Amendment Box: Resolves conflicts with A.B. No. 320, S.B. No. 122, S.B. No. 133, S.B. No. 139, S.B. No. 281 and S.B. No. 332. Makes substantive changes.
Resolves Conflicts with: AB320, SB122, SB133, SB139, SB281, SB332
Adoption of this amendment will MAINTAIN a 2/3s majority vote requirement for final passage of SB250 R1 (§§ 39, 70).
ASSEMBLY ACTION Initial and Date |SENATE ACTION Initial and Date
Adopted Lost | Adopted Lost
Concurred In Not
|Concurred In Not
Receded Not | Receded Not
Amend sec. 29, page 14, by deleting lines 38 through 43 and inserting:
“at the pleasure of the Board.”.
Amend sec. 30, page 15, by deleting line 4 and inserting “2. Each”.
Amend the bill as a whole by deleting sections 32 and 33 and adding:
“Secs. 32 and 33. (Deleted by amendment.)”.
Amend sec. 35, page 17, line 32, after “applicant” by inserting:
“for a license to practice medicine”.
Amend sec. 37, page 18, by deleting lines 5 through 9 and inserting:
“Sec. 37. 1. Each person who holds a license issued pursuant to this chapter and who accepts the privilege of practicing medicine or respiratory care within this state pursuant to the provisions of the license shall be deemed to have given his consent to the revocation of the license at any time by the Board in accordance with the provisions of this section.
2. The Board shall not revoke a license issued pursuant to this chapter unless the Board, by a majority vote of its entire membership, finds by clear and convincing evidence that the licensee committed a material violation of:
(a) Any provision of NRS 630.161 or 630.301 to 630.3067, inclusive; or
(b) Any condition, restriction or limitation imposed on the license.”.
Amend sec. 41, page 19, by deleting lines 4 through 6 and inserting:
“Board by law, the Legislative Commission shall issue to the Federation of State Medical Boards of the United States, Inc., a request for proposal to conduct regular performance audits of the Board. After considering the response to the request for proposal, if the Legislative Commission finds that the Federation of State Medical Boards of the United States, Inc., has the ability to conduct fair and impartial performance audits of the Board, the Legislative Commission shall engage the services of the Federation of State Medical Boards of the United States, Inc., to conduct regular performance audits of the Board. If the Legislative Commission finds that the Federation of State Medical Boards of the United States, Inc., does not have the ability to conduct fair and impartial performance audits of the Board or is otherwise unable to conduct such performance audits, the Legislative Commission shall direct the Audit Division of the Legislative Counsel Bureau to conduct regular performance audits of the Board.”.
Amend sec. 41, page 19, by deleting lines 41 through 45.
Amend sec. 41, page 20, line 1, by deleting “8.” and inserting “7.”.
Amend sec. 47, page 22, line 17, by deleting “1.”.
Amend sec. 47, page 22, line 20, by deleting “2. [Employ” and inserting “[2. Employ”.
Amend sec. 47, page 22, by deleting lines 22 through 24 and inserting:
“discharge of its duties.]”.
Amend the bill as a whole by deleting sections 49 and 50 and adding:
“Secs. 49 and 50. (Deleted by amendment.)”.
Amend sec. 51, page 26, by deleting lines 11 through 17 and inserting:
“[3. Every physician who is licensed pursuant to subsection 1 and who accepts the privilege of practicing medicine in this state pursuant to the provisions of the license shall be deemed to have given his consent to the revocation of the license at any time by the Board for any of the grounds provided in NRS 630.161 or 630.301 to 630.3065, inclusive.]”.
Amend sec. 59, page 32, by deleting lines 7 through 9 and inserting:
“ 7. Uses the title “M.D.”:
(a) Without having been awarded such a degree; or
(b) When not authorized by a specific statute,]”.
Amend the bill as a whole by deleting sec. 73 and adding:
“Sec. 73. (Deleted by amendment.)”.
Amend sec. 75, page 38, line 26, by deleting:
“section 73 of this act,” and inserting “NRS 633.611,”.
