SB425

requires two-thirds majority vote (§ 20)

S.B. 425

Senate Bill No. 425–Committee on Commerce and Labor

(On Behalf of the Board of Pharmacy)

March 24, 2003

____________

Referred to Committee on Commerce and Labor

SUMMARY—Makes various changes relating to pharmacy. (BDR 54‑530)

FISCAL NOTE: Effect on Local Government: No.

Effect on the State: No.

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

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

AN ACT relating to pharmacy; increasing the fee for the biennial renewal of a license for a manufacturer or wholesaler; abolishing inactive licenses; revising provisions governing prescriptions purchased with cash; revising provisions governing a rehearing of the State Board of Pharmacy concerning a contest or appeal of a decision of the Board; repealing the requirement that a notice concerning the substitution of certain drugs be displayed in a pharmacy; 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. Chapter 639 of NRS is hereby amended by adding

1-2 thereto the provisions set forth as sections 2 and 3 of this act.

1-3 Sec. 2. “Pharmaceutical technician” means a person who

1-4 performs technical services in a pharmacy under the direct

1-5 supervision of a pharmacist and is registered with the Board.

1-6 Sec. 3. “Pharmaceutical technician in training” means a

1-7 person who is:

1-8 1. Registered with the Board in order to obtain the training

1-9 and experience required to be a pharmaceutical technician; or

2-1 2. Enrolled in a program of training for pharmaceutical

2-2 technicians that is approved by the Board.

2-3 Sec. 4. NRS 639.001 is hereby amended to read as follows:

2-4 639.001 As used in this chapter, unless the context otherwise

2-5 requires, the words and terms defined in NRS 639.0015 to 639.016,

2-6 inclusive, and sections 2 and 3 of this act have the meanings

2-7 ascribed to them in those sections.

2-8 Sec. 5. NRS 639.0124 is hereby amended to read as follows:

2-9 639.0124 “Practice of pharmacy” includes, but is not limited

2-10 to, the:

2-11 1. Performance or supervision of activities associated with

2-12 manufacturing, compounding, labeling, dispensing and distributing

2-13 of a drug[.] , including the receipt, handling and storage of

2-14 prescriptions and other confidential information relating to

2-15 patients.

2-16 2. Interpretation and evaluation of prescriptions or orders for

2-17 medicine.

2-18 3. Participation in drug evaluation and drug research.

2-19 4. Advising of the therapeutic value, reaction, drug interaction,

2-20 hazard and use of a drug.

2-21 5. Selection of the source, storage and distribution of a drug.

2-22 6. Maintenance of proper documentation of the source, storage

2-23 and distribution of a drug.

2-24 7. Interpretation of clinical data contained in a person’s record

2-25 of medication.

2-26 8. Development of written guidelines and protocols in

2-27 collaboration with a practitioner which are intended for a patient in a

2-28 licensed medical facility and authorize the implementation,

2-29 monitoring and modification of drug therapy. The written

2-30 guidelines and protocols may authorize a pharmacist to order and

2-31 use the findings of laboratory tests and examinations.

2-32 9. Implementation and modification of drug therapy in

2-33 accordance with the authorization of the prescribing practitioner for

2-34 a patient in a pharmacy in which drugs, controlled substances,

2-35 poisons, medicines or chemicals are sold at retail.

2-36 The term does not include the changing of a prescription by a

2-37 pharmacist or practitioner without the consent of the prescribing

2-38 practitioner, except as otherwise provided in NRS 639.2583.

2-39 Sec. 6. NRS 639.015 is hereby amended to read as follows:

2-40 639.015 “Registered pharmacist” means:

2-41 1. A person registered in this state as such on July 1, 1947;

2-42 2. A person registered in this state as such in compliance with

2-43 the provisions of paragraph (c) of section 3 of chapter 195, Statutes

2-44 of Nevada 1951; or

3-1 3. A person who has complied with the provisions of NRS

3-2 639.120 [and 639.133] and whose name has been entered in the

3-3 registry of pharmacists of this state by the Executive Secretary of

3-4 the Board and to whom a valid certificate as a registered pharmacist

3-5 or valid renewal thereof has been issued by the Board.

3-6 Sec. 7. NRS 639.0152 is hereby amended to read as follows:

3-7 639.0152 “Supportive personnel” means [persons who perform

3-8 technical services in a pharmacy that do not require the judgment of

3-9 a pharmacist but which are related to the preparation and

3-10 distribution of drugs under the direct supervision of the pharmacist

3-11 who is responsible for all of the work performed in the pharmacy.]

3-12 any person, other than a pharmacist, intern pharmacist,

3-13 pharmaceutical technician or pharmaceutical technician in

3-14 training, who is employed by a pharmacy and has access to the

3-15 secured premises of the pharmacy.

3-16 Sec. 8. NRS 639.040 is hereby amended to read as follows:

3-17 639.040 1. The Board shall elect a President and a Treasurer

3-18 from among its members.

3-19 2. The Board shall employ [a] an Executive Secretary, who

3-20 must not be a member of the Board. The Executive Secretary shall

3-21 keep a complete record of all proceedings of the Board and of all

3-22 certificates issued, and shall perform such other duties as the Board

3-23 may require, for which services he is entitled to receive a salary to

3-24 be determined by the Board.

3-25 Sec. 9. NRS 639.070 is hereby amended to read as follows:

3-26 639.070 1. The Board may:

3-27 (a) Adopt such regulations, not inconsistent with the laws of this

3-28 state, as are necessary for the protection of the public, appertaining

3-29 to the practice of pharmacy and the lawful performance of its duties.

3-30 (b) Adopt regulations requiring that prices charged by retail

3-31 pharmacies for drugs and medicines which are obtained by

3-32 prescription be posted in the pharmacies and be given on the

3-33 telephone to persons requesting such information.

3-34 (c) Adopt regulations, not inconsistent with the laws of this

3-35 state, authorizing the Executive Secretary of the Board to issue

3-36 certificates, licenses and permits required by this chapter and

3-37 chapters 453 and 454 of NRS.

3-38 (d) Adopt regulations governing the dispensing of poisons,

3-39 drugs, chemicals and medicines.

3-40 (e) Regulate the practice of pharmacy.

3-41 (f) Regulate the sale and dispensing of poisons, drugs, chemicals

3-42 and medicines.

3-43 (g) Regulate the means of recordkeeping and storage, handling,

3-44 sanitation and security of drugs, poisons, medicines, chemicals and

3-45 devices, including, but not limited to, requirements relating to:

4-1 (1) Pharmacies, institutional pharmacies and pharmacies in

4-2 correctional institutions;

4-3 (2) Drugs stored in hospitals; and

4-4 (3) Drugs stored for the purpose of wholesale distribution.

4-5 (h) Examine and register, upon application, pharmacists and

4-6 other persons who dispense or distribute medications whom it

4-7 deems qualified.

4-8 (i) Charge and collect necessary and reasonable fees for its

4-9 services, other than those specifically set forth in this chapter.

4-10 (j) Maintain offices in as many localities in the State as it finds

4-11 necessary to carry out the provisions of this chapter.

4-12 (k) Employ an attorney, inspectors, investigators and other

4-13 professional consultants and clerical personnel necessary to the

4-14 discharge of its duties.

4-15 (l) Enforce the provisions of NRS 453.011 to 453.552, inclusive,

4-16 and enforce the provisions of this chapter and chapter 454 of NRS.

4-17 (m) Adopt regulations concerning the information required to be

4-18 submitted in connection with an application for any license,

4-19 certificate or permit required by this chapter or chapter 453 or 454

4-20 of NRS.

4-21 (n) Adopt regulations concerning the education, experience and

4-22 background of a person who is employed by the holder of a license

4-23 or permit issued pursuant to this chapter and who has access to

4-24 drugs and devices.

4-25 (o) Adopt regulations concerning the use of computerized

4-26 mechanical equipment for the filling of prescriptions.

4-27 (p) Participate in and expend money for programs that enhance

4-28 the practice of pharmacy.

4-29 2. This section does not authorize the Board to prohibit open-

4-30 market competition in the advertising and sale of prescription drugs

4-31 and pharmaceutical services.

