Senate Bill No. 425–Committee on Commerce and Labor
CHAPTER..........
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1. Chapter 639 of NRS is hereby amended by adding
thereto the provisions set forth as sections 2, 3 and 3.5 inclusive, of
this act.
Sec. 2. “Pharmaceutical technician” means a person who
performs technical services in a pharmacy under the direct
supervision of a pharmacist and is registered with the Board.
Sec. 3. “Pharmaceutical technician in training” means a
person who is:
1. Registered with the Board in order to obtain the training
and experience required to be a pharmaceutical technician; or
2. Enrolled in a program of training for pharmaceutical
technicians that is approved by the Board.
Sec. 3.5. 1. A wholesaler may sell a prescription drug only
to:
(a) A pharmacy or practitioner; or
(b) Another wholesaler if:
(1) The wholesaler who purchases the drug is licensed by
the Board or the board or other relevant authority of another
state; and
(2) The sale is a bona fide transaction.
2. A wholesaler may purchase a prescription drug only from:
(a) A manufacturer; or
(b) Another wholesaler if:
(1) The wholesaler who sells the drug is licensed by the
Board; and
(2) The sale is a bona fide transaction.
3. The Board shall not limit the quantity of prescription drugs
a wholesaler may purchase, sell, distribute or otherwise provide to
another wholesaler, distributor or manufacturer.
4. For the purposes of this section:
(a) A purchase shall be deemed a bona fide transaction if:
(1) The wholesaler purchased the drug:
(I) Directly from the manufacturer of the drug; or
(II) With a reasonable belief that the drug was
originally purchased directly from the manufacturer of the drug;
(2) The circumstances of the purchase reasonably indicate
that the drug was not purchased from a source prohibited by law;
(3) Unless the drug is purchased by the wholesaler from the
manufacturer, before the wholesaler sells the drug to another
wholesaler, the wholesaler who sells the drug conducts a
reasonable visual examination of the drug to ensure that the drug
is not:
(I) Counterfeit;
(II) Deemed to be adulterated or misbranded in
accordance with the provisions of chapter 585 of NRS;
(III) Mislabeled;
(IV) Damaged or compromised by improper handling,
storage or temperature control;
(V) From a foreign or unlawful source; or
(VI) Manufactured, packaged, labeled or shipped in
violation of any state or federal law relating to prescription drugs;
(4) The drug is shipped directly from the wholesaler who
sells the drug to the wholesaler who purchases the drug; and
(5) The documents of the shipping company concerning the
shipping of the drug are attached to the invoice for the drug and
are maintained in the records of the wholesaler.
(b) A sale shall be deemed a bona fide transaction if there is a
reasonable assurance by the wholesaler that purchases the drug
that the wholesaler will sell the drug directly and only to a
pharmacy or practitioner.
(c) The purchase or sale of a prescription drug includes,
without limitation, the distribution, transfer, trading, bartering or
any other provision of a prescription drug to another person by a
wholesaler. A transfer of a prescription drug from a wholesale
facility of a wholesaler to another wholesale facility of the
wholesaler shall not be deemed a purchase or sale of a
prescription drug pursuant to this section if the wholesaler is a
corporation whose securities are publicly traded and regulated by
the Securities Exchange Act of 1934.
Sec. 4. NRS 639.001 is hereby amended to read as follows:
639.001 As used in this chapter, unless the context otherwise
requires, the words and terms defined in NRS 639.0015 to 639.016,
inclusive, and sections 2 and 3 of this act have the meanings
ascribed to them in those sections.
Sec. 5. NRS 639.0124 is hereby amended to read as follows:
639.0124 “Practice of pharmacy” includes, but is not limited
to, the:
1. Performance or supervision of activities associated with
manufacturing, compounding, labeling, dispensing and distributing
of a drug[.] , including the receipt, handling and storage of
prescriptions and other confidential information relating to
patients.
2. Interpretation and evaluation of prescriptions or orders for
medicine.
3. Participation in drug evaluation and drug research.
4. Advising of the therapeutic value, reaction, drug interaction,
hazard and use of a drug.
5. Selection of the source, storage and distribution of a drug.
6. Maintenance of proper documentation of the source, storage
and distribution of a drug.
7. Interpretation of clinical data contained in a person’s record
of medication.
8. Development of written guidelines and protocols in
collaboration with a practitioner which are intended for a patient in a
licensed medical facility and authorize the implementation,
monitoring and modification of drug therapy. The written
guidelines and protocols may authorize a pharmacist to order and
use the findings of laboratory tests and examinations.
9. Implementation and modification of drug therapy in
accordance with the authorization of the prescribing practitioner for
a patient in a pharmacy in which drugs, controlled substances,
poisons, medicines or chemicals are sold at retail.
The term does not include the changing of a prescription by a
pharmacist or practitioner without the consent of the prescribing
practitioner, except as otherwise provided in NRS 639.2583.
Sec. 6. NRS 639.015 is hereby amended to read as follows:
639.015 “Registered pharmacist” means:
1. A person registered in this state as such on July 1, 1947;
2. A person registered in this state as such in compliance with
the provisions of paragraph (c) of section 3 of chapter 195, Statutes
of Nevada 1951; or
3. A person who has complied with the provisions of NRS
639.120 [and 639.133] and whose name has been entered in the
registry of pharmacists of this state by the Executive Secretary of
the Board and to whom a valid certificate as a registered pharmacist
or valid renewal thereof has been issued by the Board.
Sec. 7. (Deleted by amendment.)
Sec. 8. NRS 639.040 is hereby amended to read as follows:
639.040 1. The Board shall elect a President and a Treasurer
from among its members.
2. The Board shall employ [a] an Executive Secretary, who
must not be a member of the Board. The Executive Secretary shall
keep a complete record of all proceedings of the Board and of all
certificates issued, and shall perform such other duties as the Board
may require, for which services he is entitled to receive a salary to
be determined by the Board.
Sec. 9. NRS 639.070 is hereby amended to read as follows:
639.070 1. The Board may:
(a) Adopt such regulations, not inconsistent with the laws of this
state, as are necessary for the protection of the public, appertaining
to the practice of pharmacy and the lawful performance of its duties.
(b) Adopt regulations requiring that prices charged by retail
pharmacies for drugs and medicines which are obtained by
prescription be posted in the pharmacies and be given on the
telephone to persons requesting such information.
(c) Adopt regulations, not inconsistent with the laws of this
state, authorizing the Executive Secretary of the Board to issue
certificates, licenses and permits required by this chapter and
chapters 453 and 454 of NRS.
(d) Adopt regulations governing the dispensing of poisons,
drugs, chemicals and medicines.
(e) Regulate the practice of pharmacy.
(f) Regulate the sale and dispensing of poisons, drugs, chemicals
and medicines.
(g) Regulate the means of recordkeeping and storage, handling,
sanitation and security of drugs, poisons, medicines, chemicals and
devices, including, but not limited to, requirements relating to:
(1) Pharmacies, institutional pharmacies and pharmacies in
correctional institutions;
(2) Drugs stored in hospitals; and
(3) Drugs stored for the purpose of wholesale distribution.
(h) Examine and register, upon application, pharmacists and
other persons who dispense or distribute medications whom it
deems qualified.
(i) Charge and collect necessary and reasonable fees for its
services, other than those specifically set forth in this chapter.
