requires two-thirds majority vote (§§ 17, 36, 55)                                                                                                  

                                                                                                  

                                                                                                                                                                                 S.B. 389

 

Senate Bill No. 389–Senator O’Connell

 

March 17, 2003

____________

 

Referred to Committee on Commerce and Labor

 

SUMMARY—Makes various changes regarding certain physicians and other regulated professions. (BDR 54‑709)

 

FISCAL NOTE:  Effect on Local Government: No.

                           Effect on the State: Yes.

 

~

 

EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted.

Green numbers along left margin indicate location on the printed bill (e.g., 5-15 indicates page 5, line 15).

 

AN ACT relating to regulated professions; making the Attorney General the exclusive legal counsel for certain occupational boards and commissions and providing exceptions thereto; enacting provisions governing certain employment practices of the Board of Medical Examiners; establishing and revising various powers and duties of the Board of Medical Examiners; providing the Board of Medical Examiners with the power to waive requirements for licensure under certain circumstances; limiting the power of the Board of Medical Examiners to revoke licenses; revising the requirements for a special volunteer medical license; removing certain restrictions relating to the practice of medicine; requiring performance audits of the Board of Medical Examiners and the State Board of Osteopathic Medicine; creating the Critically Impacted Medical Specialties Subsidy Fund; imposing fees on certain physicians and hospitals for the benefit of the Subsidy Fund; providing for the distribution of subsidies to certain physicians to pay or defray the
cost of their malpractice insurance under certain circumstances;
and providing other matters properly relating thereto.

 

 

 


    Whereas, The Nevada Legislature has delegated the duty to the Board of Medical Examiners to license competent physicians; and

    Whereas, The Nevada Legislature intends that persons practicing medicine without a valid medical license be prosecuted; and

    Whereas, The Nevada Legislature does not intend to prohibit or punish the display of academic degrees earned from accredited institutions; and

    Whereas, The Nevada Legislature intends to facilitate public access and public input into the activities of the Board of Medical Examiners; and

    Whereas, The Nevada Legislature intends to encourage beneficial collaboration and consultation among and between health care providers in the State; and

    Whereas, The Nevada Legislature supports the efforts of the Board of Medical Examiners in maintaining and improving the quality of medical practice in the State, with or without regard for retributive punishment of licensees or discipline of licensees; and

    Whereas, The Nevada Legislature wishes to examine the efficiency of the operations of the agencies to whom the Legislature has delegated the responsibility to license physicians and to discipline or rehabilitate incompetent physicians; and

    Whereas, The Nevada Legislature intends to expand the scope of the duty of the Board of Medical Examiners and the State Board of Osteopathic Medicine, by delegating to those boards the duty to promote the improved quality of medical care rendered by licensees to the people of Nevada; and

    Whereas, There exists a major health crisis in this state attributable to the skyrocketing cost of medical malpractice insurance; and

    Whereas, Such skyrocketing medical malpractice insurance costs have resulted in a potential breakdown in the delivery of health care in this state, a denial of access to health care for the economically marginal and the depletion of physicians such as to substantially worsen the quality of health care available to the people of this state; and

    Whereas, It is necessary to provide adequate and reasonable immediate financial assistance to physicians unable to afford the current skyrocketing cost of medical malpractice insurance as the remedy to address this health care crisis and to protect the health, welfare and safety of the people of Nevada; now, therefore,

 

THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN

SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:

 


2-1  Section 1. NRS 623.133 is hereby amended to read as follows:

2-2  623.133  [1.] The Attorney General is [hereby designated as]

2-3  the legal [adviser] counsel of the Board.

2-4  [2.  Nothing in this section shall be construed so as to prevent

2-5  the Board from employing legal counsel as provided elsewhere in

2-6  this chapter.]

2-7  Sec. 2.  NRS 623.135 is hereby amended to read as follows:

2-8  623.135  The Board may employ an Executive Director, [legal

2-9  counsel,] investigators, professional consultants and other

2-10  employees necessary to the discharge of its duties, and may fix the

2-11  compensation therefor.

2-12      Sec. 3.  NRS 623A.120 is hereby amended to read as follows:

2-13      623A.120  The Board may:

2-14      1.  Employ and fix the compensation for [legal counsel,]

2-15  inspectors, special agents, investigators and clerical personnel

2-16  necessary to the discharge of its duties; and

2-17      2.  Reimburse an employee specified in subsection 1 for any

2-18  actual expenses incurred by the employee while acting on behalf of

2-19  the Board.

2-20      Sec. 4.  NRS 623A.160 is hereby amended to read as follows:

2-21      623A.160  The Attorney General is the legal [adviser] counsel

2-22  of the Board . [, but the Board may employ legal counsel.]

2-23      Sec. 5.  NRS 624.115 is hereby amended to read as follows:

2-24      624.115  1.  The Board may employ [attorneys,] investigators

2-25  and other professional consultants and clerical personnel necessary

2-26  to the discharge of its duties.

2-27      2.  The Board may require criminal investigators who are

2-28  employed by the Board pursuant to NRS 624.112 to:

2-29      (a) Conduct a background investigation of a licensee or an

2-30  applicant for a contractor’s license;

2-31      (b) Locate and identify persons who:

2-32          (1) Engage in the business or act in the capacity of a

2-33  contractor within this state in violation of the provisions of this

2-34  chapter;

2-35          (2) Submit bids on jobs situated within this state in violation

2-36  of the provisions of this chapter; or

2-37          (3) Otherwise violate the provisions of this chapter or the

2-38  regulations adopted pursuant to this chapter; and

2-39      (c) Issue a misdemeanor citation prepared manually or

2-40  electronically pursuant to NRS 171.1773 to a person who violates a

2-41  provision of this chapter that is punishable as a misdemeanor. A

2-42  criminal investigator may request any constable, sheriff or other

2-43  peace officer to assist him in the issuance of such a citation.

 

 


3-1  Sec. 6.  NRS 625.135 is hereby amended to read as follows:

3-2  625.135  The Board may employ and fix the compensation to

3-3  be paid to [attorneys,] investigators and other professional

3-4  consultants and clerical personnel necessary to the discharge of its

3-5  duties and may reimburse such employees for actual expenses they

3-6  incur while acting on behalf of the Board.

3-7  Sec. 7.  NRS 628.090 is hereby amended to read as follows:

3-8  628.090  1.  Annually the Board shall elect a President and a

3-9  Secretary-Treasurer from among its members.

3-10      2.  The Board may employ such personnel, including

3-11  [attorneys,] investigators and other professional consultants, and

3-12  arrange for such assistance as the Board may require for the

3-13  performance of its duties.

3-14      Sec. 8.  NRS 628.410 is hereby amended to read as follows:

3-15      628.410  1.  The Board may initiate proceedings under this

3-16  chapter either on its own motion or on the complaint of any person.

3-17      2.  A written notice of the hearing must be served on the

3-18  respondent not less than 30 days before the date of the hearing,

3-19  either personally or by mailing a copy thereof by registered or

3-20  certified mail to the address of the respondent last known to the

3-21  Board.

3-22      3.  If, after having been served with the notice of hearing, the

3-23  respondent fails to appear at the hearing and defend, the Board may

3-24  proceed to hear evidence against him and may enter such order as is

3-25  justified by the evidence. The order is final unless the respondent

3-26  petitions for a review thereof. Within 30 days after the date of any

3-27  order, upon a showing of good cause for failing to appear and

3-28  defend, the Board may reopen the proceedings and may permit the

3-29  respondent to submit evidence in his behalf.

3-30      4.  At any hearing , a respondent may be represented before the

3-31  Board by counsel or by a certified public accountant or registered

3-32  public accountant of this state in good standing. The respondent is

3-33  entitled, on application to the Board, to the issuance of subpoenas to

3-34  compel the attendance of witnesses on his behalf.

3-35      5.  The Board, or any member thereof, may issue subpoenas to

3-36  compel the attendance of witnesses and the production of

3-37  documents. In case of disobedience to a subpoena , the Board may

3-38  invoke the aid of any court of this state in requiring the attendance

3-39  and testimony of witnesses and the production of documentary

3-40  evidence.

3-41      6.  A hearing may be conducted by:

3-42      (a) The Board, less any member or members who have been

3-43  disqualified, without the appointment of persons to hear the case in

3-44  place of the disqualified members; or


4-1  (b) A member of the Board appointed by the Board as a hearing

4-2  officer, with the remaining members of the Board, less any member

4-3  or members who have been disqualified, to review the record, make

4-4  a final decision and issue the order,

4-5  unless the Board, after disqualifications, consists of less than three

4-6  members to hear or review the case, in which circumstance the

4-7  Governor must appoint one or more qualified persons so that the

4-8  panel which hears or reviews the case consists of at least three

4-9  persons.

4-10      7.  A stenographic record of the hearing must be kept and a

4-11  transcript thereof filed with the Board.

