. NRS 422.27235 is hereby amended to read as follows:
422.27235 1. The Director shall include in the State Plan for Medicaid a requirement that the State pay the nonfederal share of expenditures incurred for:
[1.] (a) Any laboratory testing that is necessary for therapy that uses a drug approved by the United States Food and Drug Administration for preventing the acquisition of human immunodeficiency virus . [; and]
[2.] (b) The services of a pharmacist described in NRS 639.28085. The State must provide reimbursement for such services at a rate equal to the rate of reimbursement provided to a physician, physician assistant or advanced practice registered nurse for similar services.
(c) Any service to test for, prevent or treat human immunodeficiency virus or hepatitis C provided by a provider of primary care if the service is covered when provided by a specialist and:
(1) The service is within the scope of practice of the provider of primary care; or
(2) The provider of primary care is capable of providing the service safely and effectively in consultation with a specialist and the provider engages in such consultation.
2. The Director shall include in the State Plan for Medicaid a requirement that the State reimburse an advanced practice registered nurse or a physician assistant for any service to test for, prevent or treat human immunodeficiency virus or hepatitis C at a rate equal to the rate of reimbursement provided to a physician for similar services.
3. As used in this section, primary care means the practice of family medicine, pediatrics, internal medicine, obstetrics and gynecology and midwifery.
Sec. 24. (Deleted by amendment.)
Sec. 25. NRS 422.4025 is hereby amended to read as follows:
422.4025 1. The Department shall:
(a) By regulation, develop a list of preferred prescription drugs to be used for the Medicaid program and the Childrens Health Insurance Program, and each public or nonprofit health benefit plan that elects to use the list of preferred prescription drugs as its formulary pursuant to NRS 287.012, 287.0433 or 687B.407; and
κ2023 Statutes of Nevada, Page 3499 (CHAPTER 528, SB 439)κ
(b) Negotiate and enter into agreements to purchase the drugs included on the list of preferred prescription drugs on behalf of the health benefit plans described in paragraph (a) or enter into a contract pursuant to NRS 422.4053 with a pharmacy benefit manager, health maintenance organization or one or more public or private entities in this State, the District of Columbia or other states or territories of the United States, as appropriate, to negotiate such agreements.
2. The Department shall, by regulation, establish a list of prescription drugs which must be excluded from any restrictions that are imposed by the Medicaid program on drugs that are on the list of preferred prescription drugs established pursuant to subsection 1. The list established pursuant to this subsection must include, without limitation:
(a) Prescription drugs that are prescribed for the treatment of the human immunodeficiency virus, including, without limitation, antiretroviral medications;
(b) Antirejection medications for organ transplants;
(c) Antihemophilic medications; and
(d) Any prescription drug which the Board identifies as appropriate for exclusion from any restrictions that are imposed by the Medicaid program on drugs that are on the list of preferred prescription drugs.
3. The regulations must provide that the Board makes the final determination of:
(a) Whether a class of therapeutic prescription drugs is included on the list of preferred prescription drugs and is excluded from any restrictions that are imposed by the Medicaid program on drugs that are on the list of preferred prescription drugs;
(b) Which therapeutically equivalent prescription drugs will be reviewed for inclusion on the list of preferred prescription drugs and for exclusion from any restrictions that are imposed by the Medicaid program on drugs that are on the list of preferred prescription drugs; and
(c) Which prescription drugs should be excluded from any restrictions that are imposed by the Medicaid program on drugs that are on the list of preferred prescription drugs based on continuity of care concerning a specific diagnosis, condition, class of therapeutic prescription drugs or medical specialty.
4. The list of preferred prescription drugs established pursuant to subsection 1 must include, without limitation:
(a) Any prescription drug determined by the Board to be essential for treating sickle cell disease and its variants; and
(b) Prescription drugs to prevent the acquisition of human immunodeficiency virus.
5. The regulations must provide that each new pharmaceutical product and each existing pharmaceutical product for which there is new clinical evidence supporting its inclusion on the list of preferred prescription drugs must be made available pursuant to the Medicaid program with prior authorization until the Board reviews the product or the evidence.
6. The Medicaid program must cover a prescription drug that is not included on the list of preferred prescription drugs as if the drug were included on that list if:
(a) The drug is:
(1) Used to treat hepatitis C;
(2) Used to provide medication-assisted treatment for opioid use disorder;
κ2023 Statutes of Nevada, Page 3500 (CHAPTER 528, SB 439)κ
(3) Used to support safe withdrawal from substance use disorder; or
(4) In the same class as a drug on the list of preferred prescription drugs; and
(b) All preferred prescription drugs within the same class as the drug are unsuitable for a recipient of Medicaid because:
(1) The recipient is allergic to all preferred prescription drugs within the same class as the drug;
(2) All preferred prescription drugs within the same class as the drug are contraindicated for the recipient or are likely to interact in a harmful manner with another drug that the recipient is taking;
(3) The recipient has a history of adverse reactions to all preferred prescription drugs within the same class as the drug; or
(4) The drug has a unique indication that is supported by peer-reviewed clinical evidence or approved by the United States Food and Drug Administration.
7. On or before February 1 of each year, the Department shall:
(a) Compile a report concerning the agreements negotiated pursuant to paragraph (b) of subsection 1 and contracts entered into pursuant to NRS 422.4053 which must include, without limitation, the financial effects of obtaining prescription drugs through those agreements and contracts, in total and aggregated separately for agreements negotiated by the Department, contracts with a pharmacy benefit manager, contracts with a health maintenance organization and contracts with public and private entities from this State, the District of Columbia and other states and territories of the United States; and
(b) Post the report on an Internet website maintained by the Department and submit the report to the Director of the Legislative Counsel Bureau for transmittal to:
(1) In odd-numbered years, the Legislature; or
(2) In even-numbered years, the Legislative Commission.
Sec. 26. NRS 608.156 is hereby amended to read as follows:
608.156 1. [If] In addition to any benefits required by NRS 608.1555, an employer provides health benefits for his or her employees, the employer shall provide benefits for the expenses for the treatment of alcohol and substance use disorders. The annual benefits provided by the employer must [consist of:] include, without limitation:
(a) Treatment for withdrawal from the physiological effects of alcohol or drugs, with a maximum benefit of $1,500 per calendar year.
(b) Treatment for a patient admitted to a facility, with a maximum benefit of $9,000 per calendar year.
(c) Counseling for a person, group or family who is not admitted to a facility, with a maximum benefit of $2,500 per calendar year.
2. The maximum amount which may be paid in the lifetime of the insured for any combination of the treatments listed in subsection 1 is $39,000.
3. Except as otherwise provided in NRS 687B.409, these benefits must be paid in the same manner as benefits for any other illness covered by the employer are paid.
4. The employee is entitled to these benefits if treatment is received in any:
κ2023 Statutes of Nevada, Page 3501 (CHAPTER 528, SB 439)κ
(a) Program for the treatment of alcohol or substance use disorders which is certified by the Division of Public and Behavioral Health of the Department of Health and Human Services.
(b) Hospital or other medical facility or facility for the dependent which is licensed by the Division of Public and Behavioral Health of the Department of Health and Human Services, is accredited by The Joint Commission or CARF International and provides a program for the treatment of alcohol or substance use disorders as part of its accredited activities.
Sec. 27. NRS 629.093 is hereby amended to read as follows:
629.093 Unless a specific statute or regulation requires or authorizes a greater number of hours, a provider of health care may use credit earned for continuing education relating to Alzheimers disease or the stigma, discrimination and unrecognized bias toward persons who have acquired or are at a high risk of acquiring human immunodeficiency virus in place of not more than 2 hours each year of the continuing education that the provider of health care is required to complete, other than any continuing education relating to ethics that the provider of health care is required to complete.
Sec. 28. NRS 630.253 is hereby amended to read as follows:
630.253 1. The Board shall, as a prerequisite for the:
(a) Renewal of a license as a physician assistant; or
(b) Biennial registration of the holder of a license to practice medicine,
Κ require each holder to submit evidence of compliance with the requirements for continuing education as set forth in regulations adopted by the Board.
2. These requirements:
(a) May provide for the completion of one or more courses of instruction relating to risk management in the performance of medical services.
(b) Must provide for the completion of a course of instruction, within 2 years after initial licensure, relating to the medical consequences of an act of terrorism that involves the use of a weapon of mass destruction. The course must provide at least 4 hours of instruction that includes instruction in the following subjects:
(1) An overview of acts of terrorism and weapons of mass destruction;
(2) Personal protective equipment required for acts of terrorism;
(3) Common symptoms and methods of treatment associated with exposure to, or injuries caused by, chemical, biological, radioactive and nuclear agents;
(4) Syndromic surveillance and reporting procedures for acts of terrorism that involve biological agents; and
(5) An overview of the information available on, and the use of, the Health Alert Network.
(c) Must provide for the completion by a holder of a license to practice medicine of a course of instruction within 2 years after initial licensure that provides at least 2 hours of instruction on evidence-based suicide prevention and awareness as described in subsection 6.
(d) Must provide for the completion of at least 2 hours of training in the screening, brief intervention and referral to treatment approach to substance use disorder within 2 years after initial licensure.
(e) Must provide for the biennial completion by each psychiatrist and each physician assistant practicing under the supervision of a psychiatrist of one or more courses of instruction that provide at least 2 hours of instruction relating to cultural competency and diversity, equity and inclusion.
κ2023 Statutes of Nevada, Page 3502 (CHAPTER 528, SB 439)κ
one or more courses of instruction that provide at least 2 hours of instruction relating to cultural competency and diversity, equity and inclusion. Such instruction:
(1) May include the training provided pursuant to NRS 449.103, where applicable.
(2) Must be based upon a range of research from diverse sources.
(3) Must address persons of different cultural backgrounds, including, without limitation:
(I) Persons from various gender, racial and ethnic backgrounds;
(II) Persons from various religious backgrounds;
(III) Lesbian, gay, bisexual, transgender and questioning persons;
(IV) Children and senior citizens;
(V) Veterans;
(VI) Persons with a mental illness;
(VII) Persons with an intellectual disability, developmental disability or physical disability; and
(VIII) Persons who are part of any other population that a psychiatrist or a physician assistant practicing under the supervision of a psychiatrist may need to better understand, as determined by the Board.
(f) Must allow the holder of a license to receive credit toward the total amount of continuing education required by the Board for the completion of a course of instruction relating to genetic counseling and genetic testing.
(g) Must provide for the completion by a physician or physician assistant who provides or supervises the provision of emergency medical services in a hospital or primary care of at least 2 hours of training in the stigma, discrimination and unrecognized bias toward persons who have acquired or are at a high risk of acquiring human immunodeficiency virus within 2 years after beginning to provide or supervise the provision of such services or care.