(j) Maintain offices in as many localities in the State as it finds
necessary to carry out the provisions of this chapter.
(k) Employ an attorney, inspectors, investigators and other
professional consultants and clerical personnel necessary to the
discharge of its duties.
(l) Enforce the provisions of NRS 453.011 to 453.552, inclusive,
and enforce the provisions of this chapter and chapter 454 of NRS.
(m) Adopt regulations concerning the information required to be
submitted in connection with an application for any license,
certificate or permit required by this chapter or chapter 453 or 454
of NRS.
(n) Adopt regulations concerning the education, experience and
background of a person who is employed by the holder of a license
or permit issued pursuant to this chapter and who has access to
drugs and devices.
(o) Adopt regulations concerning the use of computerized
mechanical equipment for the filling of prescriptions.
(p) Participate in and expend money for programs that enhance
the practice of pharmacy.
2. This section does not authorize the Board to prohibit open-
market competition in the advertising and sale of prescription drugs
and pharmaceutical services.
Sec. 10. NRS 639.081 is hereby amended to read as follows:
639.081 1. Except as otherwise provided in subsection 3, all
money coming into the possession of the Board must be kept or
deposited by the Executive Secretary of the Board in banks, credit
unions or savings and loan associations in the State of Nevada, or
invested in United States treasury bills or notes, to be expended for
payment of compensation and expenses of members of the Board
and for other necessary or proper purposes in the administration of
this chapter.
2. 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 or savings and loan associations in this state.
3. If a hearing officer or panel is not authorized to take
disciplinary action pursuant to subsection 2 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 attorney’s
fees or the costs of an investigation, or both.
Sec. 11. NRS 639.120 is hereby amended to read as follows:
639.120 1. An applicant to become a registered pharmacist in
this state must:
(a) Be of good moral character.
(b) Be a graduate of a college of pharmacy or department of
pharmacy of a university accredited by the American Council on
Pharmaceutical Education or Canadian Council for Accreditation
of Pharmacy Programs and approved by the Board or a graduate of
a foreign school who has passed an examination for foreign
graduates approved by the Board to demonstrate that his education
is equivalent.
(c) Pass an examination approved and given by the Board with a
grade of at least 75 on the examination as a whole and a grade of at
least 75 on the examination on law. An applicant for registration by
reciprocity must pass the examination on law with at least a grade
of 75.
(d) Complete not less than 1,500 hours of practical
pharmaceutical experience as an intern pharmacist under the direct
and immediate supervision of a registered pharmacist.
2. The practical pharmaceutical experience required pursuant
to paragraph (d) of subsection 1 must relate primarily to the selling
of drugs, poisons and devices, the compounding and dispensing of
prescriptions, preparing prescriptions , and keeping records and
preparing reports required by state and federal statutes.
3. The Board may accept evidence of compliance with the
requirements set forth in paragraph (d) of subsection 1 from boards
of pharmacy of other states in which the experience requirement is
equivalent to the requirements in this state.
Sec. 12. NRS 639.127 is hereby amended to read as follows:
639.127 1. An applicant for registration as a pharmacist in
this state must submit an application to the Executive Secretary of
the Board on a form furnished by the Board and must pay the fee
fixed by the Board. The fee must be paid at the time the application
is submitted and is compensation to the Board for the investigation
and the examination of the applicant. Under no circumstances may
the fee be refunded.
2. Proof of the qualifications of any applicant must be made to
the satisfaction of the Board and must be substantiated by affidavits,
records or such other evidence as the Board may require.
3. An application is only valid for 1 year after the date it is
received by the Board unless the Board extends its period of
validity.
4. A certificate of registration as a pharmacist must be issued to
each person who the Board determines is qualified pursuant to the
provisions of NRS 639.120[, 639.133] and 639.134. The certificate
entitles the person to whom it is issued to practice pharmacy in this
state.
Sec. 13. NRS 639.128 is hereby amended to read as follows:
639.128 The application of a natural person who applies for the
issuance of a certificate of registration as a pharmacist, [an]
intern pharmacist [or supportive personnel] , pharmaceutical
technician or pharmaceutical technician in training or a license
issued pursuant to NRS 639.233 must include the social security
number of the applicant.
Sec. 14. NRS 639.129 is hereby amended to read as follows:
639.129 1. A natural person who applies for the issuance or
renewal of a certificate of registration as a pharmacist, [an]
intern pharmacist [or supportive personnel] , pharmaceutical
technician or pharmaceutical technician in training or a license
issued pursuant to NRS 639.233 shall submit to the Board the
statement prescribed by the Welfare Division of the Department of
Human Resources 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 certificate or license; or
(b) A separate form prescribed by the Board.
3. A certificate of registration as a pharmacist, [an]
intern pharmacist [or supportive personnel] , pharmaceutical
technician or pharmaceutical technician in training or a license
issued issued pursuant to NRS 639.233 may not be issued or
renewed by the Board if the applicant is a natural person who:
(a) Fails to submit the statement required pursuant to
subsection 1; or
(b) Indicates on the statement submitted pursuant to subsection
1 that he 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 he 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. 15. NRS 639.137 is hereby amended to read as follows:
639.137 1. Any person who is not a registered pharmacist,
but who is employed in this state for the purpose of fulfilling the
requirements of paragraph (d) of subsection 1 of NRS 639.120 to
become eligible for registration as a pharmacist, shall register with
the Board as an intern pharmacist. An applicant, to be eligible for
registration as an intern pharmacist, must be enrolled in a college of
pharmacy or a department of pharmacy of a university approved by
the Board or be a graduate of a foreign school and pass an
examination for foreign graduates approved by the Board. The
application must be made on a form furnished by the Board.
2. The Executive Secretary of the Board, upon approval of the
application, shall issue a certificate of registration authorizing
the applicant to undergo practical pharmaceutical training under the
direct and immediate supervision of a registered pharmacist. The
period of validity of the certificate of registration, including any
renewal, must not exceed 4 years after the date of issue. The
certificate of registration authorizes the holder, if acting under the
direct and immediate supervision of a registered pharmacist, to
perform:
(a) The duties of a registered pharmacist as authorized by
regulation of the Board; and
(b) Other activities as authorized by regulation of the Board.
3. The certificate of registration must be posted as required by
NRS 639.150.
4. Any certificate of registration issued pursuant to the
provisions of this section may be suspended, terminated or revoked
by the Board for:
(a) Any reason set forth in this chapter as grounds for the
suspension or revocation of any certificate, license or permit; or
(b) The failure of the registered pharmacist whose name appears
on the certificate of registration to provide adequate training and
supervision for the intern pharmacist in compliance with regulations
adopted by the Board.
Sec. 16. NRS 639.1371 is hereby amended to read as follows:
639.1371 1. The ratio of [supportive personnel]
pharmaceutical technicians to pharmacists must not allow more
than one [supportive personnel] pharmaceutical technician to each
pharmacist unless the Board by regulation expands the ratio.
2. The Board shall adopt regulations concerning[supportive
personnel,] pharmaceutical technicians, including requirements
for:
(a) The qualifications, registration and supervision of
[supportive personnel;] pharmaceutical technicians, and
(b) [Services] The services which may be performed by
[supportive personnel,] pharmaceutical technicians,
to ensure the protection and safety of the public in the provision of
pharmaceutical care.