4-12      8.  At all hearings , the Attorney General , or one of his deputies

4-13  designated by him [or such other legal counsel as may be employed

4-14  shall appear and] , shall represent the Board.

4-15      9.  The decision of the Board must be by majority vote thereof.

4-16      Sec. 9.  Chapter 630 of NRS is hereby amended by adding

4-17  thereto the provisions set forth as sections 10 to 17, inclusive, of this

4-18  act.

4-19      Sec. 10.  1.  The Board may employ hearing officers,

4-20  experts, administrators, investigators, consultants and clerical

4-21  personnel necessary to the discharge of its duties.

4-22      2.  Each employee of the Board is an at-will employee who

4-23  serves at the pleasure of the Board. The Board may discharge an

4-24  employee of the Board for any reason that does not violate public

4-25  policy, including, without limitation, making a false representation

4-26  to the Board.

4-27      3.  The Board shall employ a person as the Executive

4-28  Secretary of the Board, except that the Board shall not employ the

4-29  same person as the Executive Secretary for a total of more than 8

4-30  years, regardless of whether the person serves intermittently or

4-31  continuously.

4-32      4.  The Executive Secretary serves as the chief administrative

4-33  officer of the Board at a level of compensation set by the Board.

4-34      5.  A hearing officer employed by the Board shall not act in

4-35  any other capacity for the Board or occupy any other position of

4-36  employment with the Board, and the Board shall not assign the

4-37  hearing officer any duties which are unrelated to the duties of a

4-38  hearing officer.

4-39      6.  If a person resigns his position as a hearing officer or the

4-40  Board terminates the person from his position as a hearing

4-41  officer, the Board may not rehire the person in any position of

4-42  employment with the Board for a period of 2 years following the

4-43  date of the resignation or termination. The provisions of this

4-44  subsection do not give a person any right to be rehired by the

4-45  Board and do not permit the Board to rehire a person who is


5-1  prohibited from being employed by the Board pursuant to any

5-2  other provision of law.

5-3  Sec. 11.  1.  Notwithstanding any other provision of law and

5-4  except as otherwise provided in this section, the Board shall not

5-5  adopt any regulations that prohibit or have the effect of

5-6  prohibiting a physician, physician assistant or practitioner of

5-7  respiratory care from collaborating or consulting with another

5-8  provider of health care.

5-9  2.  The provisions of this section do not prevent the Board

5-10  from adopting regulations that prohibit a physician, physician

5-11  assistant or practitioner of respiratory care from aiding or abetting

5-12  another person in the unlicensed practice of medicine or the

5-13  unlicensed practice of respiratory care.

5-14      3.  As used in this section, “provider of health care” has the

5-15  meaning ascribed to it in NRS 629.031.

5-16      Sec. 12.  1.  The Board shall maintain a website on the

5-17  Internet or its successor.

5-18      2.  Except as otherwise provided in this section, the Board and

5-19  its members and employees shall not place any information on the

5-20  website maintained by the Board unless the Board, at a regular

5-21  meeting, approves the placement of the information on the

5-22  website.

5-23      3.  The Board shall place on its website, without having a

5-24  meeting:

5-25      (a) All financial reports received by the Board;

5-26      (b) All financial reports prepared by the Board; and

5-27      (c) Any other information required to be placed on the website

5-28  by any other provision of law.

5-29      Sec. 13.  1.  Except as otherwise provided in this section,

5-30  upon the request of an applicant for a license to practice medicine,

5-31  the Board may waive one or more of the requirements for

5-32  licensure set forth in NRS 630.160 to 630.268, inclusive, and issue

5-33  a temporary license, limited license or unrestricted license to

5-34  practice medicine to the applicant if the Board, by a two-thirds

5-35  vote of its entire membership, finds that exceptional circumstances

5-36  exist which justify the issuance of such a license to the applicant.

5-37      2.  The Board shall not waive any of the requirements for

5-38  licensure set forth in NRS 630.160 to 630.268, inclusive, that are

5-39  necessary for the State to comply with the provisions of 42 U.S.C.

5-40  § 666 or any other federal law.

5-41      Sec. 14.  1.  If the Board has reason to believe that a person

5-42  has violated, is violating or is about to violate any provision of this

5-43  chapter, the Board may issue to the person a letter of warning, a

5-44  letter of concern or a nonpunitive admonishment, whether or not


6-1  the Board has initiated any disciplinary proceedings against the

6-2  person.

6-3  2.  The issuance of such a letter or admonishment:

6-4  (a) Does not preclude the Board from initiating any

6-5  disciplinary proceedings against the person or taking any

6-6  disciplinary action against the person based on any conduct

6-7  alleged or described in the letter or admonishment or any other

6-8  conduct; and

6-9  (b) Does not constitute a final decision of the Board and is not

6-10  subject to judicial review.

6-11      Sec. 15.  The Board shall not revoke a license issued

6-12  pursuant to this chapter unless the Board, by a majority vote of its

6-13  entire membership, finds by clear and convincing evidence that

6-14  the licensee committed a material violation of a provision of NRS

6-15  630.161 or 630.301 to 630.3067, inclusive.

6-16      Sec. 16.  1.  In addition to any other audits required of the

6-17  Board by law, the Legislative Commission shall engage the

6-18  services of a person specializing in managerial and financial

6-19  consulting to conduct regular performance audits of the Board.

6-20      2.  The initial performance audit of the Board must be

6-21  commenced before October 1, 2003. After the initial performance

6-22  audit is completed, additional performance audits must be

6-23  conducted:

6-24      (a) Once every 8 years, for the preceding 8-year period; or

6-25      (b) Whenever ordered by the Legislative Commission, for the

6-26  period since the last performance audit was conducted pursuant to

6-27  this section.

6-28      3.  A written report of the results of the initial performance

6-29  audit must be submitted to the Secretary of the Legislative

6-30  Commission not later than 60 days after the date that the initial

6-31  performance audit is commenced. A written report of the results of

6-32  each subsequent performance audit must be submitted to the

6-33  Secretary of the Legislative Commission as soon as practicable

6-34  after the date that the performance audit is commenced.

6-35      4.  Upon receipt of the written report of the results of each

6-36  performance audit, the Secretary of the Legislative Commission

6-37  shall:

6-38      (a) Distribute the report to the members of the Legislative

6-39  Commission and to any other Legislator who requests a copy of

6-40  the report; and

6-41      (b) Not later than 30 days after receipt of the report, make the

6-42  report available to the public.

6-43      5.  The Board shall pay all costs related to each performance

6-44  audit conducted pursuant to this section.


7-1  6.  Any person who conducts a performance audit pursuant to

7-2  this section:

7-3  (a) Is directly responsible to the Legislative Commission;

7-4  (b) Must be sufficiently qualified to conduct the performance

7-5  audit; and

7-6  (c) Must never have conducted an audit of the Board pursuant

7-7  to NRS 218.825 or have been affiliated, in any way, with a

7-8  person who has conducted an audit of the Board pursuant to

7-9  NRS 218.825.

7-10      7.  If the Legislative Commission is unable to select a person

7-11  specializing in managerial and financial consulting who meets the

7-12  requirements of this section, the Legislative Commission shall

7-13  direct the Audit Division of the Legislative Counsel Bureau to

7-14  conduct the performance audit.

7-15      8.  Each performance audit conducted pursuant to this section

7-16  must include, without limitation, a comprehensive review and

7-17  evaluation of:

7-18      (a) The methodology and efficiency of the Board in

7-19  responding to complaints filed by the public against a licensee;

7-20      (b) The methodology and efficiency of the Board in

7-21  responding to complaints filed by a licensee against another

7-22  licensee;

7-23      (c) The methodology and efficiency of the Board in conducting

7-24  investigations of licensees who have had two or more malpractice

7-25  claims filed against them within a period of 12 months;

7-26      (d) The methodology and efficiency of the Board in

7-27  conducting investigations of licensees who have been subject to

7-28  one or more peer review actions at a medical facility that resulted

7-29  in the licensee losing his professional privileges at the medical

7-30  facility for more than 30 days within a period of 12 months;

7-31      (e) The methodology and efficiency of the Board in taking

7-32  preventative steps or progressive actions to remedy or deter any

7-33  unprofessional conduct by a licensee before such conduct results

7-34  in a violation under this chapter that warrants disciplinary action;

7-35  and

7-36      (f) The managerial and administrative efficiency of the Board

7-37  in using the fees that it collects pursuant to this chapter.

7-38      Sec. 17.  1.  Except as otherwise provided in this section, in

7-39  addition to the fees prescribed by NRS 630.268, the Board shall

7-40  charge and collect from each physician an annual fee of $200 to

7-41  be deposited in the Critically Impacted Medical Specialties Subsidy

7-42  Fund created by section 62 of this act.