4-32 Sec. 10. NRS 639.081 is hereby amended to read as follows:

4-33 639.081 1. Except as otherwise provided in subsection 3, all

4-34 money coming into the possession of the Board must be kept or

4-35 deposited by the Executive Secretary of the Board in banks, credit

4-36 unions or savings and loan associations in the State of Nevada, or

4-37 invested in United States treasury bills or notes, to be expended for

4-38 payment of compensation and expenses of members of the Board

4-39 and for other necessary or proper purposes in the administration of

4-40 this chapter.

4-41 2. The Board may delegate to a hearing officer or panel its

4-42 authority to take any disciplinary action pursuant to this chapter,

4-43 impose and collect fines therefor and deposit the money therefrom

4-44 in banks, credit unions or savings and loan associations in this state.

5-1 3. If a hearing officer or panel is not authorized to take

5-2 disciplinary action pursuant to subsection 2 and the Board deposits

5-3 the money collected from the imposition of fines with the State

5-4 Treasurer for credit to the State General Fund, it may present a

5-5 claim to the State Board of Examiners for recommendation to the

5-6 Interim Finance Committee if money is needed to pay attorney’s

5-7 fees or the costs of an investigation, or both.

5-8 Sec. 11. NRS 639.120 is hereby amended to read as follows:

5-9 639.120 1. An applicant to become a registered pharmacist in

5-10 this state must:

5-11 (a) Be of good moral character.

5-12 (b) Be a graduate of a college of pharmacy or department of

5-13 pharmacy of a university accredited by the American Council on

5-14 Pharmaceutical Education or Canadian Council for Accreditation

5-15 of Pharmacy Programs and approved by the Board or a graduate of

5-16 a foreign school who has passed an examination for foreign

5-17 graduates approved by the Board to demonstrate that his education

5-18 is equivalent.

5-19 (c) Pass an examination approved and given by the Board with a

5-20 grade of at least 75 on the examination as a whole and a grade of at

5-21 least 75 on the examination on law. An applicant for registration by

5-22 reciprocity must pass the examination on law with at least a grade

5-23 of 75.

5-24 (d) Complete not less than 1,500 hours of practical

5-25 pharmaceutical experience as an intern pharmacist under the direct

5-26 and immediate supervision of a registered pharmacist.

5-27 2. The practical pharmaceutical experience required pursuant

5-28 to paragraph (d) of subsection 1 must relate primarily to the selling

5-29 of drugs, poisons and devices, the compounding and dispensing of

5-30 prescriptions, preparing prescriptions , and keeping records and

5-31 preparing reports required by state and federal statutes.

5-32 3. The Board may accept evidence of compliance with the

5-33 requirements set forth in paragraph (d) of subsection 1 from boards

5-34 of pharmacy of other states in which the experience requirement is

5-35 equivalent to the requirements in this state.

5-36 Sec. 12. NRS 639.127 is hereby amended to read as follows:

5-37 639.127 1. An applicant for registration as a pharmacist in

5-38 this state must submit an application to the Executive Secretary of

5-39 the Board on a form furnished by the Board and must pay the fee

5-40 fixed by the Board. The fee must be paid at the time the application

5-41 is submitted and is compensation to the Board for the investigation

5-42 and the examination of the applicant. Under no circumstances may

5-43 the fee be refunded.

6-1 2. Proof of the qualifications of any applicant must be made to

6-2 the satisfaction of the Board and must be substantiated by affidavits,

6-3 records or such other evidence as the Board may require.

6-4 3. An application is only valid for 1 year after the date it is

6-5 received by the Board unless the Board extends its period of

6-6 validity.

6-7 4. A certificate of registration as a pharmacist must be issued to

6-8 each person who the Board determines is qualified pursuant to the

6-9 provisions of NRS 639.120[, 639.133] and 639.134. The certificate

6-10 entitles the person to whom it is issued to practice pharmacy in this

6-11 state.

6-12 Sec. 13. NRS 639.128 is hereby amended to read as follows:

6-13 639.128 The application of a natural person who applies for the

6-14 issuance of a certificate of registration as a pharmacist, [an] intern

6-15 pharmacist , pharmaceutical technician, pharmaceutical

6-16 technician in training or supportive personnel or a license issued

6-17 pursuant to NRS 639.233 must include the social security number of

6-18 the applicant.

6-19 Sec. 14. NRS 639.129 is hereby amended to read as follows:

6-20 639.129 1. A natural person who applies for the issuance or

6-21 renewal of a certificate of registration as a pharmacist, [an] intern

6-22 pharmacist , pharmaceutical technician, pharmaceutical

6-23 technician in training or supportive personnel or a license issued

6-24 pursuant to NRS 639.233 shall submit to the Board the statement

6-25 prescribed by the Welfare Division of the Department of Human

6-26 Resources pursuant to NRS 425. 520. The statement must be

6-27 completed and signed by the applicant.

6-28 2. The Board shall include the statement required pursuant to

6-29 subsection 1 in:

6-30 (a) The application or any other forms that must be submitted

6-31 for the issuance or renewal of the certificate or license; or

6-32 (b) A separate form prescribed by the Board.

6-33 3. A certificate of registration as a pharmacist, [an] intern

6-34 pharmacist , pharmaceutical technician, pharmaceutical

6-35 technician in training or supportive personnel or a license issued

6-36 pursuant to NRS 639.233 may not be issued or renewed by the

6-37 Board if the applicant is a natural person who:

6-38 (a) Fails to submit the statement required pursuant to subsection

6-39 1; or

6-40 (b) Indicates on the statement submitted pursuant to subsection

6-41 1 that he is subject to a court order for the support of a child and is

6-42 not in compliance with the order or a plan approved by the district

6-43 attorney or other public agency enforcing the order for the

6-44 repayment of the amount owed pursuant to the order.

7-1 4. If an applicant indicates on the statement submitted pursuant

7-2 to subsection 1 that he is subject to a court order for the support of a

7-3 child and is not in compliance with the order or a plan approved by

7-4 the district attorney or other public agency enforcing the order for

7-5 the repayment of the amount owed pursuant to the order, the Board

7-6 shall advise the applicant to contact the district attorney or other

7-7 public agency enforcing the order to determine the actions that the

7-8 applicant may take to satisfy the arrearage.

7-9 Sec. 15. NRS 639.137 is hereby amended to read as follows:

7-10 639.137 1. Any person who is not a registered pharmacist,

7-11 but who is employed in this state for the purpose of fulfilling the

7-12 requirements of paragraph (d) of subsection 1 of NRS 639.120 to

7-13 become eligible for registration as a pharmacist, shall register with

7-14 the Board as an intern pharmacist. An applicant, to be eligible for

7-15 registration as an intern pharmacist, must be enrolled in a college of

7-16 pharmacy or a department of pharmacy of a university approved by

7-17 the Board or be a graduate of a foreign school and pass an

7-18 examination for foreign graduates approved by the Board. The

7-19 application must be made on a form furnished by the Board.

7-20 2. The Executive Secretary of the Board, upon approval of the

7-21 application, shall issue a certificate of registration authorizing

7-22 the applicant to undergo practical pharmaceutical training under the

7-23 direct and immediate supervision of a registered pharmacist. The

7-24 period of validity of the certificate of registration, including any

7-25 renewal, must not exceed 4 years after the date of issue. The

7-26 certificate of registration authorizes the holder, if acting under the

7-27 direct and immediate supervision of a registered pharmacist, to

7-28 perform:

7-29 (a) The duties of a registered pharmacist as authorized by

7-30 regulation of the Board; and

7-31 (b) Other activities as authorized by regulation of the Board.

7-32 3. The certificate of registration must be posted as required by

7-33 NRS 639.150.

7-34 4. Any certificate of registration issued pursuant to the

7-35 provisions of this section may be suspended, terminated or revoked

7-36 by the Board for:

7-37 (a) Any reason set forth in this chapter as grounds for the

7-38 suspension or revocation of any certificate, license or permit; or

7-39 (b) The failure of the registered pharmacist whose name appears

7-40 on the certificate of registration to provide adequate training and

7-41 supervision for the intern pharmacist in compliance with regulations

7-42 adopted by the Board.