3. The regulations adopted by the Board pursuant to this
section which prescribe:
(a) The qualifications for [supportive personnel]
pharmaceutical technicians must include:
(1) [At least 1 year of education at a postsecondary school
which is directly related to the duties performed by supportive
personnel;
(2)] The successful completion of a program for [supportive
personnel] pharmaceutical technicians which is approved by the
Board;
[(3)] (2) The completion of at least 1,500 hours of experience
in carrying out the duties of [supportive personnel; or
(4)] a pharmaceutical technician; or
(3) Any other experience or education deemed equivalent by
the Board.
(b) An expanded ratio of [supportive personnel] pharmaceutical
technicians to pharmacists must [not allow more than two
supportive personnel for each pharmacist in] be appropriate and
necessary for a particular category of pharmacy at any time.
(c) The services which may be performed by [supportive
personnel] pharmaceutical technicians must include, without
limitation, the:
(1) Removal of drugs from stock;
(2) Counting, pouring or mixing of drugs;
(3) Placing of drugs in containers;
(4) Affixing of labels to containers; and
(5) Packaging and repackaging of drugs.
4. For the purposes of this chapter, and chapters 453 and 454 of
NRS, [supportive personnel] pharmaceutical technicians may
perform acts required to be performed by pharmacists , but only to
the extent provided in regulations.
Sec. 17. NRS 639.138 is hereby amended to read as follows:
639.138 If the Board, after an investigation, denies any
application for a certificate, license or permit, the Executive
Secretary of the Board shall notify the applicant, within 10 days
after the denial is approved by the Board and entered in the official
minutes, by registered or certified mail, of the denial of the
application and the reasons therefor. The notice must inform the
applicant of his right to petition the Board for reconsideration and
his right to submit evidence to controvert the alleged violations on
which the denial was based.
Sec. 18. NRS 639.139 is hereby amended to read as follows:
639.139 1. At any time within 30 days after receipt of the
notice of denial of his application, an applicant may petition the
Board for reconsideration of the application. The petition must set
forth a denial, in whole or in part, of the violations alleged and a
statement that the applicant is prepared to submit evidence in
support of his denial of the allegations.
2. Within 30 days after the petition is received by the Board,
the Executive Secretary of the Board shall notify the petitioner, by
registered or certified mail, of the Board’s decision [either] to grant
or deny the petition for reconsideration. If the petition is granted, the
notice [shall] must include the time and place set for reconsideration
of the application by the Board.
Sec. 19. NRS 639.160 is hereby amended to read as follows:
639.160 Every registered pharmacist shall, within 10 days after
changing his place of practice as designated on the books of the
Executive Secretary of the Board, notify the Executive Secretary [of
the Board of such] of the change and of his new place of practice.
Upon receipt of [such] the notification , the Executive Secretary
shall make the necessary change in his register.
Sec. 20. NRS 639.170 is hereby amended to read as follows:
639.170 1. The Board shall charge and collect not more than
the following fees for the following services:
Actual cost
For the examination of an applicant for registration of the
as a pharmacist...................... examination
For the investigation or registration of an
applicant as a registered pharmacist..... $200
For the investigation, examination or registration
of an applicant as a registered pharmacist by
reciprocity............................................... 300
For the investigation or issuance of an original
license to conduct a retail pharmacy...... 600
For the biennial renewal of a license to conduct a
retail pharmacy........................................ 500
For the investigation or issuance of an original
license to conduct an institutional pharmacy.. 600
For the biennial renewal of a license to conduct an
institutional pharmacy............................ 500
For the issuance of an original or duplicate
certificate of registration as a registered
pharmacist................................................ 50
For the biennial renewal of registration as a
registered pharmacist.............................. 200
For the reinstatement of a lapsed registration (in
addition to the fees for renewal for the period of
lapse)....................................................... 100
[For the initial registration of supportive personnel............................... 50
For the biennial renewal of registration of
supportive personnel.............................. 50]
For the initial registration of a pharmaceutical
technician or pharmaceutical technician in
training..................................................... 50
For the biennial renewal of registration of a
pharmaceutical technician or pharmaceutical
technician in training............................ 50
For the investigation or registration of an intern
pharmacist............................................... $50
For the biennial renewal of registration as an
intern pharmacist...................................... 40
For investigation or issuance of an original license
to a manufacturer or wholesaler............ 500
For the biennial renewal of a license for a
manufacturer or wholesaler......... [400] 500
For the reissuance of a license issued to a
pharmacy, when no change of ownership is
involved, but the license must be reissued because
of a change in the information required thereon 100
[For the biennial renewal of registration issued to
a registered pharmacist placed on inactive status100]
For authorization of a practitioner to dispense
controlled substances or dangerous drugs, or both300
For the biennial renewal of authorization of a
practitioner to dispense controlled substances or
dangerous drugs, or both........................ 300
2. If a person requests a special service from the Board or
requests the Board to convene a special meeting, he must pay the
actual costs to the Board as a condition precedent to the rendition of
the special service or the convening of the special meeting.
3. All fees are payable in advance and are not refundable.
4. The Board may, by regulation, set the penalty for failure to
pay the fee for renewal for any license, permit, authorization or
certificate within the statutory period, at an amount not to exceed
100 percent of the fee for renewal for each year of delinquency in
addition to the fees for renewal for each year of delinquency.
Sec. 21. NRS 639.180 is hereby amended to read as follows:
639.180 1. Except as otherwise provided in this subsection, a
certificate, license or permit issued by the Board pursuant to this
chapter expires on October 31 of each even‑numbered year. A
certificate of registration as a pharmacist expires on October 31 of
each odd‑numbered year.
2. Except as otherwise provided by NRS 639.137, 639.230 and
639.2328, each person to whom a certificate, license or permit has
been issued may, if the certificate, license or permit has not been
revoked, renew the certificate, license or permit biennially by:
(a) Filing an application for renewal;
(b) Paying the fee for renewal;
(c) Complying with the requirement of continuing professional
education, if applicable; and
(d) If the applicant is a natural person who is applying for the
renewal of a certificate of registration as a pharmacist, [an]
intern pharmacist [or supportive personnel] , pharmaceutical
technician or pharmaceutical technician in training or a license
issued pursuant to NRS 639.233, submitting the statement required
pursuant to NRS 639.129.
3. The application for renewal, together with the fee for
renewal and, if applicable, the statement, must be delivered to the
Executive Secretary of the Board on or before the expiration date of
the certificate, license or permit, or the current renewal receipt
thereof.
4. If a certificate, license or permit is renewed, it must be
delivered to the applicant within a reasonable time after receipt of
the application for renewal and the fee for renewal.
5. The Board may refuse to renew a certificate, license or
permit if the applicant has committed any act proscribed by
NRS 639.210.
6. If the application for renewal and the fee for renewal and, if
applicable, the statement[,] are not postmarked on or before the
expiration date of the certificate, license or permit, or the current
renewal receipt thereof, the registration is automatically forfeited.
Sec. 22. NRS 639.2174 is hereby amended to read as follows:
639.2174 The Board shall not[:
1. Issue a certificate as a registered pharmacist to any person
pursuant to NRS 639.133; or
2. Renew] renew the certificate of any registered pharmacist[,]
until the applicant has submitted proof to the Board of the receipt of
the required number of continuing education units, obtained through
the satisfactory completion of an accredited program of continuing
professional education during the period for which the certificate
was issued.