3. The Board may determine whether to include in a program of continuing education courses of instruction relating to the medical consequences of an act of terrorism that involves the use of a weapon of mass destruction in addition to the course of instruction required by paragraph (b) of subsection 2.
4. The Board shall encourage each holder of a license who treats or cares for persons who are more than 60 years of age to receive, as a portion of their continuing education, education in geriatrics and gerontology, including such topics as:
(a) The skills and knowledge that the licensee needs to address aging issues;
(b) Approaches to providing health care to older persons, including both didactic and clinical approaches;
(c) The biological, behavioral, social and emotional aspects of the aging process; and
(d) The importance of maintenance of function and independence for older persons.
5. The Board shall encourage each holder of a license to practice medicine to receive, as a portion of his or her continuing education, training concerning methods for educating patients about how to effectively manage medications, including, without limitation, the ability of the patient to request to have the symptom or purpose for which a drug is prescribed included on the label attached to the container of the drug.
κ2023 Statutes of Nevada, Page 3503 (CHAPTER 528, SB 439)κ
6. The Board shall require each holder of a license to practice medicine to receive as a portion of his or her continuing education at least 2 hours of instruction every 4 years on evidence-based suicide prevention and awareness, which may include, without limitation, instruction concerning:
(a) The skills and knowledge that the licensee needs to detect behaviors that may lead to suicide, including, without limitation, post-traumatic stress disorder;
(b) Approaches to engaging other professionals in suicide intervention; and
(c) The detection of suicidal thoughts and ideations and the prevention of suicide.
7. The Board shall encourage each holder of a license to practice medicine or as a physician assistant to receive, as a portion of his or her continuing education, training and education in the diagnosis of rare diseases, including, without limitation:
(a) Recognizing the symptoms of pediatric cancer; and
(b) Interpreting family history to determine whether such symptoms indicate a normal childhood illness or a condition that requires additional examination.
8. A holder of a license to practice medicine may not substitute the continuing education credits relating to suicide prevention and awareness required by this section for the purposes of satisfying an equivalent requirement for continuing education in ethics.
9. Except as otherwise provided in NRS 630.2535, a holder of a license to practice medicine may substitute not more than 2 hours of continuing education credits in pain management, care for persons with an addictive disorder or the screening, brief intervention and referral to treatment approach to substance use disorder for the purposes of satisfying an equivalent requirement for continuing education in ethics.
10. As used in this section:
(a) Act of terrorism has the meaning ascribed to it in NRS 202.4415.
(b) Biological agent has the meaning ascribed to it in NRS 202.442.
(c) Chemical agent has the meaning ascribed to it in NRS 202.4425.
(d) Primary care means the practice of family medicine, pediatrics, internal medicine, obstetrics and gynecology and midwifery.
(e) Radioactive agent has the meaning ascribed to it in NRS 202.4437.
[(e)] (f) Weapon of mass destruction has the meaning ascribed to it in NRS 202.4445.
Sec. 29. NRS 632.343 is hereby amended to read as follows:
632.343 1. The Board shall not renew any license issued under this chapter until the licensee has submitted proof satisfactory to the Board of completion, during the 2-year period before renewal of the license, of 30 hours in a program of continuing education approved by the Board in accordance with regulations adopted by the Board. Except as otherwise provided in subsection 3, the licensee is exempt from this provision for the first biennial period after graduation from:
(a) An accredited school of professional nursing;
(b) An accredited school of practical nursing;
(c) An approved school of professional nursing in the process of obtaining accreditation; or
(d) An approved school of practical nursing in the process of obtaining accreditation.
κ2023 Statutes of Nevada, Page 3504 (CHAPTER 528, SB 439)κ
2. The Board shall review all courses offered to nurses for the completion of the requirement set forth in subsection 1. The Board may approve nursing and other courses which are directly related to the practice of nursing as well as others which bear a reasonable relationship to current developments in the field of nursing or any special area of practice in which a licensee engages. These may include academic studies, workshops, extension studies, home study and other courses.
3. The program of continuing education required by subsection 1 must include:
(a) For a person licensed as an advanced practice registered nurse:
(1) A course of instruction to be completed within 2 years after initial licensure that provides at least 2 hours of instruction on suicide prevention and awareness as described in subsection 6.
(2) The ability to receive credit toward the total amount of continuing education required by subsection 1 for the completion of a course of instruction relating to genetic counseling and genetic testing.
(b) For each person licensed pursuant to this chapter, a course of instruction, to be completed within 2 years after initial licensure, relating to the medical consequences of an act of terrorism that involves the use of a weapon of mass destruction. The course must provide at least 4 hours of instruction that includes instruction in the following subjects:
(1) An overview of acts of terrorism and weapons of mass destruction;
(2) Personal protective equipment required for acts of terrorism;
(3) Common symptoms and methods of treatment associated with exposure to, or injuries caused by, chemical, biological, radioactive and nuclear agents;
(4) Syndromic surveillance and reporting procedures for acts of terrorism that involve biological agents; and
(5) An overview of the information available on, and the use of, the Health Alert Network.
(c) For each person licensed pursuant to this chapter, one or more courses of instruction that provide at least 2 hours of instruction relating to cultural competency and diversity, equity and inclusion to be completed biennially. Such instruction:
(1) May include the training provided pursuant to NRS 449.103, where applicable.
(2) Must be based upon a range of research from diverse sources.
(3) Must address persons of different cultural backgrounds, including, without limitation:
(I) Persons from various gender, racial and ethnic backgrounds;
(II) Persons from various religious backgrounds;
(III) Lesbian, gay, bisexual, transgender and questioning persons;
(IV) Children and senior citizens;
(V) Veterans;
(VI) Persons with a mental illness;
(VII) Persons with an intellectual disability, developmental disability or physical disability; and
(VIII) Persons who are part of any other population that a person licensed pursuant to this chapter may need to better understand, as determined by the Board.
κ2023 Statutes of Nevada, Page 3505 (CHAPTER 528, SB 439)κ
(d) For a person licensed as an advanced practice registered nurse, at least 2 hours of training in the screening, brief intervention and referral to treatment approach to substance use disorder to be completed within 2 years after initial licensure.
(e) For each person licensed pursuant to this chapter who provides or supervises the provision of emergency medical services in a hospital or primary care, at least 2 hours of training in the stigma, discrimination and unrecognized bias toward persons who have acquired or are at a high risk of acquiring human immunodeficiency virus to be completed within 2 years after beginning to provide or supervise the provision of such services or care.
4. The Board may determine whether to include in a program of continuing education courses of instruction relating to the medical consequences of an act of terrorism that involves the use of a weapon of mass destruction in addition to the course of instruction required by paragraph (b) of subsection 3.
5. The Board shall encourage each licensee who treats or cares for persons who are more than 60 years of age to receive, as a portion of their continuing education, education in geriatrics and gerontology, including such topics as:
(a) The skills and knowledge that the licensee needs to address aging issues;
(b) Approaches to providing health care to older persons, including both didactic and clinical approaches;
(c) The biological, behavioral, social and emotional aspects of the aging process; and
(d) The importance of maintenance of function and independence for older persons.
6. The Board shall require each person licensed as an advanced practice registered nurse to receive as a portion of his or her continuing education at least 2 hours of instruction every 4 years on evidence-based suicide prevention and awareness or another course of instruction on suicide prevention and awareness that is approved by the Board which the Board has determined to be effective and appropriate.
7. The Board shall encourage each person licensed as an advanced practice registered nurse to receive, as a portion of his or her continuing education, training and education in the diagnosis of rare diseases, including, without limitation:
(a) Recognizing the symptoms of pediatric cancer; and
(b) Interpreting family history to determine whether such symptoms indicate a normal childhood illness or a condition that requires additional examination.
8. As used in this section:
(a) Act of terrorism has the meaning ascribed to it in NRS 202.4415.
(b) Biological agent has the meaning ascribed to it in NRS 202.442.
(c) Chemical agent has the meaning ascribed to it in NRS 202.4425.
(d) Primary care means the practice of family medicine, pediatrics, internal medicine, obstetrics and gynecology and midwifery.
(e) Radioactive agent has the meaning ascribed to it in NRS 202.4437.
[(e)] (f) Weapon of mass destruction has the meaning ascribed to it in NRS 202.4445.
κ2023 Statutes of Nevada, Page 3506 (CHAPTER 528, SB 439)κ
Sec. 30. NRS 633.471 is hereby amended to read as follows:
633.471 1. Except as otherwise provided in subsection [14] 15 and NRS 633.491, every holder of a license, except a physician assistant, issued under this chapter, except a temporary or a special license, may renew the license on or before January 1 of each calendar year after its issuance by:
(a) Applying for renewal on forms provided by the Board;
(b) Paying the annual license renewal fee specified in this chapter;
(c) Submitting a list of all actions filed or claims submitted to arbitration or mediation for malpractice or negligence against the holder during the previous year;
(d) Subject to subsection [13,] 14, submitting evidence to the Board that in the year preceding the application for renewal the holder has attended courses or programs of continuing education approved by the Board in accordance with regulations adopted by the Board totaling a number of hours established by the Board which must not be less than 35 hours nor more than that set in the requirements for continuing medical education of the American Osteopathic Association; and
(e) Submitting all information required to complete the renewal.
2. The Secretary of the Board shall notify each licensee of the requirements for renewal not less than 30 days before the date of renewal.
3. The Board shall request submission of verified evidence of completion of the required number of hours of continuing medical education annually from no fewer than one-third of the applicants for renewal of a license to practice osteopathic medicine or a license to practice as a physician assistant. Subject to subsection [13,] 14, upon a request from the Board, an applicant for renewal of a license to practice osteopathic medicine or a license to practice as a physician assistant shall submit verified evidence satisfactory to the Board that in the year preceding the application for renewal the applicant attended courses or programs of continuing medical education approved by the Board totaling the number of hours established by the Board.
4. The Board shall require each holder of a license to practice osteopathic medicine to complete a course of instruction within 2 years after initial licensure that provides at least 2 hours of instruction on evidence-based suicide prevention and awareness as described in subsection 9.
5. The Board shall encourage each holder of a license to practice osteopathic medicine to receive, as a portion of his or her continuing education, training concerning methods for educating patients about how to effectively manage medications, including, without limitation, the ability of the patient to request to have the symptom or purpose for which a drug is prescribed included on the label attached to the container of the drug.
6. The Board shall encourage each holder of a license to practice osteopathic medicine or as a physician assistant to receive, as a portion of his or her continuing education, training and education in the diagnosis of rare diseases, including, without limitation:
(a) Recognizing the symptoms of pediatric cancer; and
(b) Interpreting family history to determine whether such symptoms indicate a normal childhood illness or a condition that requires additional examination.
7. The Board shall require, as part of the continuing education requirements approved by the Board, the biennial completion by a holder of a license to practice osteopathic medicine of at least 2 hours of continuing education credits in ethics, pain management, care of persons with addictive disorders or the screening, brief intervention and referral to treatment approach to substance use disorder.