7-43 Sec. 16. NRS 639.1371 is hereby amended to read as follows:

7-44 639.1371 1. The ratio of [supportive personnel]

7-45 pharmaceutical technicians to pharmacists must not allow more

8-1 than one [supportive personnel] pharmaceutical technician to each

8-2 pharmacist unless the Board by regulation expands the ratio.

8-3 2. The Board shall adopt regulations concerning

8-4 pharmaceutical technicians and supportive personnel, including

8-5 requirements for:

8-6 (a) The qualifications, registration and supervision of

8-7 pharmaceutical technicians and supportive personnel; [and

8-8 (b) Services]

8-9 (b) The ratio of supportive personnel to pharmacists for each

8-10 category of pharmacy; and

8-11 (c) The services which may be performed by pharmaceutical

8-12 technicians and supportive personnel,

8-13 to ensure the protection and safety of the public in the provision of

8-14 pharmaceutical care.

8-15 3. The regulations adopted by the Board pursuant to this

8-16 section which prescribe:

8-17 (a) The qualifications for [supportive personnel]

8-18 pharmaceutical technicians must include:

8-19 (1) [At least 1 year of education at a postsecondary school

8-20 which is directly related to the duties performed by supportive

8-21 personnel;

8-22 (2)] The successful completion of a program for [supportive

8-23 personnel] pharmaceutical technicians which is approved by the

8-24 Board;

8-25 [(3)] (2) The completion of at least 1,500 hours of experience

8-26 in carrying out the duties of [supportive personnel; or

8-27 (4)] a pharmaceutical technician; or

8-28 (3) Any other experience or education deemed equivalent by

8-29 the Board.

8-30 (b) An expanded ratio of [supportive personnel] pharmaceutical

8-31 technicians to pharmacists must [not allow more than two

8-32 supportive personnel for each pharmacist in] be appropriate and

8-33 necessary for a particular category of pharmacy at any time.

8-34 (c) The services which may be performed by [supportive

8-35 personnel] pharmaceutical technicians must include, without

8-36 limitation, the:

8-37 (1) Removal of drugs from stock;

8-38 (2) Counting, pouring or mixing of drugs;

8-39 (3) Placing of drugs in containers;

8-40 (4) Affixing of labels to containers; and

8-41 (5) Packaging and repackaging of drugs.

8-42 4. For the purposes of this chapter, and chapters 453 and 454 of

8-43 NRS, [supportive personnel] pharmaceutical technicians may

8-44 perform acts required to be performed by pharmacists , but only to

8-45 the extent provided in regulations.

9-1 Sec. 17. NRS 639.138 is hereby amended to read as follows:

9-2 639.138 If the Board, after an investigation, denies any

9-3 application for a certificate, license or permit, the Executive

9-4 Secretary of the Board shall notify the applicant, within 10 days

9-5 after the denial is approved by the Board and entered in the official

9-6 minutes, by registered or certified mail, of the denial of the

9-7 application and the reasons therefor. The notice must inform the

9-8 applicant of his right to petition the Board for reconsideration and

9-9 his right to submit evidence to controvert the alleged violations on

9-10 which the denial was based.

9-11 Sec. 18. NRS 639.139 is hereby amended to read as follows:

9-12 639.139 1. At any time within 30 days after receipt of the

9-13 notice of denial of his application, an applicant may petition the

9-14 Board for reconsideration of the application. The petition must set

9-15 forth a denial, in whole or in part, of the violations alleged and a

9-16 statement that the applicant is prepared to submit evidence in

9-17 support of his denial of the allegations.

9-18 2. Within 30 days after the petition is received by the Board,

9-19 the Executive Secretary of the Board shall notify the petitioner, by

9-20 registered or certified mail, of the Board’s decision [either] to grant

9-21 or deny the petition for reconsideration. If the petition is granted, the

9-22 notice [shall] must include the time and place set for reconsideration

9-23 of the application by the Board.

9-24 Sec. 19. NRS 639.160 is hereby amended to read as follows:

9-25 639.160 Every registered pharmacist shall, within 10 days after

9-26 changing his place of practice as designated on the books of the

9-27 Executive Secretary of the Board, notify the Executive Secretary [of

9-28 the Board of such] of the change and of his new place of practice.

9-29 Upon receipt of [such] the notification , the Executive Secretary

9-30 shall make the necessary change in his register.

9-31 Sec. 20. NRS 639.170 is hereby amended to read as follows:

9-32 639.170 1. The Board shall charge and collect not more than

9-33 the following fees for the following services:

9-34 Actual cost

9-35 For the examination of an applicant for registration of the

9-36 as a pharmacist......................... examination

9-37 For the investigation or registration of an

9-38 applicant as a registered pharmacist. $200

9-39 For the investigation, examination or registration

9-40 of an applicant as a registered pharmacist by

9-41 reciprocity............................................ 300

9-42 For the investigation or issuance of an original

9-43 license to conduct a retail pharmacy.. 600

10-1 For the biennial renewal of a license to conduct a

10-2 retail pharmacy.................................. $500

10-3 For the investigation or issuance of an original

10-4 license to conduct an institutional pharmacy 600

10-5 For the biennial renewal of a license to conduct an

10-6 institutional pharmacy........................ 500

10-7 For the issuance of an original or duplicate

10-8 certificate of registration as a registered

10-9 pharmacist............................................. 50

10-10 For the biennial renewal of registration as a

10-11 registered pharmacist......................... 200

10-12 For the reinstatement of a lapsed registration (in

10-13 addition to the fees for renewal for the period of

10-14 lapse)................................................... 100

10-15 For the initial registration of a pharmaceutical

10-16 technician or pharmaceutical technician in

10-17 training............................................... 50

10-18 For the biennial renewal of registration of a

10-19 pharmaceutical technician or pharmaceutical

10-20 technician in training....................... 50

10-21 For the initial registration of supportive personnel 50

10-22 For the biennial renewal of registration of

10-23 supportive personnel........................... 50

10-24 For the investigation or registration of an intern

10-25 pharmacist............................................ 50

10-26 For the biennial renewal of registration as an

10-27 intern pharmacist................................. 40

10-28 For investigation or issuance of an original license

10-29 to a manufacturer or wholesaler........ 500

10-30 For the biennial renewal of a license for a

10-31 manufacturer or wholesaler.... [400] 500

10-32 For the reissuance of a license issued to a

10-33 pharmacy, when no change of ownership is

10-34 involved, but the license must be reissued because

10-35 of a change in the information required thereon100

10-36 [For the biennial renewal of registration issued to

10-37 a registered pharmacist placed on inactive status 100]

10-38 For authorization of a practitioner to dispense

10-39 controlled substances or dangerous drugs, or both300

10-40 For the biennial renewal of authorization of a

10-41 practitioner to dispense controlled substances or

10-42 dangerous drugs, or both................... 300

11-1 2. If a person requests a special service from the Board or

11-2 requests the Board to convene a special meeting, he must pay the

11-3 actual costs to the Board as a condition precedent to the rendition of

11-4 the special service or the convening of the special meeting.

11-5 3. All fees are payable in advance and are not refundable.

11-6 4. The Board may, by regulation, set the penalty for failure to

11-7 pay the fee for renewal for any license, permit, authorization or

11-8 certificate within the statutory period, at an amount not to exceed

11-9 100 percent of the fee for renewal for each year of delinquency in

11-10 addition to the fees for renewal for each year of delinquency.

11-11 Sec. 21. NRS 639.180 is hereby amended to read as follows:

11-12 639.180 1. Except as otherwise provided in this subsection, a

11-13 certificate, license or permit issued by the Board pursuant to this

11-14 chapter expires on October 31 of each even‑numbered year. A

11-15 certificate of registration as a pharmacist expires on October 31 of

11-16 each odd‑numbered year.