Sec. 23. NRS 639.230 is hereby amended to read as follows:
639.230 1. A [pharmacy or a] person operating [as a
pharmacy] a business in this state shall not use the letters “Rx” or
“RX” or the word “drug” or “drugs,” “prescription” or “pharmacy,”
or similar words or words of similar import, without first having
secured a license from the Board.
2. Each license must be issued to a specific person and for a
specific location and is not transferable. The original license must be
displayed on the licensed premises as provided in NRS 639.150.
The original license and the fee required for reissuance of a license
must be submitted to the Board before the reissuance of the license.
3. If the owner of a pharmacy is a partnership or corporation,
any change of partners or corporate officers must be reported to the
Board at such a time as is required by a regulation of the Board.
4. In addition to the requirements for renewal set forth in NRS
639.180, every person holding a license to operate a pharmacy must
satisfy the Board that the pharmacy is conducted according to law.
5. Any violation of any of the provisions of this chapter by a
managing pharmacist or by personnel of the pharmacy under the
supervision of the managing pharmacist is cause for the suspension
or revocation of the license of the pharmacy by the Board.
Sec. 24. NRS 639.231 is hereby amended to read as follows:
639.231 1. An application to conduct a pharmacy must be
made on a form furnished by the Board and must state the name,
address, usual occupation and professional qualifications, if any, of
the applicant. If the applicant is other than a natural person, the
application must state such information as to each person
beneficially interested therein.
2. As used in subsection 1, and subject to the provisions of
subsection 3, the term “person beneficially interested” means:
(a) If the applicant is a partnership or other unincorporated
association, each partner or member.
(b) If the applicant is a corporation, each of its officers, directors
and stockholders, provided that no natural person shall be deemed to
be beneficially interested in a nonprofit corporation.
3. If the applicant is a partnership, unincorporated association
or corporation and the number of partners, members or stockholders,
as the case may be, exceeds four, the application must so state, and
must list each of the four partners, members or stockholders who
own the four largest interests in the applicant entity and state their
percentages of interest. Upon request of the Executive Secretary of
the Board, the applicant shall furnish the Board with information as
to partners, members or stockholders not named in the application or
shall refer the Board to an appropriate source of such information.
4. The completed application form must be returned to the
Board with the fee prescribed by the Board, which may not be
refunded. Any application which is not complete as required by the
provisions of this section may not be presented to the Board for
consideration.
5. Upon compliance with all the provisions of this section and
upon approval of the application by the Board, the Executive
Secretary shall issue a license to the applicant to conduct a
pharmacy. Any other provision of law notwithstanding, such a
license authorizes the holder to conduct a pharmacy and to sell and
dispense drugs and poisons and devices and appliances that are
restricted by federal law to sale by or on the order of a physician.
Sec. 24.5. NRS 639.233 is hereby amended to read as follows:
639.233 1. Any person, including a wholesaler or
manufacturer, who engages in the business of wholesale distribution
or furnishing controlled substances, poisons, drugs, devices or
appliances that are restricted by federal law to sale by or on the
order of a physician to any person located within this state shall
obtain a license pursuant to the provisions of this chapter.
2. [The provisions of subsection 1 do not apply to a wholesaler
or manufacturer whose principal place of business is located in
another state and who ships controlled substances, drugs, poisons or
restricted devices or appliances to a wholesaler or manufacturer
located within this state and licensed by the Board.
3.] For the purpose of this section, a person is “engaged in the
business of furnishing” if he:
(a) Solicits or accepts orders for drugs or devices whose sale in
this state is restricted by this chapter or chapter 453 or 454 of NRS;
or
(b) Receives, stores or ships such drugs or devices.
Sec. 25. NRS 639.234 is hereby amended to read as follows:
639.234 1. The acceptance of a license issued pursuant to
NRS 639.233 constitutes a consent by the licensee to the inspection
, copying and removal for copying of his records maintained inside
and outside this state by any authorized representative of the Board.
2. If such a licensee is not a resident of this state and does not
maintain records within this state of his shipments of controlled
substances, poisons or drugs or devices or appliances that are
restricted by federal law to sale by or on the order of a physician to
persons in this state , he shall, on receipt of a written demand from
the Executive Secretary of the Board, furnish a true copy of the
records to the Board.
3. The Board may authorize as its representative any member
or representative of the Board of pharmacy or similar agency of the
state in which the records are located.
4. [Failure] The failure to furnish a true copy of the required
records or the refusal to permit their inspection is a ground for [the
revocation or] suspension of and disciplinary action relating to any
license issued pursuant to NRS 639.233.
Sec. 26. NRS 639.235 is hereby amended to read as follows:
639.235 1. No person other than a practitioner holding a
license to practice his profession in this state may prescribe or write
a prescription, except that a prescription written by a person who is
not licensed to practice in this state , but is authorized by the laws of
another state to prescribe , shall be deemed to be a legal prescription
unless the person prescribed or wrote the prescription in violation of
the provisions of NRS 453.3611 to 453.3648, inclusive.
2. If a prescription that is prescribed by a person who is not
licensed to practice in this state, but is authorized by the laws of
another state to prescribe, calls for a controlled substance listed in:
(a) Schedule II, the registered pharmacist who is to fill the
prescription shall establish and document that the prescription is
authentic and that a bona fide relationship between the patient and
the person prescribing the controlled substance did exist when the
prescription was written.
(b) Schedule III or IV, the registered pharmacist who is to fill
the prescription shall establish[, in his professional judgment,] that
the prescription is authentic and that a bona fide relationship
between the patient and the person prescribing the controlled
substance did exist when the prescription was written. This
paragraph does not require the registered pharmacist to inquire into
such a relationship upon the receipt of [each such prescription.] a
similar prescription subsequently issued for that patient.
3. A pharmacist who fills a prescription described in
subsection 2 shall record on the prescription or in the prescription
record in the pharmacy’s computer:
(a) The name of the person with whom he spoke concerning
the prescription;
(b) The date and time of the conversation; and
(c) The date and time the patient was physically examined by
the person prescribing the controlled substance for which the
prescription was issued.
4. For the purposes of subsection 2, a bona fide relationship
between the patient and the person prescribing the controlled
substance shall be deemed to exist if the patient was physically
examined by the person prescribing the controlled substances
within the 6 months immediately preceding the date the
prescription was issued.
Sec. 27. NRS 639.238 is hereby amended to read as follows:
639.238 1. Prescriptions filled and on file in a pharmacy are
not a public record. A pharmacist shall not divulge the contents of
any prescription or provide a copy of any prescription, except to:
(a) The patient for whom the original prescription was issued;
(b) The practitioner who originally issued the prescription;
(c) A practitioner who is then treating the patient;
(d) A member, inspector or investigator of the Board or an
inspector of the Food and Drug Administration or an agent of the
Investigation Division of the Department of Public Safety;
(e) An agency of State Government charged with the
responsibility of providing medical care for the patient;
(f) An insurance carrier, on receipt of written authorization
signed by the patient or his legal guardian, authorizing the release of
such information;
(g) Any person authorized by an order of a district court;
(h) Any member, inspector or investigator of a professional
licensing board which licenses a practitioner who orders
prescriptions filled at the pharmacy; [or]
(i) Other registered pharmacists for the limited purpose of and to
the extent necessary for the exchange of information relating to
persons who are suspected of:
(1) Misusing prescriptions to obtain excessive amounts of
drugs[.] ; or
(2) Failing to use a drug in conformity with the directions for
its use or taking a drug in combination with other drugs in a manner
that could result in injury to that person[.] ; or
(j) A peace officer employed by a local government for the
limited purpose of and to the extent necessary:
(1) For the investigation of an alleged crime reported by an
employee of the pharmacy where the crime was committed; or
(2) To carry out a search warrant or subpoena issued
pursuant to a court order.