κ2023 Statutes of Nevada, Page 3507 (CHAPTER 528, SB 439)κ
education credits in ethics, pain management, care of persons with addictive disorders or the screening, brief intervention and referral to treatment approach to substance use disorder.
8. The continuing education requirements approved by the Board must allow the holder of a license as an osteopathic physician or physician assistant to receive credit toward the total amount of continuing education required by the Board for the completion of a course of instruction relating to genetic counseling and genetic testing.
9. The Board shall require each holder of a license to practice osteopathic medicine to receive as a portion of his or her continuing education at least 2 hours of instruction every 4 years on evidence-based suicide prevention and awareness which may include, without limitation, instruction concerning:
(a) The skills and knowledge that the licensee needs to detect behaviors that may lead to suicide, including, without limitation, post-traumatic stress disorder;
(b) Approaches to engaging other professionals in suicide intervention; and
(c) The detection of suicidal thoughts and ideations and the prevention of suicide.
10. A holder of a license to practice osteopathic medicine may not substitute the continuing education credits relating to suicide prevention and awareness required by this section for the purposes of satisfying an equivalent requirement for continuing education in ethics.
11. The Board shall require each holder of a license to practice osteopathic medicine to complete at least 2 hours of training in the screening, brief intervention and referral to treatment approach to substance use disorder within 2 years after initial licensure.
12. The Board shall require each psychiatrist or a physician assistant practicing under the supervision of a psychiatrist to biennially complete one or more courses of instruction that provide at least 2 hours of instruction relating to cultural competency and diversity, equity and inclusion. Such instruction:
(a) May include the training provided pursuant to NRS 449.103, where applicable.
(b) Must be based upon a range of research from diverse sources.
(c) Must address persons of different cultural backgrounds, including, without limitation:
(1) Persons from various gender, racial and ethnic backgrounds;
(2) Persons from various religious backgrounds;
(3) Lesbian, gay, bisexual, transgender and questioning persons;
(4) Children and senior citizens;
(5) Veterans;
(6) Persons with a mental illness;
(7) Persons with an intellectual disability, developmental disability or physical disability; and
(8) Persons who are part of any other population that a psychiatrist or physician assistant practicing under the supervision of a psychiatrist may need to better understand, as determined by the Board.
13. The Board shall require each holder of a license to practice osteopathic medicine or as a physician assistant who provides or supervises the provision of emergency medical services in a hospital or primary care to complete at least 2 hours of training in the stigma, discrimination and unrecognized bias toward persons who have acquired or are at a high risk of acquiring human immunodeficiency virus within 2 years after beginning to provide or supervise the provision of such services or care.
κ2023 Statutes of Nevada, Page 3508 (CHAPTER 528, SB 439)κ
unrecognized bias toward persons who have acquired or are at a high risk of acquiring human immunodeficiency virus within 2 years after beginning to provide or supervise the provision of such services or care.
14. The Board shall not require a physician assistant to receive or maintain certification by the National Commission on Certification of Physician Assistants, or its successor organization, or by any other nationally recognized organization for the accreditation of physician assistants to satisfy any continuing education requirement pursuant to paragraph (d) of subsection 1 and subsection 3.
[14.] 15. Members of the Armed Forces of the United States and the United States Public Health Service are exempt from payment of the annual license renewal fee during their active duty status.
16. As used in this section, primary care means the practice of family medicine, pediatrics, internal medicine, obstetrics and gynecology and midwifery.
Sec. 31. NRS 687B.225 is hereby amended to read as follows:
687B.225 1. Except as otherwise provided in NRS 689A.0405, 689A.0412, 689A.0413, 689A.0437, 689A.044, 689A.0445, 689B.031, 689B.0312, 689B.0313, 689B.0315, 689B.0317, 689B.0374, 689C.1671, 689C.1675, 695A.1843, 695A.1856, 695B.1912, 695B.1913, 695B.1914, 695B.1924, 695B.1925, 695B.1942, 695C.1713, 695C.1735, 695C.1737, 695C.1743, 695C.1745, 695C.1751, 695G.170, 695G.1705, 695G.171, 695G.1714 and 695G.177, and sections 33, 41, 46, 54, 59, 64 and 71 of this act, any contract for group, blanket or individual health insurance or any contract by a nonprofit hospital, medical or dental service corporation or organization for dental care which provides for payment of a certain part of medical or dental care may require the insured or member to obtain prior authorization for that care from the insurer or organization. The insurer or organization shall:
(a) File its procedure for obtaining approval of care pursuant to this section for approval by the Commissioner; and
(b) Respond to any request for approval by the insured or member pursuant to this section within 20 days after it receives the request.
2. The procedure for prior authorization may not discriminate among persons licensed to provide the covered care.
Sec. 32. Chapter 689A of NRS is hereby amended by adding thereto the provisions set forth as sections 33, 34 and 35 of this act.
Sec. 33. 1. An insurer that offers or issues a policy of health insurance shall include in the policy coverage for:
(a) All drugs approved by the United States Food and Drug Administration to:
(1) Provide medication-assisted treatment for opioid use disorder, including, without limitation, buprenorphine, methadone and naltrexone.
(2) Support safe withdrawal from substance use disorder, including, without limitation, lofexidine.
(b) Any service for the treatment of substance use disorder provided by a provider of primary care if the service is covered when provided by a specialist and:
(1) The service is within the scope of practice of the provider of primary care; or
(2) The provider of primary care is capable of providing the service safely and effectively in consultation with a specialist and the provider engages in such consultation.
κ2023 Statutes of Nevada, Page 3509 (CHAPTER 528, SB 439)κ
2. An insurer shall provide the coverage required by paragraph (a) of subsection 1 regardless of whether the drug is included in the formulary of the insurer.
3. An insurer shall not:
(a) Subject the benefits required by paragraph (a) of subsection 1 to medical management techniques, other than step therapy;
(b) Limit the covered amount of a drug described in paragraph (a) of subsection 1; or
(c) Refuse to cover a drug described in paragraph (a) of subsection 1 because the drug is dispensed by a pharmacy through mail order service.
4. An insurer shall ensure that the benefits required by subsection 1 are made available to an insured through a provider of health care who participates in the network plan of the insurer.
5. A policy of health insurance subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after January 1, 2024, has the legal effect of including the coverage required by subsection 1, and any provision of the policy that conflicts with the provisions of this section is void.
6. As used in this section:
(a) Medical management technique means a practice which is used to control the cost or use of health care services or prescription drugs. The term includes, without limitation, the use of step therapy, prior authorization and categorizing drugs and devices based on cost, type or method of administration.
(b) Network plan means a policy of health insurance offered by an insurer under which the financing and delivery of medical care, including items and services paid for as medical care, are provided, in whole or in part, through a defined set of providers under contract with the insurer. The term does not include an arrangement for the financing of premiums.
(c) Primary care means the practice of family medicine, pediatrics, internal medicine, obstetrics and gynecology and midwifery.
(d) Provider of health care has the meaning ascribed to it in NRS 629.031.
Sec. 34. 1. An insurer that offers or issues a policy of health insurance shall include in the policy:
(a) Coverage of testing for and the treatment and prevention of sexually transmitted diseases, including, without limitation, Chlamydia trachomatis, gonorrhea, syphilis, human immunodeficiency virus and hepatitis B and C, for all insureds, regardless of age. Such coverage must include, without limitation, the coverage required by NRS 689A.0412 and 689A.0437.
(b) Unrestricted coverage of condoms for insureds who are 13 years of age or older.
2. A policy of health insurance subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after January 1, 2024, has the legal effect of including the coverage required by subsection 1, and any provision of the policy that conflicts with the provisions of this section is void.
Sec. 35. (Deleted by amendment.)
Sec. 36. NRS 689A.030 is hereby amended to read as follows:
689A.030 A policy of health insurance must not be delivered or issued for delivery to any person in this State unless it otherwise complies with this Code, and complies with the following:
κ2023 Statutes of Nevada, Page 3510 (CHAPTER 528, SB 439)κ
1. The entire money and other considerations for the policy must be expressed therein.
2. The time when the insurance takes effect and terminates must be expressed therein.
3. It must purport to insure only one person, except that a policy may insure, originally or by subsequent amendment, upon the application of an adult member of a family, who shall be deemed the policyholder, any two or more eligible members of that family, including the husband, wife, domestic partner as defined in NRS 122A.030, dependent children, from the time of birth, adoption or placement for the purpose of adoption as provided in NRS 689A.043, or any child on or before the last day of the month in which the child attains 26 years of age, and any other person dependent upon the policyholder.
4. The style, arrangement and overall appearance of the policy must not give undue prominence to any portion of the text, and every printed portion of the text of the policy and of any endorsements or attached papers must be plainly printed in light-faced type of a style in general use, the size of which must be uniform and not less than 10 points with a lowercase unspaced alphabet length not less than 120 points. Text includes all printed matter except the name and address of the insurer, the name or the title of the policy, the brief description, if any, and captions and subcaptions.
5. The exceptions and reductions of indemnity must be set forth in the policy and, other than those contained in NRS 689A.050 to 689A.290, inclusive, must be printed, at the insurers option, with the benefit provision to which they apply or under an appropriate caption such as Exceptions or Exceptions and Reductions, except that if an exception or reduction specifically applies only to a particular benefit of the policy, a statement of that exception or reduction must be included with the benefit provision to which it applies.
6. Each such form, including riders and endorsements, must be identified by a number in the lower left-hand corner of the first page thereof.
7. The policy must not contain any provision purporting to make any portion of the charter, rules, constitution or bylaws of the insurer a part of the policy unless that portion is set forth in full in the policy, except in the case of the incorporation of or reference to a statement of rates or classification of risks, or short-rate table filed with the Commissioner.
8. The policy must provide benefits for expense arising from care at home or health supportive services if that care or service was prescribed by a physician and would have been covered by the policy if performed in a medical facility or facility for the dependent as defined in chapter 449 of NRS.
9. [The] Except as otherwise provided in this subsection, the policy must provide [, at the option of the applicant,] benefits for expenses incurred for the treatment of alcohol or substance use disorder . [, unless] Except for the benefits required by section 34 of this act, such benefits must be provided:
(a) At the option of the applicant; and
(b) Unless the policy provides coverage only for a specified disease or provides for the payment of a specific amount of money if the insured is hospitalized or receiving health care in his or her home.