Amend the bill as a whole by adding a new section designated sec. 77.5, following sec. 77, to read as follows:
“Sec. 77.5. NRS 633.611 is hereby amended to read as follows:
633.611 [All proceedings subsequent to the filing of]
1. Except as otherwise provided in this section, a complaint filed with the Board, all documents and other information filed with the complaint and all documents and other information compiled as a result of the investigation conducted to determine whether to initiate disciplinary action are confidential . [, except to the extent necessary for the conduct of an examination, until]
2. The complaint or other document filed by the Board [determines to proceed with] to initiate disciplinary action [. If]and all documents and information considered by the Board [dismisses the complaint, the proceedings remain confidential. If the Board proceeds with disciplinary action, confidentiality concerning the proceedings is no longer required.] when determining whether to impose discipline are public records.
3. The Board may disseminate all documents and other information filed with the complaint and all documents and other information compiled as a result of an investigation to any other licensing board, national association of registered boards, an agency of the Federal Government or of the State, the Attorney General or any law enforcement agency, regardless of whether the Board initiates disciplinary action as a result of the complaint or investigation.”.
Amend sec. 163, page 84, after line 45, by inserting:
“3. The requirements set forth in this section are in addition to the requirements set forth in section 12 of Senate Bill No. 122 of this session.”.
Amend the bill as a whole by deleting sections 166 through 175 and adding:
“Secs. 166-175. (Deleted by amendment.)”.
Amend the bill as a whole by deleting sections 178 through 180 and the leadlines of repealed sections and adding new sections designated sections 178 through 184 and the leadlines of repealed sections of NRS and the text of repealed sections of enrolled bills, following sec. 177, to read as follows:
“Sec. 178. Section 2 of Senate Bill No. 122 of this session is hereby amended to read as follows:
Sec. 2. NRS 686B.070 is hereby amended to read as follows:
686B.070 1. Every authorized insurer and every rate service organization licensed under NRS [686B.130] 686B.140 which has been designated by any insurer for the filing of rates under subsection 2 of NRS 686B.090 shall file with the Commissioner all:
(a) Rates and proposed increases thereto;
(b) Forms of policies to which the rates apply;
(c) Supplementary rate information; and
(d) Changes and amendments thereof,
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made by it for use in this state.
2. Except as otherwise provided in this section and NRS 686B.110, if a proposed increase or decrease in the rate of any kind or line of insurance does not change by more than 7 percent the total average premium required to be paid by persons insured by the insurer for that particular line or kind of insurance during the 12 months immediately preceding the proposed increase or decrease, the insurer shall file the information required by subsection 1 and the supporting data required to be filed pursuant to NRS 686B.100 on or before the date on which the changes are to become effective. The provisions of this subsection do not apply if the Commissioner has determined that the market is not competitive or if the Commissioner has made any of the other determinations described in subsection 1 of NRS 686B.110.
3. In a competitive market, if the Commissioner determines that the rates of an insurer require closer supervision by the Commissioner because of the financial condition of the insurer or because the insurer has engaged in rating practices which are unfairly discriminatory, the Commissioner may require the insurer to file the information required by subsection 1 and the supporting data required to be filed pursuant to NRS 686B.100 at least 60 days before the rates become effective or may subject the rates to review pursuant to NRS 686B.110.
4. The Commissioner shall review filings made pursuant to this section as soon as practicable to:
(a) Ensure the sufficiency of the financial condition of the insurer; [and]
(b) Determine whether the insurer has engaged in rating practices which are unfairly discriminatory [.] ; and
(c) If applicable, determine whether the insurer has complied with the provisions of subsection 5.
5. If an insurer makes a filing that increases a rate for insurance covering the liability of a practitioner licensed pursuant to chapter 630, 631, 632 or 633 of NRS for a breach of his professional duty toward a patient, the insurer shall not include in the filing any component that is directly or indirectly related to the following:
(a) Capital losses, diminished cash flow from any dividends, interest or other investment returns, or any other financial loss that is materially outside of the claims experience of the professional liability insurance industry, as determined by the Commissioner.