7-43      2.  If a physician fails to pay the annual fee prescribed by this

7-44  section, the Board shall, after notice and opportunity for a

7-45  hearing, assess the physician an administrative fine of not more


8-1  than $2,000 for each such violation, in addition to any other fines

8-2  or penalties permitted by law.

8-3  3.  The Board shall not charge and collect the annual fee

8-4  prescribed by this section from a physician who:

8-5  (a) Is not actively practicing medicine in this state; or

8-6  (b) Holds a license that is restricted or limited to the practice of

8-7  medicine without compensation.

8-8  4.  All money received by the Board pursuant to this section

8-9  from fees and administrative fines must be deposited with the State

8-10  Treasurer for credit to the Critically Impacted Medical Specialties

8-11  Subsidy Fund created by section 62 of this act.

8-12      Sec. 18.  NRS 630.003 is hereby amended to read as follows:

8-13      630.003  The Legislature finds and declares that it is among the

8-14  responsibilities of State Government to ensure, as far as possible,

8-15  that only competent persons practice medicine and respiratory care

8-16  within this state. For this purpose, the Legislature delegates to the

8-17  Board of Medical Examiners the duty of determining the initial and

8-18  continuing competence of doctors of medicine, physician assistants

8-19  and practitioners of respiratory care in this state. The powers

8-20  conferred upon the Board by this chapter must be liberally construed

8-21  to carry out the provisions of this [purpose.] chapter.

8-22      Sec. 19.  NRS 630.020 is hereby amended to read as follows:

8-23      630.020  “Practice of medicine” means:

8-24      1.  To diagnose, treat, correct, prevent or prescribe for any

8-25  human disease, ailment, injury, infirmity, deformity or other

8-26  condition, physical or mental, by any means or instrumentality.

8-27      2.  To apply principles or techniques of medical science in the

8-28  diagnosis or the prevention of any such conditions.

8-29      3.  To perform any of the acts described in subsections 1 and 2

8-30  by using equipment that transfers information concerning the

8-31  medical condition of the patient electronically, telephonically or by

8-32  fiber optics.

8-33      4.  To offer, undertake, attempt to do or hold oneself out as able

8-34  to do any of the acts described in subsections 1 and 2.

8-35      [5.  To use in connection with a person’s name the words or

8-36  letters “M.D.,” or any other title, word, letter or other designation

8-37  intended to imply or designate him as a practitioner of medicine in

8-38  any of its branches, except in the manner authorized by

8-39  NRS 630A.220.]

8-40      Sec. 20.  NRS 630.045 is hereby amended to read as follows:

8-41      630.045  1.  The purpose of licensing physicians, physician

8-42  assistants and practitioners of respiratory care is to protect the public

8-43  health and safety and the general welfare of the people of this state.

8-44      2.  Any license issued pursuant to this chapter is a revocable

8-45  privilege [and no holder of] , but the Board may revoke such a


9-1  license [acquires thereby any vested right.] only in accordance with

9-2  the provisions of section 15 of this act.

9-3  Sec. 21.  NRS 630.060 is hereby amended to read as follows:

9-4  630.060  1.  Six members of the Board must be persons who

9-5  are licensed to practice medicine in this state, are actually engaged

9-6  in the practice of medicine in this state and have resided and

9-7  practiced medicine in this state for at least 5 years preceding their

9-8  respective appointments.

9-9  2.  The remaining members must be persons who have resided

9-10  in this state for at least 5 years and who:

9-11      (a) Are not licensed in any state to practice any healing art;

9-12      (b) Are not actively engaged in the administration of any facility

9-13  for the dependent as defined in chapter 449 of NRS, medical facility

9-14  or medical school; and

9-15      (c) Do not have a pecuniary interest in any matter pertaining to

9-16  the healing arts, except as a patient or potential patient.

9-17      3.  The members of the Board must be selected without regard

9-18  to their individual political beliefs.

9-19      4.  The President of the Board shall conduct a training

9-20  [programs] program to assist new members of the Board in the

9-21  performance of their duties.

9-22      Sec. 22.  NRS 630.110 is hereby amended to read as follows:

9-23      630.110  1.  Out of the money coming into the possession of

9-24  the Board, each member and advisory member of the Board is

9-25  entitled to receive:

9-26      (a) A salary of not more than $80 per day, as fixed by the Board,

9-27  while engaged in the business of the Board; and

9-28      (b) A per diem allowance and travel expenses at a rate fixed by

9-29  the Board, while engaged in the business of the Board. The rate

9-30  must not exceed the rate provided for state officers and employees

9-31  generally.

9-32      2.  While engaged in the business of the Board, each employee

9-33  of the Board is entitled to receive a per diem allowance and travel

9-34  expenses at a rate fixed by the Board. The rate must not exceed the

9-35  rate provided for state officers and employees generally.

9-36      3.  Expenses of the Board and the expenses and salaries of its

9-37  members and employees must be paid from the fees received by the

9-38  Board pursuant to the provisions of this chapter, and no part of the

9-39  salaries or expenses of the Board may be paid out of the State

9-40  General Fund or from the penalties imposed by the Board pursuant

9-41  to this chapter.

9-42      4.  [All] Except as otherwise provided in section 17 of this act,

9-43  all money received by the Board from:

9-44      (a) Fees must be deposited in financial institutions in this state

9-45  that are federally insured or insured by a private insurer pursuant to


10-1  NRS 678.755, invested in treasury bills or notes of the United

10-2  States, deposited in institutions in this state whose business is the

10-3  making of investments, or invested as authorized by NRS 355.140.

10-4      (b) Penalties must be deposited with the State Treasurer for

10-5  credit to the State General Fund.

10-6      Sec. 23.  NRS 630.125 is hereby amended to read as follows:

10-7      630.125  The Board may[:

10-8      1.  Maintain] maintain offices in as many localities in the State

10-9  as it finds necessary to carry out the provisions of this chapter.

10-10     [2.  Employ hearing officers, experts, administrators, attorneys,

10-11  investigators, consultants and clerical personnel necessary to the

10-12  discharge of its duties.]

10-13     Sec. 24.  NRS 630.130 is hereby amended to read as follows:

10-14     630.130  1.  In addition to the other powers and duties

10-15  provided in this chapter, the Board shall[:] , in the interest of the

10-16  public, judiciously:

10-17     (a) Enforce the provisions of this chapter;

10-18     (b) Establish by regulation standards for licensure under this

10-19  chapter;

10-20     (c) Conduct examinations for licensure and establish a system of

10-21  scoring for those examinations;

10-22     (d) Investigate the character of each applicant for a license and

10-23  issue licenses to those applicants who meet the qualifications set by

10-24  this chapter and the Board; and

10-25     (e) Institute a proceeding in any court to enforce its orders or the

10-26  provisions of this chapter.

10-27     2.  On or before February 15 of each odd-numbered year, the

10-28  board shall submit to the Governor and to the Director of the

10-29  Legislative Counsel Bureau for transmittal to the next regular

10-30  session of the Legislature a written report compiling:

10-31     (a) Disciplinary action taken by the Board during the previous

10-32  biennium against physicians for malpractice or negligence; and

10-33     (b) Information reported to the Board during the previous

10-34  biennium pursuant to NRS 630.3067, subsections 2 and 3 of NRS

10-35  630.307 and NRS 690B.045.

10-36  The report must include only aggregate information for statistical

10-37  purposes and exclude any identifying information related to a

10-38  particular person.

10-39     3.  The Board may adopt such regulations as are necessary or

10-40  desirable to enable it to carry out the provisions of this chapter.

10-41     Sec. 25.  NRS 630.258 is hereby amended to read as follows:

10-42     630.258  1.  A physician who is retired from active practice

10-43  and who wishes to donate his expertise for the medical care and

10-44  treatment of indigent persons in this state may obtain a special


11-1  volunteer medical license by submitting an application to the Board

11-2  pursuant to this section.

11-3      2.  An application for a special volunteer medical license must

11-4  be on a form provided by the Board and must include:

11-5      (a) Documentation of the history of medical practice of the

11-6  physician;

11-7      (b) Proof that the physician previously has been issued an

11-8  unrestricted license to practice medicine in any state of the United

11-9  States and that he has never been the subject of disciplinary action

11-10  by a medical board in any jurisdiction;

11-11     (c) [Proof that the physician satisfies the requirements for

11-12  licensure set forth in NRS 630.160;

11-13     (d)] Acknowledgment that the practice of the physician under

11-14  the special volunteer medical license will be exclusively devoted to

11-15  providing medical care to indigent persons in this state; and

11-16     [(e)] (d) Acknowledgment that the physician will not receive

11-17  any payment or compensation, either direct or indirect, or have the

11-18  expectation of any payment or compensation, for providing medical

11-19  care under the special volunteer medical license, except for payment

11-20  by a medical facility at which the physician provides volunteer

11-21  medical services of the expenses of the physician for necessary

11-22  travel, continuing education, malpractice insurance or fees of the

11-23  State Board of Pharmacy.