10. The policy must provide benefits for expense arising from hospice care.
κ2023 Statutes of Nevada, Page 3511 (CHAPTER 528, SB 439)κ
Sec. 37. NRS 689A.0437 is hereby amended to read as follows:
689A.0437 1. An insurer that offers or issues a policy of health insurance shall include in the policy coverage for:
(a) [Drugs] All drugs approved by the United States Food and Drug Administration for preventing the acquisition of human immunodeficiency virus [;] or treating human immunodeficiency virus or hepatitis C in the form recommended by the prescribing practitioner, regardless of whether the drug is included in the formulary of the insurer;
(b) Laboratory testing that is necessary for therapy that uses [such] a drug [;] to prevent the acquisition of human immunodeficiency virus;
(c) Any service to test for, prevent or treat human immunodeficiency virus or hepatitis C provided by a provider of primary care if the service is covered when provided by a specialist and:
(1) The service is within the scope of practice of the provider of primary care; or
(2) The provider of primary care is capable of providing the service safely and effectively in consultation with a specialist and the provider engages in such consultation; and
[(c)] (d) The services described in NRS 639.28085, when provided by a pharmacist who participates in the network plan of the insurer.
2. An insurer that offers or issues a policy of health insurance shall reimburse [a] :
(a) A pharmacist who participates in the network plan of the insurer for the services described in NRS 639.28085 at a rate equal to the rate of reimbursement provided to a physician, physician assistant or advanced practice registered nurse for similar services.
(b) An advanced practice registered nurse or a physician assistant who participates in the network plan of the insurer for any service to test for, prevent or treat human immunodeficiency virus or hepatitis C at a rate equal to the rate of reimbursement provided to a physician for similar services.
3. An insurer [may subject] shall not:
(a) Subject the benefits required by subsection 1 to [reasonable] medical management techniques [.] , other than step therapy;
(b) Limit the covered amount of a drug described in paragraph (a) of subsection 1;
(c) Refuse to cover a drug described in paragraph (a) of subsection 1 because the drug is dispensed by a pharmacy through mail order service; or
(d) Prohibit or restrict access to any service or drug to treat human immunodeficiency virus or hepatitis C on the same day on which the insured is diagnosed.
4. An insurer shall ensure that the benefits required by subsection 1 are made available to an insured through a provider of health care who participates in the network plan of the insurer.
5. A policy of health insurance subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after [October] January 1, [2021,] 2024, has the legal effect of including the coverage required by subsection 1, and any provision of the policy that conflicts with the provisions of this section is void.
6. As used in this section:
(a) Medical management technique means a practice which is used to control the cost or use of health care services or prescription drugs. The term includes, without limitation, the use of step therapy, prior authorization and categorizing drugs and devices based on cost, type or method of administration.
κ2023 Statutes of Nevada, Page 3512 (CHAPTER 528, SB 439)κ
includes, without limitation, the use of step therapy, prior authorization and categorizing drugs and devices based on cost, type or method of administration.
(b) Network plan means a policy of health insurance offered by an insurer under which the financing and delivery of medical care, including items and services paid for as medical care, are provided, in whole or in part, through a defined set of providers under contract with the insurer. The term does not include an arrangement for the financing of premiums.
(c) Primary care means the practice of family medicine, pediatrics, internal medicine, obstetrics and gynecology and midwifery.
(d) Provider of health care has the meaning ascribed to it in NRS 629.031.
Sec. 38. NRS 689A.046 is hereby amended to read as follows:
689A.046 1. [The] In addition to the benefits required by section 33 of this act, the benefits provided by a policy for health insurance for treatment of alcohol or substance use disorder must [consist of:] include, without limitation:
(a) Treatment for withdrawal from the physiological effect of alcohol or drugs, with a minimum benefit of $1,500 per calendar year.
(b) Treatment for a patient admitted to a facility, with a minimum benefit of $9,000 per calendar year.
(c) Counseling for a person, group or family who is not admitted to a facility, with a minimum benefit of $2,500 per calendar year.
2. Except as otherwise provided in NRS 687B.409, these benefits must be paid in the same manner as benefits for any other illness covered by a similar policy are paid.
3. The insured person is entitled to these benefits if treatment is received in any:
(a) Facility for the treatment of alcohol or substance use disorder which is certified by the Division of Public and Behavioral Health of the Department of Health and Human Services.
(b) Hospital or other medical facility or facility for the dependent which is licensed by the Division of Public and Behavioral Health of the Department of Health and Human Services, accredited by The Joint Commission or CARF International and provides a program for the treatment of alcohol or substance use disorder as part of its accredited activities.
Sec. 39. NRS 689A.330 is hereby amended to read as follows:
689A.330 If any policy is issued by a domestic insurer for delivery to a person residing in another state, and if the insurance commissioner or corresponding public officer of that other state has informed the Commissioner that the policy is not subject to approval or disapproval by that officer, the Commissioner may by ruling require that the policy meet the standards set forth in NRS 689A.030 to 689A.320, inclusive [.] , and sections 33 and 34 of this act.
Sec. 40. Chapter 689B of NRS is hereby amended by adding thereto the provisions set forth as sections 41, 42 and 43 of this act.
Sec. 41. 1. An insurer that offers or issues a policy of group health insurance shall include in the policy coverage for:
(a) All drugs approved by the United States Food and Drug Administration to:
(1) Provide medication-assisted treatment for opioid use disorder, including, without limitation, buprenorphine, methadone and naltrexone.
κ2023 Statutes of Nevada, Page 3513 (CHAPTER 528, SB 439)κ
(2) Support safe withdrawal from substance use disorder, including, without limitation, lofexidine.
(b) Any service for the treatment of substance use disorder provided by a provider of primary care if the service is covered when provided by a specialist and:
(1) The service is within the scope of practice of the provider of primary care; or
(2) The provider of primary care is capable of providing the service safely and effectively in consultation with a specialist and the provider engages in such consultation.
2. An insurer shall provide the coverage required by paragraph (a) of subsection 1 regardless of whether the drug is included in the formulary of the insurer.
3. An insurer shall not:
(a) Subject the benefits required by paragraph (a) of subsection 1 to medical management techniques, other than step therapy;
(b) Limit the covered amount of a drug described in paragraph (a) of subsection 1; or
(c) Refuse to cover a drug described in paragraph (a) of subsection 1 because the drug is dispensed by a pharmacy through mail order service.
4. An insurer shall ensure that the benefits required by subsection 1 are made available to an insured through a provider of health care who participates in the network plan of the insurer.
5. A policy of group health insurance subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after January 1, 2024, has the legal effect of including the coverage required by subsection 1, and any provision of the policy that conflicts with the provisions of this section is void.
6. As used in this section:
(a) Medical management technique means a practice which is used to control the cost or use of health care services or prescription drugs. The term includes, without limitation, the use of step therapy, prior authorization and categorizing drugs and devices based on cost, type or method of administration.
(b) Network plan means a policy of group health insurance offered by an insurer under which the financing and delivery of medical care, including items and services paid for as medical care, are provided, in whole or in part, through a defined set of providers under contract with the insurer. The term does not include an arrangement for the financing of premiums.
(c) Primary care means the practice of family medicine, pediatrics, internal medicine, obstetrics and gynecology and midwifery.
(d) Provider of health care has the meaning ascribed to it in NRS 629.031.
Sec. 42. 1. An insurer that offers or issues a policy of group health insurance shall include in the policy:
(a) Coverage of testing for and the treatment of and prevention of sexually transmitted diseases, including, without limitation, Chlamydia trachomatis, gonorrhea, syphilis, human immunodeficiency virus and hepatitis B and C, for all insureds, regardless of age. Such coverage must include, without limitation, the coverage required by NRS 689B.0312 and 689B.0315.
κ2023 Statutes of Nevada, Page 3514 (CHAPTER 528, SB 439)κ
(b) Unrestricted coverage of condoms for insureds who are 13 years of age or older.
2. A policy of group health insurance subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after January 1, 2024, has the legal effect of including the coverage required by subsection 1, and any provision of the policy that conflicts with the provisions of this section is void.
Sec. 43. (Deleted by amendment.)
Sec. 44. NRS 689B.0312 is hereby amended to read as follows:
689B.0312 1. An insurer that offers or issues a policy of group health insurance shall include in the policy coverage for:
(a) [Drugs] All drugs approved by the United States Food and Drug Administration for preventing the acquisition of human immunodeficiency virus [;] or treating human immunodeficiency virus or hepatitis C in the form recommended by the prescribing practitioner, regardless of whether the drug is included in the formulary of the insurer;
(b) Laboratory testing that is necessary for therapy that uses [such] a drug [;] to prevent the acquisition of human immunodeficiency virus;
(c) Any service to test for, prevent or treat human immunodeficiency virus or hepatitis C provided by a provider of primary care if the service is covered when provided by a specialist and:
(1) The service is within the scope of practice of the provider of primary care; or
(2) The provider of primary care is capable of providing the service safely and effectively in consultation with a specialist and the provider engages in such consultation; and
[(c)] (d) The services described in NRS 639.28085, when provided by a pharmacist who participates in the network plan of the insurer.
2. An insurer that offers or issues a policy of group health insurance shall reimburse [a] :
(a) A pharmacist who participates in the network plan of the insurer for the services described in NRS 639.28085 at a rate equal to the rate of reimbursement provided to a physician, physician assistant or advanced practice registered nurse for similar services.
(b) An advanced practice registered nurse or a physician assistant who participates in the network plan of the insurer for any service to test for, prevent or treat human immunodeficiency virus or hepatitis C at a rate equal to the rate of reimbursement provided to a physician for similar services.
3. An insurer [may subject] shall not:
(a) Subject the benefits required by subsection 1 to [reasonable] medical management techniques [.] , other than step therapy;
(b) Limit the covered amount of a drug described in paragraph (a) of subsection 1;
(c) Refuse to cover a drug described in paragraph (a) of subsection 1 because the drug is dispensed by a pharmacy through mail order service; or
(d) Prohibit or restrict access to any service or drug to treat human immunodeficiency virus or hepatitis C on the same day on which the insured is diagnosed.
4. An insurer shall ensure that the benefits required by subsection 1 are made available to an insured through a provider of health care who participates in the network plan of the insurer.
κ2023 Statutes of Nevada, Page 3515 (CHAPTER 528, SB 439)κ
5. A policy of group health insurance subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after [October] January 1, [2021,] 2024, has the legal effect of including the coverage required by subsection 1, and any provision of the policy that conflicts with the provisions of this section is void.
6. As used in this section:
(a) Medical management technique means a practice which is used to control the cost or use of health care services or prescription drugs. The term includes, without limitation, the use of step therapy, prior authorization and categorizing drugs and devices based on cost, type or method of administration.
(b) Network plan means a policy of group health insurance offered by an insurer under which the financing and delivery of medical care, including items and services paid for as medical care, are provided, in whole or in part, through a defined set of providers under contract with the insurer. The term does not include an arrangement for the financing of premiums.
(c) Primary care means the practice of family medicine, pediatrics, internal medicine, obstetrics and gynecology and midwifery.