(b) Losses that are the result of any criminal or fraudulent activities of a director, officer or employee of the insurer.
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If the Commissioner
determines that a filing includes any such component, the Commissioner shall
disapprove the increase, in whole or in part, to the extent that the increase
relies upon such a component.
6. Rates for title insurance and individual health insurance must be approved by the Commissioner pursuant to NRS 686B.110 before the insurer may use the rates.
Sec. 179. Section 4 of Senate Bill No. 122 of this session is hereby amended to read as follows:
Sec. 4. NRS 686B.110 is hereby amended to read as follows:
686B.110 1. If the Commissioner has determined that:
(a) The market is not competitive;
(b) Pursuant to NRS 686B.180, essential insurance coverage is not readily available in a voluntary market;
(c) Pursuant to NRS 686B.070, the rates of the insurer require closer supervision and that the rates are subject to review pursuant to this section;
(d) A proposed increase or decrease in the rate of any kind or line of insurance changes by more than 7 percent the total average premium required to be paid by persons insured by the insurer for that particular line or kind of insurance during the 12 months immediately preceding the proposed increase or decrease; or
(e) The rate is for title insurance or individual health insurance,
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the Commissioner shall consider each proposed increase or
decrease in the rate of any kind or line of insurance or subdivision thereof
filed with him pursuant to NRS 686B.070. If the Commissioner finds that a
proposed increase will result in a rate which is not in compliance with NRS
686B.050 [,] or
subsection 5 of NRS 686B.070, he shall disapprove the proposal.
The Commissioner shall approve or disapprove each proposal not later than 60
days after it is determined by him to be complete pursuant to subsection 4. If
the Commissioner fails to approve or disapprove the proposal within that
period, the proposal shall be deemed approved.
2. Whenever an insurer has no legally effective rates as a result of the Commissioner’s disapproval of rates or other act, the Commissioner shall, on request, specify interim rates for the insurer that are high enough to protect the interests of all parties and may order that a specified portion of the premiums be placed in an escrow account approved by him. When new rates become legally effective, the Commissioner shall order the escrowed money or any overcharge in the interim rates to be distributed appropriately, except that refunds to policyholders that are de minimis must not be required.
3. If the Commissioner disapproves a proposed rate and an insurer requests a hearing to determine the validity of his action, the insurer has the burden of showing compliance with the applicable standards for rates established in NRS 686B.010 to 686B.1799, inclusive. Any such hearing must be held:
(a) Within 30 days after the request for a hearing has been submitted to the Commissioner; or
(b) Within a period agreed upon by the insurer and the Commissioner.
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If the hearing is not held within the period specified in
paragraph (a) or (b), or if the Commissioner fails to issue an order concerning
the proposed rate for which the hearing is held within 45 days after the
hearing, the proposed rate shall be deemed approved.
4. The Commissioner shall by regulation specify the documents or any other information which must be included in a proposal to increase or decrease a rate submitted to him pursuant to NRS 686B.070. Each such proposal shall be deemed complete upon its filing with the Commissioner, unless the Commissioner, within 15 business days after the proposal is filed with him, determines that the proposal is incomplete because the proposal does not comply with the regulations adopted by him pursuant to this subsection.
5. If the Commissioner finds that a rate no longer meets the requirements of this chapter, the Commissioner may order the discontinuance of the rate. An order for the discontinuance of a rate may be issued only after a hearing with at least 10 days’ notice for all insurers and rate organizations that would be affected by such an order. The order must be in writing and include, without limitation:
(a) The grounds pursuant to which the order was issued;
(b) The date on which the order to discontinue the rate becomes effective; and
(c) The date, within a reasonable time after the date on which the order becomes effective, on which the order will expire.
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An order for the discontinuance of a rate does not affect any
contract or policy made or issued before the date on which the order becomes
effective.
Sec. 180. Section 1 of Senate Bill No. 133 of this session is hereby amended to read as follows:
Section 1. Chapter 630 of NRS is hereby amended by adding thereto a new section to read as follows:
1. Except as otherwise provided in NRS 630.161, the Board may issue a restricted license to a person who intends to practice medicine in this state as a psychiatrist in a mental health center of the Division under the direct supervision of a psychiatrist who holds an unrestricted license to practice medicine pursuant to this chapter.