11-24     3.  If the Board finds that the application of a physician satisfies

11-25  the requirements of subsection 2 and that the [retired] physician is

11-26  competent to practice medicine, the Board shall issue a special

11-27  volunteer medical license to the physician.

11-28     4.  [The initial] A physician who holds a special volunteer

11-29  medical license issued pursuant to this section [expires 1 year after

11-30  the date of issuance. The license may be renewed pursuant to this

11-31  section, and any license that is renewed expires 2 years after the date

11-32  of issuance.] is not required to renew the license, and the physician

11-33  may hold the license until it is voluntarily relinquished by the

11-34  physician or revoked by the Board in accordance with section 15

11-35  of this act.

11-36     5.  The Board shall not charge a fee for:

11-37     (a) The review of an application for a special volunteer medical

11-38  license; or

11-39     (b) The issuance [or renewal] of a special volunteer medical

11-40  license pursuant to this section.

11-41     6.  A physician who is issued a special volunteer medical

11-42  license pursuant to this section and who accepts the privilege of

11-43  practicing medicine in this state pursuant to the provisions of the

11-44  special volunteer medical license is subject to all the provisions

11-45  governing disciplinary action set forth in this chapter.


12-1      7.  A physician who is issued a special volunteer medical

12-2  license pursuant to this section shall comply with the requirements

12-3  for continuing education adopted by the Board.

12-4      Sec. 26.  NRS 630.261 is hereby amended to read as follows:

12-5      630.261  1.  Except as otherwise provided in NRS 630.161,

12-6  the Board may issue:

12-7      (a) A locum tenens license, to be effective not more than 3

12-8  months after issuance, to any physician who is licensed and in good

12-9  standing in another state, who meets the requirements for licensure

12-10  in this state and who is of good moral character and reputation. The

12-11  purpose of this license is to enable an eligible physician to serve as a

12-12  substitute for another physician who is licensed to practice medicine

12-13  in this state and who is absent from his practice for reasons deemed

12-14  sufficient by the Board. A license issued pursuant to the provisions

12-15  of this paragraph is not renewable.

12-16     (b) A special license to a licensed physician of another state to

12-17  come into this state to care for or assist in the treatment of his own

12-18  patient in association with a physician licensed in this state. A

12-19  special license issued pursuant to the provisions of this paragraph is

12-20  limited to the care of a specific patient. The physician licensed in

12-21  this state has the primary responsibility for the care of that patient.

12-22     (c) A restricted license for a specified period if the Board

12-23  determines the applicant needs supervision or restriction.

12-24     (d) A temporary license for a specified period if the physician is

12-25  licensed and in good standing in another state and meets the

12-26  requirements for licensure in this state, and if the Board determines

12-27  that it is necessary in order to provide medical services for a

12-28  community without adequate medical care. A temporary license

12-29  issued pursuant to the provisions of this paragraph is not renewable.

12-30     (e) A special purpose license to a physician who is licensed in

12-31  another state to permit the use of equipment that transfers

12-32  information concerning the medical condition of a patient in this

12-33  state across state lines electronically, telephonically or by fiber

12-34  optics if the physician:

12-35         (1) Holds a full and unrestricted license to practice medicine

12-36  in that state;

12-37         (2) Has not had any disciplinary or other action taken against

12-38  him by any state or other jurisdiction; and

12-39         (3) Meets the requirement set forth in paragraph (d) of

12-40  subsection 2 of NRS 630.160.

12-41     2.  Except as otherwise provided in this section, the Board may

12-42  renew or modify any license issued pursuant to subsection 1.

12-43     3.  Every physician who is licensed pursuant to subsection 1

12-44  and who accepts the privilege of practicing medicine in this state

12-45  pursuant to the provisions of the license shall be deemed to have


13-1  given his consent to the revocation of the license at any time by the

13-2  Board [for any of the grounds provided in NRS 630.161 or 630.301

13-3  to 630.3065, inclusive.] in accordance with the provisions of

13-4  section 15 of this act.

13-5      Sec. 27.  NRS 630.301 is hereby amended to read as follows:

13-6      630.301  The following acts, among others, constitute grounds

13-7  for initiating disciplinary action or denying licensure:

13-8      1.  Conviction of a felony . [, any offense involving moral

13-9  turpitude or any offense relating to the practice of medicine or the

13-10  ability to practice medicine.] A plea of nolo contendere is a

13-11  conviction for the purposes of this subsection.

13-12     2.  Conviction of violating any of the provisions of NRS

13-13  616D.200, 616D.220, 616D.240, 616D.300, 616D.310[,] or

13-14  616D.350 to 616D.440, inclusive.

13-15     3.  The revocation, suspension, modification or limitation of the

13-16  license to practice any type of medicine by any other jurisdiction or

13-17  the surrender of the license or discontinuing the practice of medicine

13-18  while under investigation by any licensing authority, a medical

13-19  facility, a branch of the Armed Services of the United States, an

13-20  insurance company, an agency of the Federal Government or an

13-21  employer.

13-22     4.  [Malpractice, which may be evidenced by claims settled

13-23  against a practitioner.] The commission of repeated acts of

13-24  malpractice or gross malpractice, but only if such acts are

13-25  established by clear and convincing evidence.

13-26     5.  The engaging by a practitioner in any sexual activity with a

13-27  patient who is currently being treated by the practitioner.

13-28     6.  Disruptive behavior with physicians, hospital personnel,

13-29  patients, members of the families of patients or any other persons if

13-30  the behavior interferes with patient care or has an adverse impact on

13-31  the quality of care rendered to a patient.

13-32     7.  The engaging in conduct that violates the trust of a patient

13-33  and exploits the relationship between the physician and the patient

13-34  for financial or other personal gain.

13-35     8.  The failure to offer appropriate procedures or studies, to

13-36  protest inappropriate denials by organizations for managed care, to

13-37  provide necessary services or to refer a patient to an appropriate

13-38  provider, when such a failure occurs with the intent of positively

13-39  influencing the financial well-being of the practitioner or an insurer.

13-40     9.  The engaging in conduct that brings the medical profession

13-41  into disrepute, including, without limitation, conduct that violates

13-42  any provision of a national code of ethics adopted by the Board by

13-43  regulation.

13-44     10.  The engaging in sexual contact with the surrogate of a

13-45  patient or other key persons related to a patient, including, without


14-1  limitation, a spouse, parent or legal guardian, which exploits the

14-2  relationship between the physician and the patient in a sexual

14-3  manner.

14-4      Sec. 28.  NRS 630.333 is hereby amended to read as follows:

14-5      630.333  1.  In addition to any other remedy provided by law,

14-6  the Board, through its President or Secretary-Treasurer or the

14-7  Attorney General, may apply to any court of competent jurisdiction:

14-8      (a) To enjoin any prohibited act or other conduct of a licensee

14-9  which is harmful to the public;

14-10     (b) To enjoin any person who is not licensed under this chapter

14-11  from practicing medicine or respiratory care;

14-12     (c) To limit the practice of a physician, physician assistant or

14-13  practitioner of respiratory care, or suspend his license to practice; or

14-14     (d) To enjoin the use of the title [“M. D.,”] “P.A.,” “P.A.-C,”

14-15  “R.C.P.” or any other word, combination of letters or other

14-16  designation intended to imply or designate a person as a [physician,]

14-17  physician assistant or practitioner of respiratory care, when not

14-18  licensed by the Board pursuant to this chapter, unless the use is

14-19  otherwise authorized by a specific statute.

14-20     2.  The court in a proper case may issue a temporary restraining

14-21  order or a preliminary injunction for the purposes set forth in

14-22  subsection 1:

14-23     (a) Without proof of actual damage sustained by any person;

14-24     (b) Without relieving any person from criminal prosecution for

14-25  engaging in the practice of medicine without a license; and

14-26     (c) Pending proceedings for disciplinary action by the Board.

14-27     Sec. 29.  NRS 630.352 is hereby amended to read as follows:

14-28     630.352  1.  Any member of the Board, except for an advisory

14-29  member serving on a panel of the Board hearing charges, may

14-30  participate in the final order of the Board. If the Board, after a

14-31  formal hearing, determines from a preponderance of the evidence

14-32  or, when the issue is the revocation of the license, by clear and

14-33  convincing evidence that a violation of the provisions of this

14-34  chapter or of the regulations of the Board has occurred, it shall issue

14-35  and serve on the physician charged an order, in writing, containing

14-36  its findings and any sanctions.

14-37     2.  If the Board determines that no violation has occurred, it

14-38  shall dismiss the charges, in writing, and notify the physician that

14-39  the charges have been dismissed. If the disciplinary proceedings

14-40  were instituted against the physician as a result of a complaint filed

14-41  against him, the Board may provide the physician with a copy of the

14-42  complaint.