(d) Provider of health care has the meaning ascribed to it in NRS 629.031.
Sec. 45. Chapter 689C of NRS is hereby amended by adding thereto the provisions set forth as sections 46, 47 and 48 of this act.
Sec. 46. 1. A carrier that offers or issues a health benefit plan shall include in the plan coverage for:
(a) All drugs approved by the United States Food and Drug Administration to:
(1) Provide medication-assisted treatment for opioid use disorder, including, without limitation, buprenorphine, methadone and naltrexone.
(2) Support safe withdrawal from substance use disorder, including, without limitation, lofexidine.
(b) Any service for the treatment of substance use disorder provided by a provider of primary care if the service is covered when provided by a specialist and:
(1) The service is within the scope of practice of the provider of primary care; or
(2) The provider of primary care is capable of providing the service safely and effectively in consultation with a specialist and the provider engages in such consultation.
2. A carrier shall provide the coverage required by paragraph (a) of subsection 1 regardless of whether the drug is included in the formulary of the carrier.
3. A carrier shall not:
(a) Subject the benefits required by paragraph (a) of subsection 1 to medical management techniques, other than step therapy;
(b) Limit the covered amount of a drug described in paragraph (a) of subsection 1; or
(c) Refuse to cover a drug described in paragraph (a) of subsection 1 because the drug is dispensed by a pharmacy through mail order service.
4. A carrier shall ensure that the benefits required by subsection 1 are made available to an insured through a provider of health care who participates in the network plan of the carrier.
5. A health benefit plan subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after January 1, 2024, has the legal effect of including the coverage required by subsection 1, and any provision of the plan that conflicts with the provisions of this section is void.
κ2023 Statutes of Nevada, Page 3516 (CHAPTER 528, SB 439)κ
the legal effect of including the coverage required by subsection 1, and any provision of the plan that conflicts with the provisions of this section is void.
6. As used in this section:
(a) Medical management technique means a practice which is used to control the cost or use of health care services or prescription drugs. The term includes, without limitation, the use of step therapy, prior authorization and categorizing drugs and devices based on cost, type or method of administration.
(b) Network plan means a health benefit plan offered by a carrier under which the financing and delivery of medical care, including items and services paid for as medical care, are provided, in whole or in part, through a defined set of providers under contract with the carrier. The term does not include an arrangement for the financing of premiums.
(c) Primary care means the practice of family medicine, pediatrics, internal medicine, obstetrics and gynecology and midwifery.
(d) Provider of health care has the meaning ascribed to it in NRS 629.031.
Sec. 47. 1. A carrier that offers or issues a health benefit plan shall include in the plan:
(a) Coverage of testing for and the treatment and prevention of sexually transmitted diseases, including, without limitation, Chlamydia trachomatis, gonorrhea, syphilis, human immunodeficiency virus and hepatitis B and C, for all insureds, regardless of age. Such coverage must include, without limitation, the coverage required by NRS 689C.1671 and 689C.1675.
(b) Unrestricted coverage of condoms for insureds who are 13 years of age or older.
2. A health benefit plan subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after January 1, 2024, has the legal effect of including the coverage required by subsection 1, and any provision of the plan that conflicts with the provisions of this section is void.
Sec. 48. (Deleted by amendment.)
Sec. 49. NRS 689C.166 is hereby amended to read as follows:
689C.166 Each group health insurance policy must contain in substance a provision for benefits payable for expenses incurred for the treatment of alcohol or substance use disorder, as provided in NRS 689C.167 [.] and section 46 of this act.
Sec. 50. NRS 689C.167 is hereby amended to read as follows:
689C.167 1. [The] In addition to the benefits required by section 46 of this act, the benefits provided by a group policy for health insurance, as required by NRS 689C.166, for the treatment of alcohol or substance use disorders must [consist of:] include, without limitation:
(a) Treatment for withdrawal from the physiological effects of alcohol or drugs, with a minimum benefit of $1,500 per calendar year.
(b) Treatment for a patient admitted to a facility, with a minimum benefit of $9,000 per calendar year.
(c) Counseling for a person, group or family who is not admitted to a facility, with a minimum benefit of $2,500 per calendar year.
2. Except as otherwise provided in NRS 687B.409, these benefits must be paid in the same manner as benefits for any other illness covered by a similar policy are paid.
κ2023 Statutes of Nevada, Page 3517 (CHAPTER 528, SB 439)κ
3. The insured person is entitled to these benefits if treatment is received in any:
(a) Facility for the treatment of alcohol or substance use disorders which is certified by the Division of Public and Behavioral Health of the Department of Health and Human Services.
(b) Hospital or other medical facility or facility for the dependent which is licensed by the Division of Public and Behavioral Health of the Department of Health and Human Services, is accredited by The Joint Commission or CARF International and provides a program for the treatment of alcohol or substance use disorders as part of its accredited activities.
Sec. 51. NRS 689C.1671 is hereby amended to read as follows:
689C.1671 1. A carrier that offers or issues a health benefit plan shall include in the plan coverage for:
(a) [Drugs] All drugs approved by the United States Food and Drug Administration for preventing the acquisition of human immunodeficiency virus [;] or treating human immunodeficiency virus or hepatitis C in the form recommended by the prescribing practitioner, regardless of whether the drug is included in the formulary of the carrier;
(b) Laboratory testing that is necessary for therapy that uses [such] a drug [;] to prevent the acquisition of human immunodeficiency virus;
(c) Any service to test for, prevent or treat human immunodeficiency virus or hepatitis C provided by a provider of primary care if the service is covered when provided by a specialist and:
(1) The service is within the scope of practice of the provider of primary care; or
(2) The provider of primary care is capable of providing the service safely and effectively in consultation with a specialist and the provider engages in such consultation; and
[(c)] (d) The services described in NRS 639.28085, when provided by a pharmacist who participates in the health benefit plan of the carrier.
2. A carrier that offers or issues a health benefit plan shall reimburse [a] :
(a) A pharmacist who participates in the health benefit plan of the carrier for the services described in NRS 639.28085 at a rate equal to the rate of reimbursement provided to a physician, physician assistant or advanced practice registered nurse for similar services.
(b) An advanced practice registered nurse or a physician assistant who participates in the network plan of the carrier for any service to test for, prevent or treat human immunodeficiency virus or hepatitis C at a rate equal to the rate of reimbursement provided to a physician for similar services.
3. A carrier [may subject] shall not:
(a) Subject the benefits required by subsection 1 to [reasonable] medical management techniques [.] , other than step therapy;
(b) Limit the covered amount of a drug described in paragraph (a) of subsection 1;
(c) Refuse to cover a drug described in paragraph (a) of subsection 1 because the drug is dispensed by a pharmacy through mail order service; or
(d) Prohibit or restrict access to any service or drug to treat human immunodeficiency virus or hepatitis C on the same day on which the insured is diagnosed.
κ2023 Statutes of Nevada, Page 3518 (CHAPTER 528, SB 439)κ
4. A carrier shall ensure that the benefits required by subsection 1 are made available to an insured through a provider of health care who participates in the network plan of the carrier.
5. A health benefit plan subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after [October] January 1, [2021,] 2024, has the legal effect of including the coverage required by subsection 1, and any provision of the plan that conflicts with the provisions of this section is void.
6. As used in this section:
(a) Medical management technique means a practice which is used to control the cost or use of health care services or prescription drugs. The term includes, without limitation, the use of step therapy, prior authorization and categorizing drugs and devices based on cost, type or method of administration.
(b) Network plan means a health benefit plan offered by a carrier under which the financing and delivery of medical care, including items and services paid for as medical care, are provided, in whole or in part, through a defined set of providers under contract with the carrier. The term does not include an arrangement for the financing of premiums.
(c) Primary care means the practice of family medicine, pediatrics, internal medicine, obstetrics and gynecology and midwifery.
(d) Provider of health care has the meaning ascribed to it in NRS 629.031.
Sec. 52. NRS 689C.425 is hereby amended to read as follows:
689C.425 A voluntary purchasing group and any contract issued to such a group pursuant to NRS 689C.360 to 689C.600, inclusive, are subject to the provisions of NRS 689C.015 to 689C.355, inclusive, and sections 46 and 47 of this act to the extent applicable and not in conflict with the express provisions of NRS 687B.408 and 689C.360 to 689C.600, inclusive.
Sec. 53. Chapter 695A of NRS is hereby amended by adding thereto the provisions set forth as sections 54, 55 and 56 of this act.
Sec. 54. 1. A society that offers or issues a benefit contract shall include in the contract coverage for:
(a) All drugs approved by the United States Food and Drug Administration to:
(1) Provide medication-assisted treatment for opioid use disorder, including, without limitation, buprenorphine, methadone and naltrexone.
(2) Support safe withdrawal from substance use disorder, including, without limitation, lofexidine.
(b) Any service for the treatment of substance use disorder provided by a provider of primary care if the service is covered when provided by a specialist and:
(1) The service is within the scope of practice of the provider of primary care; or
(2) The provider of primary care is capable of providing the service safely and effectively in consultation with a specialist and the provider engages in such consultation.
2. A society shall provide the coverage required by paragraph (a) of subsection 1 regardless of whether the drug is included in the formulary of the society.
3. A society shall not:
(a) Subject the benefits required by paragraph (a) of subsection 1 to medical management techniques, other than step therapy;
κ2023 Statutes of Nevada, Page 3519 (CHAPTER 528, SB 439)κ
(b) Limit the covered amount of a drug described in paragraph (a) of subsection 1; or
(c) Refuse to cover a drug described in paragraph (a) of subsection 1 because the drug is dispensed by a pharmacy through mail order service.
4. A society shall ensure that the benefits required by subsection 1 are made available to an insured through a provider of health care who participates in the network plan of the society.
5. A benefit contract subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after January 1, 2024, has the legal effect of including the coverage required by subsection 1, and any provision of the contract that conflicts with the provisions of this section is void.
6. As used in this section:
(a) Medical management technique means a practice which is used to control the cost or use of health care services or prescription drugs. The term includes, without limitation, the use of step therapy, prior authorization and categorizing drugs and devices based on cost, type or method of administration.
(b) Network plan means a benefit contract offered by a society under which the financing and delivery of medical care, including items and services paid for as medical care, are provided, in whole or in part, through a defined set of providers under contract with the society. The term does not include an arrangement for the financing of premiums.
(c) Primary care means the practice of family medicine, pediatrics, internal medicine, obstetrics and gynecology and midwifery.
(d) Provider of health care has the meaning ascribed to it in NRS 629.031.
Sec. 55. 1. A society that offers or issues a benefit contract shall include in the contract:
(a) Coverage of testing for and the treatment and prevention of sexually transmitted diseases, including, without limitation, Chlamydia trachomatis, gonorrhea, syphilis, human immunodeficiency virus and hepatitis B and C, for all insureds, regardless of age. Such coverage must include, without limitation, the coverage required by NRS 695A.1843 and 695A.1856.