2. A person who applies for a restricted license pursuant to this section is not required to take or pass a written examination as to his qualifications to practice medicine pursuant to paragraph (e) of subsection 2 of NRS 630.160, but the person must meet all other conditions and requirements for an unrestricted license to practice medicine pursuant to this chapter.
3. If the Board issues a restricted license pursuant to this section, the person who holds the restricted license may practice medicine in this state only as a psychiatrist in a mental health center of the Division and only under the direct supervision of a psychiatrist who holds an unrestricted license to practice medicine pursuant to this chapter.
4. If a person who holds a restricted license issued pursuant to this section ceases to practice medicine in this state as a psychiatrist in a mental health center of the Division:
(a) The Division shall notify the Board; and
(b) Upon receipt of such notification, the restricted license expires automatically.
5. The Board may renew or modify a restricted license issued pursuant to this section, unless the restricted license has expired automatically or has been revoked.
6. [Each person who holds a restricted license issued pursuant to this section and who accepts the privilege of practicing medicine in this state pursuant to the provisions of the restricted license shall be deemed to have given his consent to the revocation of the restricted license at any time by the Board for any of the grounds provided in NRS 630.161 or 630.301 to 630.3065, inclusive, or for any violation of the provisions of this section.
7.] The provisions of this section do not limit the authority of the Board to issue a restricted license to an applicant in accordance with any other provision of this chapter.
[8.] 7. As used in this section:
(a) “Division” means the Division of Mental Health and Developmental Services of the Department of Human Resources.
(b) “Mental health center” has the meaning ascribed to it in NRS 433.144.
Sec. 181. Section 9 of Senate Bill No. 139 of this session is hereby amended to read as follows:
Sec. 9. NRS 645.630 is hereby amended to read as follows:
645.630 1. The Commission may require a licensee, property manager or owner-developer to pay an administrative fine of not more than $5,000 for each violation he commits or suspend, revoke, deny the renewal of or place conditions upon his license, permit or registration, or impose any combination of those actions, at any time if the licensee, property-manager or owner-developer has, by false or fraudulent representation, obtained a license, permit or registration, or the licensee, property manager or owner-developer, whether or not acting as such, is found guilty of:
(a) Making any material misrepresentation.
(b) Making any false promises of a character likely to influence, persuade or induce.
(c) Accepting a commission or valuable consideration as a real estate broker-salesman or salesman for the performance of any of the acts specified in this chapter or chapter 119 or 119A of NRS from any person except the licensed real estate broker with whom he is associated or the owner-developer by whom he is employed.
(d) Representing or attempting to represent a real estate broker other than the broker with whom he is associated, without the express knowledge and consent of the broker with whom he is associated.
(e) Failing to maintain, for review and audit by the Division, each brokerage agreement and property management agreement governed by the provisions of this chapter and entered into by the licensee.
(f) Failing, within a reasonable time, to account for or to remit any money which comes into his possession and which belongs to others.
(g) If he is required to maintain a trust account:
(1) Failing to balance the trust account at least monthly; and
(2) Failing to submit to the Division an annual accounting of the trust account as required in NRS 645.310.
(h) Commingling the money or other property of his clients with his own or converting the money of others to his own use.
(i) In the case of a broker-salesman or salesman, failing to place in the custody of his licensed broker or owner-developer, as soon as possible, any deposit or other money or consideration entrusted to him by any person dealing with him as the representative of his licensed broker.
(j) Accepting other than cash as earnest money unless that fact is communicated to the owner before his acceptance of the offer to purchase and that fact is shown in the receipt for the earnest money.
(k) Upon acceptance of an agreement, in the case of a broker, failing to deposit any check or cash received as earnest money before the end of the next banking day unless otherwise provided in the purchase agreement.
(l) Inducing any party to a brokerage agreement, property management agreement, agreement of sale or lease to break it in order to substitute a new brokerage agreement, property management agreement, agreement of sale or lease with the same or another party if the inducement to make the substitution is offered to secure personal gain to the licensee or owner-developer.