 

 


15-1      3.  Except as otherwise provided in subsection 4, if the Board

15-2  finds that a violation has occurred, it may by order:

15-3      (a) Place the person on probation for a specified period on any

15-4  of the conditions specified in the order;

15-5      (b) Administer to him a public reprimand;

15-6      (c) Limit his practice or exclude one or more specified branches

15-7  of medicine from his practice;

15-8      (d) Suspend his license for a specified period or until further

15-9  order of the Board;

15-10     (e) Revoke his license to practice medicine[;] , but only in

15-11  accordance with the provisions of section 15 of this act;

15-12     (f) Require him to participate in a program to correct alcohol or

15-13  drug dependence or any other impairment;

15-14     (g) Require supervision of his practice;

15-15     (h) Impose a fine not to exceed $5,000;

15-16     (i) Require him to perform community service without

15-17  compensation;

15-18     (j) Require him to take a physical or mental examination or an

15-19  examination testing his competence;

15-20     (k) Require him to fulfill certain training or educational

15-21  requirements; and

15-22     (l) Require him to pay all costs incurred by the Board relating to

15-23  his disciplinary proceedings.

15-24     4.  If the Board finds that the physician has violated the

15-25  provisions of NRS 439B.425, the Board shall suspend his license for

15-26  a specified period or until further order of the Board.

15-27     Sec. 30.  NRS 630.400 is hereby amended to read as follows:

15-28     630.400  A person who:

15-29     1.  Presents to the Board as his own the diploma, license or

15-30  credentials of another;

15-31     2.  Gives either false or forged evidence of any kind to the

15-32  Board;

15-33     3.  Practices medicine or respiratory care under a false or

15-34  assumed name or falsely personates another licensee;

15-35     4.  Except as otherwise provided by specific statute, practices

15-36  medicine or respiratory care without being licensed under this

15-37  chapter;

15-38     5.  Holds himself out as a physician assistant or uses any other

15-39  term indicating or implying that he is a physician assistant without

15-40  being licensed by the Board; or

15-41     6.  Holds himself out as a practitioner of respiratory care or uses

15-42  any other term indicating or implying that he is a practitioner of

15-43  respiratory care without being licensed by the Board , [; or


16-1      7.  Uses the title “M.D.,” when not licensed by the Board

16-2  pursuant to this chapter, unless otherwise authorized by a specific

16-3  statute,]

16-4  is guilty of a category D felony and shall be punished as provided in

16-5  NRS 193.130.

16-6      Sec. 31.  NRS 630A.190 is hereby amended to read as follows:

16-7      630A.190  The Board may:

16-8      1.  Maintain offices in as many localities in the State as it finds

16-9  necessary to carry out the provisions of this chapter.

16-10     2.  Employ [attorneys,] investigators, hearing officers, experts,

16-11  administrators, consultants and clerical personnel necessary to the

16-12  discharge of its duties.

16-13     Sec. 32.  NRS 631.190 is hereby amended to read as follows:

16-14     631.190  In addition to the powers and duties provided in this

16-15  chapter, the Board shall:

16-16     1.  Adopt rules and regulations necessary to carry out the

16-17  provisions of this chapter.

16-18     2.  Appoint such committees, examiners, officers, employees,

16-19  agents, [attorneys,] investigators and other professional consultants

16-20  and define their duties and incur such expense as it may deem

16-21  proper or necessary to carry out the provisions of this chapter, the

16-22  expense to be paid as provided in this chapter.

16-23     3.  Fix the time and place for and conduct examinations for the

16-24  granting of licenses to practice dentistry and dental hygiene.

16-25     4.  Examine applicants for licenses to practice dentistry and

16-26  dental hygiene.

16-27     5.  Collect and apply fees as provided in this chapter.

16-28     6.  Keep a register of all dentists and dental hygienists licensed

16-29  in this state, together with their addresses, license numbers and

16-30  renewal certificate numbers.

16-31     7.  Have and use a common seal.

16-32     8.  Keep such records as may be necessary to report the acts and

16-33  proceedings of the Board. Except as otherwise provided in NRS

16-34  631.368, the records must be open to public inspection.

16-35     9.  Maintain offices in as many localities in the State as it finds

16-36  necessary to carry out the provisions of this chapter.

16-37     10.  Have discretion to examine work authorizations in dental

16-38  offices or dental laboratories.

16-39     Sec. 33.  NRS 632.065 is hereby amended to read as follows:

16-40     632.065  The Board may:

16-41     1.  Maintain offices in as many localities in the State as it finds

16-42  necessary to carry out the provisions of this chapter.

16-43     2.  Employ [attorneys,] investigators and other professional

16-44  consultants and clerical personnel necessary to the discharge of its

16-45  duties.


17-1      Sec. 34. Chapter 633 of NRS is hereby amended by adding

17-2  thereto the provisions set forth as sections 35 and 36 of this act.

17-3      Sec. 35.  1.  In addition to any other audits required of the

17-4  Board by law, the Legislative Commission shall engage the

17-5  services of a person specializing in managerial and financial

17-6  consulting to conduct regular performance audits of the Board.

17-7      2.  The initial performance audit of the Board must be

17-8  commenced before October 1, 2003. After the initial performance

17-9  audit is completed, additional performance audits must be

17-10  conducted:

17-11     (a) Once every 8 years, for the preceding 8-year period; or

17-12     (b) Whenever ordered by the Legislative Commission, for the

17-13  period since the last performance audit was conducted pursuant to

17-14  this section.

17-15     3.  A written report of the results of the initial performance

17-16  audit must be submitted to the Secretary of the Legislative

17-17  Commission not later than 60 days after the date that the initial

17-18  performance audit is commenced. A written report of the results of

17-19  each subsequent performance audit must be submitted to the

17-20  Secretary of the Legislative Commission as soon as practicable

17-21  after the date that the performance audit is commenced.

17-22     4.  Upon receipt of the written report of the results of each

17-23  performance audit, the Secretary of the Legislative Commission

17-24  shall:

17-25     (a) Distribute the report to the members of the Legislative

17-26  Commission and to any other Legislator who requests a copy of

17-27  the report; and

17-28     (b) Not later than 30 days after receipt of the report, make the

17-29  report available to the public.

17-30     5.  The Board shall pay all costs related to each performance

17-31  audit conducted pursuant to this section.

17-32     6.  Any person who conducts a performance audit pursuant to

17-33  this section:

17-34     (a) Is directly responsible to the Legislative Commission;

17-35     (b) Must be sufficiently qualified to conduct the performance

17-36  audit; and

17-37     (c) Must never have conducted an audit of the Board pursuant

17-38  to NRS 218.825 or have been affiliated, in any way, with a person

17-39  who has conducted an audit of the Board pursuant to

17-40  NRS 218.825.

17-41     7.  If the Legislative Commission is unable to select a person

17-42  specializing in managerial and financial consulting who meets the

17-43  requirements of this section, the Legislative Commission shall

17-44  direct the Audit Division of the Legislative Counsel Bureau to

17-45  conduct the performance audit.


18-1      8.  Each performance audit conducted pursuant to this section

18-2  must include, without limitation, a comprehensive review and

18-3  evaluation of:

18-4      (a) The methodology and efficiency of the Board in

18-5  responding to complaints filed by the public against a licensee;

18-6      (b) The methodology and efficiency of the Board in

18-7  responding to complaints filed by a licensee against another

18-8  licensee;

18-9      (c) The methodology and efficiency of the Board in conducting

18-10  investigations of licensees who have had two or more malpractice

18-11  claims filed against them within a period of 12 months;

18-12     (d) The methodology and efficiency of the Board in

18-13  conducting investigations of licensees who have been subject to

18-14  one or more peer review actions at a medical facility that resulted

18-15  in the licensee losing his professional privileges at the medical

18-16  facility for more than 30 days within a period of 12 months;

18-17     (e) The methodology and efficiency of the Board in taking

18-18  preventative steps or progressive actions to remedy or deter any

18-19  unprofessional conduct by a licensee before such conduct results

18-20  in a violation under this chapter that warrants disciplinary action;

18-21  and

18-22     (f) The managerial and administrative efficiency of the Board

18-23  in using the fees that it collects pursuant to this chapter.

18-24     Sec. 36. 1.  Except as otherwise provided in this section, in

18-25  addition to the fees prescribed by NRS 633.501, the Board shall

18-26  charge and collect from each osteopathic physician an annual fee

18-27  of $200 to be deposited in the Critically Impacted Medical

18-28  Specialties Subsidy Fund created by section 62 of this act.

18-29     2.  If an osteopathic physician fails to pay the annual fee

18-30  prescribed by this section, the Board shall, after notice and

18-31  opportunity for a hearing, assess the osteopathic physician an

18-32  administrative fine of not more than $2,000 for each such

18-33  violation, in addition to any other fines or penalties permitted by

18-34  law.