2. Any copy of a prescription for a controlled substance or a
dangerous drug as defined in chapter 454 of NRS, issued to a person
authorized by this section to receive such a copy, must contain all of
the information appearing on the original prescription and be clearly
marked on its face[,] “Copy, Not Refillable—For Reference
Purposes Only.” The copy must bear the name or initials of the
registered pharmacist who prepared the copy.
3. If a copy of a prescription for any controlled substance or a
dangerous drug as defined in chapter 454 of NRS is furnished to the
customer, the original prescription must be voided and notations
made thereon showing the date and the name of the person to whom
the copy was furnished.
4. If, at the express request of a customer, a copy of a
prescription for any controlled substance or dangerous drug is
furnished to another pharmacist, the original prescription must be
voided and notations made thereon showing the date and the name
of the pharmacist to whom the copy was furnished. The pharmacist
receiving the copy shall call the prescribing practitioner for a new
prescription.
5. As used in this section, “peace officer” does not include:
(a) A member of the Police Department of the University and
Community College System of Nevada.
(b) A school police officer who is appointed or employed
pursuant to NRS 391.100.
Sec. 28. NRS 639.239 is hereby amended to read as follows:
639.239 Members, inspectors and investigators of the Board,
inspectors of the Food and Drug Administration , [and] agents of the
Investigation Division of the Department of Public Safety and peace
officers described in paragraph (j) of subsection 1 of NRS 639.238
may remove any record required to be retained by state or federal
law or regulation, including any prescription contained in the files of
a practitioner, if the record in question will be used as evidence in a
criminal action, civil action or an administrative proceeding, or
contemplated action or proceeding. The person who removes a
record pursuant to this section shall:
1. Affix the name and address of the practitioner to the back of
the record;
2. Affix his initials, cause an agent of the practitioner to affix
his initials and note the date of the removal of the record on the back
of the record;
3. Affix the name of the agency for which he is removing the
record to the back of the record;
4. Provide the practitioner with a receipt for the record; and
5. Return a photostatic copy of both sides of the record to the
practitioner within 15 working days after the record is removed.
Sec. 29. NRS 639.241 is hereby amended to read as follows:
639.241 1. A hearing to determine whether the rights and
privileges granted by any certificate, certification, license or permit
issued by the Board should be revoked, suspended, limited or
conditioned must be initiated by the filing of an accusation by the
Board. The action must be entitled: The Nevada State Board of
Pharmacy v. (insert the name of the party whose certificate, license
or permit is involved), who must be designated “Respondent.”
2. The accusation is a written statement of the charges alleged
and must set forth in ordinary and concise language the acts or
omissions with which the respondent is charged to the end that the
respondent will be able to prepare his defense. [It] The accusation
must specify the statutes and regulations which the respondent is
alleged to have violated, but must not consist merely of charges
phrased in language of the statute or regulation. The accusation must
be signed by the Executive Secretary of the Board acting in his
official capacity.
Sec. 30. NRS 639.242 is hereby amended to read as follows:
639.242 1. After filing the accusation, the Executive
Secretary of the Board shall cause a copy thereof, together with one
copy of the Statement to Respondent and three copies of the form of
the Notice of Defense, to be served on the respondent.
2. Service may be [either] by personal service or by first-class
registered or certified mail addressed to the respondent at his last
address of record, or by mail to his attorney of record. Proof of
service [shall] must be retained and made a part of the case record.
Sec. 31. NRS 639.244 is hereby amended to read as follows:
639.244 1. The form for the Notice of Defense [shall] must
be prepared and furnished by the Board and [shall] permit the
respondent, by completing and signing the notice , to:
(a) [Request a hearing;
(b)] Object to the accusation as being incomplete and failing to
set forth clearly the charges; and
[(c)] (b) Deny or admit, in part or in whole, the violations
alleged.
2. The Notice of Defense [shall] must be signed by the
respondent or [by] his attorney under penalty of perjury. Failure to
file a Notice of Defense [and request a hearing shall constitute]
constitutes a waiver of the respondent’s right to a hearing, but the
Board may[, in its discretion,] grant a hearing.
Sec. 32. NRS 639.245 is hereby amended to read as follows:
639.245 Whenever a hearing has been granted by the Board,
the Executive Secretary of the Board shall serve notice on the
respondent of the time and place set for the hearing on the
accusation. 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. Service may be effected in the same manner as provided
in NRS 639.242.
Sec. 33. NRS 639.246 is hereby amended to read as follows:
639.246 1. The Executive Secretary of the Board shall issue
subpoenas for the production of witnesses, documents or papers, in
accordance with statutory provisions, at the request of any party to a
hearing or for purposes of an investigation or other matter under
inquiry by the Board.
2. Witnesses appearing pursuant to a subpoena must receive
expenses and witness fees in the amounts and under the same
circumstances as prescribed by law for witnesses in civil actions.
The expenses and fees must be paid in full by the party at whose
request the witness is subpoenaed.
3. Subpoenas must be served in the same manner as prescribed
by law for the service of subpoenas in civil actions. If any person
fails to comply with a subpoena within 10 days after its issuance, the
President of the Board, or the Executive Secretary of the Board at
the direction of the President, may petition the district court for an
order of the court compelling compliance with the subpoena.
4. Upon such a petition, the court shall enter an order directing
the person subpoenaed to appear before the court at a time and place
to be fixed by the court in its order, the time to be not more than 10
days after the date of the order, and then and there to show cause
why he has not complied with the subpoena. A certified copy of the
order must be served upon the person.
5. If it appears to the court that the subpoena was regularly
issued by the Board, the court shall enter an order compelling
compliance with the subpoena. Failure to obey the order constitutes
contempt of court.
Sec. 34. NRS 639.247 is hereby amended to read as follows:
639.247 1. Any hearing held for the purpose of suspending or
revoking any certificate, certification, license or permit must be
conducted publicly by the Board. The hearing must be presided over
by a member of the Board or his designee and three members
constitute a quorum. Any decision by the Board requires the
concurrence of at least three members. The proceedings of the
hearing must be reported or recorded by an electronic recording
device, an official court reporter or another qualified person.
2. The member of the Board or his designee presiding at the
hearing or the Executive Secretary of the Board may administer
oaths or affirmations. Continuances and adjournments may be
ordered, or may be granted, by the member or his designee
presiding, for cause shown and by orally notifying those persons
present of the time and place at which the hearing will be continued.
Sec. 35. NRS 639.252 is hereby amended to read as follows:
639.252 1. If the respondent wishes to contest or appeal the
decision of the Board, the order or any part thereof, he may, [prior
to] not later than 10 days after the time the order becomes
effective, apply in writing to the Board for a rehearing. [Such
application shall] The application must set forth with particularity
the part or parts of the decision or order to which the respondent
objects and the basis of the objection.