(b) Unrestricted coverage of condoms for insureds who are 13 years of age or older.
2. A benefit contract subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after January 1, 2024, has the legal effect of including the coverage required by subsection 1, and any provision of the contract that conflicts with the provisions of this section is void.
Sec. 56. (Deleted by amendment.)
Sec. 57. NRS 695A.1843 is hereby amended to read as follows:
695A.1843 1. A society that offers or issues a benefit contract shall include in the benefit coverage for:
(a) [Drugs] All approved by the United States Food and Drug Administration for preventing the acquisition of human immunodeficiency virus [;] or treating human immunodeficiency virus or hepatitis C in the form recommended by the prescribing practitioner, regardless of whether the drug is included in the formulary of the society;
(b) Laboratory testing that is necessary for therapy that uses [such] a drug [;] to prevent the acquisition of human immunodeficiency virus;
κ2023 Statutes of Nevada, Page 3520 (CHAPTER 528, SB 439)κ
(c) Any service to test for, prevent or treat human immunodeficiency virus or hepatitis C provided by a provider of primary care if the service is covered when provided by a specialist and:
(1) The service is within the scope of practice of the provider of primary care; or
(2) The provider of primary care is capable of providing the service safely and effectively in consultation with a specialist and the provider engages in such consultation; and
[(c)] (d) The services described in NRS 639.28085, when provided by a pharmacist who participates in the network plan of the society.
2. A society that offers or issues a benefit contract shall reimburse [a] :
(a) A pharmacist who participates in the network plan of the society for the services described in NRS 639.28085 at a rate equal to the rate of reimbursement provided to a physician, physician assistant or advanced practice registered nurse for similar services.
(b) An advanced practice registered nurse or a physician assistant who participates in the network plan of the society for any service to test for, prevent or treat human immunodeficiency virus or hepatitis C at a rate equal to the rate of reimbursement provided to a physician for similar services.
3. A society [may subject] shall not:
(a) Subject the benefits required by subsection 1 to [reasonable] medical management techniques [.] , other than step therapy;
(b) Limit the covered amount of a drug described in paragraph (a) of subsection 1;
(c) Refuse to cover a drug described in paragraph (a) of subsection 1 because the drug is dispensed by a pharmacy through mail order service; or
(d) Prohibit or restrict access to any service or drug to treat human immunodeficiency virus or hepatitis C on the same day on which the insured is diagnosed.
4. A society shall ensure that the benefits required by subsection 1 are made available to an insured through a provider of health care who participates in the network plan of the society.
5. A benefit contract subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after [October] January 1, [2021,] 2024, has the legal effect of including the coverage required by subsection 1, and any provision of the plan that conflicts with the provisions of this section is void.
6. As used in this section:
(a) Medical management technique means a practice which is used to control the cost or use of health care services or prescription drugs. The term includes, without limitation, the use of step therapy, prior authorization and categorizing drugs and devices based on cost, type or method of administration.
(b) Network plan means a benefit contract offered by a society under which the financing and delivery of medical care, including items and services paid for as medical care, are provided, in whole or in part, through a defined set of providers under contract with the society. The term does not include an arrangement for the financing of premiums.
(c) Primary care means the practice of family medicine, pediatrics, internal medicine, obstetrics and gynecology and midwifery.
κ2023 Statutes of Nevada, Page 3521 (CHAPTER 528, SB 439)κ
(d) Provider of health care has the meaning ascribed to it in NRS 629.031.
Sec. 58. Chapter 695B of NRS is hereby amended by adding thereto the provisions set forth as sections 59, 60 and 61 of this act.
Sec. 59. 1. A hospital or medical services corporation that offers or issues a policy of health insurance shall include in the policy coverage for:
(a) All drugs approved by the United States Food and Drug Administration to:
(1) Provide medication-assisted treatment for opioid use disorder, including, without limitation, buprenorphine, methadone and naltrexone.
(2) Support safe withdrawal from substance use disorder, including, without limitation, lofexidine.
(b) Any service for the treatment of substance use disorder provided by a provider of primary care if the service is covered when provided by a specialist and:
(1) The service is within the scope of practice of the provider of primary care; or
(2) The provider of primary care is capable of providing the service safely and effectively in consultation with a specialist and the provider engages in such consultation.
2. A hospital or medical services corporation shall provide the coverage required by paragraph (a) of subsection 1 regardless of whether the drug is included in the formulary of the hospital or medical services corporation.
3. A hospital or medical services corporation shall not:
(a) Subject the benefits required by paragraph (a) of subsection 1 to medical management techniques, other than step therapy;
(b) Limit the covered amount of a drug described in paragraph (a) of subsection 1; or
(c) Refuse to cover a drug described in paragraph (a) of subsection 1 because the drug is dispensed by a pharmacy through mail order service.
4. A hospital or medical services corporation shall ensure that the benefits required by subsection 1 are made available to an insured through a provider of health care who participates in the network plan of the hospital or medical services corporation.
5. A policy of health insurance subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after January 1, 2024, has the legal effect of including the coverage required by subsection 1, and any provision of the policy that conflicts with the provisions of this section is void.
6. As used in this section:
(a) Medical management technique means a practice which is used to control the cost or use of health care services or prescription drugs. The term includes, without limitation, the use of step therapy, prior authorization and categorizing drugs and devices based on cost, type or method of administration.
(b) Network plan means a policy of health insurance offered by a hospital or medical services corporation under which the financing and delivery of medical care, including items and services paid for as medical care, are provided, in whole or in part, through a defined set of providers under contract with the hospital or medical services corporation. The term does not include an arrangement for the financing of premiums.
κ2023 Statutes of Nevada, Page 3522 (CHAPTER 528, SB 439)κ
(c) Primary care means the practice of family medicine, pediatrics, internal medicine, obstetrics and gynecology and midwifery.
(d) Provider of health care has the meaning ascribed to it in NRS 629.031.
Sec. 60. 1. A hospital or medical services corporation that offers or issues a policy of health insurance shall include in the policy:
(a) Coverage of testing for and the treatment and prevention of sexually transmitted diseases, including, without limitation, Chlamydia trachomatis, gonorrhea, syphilis, human immunodeficiency virus and hepatitis B and C, for all insureds, regardless of age. Such coverage must include, without limitation, the coverage required by NRS 695B.1913 and 695B.1924.
(b) Unrestricted coverage of condoms for insureds who are 13 years of age or older.
2. A policy of health insurance subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after January 1, 2024, has the legal effect of including the coverage required by subsection 1, and any provision of the policy that conflicts with the provisions of this section is void.
Sec. 61. (Deleted by amendment.)
Sec. 62. NRS 695B.1924 is hereby amended to read as follows:
695B.1924 1. A hospital or medical services corporation that offers or issues a policy of health insurance shall include in the policy coverage for:
(a) [Drugs] All drugs approved by the United States Food and Drug Administration for preventing the acquisition of human immunodeficiency virus [;] or treating human immunodeficiency virus or hepatitis C in the form recommended by the prescribing practitioner, regardless of whether the drug is included in the formulary of the hospital or medical services organization;
(b) Laboratory testing that is necessary for therapy using [such] a drug [;] to prevent the acquisition of human immunodeficiency virus;
(c) Any service to test for, prevent or treat human immunodeficiency virus or hepatitis C provided by a provider of primary care if the service is covered when provided by a specialist and:
(1) The service is within the scope of practice of the provider of primary care; or
(2) The provider of primary care is capable of providing the service safely and effectively in consultation with a specialist and the provider engages in such consultation; and
[(c)] (d) The services described in NRS 639.28085, when provided by a pharmacist who participates in the network plan of the hospital or medical services corporation.
2. A hospital or medical services corporation that offers or issues a policy of health insurance shall reimburse [a] :
(a) A pharmacist who participates in the network plan of the hospital or medical services corporation for the services described in NRS 639.28085 at a rate equal to the rate of reimbursement provided to a physician, physician assistant or advanced practice registered nurse for similar services.
(b) An advanced practice registered nurse or a physician assistant who participates in the network plan of the hospital or medical services corporation for any service to test for, prevent or treat human immunodeficiency virus or hepatitis C at a rate equal to the rate of reimbursement provided to a physician for similar services.
κ2023 Statutes of Nevada, Page 3523 (CHAPTER 528, SB 439)κ
3. A hospital or medical services corporation [may subject] shall not:
(a) Subject the benefits required by subsection 1 to [reasonable] medical management techniques [.] , other than step therapy;
(b) Limit the covered amount of a drug described in paragraph (a) of subsection 1;
(c) Refuse to cover a drug described in paragraph (a) of subsection 1 because the drug is dispensed by a pharmacy through mail order service; or
(d) Prohibit or restrict access to any service or drug to treat human immunodeficiency virus or hepatitis C on the same day on which the insured is diagnosed.
4. A hospital or medical services corporation shall ensure that the benefits required by subsection 1 are made available to an insured through a provider of health care who participates in the network plan of the hospital or medical services corporation.
5. A policy of health insurance subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after [October] January 1, [2021,] 2024, has the legal effect of including the coverage required by subsection 1, and any provision of the policy that conflicts with the provisions of this section is void.
6. As used in this section:
(a) Medical management technique means a practice which is used to control the cost or use of health care services or prescription drugs. The term includes, without limitation, the use of step therapy, prior authorization and categorizing drugs and devices based on cost, type or method of administration.
(b) Network plan means a policy of health insurance offered by a hospital or medical services corporation under which the financing and delivery of medical care, including items and services paid for as medical care, are provided, in whole or in part, through a defined set of providers under contract with the hospital or medical services corporation. The term does not include an arrangement for the financing of premiums.
(c) Primary care means the practice of family medicine, pediatrics, internal medicine, obstetrics and gynecology and midwifery.
(d) Provider of health care has the meaning ascribed to it in NRS 629.031.
Sec. 63. Chapter 695C of NRS is hereby amended by adding thereto the provisions set forth as sections 64, 65 and 66 of this act.
Sec. 64. 1. A health maintenance organization that offers or issues a health care plan shall include in the plan coverage for:
(a) All drugs approved by the United States Food and Drug Administration to:
(1) Provide medication-assisted treatment for opioid use disorder, including, without limitation, buprenorphine, methadone and naltrexone.
(2) Support safe withdrawal from substance use disorder, including, without limitation, lofexidine.
(b) Any service for the treatment of substance use disorder provided by a provider of primary care if the service is covered when provided by a specialist and:
(1) The service is within the scope of practice of the provider of primary care; or
κ2023 Statutes of Nevada, Page 3524 (CHAPTER 528, SB 439)κ
(2) The provider of primary care is capable of providing the service safely and effectively in consultation with a specialist and the provider engages in such consultation.