18-35     3.  The Board shall not charge and collect the annual fee

18-36  prescribed by this section from an osteopathic physician who:

18-37     (a) Is not actively practicing osteopathic medicine in this state;

18-38  or

18-39     (b) Holds a license that is restricted or limited to the practice of

18-40  osteopathic medicine without compensation.

18-41     4.  All money received by the Board pursuant to this section

18-42  from fees and administrative fines must be deposited with the State

18-43  Treasurer for credit to the Critically Impacted Medical Specialties

18-44  Subsidy Fund created by section 62 of this act.

 


19-1      Sec. 37.  NRS 633.261 is hereby amended to read as follows:

19-2      633.261  1.  All reasonable expenses incurred by the Board in

19-3  carrying out the provisions of this chapter [shall] must be paid from

19-4  the fees which it receives, and no part of the salaries or expenses of

19-5  the Board may be paid out of the State General Fund . [of the State

19-6  Treasury.

19-7      2.  All]

19-8      2.  Except as otherwise provided in section 36 of this act, all

19-9  money received by the Board [shall] must be deposited in banks,

19-10  credit unions or savings and loan associations in this state and

19-11  [shall] must be paid out on its order for its expenses.  

19-12     Sec. 38.  NRS 633.271 is hereby amended to read as follows:

19-13     633.271  The Board may:

19-14     1.  Appoint an Executive Director who is entitled to such

19-15  compensation as determined by the Board.

19-16     2.  Maintain offices in as many localities in the State as it finds

19-17  necessary to carry out the provisions of this chapter.

19-18     3.  Employ [attorneys,] investigators and other professional

19-19  consultants and clerical personnel necessary to the discharge of its

19-20  duties.

19-21     Sec. 39.  NRS 634.043 is hereby amended to read as follows:

19-22     634.043  1.  The Board shall appoint an Executive Director

19-23  who serves at the pleasure of the Board and is entitled to receive

19-24  such compensation as may be fixed by the Board.

19-25     2.  The Board may:

19-26     (a) Maintain offices in as many localities in the State as it finds

19-27  necessary to carry out the provisions of this chapter.

19-28     (b) Employ [attorneys,] investigators and other professional

19-29  consultants and clerical personnel necessary to the discharge of its

19-30  duties.

19-31     (c) Enter and inspect any chiropractic office in this state in order

19-32  to enforce the provisions of this chapter.

19-33     Sec. 40.  NRS 634.208 is hereby amended to read as follows:

19-34     634.208  1.  In addition to any other remedy provided by law,

19-35  the Board, through its President[,] or Secretary or [its attorney, or]

19-36  through the Attorney General, may bring an action in any court of

19-37  competent jurisdiction to enjoin any person who does not hold a

19-38  license issued by the Board from practicing chiropractic or

19-39  representing himself to be a chiropractor.

19-40     2.  The court in a proper case may issue an injunction for such

19-41  purposes without proof of actual damage sustained by any person,

19-42  this provision being a preventive as well as a punitive measure. The

19-43  issuance of such an injunction does not relieve the person from

19-44  criminal prosecution for a violation of NRS 634.227.

 


20-1      Sec. 41.  NRS 634A.070 is hereby amended to read as follows:

20-2      634A.070  The Board may:

20-3      1.  Employ [attorneys,] investigators and other professional

20-4  consultants and clerical personnel necessary to discharge its duties.

20-5  To conduct its examinations, the Board may call to its aid persons of

20-6  established reputation and known ability in Oriental medicine.

20-7      2.  Maintain offices in as many localities in the State as it finds

20-8  necessary to carry out the provisions of this chapter.

20-9      3.  Adopt regulations not inconsistent with the provisions of this

20-10  chapter. The regulations may include a code of ethics regulating the

20-11  professional conduct of licensees.

20-12     4.  Compel the attendance of witnesses and the production of

20-13  evidence by subpoena.

20-14     Sec. 42.  NRS 635.035 is hereby amended to read as follows:

20-15     635.035  The Board may:

20-16     1.  Maintain offices in as many localities in the State as it finds

20-17  necessary to carry out the provisions of this chapter.

20-18     2.  Employ [attorneys,] investigators and other professional

20-19  consultants and clerical personnel necessary to the discharge of its

20-20  duties.

20-21     Sec. 43.  NRS 636.090 is hereby amended to read as follows:

20-22     636.090  1.  The Board may employ:

20-23     (a) Agents and inspectors to secure evidence of, and report on,

20-24  violations of this chapter.

20-25     (b) [Attorneys, investigators] Investigators and other

20-26  professional consultants and clerical personnel necessary to

20-27  administer this chapter.

20-28     2.  The Attorney General [may] shall act as counsel for the

20-29  Board.

20-30     Sec. 44.  NRS 637.070 is hereby amended to read as follows:

20-31     637.070  1.  The Board may adopt such rules and regulations

20-32  as it may deem necessary to carry out the provisions of this chapter.

20-33     2.  The Board shall have a common seal of which all courts of

20-34  this state shall take judicial notice.

20-35     3.  The Board may empower any member to conduct any

20-36  proceeding, hearing or investigation necessary to its purposes.

20-37     4.  The Board may employ and fix the compensation of

20-38  [attorneys,] investigators and other professional consultants and

20-39  such other employees and assistants as it may deem necessary to

20-40  carry out the provisions of this chapter.

20-41     Sec. 45.  NRS 638.070 is hereby amended to read as follows:

20-42     638.070  1.  The Board shall adopt regulations providing an

20-43  administrative fine in an amount not to exceed $500 if an applicant

20-44  for a license or the renewal of a license:


21-1      (a) Intentionally or knowingly makes a false or misleading

21-2  statement on his application;

21-3      (b) Knowingly fails to submit a notarized application; or

21-4      (c) Fails to inform the Board of any change of information

21-5  which was contained in his application.

21-6      2.  The Board may adopt regulations:

21-7      (a) Necessary to carry out the provisions of this chapter;

21-8      (b) Concerning the rights and responsibilities of veterinary

21-9  interns and externs and graduates of schools of veterinary medicine

21-10  located outside the United States or Canada;

21-11     (c) Concerning the rights and responsibilities of a veterinarian’s

21-12  employees who are not licensed nor working towards obtaining a

21-13  license pursuant to this chapter and whose duties require them to

21-14  spend a substantial portion of their time in direct contact with

21-15  animals;

21-16     (d) Concerning requirements for continuing education;

21-17     (e) Establishing procedures to approve schools which confer the

21-18  degree of veterinary technician or its equivalent;

21-19     (f) Concerning the disposition of animals which are abandoned

21-20  or left unclaimed at the office of a veterinarian;

21-21     (g) Establishing sanitary requirements for facilities in which

21-22  veterinary medicine is practiced, including, but not limited to,

21-23  precautions to be taken to prevent the creation or spread of any

21-24  infectious or contagious disease; and

21-25     (h) Concerning alternative veterinary medicine, including, but

21-26  not limited to, acupuncture, chiropractic procedures, dentistry,

21-27  cosmetic surgery, holistic medicine, and the provision of such

21-28  services by a licensed provider of health care under the direction of

21-29  a licensed veterinarian.

21-30     3.  The Board may:

21-31     (a) Employ [attorneys,] investigators, hearing officers for

21-32  disciplinary hearings, and other professional consultants and clerical

21-33  personnel necessary to the discharge of its duties;

21-34     (b) Conduct investigations and take and record evidence as to

21-35  any matter cognizable by it;

21-36     (c) Maintain offices in as many localities in the State as it

21-37  considers necessary to carry out the provisions of this chapter; and

21-38     (d) Purchase or rent any office space, equipment and supplies

21-39  that it considers necessary to carry out the provisions of this chapter.

21-40     Sec. 46.  NRS 638.151 is hereby amended to read as follows:

21-41     638.151  At all hearings , the Attorney General, or [an attorney

21-42  employed by the Board,] one of his deputies designated by him,

21-43  shall represent the Board.

 

 


22-1      Sec. 47.  NRS 639.070 is hereby amended to read as follows:

22-2      639.070  1.  The Board may:

22-3      (a) Adopt such regulations, not inconsistent with the laws of this

22-4  state, as are necessary for the protection of the public, appertaining

22-5  to the practice of pharmacy and the lawful performance of its duties.

22-6      (b) Adopt regulations requiring that prices charged by retail

22-7  pharmacies for drugs and medicines which are obtained by

22-8  prescription be posted in the pharmacies and be given on the

22-9  telephone to persons requesting such information.

22-10     (c) Adopt regulations, not inconsistent with the laws of this

22-11  state, authorizing the Secretary to issue certificates, licenses and

22-12  permits required by this chapter and chapters 453 and 454 of NRS.