2. The Executive Secretary of the Board shall, within 10 days
after receipt of a written application for rehearing, notify the
respondent and his attorney of record in writing, by registered or
certified mail, of [its] his action, either granting or denying [such]
the application. If the application is granted, the notice [shall] must
contain the date, time and place of the rehearing . [, which date shall
not be less than 30 days after the date of the notice.] The rehearing
must be held at the next regularly scheduled meeting of the Board.
Granting of the application by the [Board shall serve] Executive
Secretary does not serve as an automatic stay of execution of the
order pending conclusion of the rehearing.
Sec. 36. NRS 639.2555 is hereby amended to read as follows:
639.2555 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 certificate of
registration as a pharmacist, [an] intern pharmacist [or supportive
personnel] , pharmaceutical technician or pharmaceutical
technician in training or a license issued pursuant to NRS 639.223,
the Board shall deem the certificate of registration or 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 certificate of registration or license
by the district attorney or other public agency pursuant to NRS
425.550 stating that the holder of the certificate of registration or
license has complied with the subpoena or warrant or has satisfied
the arrearage pursuant to NRS 425.560.
2. The Board shall reinstate a certificate of registration as a
pharmacist, [an] intern pharmacist [or supportive personnel] ,
pharmaceutical technician or pharmaceutical technician in
training or a license issued pursuant to NRS 639.233 that has been
suspended by a district court pursuant to NRS 425.540 if the Board
receives a letter issued by the district attorney or other public agency
pursuant to NRS 425.550 to the person whose certificate of
registration or license was suspended stating that the person whose
certificate of registration or license was suspended has complied
with the subpoena or warrant or has satisfied the arrearage pursuant
to NRS 425.560.
Sec. 37. NRS 639.256 is hereby amended to read as follows:
639.256 A certificate, license or permit which has been
suspended for a specified period of time [shall] must automatically
be restored to good standing on the first day following the period of
suspension. The Executive Secretary[,] of the Board, when
notifying the respondent of the penalty imposed by the Board, shall
inform the respondent of the date on which the certificate, license or
permit will be so restored.
Secs. 38 and 39. (Deleted by amendment.)
Sec. 40. NRS 453.1545 is hereby amended to read as follows:
453.1545 1. The Board and the Division shall cooperatively
develop a computerized program to track each prescription for a
controlled substance listed in schedule II, III or IV that is filled by a
pharmacy that is registered with the Board[.] or that is dispensed by
a practitioner who is registered with the Board. The program must:
(a) Be designed to provide information regarding:
(1) The inappropriate use by a patient of controlled
substances listed in schedules II, III and IV to pharmacies,
practitioners and appropriate state agencies to prevent the improper
or illegal use of those controlled substances; and
(2) Statistical data relating to the use of those controlled
substances that is not specific to a particular patient.
(b) Be administered by the Board, the Division, the Health
Division of the Department of Human Resources and various
practitioners, representatives of professional associations for
practitioners, representatives of occupational licensing boards and
prosecuting attorneys selected by the Board and the Division.
(c) Not infringe on the legal use of a controlled substance for the
management of severe or intractable pain.
2. The Board and the Division must have access to the program
established pursuant to subsection 1 to identify any suspected
fraudulent or illegal activity related to the dispensing of controlled
substances.
3. The Board or the Division shall report any activity it
reasonably suspects may be fraudulent or illegal to the appropriate
law enforcement agency or occupational licensing board and
provide the law enforcement agency or occupational licensing board
with the relevant information obtained from the program for further
investigation.
4. Information obtained from the program relating to a
practitioner or a patient is confidential and, except as otherwise
provided by this section, must not be disclosed to any person. That
information must be disclosed:
(a) Upon the request of a person about whom the information
requested concerns or upon the request on his behalf by his attorney;
or
(b) Upon the lawful order of a court of competent jurisdiction.
5. The Board and the Division may apply for any available
grants and accept any gifts, grants or donations to assist in
developing and maintaining the program required by this section.
Sec. 40.5. NRS 453.375 is hereby amended to read as follows:
453.375 A controlled substance may be possessed and
administered by the following persons:
1. A practitioner.
2. A registered nurse licensed to practice professional nursing
or licensed practical nurse, at the direction of a physician, physician
assistant, dentist, podiatric physician or advanced practitioner of
nursing, or pursuant to a chart order, for administration to a patient
at another location.
3. An advanced emergency medical technician:
(a) As authorized by regulation of:
(1) The State Board of Health in a county whose population
is less than 100,000; or
(2) A county or district board of health in a county whose
population is 100,000 or more; and
(b) 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
439.370 in any county.
4. A respiratory therapist,at the direction of a physician or
physician assistant.
5. A medical student, student in training to become a physician
assistant or student nurse in the course of his studies at an approved
college of medicine or school of professional or practical nursing, at
the direction of a physician or physician assistant and:
(a) In the presence of a physician, physician assistant or a
registered nurse; or
(b) Under the supervision of a physician, physician assistant or a
registered nurse if the student is authorized by the college or school
to administer the substance outside the presence of a physician,
physician assistant or nurse.
A medical student or student nurse may administer a controlled
substance 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.
6. An ultimate user or any person whom the ultimate user
designates pursuant to a written agreement.
7. Any person designated by the head of a correctional
institution.
8. A veterinary technician at the direction of his supervising
veterinarian.
9. 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.
10. In accordance with applicable regulations of the State
Board of Pharmacy, an animal control officer, a wildlife biologist or
an employee designated by a federal, state or local governmental
agency whose duties include the control of domestic, wild and
predatory animals.
11. A person who is enrolled in a training program to become
an advanced emergency medical technician, respiratory therapist
or veterinary technician if the person possesses and administers
the controlled substance in the same manner and under the same
conditions that apply, respectively, to an advanced emergency
medical technician, respiratory therapist or veterinary technician
who may possess and administer the controlled substance, and
under the direct supervision of a person licensed or registered to
perform the respective medical art or a supervisor of such a
person.
Sec. 41. NRS 453.431 is hereby amended to read as follows:
453.431 1. A pharmacist shall not knowingly fill or refill any
prescription for a controlled substance for use by a person other than
the person for whom the prescription was originally issued.
2. A person shall not furnish a false name or address while
attempting to obtain a controlled substance or a prescription for a
controlled substance. A person prescribing, administering or
dispensing a controlled substance may request proper identification
from a person requesting controlled substances.
3. A pharmacist shall not fill a prescription for a controlled
substance if the prescription shows evidence of alteration, erasure or
addition, unless he obtains approval of the practitioner who issued
the prescription.
4. A pharmacist shall not fill a prescription for a controlled
substance classified in schedule II unless it is tendered on or before
the 14th day after the date of issue. This subsection does not
prohibit a practitioner from issuing a prescription on which he
indicates that the prescription may not be filled until the date
indicated on the prescription, which must not be later than 6
months after the date the prescription is issued.
5. A person who violates this section is guilty of a category C
felony and shall be punished as provided in NRS 193.130.
Sec. 41.5. NRS 454.213 is hereby amended to read as follows:
454.213 A drug or medicine referred to in NRS 454.181 to
454.371, inclusive, may be possessed and administered by:
1. A practitioner.
2. A physician assistant at the direction of his supervising
physician or a licensed dental hygienist acting in the office of and
under the supervision of a dentist.
