requires two-thirds majority vote (§§ 27, 28, 38, 40)                                                                                                  

                                                                                                  

 

Senate Bill No. 250–Senators Townsend and O’Connell

 

March 10, 2003

____________

 

Referred to Committee on Commerce and Labor

 

SUMMARY—Revises various provisions relating to regulated businesses and professions. (BDR 57‑835)

 

FISCAL NOTE:  Effect on Local Government: No.

                           Effect on the State: Yes.

 

~

 

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

 

AN ACT relating to regulated businesses and professions; revising the provisions governing the filing and approval of rates of certain insurers; authorizing certain insurers in a competitive market to change rates under certain circumstances without prior review by the Commissioner of Insurance; requiring the Commissioner to review and approve certain rates before the rates become effective; providing for the issuance by the Commissioner of orders to discontinue a rate; requiring insurers to describe in certain policies of malpractice insurance the formula or method used to determine the premiums for tail coverage; requiring insurers under certain circumstances to provide for a reduction in the premiums for certain policies of malpractice insurance; authorizing certain providers of health care to recover benefit penalties from insurers that unreasonably reject certain settlement offers in malpractice actions; requiring the district courts and the Court Administrator to compile and report certain information concerning attorney’s fees and sanctions; revising the authority of the courts to award attorney’s fees; making various changes regarding procedure and the statute of limitations in malpractice actions; authorizing certain monetary sanctions in malpractice actions; making various changes regarding the licensure of certain physicians; clarifying the jurisdiction of certain regulatory boards; imposing reporting requirements on certain

physicians; requiring certain regulatory boards to impose disciplinary action against certain physicians; requiring certain physicians to undergo tests for competency in certain circumstances; establishing an advisory panel to study certain issues relating to malpractice insurance; requiring the Commissioner of Insurance to hold public hearings on certain issues relating to malpractice insurance; providing penalties; and providing other matters properly relating thereto.

 

THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN

SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:

 

1-1  Section 1.  NRS 686B.070 is hereby amended to read as

1-2  follows:

1-3  686B.070  1.  Every authorized insurer and every rate service

1-4  organization licensed under NRS 686B.130 which has been

1-5  designated by any insurer for the filing of rates under subsection 2

1-6  of NRS 686B.090 shall file with the Commissioner all:

1-7  [1.] (a) Rates and proposed increases thereto;

1-8  [2.] (b) Forms of policies to which the rates apply;

1-9  [3.] (c) Supplementary rate information; and

1-10      [4.] (d) Changes and amendments thereof,

1-11  made by it for use in this state.

1-12      2.  Except as otherwise provided in this section and NRS

1-13  686B.110, if a proposed increase or decrease in the rate of any

1-14  kind or line of insurance does not change by more than 7 percent

1-15  the total average premium required to be paid by persons insured

1-16  by the insurer for that particular line or kind of insurance during

1-17  the 12 months immediately preceding the proposed increase or

1-18  decrease, the insurer shall file the information required by

1-19  subsection 1 and the supporting data required to be filed pursuant

1-20  to NRS 686B.100 on or before the date on which the changes are

1-21  to become effective. The provisions of this subsection do not apply

1-22  if the Commissioner has determined that the market is not

1-23  competitive or if the Commissioner has made any of the other

1-24  determinations described in subsection 1 of NRS 686B.110.

1-25      3.  In a competitive market, if the Commissioner determines

1-26  that the rates of an insurer require closer supervision by the

1-27  Commissioner because of the financial condition of the insurer or

1-28  because the insurer has engaged in rating practices which are

1-29  unfairly discriminatory, the Commissioner may require the

1-30  insurer to file the information required by subsection 1 and the

1-31  supporting data required to be filed pursuant to NRS 686B.100 at

2-1  least 60 days before the rates become effective or may subject the

2-2  rates to review pursuant to NRS 686B.110.

2-3  4.  The Commissioner shall review filings made pursuant to

2-4  this section as soon as practicable to:

2-5  (a) Ensure the sufficiency of the financial condition of the

2-6  insurer; and

2-7  (b) Determine whether the insurer has engaged in rating

2-8  practices which are unfairly discriminatory.

2-9  5.  Rates for title insurance, surety insurance and liability

2-10  insurance for medical malpractice must be approved by the

2-11  Commissioner pursuant to NRS 686B.110 before the insurer may

2-12  use the rates.

2-13      Sec. 2.  NRS 686B.110 is hereby amended to read as follows:

2-14      686B.110  1.  [The] If the Commissioner has determined

2-15  that:

2-16      (a) The market is not competitive;

2-17      (b) Pursuant to NRS 686B.180, essential insurance coverage is

2-18  not readily available in a voluntary market;

2-19      (c) Pursuant to NRS 686B.070, the rates of the insurer require

2-20  closer supervision and that the rates are subject to review pursuant

2-21  to this section;

2-22      (d) A proposed increase or decrease in the rate of any kind or

2-23  line of insurance changes by more than 7 percent the total average

2-24  premium required to be paid by persons insured by the insurer for

2-25  that particular line or kind of insurance during the 12 months

2-26  immediately preceding the proposed increase or decrease; or

2-27      (e) The rate is for title insurance, surety insurance or liability

2-28  insurance for medical malpractice,

2-29  the Commissioner shall consider each proposed increase or decrease

2-30  in the rate of any kind or line of insurance or subdivision thereof

2-31  filed with him pursuant to NRS 686B.070. If the Commissioner

2-32  finds that a proposed increase will result in a rate which is not in

2-33  compliance with NRS 686B.050, he shall disapprove the proposal.

2-34  The Commissioner shall approve or disapprove each proposal [no]

2-35  not later than 60 days after it is determined by him to be complete

2-36  pursuant to subsection 4. If the Commissioner fails to approve or

2-37  disapprove the proposal within that period, the proposal shall be

2-38  deemed approved.

2-39      2.  Whenever an insurer has no legally effective rates as a result

2-40  of the Commissioner’s disapproval of rates or other act, the

2-41  Commissioner shall , on request , specify interim rates for the

2-42  insurer that are high enough to protect the interests of all parties and

2-43  may order that a specified portion of the premiums be placed in an

2-44  escrow account approved by him. When new rates become legally

2-45  effective, the Commissioner shall order the escrowed [funds] money

3-1  or any overcharge in the interim rates to be distributed

3-2  appropriately, except that refunds to policyholders that are de

3-3  minimis must not be required.

3-4  3.  If the Commissioner disapproves a proposed rate and an

3-5  insurer requests a hearing to determine the validity of his action, the

3-6  insurer has the burden of showing compliance with the applicable

3-7  standards for rates established in NRS 686B.010 to 686B.1799,

3-8  inclusive. Any such hearing must be held:

3-9  (a) Within 30 days after the request for a hearing has been

3-10  submitted to the Commissioner; or

3-11      (b) Within a period agreed upon by the insurer and the

3-12  Commissioner.

3-13  If the hearing is not held within the period specified in paragraph (a)

3-14  or (b), or if the Commissioner fails to issue an order concerning

3-15  the proposed rate for which the hearing is held within 45 days after

3-16  the hearing, the proposed rate shall be deemed approved.

3-17      4.  The Commissioner shall by regulation specify the

3-18  documents or any other information which must be included in a

3-19  proposal to increase or decrease a rate submitted to him pursuant to

3-20  [subsection 1.] NRS 686B.070. Each such proposal shall be deemed

3-21  complete upon its filing with the Commissioner, unless the

3-22  Commissioner, within 15 business days after the proposal is filed

3-23  with him, determines that the proposal is incomplete because the

3-24  proposal does not comply with the regulations adopted by him

3-25  pursuant to this subsection.