11-17 2. Except as otherwise provided by NRS 639.137, 639.230 and

11-18 639.2328, each person to whom a certificate, license or permit has

11-19 been issued may, if the certificate, license or permit has not been

11-20 revoked, renew the certificate, license or permit biennially by:

11-21 (a) Filing an application for renewal;

11-22 (b) Paying the fee for renewal;

11-23 (c) Complying with the requirement of continuing professional

11-24 education, if applicable; and

11-25 (d) If the applicant is a natural person who is applying for the

11-26 renewal of a certificate of registration as a pharmacist, [an] intern

11-27 pharmacist , pharmaceutical technician, pharmaceutical

11-28 technician in training or supportive personnel or a license issued

11-29 pursuant to NRS 639.233, submitting the statement required

11-30 pursuant to NRS 639.129.

11-31 3. The application for renewal, together with the fee for

11-32 renewal and, if applicable, the statement, must be delivered to the

11-33 Executive Secretary of the Board on or before the expiration date of

11-34 the certificate, license or permit, or the current renewal receipt

11-35 thereof.

11-36 4. If a certificate, license or permit is renewed, it must be

11-37 delivered to the applicant within a reasonable time after receipt of

11-38 the application for renewal and the fee for renewal.

11-39 5. The Board may refuse to renew a certificate, license or

11-40 permit if the applicant has committed any act proscribed by

11-41 NRS 639.210.

11-42 6. If the application for renewal and the fee for renewal and, if

11-43 applicable, the statement[,] are not postmarked on or before the

11-44 expiration date of the certificate, license or permit, or the current

11-45 renewal receipt thereof, the registration is automatically forfeited.

12-1 Sec. 22. NRS 639.2174 is hereby amended to read as follows:

12-2 639.2174 The Board shall not[:

12-3 1. Issue a certificate as a registered pharmacist to any person

12-4 pursuant to NRS 639.133; or

12-5 2. Renew] renew the certificate of any registered pharmacist[,]

12-6 until the applicant has submitted proof to the Board of the receipt of

12-7 the required number of continuing education units, obtained through

12-8 the satisfactory completion of an accredited program of continuing

12-9 professional education during the period for which the certificate

12-10 was issued.

12-11 Sec. 23. NRS 639.230 is hereby amended to read as follows:

12-12 639.230 1. A [pharmacy or a] person operating [as a

12-13 pharmacy] a business in this state shall not use the letters “Rx” or

12-14 “RX” or the word “drug” or “drugs,” “prescription” or “pharmacy,”

12-15 or similar words or words of similar import, without first having

12-16 secured a license from the Board.

12-17 2. Each license must be issued to a specific person and for a

12-18 specific location and is not transferable. The original license must be

12-19 displayed on the licensed premises as provided in NRS 639.150.

12-20 The original license and the fee required for reissuance of a license

12-21 must be submitted to the Board before the reissuance of the license.

12-22 3. If the owner of a pharmacy is a partnership or corporation,

12-23 any change of partners or corporate officers must be reported to the

12-24 Board at such a time as is required by a regulation of the Board.

12-25 4. In addition to the requirements for renewal set forth in NRS

12-26 639.180, every person holding a license to operate a pharmacy must

12-27 satisfy the Board that the pharmacy is conducted according to law.

12-28 5. Any violation of any of the provisions of this chapter by a

12-29 managing pharmacist or by personnel of the pharmacy under the

12-30 supervision of the managing pharmacist is cause for the suspension

12-31 or revocation of the license of the pharmacy by the Board.

12-32 Sec. 24. NRS 639.231 is hereby amended to read as follows:

12-33 639.231 1. An application to conduct a pharmacy must be

12-34 made on a form furnished by the Board and must state the name,

12-35 address, usual occupation and professional qualifications, if any, of

12-36 the applicant. If the applicant is other than a natural person, the

12-37 application must state such information as to each person

12-38 beneficially interested therein.

12-39 2. As used in subsection 1, and subject to the provisions of

12-40 subsection 3, the term “person beneficially interested” means:

12-41 (a) If the applicant is a partnership or other unincorporated

12-42 association, each partner or member.

12-43 (b) If the applicant is a corporation, each of its officers, directors

12-44 and stockholders, provided that no natural person shall be deemed to

12-45 be beneficially interested in a nonprofit corporation.

13-1 3. If the applicant is a partnership, unincorporated association

13-2 or corporation and the number of partners, members or stockholders,

13-3 as the case may be, exceeds four, the application must so state, and

13-4 must list each of the four partners, members or stockholders who

13-5 own the four largest interests in the applicant entity and state their

13-6 percentages of interest. Upon request of the Executive Secretary of

13-7 the Board, the applicant shall furnish the Board with information as

13-8 to partners, members or stockholders not named in the application or

13-9 shall refer the Board to an appropriate source of such information.

13-10 4. The completed application form must be returned to the

13-11 Board with the fee prescribed by the Board, which may not be

13-12 refunded. Any application which is not complete as required by the

13-13 provisions of this section may not be presented to the Board for

13-14 consideration.

13-15 5. Upon compliance with all the provisions of this section and

13-16 upon approval of the application by the Board, the Executive

13-17 Secretary shall issue a license to the applicant to conduct a

13-18 pharmacy. Any other provision of law notwithstanding, such a

13-19 license authorizes the holder to conduct a pharmacy and to sell and

13-20 dispense drugs and poisons and devices and appliances that are

13-21 restricted by federal law to sale by or on the order of a physician.

13-22 Sec. 25. NRS 639.234 is hereby amended to read as follows:

13-23 639.234 1. The acceptance of a license issued pursuant to

13-24 NRS 639.233 constitutes a consent by the licensee to the inspection

13-25 of his records maintained inside and outside this state by any

13-26 authorized representative of the Board.

13-27 2. If such a licensee does not maintain records within this state

13-28 of his shipments of controlled substances, poisons or drugs or

13-29 devices or appliances that are restricted by federal law to sale by or

13-30 on the order of a physician to persons in this state , he shall, on

13-31 receipt of a written demand from the Executive Secretary of the

13-32 Board, furnish a true copy of the records to the Board.

13-33 3. The Board may authorize as its representative any member

13-34 or representative of the Board of pharmacy or similar agency of the

13-35 state in which the records are located.

13-36 4. Failure to furnish a true copy of the required records or

13-37 refusal to permit their inspection is a ground for the revocation or

13-38 suspension of any license issued pursuant to NRS 639.233.

13-39 Sec. 26. NRS 639.235 is hereby amended to read as follows:

13-40 639.235 1. No person other than a practitioner holding a

13-41 license to practice his profession in this state may prescribe or write

13-42 a prescription, except that a prescription written by a person who is

13-43 not licensed to practice in this state , but is authorized by the laws of

13-44 another state to prescribe , shall be deemed to be a legal prescription

14-1 unless the person prescribed or wrote the prescription in violation of

14-2 the provisions of NRS 453.3611 to 453.3648, inclusive.

14-3 2. If a prescription that is prescribed by a person who is not

14-4 licensed to practice in this state, but is authorized by the laws of

14-5 another state to prescribe, calls for a controlled substance listed in:

14-6 (a) Schedule II, the registered pharmacist who is to fill the

14-7 prescription shall establish and document that the prescription is

14-8 authentic and that a bona fide relationship between the patient and

14-9 the person prescribing the controlled substance did exist when the

14-10 prescription was written.

14-11 (b) Schedule III or IV, the registered pharmacist who is to fill

14-12 the prescription shall establish[, in his professional judgment,] that

14-13 the prescription is authentic and that a bona fide relationship

14-14 between the patient and the person prescribing the controlled

14-15 substance did exist when the prescription was written. This

14-16 paragraph does not require the registered pharmacist to inquire into

14-17 such a relationship upon the receipt of [each such prescription.] a

14-18 similar prescription subsequently issued for that patient.

14-19 3. A pharmacist who fills a prescription described in

14-20 subsection 2 shall record on the prescription or in the prescription

14-21 record in the pharmacy’s computer:

14-22 (a) The name of the person with whom he spoke concerning

14-23 the prescription;

14-24 (b) The date and time of the conversation; and

14-25 (c) The date and time the patient was physically examined by

14-26 the person prescribing the controlled substance for which the

14-27 prescription was issued.

14-28 4. For the purposes of subsection 2, a bona fide relationship

14-29 between the patient and the person prescribing the controlled

14-30 substance shall be deemed to exist if the patient was physically

14-31 examined by the person prescribing the controlled substances

14-32 within the 6 months immediately preceding the date the

14-33 prescription was issued.