3. Except as otherwise provided in subsection 4, a registered
nurse licensed to practice professional nursing or licensed practical
nurse, at the direction of a prescribing physician, physician assistant,
dentist, podiatric physician or advanced practitioner of nursing, or
pursuant to a chart order, for administration to a patient at another
location.
4. In accordance with applicable regulations of the Board, a
registered nurse licensed to practice professional nursing or licensed
practical nurse who is:
(a) 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
(b) Acting under the direction of the medical director of that
agency or facility who works in this state.
5. An intermediate emergency medical technician or an
advanced emergency medical technician, as authorized by
regulation of the State Board of Pharmacy and in accordance with
any applicable regulations of:
(a) The State Board of Health in a county whose population is
less than 100,000;
(b) A county board of health in a county whose population is
100,000 or more; or
(c) A district board of health created pursuant to NRS 439.370
in any county.
6. A respiratory therapist employed in a health care facility.
The therapist may possess and administer respiratory products only
at the direction of a physician.
7. 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.
8. A medical student or student nurse in the course of his
studies at an approved college of medicine or school of professional
or practical nursing, at the direction of a physician and:
(a) In the presence of a physician or a registered nurse; or
(b) 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.
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.
9. Any person designated by the head of a correctional
institution.
10. An ultimate user or any person designated by the ultimate
user pursuant to a written agreement.
11. A nuclear medicine technologist, at the direction of a
physician and in accordance with any conditions established by
regulation of the Board.
12. A radiologic technologist, at the direction of a physician
and in accordance with any conditions established by regulation of
the Board.
13. A chiropractic physician, but only if the drug or medicine
is a topical drug used for cooling and stretching external tissue
during therapeutic treatments.
14. A physical therapist, but only if the drug or medicine is a
topical drug which is:
(a) Used for cooling and stretching external tissue during
therapeutic treatments; and
(b) Prescribed by a licensed physician for:
(1) Iontophoresis; or
(2) The transmission of drugs through the skin using
ultrasound.
15. 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.
16. A veterinary technician at the direction of his supervising
veterinarian.
17. In accordance with applicable regulations of the Board, a
registered pharmacist who:
(a) Is trained in and certified to carry out standards and practices
for immunization programs;
(b) Is authorized to administer immunizations pursuant to
written protocols from a physician; and
(c) Administers immunizations in compliance with the
“Standards of Immunization Practices” recommended and approved
by the United States Public Health Service Advisory Committee on
Immunization Practices.
18. A person who is enrolled in a training program to become
a physician assistant, dental hygienist, intermediate emergency
medical technician, advanced emergency medical technician,
respiratory therapist, dialysis technician, nuclear medicine
technologist, radiologic technologist, physical therapist or
veterinary technician 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, dental
hygienist, intermediate emergency medical technician, advanced
emergency medical technician, respiratory therapist, dialysis
technician, nuclear medicine technologist, radiologic technologist,
physical therapist or veterinary technician 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.
Sec. 42. NRS 689A.04045 is hereby amended to read as
follows:
689A.04045 1. Except as otherwise provided in this section,
a policy of health insurance which provides coverage for
prescription drugs must not limit or exclude coverage for a drug if
the drug:
(a) Had previously been approved for coverage by the insurer
for a medical condition of an insured and the insured’s provider of
health care determines, after conducting a reasonable investigation,
that none of the drugs which are otherwise currently approved for
coverage are medically appropriate for the insured; and
(b) Is appropriately prescribed and considered safe and effective
for treating the medical condition of the insured.
2. The provisions of subsection 1 do not:
(a) Apply to coverage for any drug that is prescribed for a use
that is different from the use for which that drug has been approved
for marketing by the Food and Drug Administration;
(b) Prohibit:
(1) The insurer from charging a deductible, copayment or
coinsurance for the provision of benefits for prescription drugs to
the insured or from establishing, by contract, limitations on the
maximum coverage for prescription drugs;
(2) A provider of health care from prescribing another drug
covered by the policy that is medically appropriate for the insured;
or
(3) The substitution of another drug pursuant to NRS
639.23286 or 639.2583 to [639.2599,] 639.2597, inclusive; or
(c) Require any coverage for a drug after the term of the policy.
3. Any provision of a policy subject to the provisions of this
chapter that is delivered, issued for delivery or renewed on or after
October 1, 2001, which is in conflict with this section is void.
Sec. 43. NRS 689B.0368 is hereby amended to read as
follows:
689B.0368 1. Except as otherwise provided in this section, a
policy of group health insurance which provides coverage for
prescription drugs must not limit or exclude coverage for a drug if
the drug:
(a) Had previously been approved for coverage by the insurer
for a medical condition of an insured and the insured’s provider of
health care determines, after conducting a reasonable investigation,
that none of the drugs which are otherwise currently approved for
coverage are medically appropriate for the insured; and
(b) Is appropriately prescribed and considered safe and effective
for treating the medical condition of the insured.
2. The provisions of subsection 1 do not:
(a) Apply to coverage for any drug that is prescribed for a use
that is different from the use for which that drug has been approved
for marketing by the Food and Drug Administration;
(b) Prohibit:
(1) The insurer from charging a deductible, copayment or
coinsurance for the provision of benefits for prescription drugs to
the insured or from establishing, by contract, limitations on the
maximum coverage for prescription drugs;
(2) A provider of health care from prescribing another drug
covered by the policy that is medically appropriate for the insured;
or
(3) The substitution of another drug pursuant to NRS
639.23286 or 639.2583 to [639.2599,] 639.2597, inclusive; or
(c) Require any coverage for a drug after the term of the policy.
3. Any provision of a policy subject to the provisions of this
chapter that is delivered, issued for delivery or renewed on or after
October 1, 2001, which is in conflict with this section is void.
Sec. 44. NRS 689C.168 is hereby amended to read as follows:
689C.168 1. Except as otherwise provided in this section, a
health benefit plan which provides coverage for prescription drugs
must not limit or exclude coverage for a drug if the drug:
(a) Had previously been approved for coverage by the carrier for
a medical condition of an insured and the insured’s provider of
health care determines, after conducting a reasonable investigation,
that none of the drugs which are otherwise currently approved for
coverage are medically appropriate for the insured; and
(b) Is appropriately prescribed and considered safe and effective
for treating the medical condition of the insured.
2. The provisions of subsection 1 do not:
(a) Apply to coverage for any drug that is prescribed for a use
that is different from the use for which that drug has been approved
for marketing by the Food and Drug Administration;
(b) Prohibit:
(1) The carrier from charging a deductible, copayment or
coinsurance for the provision of benefits for prescription drugs to
the insured or from establishing, by contract, limitations on the
maximum coverage for prescription drugs;
(2) A provider of health care from prescribing another drug
covered by the plan that is medically appropriate for the insured; or
(3) The substitution of another drug pursuant to NRS
639.23286 or 639.2583 to [639.2599,] 639.2597, inclusive; or
(c) Require any coverage for a drug after the term of the plan.
3. Any provision of a health benefit plan subject to the
provisions of this chapter that is delivered, issued for delivery or
renewed on or after October 1, 2001, which is in conflict with this
section is void.