3-26      5.  If the Commissioner finds that a rate no longer meets the

3-27  requirements of this chapter, the Commissioner may order the

3-28  discontinuance of the rate. An order for the discontinuance of a

3-29  rate may be issued only after a hearing with at least 10 days’

3-30  notice for all insurers and rate organizations that would be

3-31  affected by such an order. The order must be in writing and

3-32  include, without limitation:

3-33      (a) The grounds pursuant to which the order was issued;

3-34      (b) The date on which the order to discontinue the rate

3-35  becomes effective; and

3-36      (c) The date, within a reasonable time after the date on

3-37  which the order becomes effective, on which the order will

3-38  expire.

3-39  An order for the discontinuance of a rate does not affect any

3-40  contract or policy made or issued before the date on which the

3-41  order becomes effective.

 

 

4-1  Sec. 3.  Chapter 690B of NRS is hereby amended by adding

4-2  thereto the provisions set forth as sections 4 to 11, inclusive, of this

4-3  act.

4-4  Sec. 4.  As used in NRS 690B.050 and sections 4 to 11,

4-5  inclusive, of this act, unless the context otherwise requires, the

4-6  words and terms defined in sections 5 to 8, inclusive, of this act

4-7  have the meanings ascribed to them in those sections.

4-8  Sec. 5.  “Action for malpractice” means an action for

4-9  malpractice that is subject to the provisions of chapter 41A of

4-10  NRS.

4-11      Sec. 6.  “Policy of malpractice insurance” means a policy of

4-12  insurance covering the liability of a provider of health care for

4-13  injury or death based upon professional negligence.

4-14      Sec. 7.  “Professional negligence” means a negligent act or

4-15  omission to act by a provider of health care in the rendering of

4-16  professional services, which act or omission is the proximate cause

4-17  of a personal injury or wrongful death. The term does not include

4-18  services that are outside the scope of services for which the

4-19  provider of health care is licensed or services for which any

4-20  restriction has been imposed by the applicable regulatory board or

4-21  health care facility.

4-22      Sec. 8.  “Provider of health care” or “provider” means a

4-23  physician licensed under chapter 630 or 633 of NRS, dentist,

4-24  licensed nurse, dispensing optician, optometrist, registered

4-25  physical therapist, podiatric physician, licensed psychologist,

4-26  chiropractor, doctor of Oriental medicine, medical laboratory

4-27  director or technician, or a licensed hospital and its employees.

4-28      Sec. 9.  1.  In each policy of malpractice insurance that

4-29  includes tail coverage, an insurer shall describe, in at least

4-30  10-point bold type, the formula or method that is used by the

4-31  insurer to determine the premiums for the tail coverage.

4-32      2.  For the purposes of this section, the Commissioner shall

4-33  adopt by regulation a definition of tail coverage.

4-34      Sec. 10.  1.  In each policy of malpractice insurance, an

4-35  insurer shall include provisions that provide for a reduction in the

4-36  premiums for the malpractice insurance if the provider of health

4-37  care implements a qualified risk management system. The

4-38  reduction in the premiums must equal 5 percent of the total

4-39  premiums to be paid under the policy or $10,000, whichever

4-40  amount is greater.

4-41      2.  A qualified risk management system must:

4-42      (a) Include a system to capture electronically the interaction

4-43  between the provider and the patient at the point of care; and

4-44      (b) Comply with all other requirements established by the

4-45  Commissioner.

5-1  3.  The Commissioner shall adopt regulations to:

5-2  (a) Establish the requirements for a qualified risk

5-3  management system; and

5-4  (b) Carry out the provisions of this section.

5-5  4.  The provisions of this section apply to any policy of

5-6  malpractice insurance if any part of the term of the policy provides

5-7  coverage to a provider of health care on or after October 1, 2004.

5-8  If the term of the policy begins before October 1, 2004, and ends

5-9  on or after October 1, 2004, the Commissioner shall establish a

5-10  formula or method for prorating a reduction in the premiums

5-11  pursuant to this section for the portion of the term that provides

5-12  coverage on or after October 1, 2004.

5-13      5.  The Commissioner may exempt an insurer, in whole or in

5-14  part, from the provisions of this section if such an exemption is

5-15  necessary under the Constitution of the United States or of this

5-16  state to provide a fair and reasonable return to the insurer or to

5-17  avoid a confiscatory result.

5-18      Sec. 11.  1.  A provider of health care who is insured by a

5-19  policy of malpractice insurance is entitled to a benefit penalty that

5-20  must be paid to the provider by the insurer that issued the policy

5-21  if:

5-22      (a) An action for malpractice is brought against the provider

5-23  in the district court;

5-24      (b) The plaintiff in the malpractice action makes a settlement

5-25  offer that is within the limits of coverage under the policy;

5-26      (c) The insurer, in contravention of the express instructions of

5-27  the provider, unreasonably rejects the settlement offer in light of

5-28  all the surrounding facts and circumstances; and

5-29      (d) The district court enters a judgment in favor of the plaintiff

5-30  that imposes liability on the provider for damages in an amount

5-31  that exceeds the limits of coverage under the policy and the

5-32  judgment of the district court becomes final and binding on the

5-33  parties.

5-34      2.  To collect the benefit penalty, the provider must file with

5-35  the Commissioner a claim for the benefit penalty not later than 1

5-36  year after the judgment of the district court becomes final and

5-37  binding on the parties.

5-38      3.  If the provider files a claim for a benefit penalty, the

5-39  Commissioner shall:

5-40      (a) Provide the insurer with notice of the claim; and

5-41      (b) Hold a hearing on the claim.

5-42      4.  At the hearing on the claim, if the provider presents

5-43  evidence that the judgment of the district court imposes liability on

5-44  the provider for damages in an amount that exceeds the limits of

5-45  coverage under the policy and that the insurer rejected the

6-1  settlement offer in contravention of the express instructions of the

6-2  provider, there is a rebuttable presumption that the insurer

6-3  unreasonably rejected the settlement offer. To rebut this

6-4  presumption, the insurer must present clear and convincing

6-5  evidence that its decision to reject the settlement offer was

6-6  reasonable in light of all the surrounding facts and circumstances.

6-7  5.  If the Commissioner finds that the provider is entitled to a

6-8  benefit penalty pursuant to this section, the Commissioner shall

6-9  order the insurer to pay to the provider:

6-10      (a) The benefit penalty in an amount equal to the difference

6-11  between the damages for which the provider is liable under the

6-12  judgment of the district court and the limits of coverage under the

6-13  policy, except that the benefit penalty may not exceed $150,000;

6-14  and

6-15      (b) Reasonable attorney’s fees and costs incurred by the

6-16  provider to bring and prosecute the claim for the benefit penalty.

6-17      6.  For the purposes of this section, a judgment of the district

6-18  court becomes final and binding on the parties when all rights to

6-19  appeal the judgment have been exhausted or waived by the parties.

6-20      7.  The provisions of this section do not create an exclusive

6-21  remedy and do not abrogate or limit any other action or remedy

6-22  that is available to a provider pursuant to any other statute or the

6-23  common law.