2. An order that imposes discipline and the findings of fact and conclusions of law supporting that order are public records.
Sec. 182. Section 7 of Senate Bill No. 332 of this session is hereby amended to read as follows:
Sec. 7. 1. The Board shall maintain a website on the Internet or its successor.
2. Except as otherwise provided in this section, the Board and its members and employees shall not place any information on the website maintained by the Board unless the Board, at a regular meeting, approves the placement of the information on the website.
3. The Board shall place on the website [:] , without having to approve the placement at a meeting:
(a) Each application form for the issuance or renewal of a license issued by the Board pursuant to this chapter . [; and]
(b) A list of questions that are frequently asked concerning the processes of the Board and the answers to those questions.
(c) An alphabetical list, by last name, of each physician and a brief description of each disciplinary action, if any, taken against the physician, in this state and elsewhere, which relates to the practice of medicine and which is noted in the records of the Board. The Board shall include, as part of the list on the website, the name of each physician whose license has been revoked by the Board. The Board shall make the list on the website easily accessible and user friendly for the public.
(d) All financial reports received by the Board.
(e) All financial reports prepared by the Board.
(f) Any other information required to be placed on the website by any other provision of law.
Sec. 183. 1. NRS 622.010, 623A.295, 630.142, 634.165, 638.154, 639.091 and 656.295 are hereby repealed.
2. Sections 8, 8.3 and 8.7 of Assembly Bill No. 320 of this session are hereby repealed.
3. Section 4 of Senate Bill No. 281 of this session is hereby repealed.
Sec. 184. 1. This section becomes effective on passage and approval.
2. Sections 1 to 182, inclusive, of this act become effective upon passage and approval for the purpose of adopting regulations and on July 1, 2003, for all other purposes.
3. Section 183 of this act becomes effective on July 1, 2003.
4. Section 99 of this act expires by limitation on the date on which the provisions of 42 U.S.C., § 666 requiring each state to establish procedures under which the state has authority to withhold or suspend, or to restrict the use of professional, occupational and recreational licenses of persons who:
(a) Have failed to comply with a subpoena or warrant relating to a procedure to determine the paternity of a child or to establish or enforce an obligation for the support of a child; or
(b) Are in arrears in the payment for the support of one or more children,
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are repealed by the Congress of the United States.
LEADLINES OF REPEALED SECTIONS OF NRS AND
TEXT OF REPEALED SECTIONS OF ENROLLED BILLS
622.010 “Occupational licensing board” defined.
623A.295 Confidentiality of proceedings.
630.142 Award of costs and attorney’s fees.
634.165 Confidentiality of proceedings.
638.154 Court may award costs and reasonable attorney’s fees incurred by Board.
639.091 Award of costs and attorney’s fees to Board.
656.295 Disciplinary proceedings: Costs; attorney’s fees.
Section 8 of Assembly Bill No. 320 of this session:
Sec. 8. NRS 686B.070 is hereby amended to read as follows:
686B.070 1. Every authorized insurer and every rate service organization licensed under NRS [686B.130] 686B.140 which has been designated by any insurer for the filing of rates under subsection 2 of NRS 686B.090 shall file with the Commissioner all:
[1.] (a) Rates and proposed increases thereto;
[2.] (b) Forms of policies to which the rates apply;
[3.] (c) Supplementary rate information; and
[4.] (d) Changes and amendments thereof,
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made by it for use in this state.
2. If an insurer makes a filing for a proposed increase in a rate for insurance covering the liability of a practitioner licensed pursuant to chapter 630, 631, 632 or 633 of NRS for a breach of his professional duty toward a patient, the insurer shall not include in the filing any component that is directly or indirectly related to the following:
(a) Capital losses, diminished cash flow from any dividends, interest or other investment returns, or any other financial loss that is materially outside of the claims experience of the professional liability insurance industry, as determined by the Commissioner.
(b) Losses that are the result of any criminal or fraudulent activities of a director, officer or employee of the insurer.