14-34 Sec. 27. NRS 639.238 is hereby amended to read as follows:

14-35 639.238 1. Prescriptions filled and on file in a pharmacy are

14-36 not a public record. A pharmacist shall not divulge the contents of

14-37 any prescription or provide a copy of any prescription, except to:

14-38 (a) The patient for whom the original prescription was issued;

14-39 (b) The practitioner who originally issued the prescription;

14-40 (c) A practitioner who is then treating the patient;

14-41 (d) A member, inspector or investigator of the Board or an

14-42 inspector of the Food and Drug Administration or an agent of the

14-43 Investigation Division of the Department of Public Safety;

14-44 (e) An agency of State Government charged with the

14-45 responsibility of providing medical care for the patient;

15-1 (f) An insurance carrier, on receipt of written authorization

15-2 signed by the patient or his legal guardian, authorizing the release of

15-3 such information;

15-4 (g) Any person authorized by an order of a district court;

15-5 (h) Any member, inspector or investigator of a professional

15-6 licensing board which licenses a practitioner who orders

15-7 prescriptions filled at the pharmacy; [or]

15-8 (i) Other registered pharmacists for the limited purpose of and to

15-9 the extent necessary for the exchange of information relating to

15-10 persons who are suspected of:

15-11 (1) Misusing prescriptions to obtain excessive amounts of

15-12 drugs[.] ; or

15-13 (2) Failing to use a drug in conformity with the directions for

15-14 its use or taking a drug in combination with other drugs in a manner

15-15 that could result in injury to that person[.] ; or

15-16 (j) A peace officer employed by a local government for the

15-17 limited purpose of and to the extent necessary:

15-18 (1) For the investigation of an alleged crime reported by an

15-19 employee of the pharmacy where the crime was committed; or

15-20 (2) To carry out a search warrant or subpoena issued

15-21 pursuant to a court order.

15-22 2. Any copy of a prescription for a controlled substance or a

15-23 dangerous drug as defined in chapter 454 of NRS, issued to a person

15-24 authorized by this section to receive such a copy, must contain all of

15-25 the information appearing on the original prescription and be clearly

15-26 marked on its face[,] “Copy, Not Refillable—For Reference

15-27 Purposes Only.” The copy must bear the name or initials of the

15-28 registered pharmacist who prepared the copy.

15-29 3. If a copy of a prescription for any controlled substance or a

15-30 dangerous drug as defined in chapter 454 of NRS is furnished to the

15-31 customer, the original prescription must be voided and notations

15-32 made thereon showing the date and the name of the person to whom

15-33 the copy was furnished.

15-34 4. If, at the express request of a customer, a copy of a

15-35 prescription for any controlled substance or dangerous drug is

15-36 furnished to another pharmacist, the original prescription must be

15-37 voided and notations made thereon showing the date and the name

15-38 of the pharmacist to whom the copy was furnished. The pharmacist

15-39 receiving the copy shall call the prescribing practitioner for a new

15-40 prescription.

15-41 Sec. 28. NRS 639.239 is hereby amended to read as follows:

15-42 639.239 Members, inspectors and investigators of the Board,

15-43 inspectors of the Food and Drug Administration , [and] agents of the

15-44 Investigation Division of the Department of Public Safety and peace

15-45 officers described in paragraph (j) of subsection 1 of NRS 639.238

16-1 may remove any record required to be retained by state or federal

16-2 law or regulation, including any prescription contained in the files of

16-3 a practitioner, if the record in question will be used as evidence in a

16-4 criminal action, civil action or an administrative proceeding, or

16-5 contemplated action or proceeding. The person who removes a

16-6 record pursuant to this section shall:

16-7 1. Affix the name and address of the practitioner to the back of

16-8 the record;

16-9 2. Affix his initials, cause an agent of the practitioner to affix

16-10 his initials and note the date of the removal of the record on the back

16-11 of the record;

16-12 3. Affix the name of the agency for which he is removing the

16-13 record to the back of the record;

16-14 4. Provide the practitioner with a receipt for the record; and

16-15 5. Return a photostatic copy of both sides of the record to the

16-16 practitioner within 15 working days after the record is removed.

16-17 Sec. 29. NRS 639.241 is hereby amended to read as follows:

16-18 639.241 1. A hearing to determine whether the rights and

16-19 privileges granted by any certificate, certification, license or permit

16-20 issued by the Board should be revoked, suspended, limited or

16-21 conditioned must be initiated by the filing of an accusation by the

16-22 Board. The action must be entitled: The Nevada State Board of

16-23 Pharmacy v. (insert the name of the party whose certificate, license

16-24 or permit is involved), who must be designated “Respondent.”

16-25 2. The accusation is a written statement of the charges alleged

16-26 and must set forth in ordinary and concise language the acts or

16-27 omissions with which the respondent is charged to the end that the

16-28 respondent will be able to prepare his defense. [It] The accusation

16-29 must specify the statutes and regulations which the respondent is

16-30 alleged to have violated, but must not consist merely of charges

16-31 phrased in language of the statute or regulation. The accusation must

16-32 be signed by the Executive Secretary of the Board acting in his

16-33 official capacity.

16-34 Sec. 30. NRS 639.242 is hereby amended to read as follows:

16-35 639.242 1. After filing the accusation, the Executive

16-36 Secretary of the Board shall cause a copy thereof, together with one

16-37 copy of the Statement to Respondent and three copies of the form of

16-38 the Notice of Defense, to be served on the respondent.

16-39 2. Service may be [either] by personal service or by first-class

16-40 registered or certified mail addressed to the respondent at his last

16-41 address of record, or by mail to his attorney of record. Proof of

16-42 service [shall] must be retained and made a part of the case record.

17-1 Sec. 31. NRS 639.244 is hereby amended to read as follows:

17-2 639.244 1. The form for the Notice of Defense [shall] must

17-3 be prepared and furnished by the Board and [shall] permit the

17-4 respondent, by completing and signing the notice , to:

17-5 (a) [Request a hearing;

17-6 (b)] Object to the accusation as being incomplete and failing to

17-7 set forth clearly the charges; and

17-8 [(c)] (b) Deny or admit, in part or in whole, the violations

17-9 alleged.

17-10 2. The Notice of Defense [shall] must be signed by the

17-11 respondent or [by] his attorney under penalty of perjury. Failure to

17-12 file a Notice of Defense [and request a hearing shall constitute]

17-13 constitutes a waiver of the respondent’s right to a hearing, but the

17-14 Board may[, in its discretion,] grant a hearing.

17-15 Sec. 32. NRS 639.245 is hereby amended to read as follows:

17-16 639.245 Whenever a hearing has been granted by the Board,

17-17 the Executive Secretary of the Board shall serve notice on the

17-18 respondent of the time and place set for the hearing on the

17-19 accusation. If the Board receives a report pursuant to subsection 5 of

17-20 NRS 228.420, a hearing must be held within 30 days after receiving

17-21 the report. Service may be effected in the same manner as provided

17-22 in NRS 639.242.

17-23 Sec. 33. NRS 639.246 is hereby amended to read as follows:

17-24 639.246 1. The Executive Secretary of the Board shall issue

17-25 subpoenas for the production of witnesses, documents or papers, in

17-26 accordance with statutory provisions, at the request of any party to a

17-27 hearing or for purposes of an investigation or other matter under

17-28 inquiry by the Board.

17-29 2. Witnesses appearing pursuant to a subpoena must receive

17-30 expenses and witness fees in the amounts and under the same

17-31 circumstances as prescribed by law for witnesses in civil actions.

17-32 The expenses and fees must be paid in full by the party at whose

17-33 request the witness is subpoenaed.

17-34 3. Subpoenas must be served in the same manner as prescribed

17-35 by law for the service of subpoenas in civil actions. If any person

17-36 fails to comply with a subpoena within 10 days after its issuance, the

17-37 President of the Board, or the Executive Secretary of the Board at

17-38 the direction of the President, may petition the district court for an

17-39 order of the court compelling compliance with the subpoena.