6-24      8.  If the Commissioner orders an insurer to pay a benefit

6-25  penalty pursuant to this section, no insurer doing business in this

6-26  state may use the judgment of the district court that imposes

6-27  liability on the provider or the benefit penalty as a factor, criteria

6-28  or component in:

6-29      (a) Determining whether to issue a policy of malpractice

6-30  insurance to the provider;

6-31      (b) Making any underwriting decision concerning the provider

6-32  with regard to a policy of malpractice insurance, including,

6-33  without limitation, determining the risk associated with issuing a

6-34  policy of malpractice insurance to the provider; or

6-35      (c) Calculating the amount of any premium for a policy of

6-36  malpractice insurance that is issued to the provider.

6-37      9.  If the Commissioner orders an insurer to pay a benefit

6-38  penalty pursuant to this section:

6-39      (a) The benefit penalty is not a loss, an expense or a cost of

6-40  service for the insurer;

6-41      (b) The insurer shall not include any portion of the benefit

6-42  penalty in any application for a rate adjustment or rate increase;

6-43  and

6-44      (c) The Commissioner shall not allow the insurer to recover

6-45  any portion of the benefit penalty from its policyholders.

7-1  10.  If the Commissioner orders an insurer to pay a benefit

7-2  penalty pursuant to this section on two or more occasions within a

7-3  period of 3 years, the Commissioner shall hold a hearing pursuant

7-4  to chapter 680A of NRS to determine whether to suspend, limit or

7-5  revoke the insurer’s certificate of authority. At the hearing, the

7-6  imposition of the benefit penalties pursuant to this section shall be

7-7  deemed to be sufficient grounds, standing alone, for the

7-8  Commissioner to exercise the power to suspend, limit or revoke the

7-9  insurer’s certificate of authority pursuant to chapter 680A of NRS.

7-10      Sec. 12.  NRS 690B.050 is hereby amended to read as follows:

7-11      690B.050  1.  [Each insurer which] If an insurer issues a

7-12  policy of malpractice insurance [covering the liability of] to a

7-13  provider of health care who is a physician licensed under chapter

7-14  630 [of NRS or an osteopathic physician licensed under chapter] or

7-15  633 of NRS [for a breach of his professional duty toward a patient] ,

7-16  the insurer shall report to the Commissioner , within 30 days , each

7-17  settlement or award made or judgment rendered by reason of a

7-18  claim, giving the name and address of the claimant and [physician]

7-19  the provider of health care and the circumstances of the case.

7-20      2.  The Commissioner shall report to the Board of Medical

7-21  Examiners or the State Board of Osteopathic Medicine, as

7-22  applicable, within 30 days after receiving the report of the insurer,

7-23  each claim made and each settlement, award or judgment.

7-24      Sec. 13.  NRS 3.243 is hereby amended to read as follows:

7-25      3.243  1.  In the time and manner prescribed by the Supreme

7-26  Court, the chief judge of the judicial district or, if the district has no

7-27  chief judge, a district judge designated by mutual consent of the

7-28  district judges of that district, shall submit to the Court

7-29  Administrator a report of the statistical information required

7-30  pursuant to this section and such other statistical information as

7-31  prescribed by the Supreme Court. The report must include, without

7-32  limitation, statistical information concerning:

7-33      [1.] (a) Those cases which are pending and undecided and the

7-34  judge to whom each case has been assigned;

7-35      [2.] (b) The type and number of cases each judge considered

7-36  during the preceding month;

7-37      [3.] (c) The number of cases submitted to each judge during the

7-38  preceding month;

7-39      [4.] (d) The number of cases decided by each judge during the

7-40  preceding month; and

7-41      [5.] (e) The number of full judicial days in which each judge

7-42  appeared in court or in chambers in performance of his duties during

7-43  the preceding month.

7-44      2.  In addition to the information required by subsection 1, the

7-45  report must include the following information:

8-1  (a) The number of cases in the judicial district in which a

8-2  court awarded attorney’s fees pursuant to NRS 7.085 or

8-3  paragraph (b) of subsection 2 of NRS 18.010 and, for each such

8-4  case, the amount of the attorney’s fees awarded and whether the

8-5  case was an action for malpractice; and

8-6  (b) The number of cases in the judicial district in which a

8-7  court imposed sanctions pursuant to NRS 41A.081 or Rule 11 of

8-8  the Nevada Rules of Civil Procedure and, for each such case, the

8-9  type of sanctions imposed, the amount of the sanctions if they were

8-10  monetary sanctions and whether the case was an action for

8-11  malpractice.

8-12      3.  The provisions of subsection 2 apply only to attorney’s fees

8-13  that are awarded by a court or sanctions that are imposed by a

8-14  court on or after January 1, 2004.

8-15      4.  As used in this section, “action for malpractice” means an

8-16  action for malpractice that is subject to the provisions of chapter

8-17  41A of NRS.

8-18      Sec. 14.  NRS 7.085 is hereby amended to read as follows:

8-19      7.085  1.  If a court finds that an attorney has:

8-20      [1.] (a) Filed, maintained or defended a civil action or

8-21  proceeding in any court in this state and such action or defense is

8-22  not well-grounded in fact or is not warranted by existing law or by

8-23  an argument for changing the existing law that is made in good

8-24  faith; or

8-25      [2.] (b) Unreasonably and vexatiously extended a civil action or

8-26  proceeding before any court in this state,

8-27  the court shall require the attorney personally to pay the additional

8-28  costs, expenses and attorney’s fees reasonably incurred because of

8-29  such conduct.

8-30      2.  The court shall liberally construe the provisions of this

8-31  section in favor of awarding costs, expenses and attorney’s fees in

8-32  all appropriate situations. It is the intent of the Legislature that the

8-33  court award costs, expenses and attorney’s fees pursuant to this

8-34  section and impose sanctions pursuant to Rule 11 of the Nevada

8-35  Rules of Civil Procedure in all appropriate situations to punish for

8-36  and deter frivolous or vexatious claims and defenses because such

8-37  claims and defenses overburden limited judicial resources, hinder

8-38  the timely resolution of meritorious claims and increase the costs

8-39  of engaging in business and providing professional services to the

8-40  public.

8-41      Sec. 15.  NRS 18.010 is hereby amended to read as follows:

8-42      18.010  1.  The compensation of an attorney and counselor for

8-43  his services is governed by agreement, express or implied, which is

8-44  not restrained by law.

9-1  2.  In addition to the cases where an allowance is authorized by

9-2  specific statute, the court may make an allowance of attorney’s fees

9-3  to a prevailing party:

9-4  (a) When he has not recovered more than $20,000; or

9-5  (b) Without regard to the recovery sought, when the court finds

9-6  that the claim, counterclaim, cross-claim or third-party complaint or

9-7  defense of the opposing party was brought or maintained without

9-8  reasonable ground or to harass the prevailing party. The court shall

9-9  liberally construe the provisions of this paragraph in favor of

9-10  awarding attorney’s fees in all appropriate situations. It is the

9-11  intent of the Legislature that the court award attorney’s fees

9-12  pursuant to this paragraph and impose sanctions pursuant to Rule

9-13  11 of the Nevada Rules of Civil Procedure in all appropriate

9-14  situations to punish for and deter frivolous or vexatious claims

9-15  and defenses because such claims and defenses overburden

9-16  limited judicial resources, hinder the timely resolution of

9-17  meritorious claims and increase the costs of engaging in business

9-18  and providing professional services to the public.

9-19      3.  In awarding attorney’s fees, the court may pronounce its

9-20  decision on the fees at the conclusion of the trial or special

9-21  proceeding without written motion and with or without presentation

9-22  of additional evidence.