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If the Commissioner
determines that a filing includes any such component, the Commissioner shall,
pursuant to NRS 686B.110, disapprove the proposed increase, in whole or in
part, to the extent that the proposed increase relies upon such a component.
Section 8.3 of Assembly Bill No. 320 of this session:
Sec. 8.3. NRS 686B.090 is hereby amended to read as follows:
686B.090 1. An insurer shall establish rates and supplementary rate information for any market segment based on the factors in NRS 686B.060. If an insurer has insufficient creditable loss experience, it may use rates and supplementary rate information prepared by a rate service organization, with modification for its own expense and loss experience.
2. An insurer may discharge its obligation under subsection 1 of NRS 686B.070 by giving notice to the Commissioner that it uses rates and supplementary rate information prepared by a designated rate service organization, with such information about modifications thereof as are necessary fully to inform the Commissioner. The insurer’s rates and supplementary rate information shall be deemed those filed from time to time by the rate service organization, including any amendments thereto as filed, subject [, however,] to the modifications filed by the insurer.
Section 8.7 of Assembly Bill No. 320 of this session:
Sec. 8.7. NRS 686B.110 is hereby amended to read as follows:
686B.110 1. The Commissioner shall consider each proposed increase or decrease in the rate of any kind or line of insurance or subdivision thereof filed with him pursuant to subsection 1 of NRS 686B.070. If the Commissioner finds that a proposed increase will result in a rate which is not in compliance with NRS 686B.050 [,] or subsection 2 of NRS 686B.070, he shall disapprove the proposal. The Commissioner shall approve or disapprove each proposal no later than 60 days after it is determined by him to be complete pursuant to subsection 4. If the Commissioner fails to approve or disapprove the proposal within that period, the proposal shall be deemed approved.
2. Whenever an insurer has no legally effective rates as a result of the Commissioner’s disapproval of rates or other act, the Commissioner shall on request specify interim rates for the insurer that are high enough to protect the interests of all parties and may order that a specified portion of the premiums be placed in an escrow account approved by him. When new rates become legally effective, the Commissioner shall order the escrowed funds or any overcharge in the interim rates to be distributed appropriately, except that refunds to policyholders that are de minimis must not be required.
3. If the Commissioner disapproves a proposed rate and an insurer requests a hearing to determine the validity of his action, the insurer has the burden of showing compliance with the applicable standards for rates established in NRS 686B.010 to 686B.1799, inclusive. Any such hearing must be held:
(a) Within 30 days after the request for a hearing has been submitted to the Commissioner; or
(b) Within a period agreed upon by the insurer and the Commissioner.
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If the hearing is not held within the period specified in
paragraph (a) or (b), or if the Commissioner fails to issue an order concerning
the proposed rate for which the hearing is held within 45 days after the
hearing, the proposed rate shall be deemed approved.
4. The Commissioner shall by regulation specify the documents or any other information which must be included in a proposal to increase or decrease a rate submitted to him pursuant to subsection 1. Each such proposal shall be deemed complete upon its filing with the Commissioner, unless the Commissioner, within 15 business days after the proposal is filed with him, determines that the proposal is incomplete because the proposal does not comply with the regulations adopted by him pursuant to this subsection.
Section 4 of Senate Bill No. 281 of this session:
Sec. 4. NRS 633.611 is hereby amended to read as follows:
633.611 1. All proceedings [subsequent to] after the filing of a complaint are confidential, except to the extent necessary for the conduct of an examination, until the Board determines to proceed with disciplinary action. [If]
2. Except as otherwise provided in subsection 3, if the Board dismisses the complaint, the proceedings remain confidential. If the Board proceeds with disciplinary action, confidentiality concerning the proceedings is no longer required.
3. The Board may disseminate any information or records relating to an investigation of a complaint which has been dismissed by the Board to any other licensing board, national association of registered boards, an agency of the Federal Government or of the State, the Attorney General or any law enforcement agency.”.
Amend the title of the bill by deleting the fourteenth through eighteenth lines and inserting:
“malpractice insurance; requiring the Commissioner of”.