17-40 4. Upon such a petition, the court shall enter an order directing

17-41 the person subpoenaed to appear before the court at a time and place

17-42 to be fixed by the court in its order, the time to be not more than 10

17-43 days after the date of the order, and then and there to show cause

17-44 why he has not complied with the subpoena. A certified copy of the

17-45 order must be served upon the person.

18-1 5. If it appears to the court that the subpoena was regularly

18-2 issued by the Board, the court shall enter an order compelling

18-3 compliance with the subpoena. Failure to obey the order constitutes

18-4 contempt of court.

18-5 Sec. 34. NRS 639.247 is hereby amended to read as follows:

18-6 639.247 1. Any hearing held for the purpose of suspending or

18-7 revoking any certificate, certification, license or permit must be

18-8 conducted publicly by the Board. The hearing must be presided over

18-9 by a member of the Board or his designee and three members

18-10 constitute a quorum. Any decision by the Board requires the

18-11 concurrence of at least three members. The proceedings of the

18-12 hearing must be reported or recorded by an electronic recording

18-13 device, an official court reporter or another qualified person.

18-14 2. The member of the Board or his designee presiding at the

18-15 hearing or the Executive Secretary of the Board may administer

18-16 oaths or affirmations. Continuances and adjournments may be

18-17 ordered, or may be granted, by the member or his designee

18-18 presiding, for cause shown and by orally notifying those persons

18-19 present of the time and place at which the hearing will be continued.

18-20 Sec. 35. NRS 639.252 is hereby amended to read as follows:

18-21 639.252 1. If the respondent wishes to contest or appeal the

18-22 decision of the Board, the order or any part thereof, he may, [prior

18-23 to] not later than 10 days after the time the order becomes

18-24 effective, apply in writing to the Board for a rehearing. [Such

18-25 application shall] The application must set forth with particularity

18-26 the part or parts of the decision or order to which the respondent

18-27 objects and the basis of the objection.

18-28 2. The Executive Secretary of the Board shall, within 10 days

18-29 after receipt of a written application for rehearing, notify the

18-30 respondent and his attorney of record in writing, by registered or

18-31 certified mail, of [its] his action, either granting or denying [such]

18-32 the application. If the application is granted, the notice [shall] must

18-33 contain the date, time and place of the rehearing . [, which date shall

18-34 not be less than 30 days after the date of the notice.] The rehearing

18-35 must be held at the next regularly scheduled meeting of the Board.

18-36 Granting of the application by the [Board shall serve] Executive

18-37 Secretary does not serve as an automatic stay of execution of the

18-38 order pending conclusion of the rehearing.

18-39 Sec. 36. NRS 639.2555 is hereby amended to read as follows:

18-40 639.2555 1. If the Board receives a copy of a court order

18-41 issued pursuant to NRS 425.540 that provides for the suspension of

18-42 all professional, occupational and recreational licenses, certificates

18-43 and permits issued to a person who is the holder of a certificate of

18-44 registration as a pharmacist, [an] intern pharmacist , pharmaceutical

18-45 technician, pharmaceutical technician in training or supportive

19-1 personnel or a license issued pursuant to NRS 639.233, the Board

19-2 shall deem the certificate of registration or license issued to that

19-3 person to be suspended at the end of the 30th day after the date on

19-4 which the court order was issued unless the Board receives a letter

19-5 issued to the holder of the certificate of registration or license by the

19-6 district attorney or other public agency pursuant to NRS 425.550

19-7 stating that the holder of the certificate of registration or license has

19-8 complied with the subpoena or warrant or has satisfied the arrearage

19-9 pursuant to NRS 425.560.

19-10 2. The Board shall reinstate a certificate of registration as a

19-11 pharmacist, [an] intern pharmacist , pharmaceutical technician,

19-12 pharmaceutical technician in training or supportive personnel or a

19-13 license issued pursuant to NRS 639.233 that has been suspended by

19-14 a district court pursuant to NRS 425.540 if the Board receives a

19-15 letter issued by the district attorney or other public agency pursuant

19-16 to NRS 425.550 to the person whose certificate of registration or

19-17 license was suspended stating that the person whose certificate of

19-18 registration or license was suspended has complied with the

19-19 subpoena or warrant or has satisfied the arrearage pursuant to

19-20 NRS 425.560.

19-21 Sec. 37. NRS 639.256 is hereby amended to read as follows:

19-22 639.256 A certificate, license or permit which has been

19-23 suspended for a specified period of time [shall] must automatically

19-24 be restored to good standing on the first day following the period of

19-25 suspension. The Executive Secretary[,] of the Board, when

19-26 notifying the respondent of the penalty imposed by the Board, shall

19-27 inform the respondent of the date on which the certificate, license or

19-28 permit will be so restored.

19-29 Sec. 38. NRS 639.2585 is hereby amended to read as follows:

19-30 639.2585 1. [Except where a substitution is required by

19-31 subsection 1 of NRS 639.2583:] If a prescription is purchased with

19-32 cash:

19-33 (a) Before he makes a substitution, a pharmacist shall advise the

19-34 person who presents the prescription of:

19-35 (1) The generic drug which he proposes to substitute; and

19-36 (2) The price difference between the drug under the brand

19-37 name prescribed and the drug which he proposes to substitute.

19-38 (b) The person presenting the prescription may refuse to accept

19-39 the proposed substitution.

19-40 2. A pharmacist shall not make any substitution of drugs if the

19-41 drug to be substituted is higher in cost than the drug prescribed by

19-42 brand name.

19-43 Sec. 39. NRS 639.2589 is hereby amended to read as follows:

19-44 639.2589 [1.] The form for any prescription which is issued

19-45 or intended to be filled in this state must contain a line for the

20-1 signature of the prescriber, the printed words “dispense only as

20-2 written” or “dispense as written” or the printed letters “DAW,”

20-3 and a box near that statement for the purpose of indicating that a

20-4 substitution may not be made.

20-5 [2. Substitutions may be made in filling prescriptions contained

20-6 in the orders of a physician, or of an advanced practitioner of

20-7 nursing who is a practitioner, in a facility for skilled nursing or

20-8 facility for intermediate care. Each page of the document which

20-9 contains the order must be printed with the words: “The biological

20-10 equivalent of drugs ordered may be dispensed unless initialed by the

20-11 prescriber here” and a box must be provided near that statement for

20-12 the purpose of indicating that a substitution may not be made.

20-13 3. Substitutions may be made in filling prescriptions ordered

20-14 on a patient’s chart in a hospital if the hospital’s medical staff has

20-15 approved a formulary for specific generic substitutions.]

20-16 Sec. 40. NRS 453.1545 is hereby amended to read as follows:

20-17 453.1545 1. The Board and the Division shall cooperatively

20-18 develop a computerized program to track each prescription for a

20-19 controlled substance listed in schedule II, III or IV that is filled by a

20-20 pharmacy that is registered with the Board[.] or that is dispensed by

20-21 a practitioner who is registered with the Board. The program must:

20-22 (a) Be designed to provide information regarding:

20-23 (1) The inappropriate use by a patient of controlled

20-24 substances listed in schedules II, III and IV to pharmacies,

20-25 practitioners and appropriate state agencies to prevent the improper

20-26 or illegal use of those controlled substances; and

20-27 (2) Statistical data relating to the use of those controlled

20-28 substances that is not specific to a particular patient.

20-29 (b) Be administered by the Board, the Division, the Health

20-30 Division of the Department of Human Resources and various

20-31 practitioners, representatives of professional associations for

20-32 practitioners, representatives of occupational licensing boards and

20-33 prosecuting attorneys selected by the Board and the Division.

20-34 (c) Not infringe on the legal use of a controlled substance for the

20-35 management of severe or intractable pain.

20-36 2. The Board and the Division must have access to the program

20-37 established pursuant to subsection 1 to identify any suspected

20-38 fraudulent or illegal activity related to the dispensing of controlled

20-39 substances.

20-40 3. The Board or the Division shall report any activity it

20-41 reasonably suspects may be fraudulent or illegal to the appropriate

20-42 law enforcement agency or occupational licensing board and

20-43 provide the law enforcement agency or occupational licensing board

20-44 with the relevant information obtained from the program for further

20-45 investigation.