9-23      4.  Subsections 2 and 3 do not apply to any action arising out of

9-24  a written instrument or agreement which entitles the prevailing party

9-25  to an award of reasonable attorney’s fees.

9-26      Sec. 16.  Chapter 41A of NRS is hereby amended by adding

9-27  thereto the provisions set forth as sections 17, 18 and 19 of this act.

9-28      Sec. 17.  “Professional negligence” means a negligent act or

9-29  omission to act by a provider of health care in the rendering of

9-30  professional services, which act or omission is the proximate cause

9-31  of a personal injury or wrongful death. The term does not include

9-32  services that are outside the scope of services for which the

9-33  provider of health care is licensed or services for which any

9-34  restriction has been imposed by the applicable regulatory board or

9-35  health care facility.

9-36      Sec. 18.  “Provider of health care” means a physician

9-37  licensed under chapter 630 or 633 of NRS, dentist, licensed nurse,

9-38  dispensing optician, optometrist, registered physical therapist,

9-39  podiatric physician, licensed psychologist, chiropractor, doctor of

9-40  Oriental medicine, medical laboratory director or technician, or a

9-41  licensed hospital and its employees.

9-42      Sec. 19.  1.  Except as otherwise provided in subsection 4, at

9-43  least 90 days before a plaintiff files an action for injury or death

9-44  against a provider of health care based upon professional

10-1  negligence, the plaintiff must provide a notice of his intent to file

10-2  the action to:

10-3      (a) Each defendant against whom the action is brought; and

10-4      (b) If the defendant is a physician licensed pursuant to chapter

10-5  630 or 633 of NRS, the Board of Medical Examiners or the State

10-6  Board of Osteopathic Medicine, as applicable.

10-7      2.  The notice must inform each defendant of the legal basis

10-8  for the action and the type of loss sustained and must include,

10-9  without limitation:

10-10     (a) The date and location of each alleged act of professional

10-11  negligence;

10-12     (b) A detailed description of each alleged act of professional

10-13  negligence; and

10-14     (c) A detailed description of the injuries suffered from each

10-15  alleged act of professional negligence.

10-16     3.  The notice may be served in the manner provided by law

10-17  and the Nevada Rules of Civil Procedure for the service of

10-18  process.

10-19     4.  The provisions of this section do not apply to any

10-20  defendant whose name is unknown to the plaintiff at the time the

10-21  plaintiff files the complaint and who is identified therein by a

10-22  fictitious name, as provided in N.R.C.P. 10.

10-23     5.  Failure to comply with the provisions of this section shall

10-24  not invalidate any proceedings of any court in this state, nor shall

10-25  it affect the jurisdiction of a court in this state to render a

10-26  judgment therein.

10-27     6.  Failure by an attorney to comply with the provisions of this

10-28  section is grounds for professional discipline. The State Bar of

10-29  Nevada shall investigate and take appropriate action in any such

10-30  case brought to its attention.

10-31     Sec. 20.  NRS 41A.003 is hereby amended to read as follows:

10-32     41A.003  As used in this chapter, unless the context otherwise

10-33  requires, the words and terms defined in NRS 41A.004 to 41A.013,

10-34  inclusive, and sections 17 and 18 of this act have the meanings

10-35  ascribed to them in those sections.

10-36     Sec. 21.  NRS 41A.081 is hereby amended to read as follows:

10-37     41A.081  1.  In an action for medical malpractice or dental

10-38  malpractice, all the parties to the action, the insurers of the

10-39  respective parties and the attorneys of the respective parties shall

10-40  attend and participate in a settlement conference before a district

10-41  judge, other than the judge assigned to the action, to ascertain

10-42  whether the action may be settled by the parties before trial.

10-43     2.  The judge before whom the settlement conference is held:

10-44     (a) May, for good cause shown, waive the attendance of any

10-45  party.

11-1      (b) Shall decide what information the parties may submit at the

11-2  settlement conference.

11-3      3.  The judge shall notify the parties of the time and place of the

11-4  settlement conference.

11-5      4.  The failure of any party, his insurer or his attorney to

11-6  participate in good faith in the settlement conference is grounds for

11-7  sanctions , including, without limitation, monetary sanctions,

11-8  against the party or his attorney, or both. The judges of the district

11-9  court shall liberally construe the provisions of this subsection in

11-10  favor of imposing sanctions in all appropriate situations. It is the

11-11  intent of the Legislature that the judges of the district court impose

11-12  sanctions pursuant to this subsection in all appropriate situations

11-13  to punish for and deter conduct which is not undertaken in good

11-14  faith because such conduct overburdens limited judicial resources,

11-15  hinders the timely resolution of meritorious claims and increases

11-16  the costs of engaging in business and providing professional

11-17  services to the public.

11-18     Sec. 22.  NRS 41A.097 is hereby amended to read as follows:

11-19     41A.097  1.  Except as otherwise provided in subsection 3, an

11-20  action for injury or death against a provider of health care may not

11-21  be commenced more than 4 years after the date of injury or 2 years

11-22  after the plaintiff discovers or through the use of reasonable

11-23  diligence should have discovered the injury, whichever occurs first,

11-24  for:

11-25     (a) Injury to or the wrongful death of a person occurring before

11-26  October 1, 2002, based upon alleged professional negligence of the

11-27  provider of health care;

11-28     (b) Injury to or the wrongful death of a person occurring before

11-29  October 1, 2002, from professional services rendered without

11-30  consent; or

11-31     (c) Injury to or the wrongful death of a person occurring before

11-32  October 1, 2002, from error or omission in practice by the provider

11-33  of health care.

11-34     2.  Except as otherwise provided in subsection 3, an action for

11-35  injury or death against a provider of health care may not be

11-36  commenced more than 3 years after the date of injury or [2 years] 1

11-37  year after the plaintiff discovers or through the use of reasonable

11-38  diligence should have discovered the injury, whichever occurs first,

11-39  for:

11-40     (a) Injury to or the wrongful death of a person occurring on or

11-41  after October 1, 2002, based upon alleged professional negligence of

11-42  the provider of health care;

11-43     (b) Injury to or the wrongful death of a person occurring on or

11-44  after October 1, 2002, from professional services rendered without

11-45  consent; or

12-1      (c) Injury to or the wrongful death of a person occurring on or

12-2  after October 1, 2002, from error or omission in practice by the

12-3  provider of health care.

12-4      3.  This time limitation is tolled [for] :

12-5      (a) For any period during which the provider of health care has

12-6  concealed any act, error or omission upon which the action is based

12-7  and which is known or through the use of reasonable diligence

12-8  should have been known to him.

12-9      (b) If a notice required pursuant to section 19 of this act is

12-10  served within 90 days before this time limitation, for 90 days after

12-11  the notice is served.

12-12     4.  For the purposes of this section, the parent, guardian or legal

12-13  custodian of any minor child is responsible for exercising reasonable

12-14  judgment in determining whether to prosecute any cause of action

12-15  limited by subsection 1 or 2. If the parent, guardian or custodian

12-16  fails to commence an action on behalf of that child within the

12-17  prescribed period of limitations, the child may not bring an action

12-18  based on the same alleged injury against any provider of health care

12-19  upon the removal of his disability, except that in the case of:

12-20     (a) Brain damage or birth defect, the period of limitation is

12-21  extended until the child attains 10 years of age.

12-22     (b) Sterility, the period of limitation is extended until 2 years

12-23  after the child discovers the injury.