2. A health maintenance organization shall provide the coverage required by paragraph (a) of subsection 1 regardless of whether the drug is included in the formulary of the health maintenance organization.
3. A health maintenance organization shall not:
(a) Subject the benefits required by paragraph (a) of subsection 1 to medical management techniques, other than step therapy;
(b) Limit the covered amount of a drug described in paragraph (a) of subsection 1; or
(c) Refuse to cover a drug described in paragraph (a) of subsection 1 because the drug is dispensed by a pharmacy through mail order service.
4. A health maintenance organization shall ensure that the benefits required by subsection 1 are made available to an enrollee through a provider of health care who participates in the network plan of the health maintenance organization.
5. A health care plan subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after January 1, 2024, has the legal effect of including the coverage required by subsection 1, and any provision of the plan that conflicts with the provisions of this section is void.
6. As used in this section:
(a) Medical management technique means a practice which is used to control the cost or use of health care services or prescription drugs. The term includes, without limitation, the use of step therapy, prior authorization and categorizing drugs and devices based on cost, type or method of administration.
(b) Network plan means a health care plan offered by a health maintenance organization under which the financing and delivery of medical care, including items and services paid for as medical care, are provided, in whole or in part, through a defined set of providers under contract with the health maintenance organization. The term does not include an arrangement for the financing of premiums.
(c) Primary care means the practice of family medicine, pediatrics, internal medicine, obstetrics and gynecology and midwifery.
(d) Provider of health care has the meaning ascribed to it in NRS 629.031.
Sec. 65. 1. A health maintenance organization that offers or issues a health care plan shall include in the plan:
(a) Coverage of testing for and the treatment and prevention of sexually transmitted diseases, including, without limitation, Chlamydia trachomatis, gonorrhea, syphilis, human immunodeficiency virus and hepatitis B and C, for all enrollees, regardless of age. Such coverage must include, without limitation, the coverage required by NRS 695C.1737 and 695C.1743.
(b) Unrestricted coverage of condoms for enrollees who are 13 years of age or older.
κ2023 Statutes of Nevada, Page 3525 (CHAPTER 528, SB 439)κ
2. A health care plan subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after January 1, 2024, has the legal effect of including the coverage required by subsection 1, and any provision of the plan that conflicts with the provisions of this section is void.
Sec. 66. (Deleted by amendment.)
Sec. 67. NRS 695C.050 is hereby amended to read as follows:
695C.050 1. Except as otherwise provided in this chapter or in specific provisions of this title, the provisions of this title are not applicable to any health maintenance organization granted a certificate of authority under this chapter. This provision does not apply to an insurer licensed and regulated pursuant to this title except with respect to its activities as a health maintenance organization authorized and regulated pursuant to this chapter.
2. Solicitation of enrollees by a health maintenance organization granted a certificate of authority, or its representatives, must not be construed to violate any provision of law relating to solicitation or advertising by practitioners of a healing art.
3. Any health maintenance organization authorized under this chapter shall not be deemed to be practicing medicine and is exempt from the provisions of chapter 630 of NRS.
4. The provisions of NRS 695C.110, 695C.125, 695C.1691, 695C.1693, 695C.170, 695C.1703, 695C.1705, 695C.1709 to 695C.173, inclusive, 695C.1733, 695C.17335, 695C.1734, 695C.1751, 695C.1755, 695C.1759, 695C.176 to 695C.200, inclusive, and 695C.265 do not apply to a health maintenance organization that provides health care services through managed care to recipients of Medicaid under the State Plan for Medicaid or insurance pursuant to the Childrens Health Insurance Program pursuant to a contract with the Division of Health Care Financing and Policy of the Department of Health and Human Services. This subsection does not exempt a health maintenance organization from any provision of this chapter for services provided pursuant to any other contract.
5. The provisions of NRS 695C.1694 to 695C.1698, inclusive, 695C.1701, 695C.1708, 695C.1728, 695C.1731, 695C.17333, 695C.17345, 695C.17347, 695C.1735, 695C.1737, 695C.1743, 695C.1745 and 695C.1757 and sections 64 and 65 of this act apply to a health maintenance organization that provides health care services through managed care to recipients of Medicaid under the State Plan for Medicaid.
Sec. 68. NRS 695C.1743 is hereby amended to read as follows:
695C.1743 1. A health maintenance organization that offers or issues a health care plan shall include in the plan coverage for:
(a) [Drugs] All drugs approved by the United States Food and Drug Administration for preventing the acquisition of human immunodeficiency virus [;] or treating human immunodeficiency virus or hepatitis C in the form recommended by the prescribing practitioner, regardless of whether the drug is included in the formulary of the health maintenance organization;
(b) Laboratory testing that is necessary for therapy that uses [such] a drug [;] to prevent the acquisition of human immunodeficiency virus;
(c) Any service to test for, prevent or treat human immunodeficiency virus or hepatitis C provided by a provider of primary care if the service is covered when provided by a specialist and:
κ2023 Statutes of Nevada, Page 3526 (CHAPTER 528, SB 439)κ
(1) The service is within the scope of practice of the provider of primary care; or
(2) The provider of primary care is capable of providing the service safely and effectively in consultation with a specialist and the provider engages in such consultation; and
[(c)] (d) The services described in NRS 639.28085, when provided by a pharmacist who participates in the network plan of the health maintenance organization.
2. A health maintenance organization that offers or issues a health care plan shall reimburse [a] :
(a) A pharmacist who participates in the network plan of the health maintenance organization for the services described in NRS 639.28085 at a rate equal to the rate of reimbursement provided to a physician, physician assistant or advanced practice registered nurse for similar services.
(b) An advanced practice registered nurse or a physician assistant who participates in the network plan of the health maintenance organization for any service to test for, prevent or treat human immunodeficiency virus or hepatitis C at a rate equal to the rate of reimbursement provided to a physician for similar services.
3. A health maintenance organization [may subject] shall not:
(a) Subject the benefits required by subsection 1 to [reasonable] medical management techniques [.] , other than step therapy;
(b) Limit the covered amount of a drug described in paragraph (a) of subsection 1;
(c) Refuse to cover a drug described in paragraph (a) of subsection 1 because the drug is dispensed by a pharmacy through mail order service; or
(d) Prohibit or restrict access to any service or drug to treat human immunodeficiency virus or hepatitis C on the same day on which the enrollee is diagnosed.
4. A health maintenance organization shall ensure that the benefits required by subsection 1 are made available to an enrollee through a provider of health care who participates in the network plan of the health maintenance organization.
5. A health care plan subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after [October] January 1, [2021,] 2024, has the legal effect of including the coverage required by subsection 1, and any provision of the plan that conflicts with the provisions of this section is void.
6. As used in this section:
(a) Medical management technique means a practice which is used to control the cost or use of health care services or prescription drugs. The term includes, without limitation, the use of step therapy, prior authorization and categorizing drugs and devices based on cost, type or method of administration.
(b) Network plan means a health care plan offered by a health maintenance organization under which the financing and delivery of medical care, including items and services paid for as medical care, are provided, in whole or in part, through a defined set of providers under contract with the health maintenance organization. The term does not include an arrangement for the financing of premiums.
κ2023 Statutes of Nevada, Page 3527 (CHAPTER 528, SB 439)κ
(c) Primary care means the practice of family medicine, pediatrics, internal medicine, obstetrics and gynecology and midwifery.
(d) Provider of health care has the meaning ascribed to it in NRS 629.031.
Sec. 69. NRS 695C.330 is hereby amended to read as follows:
695C.330 1. The Commissioner may suspend or revoke any certificate of authority issued to a health maintenance organization pursuant to the provisions of this chapter if the Commissioner finds that any of the following conditions exist:
(a) The health maintenance organization is operating significantly in contravention of its basic organizational document, its health care plan or in a manner contrary to that described in and reasonably inferred from any other information submitted pursuant to NRS 695C.060, 695C.070 and 695C.140, unless any amendments to those submissions have been filed with and approved by the Commissioner;
(b) The health maintenance organization issues evidence of coverage or uses a schedule of charges for health care services which do not comply with the requirements of NRS 695C.1691 to 695C.200, inclusive, and sections 64 and 65 of this act or 695C.207;
(c) The health care plan does not furnish comprehensive health care services as provided for in NRS 695C.060;
(d) The Commissioner certifies that the health maintenance organization:
(1) Does not meet the requirements of subsection 1 of NRS 695C.080; or
(2) Is unable to fulfill its obligations to furnish health care services as required under its health care plan;
(e) The health maintenance organization is no longer financially responsible and may reasonably be expected to be unable to meet its obligations to enrollees or prospective enrollees;
(f) The health maintenance organization has failed to put into effect a mechanism affording the enrollees an opportunity to participate in matters relating to the content of programs pursuant to NRS 695C.110;
(g) The health maintenance organization has failed to put into effect the system required by NRS 695C.260 for:
(1) Resolving complaints in a manner reasonably to dispose of valid complaints; and
(2) Conducting external reviews of adverse determinations that comply with the provisions of NRS 695G.241 to 695G.310, inclusive;
(h) The health maintenance organization or any person on its behalf has advertised or merchandised its services in an untrue, misrepresentative, misleading, deceptive or unfair manner;
(i) The continued operation of the health maintenance organization would be hazardous to its enrollees or creditors or to the general public;
(j) The health maintenance organization fails to provide the coverage required by NRS 695C.1691; or
(k) The health maintenance organization has otherwise failed to comply substantially with the provisions of this chapter.
2. A certificate of authority must be suspended or revoked only after compliance with the requirements of NRS 695C.340.
κ2023 Statutes of Nevada, Page 3528 (CHAPTER 528, SB 439)κ
3. If the certificate of authority of a health maintenance organization is suspended, the health maintenance organization shall not, during the period of that suspension, enroll any additional groups or new individual contracts, unless those groups or persons were contracted for before the date of suspension.
4. If the certificate of authority of a health maintenance organization is revoked, the organization shall proceed, immediately following the effective date of the order of revocation, to wind up its affairs and shall conduct no further business except as may be essential to the orderly conclusion of the affairs of the organization. It shall engage in no further advertising or solicitation of any kind. The Commissioner may, by written order, permit such further operation of the organization as the Commissioner may find to be in the best interest of enrollees to the end that enrollees are afforded the greatest practical opportunity to obtain continuing coverage for health care.
Sec. 70. Chapter 695G of NRS is hereby amended by adding thereto the provisions set forth as sections 71, 72 and 73 of this act.
Sec. 71. 1. A managed care organization that offers or issues a health care plan shall include in the plan coverage for:
(a) All drugs approved by the United States Food and Drug Administration to:
(1) Provide medication-assisted treatment for opioid use disorder, including, without limitation, buprenorphine, methadone and naltrexone.