21-1 4. Information obtained from the program relating to a

21-2 practitioner or a patient is confidential and, except as otherwise

21-3 provided by this section, must not be disclosed to any person. That

21-4 information must be disclosed:

21-5 (a) Upon the request of a person about whom the information

21-6 requested concerns or upon the request on his behalf by his attorney;

21-7 or

21-8 (b) Upon the lawful order of a court of competent jurisdiction.

21-9 5. The Board and the Division may apply for any available

21-10 grants and accept any gifts, grants or donations to assist in

21-11 developing and maintaining the program required by this section.

21-12 Sec. 41. NRS 453.431 is hereby amended to read as follows:

21-13 453.431 1. A pharmacist shall not knowingly fill or refill any

21-14 prescription for a controlled substance for use by a person other than

21-15 the person for whom the prescription was originally issued.

21-16 2. A person shall not furnish a false name or address while

21-17 attempting to obtain a controlled substance or a prescription for a

21-18 controlled substance. A person prescribing, administering or

21-19 dispensing a controlled substance may request proper identification

21-20 from a person requesting controlled substances.

21-21 3. A pharmacist shall not fill a prescription for a controlled

21-22 substance if the prescription shows evidence of alteration, erasure or

21-23 addition, unless he obtains approval of the practitioner who issued

21-24 the prescription.

21-25 4. A pharmacist shall not fill a prescription for a controlled

21-26 substance classified in schedule II unless it is tendered on or before

21-27 the 14th day after the date of issue. This subsection does not

21-28 prohibit a practitioner from issuing a prescription on which he

21-29 indicates that the prescription may not be filled until the date

21-30 indicated on the prescription, which must not be later than 6

21-31 months after the date the prescription is issued.

21-32 5. A person who violates this section is guilty of a category C

21-33 felony and shall be punished as provided in NRS 193.130.

21-34 Sec. 42. NRS 689A.04045 is hereby amended to read as

21-35 follows:

21-36 689A.04045 1. Except as otherwise provided in this section,

21-37 a policy of health insurance which provides coverage for

21-38 prescription drugs must not limit or exclude coverage for a drug if

21-39 the drug:

21-40 (a) Had previously been approved for coverage by the insurer

21-41 for a medical condition of an insured and the insured’s provider of

21-42 health care determines, after conducting a reasonable investigation,

21-43 that none of the drugs which are otherwise currently approved for

21-44 coverage are medically appropriate for the insured; and

22-1 (b) Is appropriately prescribed and considered safe and effective

22-2 for treating the medical condition of the insured.

22-3 2. The provisions of subsection 1 do not:

22-4 (a) Apply to coverage for any drug that is prescribed for a use

22-5 that is different from the use for which that drug has been approved

22-6 for marketing by the Food and Drug Administration;

22-7 (b) Prohibit:

22-8 (1) The insurer from charging a deductible, copayment or

22-9 coinsurance for the provision of benefits for prescription drugs to

22-10 the insured or from establishing, by contract, limitations on the

22-11 maximum coverage for prescription drugs;

22-12 (2) A provider of health care from prescribing another drug

22-13 covered by the policy that is medically appropriate for the insured;

22-14 or

22-15 (3) The substitution of another drug pursuant to NRS

22-16 639.23286 or 639.2583 to [639.2599,] 639.2597, inclusive; or

22-17 (c) Require any coverage for a drug after the term of the policy.

22-18 3. Any provision of a policy subject to the provisions of this

22-19 chapter that is delivered, issued for delivery or renewed on or after

22-20 October 1, 2001, which is in conflict with this section is void.

22-21 Sec. 43. NRS 689B.0368 is hereby amended to read as

22-22 follows:

22-23 689B.0368 1. Except as otherwise provided in this section, a

22-24 policy of group health insurance which provides coverage for

22-25 prescription drugs must not limit or exclude coverage for a drug if

22-26 the drug:

22-27 (a) Had previously been approved for coverage by the insurer

22-28 for a medical condition of an insured and the insured’s provider of

22-29 health care determines, after conducting a reasonable investigation,

22-30 that none of the drugs which are otherwise currently approved for

22-31 coverage are medically appropriate for the insured; and

22-32 (b) Is appropriately prescribed and considered safe and effective

22-33 for treating the medical condition of the insured.

22-34 2. The provisions of subsection 1 do not:

22-35 (a) Apply to coverage for any drug that is prescribed for a use

22-36 that is different from the use for which that drug has been approved

22-37 for marketing by the Food and Drug Administration;

22-38 (b) Prohibit:

22-39 (1) The insurer from charging a deductible, copayment or

22-40 coinsurance for the provision of benefits for prescription drugs to

22-41 the insured or from establishing, by contract, limitations on the

22-42 maximum coverage for prescription drugs;

22-43 (2) A provider of health care from prescribing another drug

22-44 covered by the policy that is medically appropriate for the insured;

22-45 or

23-1 (3) The substitution of another drug pursuant to NRS

23-2 639.23286 or 639.2583 to [639.2599,] 639.2597, inclusive; or

23-3 (c) Require any coverage for a drug after the term of the policy.

23-4 3. Any provision of a policy subject to the provisions of this

23-5 chapter that is delivered, issued for delivery or renewed on or after

23-6 October 1, 2001, which is in conflict with this section is void.

23-7 Sec. 44. NRS 689C.168 is hereby amended to read as follows:

23-8 689C.168 1. Except as otherwise provided in this section, a

23-9 health benefit plan which provides coverage for prescription drugs

23-10 must not limit or exclude coverage for a drug if the drug:

23-11 (a) Had previously been approved for coverage by the carrier for

23-12 a medical condition of an insured and the insured’s provider of

23-13 health care determines, after conducting a reasonable investigation,

23-14 that none of the drugs which are otherwise currently approved for

23-15 coverage are medically appropriate for the insured; and

23-16 (b) Is appropriately prescribed and considered safe and effective

23-17 for treating the medical condition of the insured.

23-18 2. The provisions of subsection 1 do not:

23-19 (a) Apply to coverage for any drug that is prescribed for a use

23-20 that is different from the use for which that drug has been approved

23-21 for marketing by the Food and Drug Administration;

23-22 (b) Prohibit:

23-23 (1) The carrier from charging a deductible, copayment or

23-24 coinsurance for the provision of benefits for prescription drugs to

23-25 the insured or from establishing, by contract, limitations on the

23-26 maximum coverage for prescription drugs;

23-27 (2) A provider of health care from prescribing another drug

23-28 covered by the plan that is medically appropriate for the insured; or

23-29 (3) The substitution of another drug pursuant to NRS

23-30 639.23286 or 639.2583 to [639.2599,] 639.2597, inclusive; or

23-31 (c) Require any coverage for a drug after the term of the plan.

23-32 3. Any provision of a health benefit plan subject to the

23-33 provisions of this chapter that is delivered, issued for delivery or

23-34 renewed on or after October 1, 2001, which is in conflict with this

23-35 section is void.

23-36 Sec. 45. NRS 695A.184 is hereby amended to read as follows:

23-37 695A.184 1. Except as otherwise provided in this section, a

23-38 benefit contract which provides coverage for prescription drugs

23-39 must not limit or exclude coverage for a drug if the drug:

23-40 (a) Had previously been approved for coverage by the society

23-41 for a medical condition of an insured and the insured’s provider of

23-42 health care determines, after conducting a reasonable investigation,

23-43 that none of the drugs which are otherwise currently approved for

23-44 coverage are medically appropriate for the insured; and

24-1 (b) Is appropriately prescribed and considered safe and effective

24-2 for treating the medical condition of the insured.

24-3 2. The provisions of subsection 1 do not:

24-4 (a) Apply to coverage for any drug that is prescribed for a use

24-5 that is different from the use for which that drug has been approved

24-6 for marketing by the Food and Drug Administration;

24-7 (b) Prohibit:

24-8 (1) The society from charging a deductible, copayment or

24-9 coinsurance for the provision of benefits for prescription drugs to

24-10 the insured or from establishing, by contract, limitations on the

24-11 maximum coverage for prescription drugs;

24-12 (2) A provider of health care from prescribing another drug

24-13 covered by the benefit contract that is medically appropriate for the

24-14 insured; or

24-15 (3) The substitution of another drug pursuant to NRS

24-16 639.23286 or 639.2583 to [639.2599,] 639.2597, inclusive; or

24-17 (c) Require any coverage for a drug after the term of the benefit

24-18 contract.