12-24     [5.  As used in this section, “provider of health care” means a

12-25  physician licensed under chapter 630 or 633 of NRS, a dentist,

12-26  registered nurse, dispensing optician, optometrist, registered

12-27  physical therapist, podiatric physician, licensed psychologist,

12-28  chiropractor, doctor of Oriental medicine, medical laboratory

12-29  director or technician, or a licensed hospital as the employer of any

12-30  such person.]

12-31     Sec. 23.  Chapter 630 of NRS is hereby amended by adding

12-32  thereto the provisions set forth as sections 24 to 28, inclusive, of this

12-33  act.

12-34     Sec. 24.  1.  In addition to the other requirements for

12-35  licensure, an applicant for a license to practice medicine shall

12-36  submit to the Board information describing:

12-37     (a) Any claims made against the applicant for malpractice

12-38  within the 5 years immediately preceding the filing of the

12-39  application for a license, whether or not a civil action was filed

12-40  concerning the claim;

12-41     (b) Any complaints filed against the applicant with a licensing

12-42  board of another state and any disciplinary action taken against

12-43  the applicant by a licensing board of another state within the 5

12-44  years immediately preceding the filing of the application for a

12-45  license; and

13-1      (c) Any complaints filed against the applicant with a hospital,

13-2  clinic or medical facility or any disciplinary action taken against

13-3  the applicant by a hospital, clinic or medical facility within the 5

13-4  years immediately preceding the filing of the application for a

13-5  license.

13-6      2.  The Board shall not issue a license to the applicant until it

13-7  has received all the information required by this section.

13-8      Sec. 25.  1.  In addition to the other requirements for

13-9  licensure, if an applicant for a license to practice in this state has

13-10  never been licensed to practice in any state, the applicant shall

13-11  submit to the Board a letter of recommendation from the person

13-12  who is the head of the residency program where the applicant

13-13  received training.

13-14     2.  The Board shall not issue a license to the applicant until it

13-15  has received the letter of recommendation required by this section.

13-16     3.  If the person who is the head of the residency program

13-17  where the applicant received training has recommended the

13-18  applicant for licensure by the Board, the person is immune from

13-19  civil liability for his actions and any consequences of his actions

13-20  unless, when the person recommended the applicant for licensure

13-21  by the Board, the person acted without any reasonable grounds to

13-22  support the recommendation.

13-23     4.  If the person who is the head of the residency program

13-24  where the applicant received training has refused to recommend

13-25  the applicant for licensure by the Board or has disclosed to the

13-26  Board any adverse information concerning the abilities,

13-27  qualifications, attributes or character of the applicant, the person

13-28  is immune from civil liability for his actions and any consequences

13-29  of his actions unless:

13-30     (a) When the person refused to recommend the applicant for

13-31  licensure by the Board, the person acted without any reasonable

13-32  grounds to support the refusal; or

13-33     (b) When the person disclosed the adverse information to the

13-34  Board, the person acted without any reasonable grounds to believe

13-35  that the adverse information was accurate.

13-36     Sec. 26.  The expiration of a license by operation of law or by

13-37  order or decision of the Board or a court, or the voluntary

13-38  surrender of a license by a licensee, does not deprive the Board of

13-39  jurisdiction to proceed with any investigation of, or action or

13-40  disciplinary proceeding against, the licensee or to render a

13-41  decision suspending or revoking the license.

13-42     Sec. 27.  1.  A physician shall report to the Board any action

13-43  filed or claim submitted to arbitration or mediation for

13-44  malpractice or negligence against the physician and the

14-1  settlement, award, judgment or other disposition of the action or

14-2  claim within 10 days after:

14-3      (a) The action was filed or the claim was submitted to

14-4  arbitration or mediation; and

14-5      (b) The disposition of the action or claim.

14-6      2.  If the Board finds that a physician has violated the

14-7  provisions of this section, the Board shall impose a fine of $5,000,

14-8  in addition to any other fines or penalties permitted by law.

14-9      Sec. 28.  1.  If the Board receives a report pursuant to the

14-10  provisions of NRS 630.3067, 690B.045, 690B.050 or section 27 of

14-11  this act that a judgment has been rendered by reason of a claim of

14-12  malpractice or negligence against a physician, regardless of any

14-13  appeal of the judgment, the Board shall conduct a hearing to

14-14  determine whether to impose disciplinary action against the

14-15  physician for violation of the provisions of subsection 4 of NRS

14-16  630.301 or subsection 12 of NRS 630.306.

14-17     2.  The results of any examination of the physician conducted

14-18  pursuant to the provisions of subsection 2 of NRS 630.318 must be

14-19  considered a part of the record of the hearing before the Board.

14-20     3.  If, after conducting the hearing, the Board finds that a

14-21  violation of the provisions of subsection 4 of NRS 630.301 or

14-22  subsection 12 of NRS 630.306 has occurred, the Board shall by

14-23  order:

14-24     (a) Place the physician on probation for a specified period on

14-25  any of the conditions specified in the order;

14-26     (b) Administer to him a public reprimand;

14-27     (c) Impose a fine not to exceed $5,000;

14-28     (d) Require him to perform community service without

14-29  compensation;

14-30     (e) Require him to fulfill certain training or educational

14-31  requirements; and

14-32     (f) Require him to pay all costs incurred by the Board relating

14-33  to his disciplinary proceedings.

14-34     4.  The provisions of subsection 3 do not limit the authority of

14-35  the Board to:

14-36     (a) Limit the practice of the physician or exclude one or more

14-37  specified branches of medicine from his practice;

14-38     (b) Require supervision of his practice;

14-39     (c) Require him to participate in a program to correct alcohol

14-40  or drug dependence or any other impairment;

14-41     (d) Suspend his license for a specified period or until further

14-42  order of the Board; or

14-43     (e) Revoke his license to practice medicine. If the Board

14-44  revokes the license to practice medicine, the Board is not required

14-45  to take any disciplinary action set forth in subsection 3 that would

15-1  be inconsistent with the revocation of the license to practice

15-2  medicine.

15-3      5.  The Board shall not remove any restrictions imposed on a

15-4  physician pursuant to this section until the physician has

15-5  successfully completed the training or educational requirements

15-6  ordered by the Board. If the person who provides the training or

15-7  educational instruction to the physician issues a certificate of

15-8  satisfactory completion, the certificate shall be deemed to be proof

15-9  that the physician satisfactorily completed the training or

15-10  educational requirements ordered by the Board.

15-11     Sec. 29.  NRS 630.130 is hereby amended to read as follows:

15-12     630.130  1.  In addition to the other powers and duties

15-13  provided in this chapter, the Board shall:

15-14     (a) Enforce the provisions of this chapter;

15-15     (b) Establish by regulation standards for licensure under this

15-16  chapter;

15-17     (c) Conduct examinations for licensure and establish a system of

15-18  scoring for those examinations;

15-19     (d) Investigate the character of each applicant for a license and

15-20  issue licenses to those applicants who meet the qualifications set by

15-21  this chapter and the Board; and

15-22     (e) Institute a proceeding in any court to enforce its orders or

15-23  the provisions of this chapter.

15-24     2.  On or before February 15 of each odd-numbered year, the

15-25  Board shall submit to the Governor and to the Director of the

15-26  Legislative Counsel Bureau for transmittal to the next regular

15-27  session of the Legislature a written report compiling:

15-28     (a) Disciplinary action taken by the Board during the previous

15-29  biennium against physicians for malpractice or negligence; and

15-30     (b) Information reported to the Board during the previous

15-31  biennium pursuant to NRS 630.3067, subsections 2 and 3 of NRS

15-32  630.307 and NRS 690B.045[.] and 690B.050 and section 27 of this

15-33  act.