22-13     (d) Adopt regulations governing the dispensing of poisons,

22-14  drugs, chemicals and medicines.

22-15     (e) Regulate the practice of pharmacy.

22-16     (f) Regulate the sale and dispensing of poisons, drugs, chemicals

22-17  and medicines.

22-18     (g) Regulate the means of recordkeeping and storage, handling,

22-19  sanitation and security of drugs, poisons, medicines, chemicals and

22-20  devices, including, but not limited to, requirements relating to:

22-21         (1) Pharmacies, institutional pharmacies and pharmacies in

22-22  correctional institutions;

22-23         (2) Drugs stored in hospitals; and

22-24         (3) Drugs stored for the purpose of wholesale distribution.

22-25     (h) Examine and register, upon application, pharmacists and

22-26  other persons who dispense or distribute medications whom it

22-27  deems qualified.

22-28     (i) Charge and collect necessary and reasonable fees for its

22-29  services, other than those specifically set forth in this chapter.

22-30     (j) Maintain offices in as many localities in the State as it finds

22-31  necessary to carry out the provisions of this chapter.

22-32     (k) Employ an [attorney,] inspectors, investigators and other

22-33  professional consultants and clerical personnel necessary to the

22-34  discharge of its duties.

22-35     (l) Enforce the provisions of NRS 453.011 to 453.552, inclusive,

22-36  and enforce the provisions of this chapter and chapter 454 of NRS.

22-37     (m) Adopt regulations concerning the information required to be

22-38  submitted in connection with an application for any license,

22-39  certificate or permit required by this chapter or chapter 453 or 454

22-40  of NRS.

22-41     (n) Adopt regulations concerning the education, experience and

22-42  background of a person who is employed by the holder of a license

22-43  or permit issued pursuant to this chapter and who has access to

22-44  drugs and devices.


23-1      (o) Adopt regulations concerning the use of computerized

23-2  mechanical equipment for the filling of prescriptions.

23-3      (p) Participate in and expend money for programs that enhance

23-4  the practice of pharmacy.

23-5      2.  This section does not authorize the Board to prohibit open-

23-6  market competition in the advertising and sale of prescription drugs

23-7  and pharmaceutical services.

23-8      Sec. 48.  NRS 640.050 is hereby amended to read as follows:

23-9      640.050  1.  The Board shall examine and license qualified

23-10  physical therapists and qualified physical therapist’s assistants.

23-11     2.  The Board may adopt reasonable regulations to carry this

23-12  chapter into effect, including, but not limited to, regulations

23-13  concerning the:

23-14     (a) Issuance and display of licenses.

23-15     (b) Supervision of physical therapist’s assistants and physical

23-16  therapist’s technicians.

23-17     (c) Treatments and other regulated procedures which may be

23-18  performed by physical therapist’s technicians.

23-19     3.  The Board shall keep a record of its proceedings and a

23-20  register of all persons licensed under the provisions of this chapter.

23-21  The register must show:

23-22     (a) The name of every living licensee.

23-23     (b) The last known place of business and residence of each

23-24  licensee.

23-25     (c) The date and number of each license issued as a physical

23-26  therapist or physical therapist’s assistant.

23-27     4.  During September of every year in which renewal of a

23-28  license is required, the Board shall compile a list of licensed

23-29  physical therapists authorized to practice physical therapy and

23-30  physical therapist’s assistants licensed to assist in the practice

23-31  of physical therapy in this state. Any interested person in the State

23-32  may obtain a copy of the list upon application to the Board and the

23-33  payment of such amount as may be fixed by the Board, which

23-34  amount must not exceed the cost of the list so furnished.

23-35     5.  The Board may:

23-36     (a) Maintain offices in as many localities in the State as it finds

23-37  necessary to carry out the provisions of this chapter.

23-38     (b) Employ [attorneys,] investigators and other professional

23-39  consultants and clerical personnel necessary to the discharge of its

23-40  duties.

23-41     (c) Adopt a seal of which a court may take judicial notice.

23-42     6.  Any member or agent of the Board may enter an office,

23-43  clinic or hospital where physical therapy is practiced and inspect it

23-44  to determine if the physical therapists are licensed.


24-1      7.  Any member of the Board may administer an oath to a

24-2  person testifying in a matter that relates to the duties of the Board.

24-3      Sec. 49.  NRS 641.115 is hereby amended to read as follows:

24-4      641.115  1.  The Board may:

24-5      (a) Maintain offices in as many localities in the State as it

24-6  considers necessary to carry out the provisions of this chapter.

24-7      (b) Employ [attorneys,] investigators, consultants, hearings

24-8  officers and employees necessary to the discharge of its duties.

24-9      2.  Any expense incurred by the Board may not be paid out of

24-10  the State General Fund.

24-11     Sec. 50.  NRS 641C.180 is hereby amended to read as follows:

24-12     641C.180  The Board may:

24-13     1.  Maintain offices in as many locations in this state as it

24-14  considers necessary to carry out the provisions of this chapter.

24-15     2.  Employ [attorneys,] investigators and other persons

24-16  necessary to carry out its duties.

24-17     Sec. 51.  NRS 642.055 is hereby amended to read as follows:

24-18     642.055  The Board may:

24-19     1.  Maintain offices in as many localities in the State as it finds

24-20  necessary to carry out the provisions of this chapter.

24-21     2.  Employ [attorneys,] investigators and other professional

24-22  consultants and clerical personnel necessary to the discharge of its

24-23  duties.

24-24     Sec. 52.  NRS 643.050 is hereby amended to read as follows:

24-25     643.050  1.  The Board may:

24-26     (a) Maintain offices in as many locations in this state as it finds

24-27  necessary to carry out the provisions of this chapter.

24-28     (b) Employ [attorneys,] investigators and other professional

24-29  consultants and clerical personnel necessary to the discharge of its

24-30  duties.

24-31     (c) Adopt regulations necessary to carry out the provisions of

24-32  this chapter.

24-33     2.  The Board shall prescribe, by regulation, sanitary

24-34  requirements for barbershops and barber schools.

24-35     3.  Any member of the Board or its agents or assistants may

24-36  enter and inspect any barbershop or barber school at any time during

24-37  business hours or at any time when the practice of barbering or

24-38  instruction in that practice is being carried on.

24-39     4.  The Board shall keep a record of its proceedings relating to

24-40  the issuance, refusal, renewal, suspension and revocation of

24-41  licenses. The record must contain the name, place of business and

24-42  residence of each licensed barber, licensed apprentice and instructor,

24-43  and the date and number of his license. The record must be open to

24-44  public inspection at all reasonable times.


25-1      5.  The Board may approve and, by official order, establish the

25-2  days and hours when barbershops may remain open for business

25-3  whenever agreements fixing such opening and closing hours have

25-4  been signed and submitted to the Board by any organized and

25-5  representative group of licensed barbers of at least 70 percent of the

25-6  licensed barbers of any county. The Board may investigate the

25-7  reasonableness and propriety of the hours fixed by such an

25-8  agreement, as is conferred by the provisions of this chapter, and the

25-9  Board may fix hours for any portion of a county.

25-10     6.  The Board may adopt regulations governing the conduct of

25-11  barber schools and the course of study of barber schools.

25-12     Sec. 53.  NRS 644.150 is hereby amended to read as follows:

25-13     644.150  The Board may employ inspectors, investigators,

25-14  advisers, examiners and clerks and secure the services of [attorneys

25-15  and] other professional consultants, but no part of the compensation

25-16  of those persons or reasonable expenses incurred by the Board may

25-17  be paid by the State.

25-18     Sec. 54.  NRS 228.110 is hereby amended to read as follows:

25-19     228.110  1.  The Attorney General and his duly appointed

25-20  deputies [shall be] :

25-21     (a) Are the legal advisers on all state matters arising in the

25-22  Executive Department of the State Government.

25-23     (b) Are the exclusive attorneys and counselors at law who may

25-24  represent, within the State, each board or commission created by

25-25  title 54 of NRS, unless the Attorney General and his deputies are

25-26  disqualified to act in the particular matter.

25-27     2.  [No] A board, commission, agency, officer, commissioner

25-28  or appointee of the Executive Department of the Government of the

25-29  State of Nevada shall not employ or contract with any attorney at

25-30  law or counselor at law to represent the State of Nevada within the

25-31  State[,] or to be compensated by state [funds,] money, directly or

25-32  indirectly, as an attorney acting within the State for the State of

25-33  Nevada or any agency in the Executive Department thereof , unless

25-34  [the] :

25-35     (a) The Attorney General and his deputies are disqualified to act

25-36  in [such matter or unless an] the particular matter; or

25-37     (b) An act of the Legislature specifically authorizes the

25-38  employment of or the contracting with other attorneys or

25-39  counselors at law. For the purposes of this paragraph, no provision

25-40  in title 54 of NRS authorizes a board or commission created by

25-41  that title to employ or contract with other attorneys or counselors

25-42  at law to represent the board or commission within the State.