24-19 3. Any provision of a benefit contract subject to the provisions

24-20 of this chapter that is delivered, issued for delivery or renewed on or

24-21 after October 1, 2001, which is in conflict with this section is void.

24-22 Sec. 46. NRS 695B.1905 is hereby amended to read as

24-23 follows:

24-24 695B.1905 1. Except as otherwise provided in this section, a

24-25 contract for hospital or medical services which provides coverage

24-26 for prescription drugs must not limit or exclude coverage for a drug

24-27 if the drug:

24-28 (a) Had previously been approved for coverage by the insurer

24-29 for a medical condition of an insured and the insured’s provider of

24-30 health care determines, after conducting a reasonable investigation,

24-31 that none of the drugs which are otherwise currently approved for

24-32 coverage are medically appropriate for the insured; and

24-33 (b) Is appropriately prescribed and considered safe and effective

24-34 for treating the medical condition of the insured.

24-35 2. The provisions of subsection 1 do not:

24-36 (a) Apply to coverage for any drug that is prescribed for a use

24-37 that is different from the use for which that drug has been approved

24-38 for marketing by the Food and Drug Administration;

24-39 (b) Prohibit:

24-40 (1) The insurer from charging a deductible, copayment or

24-41 coinsurance for the provision of benefits for prescription drugs to

24-42 the insured or from establishing, by contract, limitations on the

24-43 maximum coverage for prescription drugs;

25-1 (2) A provider of health care from prescribing another drug

25-2 covered by the contract that is medically appropriate for the insured;

25-3 or

25-4 (3) The substitution of another drug pursuant to NRS

25-5 639.23286 or 639.2583 to [639.2599,] 639.2597, inclusive; or

25-6 (c) Require any coverage for a drug after the term of the

25-7 contract.

25-8 3. Any provision of a contract for hospital or medical services

25-9 subject to the provisions of this chapter that is delivered, issued for

25-10 delivery or renewed on or after October 1, 2001, which is in conflict

25-11 with this section is void.

25-12 Sec. 47. NRS 695C.1734 is hereby amended to read as

25-13 follows:

25-14 695C.1734 1. Except as otherwise provided in this section,

25-15 evidence of coverage which provides coverage for prescription

25-16 drugs must not limit or exclude coverage for a drug if the drug:

25-17 (a) Had previously been approved for coverage by the health

25-18 maintenance organization or insurer for a medical condition of an

25-19 enrollee and the enrollee’s provider of health care determines, after

25-20 conducting a reasonable investigation, that none of the drugs which

25-21 are otherwise currently approved for coverage are medically

25-22 appropriate for the enrollee; and

25-23 (b) Is appropriately prescribed and considered safe and effective

25-24 for treating the medical condition of the enrollee.

25-25 2. The provisions of subsection 1 do not:

25-26 (a) Apply to coverage for any drug that is prescribed for a use

25-27 that is different from the use for which that drug has been approved

25-28 for marketing by the Food and Drug Administration;

25-29 (b) Prohibit:

25-30 (1) The health maintenance organization or insurer from

25-31 charging a deductible, copayment or coinsurance for the provision

25-32 of benefits for prescription drugs to the enrollee or from

25-33 establishing, by contract, limitations on the maximum coverage for

25-34 prescription drugs;

25-35 (2) A provider of health care from prescribing another drug

25-36 covered by the evidence of coverage that is medically appropriate

25-37 for the enrollee; or

25-38 (3) The substitution of another drug pursuant to NRS

25-39 639.23286 or 639.2583 to [639.2599,] 639.2597, inclusive; or

25-40 (c) Require any coverage for a drug after the term of the

25-41 evidence of coverage.

25-42 3. Any provision of an evidence of coverage subject to the

25-43 provisions of this chapter that is delivered, issued for delivery or

25-44 renewed on or after October 1, 2001, which is in conflict with this

25-45 section is void.

26-1 Sec. 48. NRS 695F.156 is hereby amended to read as follows:

26-2 695F.156 1. Except as otherwise provided in this section,

26-3 evidence of coverage which provides coverage for prescription

26-4 drugs must not limit or exclude coverage for a drug if the drug:

26-5 (a) Had previously been approved for coverage by the prepaid

26-6 limited health service organization for a medical condition of an

26-7 enrollee and the enrollee’s provider of health care determines, after

26-8 conducting a reasonable investigation, that none of the drugs which

26-9 are otherwise currently approved for coverage are medically

26-10 appropriate for the enrollee; and

26-11 (b) Is appropriately prescribed and considered safe and effective

26-12 for treating the medical condition of the enrollee.

26-13 2. The provisions of subsection 1 do not:

26-14 (a) Apply to coverage for any drug that is prescribed for a use

26-15 that is different from the use for which that drug has been approved

26-16 for marketing by the Food and Drug Administration;

26-17 (b) Prohibit:

26-18 (1) The organization from charging a deductible, copayment

26-19 or coinsurance for the provision of benefits for prescription drugs to

26-20 the enrollee or from establishing, by contract, limitations on the

26-21 maximum coverage for prescription drugs;

26-22 (2) A provider of health care from prescribing another drug

26-23 covered by the evidence of coverage that is medically appropriate

26-24 for the enrollee; or

26-25 (3) The substitution of another drug pursuant to NRS

26-26 639.23286 or 639.2583 to [639.2599,] 639.2597, inclusive; or

26-27 (c) Require any coverage for a drug after the term of the

26-28 evidence of coverage.

26-29 3. Any provision of an evidence of coverage subject to the

26-30 provisions of this chapter that is delivered, issued for delivery or

26-31 renewed on or after October 1, 2001, which is in conflict with this

26-32 section is void.

26-33 Sec. 49. NRS 695G.166 is hereby amended to read as follows:

26-34 695G.166 1. Except as otherwise provided in this section, a

26-35 health care plan which provides coverage for prescription drugs

26-36 must not limit or exclude coverage for a drug if the drug:

26-37 (a) Had previously been approved for coverage by the managed

26-38 care organization for a medical condition of an insured and the

26-39 insured’s provider of health care determines, after conducting a

26-40 reasonable investigation, that none of the drugs which are otherwise

26-41 currently approved for coverage are medically appropriate for the

26-42 insured; and

26-43 (b) Is appropriately prescribed and considered safe and effective

26-44 for treating the medical condition of the insured.

26-45 2. The provisions of subsection 1 do not:

27-1 (a) Apply to coverage for any drug that is prescribed for a use

27-2 that is different from the use for which that drug has been approved

27-3 for marketing by the Food and Drug Administration;

27-4 (b) Prohibit:

27-5 (1) The organization from charging a deductible, copayment

27-6 or coinsurance for the provision of benefits for prescription drugs to

27-7 the insured or from establishing, by contract, limitations on the

27-8 maximum coverage for prescription drugs;

27-9 (2) A provider of health care from prescribing another drug

27-10 covered by the plan that is medically appropriate for the insured; or

27-11 (3) The substitution of another drug pursuant to NRS

27-12 639.23286 or 639.2583 to [639.2599,] 639.2597, inclusive; or

27-13 (c) Require any coverage for a drug after the term of the plan.

27-14 3. Any provision of a health care plan subject to the provisions

27-15 of this chapter that is delivered, issued for delivery or renewed on or

27-16 after October 1, 2001, which is in conflict with this section is void.

27-17 Sec. 50. NRS 639.133, 639.205, 639.2323 and 639.2599 are

27-18 hereby repealed.

27-19 LEADLINES OF REPEALED SECTIONS

27-20 639.133 Registration of pharmacist not possessing formal

27-21 educational requirements.

27-22 639.205 Inactive status.

27-23 639.2323 Nuclear pharmacy: Publications required on

27-24 premises.

27-25 639.2599 Display of notice regarding substitution.

27-26 H