15-34  The report must include only aggregate information for statistical

15-35  purposes and exclude any identifying information related to a

15-36  particular person.

15-37     3.  The Board may adopt such regulations as are necessary or

15-38  desirable to enable it to carry out the provisions of this chapter.

15-39     Sec. 30.  NRS 630.3062 is hereby amended to read as follows:

15-40     630.3062  The following acts, among others, constitute grounds

15-41  for initiating disciplinary action or denying licensure:

15-42     1.  Failure to maintain timely, legible, accurate and complete

15-43  medical records relating to the diagnosis, treatment and care of a

15-44  patient.

15-45     2.  Altering medical records of a patient.

16-1      3.  Making or filing a report which the licensee knows to be

16-2  false, failing to file a record or report as required by law or willfully

16-3  obstructing or inducing another to obstruct such filing.

16-4      4.  Failure to make the medical records of a patient available for

16-5  inspection and copying as provided in NRS 629.061.

16-6      5.  Failure to comply with the requirements of [NRS 630.3067.]

16-7  section 27 of this act.

16-8      6.  Failure to report any person the licensee knows, or has

16-9  reason to know, is in violation of the provisions of this chapter or

16-10  the regulations of the Board.

16-11     Sec. 31.  NRS 630.3067 is hereby amended to read as follows:

16-12     630.3067  1.  The insurer of a physician licensed under this

16-13  chapter [and the physician] must report to the Board any action filed

16-14  or claim submitted to arbitration or mediation for malpractice or

16-15  negligence against the physician and the settlement, award,

16-16  judgment or other disposition of the action or claim within 30 days

16-17  after:

16-18     (a) The action was filed or the claim was submitted to

16-19  arbitration or mediation; and

16-20     (b) The disposition of the action or claim.

16-21     2.  The Board shall report any failure to comply with subsection

16-22  1 by an insurer licensed in this state to the Division of Insurance of

16-23  the Department of Business and Industry. If, after a hearing, the

16-24  Division of Insurance determines that any such insurer failed to

16-25  comply with the requirements of subsection 1, the Division may

16-26  impose an administrative fine of not more than $10,000 against the

16-27  insurer for each such failure to report. If the administrative fine is

16-28  not paid when due, the fine must be recovered in a civil action

16-29  brought by the Attorney General on behalf of the Division.

16-30     Sec. 32. NRS 630.318 is hereby amended to read as follows:

16-31     630.318  1.  If the Board or any investigative committee of the

16-32  Board has reason to believe that the conduct of any physician has

16-33  raised a reasonable question as to his competence to practice

16-34  medicine with reasonable skill and safety to patients, it may order

16-35  that the physician undergo a mental or physical examination or an

16-36  examination testing his competence to practice medicine by

16-37  physicians or other examinations designated by the Board to assist

16-38  the Board or committee in determining the fitness of the physician

16-39  to practice medicine.

16-40     2.  If the Board receives a report pursuant to the provisions of

16-41  NRS 630.3067, 690B.045, 690B.050 or section 27 of this act that a

16-42  judgment has been rendered by reason of a claim of malpractice

16-43  or negligence against a physician, regardless of any appeal of the

16-44  judgment, the Board shall order that the physician undergo a

16-45  mental or physical examination or an examination testing his

17-1  competence to practice medicine by physicians or other

17-2  examinations designated by the Board to assist the Board or any

17-3  investigative committee of the Board in determining the fitness of

17-4  the physician to practice medicine.

17-5      3.  For the purposes of this section:

17-6      (a) Every physician who applies for a license or who is licensed

17-7  under this chapter shall be deemed to have given his consent to

17-8  submit to a mental or physical examination or an examination

17-9  testing his competence to practice medicine when ordered to do so

17-10  in writing by the Board.

17-11     (b) The testimony or reports of the examining physicians are not

17-12  privileged communications.

17-13     [3.] 4. Except in extraordinary circumstances, as determined by

17-14  the Board, the failure of a physician licensed under this chapter to

17-15  submit to an examination when directed as provided in this section

17-16  constitutes an admission of the charges against him.

17-17     Sec. 33.  NRS 630.352 is hereby amended to read as follows:

17-18     630.352  1.  Any member of the Board, except for an advisory

17-19  member serving on a panel of the Board hearing charges, may

17-20  participate in the final order of the Board. If the Board, after a

17-21  formal hearing, determines from a preponderance of the evidence

17-22  that a violation of the provisions of this chapter or of the regulations

17-23  of the Board has occurred, it shall issue and serve on the physician

17-24  charged an order, in writing, containing its findings and any

17-25  sanctions.

17-26     2.  If the Board determines that no violation has occurred, it

17-27  shall dismiss the charges, in writing, and notify the physician that

17-28  the charges have been dismissed. If the disciplinary proceedings

17-29  were instituted against the physician as a result of a complaint filed

17-30  against him, the Board may provide the physician with a copy of the

17-31  complaint.

17-32     3.  Except as otherwise provided in subsection 4[,] and

17-33  sections 27 and 28 of this act, if the Board finds that a violation has

17-34  occurred, it may by order:

17-35     (a) Place the person on probation for a specified period on any

17-36  of the conditions specified in the order;

17-37     (b) Administer to him a public reprimand;

17-38     (c) Limit his practice or exclude one or more specified branches

17-39  of medicine from his practice;

17-40     (d) Suspend his license for a specified period or until further

17-41  order of the Board;

17-42     (e) Revoke his license to practice medicine;

17-43     (f) Require him to participate in a program to correct alcohol or

17-44  drug dependence or any other impairment;

17-45     (g) Require supervision of his practice;

18-1      (h) Impose a fine not to exceed $5,000;

18-2      (i) Require him to perform community service without

18-3  compensation;

18-4      (j) Require him to take a physical or mental examination or an

18-5  examination testing his competence;

18-6      (k) Require him to fulfill certain training or educational

18-7  requirements; and

18-8      (l) Require him to pay all costs incurred by the Board relating to

18-9  his disciplinary proceedings.

18-10     4.  If the Board finds that the physician has violated the

18-11  provisions of NRS 439B.425, the Board shall suspend his license for

18-12  a specified period or until further order of the Board.

18-13     Sec. 34.  Chapter 633 of NRS is hereby amended by adding

18-14  thereto the provisions set forth as sections 35 to 40, inclusive, of this

18-15  act.

18-16     Sec. 35.  1.  In addition to the other requirements for

18-17  licensure, an applicant for a license to practice shall submit to the

18-18  Board information describing:

18-19     (a) Any claims made against the applicant for malpractice

18-20  within the 5 years immediately preceding the filing of the

18-21  application for a license, whether or not a civil action was filed

18-22  concerning the claim;

18-23     (b) Any complaints filed against the applicant with a licensing

18-24  board of another state and any disciplinary action taken against

18-25  the applicant by a licensing board of another state within the 5

18-26  years immediately preceding the filing of the application for a

18-27  license; and

18-28     (c) Any complaints filed against the applicant with a hospital,

18-29  clinic or medical facility or any disciplinary action taken against

18-30  the applicant by a hospital, clinic or medical facility within the 5

18-31  years immediately preceding the filing of the application for a

18-32  license.

18-33     2.  The Board shall not issue a license to the applicant until it

18-34  has received all the information required by this section.