25-43     3.  All claims for legal services rendered in violation of this

25-44  section [shall be] are void.


26-1      Sec. 55.  Chapter 449 of NRS is hereby amended by adding

26-2  thereto a new section to read as follows:

26-3      1.  Not later than 15 days after the end of each month, a

26-4  hospital shall report to the Health Division the number of live

26-5  births that occurred at the hospital during that month.

26-6      2.  In addition to any fees collected pursuant to NRS 449.050,

26-7  the Health Division shall charge and collect from each hospital a

26-8  monthly fee of $50 for each live birth that occurred at the hospital

26-9  during each month.

26-10     3.  If a hospital violates any provision of this section, the

26-11  Health Division shall, after notice and opportunity for a hearing,

26-12  assess the hospital an administrative fine of not more than $2,000

26-13  for each such violation, in addition to any other fines or penalties

26-14  permitted by law.

26-15     4.  On a monthly basis, the Division shall deposit the fees and

26-16  fines collected pursuant to this section with the State Treasurer for

26-17  credit to the Critically Impacted Medical Specialties Subsidy Fund

26-18  created by section 62 of this act.

26-19     Sec. 56.  Chapter 690B of NRS is hereby amended by adding

26-20  thereto the provisions set forth as sections 57 to 65, inclusive, of this

26-21  act.

26-22     Sec. 57. As used in sections 57 to 65, inclusive, of this act,

26-23  unless the context otherwise requires, the words and terms defined

26-24  in sections 58 to 61, inclusive, of this act have the meanings

26-25  ascribed to them in those sections.

26-26     Sec. 58.  “Malpractice insurance” means a policy of

26-27  insurance covering the liability of a physician for a breach of his

26-28  professional duty toward a patient.

26-29     Sec. 59.  “Physician” means a person who has been issued a

26-30  license in this state to practice medicine pursuant to the provisions

26-31  of chapter 630 of NRS or osteopathic medicine pursuant to the

26-32  provisions of chapter 633 of NRS.

26-33     Sec. 60.  “Subsidy” means money paid by the Commissioner

26-34  from the Subsidy Fund.

26-35     Sec. 61.  “Subsidy Fund” means the Critically Impacted

26-36  Medical Specialties Subsidy Fund created by section 62 of this act.

26-37     Sec. 62.  1.  The Critically Impacted Medical Specialties

26-38  Subsidy Fund is hereby created in the State Treasury as a special

26-39  revenue fund, to be administered by the Commissioner.

26-40     2.  The money in the Subsidy Fund must be used to provide

26-41  subsidies to pay or defray the cost of malpractice insurance for

26-42  physicians who are practicing in specific branches of medicine or

26-43  osteopathic medicine that have been critically impacted by the cost

26-44  of malpractice insurance in this state.


27-1      Sec. 63. 1.  If a physician wants to receive a subsidy from

27-2  the Subsidy Fund to pay or defray the cost of malpractice

27-3  insurance, the physician must file with the Commissioner an

27-4  application for a subsidy.

27-5      2.  An application for a subsidy must include:

27-6      (a) Information establishing the gross revenue that the

27-7  physician derives from practicing medicine or osteopathic

27-8  medicine in this state and elsewhere;

27-9      (b) Information establishing the amount of the premiums that

27-10  the physician pays for malpractice insurance;

27-11     (c) Information establishing each specific branch of medicine

27-12  or osteopathic medicine in which the physician practices; and

27-13     (d) Any other information requested by the Commissioner.

27-14     Sec. 64.  1.  A physician is eligible to receive a subsidy from

27-15  the Subsidy Fund if:

27-16     (a) Of the gross revenue that the physician derives from

27-17  practicing medicine or osteopathic medicine in this state and

27-18  elsewhere, a majority of that gross revenue is derived in this state;

27-19     (b) The physician practices medicine or osteopathic medicine

27-20  in this state predominately in a specific branch of medicine or

27-21  osteopathic medicine that has been critically impacted by the cost

27-22  of malpractice insurance in this state;

27-23     (c) The amount of the premiums paid by the physician for

27-24  malpractice insurance exceeds 15 percent of the gross revenue

27-25  that the physician derives from practicing medicine or osteopathic

27-26  medicine in this state and elsewhere; and

27-27     (d) The physician has not received a subsidy from the Subsidy

27-28  Fund during the previous 12 months.

27-29     2.  If the Commissioner determines that a physician is eligible

27-30  for a subsidy, the Commissioner may pay to the physician a

27-31  subsidy to be used by the physician to pay or defray the cost of his

27-32  malpractice insurance. The amount of the subsidy must equal the

27-33  amount that is necessary to reduce the cost of the physician’s

27-34  malpractice insurance to 15 percent of the gross revenue that the

27-35  physician derives from practicing medicine or osteopathic

27-36  medicine in this state, provided that the amount of the subsidy

27-37  must not exceed $30,000 for any period of 12 months.

27-38     3.  When the Commissioner renders a decision regarding the

27-39  eligibility of a physician for a subsidy, the amount of a subsidy or

27-40  any other issue relating to a subsidy, the decision of the

27-41  Commissioner is final and binding on the physician and is not

27-42  subject to judicial review.

27-43     4.  If a physician is receiving assistance to pay the cost of his

27-44  malpractice insurance from sources other than the Subsidy Fund,

27-45  the Commissioner shall deduct the amount received from the other


28-1  sources from the amount payable to the physician from the

28-2  Subsidy Fund.

28-3      Sec. 65.  The Commissioner shall adopt regulations to carry

28-4  out the provisions of sections 57 to 65, inclusive, of this act,

28-5  including, without limitation, regulations:

28-6      1.  Establishing the manner in which an application for a

28-7  subsidy must be filed with the Commissioner and specifying the

28-8  information that must be filed with the application; and

28-9      2.  Identifying the specific branches of medicine or

28-10  osteopathic medicine that have been critically impacted by the cost

28-11  of malpractice insurance in this state.

28-12     Sec. 66.  Notwithstanding the amendatory provisions of this

28-13  act, if an attorney, on July 1, 2003, is an employee of or has a

28-14  contract with a board or commission created pursuant to title 54 of

28-15  NRS, the attorney may continue to represent the board or

28-16  commission within the State until the attorney’s position of

28-17  employment or contract with the board or commission is

28-18  relinquished or terminated pursuant to law or by operation of the

28-19  contract.

28-20     Sec. 67.  Notwithstanding any other provision of law, on and

28-21  after July 1, 2003, and before January 1, 2005:

28-22     1.  The Board of Medical Examiners shall not charge and

28-23  collect from a licensee any fee prescribed by NRS 630.268 in an

28-24  amount that the exceeds the amount that was charged and collected

28-25  for the fee on January 1, 2002.

28-26     2.  The State Board of Osteopathic Medicine shall not charge

28-27  and collect from a licensee any fee prescribed by NRS 633.501 in an

28-28  amount that the exceeds the amount that was charged and collected

28-29  for the fee on January 1, 2002.

28-30     Sec. 68.  1.  Not later than July 15, 2003, the Board of

28-31  Medical Examiners shall:

28-32     (a) Transfer the sum of $2,500,000 from its accounts to the State

28-33  Treasurer for credit to the Critically Impacted Medical Specialties

28-34  Subsidy Fund; and

28-35     (b) Charge and collect the annual fee prescribed by section 17 of

28-36  this act.

28-37     2.  Not later than July 15, 2003, the State Board of Osteopathic

28-38  Medicine shall:

28-39     (a) Transfer the sum of $100,000 from its accounts to the State

28-40  Treasurer for credit to the Critically Impacted Medical Specialties

28-41  Subsidy Fund; and

28-42     (b) Charge and collect the annual fee established pursuant to

28-43  section 36 of this act.

28-44     3.  If, on June 1, 2005, there is any money remaining in the

28-45  Critically Impacted Medical Specialties Subsidy Fund:


29-1      (a) The remaining money must not be committed for

29-2  expenditure; and

29-3      (b) The Commissioner of Insurance shall transfer the remaining

29-4  money to the Nevada Health Professionals Assistance Foundation as

29-5  soon as all payments of money committed for expenditure from the

29-6  Critically Impacted Medical Specialties Subsidy Fund have been

29-7  made.

29-8      4.  As used in this section, “Critically Impacted Medical

29-9  Specialties Subsidy Fund” means the Fund created by section 62 of

29-10  this act.

29-11     Sec. 69.  1.  This act becomes effective upon passage and

29-12  approval for the purpose of adopting regulations and on July 1,

29-13  2003, for all other purposes.

29-14     2.  Sections 17, 22, 36, 37, 55 and 57 to 65, inclusive, of this act

29-15  expire by limitation on July 1, 2005.

 

29-16  H