(2) Support safe withdrawal from substance use disorder, including, without limitation, lofexidine.
(b) Any service for the treatment of substance use disorder provided by a provider of primary care if the service is covered when provided by a specialist and:
(1) The service is within the scope of practice of the provider of primary care; or
(2) The provider of primary care is capable of providing the service safely and effectively in consultation with a specialist and the provider engages in such consultation.
2. A managed care organization shall provide the coverage required by paragraph (a) of subsection 1 regardless of whether the drug is included in the formulary of the managed care organization.
3. A managed care organization shall not:
(a) Subject the benefits required by paragraph (a) of subsection 1 to medical management techniques, other than step therapy;
(b) Limit the covered amount of a drug described in paragraph (a) of subsection 1; or
(c) Refuse to cover a drug described in paragraph (a) of subsection 1 because the drug is dispensed by a pharmacy through mail order service.
4. A managed care organization shall ensure that the benefits required by subsection 1 are made available to an insured through a provider of health care who participates in the network plan of the managed care organization.
5. A health care plan subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after January 1, 2024, has the legal effect of including the coverage required by subsection 1, and any provision of the plan that conflicts with the provisions of this section is void.
κ2023 Statutes of Nevada, Page 3529 (CHAPTER 528, SB 439)κ
6. As used in this section:
(a) Medical management technique means a practice which is used to control the cost or use of health care services or prescription drugs. The term includes, without limitation, the use of step therapy, prior authorization and categorizing drugs and devices based on cost, type or method of administration.
(b) Network plan means a health care plan offered by a managed care organization under which the financing and delivery of medical care, including items and services paid for as medical care, are provided, in whole or in part, through a defined set of providers under contract with the managed care organization. The term does not include an arrangement for the financing of premiums.
(c) Primary care means the practice of family medicine, pediatrics, internal medicine, obstetrics and gynecology and midwifery.
(d) Provider of health care has the meaning ascribed to it in NRS 629.031.
Sec. 72. 1. A managed care organization that offers or issues a health care plan shall include in the plan:
(a) Coverage of testing for, treatment of and prevention of sexually transmitted diseases, including, without limitation, Chlamydia trachomatis, gonorrhea, syphilis, human immunodeficiency virus and hepatitis B and C, for all insureds, regardless of age. Such coverage must include, without limitation, the coverage required by NRS 695G.1705 and 695G.1714.
(b) Unrestricted coverage of condoms for insureds who are 13 years of age or older.
2. A health care plan subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after January 1, 2024, has the legal effect of including the coverage required by subsection 1, and any provision of the plan that conflicts with the provisions of this section is void.
Sec. 73. (Deleted by amendment.)
Sec. 74. NRS 695G.1705 is hereby amended to read as follows:
695G.1705 1. A managed care organization that offers or issues a health care plan shall include in the plan coverage for:
(a) [Drugs] All drugs approved by the United States Food and Drug Administration for preventing the acquisition of human immunodeficiency virus [;] or treating human immunodeficiency virus or hepatitis C in the form recommended by the prescribing practitioner, regardless of whether the drug is included in the formulary of the managed care organization;
(b) Laboratory testing that is necessary for therapy that uses [such] a drug [;] to prevent the acquisition of human immunodeficiency virus;
(c) Any service to test for, prevent or treat human immunodeficiency virus or hepatitis C provided by a provider of primary care if the service is covered when provided by a specialist and:
(1) The service is within the scope of practice of the provider of primary care; or
(2) The provider of primary care is capable of providing the service safely and effectively in consultation with a specialist and the provider engages in such consultation; and
[(c)] (d) The services described in NRS 639.28085, when provided by a pharmacist who participates in the network plan of the managed care organization.
κ2023 Statutes of Nevada, Page 3530 (CHAPTER 528, SB 439)κ
2. A managed care organization that offers or issues a health care plan shall reimburse [a] :
(a) A pharmacist who participates in the network plan of the managed care organization for the services described in NRS 639.28085 at a rate equal to the rate of reimbursement provided to a physician, physician assistant or advanced practice registered nurse for similar services.
(b) An advanced practice registered nurse or a physician assistant who participates in the network plan of the managed care organization for any service to test for, prevent or treat human immunodeficiency virus or hepatitis C at a rate equal to the rate of reimbursement provided to a physician for similar services.
3. A managed care organization [may subject] shall not:
(a) Subject the benefits required by subsection 1 to [reasonable] medical management techniques [.] , other than step therapy;
(b) Limit the covered amount of a drug described in paragraph (a) of subsection 1;
(c) Refuse to cover a drug described in paragraph (a) of subsection 1 because the drug is dispensed by a pharmacy through mail order service; or
(d) Prohibit or restrict access to any service or drug to treat human immunodeficiency virus or hepatitis C on the same day on which the insured is diagnosed.
4. A managed care organization shall ensure that the benefits required by subsection 1 are made available to an insured through a provider of health care who participates in the network plan of the managed care organization.
5. A health care plan subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after [October] January 1, [2021,] 2024, has the legal effect of including the coverage required by subsection 1, and any provision of the plan that conflicts with the provisions of this section is void.
6. As used in this section:
(a) Medical management technique means a practice which is used to control the cost or use of health care services or prescription drugs. The term includes, without limitation, the use of step therapy, prior authorization and categorizing drugs and devices based on cost, type or method of administration.
(b) Network plan means a health care plan offered by a managed care organization under which the financing and delivery of medical care, including items and services paid for as medical care, are provided, in whole or in part, through a defined set of providers under contract with the managed care organization. The term does not include an arrangement for the financing of premiums.
(c) Primary care means the practice of family medicine, pediatrics, internal medicine, obstetrics and gynecology and midwifery.
(d) Provider of health care has the meaning ascribed to it in NRS 629.031.
Sec. 75. 1. The first application that a physician, osteopathic physician or physician assistant licensed pursuant to chapter 630 or 633 of NRS or a nurse who provides or supervises the provision of emergency medical services in a hospital or primary care and who is licensed on January 1, 2024, submits to renew his or her license on or after that date must include, without limitation, proof that the applicant has completed at least 2 hours of training in the stigma, discrimination and unrecognized bias toward persons who have acquired or are at a high risk of acquiring human immunodeficiency virus, as required by NRS 630.253, 632.343 and 633.471, as amended by sections 28, 29 and 30 of this act, respectively, as applicable.
κ2023 Statutes of Nevada, Page 3531 (CHAPTER 528, SB 439)κ
January 1, 2024, submits to renew his or her license on or after that date must include, without limitation, proof that the applicant has completed at least 2 hours of training in the stigma, discrimination and unrecognized bias toward persons who have acquired or are at a high risk of acquiring human immunodeficiency virus, as required by NRS 630.253, 632.343 and 633.471, as amended by sections 28, 29 and 30 of this act, respectively, as applicable.
2. As used in this section, primary care means the practice of family medicine, pediatrics, internal medicine, obstetrics and gynecology and midwifery.
Sec. 76. The Legislature hereby finds and declares that:
1. In Lapinski v. State, 84 Nev. 611, 613 (1968), the Nevada Supreme Court held that the power to define crimes and penalties lies exclusively in the legislature.
2. The Nevada Supreme Court has further held in Tellis v. State, 84 Nev. 587, 591 (1968), Sparkman v. State, 95 Nev. 76, 82 (1979) and State v. Dist. Ct. (Pullin), 124 Nev. 564, 567-68 (2008), that the penalty for a crime is determined by the law in effect at the time the offender committed the crime and not the law in effect at the time the offender is sentenced unless the Legislature has expressed its clear intent that a statute ameliorating the penalty apply retroactively.
3. NRS 441A.118 states that [t]he Legislature hereby finds and declares that the spread of communicable diseases is best addressed through public health measures rather than criminalization.
4. For those reasons, the Legislature is exercising its exclusive power to define the acts which subject a person to criminal penalties by:
(a) Retroactively applying the provisions of section 24 of chapter 491, Statutes of Nevada 2021, at page 3199, which repealed certain criminal offenses that were based on a person having the human immunodeficiency virus, to apply to conduct that occurred before those offenses were repealed; and
(b) Making certain offenses which were punishable as category A felonies before the effective date of section 13 of this act based on the potential to spread a communicable disease instead punishable as category B felonies, category D felonies or gross misdemeanors.
Sec. 77. 1. The provisions of section 24 of chapter 491, Statutes of Nevada 2021, at page 3199, apply to any violation of NRS 201.205 or 201.358, as those sections existed before the enactment of section 24 of chapter 491, Statutes of Nevada 2021, at page 3199, if the violation occurred before, on or after June 6, 2021, and the person was convicted on or after the effective date of this section.
2. If, before June 6, 2021, a person committed a violation of NRS 201.205 or 201.358, as those sections existed before the enactment of section 24 of chapter 491, Statutes of Nevada 2021, at page 3199, and the person was not charged for that violation before the effective date of this section, the person must not be charged for that violation.
3. Each court in this State shall cancel each outstanding bench warrant issued by the court for a person who failed to appear in court in relation to an alleged violation of NRS 201.205 or 201.358, as those sections existed before the enactment of section 24 of chapter 491, Statutes of Nevada 2021, at page 3199.
κ2023 Statutes of Nevada, Page 3532 (CHAPTER 528, SB 439)κ
4. The Central Repository for Nevada Records of Criminal History shall remove from each database or compilation of records of criminal history maintained by the Central Repository all records of bench warrants issued for a person who failed to appear in court in relation to an alleged violation of NRS 201.205 or 201.358, as those sections existed before the enactment of section 24 of chapter 491, Statutes of Nevada 2021, at page 3199.
Sec. 78. 1. The provisions of NRS 212.189, as amended by section 13 of this act, apply to any violation of that section, that occurred before, on or after the effective date of that section, if the person was not convicted before the effective date of that section.
2. If a person commits a violation of NRS 212.189 which is punishable as a category A felony before the effective date of section 13 of this act, and the violation is punishable as a category B felony, a category D felony or a gross misdemeanor pursuant to NRS 212.189, as amended by section 13 of this act, the person must not be charged with or convicted of a category A felony, if the violation occurs on or after the effective date of section 13 of this act, and may only be charged with and convicted of a category B felony, category D felony or gross misdemeanor, as applicable, on or after the effective date of section 13 of this act.
Sec. 79. The provisions of NRS 354.599 do not apply to any additional expenses of a local government that are related to the provisions of this act.
Sec. 80. 1. This section and sections 3 to 10, inclusive, 13, 76, 77 and 78 of this act become effective upon passage and approval.
2. Sections 1, 2, 11, 12, 14 to 75, inclusive, and 79 of this act become effective:
(a) Upon passage and approval for the purpose of adopting any regulations and performing any other preparatory administrative tasks that are necessary to carry out the provisions of this act; and
(b) On January 1, 2024, for all other purposes.
________