18-35     Sec. 36.  1.  In addition to the other requirements for

18-36  licensure, if an applicant for a license to practice in this state has

18-37  never been licensed to practice in any state, the applicant shall

18-38  submit to the Board a letter of recommendation from the person

18-39  who is the head of the residency program where the applicant

18-40  received training.

18-41     2.  The Board shall not issue a license to the applicant until it

18-42  has received the letter of recommendation required by this section.

18-43     3.  If the person who is the head of the residency program

18-44  where the applicant received training has recommended the

18-45  applicant for licensure by the Board, the person is immune from

19-1  civil liability for his actions and any consequences of his actions

19-2  unless, when the person recommended the applicant for licensure

19-3  by the Board, the person acted without any reasonable grounds to

19-4  support the recommendation.

19-5      4.  If the person who is the head of the residency program

19-6  where the applicant received training has refused to recommend

19-7  the applicant for licensure by the Board or has disclosed to the

19-8  Board any adverse information concerning the abilities,

19-9  qualifications, attributes or character of the applicant, the person

19-10  is immune from civil liability for his actions and any consequences

19-11  of his actions unless:

19-12     (a) When the person refused to recommend the applicant for

19-13  licensure by the Board, the person acted without any reasonable

19-14  grounds to support the refusal; or

19-15     (b) When the person disclosed the adverse information to the

19-16  Board, the person acted without any reasonable grounds to believe

19-17  that the adverse information was accurate.

19-18     Sec. 37.  The expiration of a license by operation of law or by

19-19  order or decision of the Board or a court, or the voluntary

19-20  surrender of a license by a licensee, does not deprive the Board of

19-21  jurisdiction to proceed with any investigation of, or action or

19-22  disciplinary proceeding against, the licensee or to render a

19-23  decision suspending or revoking the license.

19-24     Sec. 38.  1.  An osteopathic physician shall report to the

19-25  Board any action filed or claim submitted to arbitration or

19-26  mediation for malpractice or negligence against the osteopathic

19-27  physician and the settlement, award, judgment or other disposition

19-28  of the action or claim within 10 days after:

19-29     (a) The action was filed or the claim was submitted to

19-30  arbitration or mediation; and

19-31     (b) The disposition of the action or claim.

19-32     2.  If the Board finds that an osteopathic physician has

19-33  violated the provisions of this section, the Board shall impose a

19-34  fine of $5,000, in addition to any other fines or penalties permitted

19-35  by law.

19-36     Sec. 39.  1.  If the Board receives a report pursuant to the

19-37  provisions of NRS 633.526, 690B.045, 690B.050 or section 38 of

19-38  this act that a judgment has been rendered by reason of a claim of

19-39  malpractice or negligence against an osteopathic physician,

19-40  regardless of any appeal of the judgment, the Board shall order

19-41  that the osteopathic physician undergo a mental or physical

19-42  examination or an examination testing his competence to practice

19-43  medicine by osteopathic physicians or other examinations

19-44  designated by the Board to assist the Board or any investigative

20-1  committee of the Board in determining the fitness of the

20-2  osteopathic physician to practice medicine.

20-3      2.  For the purposes of this section:

20-4      (a) Every osteopathic physician who applies for a license or

20-5  who holds a license under this chapter shall be deemed to have

20-6  given his consent to submit to a mental or physical examination or

20-7  an examination testing his competence to practice medicine when

20-8  ordered to do so in writing by the Board.

20-9      (b) The testimony or reports of the examining osteopathic

20-10  physician are not privileged communications.

20-11     Sec. 40.  1.  If the Board receives a report pursuant to NRS

20-12  633.526, 690B.045, 690B.050 or section 38 of this act that a

20-13  judgment has been rendered by reason of a claim of malpractice

20-14  or negligence against an osteopathic physician, regardless of any

20-15  appeal of the judgment, the Board shall conduct a hearing to

20-16  determine whether to impose disciplinary action against the

20-17  osteopathic physician for violation of the provisions of subsection

20-18  4 or 5 of NRS 633.511.

20-19     2.  The results of any examination of the osteopathic

20-20  physician conducted pursuant to the provisions of section 39 of

20-21  this act must be considered a part of the record of the hearing

20-22  before the Board.

20-23     3.  If, after conducting the hearing, the Board finds that a

20-24  violation of the provisions of subsection 4 or 5 of NRS 633.511 has

20-25  occurred, the Board shall by order:

20-26     (a) Place the osteopathic physician on probation for a

20-27  specified period on any of the conditions specified in the order;

20-28     (b) Administer to him a public reprimand;

20-29     (c) Impose a fine not to exceed $5,000;

20-30     (d) Require him to perform community service without

20-31  compensation;

20-32     (e) Require him to fulfill certain training or educational

20-33  requirements; and

20-34     (f) Require him to pay all costs incurred by the Board relating

20-35  to his disciplinary proceedings.

20-36     4.  The provisions of subsection 3 do not limit the authority of

20-37  the Board to:

20-38     (a) Limit the practice of the osteopathic physician or exclude

20-39  one or more specified branches of osteopathic medicine from his

20-40  practice;

20-41     (b) Require supervision of his practice;

20-42     (c) Require him to participate in a program to correct alcohol

20-43  or drug dependence or any other impairment;

20-44     (d) Suspend his license for a specified period or until further

20-45  order of the Board; or

21-1      (e) Revoke his license to practice osteopathic medicine. If the

21-2  Board revokes the license to practice osteopathic medicine, the

21-3  Board is not required to take any disciplinary action set forth in

21-4  subsection 3 that would be inconsistent with the revocation of the

21-5  license to practice osteopathic medicine.

21-6      5.  The Board shall not remove any restrictions imposed on an

21-7  osteopathic physician pursuant to this section until the osteopathic

21-8  physician has successfully completed the training or educational

21-9  requirements ordered by the Board. If the person who provides the

21-10  training or educational instruction to the osteopathic physician

21-11  issues a certificate of satisfactory completion, the certificate shall

21-12  be deemed to be proof that the osteopathic physician satisfactorily

21-13  completed the training or educational requirements ordered by the

21-14  Board.

21-15     Sec. 41.  NRS 633.286 is hereby amended to read as follows:

21-16     633.286  1.  On or before February 15 of each odd-numbered

21-17  year, the Board shall submit to the Governor and to the Director of

21-18  the Legislative Counsel Bureau for transmittal to the next regular

21-19  session of the Legislature a written report compiling:

21-20     (a) Disciplinary action taken by the Board during the previous

21-21  biennium against osteopathic physicians for malpractice or

21-22  negligence; and

21-23     (b) Information reported to the Board during the previous

21-24  biennium pursuant to NRS 633.526, subsections 2 and 3 of NRS

21-25  633.533 and NRS 690B.045[.] and 690B.050 and section 38 of this

21-26  act.

21-27     2.  The report must include only aggregate information for

21-28  statistical purposes and exclude any identifying information related

21-29  to a particular person.

21-30     Sec. 42.  NRS 633.511 is hereby amended to read as follows:

21-31     633.511  The grounds for initiating disciplinary action pursuant

21-32  to this chapter are:

21-33     1.  Unprofessional conduct.

21-34     2.  Conviction of:

21-35     (a) A violation of any federal or state law regulating the

21-36  possession, distribution or use of any controlled substance or any

21-37  dangerous drug as defined in chapter 454 of NRS;

21-38     (b) A felony;

21-39     (c) A violation of any of the provisions of NRS 616D.200,

21-40  616D.220, 616D.240 or 616D.300 to 616D.440, inclusive; or

21-41     (d) Any offense involving moral turpitude.