Sec. 45. NRS 695A.184 is hereby amended to read as follows:
695A.184 1. Except as otherwise provided in this section, a
benefit contract which provides coverage for prescription drugs
must not limit or exclude coverage for a drug if the drug:
(a) Had previously been approved for coverage by the society
for a medical condition of an insured and the insured’s provider of
health care determines, after conducting a reasonable investigation,
that none of the drugs which are otherwise currently approved for
coverage are medically appropriate for the insured; and
(b) Is appropriately prescribed and considered safe and effective
for treating the medical condition of the insured.
2. The provisions of subsection 1 do not:
(a) Apply to coverage for any drug that is prescribed for a use
that is different from the use for which that drug has been approved
for marketing by the Food and Drug Administration;
(b) Prohibit:
(1) The society from charging a deductible, copayment or
coinsurance for the provision of benefits for prescription drugs to
the insured or from establishing, by contract, limitations on the
maximum coverage for prescription drugs;
(2) A provider of health care from prescribing another drug
covered by the benefit contract that is medically appropriate for the
insured; or
(3) The substitution of another drug pursuant to NRS
639.23286 or 639.2583 to [639.2599,] 639.2597, inclusive; or
(c) Require any coverage for a drug after the term of the benefit
contract.
3. Any provision of a benefit contract subject to the provisions
of this chapter that is delivered, issued for delivery or renewed on or
after October 1, 2001, which is in conflict with this section is void.
Sec. 46. NRS 695B.1905 is hereby amended to read as
follows:
695B.1905 1. Except as otherwise provided in this section, a
contract for hospital or medical services which provides coverage
for prescription drugs must not limit or exclude coverage for a drug
if the drug:
(a) Had previously been approved for coverage by the insurer
for a medical condition of an insured and the insured’s provider of
health care determines, after conducting a reasonable investigation,
that none of the drugs which are otherwise currently approved for
coverage are medically appropriate for the insured; and
(b) Is appropriately prescribed and considered safe and effective
for treating the medical condition of the insured.
2. The provisions of subsection 1 do not:
(a) Apply to coverage for any drug that is prescribed for a use
that is different from the use for which that drug has been approved
for marketing by the Food and Drug Administration;
(b) Prohibit:
(1) The insurer from charging a deductible, copayment or
coinsurance for the provision of benefits for prescription drugs to
the insured or from establishing, by contract, limitations on the
maximum coverage for prescription drugs;
(2) A provider of health care from prescribing another drug
covered by the contract that is medically appropriate for the insured;
or
(3) The substitution of another drug pursuant to NRS
639.23286 or 639.2583 to [639.2599,] 639.2597, inclusive; or
(c) Require any coverage for a drug after the term of the
contract.
3. Any provision of a contract for hospital or medical services
subject to the provisions of this chapter that is delivered, issued for
delivery or renewed on or after October 1, 2001, which is in conflict
with this section is void.
Sec. 47. NRS 695C.1734 is hereby amended to read as
follows:
695C.1734 1. Except as otherwise provided in this section,
evidence of coverage which provides coverage for prescription
drugs must not limit or exclude coverage for a drug if the drug:
(a) Had previously been approved for coverage by the health
maintenance organization or insurer for a medical condition of an
enrollee and the enrollee’s provider of health care determines, after
conducting a reasonable investigation, that none of the drugs which
are otherwise currently approved for coverage are medically
appropriate for the enrollee; and
(b) Is appropriately prescribed and considered safe and effective
for treating the medical condition of the enrollee.
2. The provisions of subsection 1 do not:
(a) Apply to coverage for any drug that is prescribed for a use
that is different from the use for which that drug has been approved
for marketing by the Food and Drug Administration;
(b) Prohibit:
(1) The health maintenance organization or insurer from
charging a deductible, copayment or coinsurance for the provision
of benefits for prescription drugs to the enrollee or from
establishing, by contract, limitations on the maximum coverage for
prescription drugs;
(2) A provider of health care from prescribing another drug
covered by the evidence of coverage that is medically appropriate
for the enrollee; or
(3) The substitution of another drug pursuant to NRS
639.23286 or 639.2583 to [639.2599,] 639.2597, inclusive; or
(c) Require any coverage for a drug after the term of the
evidence of coverage.
3. Any provision of an evidence of coverage subject to the
provisions of this chapter that is delivered, issued for delivery or
renewed on or after October 1, 2001, which is in conflict with this
section is void.
Sec. 48. NRS 695F.156 is hereby amended to read as follows:
695F.156 1. Except as otherwise provided in this section,
evidence of coverage which provides coverage for prescription
drugs must not limit or exclude coverage for a drug if the drug:
(a) Had previously been approved for coverage by the prepaid
limited health service organization for a medical condition of an
enrollee and the enrollee’s provider of health care determines, after
conducting a reasonable investigation, that none of the drugs which
are otherwise currently approved for coverage are medically
appropriate for the enrollee; and
(b) Is appropriately prescribed and considered safe and effective
for treating the medical condition of the enrollee.
2. The provisions of subsection 1 do not:
(a) Apply to coverage for any drug that is prescribed for a use
that is different from the use for which that drug has been approved
for marketing by the Food and Drug Administration;
(b) Prohibit:
(1) The organization from charging a deductible, copayment
or coinsurance for the provision of benefits for prescription drugs to
the enrollee or from establishing, by contract, limitations on the
maximum coverage for prescription drugs;
(2) A provider of health care from prescribing another drug
covered by the evidence of coverage that is medically appropriate
for the enrollee; or
(3) The substitution of another drug pursuant to NRS
639.23286 or 639.2583 to [639.2599,] 639.2597, inclusive; or
(c) Require any coverage for a drug after the term of the
evidence of coverage.
3. Any provision of an evidence of coverage subject to the
provisions of this chapter that is delivered, issued for delivery or
renewed on or after October 1, 2001, which is in conflict with this
section is void.
Sec. 49. NRS 695G.166 is hereby amended to read as follows:
695G.166 1. Except as otherwise provided in this section, a
health care plan which provides coverage for prescription drugs
must not limit or exclude coverage for a drug if the drug:
(a) Had previously been approved for coverage by the managed
care organization for a medical condition of an insured and the
insured’s provider of health care determines, after conducting a
reasonable investigation, that none of the drugs which are otherwise
currently approved for coverage are medically appropriate for the
insured; and
(b) Is appropriately prescribed and considered safe and effective
for treating the medical condition of the insured.
2. The provisions of subsection 1 do not:
(a) Apply to coverage for any drug that is prescribed for a use
that is different from the use for which that drug has been approved
for marketing by the Food and Drug Administration;
(b) Prohibit:
(1) The organization from charging a deductible, copayment
or coinsurance for the provision of benefits for prescription drugs to
the insured or from establishing, by contract, limitations on the
maximum coverage for prescription drugs;
(2) A provider of health care from prescribing another drug
covered by the plan that is medically appropriate for the insured; or
(3) The substitution of another drug pursuant to NRS
639.23286 or 639.2583 to [639.2599,] 639.2597, inclusive; or
(c) Require any coverage for a drug after the term of the plan.
3. Any provision of a health care plan subject to the provisions
of this chapter that is delivered, issued for delivery or renewed on or
after October 1, 2001, which is in conflict with this section is void.
Sec. 50. NRS 639.0152, 639.133, 639.205, 639.2323 and
639.2599 are hereby repealed.
20~~~~~03