21-42     3.  The suspension of the license to practice osteopathic

21-43  medicine by any other jurisdiction.

21-44     4.  Gross or repeated malpractice, which may be evidenced by

21-45  claims of malpractice settled against a practitioner.

22-1      5.  Professional incompetence.

22-2      6.  Failure to comply with the requirements of [NRS 633.526.]

22-3  section 38 of this act.

22-4      Sec. 43.  NRS 633.526 is hereby amended to read as follows:

22-5      633.526  1.  The insurer of an osteopathic physician licensed

22-6  under this chapter [and the osteopathic physician] must report to the

22-7  Board any action filed or claim submitted to arbitration or mediation

22-8  for malpractice or negligence against the osteopathic physician and

22-9  the settlement, award, judgment or other disposition of the action or

22-10  claim within 30 days after:

22-11     (a) The action was filed or the claim was submitted to

22-12  arbitration or mediation; and

22-13     (b) The disposition of the action or claim.

22-14     2.  The Board shall report any failure to comply with subsection

22-15  1 by an insurer licensed in this state to the Division of Insurance of

22-16  the Department of Business and Industry. If, after a hearing, the

22-17  Division of Insurance determines that any such insurer failed to

22-18  comply with the requirements of subsection 1, the Division may

22-19  impose an administrative fine of not more than $10,000 against the

22-20  insurer for each such failure to report. If the administrative fine is

22-21  not paid when due, the fine must be recovered in a civil action

22-22  brought by the Attorney General on behalf of the Division.

22-23     Sec. 44.  NRS 633.651 is hereby amended to read as follows:

22-24     633.651  1.  The person charged in a formal complaint is

22-25  entitled to a hearing before the Board, but the failure of the person

22-26  charged to attend his hearing or his failure to defend himself must

22-27  not delay or void the proceedings. The Board may, for good cause

22-28  shown, continue any hearing from time to time.

22-29     2.  [If] Except as otherwise provided in sections 38 and 40 of

22-30  this act, if the Board finds the person guilty as charged in the formal

22-31  complaint, it may by order:

22-32     (a) Place the person on probation for a specified period or until

22-33  further order of the Board.

22-34     (b) Administer to the person a public reprimand.

22-35     (c) Limit the practice of the person to, or by the exclusion of,

22-36  one or more specified branches of osteopathic medicine.

22-37     (d) Suspend the license of the person to practice osteopathic

22-38  medicine for a specified period or until further order of the Board.

22-39     (e) Revoke the license of the person to practice osteopathic

22-40  medicine.

22-41  The order of the Board may contain such other terms, provisions or

22-42  conditions as the Board deems proper and which are not inconsistent

22-43  with law.

22-44     Sec. 45.  1.  The Commissioner shall conduct a study

22-45  concerning insurers that issue policies of malpractice insurance to

23-1  providers of health care in this state. The study must include,

23-2  without limitation, investigation and fact-finding concerning:

23-3      (a) Current actuarial practices, including, without limitation:

23-4          (1) Bandwidth used in data transmission;

23-5          (2) Credits relating to premiums; and

23-6          (3) Charges imposed for specific medical or dental

23-7  specialties;

23-8      (b) Procedures relating to and factors used for the underwriting

23-9  of losses;

23-10     (c) The adequacy of standards, practices and procedures relating

23-11  to the reserves of insurers; and

23-12     (d) The strategies used to price policies of malpractice insurance

23-13  and other products, including, without limitation, the impact of such

23-14  strategies on the reserves of insurers.

23-15     2.  For the purposes of this section, the Commissioner shall

23-16  appoint an advisory panel within the Division of Insurance of the

23-17  Department of Business and Industry, consisting of:

23-18     (a) An actuary;

23-19     (b) A person with expertise regarding policy-making and

23-20  decision-making within the insurance industry; and

23-21     (c) A person with expertise regarding policies of malpractice

23-22  insurance.

23-23     3.  The advisory panel appointed pursuant to this section shall:

23-24     (a) With regard to the available databases containing actuarial

23-25  information relating to policies of malpractice insurance:

23-26         (1) Review all such databases;

23-27         (2) Investigate the accuracy of such databases, including,

23-28  without limitation, the accuracy of data relating to insurers and to

23-29  specific medical or dental specialties;

23-30         (3) Study the feasibility of combining such databases into

23-31  one database, including, without limitation, the potential accuracy of

23-32  that one combined database; and

23-33         (4) Formulate recommendations for improving the accuracy

23-34  and accessibility of such databases and, if feasible, for combining

23-35  such databases into one database;

23-36     (b) With regard to policies of malpractice insurance:

23-37         (1) Review the forms for such policies and determine

23-38  whether the forms are properly used; and

23-39         (2) Review the adequacy of standards, practices and

23-40  procedures relating to the reserves of insurers;

23-41     (c) Review any other matters as directed by the Commissioner;

23-42  and

23-43     (d) Report all findings, determinations and recommendations

23-44  required by this subsection to the Commissioner, in the manner

23-45  prescribed by the Commissioner.

24-1      4.  The Commissioner shall hold public hearings, at such times

24-2  and places as the Commissioner deems appropriate, to:

24-3      (a) Carry out the study required pursuant to subsection 1;

24-4      (b) Review and consider the report of the advisory panel

24-5  pursuant to subsection 3; and

24-6      (c) Afford the general public and representatives of

24-7  governmental agencies and of organizations interested in insurance

24-8  the opportunity to present relevant information and

24-9  recommendations.

24-10     5.  The Commissioner and the advisory panel may employ any

24-11  consultants and professional and secretarial staff that the

24-12  Commissioner deems necessary to carry out fully the requirements

24-13  of this section.

24-14     6.  The Commissioner shall assess to the Board of Medical

24-15  Examiners all costs related to carrying out the requirements of this

24-16  section. The Board of Medical Examiners shall pay any claim

24-17  submitted to the Board by the Commissioner pursuant to this section

24-18  not less than 30 days after such submission.

24-19     7.  The Commissioner shall submit to the Director of the

24-20  Legislative Counsel Bureau for distribution to the Legislature a

24-21  report of his findings and any recommendations for legislation

24-22  pursuant to this section not later than March 1, 2004.

24-23     8.  As used in this section:

24-24     (a) “Commissioner” means the Commissioner of Insurance.

24-25     (b) “Policy of malpractice insurance” has the meaning ascribed

24-26  to it in section 6 of this act.

24-27     (c) “Provider of health care” has the meaning ascribed to it in

24-28  section 8 of this act.

24-29     Sec. 46.  1.  The provisions of section 19 of this act do not

24-30  apply to an action filed before October 1, 2003.

24-31     2.  The amendatory provisions of section 22 of this act do not

24-32  apply to a cause of action that accrues before October 1, 2003.

24-33     Sec. 47.  1.  The provisions of this act become effective upon

24-34  passage and approval for the purpose of adopting regulations, and

24-35  on October 1, 2003, for all other purposes.

24-36     2.  If the Initiative Petition which is commonly known as “Keep

24-37  Our Doctors in Nevada” is submitted as a question and is approved

24-38  by a majority of the voters voting on the question at the general

24-39  election held in 2004, sections 17 to 20, inclusive, and 22 of this act

24-40  expire by limitation on the date that the Initiative Petition becomes

24-41  law and takes effect pursuant to Section 2 of Article 19 of the

24-42  Nevada Constitution.

 

24-43  H